bluuebunny/crossref_metadata_2025_split huggingface dataset:
Audit on the Efficient Use of Cross-Matched Blood in Elective Total Hip and Total Knee Replacement
Authors: Rogers BA , Johnstone DJ 
Published: March 2006

INTRODUCTION This prospective audit studies the use of cross-matched blood in 301 patients over a 1-year period undergoing total knee (TKR) and total hip replacement (THR) surgery in an orthopaedic unit. PATIENTS AND METHODS Analysis over the first 6 months revealed a high level of unnecessary cross-matched blood. The following interventions were introduced: (i) to cease routine cross-matching for THR; (ii) all patients to have a check full blood count on day 2 after surgery; and (iii) Hb < 8 g/dl to be considered as the trigger for transfusion in patients over 65 years and free from significant co-morbidity. These changes are in accordance with published national guidelines [Anon. Guidelines for the clinical use of red cell transfusions. Br J Haematol 2001; 113: 24–31]. RESULTS In the next 6 months, the number of units cross-matched but not transfused fell by 96% for THR, and the cross-match transfusion (C:T) ratio reduced from 3.21 to 1.62. Reductions were also observed for the TKR cohort. These results provide evidence of a substantial risk and cost benefit in the use of this limited resource. A telephone survey of 44 hospitals revealed that 20 hospitals routinely cross-matched blood for THR and 11 do so for TKR. CONCLUSIONS Changes can be made to the Maximum Surgical Blood Ordering Schedules (MSBOS) in other orthopaedic units according to national guidelines.
Variations in Clinical Audit Collection: A Survey of Plastic Surgery Units Across the British Isles
Authors: Simmons Jon M , Matteucci Paolo , Leon-Villapalos Jorge , Mallucci Patrick L , Withey Simon J , Butler Peter EM 
Published: March 2006

INTRODUCTION Clinical audit is a requirement of good medical and surgical practice and is central to the UK Government's plans to modernise the NHS. MATERIALS AND METHODS A survey was conducted to assess clinical audit data collection and collation within plastic surgery departments across the UK. The survey identified a variety of different data collection and collation methods, with extensive differences between plastic surgery departments. Those responsible for data collection and its funding were also identified by the survey. RESULTS Results were obtained from 45 plastic surgery departments. Of the 45 departments surveyed, 12 collect data prospectively, whereas 26 units collect data retrospectively. The remaining departments collect data using a combination of methods. Of the units surveyed, 28 collect data on paper-based systems, with only 13 units using electronic applications. The personnel responsible for data collection were identified as being junior doctors. Departments collecting data prospectively do so from a greater number of sources than those collecting data retrospectively. CONCLUSIONS This survey has focused on plastic surgery. The authors believe that similar results would be obtained from a survey of other surgical specialties. A huge variation in all parameters relating to the collection and collation of clinical audit data is seen. There are few standards within this specialty for data collection. Much work must be done in order to reach targets set by the UK Government.
A Prospective Audit of 300 Consecutive Young Women with an Acute Presentation of Right Iliac Fossa Pain
Authors: Rennie Adam TM , Tytherleigh Matthew G , Theodoroupolou Katerina , Farouk Ridzuan 
Published: March 2006

INTRODUCTION A prospective study of 300 women of child-bearing age presenting with right iliac fossa pain was carried out to determine what proportion had appendicitis and whether active observation resulted in a delay in diagnosis to the detriment of the patient. PATIENTS AND METHODS Data were prospectively collected for 300 consecutive women of childbearing age referred with right iliac fossa pain to general surgeons at a district general hospital. RESULTS After clinical assessment, 71 were discharged home immediately. Two others were found to be pregnant and 4 admitted to gynaecology. The remaining 223 women were admitted to the general surgical unit, 112 of whom underwent immediate appendicectomy. Of these, 97 had acute appendicitis. Two suffered deep infection and two had a superficial wound infection. A further decision to operate was made in 42 of 111 patients admitted for active observation, with 36 having acute appendicitis and 2 having a carcinoid tumour. Four had a wound infection. The average in-patient stay of those admitted for active observation and not operated on was 2 days (range, 1–4 days) compared with a length of stay of 2 days (range, 1–7 days) for those who underwent ‘immediate’ appendicectomy. CONCLUSIONS Most women of child-bearing age who present with right iliac fossa pain do not have appendicitis. Those who do not have the classical features of appendicitis or peritonism can be safely managed by active observation.
Symptomatic Presentation of Early Colorectal Cancer
Authors: Smith D , Ballal M , Hodder R , Soin G , Selvachandran SN , Cade D 
Published: March 2006

INTRODUCTION It is believed that increased detection of earlier stage colorectal cancer can only be achieved by screening asymptomatic individuals. We describe a referral pathway for a symptomatic population which achieves a 30% Dukes' A detection rate. PATIENTS AND METHODS From October 1999, 4253 patients with distal colonic symptoms, referred by general practitioners, completed a patient consultation questionnaire (PCQ) linked to a computerised record. A weighted numerical score (WNS) was derived for each patient. Patients underwent flexible sigmoidoscopy, a diagnostic outcome was recorded and later Dukes' stage appended. Early and advanced colorectal cancers were separated and PCQ derived symptom profiles compared. Chi-square, Fisher exact, Student's t-test and logistic regression were used for statistical analysis. RESULTS A total of 183 patients had cancer, 55 (30%) were Dukes' A early colorectal cancers, 112 were advanced colorectal cancers (Dukes' B–D) and 16 could not be staged. Early colorectal cancers had significant symptoms and comparable profile to advanced colorectal cancers. The tendency in advanced colorectal cancers was towards greater symptom prevalence for only a few primary and systemic symptoms, as reflected by a higher WNS of 75 (P = 0.001) CONCLUSIONS Early colorectal cancers do have significant symptoms which can easily be captured by a PCQ and objective scoring tool in the secondary care setting. Detection of these cancers has the potential to improve survival.
The Effects of Saccharomyces boulardii on Bacterial Translocation in Rats with Obstructive Jaundice
Authors: Geyik Mehmet Faruk , Aldemir Mustafa , Hosoglu Salih , Ayaz Celal , Satilmis Selda , Buyukbayram Huseyin , Kokoglu Omer Faruk 
Published: March 2006

INTRODUCTION The aim of this study was to investigate the effect of Saccharomyces boulardii treatment on preventing bacterial translocation in an obstructive jaundice animal model. MATERIALS AND METHODS Sixty adult rats were divided into five groups: group 1 – the sham-operated group; group 2 – the common bile duct ligation group; group 3 – the S. boulardii group; group 4 – the ampicillin-sulbaktam group; and group 5 – the S. boulardii plus ampicillin-sulbaktam group. The saline, antibiotics and S. boulardii were given, respectively, for a 7-day period as a single dose per day via temporary orogastric intubation. Seven days following the obstructive jaundice, the animal had laparatomy under sterile conditions. Segments of ileum were removed for histopathological examination. Blood, liver, spleen and mesenteric lymph nodes were taken for microbiological culture. RESULTS Bacterial translocation rates were 0% in the sham-operated group, 83% in group 2, 42% in group 3, 42% in group 4 and 33% in group 5. Bacterial translocation significantly increased in group 2 compared to groups 3, 4 and 5 (P = 0.001). The bacterial counts (CFU/g) of group 2 were significantly higher than those of groups 3, 4 and 5 (P = 0.001). Histopathological examination of ileum specimens revealed a significant decrease in the heights of villi in groups 2–5 compared to the sham-operated group (P = 0.001). The mean villus height in groups 3 and 5 was significantly higher than that of group 4 (P = 0.001). CONCLUSIONS S. boulardii was found to be effective in the successful control of translocation and improvement of intestinal barrier function.
Timing of Re-Transfusion Drain Removal Following Total Knee Replacement
Authors: Leeman MF , Costa ML , Costello E , Edwards D 
Published: March 2006

INTRODUCTION The use of postoperative drains following total knee replacement (TKR) has recently been modified by the use of re-transfusion drains. The aim of our study was to investigate the optimal time for removal of re-transfusion drains following TKR. PATIENTS AND METHODS The medical records of 66 patients who had a TKR performed between October 2003 and October 2004 were reviewed; blood drained before 6 h and the total volume of blood drained was recorded. RESULTS A total of 56 patients had complete records of postoperative drainage. The mean volume of blood collected in the drain in the first 6 h was 442 ml. The mean total volume of blood in the drain was 595 ml. Therefore, of the blood drained, 78% was available for transfusion. CONCLUSION Re-transfusion drains should be removed after 6 h, when no further re-transfusion is permissible.
It is Highly Unlikely that the Development of an Abdominal Wall Hernia can be Attributable to a Single Strenuous Event
Authors: Samir Pathak , Poston Graeme J 
Published: March 2006

INTRODUCTION There is a commonly held belief that the development of a hernia can be attributed to a single strenuous or traumatic event. Hence, many litigants are successful in compensation claims, causing mounting financial burdens on employers, the courts, insurance companies and the tax-payer. However, there is very little scientific evidence to support this assertion. The aim of this study was to ascertain whether there was any causal link in this process. PATIENTS AND METHODS A total of 133 new patients with 135 abdominal herniae of all varieties (115 inguinal, 3 femoral, 9 umbilical, 4 incisional, and 4 ventral or epigastric), of which 25 were recurrent received structured questionnaires on arrival in the surgical clinic. These questionnaires covered all possible aetiological factors for hernia development (type of work, COAD, smoking, pregnancy, obesity, chronic bladder outflow obstruction, previous surgery including appendicectomy), in addition to any possible attribution to a single strenuous or traumatic event. We then reviewed the GP records in the surgery of all patients who answered positively to the latter possible cause. RESULTS In the study group, 119 (89%) reported a gradual onset of symptoms. Of the 15 (12 male, 3 female; 11%) who believed that their hernia might be related to a single strenuous or traumatic event, 5 had no other aetiological factors. However, not one of the 15 was found to have contemporaneous forensic medical evidence to support their possible claim. CONCLUSIONS We conclude that we are unable to find any clinical evidence to support the hypothesis that a hernia might develop as the result of one single strenuous or traumatic event. While we accept that this mechanism might still possibly occur, we believe that, at best, it is extremely uncommon. If a medical expert is preparing a report on such a case in a claim for personal injury, then they have a duty to the court to examine carefully all the contemporaneous medical records. If no clinical evidence exists to support the claim, then they have a duty to the court not to support the plaintiff's claim.
Effect of the Reporting-Interval Size on Critical Difference Estimation: Beyond “2.77”
Authors: Jones Graham Ross Dallas 
Published: March 2006

Abstract
Background: The reporting interval is the bin size used to report numerical pathology results and must be determined for every analyte. The influence of the size of the reporting interval on the critical difference (CD) between two results from the same patient has not been addressed previously.
Methods: The effect of changing the reporting-interval size (RIS) on CDs was modeled by use of a spreadsheet application. The findings were applied to data on CDs with analytical precision values from our laboratory.
Results: As the RIS increases relative to the combined analytical and within-person biological variation, there is an approximately linear increase in the CD from the value determined by use of published techniques. The revised estimate is as follows: CD = 21/2 × z × (SDa2 + SDi2)1/2 + 1.5 × RIS, where CD, SD, and RIS are all in the same units. This effect is seen for any probability associated with the critical difference and for both uni- and bidirectional changes.
Conclusions: The choice of reporting interval should be made in the light of assay requirements. Where there is a clinical need for detection of small changes in analyte concentration, the reporting interval should be kept small relative to the combined variation attributable to assay precision and within-person biological variation.
Creep Crack Growth Predictions in Component Using a Damage Based Approach
Authors: Yatomi M , Nikbin KM 
Published: March 2006

Abstract
This paper presents a numerical study of simulated creep crack growth (CCG) prediction in a compact tension [C(T)] specimen and a pipe component containing cracks. The results are compared to experimental data of the same consisting of creep crack growth tests of a carbon-manganese steel (C-Mn) tested at 360°C. The constitutive behavior for this steel is described by a power law creep model and the uniaxial properties are used in a damage based model to predict CCG. For comparison between CCG properties of the pipe and C(T) specimens, different reference stress methods were used to derive appropriate C* values. It has been shown that the global solution for collapse in the cracked pipes gives the best correlation with the C(T) data. On this basis CCG rates for pipe are higher than those for C(T) specimens at the same value of C*. The damage-based approach combined with a crack tip constraint model based on void growth is also used to predict the crack propagation rates in the pipe component using a two-dimensional finite elements (FE) mesh. Elastic-plastic-creep analyses are performed using a node debonding criteria to simulate and predict crack extension under plane stress and plane strain conditions. It has been found that CCG against time predicted from the FE under plane stress conditions is almost the same as those for the experimental data. Comparing C* derived from different reference stress methods to C* from FE analysis it has been found that C* from FE under plane strain condition correlates best with C* from the global reference stress solution. Consequently the main CCG difference between the C(T) and the pipe component is found to be due to the method of estimating C* and not due to constraint effects.
The Effect of Large Strain Cycling on the Fatigue Strength of Welded Joint
Authors: Okuya K , Kondo Y 
Published: March 2006

Abstract
Earthquakes sometimes create damages to steel structures. The structures which have not been seriously damaged are still used after an earthquake. The fatigue strength of these structures, however, might have been decreased due to the cyclic loads during an earthquake. In order to clarify the effect of seismic loading on the fatigue strength of the welded joint of a steel structure, a high cycle fatigue test of welded joint after large straining was performed. Although a large residual tensile stress induced by plastic deformation caused little effect on the fatigue limit even in gross plasticity condition, the cyclic application of large strain substantially decreased the fatigue limit. An application of large straining for a small number of cycles initiated a short crack at the weld toe in the low cycle fatigue manner, which acted as a trigger for high cycle fatigue failure after seismic loading. The reduction of fatigue limit depended on the size of the crack. The linear elastic fracture mechanics was used to evaluate the fatigue strength of welded joint. Although the short crack was initiated by cyclic application of plastic straining and the crack was in gross plasticity, the ΔKth of the small crack determined the fatigue limit of small-cracked welded joint after seismic loading.
Validation of a Gravimetric Procedure for Recovery of Processing Materials from Porous Coated Metal Implants
Authors: Moseley JP , Hooper MT , Bible SJ 
Published: March 2006

Abstract
Test coupons of ASTM F 75 cobalt chrome alloy with sintered bead coatings were contaminated with known amounts of a paraffin based buffing compound and heated to simulate buffing friction. The soils were then recovered by sonication for 1 to 6 h in hexane and analyzed using a gravimetric technique. Values were determined for the amounts recovered for both soluble and insoluble components of the buffing compounds and the percent recovery was calculated. For this system, the optimum time for sonication was determined to be 4 h, with recovery values greater than 80%. Analyses run on uncontaminated coupons yielded 0.06 mg of insoluble debris. Elemental analysis of that debris was consistent with erosion of the glassware during sonication.
A Metallurgist's Views on the Selection of Engineering Alloys for Applications Involving Oxygen-Enriched Atmospheres: Keynote Address
Authors: Zawierucha R 
Published: March 2006

AbstractIt is believed that most people never intend to become metallurgists involved in materials selection issues for systems involving oxygen-enriched atmospheres. However, oxygen applications involve multiple engineering and scientific disciplines and as a consequence, metallurgists or materials scientists become involved, sometimes as failure analysts. ASTM Committee G-4 was formed in 1975. Its first standard was G-63, dealing with nonmetallic materials. In its first symposium conducted in 1982, this committee documented its intention to develop selection guidelines for metals. However, test standards for metals still remained in the future. It is the purpose of this paper to review materials testing techniques and criteria for engineering alloys in oxygen-enriched atmospheres. Metallurgical factors which influence materials performance and selection for oxygen applications are discussed. In addition, potential advanced oxygen applications and materials requirements for these applications are reviewed. Testing requirements for advanced applications are discussed. Advanced alloys capable of handling the complex and hazardous environmental conditions will be needed. Engineering trade-offs may be required.
Hot Wire Method to Characterize the Thermal Conductivity of Particle-Filled Polymer Grouts Used in Pipe-in-Pipe Application
Authors: Kulkarni SP , Vipulanandan C 
Published: March 2006

Abstract
Insulated flowlines are considered a practical solution to prevent hydrate formation and paraffin deposition during the transportation of unprocessed well fluids to production facilities. A conventional pipe-in-pipe (PIP) system relies mainly on the heat transfer mode based on the thermal conductivity of the insulation material. Hence, in this study, a laboratory procedure was used to determine the thermal conductivity (k) of a polymer-based insulator (pumpable before setting) with and without filler materials. Microspheres (&lt;0.008 in. (0.2 mm)) and aggregates (&lt;0.752 in. (19.1 mm)) were used as filler materials. The conventional radial-flow hot wire method was compared with the axial-flow hot wire method to determine the thermal conductivity. Both transient and steady state conditions were used to determine the thermal conductivity of polymer composites. The thermal conductivity of the polymer at steady state was 0.107 W/mk, which was reduced due to the addition of microspheres and was increased due to the addition of aggregates. The thermal conductivity of pure polymer at steady state was 14.5 % higher than the transient thermal conductivity. Based on published data, a relationship between thermal conductivity and density was developed and verified with data from the current study.
Contrasted Polymorphism Patterns in a Large Sample of Populations From the Evolutionary Genetics Model Drosophila simulans
Authors: Baudry Emmanuelle , Derome Nicolas , Huet Michèle , Veuille Michel 
Published: March 2006

Abstract
African populations of Drosophila simulans are thought to be ancestral in this model species and are increasingly used for testing general hypotheses in evolutionary genetics. It is often assumed that African populations are more likely to be at a neutral mutation drift equilibrium than other populations. Here we examine population structuring and the demographic profile in nine populations of D. simulans. We surveyed sequence variation in four X-linked genes (runt, sevenless, Sex-lethal, and vermilion) that have been used in a parallel study in the closely related species D. melanogaster. We found that an eastern group of populations from continental Africa and Indian Ocean islands (Kenya, Tanzania, Madagascar, and Mayotte Island) is widespread, shows little differentiation, and has probably undergone demographic expansion. The other two African populations surveyed (Cameroon and Zimbabwe) show no evidence of population expansion and are markedly differentiated from each other as well as from the populations from the eastern group. Two other populations, Europe and Antilles, are probably recent invaders to these areas. The Antilles population is probably derived from Europe through a substantial bottleneck. The history of these populations should be taken into account when drawing general conclusions from variation patterns.
The mushroom body defect Gene Product Is an Essential Component of the Meiosis II Spindle Apparatus in Drosophila Oocytes
Authors: Yu James X , Guan Zhonghui , Nash Howard A 
Published: March 2006

Abstract
In addition to their well-known effects on the development of the mushroom body, mud mutants are also female sterile. Here we show that, although the early steps of ovary development are grossly normal, a defect becomes apparent in meiosis II when the two component spindles fail to cohere and align properly. The products of meiosis are consequently mispositioned within the egg and, with or without fertilization, soon undergo asynchronous and spatially disorganized replication. In wild-type eggs, Mud is found associated with the central spindle pole body that lies between the two spindles of meiosis II. The mutant defect thus implies that Mud should be added to the short list of components that are required for the formation and/or stability of this structure. Mud protein is also normally found in association with other structures during egg development: at the spindle poles of meiosis I, at the spindle poles of early cleavage and syncytial embryos, in the rosettes formed from the unfertilized products of meiosis, with the fusomes and spectrosomes that anchor the spindles of dividing cystoblasts, and at the nuclear rim of the developing oocyte. In contrast to its important role at the central spindle pole body, in none of these cases is it clear that Mud plays an essential role. But the commonalities in its location suggest potential roles for the protein in development of other tissues.