bluuebunny/crossref_metadata_2025_split huggingface dataset:
How open were European primeval forests? Hypothesis testing using palaeoecological data
Authors: MITCHELL FRASER J. G. 
Published: January 2005

Summary

The Vera hypothesis that large herbivores maintained an open landscape in the primeval landscape of lowland Europe is tested using palaeoecological data. The hypothesis suggests that the high abundance of Quercus and Corylus apparent in European pollen diagrams could not have derived from a landscape dominated by closed canopy forests. If natural forest landscapes were indeed more open, current forest conservation management policy across Europe would need to be reconsidered.
Relative proportions of Quercus and Corylus pollen are compared from regions which supported large herbivores with data from Ireland, where large herbivores were excluded. Similarity between the two data sets indicates that large herbivores were not required to maintain these taxa in the primeval landscape.
Fine spatial resolution pollen data from small hollows in Europe and eastern USA were also reviewed. Data from moss polsters show that percentage arboreal pollen is a reliable indicator of canopy openness in theses sites. The palaeoecological data demonstrate that open canopy forest has only ever been maintained by human exploitation.
Large herbivores in Europe do not therefore appear to have maintained an open landscape in primeval times although evidence suggests that they would have influenced the species composition of the forest canopy.
It is proposed that data sources other than pollen should be explored as proxies for past forest structure to test this hypothesis more thoroughly.
Misrepresentations about palliative options and prognosis in motor neurone disease: some legal considerations
Authors: Foster Charles 
Published: January 2005

AbstractIf euthanasia were legalized, clinicians would be under a duty to explain to patients requesting euthanasia what the prognosis and palliative options were. Anecdotal evidence suggests that some patients suffering from motor neurone disease may request euthanasia because of a fear of choking to death. The literature indicates that with competent palliative care this is unlikely to occur. It is assumed, for the purposes of argument, that responsible clinicians would accordingly reassure patients that such a fear was unwarranted, and that such a reassurance would cause patients for whom choking was the main concern either to withdraw a request for euthanasia or not to make it in the first place. The legal consequences of both negligent and deliberate failure to represent the true prognostic and palliative situation are discussed. In the case of a deliberate failure, with the intention to induce the patient to consent to euthanasia, it is suggested that a verdict of murder would be ethically right. It is argued that such a failure is best regarded as an omission. The English law currently does not countenance the possibility of murder by omission. It is suggested that the distinction between acts and omissions, while sometimes convenient, can sometimes produce injustice, and that the distinction should not be allowed to prevent conviction for murder where this is clearly appropriate.
Breast cancer incidence: what do the figures mean?
Authors: Johnson Ann , Shekhdar Jane 
Published: January 2005

AbstractRationale, aims and objectives  Against the background of a general rise in the incidence of breast cancer temporal variations appear in different age groups, including changes attributable to the introduction of breast screening. This paper attempts to distinguish the influence of breast screening and to examine any underlying patterns.Methods  The incidence data published by the Office of National Statistics for England and Wales have been examined using the method of least squares regression. These data have been subjected to major revision: a new system was introduced in 1971. That year, therefore, has been taken as the starting point for the analyses. Regression lines were fitted from 1971, 1984 and 1988 (when breast screening was started).Results  Between 1971 and 1984 breast cancer incidence was unchanged in women under 50 years. In all other age groups and time periods the incidence has risen throughout 1971–1999. The rate of increase remained constant for women over 64 but changed in 1984 for all women under 65 years. The rate of increase is rising exponentially with age since 1984 in the women under 65. The superimposed increases due to screening have been separated from the underlying rates.Conclusions  In the period surveyed there appears to have been a change in the rates of increase in incidence of breast cancer in women under 65 that dates from 1984. This change can be separated from the spurious increase due to breast screening. The rates in women over 64 have remained constant.
Demographic and clinical characteristics of patients admitted to medical departments
Authors: Raveh D. , Gratch L. , Yinnon A.M. , Sonnenblick M. 
Published: January 2005

AbstractIntroduction  The significant changes, which have affected departments of medicine over the last two decades, have been much editorialized. Surprisingly few data have been published that document these changes. We describe the demographic and clinical characteristics of patients admitted to one hospital's departments of internal medicine. Methods  During a 3 months prospective study, 1039 patients (46% of all 2277 new admissions to the departments of medicine, consisting of ± 175 beds) were randomized for inclusion. Information was extracted from the medical records regarding  demography;  functional  capacity;  clinical  data  and  outcome.Results  The mean age of the patients was 72 ± 16 years (mean ± SD); 51% were male, 56% were married, and 83% lived at home. Although 293 patients (28%) were defined as dependent, the majority lived at home (170, 58%). Cognition was normal in only 74%. The four most common disease categories leading to admission were infections (383 patients, 37%), cardiovascular disorders (372, 36%), respiratory conditions (284, 27%) and genito‐urinary problems (90, 9%). Overall, 98 persons died (9%). Independent risk factors for death were: mechanical ventilation; a ‘do not resuscitate’ order; a high APACHE‐II score; a low serum albumin level; higher age; and not being married (P < 0.01).  Conclusions  Geriatric patients occupy a central position in our medical wards. These data are relevant for allocation of special resources for departments with high proportions of geriatric patients; for the design of employment conditions that ascertains continuing job satisfaction; as well as for the planning of teaching opportunities for residents and students.
Selecting a subjective health status measure for optimum utility in everyday orthopaedic practice
Authors: McQueen David A. , Long Michael J. , Schurman John R. 
Published: January 2005

AbstractBackground  The time required to complete patient  outcome question‐naires such as the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Short Form General Health Survey (SF‐36) and the Musculoskeletal Function Assessment (MFA) can sometimes threaten elderly, compromised patients sufficiently to compromise compliance with follow‐up clinics. Incomplete questionnaires can also present problems of data bias. A little used (in the USA), patient‐friendly questionnaire, the Nottingham Health Profile (NHP) has the potential to reduce the statistical and practical problems associated with the more generally used instruments. We hypothesized that NHP will produce similar results to WOMAC and SF‐36 and is more sensitive to small changes in patient outcomes than SF‐36 and MFA.Method  Twenty‐three patients blindly completed WOMAC, SF‐36 and NHP questionnaires. Spearman's Rank Order Correlation was used to compare the component scores of each instrument. Simulation of the before and after results of 10 fictitious patient comparing MFA and NHP was conducted using the related sample t‐test.Results  Seven of nine correlation coefficients were statistically significant and ranged from 0.711 to 0.901. The significance of the before and after difference on the five‐point scale response was P = 0.05 when the NHP was used and P = 0.07 when MFA was used. The before and after difference on ‘yes–no’ response questions was P < 0.001 when NHP was used but showed no difference when the MFA was used.Conclusions  Our hypothesis was supported and we suggest that NHP can be used with confidence as an alternative to other patient outcome instruments.
The epidemiology of peripheral vein complications: evaluation of the efficiency of differing methods for the maintenance of catheter patency and thrombophlebitis prevention
Authors: Myrianthefs Pavlos , Sifaki Maria , Samara Irini , Baltopoulos George 
Published: January 2005

AbstractBackground and aims  Peripheral vein catheter patency and infusion thrombophlebitis remains a significant problem in everyday clinical practice. The aim of the study was to investigate the epidemiology of peripheral vein complications and to evaluate three different methods for the maintenance of peripheral vein catheter patency and the prevention of vein thrombophlebitis.Methods  A total of 300 post‐operative patients undergoing elective orthopaedic surgery were prospectively studied. Patients were divided into three groups: controls – catheters not flushed following drug administration; saline group – the catheters flushed with 3 mL of normal saline 0.9% after each catheter use; heparin group – the catheters flushed with 3 mL of 100‐U/mL heparin in normal saline 0.9% after each catheter use.Results  Complications occurred in 36% of the patients and the incidence of thrombophlebitis was 8% and only 4% in the control group. In the normal saline group there was a significant increase in total complications and obstruction together with thrombophlebitis as compared with the control  group.  Kaplan‐Meier  curves  demonstrate  that  the  control  group  had a  significantly  higher  proportion  of  catheters  without  complications.Conclusions  The use of normal saline solutions in post‐operative patients thus should be avoided for catheter maintenance. In patients receiving low molecular weight heparin, no intravenous flushing should be used for preventing catheter obstruction or thrombophlebitis in order to reduce costs and nursing workload.
Novel rescue therapy for C4d‐positive acute humoral renal allograft rejection
Authors: Min Liu , Shuming Ji , Zheng Tang , Daxi Ji , Huiping Chen , Zhihong Liu , Leishi Li 
Published: January 2005

Abstract:  Objective:  To investigate the efficacy of immunoadsorption (IA) in combination with tacrolimus (TAC) and mycophenolate mofetil (MMF) rescue therapy for C4d‐positive acute humoral rejection (AHR) of renal transplants.Methodology:  Six of 185 cadaveric renal allograft recipients transplanted at our institute developed AHR over a mean period of 4.8 ± 0.8 d after operation. The ages ranged from 35 to 51 yr (mean 42.6 ± 5.6 yr). C4d deposits in peritubular capillaries (PTC) and accumulation of granulocytes in PTC were observed. IA with staphylococcal protein A and TAC–MMF combination therapy were given.Results:  After subjected to IA for 6.3 ± 1.03 sessions combined with TAC (0.14–0.16 mg/kg/d) and MMF (1.5 g/d) therapy, renal function recovered in all the patients. The mean duration of treatment when serum creatinine decreased was 14 ± 2.9 d. The pre‐IA panel reactive antibody reactivity was as high as 50.2 ± 6.1%, and was significantly reduced to 8.3 ± 2.9% after IA. Repeated allograft kidney biopsy in four of six patients revealed a favorable remission of AHR. With a mean follow‐up of 18.8 ± 5.46 months, patient and allograft survival are 100%, renal function remained stable with a mean serum creatinine of 1.2 ± 0.22 mg/dL.Conclusion:  The optimal treatment for alloantibody‐mediated AHR remains undefined. Our findings suggest that a therapeutic approach combining IA and TAC–MMF rescue has excellence to improve the outcome of AHR.
Standard chronic immunosuppression after kidney transplantation for systemic lupus erythematosus eliminates recurrence of disease
Authors: Dong Guanglong , Panaro Fabrizio , Bogetti Diego , Sammartino Cinzia , Rondelli Damiano , Sankary Howard , Testa Giuliano , Benedetti Enrico 
Published: January 2005

Abstract:  Background:  There is only limited experience in patients with systemic lupus erythematosus (SLE) with drugs that have developed for immunosuppression after organ transplantation, namely calcineurin inhibitors (CI). The aim of this study is to determine the effect of these drugs on disease activity after kidney transplant in patients affected by SLE.Methods:  Between January 1990 to March 2003, 13 patients with end‐ stage renal disease secondary to SLE received 14 kidney transplants. The outcome variables assessed include graft and patient survival as well as clinical and serological lupus activity.Results:  All received CI‐based immunosuppression (cyclosporine or tacrolimus). Actuarial patient and graft survivals at 5 yr were 100 and 93%, respectively. Recurrence of clinical or serological disease was never detected.Conclusions:  To date, only anecdotal experience with CI in the treatment of SLE has been reported. The favorable response observed in our patients suggests that CI at low‐doses are effective in preventing SLE‐reactivation. Further studies focused on calcineurin inhibitor treatment in SLE patients who fail to respond to standard medical management should be conducted.
Factors modifying stress from adverse effects of immunosuppressive medication in kidney transplant recipients
Authors: Rosenberger Jaroslav , Geckova Andrea Madarasova , van Dijk Jitse P , Roland Robert , van den Heuvel Wim JA , Groothof f Johan W 
Published: January 2005

Abstract:  Introduction:  The adverse effects of immunosuppression appear in the majority of patients with a negative impact on morbidity, mortality and quality of life. The group of adverse symptoms manifested as changes in appearance, mood and energy are often more stressful than serious metabolic changes because of their direct negative influence on patients’ well‐being. The aim of this study is to explore the adverse symptoms of immunosuppressive medication which are the most stressful for transplanted patients, and which are the modifying factors.Patients and methods:  A total of 157 adult kidney transplant recipients from two transplant centres in Slovakia with a functioning graft transplanted <7 yr ago were examined. Patients participated in an interview focusing on stress from adverse effects, and their education and social support. Medical records were searched for information about immunosuppression protocols, dialysis treatment before transplantation, type of received organ and period after transplantation. The effect of the selected variables on the total score for stress from adverse effects was tested using ANOVA. The effect of the selected factors on stress from each single adverse effect was explored using t‐test and ANOVA.Results:  The most stressful symptoms were pain, weakness, weight gain, facial changes, depression and anxiety. The mean value of the total score for stress from adverse effects was 8.03 ± 6.53 (minimum 0, maximum 30, range: 0–64), indicating low stress. Women and patients with lower education significantly more often felt the adverse effects of immunosuppression as stressful (p < 0.001 and p < 0.05, respectively). Age, social support, dialysis modality before transplantation, time from transplantation and type of immunosuppressive treatment did not affect the total score for stress from adverse effects. However, variables that were not significant in the overall score reached significance in some symptoms.Conclusions:  Women and patients with lower education significantly more often felt the adverse effects of immunosuppression as stressful; in a more detailed analysis the use of new drugs was connected with less stress in some symptoms. The use of these drugs can improve life quality for transplant recipients, decrease non‐compliance, and thus prevent graft loss.
Laparoscopic donor nephrectomy vs. open live donor nephrectomy: a quality of life and functional study
Authors: Buell Joseph F , Lee Lucy , Martin Jill E , Dake Natalie A , Cavanaugh Teresa M , Hanaway Michael J , Weiskittel Pat , Munda Rino , Wesley Alexander J , Cardi Michael , Ram Peddi V , Zavala Edward Y , Berilla Elaine , Clippard Marketa , Roy First M , Steve Woodle E 
Published: January 2005

Abstract:  Background:  Few studies have compared the quality of life (QoL) and functional recuperation of laproscopic donor nephrectomy (LDN) vs. open donor nephrectomy (ODN) donors. This study utilized the SF‐36 health survey, single‐item health‐related quality of life (HRQOL) score, and a functional assessment questionnaire (‘Donor Survey’).Methods:  Questionnaires were sent to 100 LDN and 50 ODN donors. These donors were patients whose procedures were performed at The University Hospital and The Christ Hospital in Cincinnati, Ohio.Results:  A total of 46 (46%) LDN and 21 (42%) ODN donors returned the completed surveys. The demographics of the two groups were similar. LDN patients reported a more rapid return to 100% normal health (69 vs. 116 d; p = 0.24), part‐time work (21.9 vs. 23.2 d; p = 0.09), and necessitated fewer physician office visits post‐operative (2.8 vs. 4.4; p = 0.01). ODN patients reported shorter duration of oral pain medication use (13.4 vs. 7.2 d; p = 0.02). However, a greater number of ODN patients reported post‐surgical chronic pain (3 vs. 6; p < 0.05) and hernia (0 vs. 2; p = 0.19). The overall QoL for both groups was comparable with the general USA population.Conclusions:  The results of this study support the decisions of many kidney transplant centers to adopt LDN programs as standard of care.
A prospective 3‐yr evaluation of tacrolimus‐based immunosuppressive therapy in immunological high risk renal allograft recipients
Authors: Zaltzman Jeffrey S. , Boucher Anne , Busque Stephan , Halloran Phillip F. , Landsberg David N. , McAlister Vivian C. , Russell David , Shoker Ahmed , Shapiro Jean , Tchervenkov Jean I. , Ferguson Ralph 
Published: January 2005

Abstract: Background: There have been no published data on use of the the newer immunosuppressants tacrolimus and mycophenolate mofetil (MMF) in high immunological risk renal transplantation. We therefore undertook a prospective study to systematically assess outcomes using these agents as part of an aggressive immunosuppressive regimen.Methods: Fifty‐nine high‐risk renal allograft recipients were enrolled at 10 Canadian sites and given a regimen of: a biological induction agent, tacrolimus, MMF, and corticosteroids. Patients included 10 (17%) who had lost a previous graft to rejection <1 yr, 31 (53%) with a current panel reactive antibody (PRA) >30%, 47 (80%) with a historic PRA >50%, four (7%) who had a positive historical T‐cell crossmatch with the current donor, and six (10%) with a current positive B‐cell crossmatch. The mean peak PRA was 76 ± 33%.Results: The estimated 3‐yr Kaplan–Meier patient and graft survival estimates were 89% and 75%, respectively. There were nine graft losses other than deaths with a functioning graft, of which six were preceded by delayed graft function (p = 0.01,χ2). Sixteen (27%) recipients experienced at least one episode of biopsy‐confirmed acute rejection. Infections included cytomegalovirus in 16 patients, eight of whom had tissue‐invasive disease. Only one malignancy occurred.Conclusions: The immunosuppressive strategy investigated is effective and displays a satisfactory safety profile in high immunological risk renal allograft recipients.
Histology and Ultrastructure of the Equine Lingual Tonsil. I. Crypt Epithelium and Associated Structures
Authors: Kumar P. , Timoney J. F. 
Published: January 2005

SummaryThe microstructural and ultrastructural features of the equine lingual tonsil were studied in five young horses. Located at the root of the tongue it presented an irregular surface with rounded elevations, numerous folds and crypts. Stratified squamous non‐keratinized epithelium lining its outer surface was modified by heavy infiltration of lymphoid cells to form reticular epithelium within the crypt. The latter implies a role in initiating and maintaining immune responses to incoming infectious agents and antigens. Lamellated structures resembling Hassall's corpuscle were observed towards the outer surface epithelium. Microplicae were visible by scanning electron microscopy on the surface of both the outer and reticular epithelia. No microvillus cells resembling M cells were observed. The stratum superficiale of the reticular epithelium showed strong affinity for Soybean (SBA), Phosphocarpus tetragonolobus 1 (WBA 1), Ulex europaeus (UEA) and Griffonia simplicifolia 1 isolectin‐B4 (GS1‐B4). The characteristic lectin binding patterns may be useful for embryological and microbiological investigations. Vimentin filaments were not detected consistent with absence of M cells. Mucus glandular acini in the deeper lamina propria mucosae contained glycogen, acidic, neutral and weakly sulphated mucopolysaccharides. Transmission electron microscopy revealed that the layers of the outer surface and reticular epithelia shared characteristic features except the stratum superficiale, which had nuclei of varying shapes and an abundance of cell organelles. A few mast cells with electron lucent granules and myelinated nerve fibres were localized in the deeper portion.
Anatomy of the Cranioencephalic Structures of the Camel (Camelus dromedarius L.) by Imaging Techniques: A Magnetic Resonance Imaging Study
Authors: Arencibia A. , Rivero M. A. , Gil F. , Ramírez J. A. , Corbera J. A. , Ramírez G. , Vázquez J. M. 
Published: January 2005

SummaryThe objective of this study was to define the anatomy of the cranioencephalic structures and associated formations in camel using magnetic resonance imaging (MRI). MR images were acquired in sagittal, transverse and oblique dorsal planes, using spin‐echo techniques, a magnet of 1.5 T and a standard human body coil. MR images were compared with corresponding frozen cross‐sections of the head. Different anatomic structures were identified and labelled at each level. The resulting images provided excellent soft tissue contrast and anatomic detail of the brain and associated structures of the camel head. Annotated MR images from this study are intended to be a reference for clinical imaging studies of the head of the dromedary camel.
Variation in the Boldness of Courting Sand Fiddler Crabs (Uca pugilator)
Authors: Pratt Ann E. , McLain Denson K. , Berry Allison S. 
Published: January 2005

AbstractIndividuals can express boldness in their readiness to resume courtship signaling following a perceived threat. The degree of boldness that is selectively favored depends on the magnitude of costs and benefits that may vary across time and space. We examined within‐ and between‐individual variation in the boldness of courting male sand fiddler crabs, Uca pugilator, across an entire breeding season at a South Carolina (USA) salt marsh where courtship is restricted to supratidal embankments. Boldness was assessed by the time to re‐emergence and the number of re‐emergences of males who were purposely startled into their breeding burrows once every 3 min for a total of five times. The two measures of boldness were significantly positively correlated. Courting males are on average bolder when their density is high and when tidal conditions correspond to peaks in the number of females moving over the embankment surface. Time to re‐emergence increases with successive startles although some males consistently re‐emerge faster than others. Large males are not bolder than small males. When male density is high, nearest neighbors frequently re‐emerge at the same time, suggesting that males cue on the responses of other nearby males, perhaps by assessing substrate vibration. This may reduce the chance of losing a potential mate to a local competitor.