bluuebunny/crossref_metadata_2025_split huggingface dataset:
MERKEL CELL CARCINOMA: IMPROVED OUTCOME WITH ADJUVANT RADIOTHERAPY
Authors: Veness Michael J. , Perera Lakmalie , McCourt Junie , Shannon Jennifer , Hughes T. Michael , Morgan Gary J. , Gebski Val 
Published: May 2005

Background:  Merkel cell carcinoma is an aggressive primary cutaneous neuroendocrine carcinoma. Patients remain at high risk of locoregional and distant relapse despite treatment. Most studies support the incorporation of locoregional adjuvant radiotherapy in reducing the risk of relapse.Methods:  Between 1980 and 2002, 86 patients diagnosed with Merkel cell carcinoma were treated with curative intent at Westmead Hospital, Sydney. Multivariate analysis was performed using Cox regression analysis. Disease‐free survival and overall survival was calculated using Kaplan–Meier survival curves.Results:  Median age at diagnosis was 75 years (range 46–89 years) in 49 men and 37 women. Median duration of follow up was 31 months (range 6–153 months). Fifty‐one (59%) patients presented with a primary lesion, 19 (22%) with a primary lesion and clinical nodal disease and 16 (19%) with lymph node metastases from an unknown primary. A total of 47 of 86 (55%) relapsed with regional nodal relapse, the commonest site of first relapse. Local relapse was similar for patients undergoing surgery (5/37; 14%) compared with surgery and adjuvant radiotherapy (3/25; 12%). Nodal relapse occurred in 14 of 36 (37%) treated with surgery compared with 7 of 38 (18%) patients treated with surgery and adjuvant radiotherapy. Patients treated with surgery and adjuvant radiotherapy experienced a better median disease free survival compared to those undergoing surgery alone (10.5 months vs 4 months; P < 0.01). The 5‐year overall and disease‐free survival rate for the entire study population was 47% and 25%, respectively. Twenty‐six patients (30%) died as a result of Merkel cell carcinoma.Conclusion:  Merkel cell carcinoma is an aggressive skin cancer. The addition of adjuvant radiotherapy markedly improves regional control rates and should be considered best practice.
INEQUALITIES IN RURAL HEALTH CARE: DIFFERENCES IN SURGICAL INTERVENTION BETWEEN METROPOLITAN AND RURAL WESTERN AUSTRALIA
Authors: Ng Jonathon Q. , Hall Sonja E. , Holman C. D’Arcy J. , Semmens James B. 
Published: May 2005

Background:  To compare surgical procedure rates between metropolitan and rural/remote residents in Western Australia (WA).Methods:  The WA Data Linkage System was used to identify all patients who underwent a procedure for cataract, ureteric calculi or urinary outflow obstruction symptoms for the time periods 1981–2000, 1981–1997 and 1981–1995, respectively. Age‐standardized procedure rates were calculated and Poisson regression modelling was used to estimate effects of locality of residence and demographic covariates.Results:  Overall, rural/remote patients underwent first‐time procedures for cataract (IRR 0.92; 95% CI 0.90–0.94), ureteric calculi (0.76; 0.72–0.80), or urinary outflow obstruction (0.71; 0.69–0.74) less frequently than patients in the metropolitan area. They were also significantly less likely to undergo multiple procedures for cataracts (0.90; 0.88–0.91) and ureteric calculi (0.69; 0.67–0.73).Conclusion:  A distinctly reduced level of surgical intervention was found in rural patients for three generally non‐life threatening conditions. The reasons for this require further investigation.
EXPERIENCE OF SENTINEL NODE BIOPSY ALONE IN EARLY BREAST CANCER WITHOUT FURTHER AXILLARY DISSECTION IN PATIENTS WITH NEGATIVE SENTINEL NODE
Authors: Soni Naresh K. , Spillane Andrew J. 
Published: May 2005

Aims:  The aims of surgical therapy of breast cancer are loco‐regional tumour control and staging. Axillary staging is still considered the single most important prognostic indicator in breast cancer. Surgical removal of axillary nodes remains the standard way to assess their involvement in most centres. The morbidity associated with axillary dissection (AD) is well recognized. In recent years sentinel node biopsy (SNB) has evolved. Multiple studies suggest it has the same accuracy as AD in axillary staging and less morbidity in early breast cancer (EBC). SNB has become the standard of practice in EBC in many parts of the world. In Australia, the preference has been to wait for the results of the Sentinel Node versus Axillary Clearance (SNAC) trial as well as other international trials before accepting SNB as a standard of care. The experience of a single surgeon with SNB alone in EBC without further completion axillary dissection (CAD) in negative sentinel node (SLN) is described in the present paper.Methods:  An audit was done of the senior author's prospective data from the Royal Australasian College of Surgeons database. Other information was added retrospectively from case notes.Results:  Between December 2000 and December 2003, 154 EBC cases (153 patients) underwent SNB alone. An average of four SLN was removed. Of these cases, 31.8% had positive SLNs (excluding 2.6% cases that had isolated tumour cells), of these, 93.9% had metastases (39.1% micro‐ and 60.9% macro‐metastases) in axillary‐SLN (ASLN) and almost all of these had CAD. ASLNs were the only positive nodes in 73.9%. Extra‐ASLN retrieved in 68.8% of 34% demonstrated on lymphoscintigraphy. Of these, 12.1% were positive (6.1% micro‐ and macro‐metastases each), all internal mammary. Mean follow up was 22.1 months. There was one local‐regional‐systemic and one systemic recurrence over this time.Conclusion:  SNB has a valid role in staging of the axilla particularly in low‐risk patients. After adequate self audit, SNB offers a minimal morbidity and reliable method of axillary staging. Patients choosing SNB alone must understand that the long‐term results of the randomized controlled trial are still pending for level I evidence of long‐term efficacy.
Conceptualising Lifelong Learning: a reflection on lifelong learning at Lund University (Sweden) and Middlesex University (UK)
Authors: ABUKARI ABDULAI 
Published: May 2005

AbstractLifelong Learning has in recent years become a fundamental element of many educational policy strategies aimed at achieving the goal of socio‐economic development. The role of universities in this is viewed by some as crucial and requires some attention. This article examines the concept of lifelong learning and suggests another way in which it could be conceptualised. It further reflects on how two European universities understand and implement lifelong learning and the implications for European regional educational policies in view of the knowledge society.
A Conceptual Schema Language for the Management of Multiple Representations of Geographic Entities
Authors: Friis‐Christensen Anders , Jensen Christian S , Nytun Jan P , Skogan David 
Published: May 2005

AbstractMultiple representation of geographic information occurs when a real‐world entity is represented more than once in the same or different databases. This occurs frequently in practice, and it invariably results in the occurrence of inconsistencies among the different representations of the same entity. In this paper, we propose an approach to the modeling of multiple represented entities, which is based on the relationships among the entities and their representations. Central to our approach is the Multiple Representation Schema Language that, by intuitive and declarative means, is used to specify rules that match objects representing the same entity, maintain consistency among these representations, and restore consistency if necessary. The rules configure a Multiple Representation Management System, the aim of which is to manage multiple representations over a number of autonomous federated databases. We present a graphical and a lexical binding to the schema language. The graphical binding is built on an extension to the Unified Modeling Language and the Object Constraint Language. We demonstrate that it is possible to implement the constructs of the schema language in the object‐relational model of a commercial RDBMS.
Analysing Product‐Specific Behaviour to Support Process Dependent Updates in a Dynamic Spatial Updating Model
Authors: Arnold Lesley M , Wright Graeme L 
Published: May 2005

AbstractA scale‐independent database that allows derived maps to be dynamically updated from a centrally maintained data source is an appealing alternative to traditional map revision techniques, which by today's standards are costly and inefficient. This paper presents a dynamic spatial updating model that supports automated updating of non‐standard maps in a scale‐independent database‐centric map production environment. Maps derived from the database are not separate data sets, but rather active views of the database. Each derived map is displayed in a unique way by implementing cartographic operations at the map level. While the operations applied require user involvement for strategic cartographic decisions, and algorithmic initiation and control, the technique allows geographic data to be processed cartographically without affecting the geometric integrity of the database. Each time a derived map is opened it retrieves the spatial data (and updates) from the database and applies the unique cartographic representation methods that persist on the individual derived maps. Database updates are automatically triggered to cartographic products, as process dependent updates, according to their individual product‐specific behaviour. This paper investigates product‐specific behaviour (product multiplicities) and the cartographic processing requirements to support dynamic spatial updating techniques in an object‐oriented map publishing environment. These techniques are implemented in an off‐the‐shelf software environment using ArcGIS.
Deriving Directional Variance from Covariance Matrix
Authors: Li Xingong 
Published: May 2005

AbstractDirectional variance characterizes the dispersion of a sample of directions. The derivation of directional variance, as it has appeared in the directional statistics literature, is from a geometric and intuitive approach. This short note presents a new derivation from the covariance matrix of directions. It provides a connection from directional variance to the covariance matrix of unit vectors.
Intellectual Disabilities and Socioeconomic Inequalities in Health: An Overview of Research
Authors: Graham Hilary 
Published: May 2005

Background There is an enduring association between socioeconomic position and health, both over time and across major causes of death. Children and adults with intellectual disabilities are disproportionately represented among the poorer and less healthy sections of the population. But research on health inequalities, and on the broader societal influences on health, has yet to be integrated into perspectives and policy for people with intellectual disabilities.Methods The paper reviews evidence on the patterns and causes of socioeconomic inequalities in health.Results It points to evidence that socioeconomic position is the fundamental determinant of health, drawing on longitudinal studies to highlight how it exerts its influence on health from before birth and across the lifecourse. The factors shaping an individual's socioeconomic position are also discussed.Conclusions The paper concludes by identifying research and policy challenges.
A Pilot of a Gerontological Advanced Practice Nurse Preventive Intervention
Authors: Hahn Joan Earle , Aronow Harriet Udin 
Published: May 2005

Background  Persons with an intellectual and developmental disability frequently face barriers in accessing preventive services in community‐based health care systems. As they age into middle years, they are at increased risk for functional decline. This paper presents a description of an advanced practice nurse (APN) intervention used in a pilot study that explored the feasibility of using an in‐home preventive model based on a comprehensive geriatric assessment with persons ageing with an intellectual and developmental disability.Method  The APN intervention was fully provided to a sub‐sample (n = 70) of 201 participants with an intellectual and developmental disability enrolled in a programme called ‘Stay Well and Healthy!’ The APN intervention included an initial home visit for a comprehensive geriatric assessment with follow‐up home visits to review health status and assess adherence with recommendations and provide education and support to promote health and prevent functional decline.Results  Advanced practice nurses identified a number of active health‐related problems for persons ageing with an intellectual and developmental disability (mean 5.2; range 1–14) that had potential effects on function and survival. The majority of recommendations (mean 14.4; range 6–35) were for clinical preventive services (42.2%) and self‐care for health‐related issues (36.8%).Conclusions  This study showed that there were problems consistent with persons ageing with an intellectual and developmental disability and older adults without disability. The in‐home preventive APN intervention to promote healthy ageing and reduce health disparities in this population is feasible, needed, and warrants further study.
The Development of a Health Status Measure for Self‐report by People with Intellectual Disabilities
Authors: Ruddick Loraine , Oliver Chris 
Published: May 2005

Background  Health status is an important domain of quality of life of people with intellectual disabilities. This paper describes the development of a self‐report health status measure for use with people with intellectual disabilities living in staffed community‐based accommodation, and reports preliminary reliability data for the schedule.Method  Question and response items were adapted from a well‐established measure (SF‐36) used in the general population incorporating subscales such as General Health, Physical Functioning, Bodily Pain, Vitality, Mental Health, and Sensory Functioning. A variety of closed and open response formats were used based on the growing literature examining methods for interviewing people with intellectual disabilities.Results  Internal reliability and response consistency were investigated. Reliability for Physical Functioning, General Health and Bodily Pain was reasonable, but was unsatisfactory for Sensory Functioning, and Mental Health.Conclusions  The findings are discussed in light of the challenge of eliciting reliable responses from people with intellectual disabilities. Question methodologies can be built upon in further research.
From Institutional to Community Support: Consequences for Medical Care
Authors: van Loon Jos , Knibbe Jeroen , Van Hove Geert 
Published: May 2005

Background  Concerns have been raised about the quality of medical care available for people with intellectual disabilities in community‐based services. The aims of this study were to evaluate a model of medical care developed during a programme of deinstitutionalization, based on a specialist physician supporting general practitioners (GPs).Method  Postal questionnaire survey of all 36 GPs participating in the specialist physician support programme. Responses were received from 22 participants (response rate 61%).Results  The majority of GPs agreed that clients with intellectual disabilities should receive services in primary care settings. While they also reported themselves to be capable of providing medical care to people with intellectual disabilities, they also reported the provision of specialist support to be important.Conclusions  It is possible to provide high quality medical care in community‐based settings if specialist support is made available for GPs.
Hospital Utilization among Persons with an Intellectual Disability, Ontario, Canada, 1995–2001
Authors: Balogh Robert S. , Hunter Duncan , Ouellette‐Kuntz Hélène 
Published: May 2005

Background  It has been suggested that persons with an intellectual disability consume a disproportionate amount of hospital services. Policy changes in Ontario in the 1970s and 1980s made it necessary for community health services to accommodate this population that formerly received most of its medical care in the institutions where they lived. It is frequently suggested that community health services are currently inadequate to care for this population.Methods  The study was a retrospective analysis of routinely collected hospitalization data for persons living in Ontario with an intellectual disability, between 1995 and 2001.Results  A substantial proportion of hospitalizations of persons with an intellectual disability were for mental disorders and dental diseases. Of all in‐hospital stays, one‐third were for mental disorders such as schizophrenia and depression. Of all day‐surgery admissions, almost 40% were for dental diseases corresponding to a high rate of dental procedures. The study also identified high ambulatory care‐sensitive condition hospitalization rates. In‐hospital surgical procedure rates, however, were low.Interpretation  This study is the first to fully describe patterns of hospitalization for persons with an intellectual disability in Ontario, Canada. A recurring finding is the large discrepancy between statistics for persons with an intellectual disability and published data for the general population. The study limitations mean further research is required to confirm the results and to determine if persons with an intellectual disability are receiving the health care they are entitled to in Ontario.
Abstract no.: 1  The vasorelaxing influence of adrenomedullin in isolated bovine retinal arteries
Authors: Boussery Koen , Delaey Christophe , Van de Voorde Johan 
Published: May 2005

Aims:  Adrenomedullin (AM), a peptide noted in a broad variety of tissues and cells, is known to induce relaxations in different vascular beds and isolated blood vessels, including the (extra‐ocular) central retinal artery. A role for AM in the regulation of ocular blood flow has been suggested, but so far no data were available on the direct influence of AM on smooth muscle tone in intra‐ocular retinal arteries. The present study therefore aimed to assess and to characterise the vasorelaxing effect of AM on isolated (intra‐ocular) bovine retinal arteries (BRA).Methods:  Retinal arteries were isolated from bovine eyes and mounted in a wire‐myograph for isometric tension recording. Concentration‐response curves were constructed by cumulative addition of AM (1 pM to 0.1 μM) in the organ bath.Results:  AM caused a concentration‐dependent relaxation of the BRA. The AM‐response was reduced after removal of the endothelium of the BRA (30 nM: from 38.14 ± 4.90% to 25.71 ± 4.32% relaxation, n = 7, P < 0.05). Also treatment of the BRA with the NOS‐inhibitor L‐NA or the soluble guanylyl cyclase inhibitor ODQ significantly reduced the AM‐response, whereas cyclo‐oxygenase inhibition or the adenosine receptor antagonist 8‐SPT had no effect. The AM‐receptor antagonist AM 22–52 caused a small, but significant reduction in the AM‐response (30 nM: from 55.33 ± 9.65% to 47.50 ± 8.26% relaxation, n = 6, P < 0.05). The CGRP‐receptor antagonist CGRP 8–37 caused a more pronounced decrease in AM‐response (30 nM: from 55.43 ± 10.53% to 17.77 ± 6.57% relaxation, n = 6, P < 0.05).Conclusion:  The present study demonstrates that AM induces vasodilation in isolated BRA. Thereby, our findings support the hypothesis that AM may have a role in the regulation of retinal blood flow. Endothelium‐derived NO and stimulation of CGRP‐ and AM‐receptors appear to be involved in the AM‐response, whereas prostanoids and activation of adenosine receptors are not involved.
Abstract no.: 3  Impaired clearance of apoptotic cells in atherosclerosis
Authors: Schrijvers Dorien M. , Martinet Wim , De Meyer Guido R.Y. , Kockx Mark M. , Herman Arnold G. 
Published: May 2005

Background:  Apoptotic cell death is a prominent feature of human atherosclerotic plaques. When the apoptotic remains of a cell are not efficiently removed, inevitable leaking of the cell content occurs, inciting an inflammatory reaction. Since human atherosclerotic plaques show signs of both apoptosis and inflammation, we questioned whether cells induced to undergo apoptotic cell death are efficiently removed.Results:  We compared the scavenging activity of macrophages in human carotid endarterectomy specimens with macrophages in human hyperplastic tonsils. The ratio of free versus phagocytized apoptotic cells was 19 times higher in the plaque, indicating a severe defect in clearance of apoptotic cells. To determine possible causes, fluorescently labelled apoptotic cells, were incubated with J774 macrophages or murine peritoneal macrophages under different atherosclerosis‐related conditions and phagocytosis was evaluated by flow cytometry. We found that overload of macrophages with inert particles (beads) prevented further uptake of apoptotic cells. Oxidative stress, induced by peroxynitrite donor SIN‐1A, significantly inhibited uptake of apoptotic cells as well. Oxidized erythrocytes (oxRBC) and oxidized low density lipoproteins (oxLDL) reduced phagocytosis of apoptotic cells by competition for the same receptor(s) on macrophages. Uptake of blood platelets did not affect phagocytosis of apoptotic cells.Conclusion:  Our results demonstrate that clearance of apoptotic cells is deficient in human atherosclerosis, due to overfilling of macrophages, oxidative stress and competitive inhibition by oxLDL and oxRBC. This lack of clearance could have severe consequences regarding further accumulation of necrotic debris, plaque thrombogenicity and stability of human atherosclerotic plaques.
Abstract no.: 7  Effects of gestational day 11 exposure to methylazoxymethanol acetate on Morris water maze performance, prepulse inhibition and latent inhibition in adult male Wistar rats
Authors: de Bruin N.M.W.J. , Talamini L.M. , Mahieu M. , Patel T. , Ashton D. 
Published: May 2005

In the present study, gestating dams were treated with methylazoxymethanol acetate (MAM). MAM causes DNA damage, and this mechanism kills actively dividing neurons and thereby disrupts neurogenesis. This has been considered to be a neurodevelopmental animal model of schizophrenia (Talamini et al. 1998, Brain Res. 789:293–306). Schizophrenic patients show deficits in learning/memory function, sensorimotor gating and latent inhibition. Our aim was to investigate whether we could observe similar deficits in adult offspring of MAM‐treated dams.Methods:  Pregnant Wistar rats received an injection of either solvent or 20 mg/kg (IP) of MAM on the 11th day of gestation. 12 hours later, the rats received a second injection with either saline or MAM. Four groups of animals were tested at adult age (>75 days old): (1) offspring of untreated naïve mothers; (2) offspring of mothers that received two solvent injections (sol/sol); (3) offspring of mothers that first received MAM and solvent with the second injection (MAM/sol); (4) offspring of mothers subjected to two MAM injections (MAM/MAM). The Morris water maze test was used as a measure for spatial learning and mnemonic capabilities. Sensorimotor gating was studied by means of the prepulse inhibition (PPI) paradigm. Finally, the latent inhibition (conditioned taste aversion) paradigm was used to assess learned irrelevance.Results:  (1) Animals learned to find the invisible platform in the Morris water maze. MAM did not disrupt acquisition in this test. There were also no differences in long‐term spatial memory in the Morris water maze probe trial. (2) Treatment groups did not differ in the level of PPI or startle reactivity. (3) No effects of MAM treatment were found on latent inhibition. (4) However, there was a difference in body weight between treatment groups: MAM/sol animals had a lower body weight than animals from the naïve group and MAM/MAM rats were significantly lower in weight compared to both the naïve and sol/sol animals.Conclusion:  Gestational day 11 exposure to MAM did not disrupt learning/memory function, prepulse inhibition or latent inhibition in adult male Wistar rats. The lack of effects of MAM on the above mentioned behavioral parameters in the present study brings into question the relevance of this model for the cognitive and information processing aspects of schizophrenia.