bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multilateralism, Regionalism, Bilateral and Crossregional Free Trade Arrangements: All Paved with Good Intentions for ASEAN?
Authors: Low Linda 
Published: December 2004

Current initiatives in Asia and Asia Pacific regionalism are responses to regionalism happening elsewhere in the context of globalization, information communication technology and knowledge‐based economy. The conclusion is that many economies are ‘having it both ways’ in multilateralism under World Trade Organization (WTO) and new regionalism. The argument is that the ‘first best’ theory of free trade under multilateralism and WTO have fallen short. A ‘second best’ theory of new regionalism has been acknowledged by the Doha ministerial declaration to complement and supplement WTO. Both Asia challenged Asia‐Pacific Economic Cooperation (APEC) and the Association of South‐East Asian Nations (ASEAN) are challenged by ASEAN Plus Three (APT), which originated from the Asian crisis in the failed Asian Monetary Fund (AMF). Singapore has responded to these challenges in bilateral trading agreements, driven by its idiosyncratic features of a small, city–state economy and frustrated by laggard ASEAN. Increasingly, there is a divergence in macroeconomic policy between Singapore and ASEAN in terms of openness and competition. The dilemma in Singapore's strategy of bilateral trading agreements and foreign economic trade policy is precisely this divergence in macroeconomic philosophy and policy. The pressure on ASEAN is no less from APT, China and regionalism elsewhere than from Singapore. However, the present paper concedes that bilateral and crossregional trading arrangements are still second best, and that broader regionalism and multilateralism are still superior. With so many regional trading arrangements and emerging competition policy there may be rules of origin or ‘spaghetti bowl’ effects for Singapore. In ‘realpolitiks’ and real political economy, the balancing of gains and benefits is not easy.
Technical Efficiency of Industrial State‐Owned Enterprises in Vietnam
Authors: Vu Quoc Ngu 
Published: December 2004

Measured among themselves, industrial state‐owned enterprises (SOE) in Vietnam have recorded a rather high level of technical efficiency, as well as a moderate improvement in technical efficiency between the 1997 and 1998. Of the possible factors, the share of skilled workers, location in Ho Chi Minh City (formerly Saigon) and engagement in export activities were considered the most important in determining the technical efficiency level. Between 1997 and 1998 there was no evidence of technological progress. For the ongoing SOE reform process in Vietnam, attention should be given to improving the skills of the work force and to encouraging the export‐led development strategy. Creating a competitive envir‐onment and a fully developed system of market‐supporting institutions is also highly needed. In addition, it is necessary to invest in new technology for industrial SOE in Vietnam.
Call My Bluff: Multiple Interpretations of an Organizational Process
Authors: Brooks Ian 
Published: December 2004

This paper attempts to illustrate the value of interpreting organizational processes from a variety of perspectives. It demonstrates that this approach reflects the natural richness of organization and avoids the rather blinkered search for single‐paradigm explanations. It does not seek to offer the answer, but rather some possible insights. By combining both actor and researcher frames, it sheds light upon a particular process of social interaction within an organization. Both the context, an NHS trust hospital, and the content, a significant change scenario, brings richness and relevance to the debate.The paper outlines the macro and micro context before focusing on the interpretative methodological approach. The research involved collecting and analysing over thirty hours of taped, semi‐structured interview discourse with senior and middle management and some junior staff. After describing the change initiative, an attempt at multi‐skilling and the response of recipient actors to the proposals, the paper outlines three readings which seek to explain the events that occurred. The reader is invited to play the game ‘Call my Bluff’ and to choose the scenario that represents the most plausible explanation. The three interpretative frames employed are a managerial, a cultural and a political perspective. The paper concludes by raising some important issues in research, organizational change and the NHS.
Degenerate neuronal systems sustaining cognitive functions
Authors: Noppeney Uta , Friston Karl J. , Price Cathy J. 
Published: December 2004

AbstractThe remarkable resilience of cognitive functions to focal brain damage suggests that multiple degenerate neuronal systems can sustain the same function either via similar mechanisms or by implementing different cognitive strategies. In degenerate functional neuroanatomy, multiple degenerate neuronal systems might be present in a single brain where they are either co‐activated or remain latent during task performance. In degeneracy over subjects, a particular function may be sustained by only one neuronal system within a subject, but by different systems over subjects. Degeneracy over subjects might have arisen from (ab)normal variation in neurodevelopmental trajectories or long‐term plastic changes following structural lesions. We discuss how degenerate neuronal systems can be revealed using (1) intersubject variability, (2) multiple lesion studies and (3) an iterative approach integrating information from lesion and functional imaging studies.
Graft repair of the peroneal nerve restores histochemical profile after long‐term reinnervation of the rat extensor digitorum longus muscle in contrast to end‐to‐end repair
Authors: Lehnert M. , Maier B. , Frank J. M. , Steudel W. I. , Marzi I. , Mautes A. 
Published: December 2004

AbstractDeclining motor function is a prominent feature of ageing physiology. One reason for this is a reduction in plasticity that normally compensates for ongoing reorganization of motor units under physiological conditions. Previous work from our laboratory has shown that microsurgical repair of the transected peroneal nerve is followed by considerable changes in the histochemical profile of the reinnervated extensor digitorum longus (EDL) muscle and that these changes are dependent on both the time and the type of nerve repair. At 6 months postoperatively, a trend toward reversibility could be discerned. In the present work, we analysed the long‐term reorganization of histochemical motor unit distribution patterns 15 months after performing either end‐to‐end repair or grafting of the peroneal nerve in 3‐month‐old rats. In addition, the EDL muscles of an age‐matched control group (age 18 months) were analysed for age‐dependent changes. We observed a loss of histochemical organization of motor units leading to an additional fibre type (SDH‐INT) in the control group. Fifteen months after end‐to‐end repair, the histochemical profile showed a decrease in fibre type IIA and an increase in fibre type SDH‐INT (P < 0.05), indicating a profound histochemical disorganization of motor units. In contrast, nerve grafting largely restored the histochemical profile of reinnervated EDL muscles. Fibre type grouping was present after both types of nerve repair. These findings show that reorganization of the histochemical profile in reinnervated muscles is dependent on the time and type of nerve repair and is long lasting. In this study, grafting provided superior results compared with end‐to‐end repair. These long‐term results after peripheral nerve repair are influenced by age‐dependent changes. Accordingly, nerve repair reduces the normal functional plasticity of motor unit organization. This reduction is enhanced by increasing age.
Craniofacial variability and morphological integration in mice susceptible to cleft lip and palate
Authors: Hallgrímsson Benedikt , Dorval Curtis J. , Zelditch Miriam Leah , German Rebecca Z. 
Published: December 2004

AbstractA/WySnJ mice are an inbred strain that develops cleft lip with or without cleft palate (CL/P) with a frequency of 25–30% and a predominantly unilateral expression pattern. As in humans, the pattern of incomplete penetrance, and variable and frequent unilateral expression suggests a role for altered regulation of variability (developmental stability, canalization and developmental integration) during growth. We compared both mean and variability parameters for craniofacial shape and size among A/WySnJ mice, a strain that does not develop CL/P (C57BL/6J) and their F1 cross. We show that adult A/WySnJ mice that do not express cleft lip exhibit decreased morphological integration of the cranium and that the co‐ordination of overall shape and size variation is disrupted compared with both C57BL/6J mice and the F1 cross. The decrease in integration is most pronounced in the palate and face. The absence of this pattern in the F1 cross suggests that it is determined by recessive genetic factors. By contrast, the shape differences between the strains, which are thought to predispose A/WySnJ mice to CL/P, show a range of dominance which suggests a polygenic basis. We suggest that decreased integration of craniofacial growth may be an aetiological factor for CL/P in A/WySnJ mice.
On the role of general system theory for functional neuroimaging
Authors: Stephan Klaas Enno 
Published: December 2004

AbstractOne of the most important goals of neuroscience is to establish precise structure–function relationships in the brain. Since the 19th century, a major scientific endeavour has been to associate structurally distinct cortical regions with specific cognitive functions. This was traditionally accomplished by correlating microstructurally defined areas with lesion sites found in patients with specific neuropsychological symptoms. Modern neuroimaging techniques with high spatial resolution have promised an alternative approach, enabling non‐invasive measurements of regionally specific changes of brain activity that are correlated with certain components of a cognitive process. Reviewing classic approaches towards brain structure–function relationships that are based on correlational approaches, this article argues that these approaches are not sufficient to provide an understanding of the operational principles of a dynamic system such as the brain but must be complemented by models based on general system theory. These models reflect the connectional structure of the system under investigation and emphasize context‐dependent couplings between the system elements in terms of effective connectivity. The usefulness of system models whose parameters are fitted to measured functional imaging data for testing hypotheses about structure–function relationships in the brain and their potential for clinical applications is demonstrated by several empirical examples.
Individual identity and organisational control: Empowerment and Modernisation in a Primary Care Trust
Authors: McDonald Ruth 
Published: December 2004

AbstractThe notion of empowerment has been increasingly used within management discourses in recent years. Enthusiastic supporters conceive it as an acknowledgement of the individual employee as a talented, creative being, and hence a productive resource for contributing to organisational goals. Alternatively, more critical commentators have interpreted it as another means of exercising control over employees and their identities. Although various commentators have speculated on the management of identity as a means of organizational control, there is very little empirical work from which to draw conclusions. This paper, using participant observation and interview data, represents a contribution to the small body of empirical research in the area. It focuses on an initiative aimed ostensibly at ‘empowering’ staff in an English Primary Care Trust, which may be seen as an attempt at increasing organisational control by shaping employee identities. As such, these processes can be understood more readily in terms of ethics rather than empowerment. The term ethics is used here in a Foucauldian sense and is linked to the processes of self‐definition and self‐constraint by which individuals train themselves to become ethical persons. The paper suggests that the outcome of attempts to manufacture particular forms of subjectivity by such methods as ‘empowerment’ programmes may be very different from those intended.
The interactional management of patients’ physical incompetence: a conversation analytic study of physiotherapy interactions
Authors: Parry Ruth Helen 
Published: December 2004

AbstractPatients’ physical incompetence is a feature of many clinical interactions; the challenges it presents are not only technical but also interactional. This paper examines how interpretations and interactional consequences of physical incompetence are dealt with during stroke physiotherapy. A conversation analytic approach was used to examine video‐recorded treatment sessions. Analysis demonstrated that managing physical incompetence forms an important element of the organisation of these interactions. Through their conduct, patients and therapists limit and counter its various negative implications, including those which attribute it to failure of a patient's efforts, co‐operation and personal competence, and failure of therapy. Understanding orientations to incompetence and their influence upon interactions provides some explanations, or ‘good reasons’, for certain features of clinical interactions that have attracted criticism. Analysis also shows how management of incompetence is grounded in the clinician's authority and contributes to its maintenance.In the face of failures of physical competence, participants collaboratively and continually work to portray patients as deserving of treatment rather than sanction, and to convey that despite evident difficulties, the therapeutic process is a co‐operative and successful endeavour. The paper examines how these meanings are addressed and accomplished through interaction.
Understanding complex trajectories in health and social care provision
Authors: Allen Davina , Griffiths Lesley , Lyne Patricia 
Published: December 2004

AbstractEnsuring collaboration between health and social care providers is a well‐established policy concern in most developed countries. Thus far, however, this has proved to be a frustratingly elusive goal. Despite the growing body of empirical work devoted to this issue, social scientific theorising on the management of complex caring trajectories remains under‐developed. This paper is an attempt to begin to address this gap in the literature. Drawing onStrausset al.'s (1985) writings on illness trajectories andElias's (1978) game model, we offer a framework – centred on the notion of a caring trajectory game – that can assist understanding of the linkages between individual trajectories of care and broader health and social care systems. It is only when we have developed a more theoretically sophisticated understanding of this relationship that we can begin to explain why trajectories of care take the course that they do. The framework arises from our analysis of eight ethnographic case studies of adults undergoing rehabilitation from a first acute stroke. In this paper we illustrate its utility by reference to one specific case: Edward.
Furosemide responsiveness, non‐adherence and resistance during the chronic treatment of heart failure: a longitudinal study
Authors: MacFadyen Robert J. , Gorski J. Christopher , Brater D. Craig , Struthers Allan D. 
Published: December 2004

Background and methodsLoop diuretic therapy is an essential part of chronic systolic heart failure (CH)F management, yet response to treatment can be variable. We analysed diuretic responsiveness in 39 stable patients with CHF in the community over 2 years. We measured serum ACE as a marker of adherence to ACE inhibitor therapy and urinary furosemide as a marker of diuretic adherence and action. Patients’ clinical outcome was stable and not hospitalized (Group 0); alive but hospitalized (Group 1); or dead during follow up (Group 2).ResultsPrescribed furosemide dose was variable (range 20–370 mg generally once daily) and progressive dose increments were common. Failed furosemide adherence (defined as < 10% of a dose excreted in 24 h urine where normal average excretion = 50% of an oral dose) during static prescribed dosing was infrequent relative to all days of therapy; yet was equally common across all outcome groups. Furosemide non‐adherence appeared to be independent of non‐adherence with ACE inhibitor (as marked by serum ACE activity > 20 U l−1) treatment. Furosemide responsiveness (mm of sodium excreted per mg furosemide in urine) showed no relationship to prescribed dose and paradoxically tended to rise in patients with higher basal aldosterone concentrations. Furosemide responsiveness fell by outcome class despite increased dose. Within‐patient responsiveness remained relatively constant although highly variable between individuals.ConclusionsFurosemide responsiveness varied greatly between individuals but was constant within an individual. Non‐adherence with furosemide was less common among those who died and appeared to occur at different time points from non‐adherence with ACE inhibitor treatment, which was slightly more common in all outcome groups. Patients who died were prescribed higher furosemide doses and had greater furosemide excretion yet had similar sodium excretion. The main factor in response to chronic furosemide therapy was intrarenal diuretic resistance. Gross non‐adherence was less important.
A comparison of three different sources of data in assessing the frequencies of adverse reactions to amiodarone
Authors: Loke Yoon K. , Derry Sheena , Aronson Jeffrey K. 
Published: December 2004

AimsTo compare the frequencies of adverse drug reactions (ADRs) to amiodarone from three separate datasets: (i) a meta‐analysis of clinical trials, (ii) spontaneous reports published in medical journals, and (iii) spontaneous reports sent to the World Health Organization (WHO).MethodsWe classified the ADRs into eight categories, based on the site involved, and built a rank order of the ADRs by category (from most to least commonly reported) for each dataset. We also calculated the relative proportions for all eight ADR categories within each dataset, in order to be able to compare the distributions of ADR frequencies: we assigned an index value of 1.0 to the frequency of respiratory toxicity in each set and calculated values for the other ADRs relative to respiratory toxicity.ResultsThyroid disorders were the most commonly reported ADRs in the WHO dataset. In contrast, published case reports showed a preponderance of respiratory disorders, while in the meta‐analysis cardiac conduction problems were the most frequent. The rank orders of ADRs differed among the three datasets, as did the index values of specific ADR categories with respect to the respiratory category.ConclusionsThe distributions of ADR rank order and relative frequencies are dissimilar among the three datasets, as each dataset compiles information in a different way. Nevertheless, each dataset has its own specific strengths, and all three should be used together in obtaining a complete picture of a drug's safety profile. Important therapeutic and regulatory decisions should not simply be based on one source of data.
Theophylline has no advantages over caffeine as a putative model drug for assessing CYP1A2 activity in humans
Authors: Rasmussen Birgitte Buur , Brøsen Kim 
Published: December 2004

Aims The cytochrome P4501A2 (CYP1A2) catalyses the metabolism of a number of clinically used drugs, and thus there is an interest in determining the activity of CYP1A2 in patients before treatment with CYP1A2 substrates. Caffeine is the most commonly used model drug to assess CYP1A2 function, but due to the complex metabolism of caffeine, there is a need for an alternative drug to use as an index of CYP1A2 activity. In this study the CYP1A2 substrate theophylline was tested as a possible alternative to caffeine as a model drug for CYP1A2. Methods Twelve healthy volunteers ingested 200 mg of caffeine, and the caffeine metabolic ratios (CMR), CMRurine=(AFMU+1MX+1MU)/17DMU and CMRplasma=17DMX/137TMX were determined 6 h after drug intake. After a period of about 2 months the volunteers ingested 257 mg theophylline and blood samples were drawn and urine was collected during the following 48 h. The oral and partial clearances of theophylline were calculated via N‐demethylation and 8‐hydroxylation. The theophylline metabolic ratios, 1MU/13DMX and 3MX/13DMX being evaluated as indices of CYP1A2 catalysed N‐demethylation and 13DMU/13DMX as an index of partly CYP1A2 catalysed 8‐hydroxylation, were estimated in 0–12 h, 0–24 h and 0–48 h urine samples, and in plasma and spot urine samples 6 h after the intake of theophylline. Results The theophylline plasma ratios for the N‐demethylation pathways correlated with the oral clearance of theophylline (rs=0.881‐0.934, P<0.001) and with the respective formation clearances of the metabolites (rs=0.712‐0.925, P<0.05). Furthermore, all of the theophylline plasma ratios correlated with the caffeine plasma ratio (rs=0.645‐0.663, P<0.05). None of the caffeine metabolic ratios and none of the 6 h urinary theophylline ratios correlated with the oral or the partial clearances of theophylline (rs=0.042‐0.556, P >0.05). The theophylline 0‐12 h urine ratios correlated with the oral clearance of theophylline (rs=0.677‐0.757, P<0.05) and with the respective formation clearances of the metabolites (rs=0.705‐0.750, P<0.05). However, none of the theophylline urine ratios correlated with any of the caffeine metabolic ratios. Conclusions In summary the theophylline 6 h plasma and 0–12 h urine ratios 1MU/13DMX and 3MX/13DMX, both reflecting N‐demethylation seem to be predictors of the CYP1A2 mediated metabolism of theophylline, whereas only the plasma ratio correlated with the caffeine plasma 17DMX/137TMX ratio. Thus, it would appear that the plasma theophylline N‐demethylation ratios are superior to the urine ratios as indices of CYP1A2 activity. However, because in some individuals the concentrations of theophylline metabolites in plasma were close to the limit of detection, it is concluded that theophylline does not have marked advantages over caffeine as a model drug for assessing CYP1A2 activity.
The haemodynamic effects of subcutaneous sumatriptan, a 5HT1‐receptor agonist
Authors: Hood Stuart , David Birnie  , Hillis Stewart 
Published: December 2004

Aims Previous in vivo studies with sumatriptan, a 5HT1‐receptor agonist, have demonstrated vasopressor responses in the pulmonary and systemic arterial circulation. Pulmonary artery wedge pressure (PAWP) also increases after sumatriptan injection, raising the possibility of an additional venoconstrictive action or a negative inotropic effect. The mechanism for the rise in PAWP was investigated in the study. Methods Ten patients undergoing diagnostic coronary arteriography underwent haemodynamic monitoring. Results There was a significant rise (P<0.05) in systemic and pulmonary arterial pressure and total systemic and pulmonary vascular resistance. There was a similar rise (P<0.05) in PAWP and left ventricular end diastolic pressure (LVEDP). There was no change in cardiac output nor in peak rate of left ventricular pressure rise (dP/dt). Conclusions The sumatriptan induced rise in PAWP and LVEDP appears consequent upon increased afterload although a negative inotropic effect cannot be excluded.