bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intrathoracic Bifurcation of the Left Common Carotid Artery with a Symptomatic Internal Carotid Artery Stenosis
Authors: Mohan Chittur R. , Sharp William J. , Hoballah Jamal J. , Schueppert Michael T. , Kresowik Timothy F. , Corson John D. 
Published: June 2007

A forty-eight-year-old woman was evaluated for left hemispheric and transient left monocular symptoms referable to the carotid bifurcation. She was found to have an intrathoracic bifurcation of the left common carotid artery. The angiogram showed a 95% stenosis of the proximal left internal carotid artery arising at an intrathoracic location off a short trunk of the left common carotid artery. She had a history of a Blalock-Taussig shunt and a later total correction of Fallot's tetralogy. Operative correction of the carotid lesion consisted of cervical transposition of the left internal carotid artery to the left external carotid artery. Her postoperative course was uneventful, and follow-up for nearly a year continues to demonstrate a widely patent reconstruction with resolution of her symptoms. The carotid bifurcation may be found at varying locations in the neck; however, a review of the English literature did not disclose any reports of an intrathoracic carotid bifurcation. Given the potential for misdiagnosis, this abnormality should be considered when the bifurcation is not found in its more usual locale on duplex interrogation of this artery.
Value of Color Flow Duplex Imaging in Detection of Subtotal and Total Internal Carotid Artery Occlusion
Authors: Labropoulos N. , Androulakis A. , Allan R. , Giannoukas A. D. , Touloupakis E. , Tegos T. , Al Kutoubi A. , Nicolaides A. N. 
Published: June 2007

The aim of this retrospective study was to estimate the predictive value of color flow duplex imaging (CFDI) in the detection of near-total and total internal carotid artery (ICA) occlusion. The authors reviewed all diagnoses of 95-99% ICA stenosis and ICA occlusion made by CFDI from 1991 to 1994 at St. Mary's Hospital. One hundred thirtyseven patients with CFDI diagnosis of ICA occlusion and 42 with 95-99% stenosis had also been subjected to intraarterial digital substraction angiography during the same period and within one month from the CFDI. They compared the results of both methods to estimate the positive predictive value (PPV) of CDFI in the detection of ICA occlusion and 95-99% stenosis. Furthermore, they compared the PPV of CDFI diagnoses during 1991-1993 with that of 1994 for the same spectrum of ICA disease. CFDI had 96% PPV in the diagnosis of carotid occlusion (95% confidence interval, 94-97.9%, false-positive rate 3.6%) and 83% in the diagnosis of 95-99% stenosis (95% confidence interval 63.4-88.9%, false-positive rate 17%). Although there was improvement of CFDI's ability in the diagnosis of occlusion during 1994 in comparison with the 1991-1993 period, this was not statistically significant (PPV 95.9% and 97.4% respectively). CFDI may slightly underestimate or overestimate the degree of tight ICA stenosis. However, in the diagnosis of ICA occlusion CFDI is highly reliable.
An Evaluation of the Utility of Intravascular Ultrasound in an Endovascular Practice
Authors: Kulbaski Mark J. , Marshall J. Jeffrey , Kosinski Andrzej S. , Lumsden Alan B. 
Published: June 2007

Intravascular ultrasound (IVUS) has been shown to be superior to arteriography for measuring luminal stenosis and characterizing plaque morphology and content. However, IVUS has not been routinely adopted during endovascular interventions, which may be due to the added time, expense, and general perception of the efficacy of arteriography. The authors performed a prospective study to assess the utility of IVUS in a typical vascular surgery practice consisting of open and catheter-based procedures. Over a recent 7-month period, IVUS was used by one vascular surgeon during 21 procedures in 20 patients at the Emory University affiliated hospitals. The procedures included 11 cases of iliac artery angioplasty or stenting (with or without concomitant infrainguinal reconstruction), six diagnostic iliac arteriograms, three cases of supraaortic trunk stenting, and an innominate arteriogram. Useful information given by IVUS was noted. Estimates of the percent cross-sectional area stenoses of 19 lesions were made by IVUS and arteriography for comparison. In 6 of 21 (29%) of cases, information from IVUS changed or facilitated intraoperative plans that were made on the basis of arteriography. Three modified procedures included redilating an underexpanded iliac artery stent, dilating a fold in an iliac artery stent-graft, and stenting an iliac artery stenosis, all of which were not detected with arteriography. In three additional cases, IVUS proved to be valuable for precisely positioning stents in the supraaortic vessels when intraoperative arteriography was suboptimal. The mean percent cross-sectional area of the stenoses was not significantly different when measured by IVUS (43.7%) or by arteriography (49.1%) (p=0.42). IVUS is especially advantageous during complicated stenting procedures and supraaortic revascularization and should be available to the surgeon who performs catheter-based interventions. Diagnostic arteriography will detect most hemodynamically significant lesions, but IVUS can be used to clarify the anatomy in selected cases.
Aortic Aneurysmorrhaphy: Establishing Concurrent Results for Comparison with Endoluminal Therapies
Authors: Harris E. John , Dalman Ronald L. 
Published: June 2007

The authors began to evaluate endoluminal vascular prostheses in 1991. Since then, market-driven changes in health care delivery have led to shortened hospital stays and intensive care unit (ICU) stays for elective aortic aneurysmorrhapy without increasing morbidity and mortality. They reviewed concurrent results of their open surgery program during this time period to establish a baseline for mortality, morbidity, and overall outcome. Prospective follow-up identified 90 consecutive elective aortic aneurysms repaired by two fellowship-trained vascular surgeons between August 1, 1991, and August 1, 1997. All patients with aortic aneurysms 50 mm or larger presenting to the authors' clinics were offered elective aneurysmorrhaphy with no patients refused operation owing to excessive operative risk. All procedures were performed with resident participation. Mean patient age was 69.7 years (range 49-83). Risk factors included a significant smoking history in 97%, hypertension in 83%, cardiac insufficiency in 74%, pulmonary insufficiency in 42%, and renal insufficiency in 18% of the patients. There were three juxtarenal and 87 infrarenal aneurysms with a mean diameter of 58 mm (range 45-90 mm). Iliac and femoral artery aneurysmal or occlusive disease was frequent with 72 bifurcated grafts used for repair, and 18 tube grafts. There were 29 concomitant procedures: eight renal artery reimplantations, six renal artery bypasses, three infrainguinal bypasses, five distal artery aneurysm exclusions, three inferior mesenteric artery reimplantations, two nephrectomies, and two renal artery endarterectomies. There were no perioperative deaths. Survival was 97.3% at 6 years by life-table analysis, with a mean follow-up of 25.3 months (range 0.13-70.5 months). Major morbidity prolonging hospitalization occurred in 17.7%; all patients were discharged from the hospital and returned to independent living. No patient required permanent dialysis and all patients were extubated without extraordinary measures. Mean blood loss was 908.7 mL (range 250-5,000 mL). Mean hospital stay was 15.6 days (range 3-55 days) and mean ICU stay was 3.7 days (range 1-18 days). In the last 1.5 years of the study procedures were performed with reduced utilization of resources; mean blood loss 735 mL (range 250-2,500 mL), mean hospital stay 10.96 (range 3-55) days, and mean ICU stay 2.65 (range 1-14) days. Overall primary graft patency at 6 years was 99.2% by life-table analysis. Elective open aortic aneurysmorrhaphy can be safely performed in high-risk patients in their seventh, eighth, and ninth decades of life. Improved perioperative management of elective aneurysmorrhaphy procedures has led to decreased hospital and ICU stays while maintaining acceptable morbidity and low mortality rates. Direct comparison of evolving endoluminal aneurysmorrhaphy techniques with open aneurysmorrhaphy techniques must utilize concurrent morbidity and mortality data in preference to historic control data.
B-mode Ultrasound Imaging in Symptomatic Internal Carotid Artery Stenosis: Correlation with Clinical and Operative Findings
Authors: Kim Geun Eun , Cho Yong Pil , Kwon Tae Won , Kim Ho Sung , Hong Hee Sun , Lee Myoung Chong 
Published: June 2007

B-mode ultrasound (duplex) imaging is a technique that enables the evaluation of plaque characteristics. The purpose of this study was to determine the accuracy and usefulness of duplex imaging by comparing a relationship between the preoperative clinical neurologic status, preoperative duplex findings, and operative findings in patients who had carotid endarterectomy (CEA) for symptomatic high-grade internal carotid artery (ICA) stenosis. Sixty patients with symptomatic ICA stenosis who underwent CEA from September 1995 to August 1998 were included in this study. Plaque morphology was categorized in terms of echogenicity by preoperative duplex imaging. A correlation between the frequency of preoperative ischemic stroke and duplex and operative findings was prospectively evaluated. Thirty-eight patients had recent and multiple cerebral ischemia, and 22 experienced a single episode more than 1 month before CEA. Recent and multiple events occurred in 24 (72.7%) of 33 patients with echolucent plaques, but only 6 (40.0%) of 15 with echogenic plaques (p<0.05). Thirty-six (75%) of 48 patients with soft plaques by operative findings had recent and multiple events, but only two (16.7%) of 12 with calcified plaques experienced recent and multiple events (p<0.01). Overall sensitivity, specificity, and accuracy of duplex imaging were 79.5%, 77.8%, and 79.2%, respectively. Duplex imaging is reliable in determining ICA plaque characteristics. Recent and multiple cerebral ischemia occurred more frequently in patients with echolucent plaques by preoperative duplex and soft plaques by operative findings. The presence of echolucent plaque may be used as a strong indication for CEA in patients who have asymptomatic high-grade ICA stenosis.
Cholecystectomy During Abdominal Aortic Aneurysm Repair in Patients with Gallstones
Authors: D'Angelo Anthony J. , Kline Roxana G. , Faust Glenn R. , Cohen Jon R. 
Published: June 2007

Background: Simultaneous cholecystectomy for asymptomatic cholelithiasis during abdominal aortic aneurysm (AAA) repair is not widely accepted. We reviewed our data to determine morbidity and mortality in patients with cholelithiasis undergoing AAA repair. Methods: Over the past 5 years, 320 infrarenal AAA repairs were done in our institution. Twenty-nine patients were identified as having had a prior cholecystectomy, leaving 291 patients in the study group. Forty-seven patients (16%) were found to have cholelithiasis. Thirty patients underwent a cholecystectomy at the time of the AAA repair (GpA), whereas 17 patients did not have their gallbladder removed (GpB). Patient characteristics, postoperative complications, and mortality were compared. Results: Two patients in GpA died (6.7%), one of renal failure and the other of respiratory failure. In GpB there were three deaths (17.6%) due to postoperative hemorrhage. No deaths in either group were related to the biliary tract. Ten infectious complications occurred in six patients in GpB (35%), compared with only 10% of patients in GpA (p<0.05). Cholecystitis occurred in 24% of patients in GpB, with no cases in GpA (p<0.02). Complications directly related to the biliary tract occurred in 35% of patients in GpB (p<0.02). Conclusions: These data indicate that asymptomatic gallstones resulted in significant morbidity during the postoperative recovery period from AAA repair. We conclude that patients with asymptomatic gallstones should undergo routine cholecystectomy at the time of the AAA repair.
The Idea of a ‘Missionary Bishop’ in the Spread of the Anglican Communion in the Nineteenth Century
Authors: Yates Timothy 
Published: June 2007

ABSTRACTIn the 1830s, among those associated with the Tractarian revival in England and also among certain figures in the (then) Protestant Episcopal Church of the United States (PECUSA), the idea of the ‘missionary bishop’ was propagated, which presented the bishop as a pioneer evangelist as the apostles were understood to be in New Testament times and saw the planting of the Church as necessarily including a bishop from the beginning for the ‘full integrity’ of the Church to be present. This view of the bishop as the ‘foundation stone’ was not held by the Evangelicals of the Church Missionary Society (CMS), who saw the bishop by contrast as the ‘crown’ or coping stone of the young churches. Two main protagonists were the High Churchman, Samuel Wilberforce, Bishop of Oxford, and the honorary secretary and missionary strategist, Henry Venn. The party, led by C.F. Mackenzie as Bishop and mounted by the Universities’ Mission to Central Africa (UMCA) in 1861 to the tribes near Lake Nyassa, was the outworking of this Tractarian ideal.
Innovation and Undecidability: Some Implications for theKoinoniaof the Anglican Church
Authors: Pickard Stephen 
Published: June 2007

ABSTRACTThe Anglican Church is now a worldwide communion and international Anglicanism is marked by a high degree of variety and significant tensions both at local and international levels. Dealing with diversity and conflict across the communion may be the most pressing issue facing Anglicanism in the twenty-first century. Certainly the needs of mission require a strong focus on local and regional concerns and the history of Anglicanism bears testimony to a strong emphasis on a contextual and incarnational approach to discipleship, worship and social engagement. For this reason the Anglican Church has always wrestled with the tension between its inherited identity and the demand for relevance in an expanding communion. Many of the tensions and unresolved conflicts that beset modern Anglicanism arise because of the astonishing capacity of the Church to develop new responses in new situations that result in practices that do not fit easily with the received tradition. These point to a fundamental fact of Christianity; its inherent creativity and capacity for innovation. But not all innovations are wise for the Church; many innovations generate further conflict and the people of God are often confused or puzzled about what innovations to adopt or reject, and how to facilitate either of these scenarios. Some examples in the history of Christianity include controversies over the date of Easter, the development of church order (for example, episcopacy), doctrinal developments (for example,homoousionof the Nicene Creed), and issues to do with slavery, marriage, divorce and, more recently, ordination of women. None of these ‘innovations’ were greeted with immediate consensus at the point of local adoption nor as the innovation became more widely known and assimilated into the life of the Church.From an ecclesial point of view the fact of innovation represents both a challenge to, and opportunity for an enhancedkoinoniain the gospel. Minimally this involves commitment to ongoing patient dialogue and face-to-face encounter as innovations are wrestled with, differences explored and conflicts faced. This article considers further the concepts of innovation and undecidability as critical issues underlying much of our current difficulties. The article then inquires as to their relevance and importance for thekoinoniaof the Anglican Communion.
Naturalized Virtue Ethics and the Epistemological Gap
Authors: Brown Stephen 
Published: June 2007

AbstractThe proponent of the epistemological gap maintains that value claims are justified in a different way than are nonvalue claims. I show that a neo-Aristotelian naturalized virtue ethics does not fall prey to this gap. There are ethical claims concerning human beings that are epistemically justified in a way logically identical to the way in which are justified certain nonethical claims about human and nonhuman organisms. This demonstration (1) lends credibility to naturalized virtue ethics, (2) calls into question the very notion of an epistemological gap, and (3) confronts antinaturalists with a dilemma.
The Legacies of John Rawls
Authors: D’agostino Fred 
Published: June 2007

AbstractTo understand the continuing importance of John Rawls’s work, we need to understand the background, the object and the method of his fifty-year quest as a political thinker. The background to Rawls’s investigation was a (carefully circumscribed) acknowledgement of a certain kind of evaluative pluralism. The object of Rawls’s work was to develop a method of commensuration that would enable us, the free and equal citizens of a democratic society, to identify a common basis for our dealings, in search of mutual benefit, with one another. Finally, the method used by Rawls in his work was broadly, though tacitly rather than explicitly, pragmatist in character, especially in the sense that Rawls was aiming, now explicitly, to develop principles of political association that generate their own support in the attitudes and actions of those whose behavior they are intended to guide.
Patients' and nurses' views of nurse-led heart failure clinics in general practice: a qualitative study
Authors: Lloyd-Williams Ffion , Beaton Susan , Goldstein Pauline , Mair Frances , May Carl , Capewell Simon 
Published: June 2007

Objectives: To ascertain nurses' and patients' views and experiences of a nurse-led heart failure clinic provided in general practice. Methods: The study was set in eight general practices in the North-West of England. Semi-structured interviews were devised and administered, with all the nurses providing the clinics and a purposive sample of patients attending the clinics. The interviews were tape-recorded and transcribed. Constant comparative analysis was used to identify key issues and themes. Results: Nurses felt that the self-care advice provided had empowered patients to manage their condition. Explaining why a medication had been prescribed, and how it controlled heart failure, was felt to increase compliance. Although communication was deemed good, some patients were reticent about asking questions. Patients were knowledgeable about their prescribed heart failure medications, but some did not recall having discussed their medications. Also, medication inserts led some patients to question their prescription. Patients remained confused about the purpose and outcome of investigations. Furthermore, many patients suggested that they had problems adhering to or remembering the advice given. Discussion: There are practical benefits to be obtained from attending a nurse-led heart failure clinic in primary care. However, patients and healthcare providers may have quite divergent views about such a service and its benefits, emphasizing the potential value of consumer involvement and feedback when developing and delivering such services.
Effects of a brief computer-assisted diabetes self-management intervention on dietary, biological and quality-of-life outcomes
Authors: Glasgow Russell E. , Nutting Paul A. , Toobert Deborah J. , King Diane K. , Strycker Lisa A. , Jex Marleah , O'Neill Caitlin , Whitesides Holly , Merenich John 
Published: June 2007

Objective: There is a need for practical, efficient and broad-reaching diabetes self-management interventions that can produce changes in lifestyle behaviours such as healthy eating and weight loss. The objective of this study was to evaluate such a computer-assisted intervention. Methods: Type 2 diabetes primary care patients ( n=335) from fee-for-service and health maintenance organization settings were randomized to social cognitive theory-based tailored self-management (TSM) or computer-aided enhanced usual care (UC). Intervention consisted of computer-assisted self-management assessment and feedback, tailored goal-setting, barrier identification, and problem-solving, followed by health counsellor interaction and follow-up calls. Outcomes were changes in dietary behaviours (fat and fruit/vegetable intake), haemoglobin A1c (HbA1c), lipids, weight, quality of life, and depression. Results: TSM patients reduced dietary fat intake and weight significantly more than UC patients at the 2-month follow-up. Among patients having elevated levels of HbA1c, lipids or depression at baseline, there were consistent directional trends favouring intervention, but these differences did not reach significance. The intervention proved feasible and was implemented successfully by a variety of staff. Conclusions: This relatively low-intensity intervention appealed to a large, generally representative sample of patients, was well implemented, and produced improvement in targeted behaviours. Implications of this practical clinical trial for dissemination are discussed.
Church, World and Christ in Teilhard de Chardin
Authors: Grumett David 
Published: June 2007

AbstractIn the cosmology and theology of Pierre Teilhard de Chardin, the Church has not often been considered to possess any significant function. In fact, Teilhard devotes considerable attention to several key ecclesiological questions. Fundamental to the Christian mission of the conversion of the world to Christ is an incarnational theology of the conversion of the Church to the world. This requires the Church to accept the modern world as currently and contingently constituted. The Church spiritually transforms the materiality of the world in its sacraments and through the practical works of its members. It provides the physical means of the convergence of the world towards its final unity, and for this reason calls its members to obedience, despite its imperfections. Catholicism has the potential to bring all Christians to unity in a self-transforming ecumenism that could also encompass other faiths.
Composition Profiler: a tool for discovery and visualization of amino acid composition differences
Authors: Vacic Vladimir , Uversky Vladimir N , Dunker A Keith , Lonardi Stefano 
Published: June 2007

Abstract

Background
Composition Profiler is a web-based tool for semi-automatic discovery of enrichment or depletion of amino acids, either individually or grouped by their physico-chemical or structural properties.

Results
The program takes two samples of amino acids as input: a query sample and a reference sample. The latter provides a suitable background amino acid distribution, and should be chosen according to the nature of the query sample, for example, a standard protein database (e.g. SwissProt, PDB), a representative sample of proteins from the organism under study, or a group of proteins with a contrasting functional annotation. The results of the analysis of amino acid composition differences are summarized in textual and graphical form.

Conclusion
As an exploratory data mining tool, our software can be used to guide feature selection for protein function or structure predictors. For classes of proteins with significant differences in frequencies of amino acids having particular physico-chemical (e.g. hydrophobicity or charge) or structural (e.g. α helix propensity) properties, Composition Profiler can be used as a rough, light-weight visual classifier.