bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does a Second‐look Operation Improve Survival in Patients with Peritonitis due to Acute Mesenteric Ischemia? A Five‐year Retrospective Experience
Authors: Kaminsky Oleg , Yampolski Igal , Aranovich David , Gnessin Ehud , Greif Franklin 
Published: April 2005

AbstractSecond‐look laparotomy is one of the mainstays of surgical treatment of acute mesenteric ischemia (AMI). The aim of this study was to analyze its role in the survival of patients with infarcted gangrenous bowel resulting from AMI. A retrospective chart review of all patients admitted over the study period was undertaken. The study population consisted of 41 patients with clinical evidence of peritonitis and gangrenous, perforated bowel on surgical exploration. Outcome was compared among patients who underwent second‐look laparotomy and those who did not. Fifteen patients with an American Society of Anesthesiologists (ASA) score of less than 4 underwent second‐look laparotomy. Six patients had residual necrotic bowel that required additional resection. Only one (17%) of them survived. Of the nine remaining patients, who had no evidence of necrosis, only two survived (22%). Overall survival in this group was 20%. Twenty‐six patients were managed without second‐look laparotomy. Nine of them, with an ASA score of 4–5, died soon after the operation. The decision not to operate on the remaining 17 patients with an ASA score <4 was made by an experienced surgeon. Eleven of those patients (65%) survived. Overall survival in the non‐second‐look group was 42%. Excluding the early deaths, the survival in the non re‐explored group was significantly higher than in the second‐look group (65% vs. 20%, p = 0.011). A selective approach to the surgical treatment of acute mesenteric ischemia based on the sound clinical judgment of an experienced surgeon may be as appropriate as its universal application.
Local Platelet Trapping as the Cause of Thrombocytopenia after Hepatic Cryotherapy
Authors: Pistorius Georg A. , Alexander Christof , Krisch Carl‐Martin , Feifel Gernot , Schilling Martin K. , Menger Michael D. 
Published: April 2005

AbstractCryosurgery has been shown to be an effective approach to destruction of unresectable hepatic tumors. However, hepatic cryoablation may also be associated with local and systemic side effects, including thrombocytopenia and clotting dysfunction. Although thrombocytopenia is known to relate to the magnitude of hepatocellular injury, its etiology is still unknown. With the use of whole‐body scintigraphy after injection of indium‐111‐labeled platelets we here demonstrated in six patients undergoing cryoablation of hepatic tumors that manifestation of systemic thrombocytopenia after cryosurgery is associated with excessive platelet trapping and destruction within the cryolesion. We therefore conclude that local platelet trapping represents a major cause of cryothermia‐induced systemic thrombocytopenia.
Why We Need Confidence Intervals
Authors: Altman Douglas G. 
Published: April 2005

AbstractThe estimation approach to statistical analysis aims to quantify the effect of interest as an “estimate” of a clinically relevant quantity and to quantify the uncertainty in this estimate by means of a confidence interval (CI). As such, results expressed in this form are much more informative than results presented just as p values. This article focuses on the principles rather than the mathematics of CIs and discusses interpretation of CIs and some common misuses. CIs can be constructed for almost all analyses. They are especially useful for avoiding misinterpretation of nonsignificant results of small studies. CIs should be provided routinely for the main results of trials and observational studies.
Patient’s Preference and Randomization: New Paradigm of Evidence‐based Clinical Research
Authors: Millat Bertrand , Borie Frédéric , Fingerhut Abe 
Published: April 2005

AbstractThe limitations associated with the traditional randomized controlled design as applied to clinical surgical research must be recognized. The aim of randomization is to ensure initial comparability between groups of eligible patients for whom treatments are compared, thus eliminating their individual influence on outcome. Randomized controlled trials in the surgical literature are sparse; patient preferences might be a major obstacle to their performance. External validity of results of clinical trials depends on the representativity of patients who participate in trials: Compliance to participate through informed consent may act as a selection bias. In surgical randomized trials where it is not often possible for patients to remain blinded to the treatment to which they have been allocated, patient preferences can influence the effectiveness of treatments. In this setting, we need to look at alternatives and the potential advantages of adopting more flexible and clinically relevant approaches to the design of surgical trials. We have to accept the weight of the patient’s individual decision in everyday practice. Hence, to negate the importance of these individual choices when evaluating surgical outcomes is unrealistic. An original design reported herein might become a new paradigm for surgical evaluation.
Limits of Evidence‐based Surgery
Authors: Slim Karem 
Published: April 2005

AbstractEvidence‐based medicine can be summarized as the use of current best evidence in the care of individual patients. When applied to surgical practice, it appears clearly that the concept of evidence‐based medicine involves some limitations. To discuss these limits, the author went back over the terms of the evidence‐based medicine definition. Limits are related to the low quantity and quality of randomized controlled trials and meta‐analyses in surgery, the difficulties when critically appraising the literature and applying the results of evidence to individual patients, and bringing surgeons more willing to endorse the principles of evidence‐based medicine. However all these limits can be overcome in the future, with the aim that evidence‐based surgery will not be a passing fad.
GIS‐based regionalisation of radiation, temperature and coupling measures in complex terrain for low mountain ranges
Authors: Häntzschel Janet , Goldberg Valeri , Bernhofer Christian 
Published: April 2005

AbstractIn low mountain‐range areas with complex topography, climate elements show a high variability caused by manifold interactions between relief and land use. The lack of continuous measurements demands concepts for the transfer of regional climatic information to smaller scales. In this study, a radiation model and a coupled vegetation atmosphere model using GIS were combined to estimate radiation balances, temperature and evapotranspiration as well as coupling and feedback mechanisms between vegetation and atmosphere of small‐scale heterogeneous areas.In the system HIRGIS, these approaches were parameterised with the output of the vegetation‐boundary layer model HIRVAC and transferred in a GIS (ArcView) environment to consider topographic influences including sky view factors as well as the influence of different land uses (e.g. pasture and forest) especially on net radiation. Depending on the horizontal resolution of the digital elevation data, it is feasible to model area‐related meteorological surface data without any interpolation methods and associated loss of precision. The results are applicable to water budget modelling, forest management, alternative energy supply or downscaling of satellite information.To illustrate the results, the area of the Tharandter Wald near Dresden as well as the Sperrgraben watershed in the Bavarian Alps were selected. The results clearly show the combined effects of topography and land use. The differences of solar irradiance on a clear spring morning between slopes oriented east–west and south–east in the Tharandter Wald reach up to 800 W/m2. The daily sum of evapotranspiration on a steep, south‐facing spruce‐covered surface in the Sperrgraben watershed is two times higher than the evapotranspiration on a north‐facing grass surface.Model results match data collected at the ‘Anchor Station Tharandter Wald’ and from the Sperrgraben watershed for the periods under investigation. Copyright © 2005 Royal Meteorological Society.
Spatial interpolation‐based mapping of the spring frost hazard in the Champagne vineyards
Authors: Madelin M. , Beltrando G. 
Published: April 2005

AbstractThe Champagne vineyards, famous worldwide, are located at the northern limit of viticulture. Consequently, they are very sensitive to spring frosts that can occur after bud burst. These spring frosts occur mainly in radiative atmospheric situations (low speed wind, clear sky) where spatial variations in minimum temperatures are very important. The latter depend on several factors at different scales: from the macroclimatic scale, where the geographical location (latitude/longitude) has a strong influence, to the topoclimatic scale, where environmental and topographical factors play an important role. After a brief recall of the definition of these different factors extracted from a Digital Elevation Model and a land‐use database, we propose a spatial interpolation of minimum temperatures in the Champagne vineyards based on multiple regression. From this interpolation, we can map the frost hazard for the whole vineyard from data measured over five spring seasons (1998–2003) and for about 20 weather stations. In this paper, we present this mapping technique and compare it with the data for spring 2003 when particularly strong frosts occurred. Copyright © 2005 Royal Meteorological Society.
Maternal complications in women with chronic hypertension: a population‐based cohort study
Authors: Zetterström Karin , Lindeberg Solveig Nordén , Haglund Bengt , Hanson Ulf 
Published: April 2005

Background.  The aim of the study was to determine if pregnant women with chronic hypertensive disease have an independent risk for preeclampsia, gestational diabetes or placental abruption. To examine if superimposed preeclampsia in this group of women is related to an increased risk of placental abruption.Methods.  This study is a population‐based cohort study using the Swedish Medical Birth Register 1992–98. A population of 681 515 women aged between 15–44 years with singleton pregnancies, excluding women with systemic lupus erythematosus (SLE), diabetes mellitus and chronic renal disease were studied. Among these, 3374 women were diagnosed with chronic hypertensive disease. Multiple logistic regression analysis was performed and the outcome measures of crude and adjusted odds ratios (OR) were presented with 95% confidence intervals (CI).Results.  Chronic hypertensive disease is associated with multiparity, age, high body mass index and Nordic ethnicity. After controlling for confounders, chronic hypertensive disease is an independent risk factor for preeclampsia (OR 3.8; 95% CI 3.4–4.3), gestational diabetes (OR 1.8; 95% CI 1.4–2.4) and placental abruption (OR 2.3; 95% CI 1.6–3.4).Conclusion.  Chronic hypertensive disease is independently associated with an increased incidence of preeclampsia, gestational diabetes and placental abruption.
Impact of rapid socio‐economic changes on teenage pregnancies in Estonia during 1992–2001
Authors: Haldre Kai , Karro Helle , Rahu Mati , Tellmann Alvi 
Published: April 2005

Background.  Major socio‐economic changes, including health care reforms and changes in the school curriculum, took place in Estonia after the country regained its independence in 1991. These changes affected people's reproductive behavior in many ways. In this article, the impact of the changes on the reproductive behavior of teenage girls, measured by adolescent fertility and abortion rates between 1992 and 2001, is analyzed.Methods.  National data on abortions and births were obtained from official medical statistics, particularly from the Estonian Abortion Registry and the Estonian Medical Birth Registry. Female population denominators for the age group 15–19 were obtained from the Statistical Office of Estonia.Results.  In teenagers, the birth rate decreased more than two times, from 49.7 per 1000 in 1992 to 23.8 per 1000 in 2001. The abortion rate per 1000 decreased from 55.5 in 1992 to 30.4 in 2001. Compared with all women of fertile age (15–49 years), at the beginning of the decade, teenagers decided more often to have a baby, and, at the end of the decade, they decided more often to terminate the pregnancy. Two‐thirds of all pregnancies in teenagers end in abortion – either legally induced abortion (legal abortion and therapeutic abortion) or spontaneous abortion. In 2001, the abortion ratio was 116.4 among ethnic Estonians and 147.9 among non‐Estonians.Conclusions.  The case in Estonia again proves that the availability of information, contraceptives, services and education, and the existence of other goals in life besides childbearing, have an impact on teenage birth and abortion rates. Successful health promotion activities should take into consideration the differences in the reproductive behavior of different ethnic groups.
Evaluating cochlear implant trauma to the scala vestibuli
Authors: Adunka O. , Kiefer J. , Unkelbach M.H. , Radeloff A. , Gstoettner W. 
Published: April 2005

Objectives: Placement of cochlear implant electrodes into the scala vestibuli may be intentional, e.g. in case of blocked scala tympani or unintentional as a result of trauma to the basilar membrane or erroneous location of the cochieostomy. The aim of this study was to evaluate the morphological consequences and cochlear trauma after implantation of different cochlear implant electrode arrays in the scala vestibuli.Design: Human temporal bone study with histological and radiological evaluation.Setting: Twelve human cadaver temporal bones were implanted with different cochlear implant electrodes. Implanted bones were processed using a special method to section undecalcified bone.Main outcome measures: Cochlear trauma and intracochlear positions.Results: All implanted electrodes were implanted into the scala vestibuli using a special approach that allows direct scala vestibuli insertions. Fractures of the osseous spiral lamina were evaluated in some bones in the basal cochlear regions. In most electrodes, delicate structures of the organ of Corti were left intact, however, Reissner's membrane was destroyed in all specimens and the electrode lay upon the tectorial membrane. In some bones the organ of Corti was destroyed.Conclusions: Scala vestibuli insertions did not cause severe trauma to osseous or neural structures, thus preserving the basis for electrostimulation of the cochlea. However, destruction of Reissner's membrane and impact on the Organ of Corti can be assumed to destroy residual hearing.
Transcriptional Activation of the Oxytocin Promoter by Oestrogens Uses a Novel Non‐Classical Mechanism of Oestrogen Receptor Action
Authors: Koohi M. K. , Ivell R. , Walther N. 
Published: April 2005

AbstractTranscriptional activation of the gene coding for the neuropeptide hormone oxytocin by oestrogens does not follow the classical model of oestrogen receptor action. The oxytocin promoter does not contain an oestrogen response element (ERE), but instead a high‐affinity binding site for nuclear orphan receptors. In the present study, the oestrogen‐dependent up‐regulation of the bovine oxytocin promoter is investigated in MDA‐MB 231 cells. Control by oestrogen is shown to be dependent on the integrity of the nuclear orphan receptor binding site and the presence of ligand‐activated oestrogen receptor, but independent of oestrogen receptor binding to DNA. Partial agonists tamoxifen and raloxifen and the pure antagonist ICI 182 780 all show agonistic activities on transcription, while exhibiting normal binding affinities to oestrogen receptor (ER)α. Nuclear orphan receptors oestrogen receptor‐related receptor α (ERRα) and germ cell nuclear factor (GCNF) are expressed to significant levels in MDA‐MB 231 cells. Binding of ERRα to the oxytocin promoter binding site can be demonstrated, suggesting the involvement of this nuclear orphan receptor in oestrogen‐dependent up‐regulation. The oestrogenic stimulation of the oxytocin promoter apparently is dependent on the stimulation of the transcriptional activity of this nuclear orphan receptor by ERK‐1/ERK‐2 mitogen‐activated protein kinases (MAP kinases). This novel nonclassical mechanism of oestrogen action most probably is not restricted to the regulation of neuropeptide hormone expression, but may further contribute to the multitude of tissue‐specific effects of oestrogenic substances.
Can a Mixed Health Care System be Desirable on Equity Grounds?*
Authors: March Maurice , Schroyen Fred 
Published: April 2005

AbstractShould health care provision be public, private, or both? We consider this question in a setting where people differ in their earnings capacity and face some illness risk. We assume that illness reduces an individual's time endowment when waiting for treatment. Treatment can be obtained in a competitive private sector (through private insurance) or in the National Health Service (NHS) where it is provided free of charge but after some (endogenous) waiting time. The equilibrium in the health care sector consists of a waiting time in the NHS such that no patient wants to switch health care provider. This equilibrium is governed by two public policies: the income tax system and the size of the NHS. We find that: (i) a mixed system with a small NHS is never desirable; (ii) actuarially fair sickness insurance is never desirable either; (iii) a mixed system with a sufficiently large NHS may improve on a pure public system if the dispersion of earnings capacities is large enough; and (iv) the welfare gains from such a mixed system are not likely to be significant.
Unions: Rent Creators or Extractors?*
Authors: Skovsgaard Aidt Toke , Sena Vania 
Published: April 2005

AbstractThis paper proposes a model of workplace‐specific unions that integrates two views of what unions do. One view holds that unions mainly engage in rent extraction. Another view holds that unions mainly engage in rent creation by providing agency services that increase workplace productivity. We demonstrate that the choice between the two activities is systematically related to the economic and regulatory environment in which the union operates. Product market competition encourages rent creation, while labor market deregulation encourages rent extraction. Moreover, we provide a rationale for why firms may want to subsidize unions.
FLOATING CURRENCIES, CAPITAL CONTROLS, OR CURRENCY BOARDS: WHAT'S THE BEST REMEDY FOR THE CURRENCY CRISES?
Authors: Singal Vijay 
Published: April 2005

A number of different solutions have been proposed to deal with the Asian currency crisis. One proposal championed by the International Monetary Fund (IMF) is to allow the currencies to float while seeking to maintain their value through tight monetary policy. A second proposal calls for restrictions on capital flows. A third is establishment of currency boards, which seek to stabilize a currency's value by “pegging” it to the value of another currency.In examining each of these three alternatives, this article concludes that none offers a perfect solution. Capital controls are almost always bad, creating serious distortions throughout the economy and destroying investor confidence. Currency boards, as past experience suggests, can be effective in certain circumstances. Nevertheless, there are concerns that currency boards deprive countries of all policy flexibility (some of which could be helpful in coping with crises), are difficult to set up so as to maintain credibility, and may lack adequate reserves to instill confidence. Such concerns have stood in the way of using of currency boards in the cases of Russia and Indonesia.Having expressed reservations about these two “more radical” solutions, this article closes by noting the main problem with the IMF's prescription of floating currencies: its insistence on high interest rates and tight monetary policy. Because high interest rates tend to be ruinous for the local economy—and their effectiveness in limiting currency depreciation in times of crisis is far from clear—the author argues that interest rates should be raised only to compensate for inflation. Consistent with the recent experience of Brazil, the best solution may be just to allow currencies to float with a relatively loose monetary policy.
STRENGTHENING THE GLOBAL FINANCIAL SYSTEM: ASSESSING THE CRISIS AND THE POLICY RESPONSE
Authors: Haraf William S. 
Published: April 2005

The financial crisis that began with Thailand's devaluation in the summer of 1997 exposed significant weaknesses both in the structure of markets in emerging countries and in the crisis‐prevention and crisis‐management mechanisms built into the international financial system. Since then numerous efforts have been made to assess the causes of the crisis, and official institutions such as the Group of 7, the IMF, and the World Bank have laid out an agenda for reform.This article discusses the four cornerstones of the reform program:

Encouraging the development of sound, well‐structured banking sectors subject to well‐designed systems of bank regulation and supervision.
Ensuring that private institutions have the incentives, governance structures, and internal controls in place to avoid inappropriate risks.
Strengthening disclosure requirements to ensure that global lenders and investors have the quantity and quality of information they need to make informed judgments about risks and returns.
Ensuring that monetary, fiscal, and exchange rate policies are appropriate and resilient enough to permit emerging market governments to withstand a crisis.

As recommended in the article on Indonesia, the author encourages the private sector to make greater use of innovative financing arrangements to manage their risk exposures—for example, through standby lines of credit or pre‐negotiated options that would allow a debtor to automatically restructure its obligations under certain conditions.
The Common Viral Insertion Site
Evi12
Is Located in the 5′-Noncoding Region of
Gnn
, a Novel Gene with Enhanced Expression in Two Subclasses of Human Acute Myeloid Leukemia
Authors: van den Akker Eric , Vankan-Berkhoudt Yolanda , Valk Peter J. M. , Löwenberg Bob , Delwel Ruud 
Published: April 2005

ABSTRACT

The leukemia and lymphoma disease locus
Evi12
was mapped to the noncoding region of a novel gene,
Gnn
(named for
Grp94
neighboring nucleotidase), that is located immediately upstream of the
Grp94
/
Tra1
gene on mouse chromosome 10. The
Gnn
gene is conserved in mice and humans. Expression of fusion constructs between
GFP
and
Gnn
cDNA isoforms in HEK-293 cells showed that Gnn proteins are located mainly in the cytoplasm. Immunoblotting experiments demonstrated the presence of multiple Gnn protein isoforms in most organs, with the lowest levels of expression of the protein detected in bone marrow and spleen. The
Evi12
-containing leukemia cell line NFS107 showed high levels of expression of a ∼150-kDa Gnn isoform (Gnn
107
) that was not observed in control cell lines. Overexpression may be due to the viral insertion in
Evi12
. The Gnn
107
protein is probably encoded by a
Gnn
cDNA isoform that is expressed exclusively in NFS107 cells and that includes sequences of TU12B1-TY, a putative protein with homology to 5′-nucleotidase enzymes. Interestingly, using Affymetrix gene expression data of a cohort of 285 patients with acute myeloid leukemia (AML), we found that
GNN
/
TU12B1-TY
expression was specifically increased in two AML clusters. One cluster consisted of all AML patients with a t(8;21) translocation, and the second cluster consisted of AML patients with a normal karyotype carrying a
FLT3
internal tandem duplication. These findings suggest that we identified a novel proto-oncogene that may be causally linked to certain types of human leukemia.