bluuebunny/crossref_metadata_2025_split huggingface dataset:
Iodinated contrast media: effect of osmolarity and injection temperature on erythrocyte morphology in vitro
Authors: Kerl J. M. , Nguyen S. A. , Lazarchick J. , Powell J. W. , Oswald M. W. , Alvi F. , Costello P. , Vogl T. J. , Schoepf U. J. 
Published: March 2008

Background: Some side effects of intravenously injected iodinated contrast media are thought to be linked to the biological properties of the various agents and their effect on blood components. Purpose: To assess the effect of osmolarity and injection temperature of iodinated contrast media on erythrocyte (RBC) morphology in vitro. Material and Methods: Blood from 20 volunteers was incubated with three different contrast media (320 mg I/ml iso-osmolar iodixanol, 300 mg I/ml low-osmolar iopromide, 300 mg I/ml low-osmolar iopamidol) injected at 37°C, 43°C, and 48°C, and in two different volumes corresponding to the estimated concentration at the site of venous injection and after systemic distribution. After 10 min incubation, aliquots were removed for complete blood count analysis and blood smears. Two hematologists blindedly and independently reviewed all smears, and determined the grade of morphological RBC changes compared to a blank sample. Results: There was excellent (κ = 0.98) inter-reader correlation for grading RBC changes. At systemic concentration at 37°C, the grade of RBC changes was significantly ( P<0.05) less in blood samples exposed to iso-osmolar iodixanol (mean 0.21) as compared to low-osmolar iopromide (mean 0.26) and low-osmolar iopamidol (mean 0.58). These differences became more significant at higher volumes, corresponding to concentrations at the site of injection and higher injection temperatures. Conclusion: In vitro, RBC morphology is less affected by iso-osmolar as compared to low-osmolar contrast media. These differences become more significant at higher injection temperatures that are proposed to improve flow dynamics for high-speed injection.
Nutrition, the brain and prolonged exercise
Authors: Watson Phil 
Published: March 2008

AbstractPossible peripheral mechanisms of fatigue have been widely documented, including the depletion of muscle glycogen and the loss of body fluids. The notion that the brain may be intimately involved in the fatigue process is not a new one, but recently possible neurobiological mechanisms involved in this response have been investigated. Changes in central neurotransmission occur during exercise that may result in feelings of tiredness, lethargy, and a loss of motivation to continue exercise, contributing to the development of fatigue. There is evidence that manipulation of the neurotransmitters serotonin, dopamine, and noradrenaline, through the administration of pharmacological agents, may delay the onset of fatigue during prolonged exercise, particularly when performing in a warm environment. Supplementation with branched‐chain amino acids and tyrosine can influence perceived exertion and some measures of mental performance, but the results of several apparently well‐controlled laboratory studies have not demonstrated a positive effect on exercise capacity under temperate conditions. The ergogenic effects of carbohydrate and caffeine are well documented, but often little attention is paid to the central effects of these nutrients. Carbohydrate ingestion has been demonstrated to alter brain activity and cerebral metabolism, factors that may be important in the development of fatigue and the maintenance of skill performance. There is strong evidence for a positive effect of caffeine on exercise performance, with recent data highlighting the role of central adenosine as a mediator of this response.
INHIBITION OF CONVERSION OF THYROXINE TO TRIIODOTHYRONINE IN PATIENTS WITH SEVERE CHRONIC ILLNESS
Authors: CARTER J. N. , EASTMAN C. J. , CORCORAN J. M. , LAZARUS L. 
Published: March 2008

SummaryMany clinically euthyroid patients with severe, chronic, non‐thyroidal illnesses (i.e. sick euthyroid patients) have very low circulating concentrations of total and absolute free triiodothyronine (T3), low‐normal concentrations of total thyroxine (T4), elevated concentrations of absolute free T4, and circulating concentrations of thyrotrophin (TSH) that are either normal or subnormal. This study was undertaken to elucidate the mechanism of the low circulating T3 concentrations. The disappearance rate of 125I‐T3 from the circulation of five representative sick euthyroid patients, was studied and found to be slower, but not significantly so, compared with three control subjects, thus excluding an increased destruction rate as the cause of the low T3 levels. A selective decrease of T3 secretion from the thyroid gland of these patients was also excluded by the results of TSH stimulation tests. Inhibition of extra‐thyroidal conversion of T4 to T3 was suggested by studies of the thyroid function in a hypothyroid woman with a Grade IV lymphoma on T4 replacement therapy. When the lymphoma was in remission, her circulating T3 concentration was 2–55 nmol/1 but when it relapsed it fell to 0–55 nmol/1. The T4 concentrations were 124–7 nmol/1 and 126 nmol/1 respectively. Decreased monodeiodination of T4 to T3 in sick euthyroid patients was confirmed by paper chromatography of extracted serum obtained 48 h after an i.v. injection of 125I‐T4 into two severely ill patients from the intensive therapy unit and a control subject. Peaks of radioactivity corresponding to 125I‐T4 and 125I‐T3 were detected in the control subject, but only a single peak corresponding to 125I‐T4 was detected in the ill patients.
TRANSPLACENTAL GRADIENTS OF SEX‐HORMONE‐BINDING GLOBULIN IN HUMAN AND SIMIAN PREGNANCY
Authors: ANDERSON D. C. , LASLEY B. L. , FISHER R. A. , SHEPHERD J. H. , NEWMAN L. , HENDRICKX A. G. 
Published: March 2008

SummaryAn attempt has been made to clarify the degree and control of production of the concentration gradient of sex‐hormone‐binding globulin (SHBG) between human mother and fetus. SHBG was measured by an improved ammonium sulphate precipitation method using 5α‐dihydrotestosterone as ligand. Maternal and fetal (cord blood) plasma SHBG was measured at delivery in twenty‐three normal, four twin and one anencephalic pregnancies and in non‐pregnant subjects. Comparison was also made with two macaque species, the rhesus monkey (M. mulatto) and the bonnet monkey (M. radiata), sampled shortly after delivery.In the human, a highly consistent gradient (mean 21‐fold) was found between mother and fetus, which was independent of fetal sex and weight. Fetal but not maternal SHBG was significantly higher in the twin pregnancies. Maternal SHBG was 5‐fold higher than in forty non‐pregnant women, and fell with a half‐life of 7.1 days immediately post‐partum.In the two monkey species, SHBG with similar binding‐characteristics exists but levels were 2.5‐fold higher in the non‐pregnant adult females than in women. In pregnancy, maternal SHBG levels were unchanged in the bonnet (nine observations) and fell markedly in the rhesus monkey (twenty‐three observations); levels in the infants were comparably low in all three species, though more variable in the monkeys. In seven bonnet monkey mother‐infant pairs sampled again 2 or 8 weeks later, SHBG had risen markedly (mean 6.1‐fold) in the infants as has been shown previously in the human. The species differences in the non‐pregnant females and the mothers may in part be related to species differences in oestrogen production. The macaque monkey appears suitable for studying further the mechanism of the neonatal SHBG rise, in which oestrogens cannot be implicated but thyroid hormones may be involved.
Information systems and uncertainty: a conspiracy of misplaced confidence
Authors: Straub B. , Angell IO 
Published: March 2008

Abstract. Information technology is becoming an increasingly important factor in contemporary management. Information systems are being set up in business explicitly to accommodate the new opportunities of this technology, and these are having a lasting effect on managerial practice. The full implications of this technology‐driven development have not been appreciated by organizations, which in absorbing technological systems, are tolerating a great drain on their resources.The efficacy of computers is predicated on the acceptance of some very specific perspectives. A growing discontent and disappointment with their limited achievements is our reason for advocating a different point of view. We will discuss how a shift in perspective, particularly in respect to the perception of uncertainty, will affect thinking and practice in the field of management support systems. We will render our view of the application of computerized decision support systems (DSS), and especially, we will focus on the beliefs and assumptions that have shaped this technology thus far. To this end we will discuss the concept of uncertainty, by juxtaposing current thinking and practice with our understanding of the context of its application. Finally, we will place our understanding of uncertainty in a managerial context and explain the implications this would have for strategists.
The design of large knowledge‐based systems: the example of Digital Equipment's XSEL project
Authors: Mumford E. 
Published: March 2008

Abstract. This paper discusses the management problems associated with building and implementing large systems. The example described is XSEL, a configuring expert system designed by the Digital Equipment Corporation for worldwide application.Digital, like many other larger computer manufacturers, had experienced problems in achieving a high level of configuring accuracy when assembling its computer. These problems showed up in the manufacturing plants but originated in the sales offices. They caused difficulties with customers and increased manufacturing and selling costs. The company decided that an expert system could solve the problem.The processes associated with the design of this successful system created as many human as technical challenges. The paper describes these, discusses how and why they originated, and evaluates Digital's strategies for solving them. It makes some general recommendations for the successful management of major change.
The influence of rhetorical schemes on innovation decisions
Authors: King W. R. , Kugler J. L. 
Published: March 2008

Abstract. Innovation may be viewed as a political process in which rival ideas, sponsored by rival individuals or groups, compete for acceptance and support. Sponsors of a particular idea must build, through argumentation, a consensus to support their idea.This paper addressed rhetorical schemes as a potentially important element of the innovation decision. While rhetorical actions have been studied in other contexts, they have not been investigated in innovation decision situations.The construct of rhetorical scheme is developed in this paper as a way to explain the outcomes of the innovation decision process. A scenario was devised in which decision makers face two different rhetorical schemes, emotional/affective and technical/logical, both related to a technology innovation. A hypothesis is tested in order to make a preliminary judgement on the impact of the rhetoric scheme on the financial choices made by the decision makers. The results suggest that the current innovation paradigms might be usefully extended by incorporating rhetorical actions as explanatory elements.
An empirical study of the validation process within requirements determination
Authors: Flynn D. J. , Warhurst R. 
Published: March 2008

Abstract. An empirical investigation into the validation process within requirements determination is described in which systems analysts were asked to complete a questionnaire concerning important validation issues. We describe the major validation activities, a set of major problems experienced by the respondents, factors affecting the process and hypotheses for problem explanations. The levels of experience of the respondents and the organizations for which they work appear to be significant.Analysts employ a very traditional approach, expressing the specification mainly in English, and they experience problems in using over‐formal notations in informal situations with users, as well as problems in deriving full benefit from notations when building the specification and detecting its properties. Not all of the specification is validated and tool use is not widespread and does not appear to be effective.We define the concepts of formal and informal view, and suggest that method and tool use will not necessarily increase in organizations as it is apparent that research into the more effective application of formal notations is necessary. In addition, it is clear that the factors that affect the validation process are not only technical, but individual and organizational, necessitating the development of suitable informal activities which take these factors into account.
Ethics and information technology use: a factor analysis of attitudes to computer use
Authors: Conger Sue , Loch Karen D. , Helft B. Loerine 
Published: March 2008

Abstract. In 1986 Richard O. Mason identified privacy, accuracy, property and access as four ethical issues for the information age. The research reported here sought to answer the questions: are these social issues empirically verifiable constructs? Second, what consensus exists on the factors?A field survey of 79 business professionals and students identified 12 factors which were grouped into five clusters: ownership, access, motivation, responsibility and privacy. These constructs identify additional dimensions and complexity to extend Mason's definition of key ethical issues. The importance of separating the computer user who experiences the ethical dilemma from the stakeholder(s) who deal with the consequences of the dilemma is identified.This study also demonstrates some consensus within the survey items. Consensus exists that it is unethical to profit from non‐job, computer‐related acts. Consensus also exists that personal use of company‐owned information technology resources is acceptable. The other items show little consensus, identifying areas of necessary discussion within the computing professions to determine ethically consistent and appropriate computer uses.
Living with chronic obstructive pulmonary disease at the end of life: a phenomenological study
Authors: Ek Kristina , Ternestedt Britt‐Marie 
Published: March 2008

AbstractTitle.  Living with chronic obstructive pulmonary disease at the end of life: a phenomenological study Aim.  This paper is a report of a study to describe the essential structure of the lived experience of living with severe chronic obstructive pulmonary disease (COPD) during the palliative phase of the disease.Background.  Chronic obstructive pulmonary disease is one of the most common diseases throughout the world. Shortness of breath, fatigue and cough are the most troublesome symptoms, and living with COPD often imposes limitations on daily living. The disease has a great impact on quality of life and affects the extent to which people can be active in daily life.Methods.  We conducted qualitative interviews of eight people with COPD and collected data over a 2‐month period in 2003. Our patients were recruited from two pulmonary disease clinics in West Sweden. We used a phenomenological methodology to analyse the interviews.Findings.  Daily life for people with COPD is affected in several different ways. The patients described how their physical limitations forced them to refrain from meaningful activities in everyday life and led to social isolation. Everyday emotions vacillated between viewing life as meaningful and meaningless. A sense of involvement and the belief that life was meaningful gave the individual the energy and the desire to continue living and to envision a future.Conclusion.  Nursing care should include support and facilitation, so that patients can live rather than exist to the end of their lives. It is important to learn from patients and tailor activities to their social, existential and physical priorities, where appropriate family‐centred support may be most effective.
Imaging features of hepatic angiomyolipomas
Authors: Low SCS , Peh WCG , Muttarak M , Cheung HS , Ng IOL 
Published: March 2008

SummaryWe review the imaging appearances of hepatic angiomyolipomas in patients with and without tuberous sclerosis. Sporadic hepatic angiomyolipomas have a varied appearance because of the inconstant proportion of fat, making confident imaging diagnosis difficult and necessitating biopsy in many cases. In patients with tuberous sclerosis, hepatic angiomyolipomas have a more consistent imaging appearance and, together with other features of the syndrome, can be more easily diagnosed. Preoperative diagnosis helps obviate unnecessary surgery.
Non‐invasive prediction of the degree of liver fibrosis in patients with hepatitis C using an ultrasound contrast agent. A pilot study
Authors: Searle J , Mendelson R , Zelesco M , Sanford J , Cheng W , McKinstry C , Ramsay D 
Published: March 2008

SummaryIt has been shown that the severity of hepatic fibrosis in patients with hepatitis C can be predicted non‐invasively by measuring intrahepatic circulatory time (IHCT) using a microbubble agent with spectral Doppler analysis. The aim of this study was to assess whether this technique is reproducible using a third‐generation microbubble agent and contrast harmonic imaging, which are becoming the standard ultrasound techniques in all radiology departments. Twenty‐three untreated patients with hepatitis C, who had undergone a recent liver biopsy, were studied prospectively. Based on their histological fibrosis score, patients were divided into four groups (fibrosis levels 1–4). Contrast harmonic imaging was carried out after an intravenous bolus of a microbubble agent (Optison; Amersham Health, Milwaukee, WI, USA). IHCT was calculated by measuring the difference between the hepatic vein and hepatic artery microbubble arrival times. The IHCT was compared with the degree of fibrosis. Significant differences were shown between the groups for IHCT. There were significant differences between fibrosis levels 1 and 3 and between fibrosis levels 1 and 4. This study has shown that calculation of IHCT using a third‐generation microbubble agent and contrast harmonic imaging can differentiate mild fibrosis from more severe degrees of fibrosis in patients with hepatitis C.
Atypical appendicitis: The impact of CT and its management
Authors: See TC , Watson CJE , Arends MJ , Ng CS 
Published: March 2008

SummaryAcute appendicitis is a diagnosis that can be made on clinical symptoms and signs but can often be extremely challenging. Difficulties arise particularly when the presentation is atypical, and this can lead to untoward sequelae. In this review, we present the range of presentations of atypical appendicitis, the variety of management options and the potential value of CT.
Dose escalation of radical radiation therapy in non‐small‐cell lung cancer using positron emission tomography/computed tomography‐defined target volumes: Are class solutions obsolete?
Authors: Everitt S , Schneider‐Kolsky M , Yuen K , Budd R , Mac Manus M 
Published: March 2008

SummaryThis study investigated the maximum theoretical radiation dose that could safely be delivered to 20 patients diagnosed with non‐small‐cell lung cancer. Two three‐dimensional conformal radiation therapy (RT) class‐solution techniques (A and B) and an individualized three‐dimensional conformal RT technique (C) were compared at the standard dose of 60 Gy (part I). Dose escalation was then attempted for each technique successfully at 60 Gy, constrained by predetermined limits for lung and spinal canal (part II). Part I and part II data were reanalysed to include oesophageal dose constraints (part III). In part I, 60 Gy was successfully planned using techniques A, B and C in 19 (95%), 18 (90%) and 20 (100%) patients, respectively. The mean escalated dose attainable for part II using techniques A, B and C were 76.4, 74 and 97.8 Gy, respectively (P < 0.0005). One (5%) patient was successfully planned for 120 Gy using techniques A and B, whereas four (20%) were successfully planned using technique C. Following the inclusion of additional constraints applied to the oesophagus in part III, the amount of escalated dose remained the same for all patients who were successfully planned at 60 Gy apart from two patients when technique C was applied. In conclusion, individualized three‐dimensional conformal RT facilitated greater dose conformation and higher escalation of dose in most patients. With modern planning tools, simple class solutions are obsolete for conventional dose radical RT in non‐small‐cell lung cancer. Highly individualized conformal planning is essential for dose escalation.
Radiation recall dermatitis with gatifloxacin: A review of literature
Authors: Jain S , Agarwal J , Laskar S , Gupta T , Shrivastava S 
Published: March 2008

SummaryRadiation recall dermatitis (RRD) is a hypersensitivity skin reaction at the previously irradiated site after the administration of certain pharmacologic agent, which recovers on stopping the medication. RRD is a well‐recognized phenomenon with the use of chemotherapeutic agents; however, only a few cases have been reported with noncytotoxic antibiotics, despite their common use in patients with cancer. We report here a case of RRD with the use of gatifloxacin and describe the time dose factors of radiation exposure, characteristics of skin reactions, management and response and our reasons to label this case as RRD. We also discuss published work regarding proposed mechanisms, histological features, radiation dose threshold and response to rechallange with the RRD‐triggering drug. If RRD is to be characterized unequivocally, all the potential areas of confusion must be clarified like radiosensitization, nonhealing of acute reactions and skin‐related adverse effects of the RRD‐triggering drug. With the same objective, we further discussed radiosensitization and photosensitizing potential of fluoroquinolones. Gatifloxacin, although devoid of photosensitivity reactions, may cause idiosyncratic hypersensitivity reaction to cause RRD and should be considered as a potential cause of RRD. Given the potential severity of the reaction and increasing use of gatifloxacin, it is important to be aware of this phenomenon.
Thyroid Suppression and the Long‐Acting Thyroid Stimulator Following Radioactive Iodine Therapy for Thyrotoxicosis
Authors: Alford F. P. , Larkins R. G. , Martin F. I. B. 
Published: March 2008

Summary: Triiodothyronine suppression tests were performed on 47 patients five to 34 months after radioactive‐iodine therapy for thyrotoxicosis. Serum long‐acting thyroid stimulator (LATS) was measured before and at intervals after radioactive iodine. No relationship was found between thyroid suppressibility and serum LATS at the time of the suppression test, nor between suppress/‐bility and the highest LATS litre obtained for each patient during the investigation. Serum LATS was not related to |131 uptake prior to triiodothyronine nor to persistence of toxicity, but there was a slightly higher incidence of detectable LATS in patients whose goitres did not decrease in size following I131 therapy. Thyroid stimulating hormone was measured at the time of the suppression test in eleven patients and it did not appear to be a major determinant of thyroid suppressibility.The results do not support an aetio‐logical role for circulating LATS in thyrotoxicosis, but a possible role for intrathyroidal LATS cannot be discounted.