bluuebunny/crossref_metadata_2025_split huggingface dataset:
Understanding Web server configuration issues
Authors: Arlitt Martin , Williamson Carey 
Published: January 2004

AbstractThis paper proposes a methodological approach to the evaluation of Web server performance in a simple local area network test environment. The paper examines how different system and application configuration parameters can, over a range of workloads, impact the performance of a Web server. Our approach relies on relatively fine‐grain reporting of performance data for a broad set of system‐level metrics. Graphical visualization of these performance indices helps to identify the primary system bottleneck in each configuration studied.The Apache Web server is used as a case study to demonstrate the methodology. Our experiments quantify the performance implications of several configuration decisions common to any Web server implementation, and also serve to illustrate several performance anomalies specific to the Apache Web server (if misconfigured). Copyright © 2004 John Wiley & Sons, Ltd.
Exploring students' responses to conceptual questions when engaged with planned writing experiences: A study with year 10 science students
Authors: Hand Brian , Hohenshell Liesl , Prain Vaughan 
Published: January 2004

AbstractWhereas there has been strong advocacy of the value of writing for learning in science, the role of student planning in this approach and the relationships between planning, writing, and learning have been underresearched. Our mixed method study aimed to address this issue by seeking to identify quantitative differences in learning outcomes between two groups of students exposed to varying degrees of planning activities in writing‐to‐learn experiences. We also identified differences in learning outcomes between a group of students with two writing experiences and a group with one writing experience. Results indicate that students with planned writing activities did not score significantly better on conceptual questions as a group than students who had delayed planning experiences. Students with two writing experiences as opposed to one also scored significantly better as a group on answering conceptual questions both immediately after the writing experience and on a test 8 weeks after the unit. The difference in writing treatment initially significantly affected males compared with females but this effect disappeared with further opportunities to write. Students' comments provide support for using nontraditional writing tasks as a means to assist learning, particularly when the focus is on an audience different from the teacher. In reporting on different learning outcomes for the two groups, we consider various implications including identification of some key conditions for student writing to serve learning. © 2004 Wiley Periodicals, Inc. J Res Sci Teach 41: 186–210, 2004
Role of the microcomputer‐based laboratory display in supporting the construction of new understandings in thermal physics
Authors: Russell David W. , Lucas Keith B. , McRobbie Campbell J. 
Published: January 2004

AbstractTeachers' failure to use the microcomputer‐based laboratory (MBL) more widely may be a result of not recognizing its capacity to transform laboratory activities. This research aimed to increase understanding of how MBL activities designed to be consistent with a constructivist theory of learning support or constrain student construction of understanding. The first author conducted the research with his Year 11 physics class of 15 students. Dyads addressed 10 tasks in thermal physics using a predict–observe–explain format. Data sources included video and audio recordings of students and teacher during four 70‐minute sessions, students' computer data and written notes, semistructured student interviews, and the teacher's journal. Analysis of students' discourse identified many instances in which students' initial understandings of thermal physics were mediated in multiple ways by the screen display. The findings are presented as eight assertions. Recommendations are made for developing pedagogical strategies incorporating MBL activities that will likely catalyze student construction of understanding. © 2004 Wiley Periodicals, Inc. J Res Sci Teach 41: 165–185, 2004
Fostering radical conceptual change through dual‐situated learning model
Authors: She Hsiao‐Ching 
Published: January 2004

AbstractThis article examines how the Dual‐Situated Learning Model (DSLM) facilitates a radical change of concepts that involve the understanding of matter, process, and hierarchical attributes. The DSLM requires knowledge of students' prior beliefs of science concepts and the nature of these concepts. In addition, DSLM also serves two functions: it creates dissonance with students' prior knowledge by challenging their epistemological and ontological beliefs about science concepts, and it provides essential mental sets for students to reconstruct a more scientific view of the concepts. In this study, the concept “heat transfer: heat conduction and convection,” which requires an understanding of matter, process, and hierarchical attributes, was chosen to examine how DSLM can facilitate radical conceptual change among students. Results show that DSLM has great potential to foster a radical conceptual change process in learning heat transfer. Radical conceptual change can definitely be achieved and does not necessarily involve a slow or gradual process. © 2004 Wiley Periodicals, Inc. J Res Sci Teach 41: 142–164, 2004
Crossing cultural borders into science teaching: Early life experiences, racial and ethnic identities, and beliefs about diversity
Authors: Brand Brenda R. , Glasson George E. 
Published: January 2004

AbstractThe purpose of this ethnographic study was to explore the development of belief systems as related to racial and ethnic identities of preservice teachers as they crossed cultural borders into science teaching. Data were collected throughout a yearlong teacher preparation program to learn how early life experiences and racial and ethnic identities of preservice teachers influenced both their beliefs about diversity in science classrooms and science teaching pedagogy. Case studies of three preservice teachers from diverse racial and ethnic background are presented: Asian American, African American, and Rural Appalachian. Using Bank's ethnicity typology, findings suggest that racial and ethnic identity, developed in early life experiences of preservice teachers, provided clarity on the rigidity of their beliefs about diversity and how they view science teaching. By learning about the border crossing experiences of preservice teachers in relation to their beliefs about diversity as related to racial and ethnic identities, the researchers hoped to provide insight on preparing preservice teachers for the challenges of working in diverse classrooms. © 2004 Wiley Periodicals, Inc. J Res Sci Teach 41: 119–141, 2004
Resection of Hilar Cholangiocarcinomas: Pivotal Prognostic Factors and Impact of Tumor Sclerosis
Authors: Puhalla Harald , Gruenberger Thomas , Pokorny Herwig , Soliman Thomas , Wrba Fritz , Sponer Ulrike , Winkler Thomas , Ploner Meinhard , Raderer Markus , Steininger Rudolf , Mühlbacher Ferdinand , Laengle Friedrich 
Published: January 2004

AbstractThe well‐known poor prognosis of proximal bile duct cancer is due to its unfortunate anatomical location and its late diagnosis. Successful tumor resection, which is considered to be optimal treatment, depends on many factors. Eighty‐eight patients suffering from proximal bile duct cancer underwent surgical exploration at our institution between 1977 and 1998. In 37 patients the tumor was resectable; in the remaining 51 patients exploratory laparotomy or a palliative operation was performed. The median survival after tumor resection was 18.6 months, but median survival after a palliative procedure or an exploratory laparotomy was only 3.4 months (p < 0.001). A curative R0 resection was possible in 11 patients, an R1 resection was performed in 22 patients, and 4 patients had an R2 resection. The median survival rate after R0 resection was 83.6 months, 12.3 months after R1 resection, and 2.7 months after R2 resection (p < 0.001). Survival after resection in patients with negative lymph nodes (n = 30) was significantly longer than in those with positive lymph nodes (n = 7) (p = 0.022). Grade of tumor sclerosis tended to have an influence on resectability rate (p = 0.076). The pattern of tumor growth was without statistical influence. Multivariate analysis revealed resection (p < 0.001) as the only significant prognostic marker for patient survival. Radical resection is the only therapy that provides a chance for long‐term survival, with sclerosis of the cancer tending to have an influence on univariate analysis.
Role of Somatostatin in the Prevention of Pancreatic Stump‐related Morbidity following Elective Pancreaticoduodenectomy in High‐risk Patients and Elimination of Surgeon‐related Factors: Prospective, Randomized, Controlled Trial
Authors: Shan Yan‐Shen , Sy Edgar D. , Lin Pin‐Wen 
Published: January 2004

AbstractA prospective, randomized, controlled trial was performed to determine the efficacy of somatostatin in the prevention of pancreatic stump‐related complications with elimination of surgeon‐related factors in high‐risk patients undergoing panceaticoduodenectomy. From August 1997 to December 2000, 54 patients, 28 men and 26 women, with age ranged from 32 to 89 years, were randomly assigned to somatostatin group (n = 27) or placebo group (n = 27). Ninety‐four percent of the patients had pancreatic and periampullary lesions; 6% had secondary lesion involving the duodenum such as local recurrent colon carcinoma and renal cell carcinoma. These patients received either standard pancreaticoduodenectomy or pylorus‐preserving pancreaticoduodenectomy. An experienced surgeon performed all operations in same fashion to minimize the surgical factor. A transanastomotic tube was inserted into the pancreatic duct for diversion of pancreatic juice in the pancreaticojejunostomy for a 3‐weeks period postoperatively. Intravenous infusion of somatostatin was given at a dose of 250μg/hr in the somastotatin group and normal saline was given to the control group for 7 days postoperatively. There was one perioperative death in each group, resulting in a 3.7% mortality rate. In the somastotatin group, as compared to the placebo group, the incidence of overall morbidity and pancreatic stump related complications were significantly lower with a mean decrease of 50% pancreatic juice output and a slightly shorter duration of hospital stays. In conclusion, after excluding surgeon related factor, prophylactic use of somatostatin reduces the incidence and severity of pancreatic stump related complications in high‐risk patients having pancreaticoduodenectomy via decreased secretion of pancreatic exocrine.
Laparoscopy‐assisted Repair of Diaphragm Injuries
Authors: Shaw John M. , Navsaria Pradeep H. , Nicol Andrew J. 
Published: January 2004

AbstractIn this study we review our experience with an alternative laparoscopy‐assisted technique for repair of diaphragm injuries. All patients admitted with an isolated diaphragm injury who underwent laparoscopy‐assisted repair between January 1996 and February 2000 were included in the study. The diagnosis of the diaphragm injury was either obvious, with omentum herniating through the chest wall, or occult with confirmation of the injury at laparoscopy. Repair of the diaphragm was performed using standard surgical instruments via a 4‐cm subcostal incision with use of abdominal wall traction and the laparoscope for visualization of the defect. A total of 24 patients underwent successful laparoscopy‐assisted repair; There were twenty men and four women with an average age of 28.8 years (range 23–49 years). The average Revised Trauma score was 12. There were 23 grade II and 2 grade III diaphragm injuries. The mean operative time was 61 minutes (range 25–120 minutes) and the average hospital stay from the time of surgery to the time of discharge was 2.29 days (range 1–4 days). The procedure failed in one patient as a result of gaseous distension of the bowel. One patient developed a tension pneumothorax, and two others developed atelectasis. Laparoscopic‐assisted repair of isolated diaphragm injuries using abdominal wall traction and standard surgical instruments is a feasible option with minimal morbidity and no mortality.
Current Management of Colon Trauma
Authors: Maxwell Robert A. , Fabian Timothy C. 
Published: January 2004

AbstractThis article offers a comprehensive review of colon trauma from World War I to the present. The process of evidence‐based medicine was used to analyze the data from the past 25 years and define standards of care in the field. Where data are less compelling, recommendations and suggestions are provided for future research. Topics highlighted include destructive and nondestructive colon injuries, rectal injuries, on‐table colonic lavage, colonic bypass tubes, risk factors, perioperative antibiotics, and colostomy closure.
Immunohistochemical Evaluation for Intraoperative Rapid Pathological Assessment of the Gastric Margin
Authors: Matsusaka Satoshi , Nagareda Tomohumi , Yamasaki Hajime , Kitayama Yoshihiro , Okada Toshihiro , Maeda Shigeto 
Published: January 2004

AbstractIn patients undergoing surgery for gastric cancer, as the resection area is difficult to define preoperatively, we define the resection area by intraoperative rapid pathological assessment of the resected margin. In some patients, however, the result of postoperative assessment of a permanent section differs from the result obtained intraoperatively. In this study we explored methods of improving the accuracy of intraoperative pathological assessment. Of the patients who underwent surgery for gastric cancer at Takarazuka Municipal Hospital, between April 2000 and July 2001, intraoperative pathological assessment of the resection margin was performed in 34 because it could not be accurately defined preoperatively. The intraoperative assessment consisted of touch smear cytological examination and hematoxylin and eosin (HE) and cytokeratin (CK) histological examination. The time required to perform cytological examination and HE and CK immunohistochemistry by this modified method, which uses an ENVISION Kit/HRP, was approximately 20 minutes for each procedure. Touch smear cytological examination gave false positive results in 3 of 34 patients (8.8%). Of the 14 patients preoperatively diagnosed with signet‐ring cell carcinoma, intraoperative HE histological analysis yielded a false negative result in one (7.1%). The results of CK histological assessment of these patients were all consistent with those of postoperative examination of permanent sections. Of the 20 patients preoperatively diagnosed with non‐signet‐ring cell carcinoma, HE analysis yielded a false negative result in one (5%). The results of CK histological assessment of these patients were all consistent with those of postoperative examination of permanent sections. Our modified CK staining method with the ENVISION Kit/HRP allows intraoperative pathological assessment to be performed accurately and rapidly. This method is more useful than HE immunohistochemistry for the assessment of resected gastric margins.
Risk Factors for Nonhepatic Surgery in Patients with Cirrhosis
Authors: del Olmo Juan A. , Flor‐Lorente Blas , Flor‐Civera Blas , Rodriguez Felicidad , Serra Miguel A. , Escudero Amparo , Lledó Salvador , Rodrigo José M. 
Published: January 2004

AbstractCirrhosis of the liver appears to have an unfavorable prognosis in the surgical patient. The aim of this study was to determine risk factors for morbidity and mortality in patients with cirrhosis undergoing nonhepatic surgery. We studied 135 patients with liver cirrhosis undergoing nonhepatic procedures and 86 controls matched by age, sex, and preoperative diagnosis. Preoperative, intraoperative, and postoperative variables associated with 30‐day mortality and morbidity were assessed by univariate and multivariate analyses. Patients with cirrhosis showed higher blood transfusion requirements, longer length of hospital stay, and a higher number of complications than controls. The mortality rate was 16.3% in cirrhotics and 3.5% in controls. By univariate analysis, the need for transfusions, prothrombin time, and Child‐Pugh score were significantly associated with postoperative liver decompensation, whereas duration of surgery, prothrombin time, Child‐Pugh score, cirrhosis‐related complications, and general complications were significantly associated with mortality. In the multivariate analysis, Child‐Pugh score (odds ratio [OR] 24.4; 95% confidence interval [CI] 5.5 to 106); duration of surgery (OR 5; 95% CI 1.2 to 15.6), and postoperative general complications (OR 3.7; 95% CI 3.4 to 6.4) were independent predictors of mortality. Patients with cirrhosis undergoing nonhepatic operations are at significant risk of perioperative complications leading to death. Independent variables associated with perioperative mortality include preoperative Child‐Pugh score, the duration of surgery, and the presence of postoperative general complications.
Itemized Bill: Novel Method to Audit the Process of Laparoscopic Cholecystectomy
Authors: Pal Khawaja Mohammad Inam , Ahmed Mushtaq 
Published: January 2004

AbstractOne of the recurring obstacles to the successful completion of a medical audit cycle is the unavailability of accurate and complete information. This is particularly evident in the review of clinical processes, where the hand‐written medical record is the source of information. We have attempted to bypass this information deficit by using information recorded primarily for financial transactions, using the itemized bill. The study was conducted in two parts. Initially information recorded as an itemized bill for the in‐hospital process of laparoscopic cholecystectomies over a one‐year period was analyzed. Areas for change in practice were identified, and recommendations were developed. These recommendations were presented to a multidisciplinary group consisting of consultants, residents, and nursing staff involved in caring for these patients. A clinical pathway was developed and implemented from these recommendations. One year after introduction, a review of the clinical pathway was undertaken using the same methodology. The in‐hospital process consisted of 23 charge categories according to the itemized bill. Of these, 8 accounted for 95% of the total charge. The surgeon’s fee and the anesthesiologist’s fee accounted for 34% of the total; medical/surgical supplies, 20%; operating theater time, 17%; pharmacy, 7%; radiology, 5%; laboratory, 7%; and ward, 4%. Areas were identified in the latter 6 categories for change. Review of practice 1 year after implementation of the changes showed that a large number of recommendations were in place. We describe a new method for auditing the processes of medical care, using the itemized bill to adapt and use information primarily recorded for financial purposes.
Doxorubicin Activity Is Enhanced by Hyperthermia in a Model of Ex Vivo Vascular Perfusion of Human Colon Carcinoma
Authors: Pilati Pierluigi , Mocellin Simone , Rossi Carlo R. , Scalerta Romano , Alaggio Rita , Giacomelli Luciano , Geroni Cristina , Nitti Donato , Lise Mario 
Published: January 2004

AbstractThere is little information on the pharmacokinetics and pharmacodynamics of doxorubicin (DXR) administered during locoregional treatments of colon carcinoma under hyperthermic conditions. The aim of this study was to evaluate distribution and activity of DXR in healthy tissue and tumor tissues under hyperthermic conditions by using an experimental model of ex vivo isolated vascular perfusion of human colon segments bearing primary carcinoma. The influence of topoisomerase‐IIα (TPI2α) expression on the anti‐cancer activity of DXR combined with heat was evaluated as well. Twenty seven colon segments surgically resected for primary carcinoma were perfused ex vivo under physiological conditions (group A, n = 7), with DXR (group B, n = 6), under hyperthermic conditions (group C, n = 6), and with the combination DXR–hyperthermia (group D, n = 8). Samples of perfusate and tissues (normal and pathologic) were collected during 90 minutes of perfusion. Doxorubicin concentration in perfusate and tissues was assessed with high‐performance liquid chromatography. Protein expression of TPI2α, the main molecular target of DXR, was measured by image analysis in normal mucosa and tumor samples. Drug uptake was increased by heat equally in healthy and diseased tissue. Under hyperthermic conditions, DXR activity was significantly higher in pathologic mucosa than in normal mucosa. Furthermore, the activity of DXR combined with heat correlated with baseline TPI2α levels in tumor tissue. From these findings, it appears that heat sensitizes tumor cells—but not normal mucosa—to DXR activity. Furthermore, protein levels of TPI2α in pretreatment samples could predict tumor sensitivity to DXR.
Persistent Primary Hyperparathyroidism Caused by Adenomas Identified in Pharyngeal or Adjacent Structures
Authors: Chan Teresa J. , Libutti Steven K. , McCart J. Andrea , Chen Clara , Khan Anjum , Skarulis Monica K. , Weinstein Lee S. , Doppman John L. , Marx Stephen J. , Alexander H. Richard 
Published: January 2004

AbstractAbnormalities in the normal migration of the parathyroid glands during embryological development of the head and neck may result in considerable variability in the location of parathyroid tissue. Ectopic parathyroid adenomas present diagnostic and technical challenges and are frequently the cause of persistent primary hyperparathyroidism (HPT) after unsuccessful initial parathyroid surgery. We report a series of eight patients with persistent primary HPT who had adenomas in rare and unusual locations associated with various pharyngeal structures. Four were located within the epineurium of the vagus nerve at or above the level of the carotid bifurcation, and four were located within the paranasopharyngeal space or oropharynx. Noninvasive and invasive preoperative imaging studies were crucial in localizing the neoplasms in these patients and permitted the use of a direct surgical approach, resulting in cure in all patients and a low complication rate. The location of parathyroid glands in high pharyngeal and cervical structures is a consequence of anomalous or arrested descent through developing pharyngeal structures and illustrates the remarkable spectrum of ectopic parathyroid adenomas that occur secondary to this phenomenon.