bluuebunny/crossref_metadata_2025_split huggingface dataset:
Haemodynamic effects of volume resuscitation by hypertonic saline‐dextran (HSD) in porcine acute cardiac tamponade
Authors: Terajima K. , Åneman A. , Haljamäe H. 
Published: December 2003

Background:  Hypertonic saline‐dextran (HSD) has been utilized for small‐volume resuscitation in acute circulatory shock. However, HSD has also been reported to induce myocardial depression. The aim of this study was to examine the effects of HSD on cardiac performance and splanchnic perfusion in a low cardiac output model based on experimental cardiac tamponade.Methods:  Seven anaesthetized, mechanically ventilated pigs of both sexes (weight 24 ± 2 kg, mean ± SEM) completed a randomized, cross‐over protocol. A low cardiac output state was established by intrapericardial infusion of dextran. Animals were resuscitated by bolus infusions (4 ml kg−1 in 2 min) of either 7.5% hypertonic saline‐dextran or Ringer's acetated solution (RAc) and then observed during tamponade (20 min) and following its release (40 min). Central haemodynamics, portal venous (QPV) and renal arterial (QRA) flows were measured together with gastric, jejunal, hepatic and renal laser‐Doppler flowmetry.Results:  Resuscitation using HSD in a low cardiac output state completely restored QPV and improved gastric, jejunal, hepatic and renal microcirculation as assessed by laser‐Doppler flowmetry while no significant effect was observed in QRA. No such beneficial effects could be observed when animals were resuscitated using RAc. The improved haemodynamic state by HSD was maintained following release of cardiac tamponade while perfusion in RAc resuscitated animals returned to baseline or even remained depressed (hepatic and renal microcirculation). No signs of cardiodepression by HSD were observed.Conclusion:  Resuscitation using HSD in a low cardiac output state restored splanchnic perfusion and microcirculation without any signs of cardiodepression.
Cellular mechanism of pituitary adenylate cyclase‐activating polypeptide‐induced atrial tachyarrhythmia in canine isolated arterially perfused right atria
Authors: Hirose Masamichi , Chiba Shigetoshi 
Published: December 2003

Summary1. Pituitary adenylate cyclase‐activating polypeptide (PACAP) induces atrial tachyarrhythmia (AT). However, the cellular mechanism responsible for this remains unclear.2. In six canine isolated arterially perfused right atria, high‐resolution optical mapping techniques were used to measure action potentials during control conditions and after PACAP injection (1 nmol).3. During steady state pacing at a cycle length of 300 msec, the action potential duration was shorter during PACAP than during control (P < 0.001). In addition, maximum repolarization gradients during PACAP (4 ± 1 msec/mm) were similar to those during control (5 ± 1 msec/mm; n = 6). Transmural repolarization gradients were also similar between the two groups.4. After PACAP, AT was easily initiated with a single premature extrastimulus and was associated with a focal pattern of activation. However, AT was not initiated by a single premature stimulus during control.5. In conclusion, the PACAP‐induced AT is associated with a focal pattern of activation that is independent of local repolarization gradients. These data suggest that increased dispersion of repolarization is not necessarily required for the induction of AT.
Which types of non‐bleeding visible vessels in gastric peptic ulcers should be treated by endoscopic hemostasis?
Authors: AMANO Y , MORIYAMA N , SUETSUGU H , ISHIMURA N , IMAOKA T , KOMAZAWA Y , FUJISHIRO H , ISHIHARA S , ADACHI K , KINOSHITA Y 
Published: December 2003

AbstractBackground and Aims:  Because non‐bleeding visible vessels (NBVV) of gastric peptic ulcers have the potential to re‐bleed, endoscopic hemostatic treatment may be necessary during the first emergency endoscopy. However, not all NBVV re‐bleed, and endoscopic hemostasis sometimes causes fatal side‐effects. Therefore, we have evaluated the risk of re‐bleeding from various NBVV in gastric peptic ulcers to determine which types should be treated by endoscopy to prevent re‐bleeding.Methods:  A total of 227 NBVV in 202 patients with gastric peptic ulcers that were endoscopically followed without endoscopic hemostatic procedures were classified by the following factors: vessel color, form, location of the NBVV in the ulcer crater, and location of the ulcer in the stomach. The re‐bleeding rate was then analyzed for each type of NBVV.Results:  Significantly high rates of re‐bleeding were observed in cases with white, protruded and peripheral NBVV. In particular, white NBVV located in the peripheral zone of the ulcer crater were frequent re‐bleeding sources. The location of the ulcer in the stomach was not a statistically significant factor in determining re‐bleeding rates.Conclusion:  We found that white, protruded and peripherally located NBVV in gastric ulcers have a higher chance of re‐bleeding if preventive endoscopic hemostatic procedures are not performed.
Hepatic stellate cells in hepatitis C patients: Relationship with liver iron deposits and severity of liver disease
Authors: MARTINELLI ANA LC , RAMALHO LEANDRA NZ , ZUCOLOTO SERGIO 
Published: December 2003

AbstractBackground and Aim:  To determine the relationship between hepatic stellate cell (HSC) populations and severity of liver disease and liver iron deposits in patients with chronic hepatitis C virus (HCV). We also studied the relationship between iron cellular distribution and HSC population and the role of HFE mutations in the determination of iron deposits.Methods:  Forty‐nine chronic HCV patients with varying degrees of liver damage and liver iron deposits were studied. A liver biopsy was scored for histology activity index (HAI), fibrosis and iron deposits. The number of HSC in the liver was evaluated by an immunohistochemical double‐staining method to identify glial fibrillary acid protein (GFAP) and smooth muscle alpha‐actin (α‐SMA).Results:  The HSC population was significantly higher in HCV patients than in normal controls and was predominant in zones 1 and 3. Liver iron deposits were observed in 49% of patients and were mild/moderate in most cases. We found a significantly higher number of GFAP and α‐SMA positive cells in patients with liver iron deposits compared with those without iron deposits, and a positive correlation between liver iron scores and number (%) of GFAP and α‐SMA positive cells. We observed a significantly higher number of GFAP and α‐SMA positive cells in moderate/severe hepatitis than in minimal/mild hepatitis, and a positive correlation between GFAP and α‐SMA positive cells and HAI and fibrosis scores.Conclusions:  Liver iron deposits in chronic HCV are common and are associated with activation of HSC. Thus, even mild iron deposits might stimulate HSC and contribute to liver damage.
Randomized comparative study of surgical adjuvant chemotherapy using 5‐fluorouracil and dl‐leucovorin with CDDP, 5‐FU and dl‐leucovorin for advanced colorectal cancer
Authors: OKABE SATOSHI , ARAI TAKEHIRO , YAMASHITA HIRONORI , SUGIHARA KENICHI , SASAKI TSUNEO 
Published: December 2003

AbstractBackground:  5‐fluorouracil (5‐FU) is the most useful chemotherapeutic agent for colorectal carcinoma. Recently, the effectiveness of multidrug therapy in modifying the anticancer activity of 5‐FU for advanced cases was clarified. We conducted a randomized comparative study of surgical adjuvant chemotherapy comparing cis‐diamminedichloroplatinum (CDDP), 5‐FU and dl‐leucovorin (LV) (PFL therapy) with dl‐LV and 5‐FU (FL therapy) in patients who underwent curative resection of stage II and III colorectal carcinoma.Methods:  Thirty‐one patients, 13 ungergoing PFL therapy and 18 undergoing FL therapy, completed the scheduled administration, while 20 dropped out. Administration schedules were as follows: PFL therapy consisted of 13 mg/m2 CDDP, 300 mg/m2 5‐FU and 30 mg/body weight LV for 5 consecutive days. The FL therapy consisted of 300 mg/m2 5‐FU and 30 mg/body weight LV for 5 consecutive days in hospital. Both regimens were followed by biweekly administration of the same dosages of LV and 5‐FU in an outpatient setting.Results:  Seven of 23 patients in the PFL therapy group and five of 28 patients in the FL therapy group experienced recurrence of colorectal carcinomas. Regarding prognosis of stage II patients, both groups showed similar results in 5‐year disease specific survival and disease‐free survival. However, stage III patients obtained better prognostic results in the FL therapy group than in the PFL therapy group. Major toxicities in these regimens were vomiting and leukopenia, both being more frequent in the PFL therapy group. Symptoms of toxicity resolved completely in all patients.Conclusion:  From the present study we found that PFL therapy brought no benefit for stage II and III colorectal carcinoma compared with FL therapy. We should search for more appropriate adjuvant therapy, increasing the therapeutic effect of 5‐FU + LV for stage II and III colorectal carcinoma.
Walking speed as a good predictor for maintenance of I‐ADL among the rural community elderly in Japan: A 5‐year follow‐up study from TMIG‐LISA
Authors: Suzuki Takao , Yoshida Hideyo , Kim Hunkyung , Yukawa Harumi , Sugiura Miho , Furuna Taketo , Nishizawa Satoshi , Kumagai Shu , Shinkai Shoji , Ishizaki Tatsuro , Watanabe Shuichiro , Shibata Hiroshi 
Published: December 2003

Background  A population‐based prospective cohort study was undertaken to examine the predictors of functional decline in instrumental activities of daily living (I‐ADL) among non‐disabled older Japanese subjects living in a rural community during a five‐year interval from 1992 to 1997.Methods  The subjects consisted of 624 men and women aged from 65–89 years and independent in I‐ADL at baseline, who could be completely followed for five years. Independent variables were various physical factors potentially associated with higher level of functional capacity obtained from an interview survey and medical examinations at baseline. Dependent variables were functional status in I‐ADL obtained at the time of the 5‐year follow‐up.Results  Significant predictors of functional decline in I‐ADL during a 5‐year follow‐up period included: (1) older age; (2) higher blood pressure; and (3) lower maximum walking speed at baseline. Among these predictor, the maximum walking speed is likely to the strongest predictor for the decline in I‐ADL.Conclusion  The ability to walk faster in the old age is strongly associated with independence in the other I‐ADL, and walking speed should be modified by the lifestyle to strengthen muscles of the lower extremities in daily life.
An intervention study to improve the nutritional status of functionally competent community‐living senior citizens
Authors: Kumagai Shu , Watanabe Shuichiro , Shibata Hiroshi , Amano Hidenori , Hujiwara Yoshinori , Yoshida Yuko , Shinkai Shoji , Yukawa Harumi , Yoshida Hideyo , Suzuki Takao 
Published: December 2003

Objective:  To evaluate the feasibility and effectiveness of a program to improve the dietary habits and nutritional status of functionally competent community‐living senior citizens.Design:  A four‐year community‐based intervention.Setting and methods:  The study population was a representative sample of functionally competent seniors aged ≥ 65 years (229 men, 357 women, mean age: 71.0 years) living in a rural area (Nangai village, Northern Japan). Formal services (lectures and practice sessions, focusing mainly on improvement of dietary habits and other aspects of lifestyle) were provided to the community over a 4‐year period (1996–2000). Food frequency questionnaires assessed changes in consumption of the seven main food groups for the region (meat, fish and shellfish, eggs, milk, dark‐colored vegetables, fruit, and fats and oils). Serum albumin and hemoglobin concentrations were measured immediately before and after the intervention. Changes over the intervention period were contrasted with those in an age‐ and gender‐matched population of 179 men and 293 women from the same community who had been observed during the previous four years (1992–1996).Results:  The frequency of consumption of meat, dark‐colored vegetables, and fats and oils increased significantly in the intervention population, in contrast to the observational population, where the frequency of consumption of meat, fish and shellfish, fats and oils decreased. In apparent consequence, the intervention population showed a significant increase of serum albumin (men and women) and of hemoglobin (women only), whereas the observational population showed decreases in serum albumin and hemoglobin in both men and women.Conclusions:  These services provided were feasible and effective in improving dietary habits, and enhancing the nutritional status of functionally competent community‐living senior citizens.
Impact of history or onset of chronic medical conditions on higher‐level functional capacity among older community‐dwelling Japanese adults
Authors: Fujiwara Yoshinori , Shinkai Shoji , Kumagai Shu , Amano Hidenori , Yoshida Yuko , Yoshida Hideyo , Kim Hunkyung , Suzuki Takao , Watanabe Shuichiro , Ishizaki Tatsuro , Shibata Hiroshi 
Published: December 2003

Background:  Many studies have examined the impact of chronic medical conditions on the age‐related decline in basic activities of daily living (BADL) and the instrumental activities of daily living (IADL), but less is known concerning the influence of chronic disease on physical, cognitive, social, and economic aspects of higher‐level functional capacity.Methods:  Subjects comprised 793 and 725 persons aged 65–84 years, living in an urban and a rural Japanese community, respectively. A baseline interview established any history of chronic medical conditions. Four years later, a second interview again assessed chronic disease, and higher‐level functional capacity was evaluated using the Tokyo Metropolitan Institute of Gerontology (TMIG) Index of Competence.Results:  Multiple logistic regression analysis revealed that declines in total score and/or any of three subscales of the TMIG Index of Competence were significantly associated with a history of chronic disease, the onset of visual impairment and the development of hearing impairment, even after controlling for the subject's age, gender, educational attainment, and baseline TMIG Index of Competence. Episodes of stroke were significantly associated with declines in IADL. Hypertension, diabetes mellitus, and heart disease were also significantly associated with a decrease in functional competence, although each affected a different subscale of the TMIG Index of Competence.Conclusions:  The present results underline the importance of controlling chronic medical conditions through a physically active lifestyle and an appropriate medical regimen in order to limit the age‐related decline in functional capacity.
Active life expectancy based on activities of daily living for older people living in a rural community in Japan
Authors: Ishizaki Tatsuro , Yoshida Hideyo , Kumagai Shu , Watanabe Shuichiro , Shinkai Shoji , Suzuki Takao , Shibata Hiroshi , Imanaka Yuichi 
Published: December 2003

Objectives:  To examine functional transitions in activities of daily living (ADL) over a one‐year interval among older Japanese living in a rural community, and to estimate their active life expectancy (ALE) based on ADL.Design:  A prospective cohort study.Setting:  A community‐based environment.Participants:  A total of 1069 residents aged 65 or older in Nangai Village, Akita, JapanMeasurements:  A structured interviewed questionnaire, which involved age, sex, and four ADL items, was used for each survey in both 1996 and 1997. We defined functional dependency in ADL as a loss of independence in any ADL item. In addition, we defined ALE as the average number of remaining life years free of ADL dependence at a given age.Results:  Of the baseline cohort (n = 1069), we received 1068 analyzable questionnaires at the follow‐up survey in 1997. During the follow‐up, 95% of subjects who were initially independent in ADL remained independent. Active life expectancies for men and women were estimated to be 15.4 and 17.8 more years at 65 years of age, respectively.Conclusion:  The study revealed that women had longer average life years than men in terms of ADL disabilities.
Untying The Gordian Knot: The Multiple Links Between Exchange Rates and Foreign Direct Investment
Authors: PAIN NIGEL , VAN WELSUM DESIRÉE 
Published: December 2003

AbstractTheoretical and empirical studies show that the level and volatility of exchange rates can have significant effects on foreign direct investment (FDI). But the evidence is ambiguous, with the impact of exchange rates being heterogeneous across countries and types of investment, and varying over time. Fixed exchange rate regimes may stimulate investment, but largely because of their indirect benefits for the investment climate rather than because of lower currency volatility, especially in larger economies. Careful judgements still need to be made about the appropriate entry rate, since real exchange rate levels can have a long‐lasting impact on the spatial distribution of economic activities and living standards.
A Macroeconomic Analysis of EU Accession under Alternative Monetary Policies
Authors: DEVEREUX MICHAEL B. 
Published: December 2003

AbstractThis article provides an analytical discussion of the adjustment to EU accession for an economy under alternative assumptions about monetary policy rules. The post‐accession phase is characterized by rapid capital inflows and real exchange rate appreciation. If accession is combined with membership of the euro area and a pegged exchange rate, then the post‐accession period exhibits excessive foreign borrowing, high wage inflation, an excessive stock market boom, and much too rapid growth in the non‐traded sector at the expense of the exportable goods sector. Alternative monetary policies can be used to eliminate the inefficiencies of the post‐accession adjustment, but some bring real costs in terms of lower growth and unemployment. We find that the best policy is one of flexible inflation targeting with some weight on exchange rate stability. In the absence of exchange rate adjustment, fiscal policy could be used, but this requires complicated time‐varying expenditure taxes. While the analytical discussion emphasizes the benefits of exchange rate adjustment, a later section of the article explores some more recent arguments regarding non‐traditional costs of exchange rate volatility.
Institutional recipes as a source of information about food habits*
Authors: Mitchell Janet 
Published: December 2003

AbstractThe School of Home Science at the University of Otago, Dunedin, New Zealand was established in 1911 to enable women to obtain a university qualification in Home Science. Accommodation was provided for students in the Home Science Hostels. From 1940 until 1990 the hostels accommodated approximately 120 students each year. In 1943, a set of recipe cards was published for use in hostel kitchens. They were used continuously as a basis for hostel meals until 1993 and were revised four times during the period. It is suggested that an explanation of the original selection of the recipes together with an interpretation of additions and omission over the period would mirror and explain changing attitudes to food in New Zealand society. The content of the sets was examined, omissions and additions noted and a comparison made with recipes included in popular New Zealand and American household cookbooks. Overall, it was found that factors that influenced the make‐up of the recipe set and bought about change were: the background of the Foods Department staff, the hostel food supervisors, the requirements of the student residents, nutritional guidelines and food ideologies. The first recipe set revealed some American influence, but over the period, despite the institutional context, hostel meals, remained fairly traditional and mirrored the food practices of most New Zealand households.
Deskilling the domestic kitchen: national tragedy or the making of a modern myth?**
Authors: Lyon Phil , Colquhoun Anne , Alexander Emily 
Published: December 2003

AbstractIn the UK, television cookery programmes engage the attention and enthusiasm of large audiences. Celebrity chefs are household names whose books nearly always top best‐seller lists. Magazines and newspapers routinely include meal recipes and reports on food‐related issues. In this sense, the domestic preparation of food has probably never attracted greater public interest. Paradoxically, much is also now said and written about the general loss of practical cooking skills. The latter takes on a special significance especially in relation to adverse changes in UK eating patterns and food safety problems. The paper contributes to an understanding of this paradox by examining what has happened to food preparation skills. The 20th century was a context for massive social and technological changes, and these were reflected in the domestic environment. Among younger cohorts many of traditional food preparation skills have atrophied but to some extent we can view this in terms of changed timescales of acquisition. Also, on the basis of historical evidence, there may be grounds for optimism in a re‐evaluation of the extent and diversity of cooking skills in the past.
Linking Objectives to Actions: A Decision Support Approach Based on Cause–Effect Linkages
Authors: Tan Kim Hua , Platts Ken 
Published: December 2003

ABSTRACTThe process of translating objectives into actions is a difficult task. This difficulty is due to the wide range of possibilities and the lack of structured information. Managers must take into account relevant information and generate a range of options before a decision is reached. So far, little is available to guide managers in translating a set of objectives into actions. This paper presents a three‐stage action‐planning process to address this gap. The process, supported by a software tool, takes managers through the stages of model building, action generation, and action evaluation and selection. A case study illustrates the application of the process. The paper concludes by discussing the implication of this work for managers and academics.
Improving Decision Effectiveness of Artificial Neural Networks: A Modified Genetic Algorithm Approach
Authors: Sexton Randall S. , Sriram Ram S. , Etheridge Harlan 
Published: December 2003

ABSTRACTThis study proposes the use of a modified genetic algorithm (MGA), a global search technique, as a training method to improve generalizability and to identify relevant inputs in a neural network (NN) model. Generalizability refers to the NN model's ability to perform well on exemplars (observations) that were not used during training (out‐of‐sample); improved generalizability enhances NN's acceptability as a valid decision‐support tool. The MGA improves generalizability by setting unnecessary weights (or connections) to zero and by eliminating these weights. Because the eliminated weights have no further impact on the training (in‐sample or out‐of‐sample data), the relevant variables can be identified from the model. By eliminating unnecessary weights, the MGA is able to search and find a parsimonious model that generalizes well. Unlike the traditional NN, the MGA identifies the model variables that contribute to an outcome, helping decision makers to rationalize output and accept results with greater confidence. The study uses real‐life data to demonstrate the use of MGA.