bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adenocarcinoma of the uterine cervix: the presence of human papillomavirus and the method of detection
Authors: Andersson Sonia , Larson Barbro , Hjerpe Anders , Silfverswärd Claes , Sällström Jan , Wilander Erik , Rylander Eva 
Published: September 2003

Background.  Effective screening programs have contributed to a decrease in the incidence of cervical squamous cell carcinomas but have had a limited sensitivity in the detection of adenocarcinoma precursor lesions. The aim of our study was to analyze cervical adenocarcinoma in greater detail: symptoms preceding the detection, the method of detection and the prevalence of human papillomavirus (HPV) with respect to age at diagnosis.Material and methods.  Clinical data were abstracted from the medical records of 82 women with pure invasive cervical adenocarcinomas. As diagnostic tools we used polymerase chain reaction (PCR)‐based single‐strand conformation polymorphism (SSCP) and/or direct DNA sequencing for HPV detection.Results.  Age at diagnosis predicting factors were HPV status, positive lymph nodes, histology and stage. HPV‐negativity, lymph node metastases, advanced stage and poor differentiation were all associated with a high diagnostic age. In the multivariate analysis only HPV status was shown to have an independent impact on age at diagnosis, while stage showed only borderline significance. Twenty‐three percent of the cancers were detected by screening and the remaining were due to different symptoms. Among the women considered, 93% had a normal Papanicolaou (Pap) smear 3 years before diagnosis and 60% within 1 year. There was no significant correlation between smoking, oral contraceptives and HPV‐positivity.Conclusions.  The absence of HPV was significantly associated with a high age at diagnosis. Pap screening had a limited effect in detecting adenocarcinoma at an early stage.
Investigation of erosion and abrasion on enamel and dentine: a model in situ using toothpastes of different abrasivity
Authors: Hooper S. , West N. X. , Pickles M. J. , Joiner A. , Newcombe R. G. , Addy M. 
Published: September 2003

ZusammenfassungGrundlagen: In‐vitro‐Studien lassen annehmen, dass Abrasion und Erosion bei der Produktion von Schmelz‐ und Dentinabtrag synergistisch wirken. Seit kurzem sind in‐situ‐Methoden zum getrennten Studium von Erosion und Abrasion von dentalen Geweben verfügbar. Das Ziel dieser Studie war es zwei in‐situ‐Protokolle zu kombinieren, im das Wechselspiel zwischen Erosion und Abrasion von Schmelz und Dentin zu studieren.Methode: Die randomisierte einfach‐blind‐Studie, wurde mit je 5 Behandlungen an 15 gesunden Freiwilligen durchgeführt und hatte ein cross‐over.Design. Während jeder der 10‐tägigen Studienperioden trugen die Teilnehmer von 9 Uhr morgens bis 5 Uhr abends im Oberkiefer eine Acryl‐Tiefziehschiene, welche eine polierte Schmelz‐ und eine polierte Dentinfläche enthielt.Die Behandlungsmaßnahmen für die Flächen waren:1. Trinkwasser und Putzen mit Zahnpasta A.2. Trinkwasser und Putzen mit Zahnpasta B.3. Orangensaft Trinken.4. Orangensaft Trinken und Putzen mit Zahnpasta A.5. Orangensaft Trinken und Putzen mit Zahnpasta B.Die Trink‐ und Putzzeiten waren etwa 9.00, 11.00, 13.00 und 15.00 Uhr. Von den Drinks wurden 250 ml während 10 min konsumiert und das ex‐vivo‐Putzen erfolgte für 1 min pro Fläche. Für jede Periode erfolgten die Messungen des Gewebeverlusts an Tag 5 und 10 unter Verwendung eines Profilometers.Ergebnisse: Alle Behandlungen produzierten im Verlaufe der Zeit steigenden Gewebeverlust, der für Dentin beträchtlich größer war als für Schmelz. Für Schmelz zeigten die Daten an Tag 5 und 10 einen signifikanten Effekt der Erosion (z.B. war Orangensaft beträchtlich erosiver als Wasser), aber keinen signifikanten Effekt für die Abrasion (z.B. keine signifikanten Unterschiede zwischen den zwei Zahnpasten). Die kombinierten Effekte von Orangensaft und Zahnpasta wiesen in Richtung einer Synergie erreichten jedoch keine Signifikanz. Auf Dentin übertrafen die Daten an Tag 10 den bei 50 μm gesetzten Grenzwert und nur die Daten von Tag 5 wurden berücksichtigt. Es gab signifikante Effekte für die Erosion (Orangensaft produzierte signifikant mehr Erosion als Wasser) und für die Abrasion (Paste A war signifikant abrasiver für Dentin als Paste B). Für Dentin konnte der Synergieeffekt wegen des Begrenzungseffekts, da die Daten den Profilometergrenzwert überschritten hatten, nicht untersucht werden.Schlussfolgerungen: Eine Erosion erhöht die Anfälligkeit von Schmelz für Zahnpastaabrasion. Dentin ist beträchtlich anfälliger als Schmelz für Erosion und Abrasion allein oder deren Kombination. Der Dentinverlust schein mit der Abrasivität der Zahnpasta (RDA‐Wert) zu korrelieren.
Longitudinal validation of a risk calculator for periodontal disease
Authors: Page Roy C. , Martin John , Krall Elizabeth A. , Mancl Lloyd , Garcia Raul 
Published: September 2003

AbstractBackground: Risk assessment and utilization of the results are important components of prevention, diagnosis and treatment of periodontal diseases. Risk assessment is relatively new to dentistry. Currently risk is assessed by subjective evaluation and results vary widely among clinicians. We have developed a computer‐based risk assessment tool, the Periodontal Risk Calculator (PRC), for objective, quantitative assessment of risk. The purpose of the study reported here was to evaluate the accuracy and validity of this tool.Methods: Clinical records and radiographs of 523 subjects enrolled in the VA Dental Longitudinal Study of Oral Health and Disease, covering a period of 15 years, were used. Information from baseline examinations was entered into the risk calculator and a risk score on a scale of l–5 for periodontal deterioration was calculated for each subject. Actual periodontal status in terms of alveolar bone loss determined using digitized radiographs, and tooth loss determined from the clinical records, was assessed at years 3, 9 and 15. The strength of the association between risk prediction and actual outcome was determined statistically.Results: The risk scores were strong predictors of future periodontal status measured as worsening severity and extent of alveolar bone loss and tooth loss, especially loss of periodontally affected teeth. Over the entire 15‐year period, risk scores consistently ranked groups from least to most bone loss and tooth loss. Risk groups differed greatly from one another. By year 3, the incidence rate of bone loss of group 5 was 3.7‐fold greater than for group 2, and by year 15, the loss of periodontally affected teeth was 22.7‐fold greater than for group 2 (p<0.001). By year 15, 83.7% of subjects in risk group 5 had lost one or more periodontally affected teeth compared to 20.2% of subjects in group 2.Conclusions: Risk scores calculated using the PRC and information gathered during a standard periodontal examination predict future periodontal status with a high level of accuracy and validity. Use of the risk assessment tool over time may be expected to result in more uniform and accurate periodontal clinical decision‐making, improved oral health, reduction in the need for complex therapy and reduction in health‐care cost.
Specialist palliative care: patients’ experiences
Authors: Seymour Jane , Ingleton Christine , Payne Sheila , Beddow Vikki 
Published: September 2003

Background. Nursing research generally, and palliative care research in particular, has been criticized for generating numerous small scale, often qualitative and/or evaluative studies, from which it is difficult to draw generalizations.Aims. Our aim in this study was to conduct a synthesis of three evaluative studies of palliative care services in the United Kingdom (UK), to ascertain patients’ reported expectations and experiences of specialist care. We also demonstrate how secondary data analysis and synthesis can identify commonalities and differences between services.Methods. Secondary qualitative data analysis was conducted on interview data gathered from 37 patients during three evaluation studies of specialist palliative care services. All studies used formative evaluation methodology.Findings. Four themes were identified: (1) knowledge and information about services, (2) meeting practical and psychosocial needs, (3) lack of control, and (4) family atmosphere. Data are presented to illustrate the presence or absence of these themes in patients’ accounts of their expectations and experiences of each service.Study limitations. Data were collected at different times between 1998 and 2000, and interviews were conducted by different researchers.Conclusions. Synthesizing findings from small scale qualitative studies offers the possibility of demonstrating their applicability beyond local and specific contexts. It is imperative to listen to the experiences of patients and carers as a basis for developing interventions and guidelines for services. The methods proposed in this paper offer the potential for these voices of experience to be heard more widely.
Psycho‐spiritual well‐being in patients with advanced cancer: an integrative review of the literature
Authors: Lin Hung‐Ru , Bauer‐Wu Susan M. 
Published: September 2003

Purpose. An integrative literature review was undertaken to examine the research on psycho‐spiritual well‐being in terminally ill people, specifically patients with advanced cancer.Method. A comprehensive search of MEDLINE, CINAHL, CancerLit and PsycINFO using relevant keywords produced 43 primary research studies that investigated psycho‐spiritual well‐being in patients with advanced cancer. Each report was read, critiqued and systematically assessed for purpose statement or research questions, study design, sample size, characteristics of the subjects, measurement of independent and dependent variables, sample attrition, method of data analysis and results. Major themes and findings were identified for each of the studies.Findings. Psycho‐spiritual well‐being is an area of interest to researchers all over the world. Retrieved studies had been conducted in 14 countries by researchers in a variety of disciplines, including nursing, medicine, psychology and theology. Six major themes repeatedly emerged as essential components of psycho‐spiritual well‐being: self‐awareness, coping and adjusting effectively with stress, relationships and connectedness with others, sense of faith, sense of empowerment and confidence, and living with meaning and hope.Conclusion. Patients with an enhanced sense of psycho‐spiritual well‐being are able to cope more effectively with the process of terminal illness and find meaning in the experience. Prognostic awareness, family and social support, autonomy, hope and meaning in life all contribute to positive psycho‐spiritual well‐being. Emotional distress, anxiety, helplessness, hopelessness and fear of death all detract from psycho‐spiritual well‐being. The research indicated that health professionals can play an important role in enhancing psycho‐spiritual well‐being, but further research is needed to understand specific interventions that are effective and contribute to positive patient outcomes.
Treatment of Kasabach–Merritt syndrome: a stepwise regimen of prednisolone, dipyridamole, and interferon
Authors: Wananukul Siriwan , Nuchprayoon Issaraang , Seksarn Panya 
Published: September 2003

AbstractBackground  Kasabach–Merritt syndrome (KMS) is a rare, aggressive, vascular tumor with thrombocytopenia and consumptive coagulopathy. A standard treatment regimen for KMS has not been established. We reviewed our experience of a stepwise approach for the treatment of 10 children with KMS.Methods  All patients were first treated with oral corticosteroid (initially 3 mg/kg/day then 5 mg/kg/day) and dipyridamole. Interferon‐alpha‐2b (IFNα2b) was used as second therapy for steroid‐resistant cases for 12 months, then tapered to an alternate‐day regimen, and then discontinued. Adjunctive therapy, including embolization of the feeding vessel or chemotherapy, was additionally used in patients who failed to respond to IFN or could not be taken off IFN.Results  Ten patients were treated on this protocol with a follow‐up time of 1–6 years. Oral corticosteroid plus dipyridamole was successful in four patients, but was tapered off by 12 months without recurrence in only two cases. Of the eight steroid‐resistant cases, IFNα2b successfully induced regression of the tumor and increased the platelet count in six patients; however, IFNα2b was successful as monotherapy in only three cases; two patients died of aspiration pneumonia whilst on therapy and one patient could not be taken off IFNα2b until weekly vincristine was given (eight doses). Two other patients did not respond to IFNα2b in 4 weeks; embolization and vinblastine was used in one patient to induce regression of the tumor and resolution of thrombocytopenia. Hypertension developed in all children on high‐dose prednisolone.Conclusions  KMS may be treated in a stepwise approach. High‐dose steroid does not result in a high response rate and is not tolerated well. The response to IFNα2b is more favorable, but life‐threatening adverse events may occur. Chemotherapy with vincristine or vinblastine may be useful as adjunctive therapy in KMS, but experience is still limited.
Nurse administered relative analgesia using high concentration nitrous oxide to facilitate minor procedures in children in an emergency department
Authors: Frampton A , Browne G J , Lam L T , Cooper M G , Lane L G 
Published: September 2003

Aims:To describe the experience of using high concentration nitrous oxide (N2O) relative analgesia administered by nursing staff in children undergoing minor procedures in the emergency department (ED) and to demonstrate its safety.Method:Data were collected over a 12 month period for all procedures in the ED performed under nurse administered N2O sedation. All children greater than 12 months of age requiring a minor procedure who had no contraindication to the use of N2O were considered for sedation by this method. The primary outcome measure was the incidence of a major complication namely respiratory distress or hypoxia during the procedure. Secondary outcome measures were minor complications and the maximum concentration of N2O used.Results:Data were collected for a total of 224 episodes of nurse administered N2O sedation over a 12 month period. In 73.2% of children no complications were recorded. One major complication was recorded (respiratory distress) and the most common minor complication was mask intolerance in 17%. The mean maximum concentration of N2O used was 60.2%.Conclusions:N2O is a safe analgesic in children over the age of 1 year undergoing painful or stressful procedures in the ED. It may safely be administered in concentrations of up to 70% by nursing staff after appropriate training.
Improving the effectiveness of the emergency management of renal colic in a district general hospital: a completed audit cycle
Authors: Kastner C , Tagg A 
Published: September 2003

Objectives:To assess the current practice of emergency management of renal colic in a district hospital, review literature, implement new guidelines, and assess them.Methods:Data were collected about the use of analgesia, waiting time for intravenous urography (IVU), and admission status of patients presenting to the hospital with symptoms of renal colic over the period of three months. A literature search into the use of analgesia, imaging, and treatment was performed. Members of the involved departments were consulted and new guidelines developed and implemented. This was followed by further data collection over three months.Results:Seven of 14 patients were admitted. Five to wait for their IVU. Their average waiting time was 12.3 (SD 2.2) hours. Mainly intramuscular opioid analgesia was used. Literature recommended the use of diclofenac. Although computed tomography was favoured it was decided to continue to use IVU because of circumstances within the hospital. The literature recommended a cut off between conservative and surgical treatment at a calculus size of >4 mm. Existing policies of the relevant departments were obeyed and a training system for the junior doctors was introduced. Emergency department staff were encouraged to perform 3-film IVUs. After this, of 5 of 19 patients were admitted, only one of those to wait for an IVU. The average waiting time for an IVU was 4.1 (SD 0.96) hours. Rectal diclofenac was noted to be the drug of choice.Conclusion:Coordination of efforts, interdepartmental communication, and a practical application of available literature has resulted in a significant improvement of effectiveness without affecting medical standards, workload, or resources. Accident and emergency senior house officers felt highly satisfied at being able to complete management from presentation to diagnosis and treatment. Interdisciplinary communication has to be continued to maintain smooth operation of the guidelines.
Impact of health consequences feedback on patients acceptance of advice about alcohol consumption
Authors: Patton R , Crawford M J , Touquet R 
Published: September 2003

Objectives:To demonstrate the impact of health consequences feedback on patients willingness to accept advice about drinking.Methods:281 patients identified as hazardous drinkers were offered advice about alcohol consumption. During the experimental period patients’ were given feedback as to the health consequences.Results:Introduction of feedback led to a 23% increase in the proportion of patients who were willing to accept brief advice.Conclusions:Feedback provision should be included as part of Screening and Brief intervention programmes to increase the number of patients that may benefit from an intervention.
Aspects of higher training in emergency medicine
Authors: Kilroy D A 
Published: September 2003

Abstract

Objectives
To devise and develop a structured questionnaire addressing important issues relating to specialist registrar training in emergency medicine in the UK, and to then administer this questionnaire nationally to higher trainees in order to establish current practice and opinion regarding those issues.

Methods
Informal interviews with current trainees were undertaken to identify themes which might be of wider importance in relation to training. The transcriptions were incorporated into a discussion questionnaire which was circulated to other trainees and to members of the Joint Committee on Higher Training in Accident and Emergency. A postal survey was developed from this draft and distributed to all trainees currently registered with the Faculty of Accident and Emergency Medicine.

Results
The response rate was 75%. Collective responses to certain aspects of training are demonstrated in order to reflect current practice and opinion among UK specialist registrars and to allow further debate.

Conclusion
Development of a structured questionnaire allows issues in relation to training in emergency medicine to be assessed. The findings of the survey allow national data to be presented which will be of interest to trainees and trainers in the UK as well as overseas.
Discretized Yang–Mills and Born–Infeld Actions on Finite Group Geometries
Authors: Aschieri P. , Castellani L. , Isaev A. P. 
Published: September 2003

Discretized non-Abelian gauge theories living on finite group spaces G are defined by means of a geometric action ∫ Tr F ∧ *F. This technique is extended to obtain discrete versions of the Born–Infeld action. The discretizations are in 1–1 correspondence with differential calculi on finite groups. A consistency condition for duality invariance of the discretized field equations is derived for discretized U(1) actions S[F] living on a four-dimensional Abelian G. Discretized electromagnetism satisfies this condition and therefore admits duality rotations. Yang–Mills and Born–Infeld theories are also considered on product spaces MD×G, and we find the corresponding field theories on MD after Kaluza–Klein reduction on the G discrete internal spaces. We examine in detail the case G=ZN, and discuss the limit N→∞. A self-contained review on the noncommutative differential geometry of finite groups is included.
Group Properties of Defective Crystal Structures
Authors: Parry G. P. 
Published: September 2003

The continuum mechanics of crystals draws on the atomistic view of crystal structure by assuming that the symmetries of perfect (atomic) crystal lattices define the material symmetry groups of associated continua. Thus, for example, the discrete (point) group which gives the rotational symmetries of a perfect cubic lattice is employed, commonly, in defining the material symmetry group of the strain energy function of a linearly elastic continuum with cubic symmetry. In fact, the general procedure has also been used successfully in the context of nonlinear elasticity theory; it amounts to a constitutive assumption which transfers some aspect of a relevant discrete structure to the continuum model. Here I begin to extend this procedure so as to encompass crystals with uniform distribution of defects. The extension is of interest because the behavior of defects is reckoned to amount for significant variations in the mechanical strength of crystalline materials. So an understanding of the geometry of configurations of points that represent uniform distributions of defects is a prerequisite for constructing energy functions that model continua where relevant defect densities are non-zero, if we accept that the symmetries of such configurations define the material symmetry group of the corresponding continuum. The paper investigates the structure of these configurations.
Asymmetric Reduction of α,β-Unsaturated Cyclic Ketones by a Yeast
Authors: Matsumoto Kazutsugu , Kawabata Yoichi , Takahashi Jun , Fujita Yoshitomo , Hatanaka Minoru 
Published: September 2003

Abstract
The asymmetric reduction of the carbon-carbon double bond of α,β-unsaturated cyclic compounds proceeds with high enantioselectivity when catalyzed by Yamadazyma farinosa IFO 10896. Microbial reduction of 2-methyl-2-cyclohexen-1-one followed by PCC oxidation affords the optically active (R)-2-methyl-1-cyclohexanone of 95% ee. On the other hand, the sequential reactions of (E)-2-propylidene-1-cyclohexanone gives the unsaturated ketone possessing an S-configuration at the C-2 position.
Room Temperature Ultraviolet Electroluminescence from Poly(methylphenylsilane)
Authors: Xu Yonghua , Fujino Takahiro , Naito Hiroyoshi , Oka Kunio , Dohmaru Takaaki 
Published: September 2003

Abstract
Using carefully purified poly(methylphenylsilane) (PMPS), we have successfully fabricated PMPS LEDs which emit UV light at room temperature for the first time. The study of I-V characteristics of PMPS LEDs indicates that Trapped-Charge-Limited (TCL) currents dominate the charge transport in LEDs at high current region.
Electrocatalytic Dehalogenation of Chloroaromatics on Palladium-loaded Carbon Felt Cathode in Aqueous Medium
Authors: Tsyganok Andrey I , Yamanaka Ichiro , Otsuka Kiyoshi 
Published: September 2003

Abstract
The selective dechlorination of highly toxic chloroaromatic herbicides based on phenoxyacetic acid was successfully achieved under mild experimental conditions in aqueous medium by electrocatalytic reduction at palladium-loaded carbon felts. Such cathode material is in principle available for dechlorination of chloroaromatics having different molecular structure.
Reduction and Agglomeration of Silver in the Course of Formation of Silver Nano Cluster in Poly(methyl methacrylate)
Authors: Yanagihara Naohisa 
Published: September 2003

Abstract
Characterization of Ag nanocluster in poly(methyl methacrylate), PMMA, and kinetic observation on the polymerization of MMA in the presence of silver(I) complex have been investigated. On the basis of these studies, it was revealed that the growing polymer radical is responsible for the reduction of Ag ion and the heat-treatment appears to play an important role for the agglomeration and the formation of Ag cluster.