bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prediction of fetal anemia in rhesus disease by measurement of fetal middle cerebral artery peak systolic velocity
Authors: Scheier M. , Hernandez‐Andrade E. , Carmo A. , Dezerega V. , Nicolaides K. H. 
Published: April 2004

AbstractObjectiveIn red blood cell (RBC) isoimmunized pregnancies fetal anemia is associated with a hyperdynamic circulation. The aim of the present study was to examine further the possible value of fetal middle cerebral artery peak systolic velocity (MCA‐PSV) in the management of affected pregnancies.MethodsA reference range of fetal MCA‐PSV with gestation was constructed from the study of 813 normal singleton pregnancies at 20–40 weeks' gestation. Fetal MCA‐PSV was also measured in 58 fetuses from RBC isoimmunized pregnancies, with maternal hemolytic antibody concentration of >15 IU/mL at 19–38 weeks' gestation and within 10 days of measurement of fetal hemoglobin concentration in blood obtained either by cordocentesis (n = 43) or at delivery (n = 15). In the RBC isoimmunized pregnancies each of the measured MCA‐PSV and hemoglobin concentrations was expressed as a delta value (difference in SDs from the normal mean for gestation). Regression analysis was used to determine the significance of the association between delta MCA‐PSV and delta fetal hemoglobin concentration.ResultsIn the normal pregnancies there was a significant increase in fetal MCA‐PSV with gestation (mean MCA‐PSV = 100.0223 × GA + 0.963). In RBC isoimmunized pregnancies the fetal MCA‐PSV was increased and there was a significant association between delta MCA‐PSV and delta hemoglobin concentration (delta hemoglobin = (delta MCA‐PSV + 0.093)/−0.356; R2 = 0.638, P < 0.0001). An MCA‐PSV of mean + 1.5 SDs detected 96% of severely anemic fetuses, with a hemoglobin deficit of at least 6 SDs, for a false‐positive rate of 14%.ConclusionMeasurement of fetal MCA‐PSV is a useful method of assessing fetal anemia. In the clinical management of isoimmunized pregnancies a cut‐off in MCA‐PSV of mean + 1.5 SDs can identify nearly all severely anemic fetuses with a low false‐positive rate. Copyright © 2004 ISUOG. Published by John Wiley & Sons, Ltd.
PVC degradation during injection molding: Experimental evaluation
Authors: Garcia Jose L. , Koelling Kurt W. , Xu Guojun , Summers James W. 
Published: April 2004

AbstractThis paper focuses on experimental observations of poly(vinyl chloride) (PVC) degradation during injection molding. Degradation of poly(vinyl chloride) has been extensively studied. These studies have been performed in quiescent systems with very little or no strain applied to the sample. However, during processing, the polymer experiences very large deformations, in particular in the case of injection molding. This work demonstrates that the large shear during injection molding causes a significant increase of degradation as compared to studies in quiescent systems. It was also observed that degradation occurs in less than 1/10 the time required for quiescent systems. Finally, the flow geometry also affects the degradation behavior during processing. Understanding the parameters leading to degradation could lead to schemes to avoid it. J. Vinyl Addit. Technol. 10:17–40, 2004. © 2004 Society of Plastics Engineers.
Ninety‐four Appendectomies for Suspected Acute Appendicitis during Pregnancy
Authors: Ueberrueck Torsten , Koch Andreas , Meyer Lutz , Hinkel Michael , Gastinger Ingo 
Published: April 2004

ABSTRACTAcute appendicitis during pregnancy is a rare event, and large numbers of cases reported in the literature stem entirely from data stored in national registers. Between 1974 and 2000 relevant perioperative data on the treatment of appendicitis were collected consecutively and analyzed retrospectively. Surgical and obstetric data relating to the medical history, the clinical, intraoperative, and histologic findings, and the course of the pregnancy were recorded. Altogether, 9793 appendectomies were performed, 94 of which were in pregnant women (24.5% during the first trimester, 51% during the second trimester, and 24.5% during the third trimester). This represents 0.2% of the 46,960 deliveries during the period under observation. Fifty percent of the case histories during the second trimester were atypical. The overall perforation rate was 14.9%; it was 8.7%, 12.5%, and 26.1% during the three trimesters, respectively. Maternal mortality was 0%; the combined miscarriage/abortion rate was 8.5% (n = 8); and infant mortality was 3.2% (n = 3). The postoperative spontaneous abortion rate was 13.0% and the additional therapeutic/requested abortion rate 21.7% during the first trimester. In view of the elevated postoperative abortion rate and the facility of the clinical diagnosis during the first trimester, the indication for invasive diagnostic measures and surgery requires careful consideration. During the second and third trimesters the difficulty of establishing a clinical diagnosis makes it necessary to undertake exploratory surgery early.
Decortication for Chronic Parapneumonic Empyema: Results of a Prospective Study
Authors: Melloni Giulio , Carretta Angelo , Ciriaco Paola , Negri Giampiero , Voci Carlopietro , Augello Giuseppe , Zannini Piero 
Published: April 2004

ABSTRACTDespite advances in diagnostic methods, surgical techniques, and supportive therapy, chronic parapneumonic empyema is still associated with considerable morbidity and mortality. A prospective study was performed on a consecutive series of patients with chronic parapneumonic empyema to analyze the results of surgical treatment and identify clinical predictors of poor outcome. From 1993 to 2000 a total of 40 patients underwent decortication for chronic parapneumonic empyema. There was no mortality. All 40 patients had definitive resolution of the empyema. Altogether, 34 patients (87.5%) had an uneventful postoperative course, and 5 (12.5%) experienced complications (2 prolonged febrile syndromes, 3 cases of sepsis requiring mechanical respiratory assistance). All complications resolved well with adequate treatment without further consequences. Definitive results of the surgical procedures assessed at the 6‐month follow‐up examination were good in 21 patients and satisfactory in 19. No unsatisfactory results were observed in any of the patients. Univariate analysis showed that three variables predicted morbidity: co‐morbidities (p = 0.039), symptom duration ≥ 60 days (p = 0.009), and duration of preoperative conservative treatment ≥ 30 days (p = 0.006). Multivariate analysis showed that only symptom duration ≥ 60 days (p = 0.041) and duration of conservative treatment ≥ 30 days (p = 0.025) were associated with morbidity. Decortication is a highly effective treatment for chronic parapneumonic empyema and may be performed with low morbidity and mortality. Because prolonged duration of symptoms and conservative treatment increase morbidity, early surgical intervention seems to be the optimal modality for the treatment of chronic parapneumonic empyema.
Correlation between Radiologic and Pathologic Dimensions of Adrenal Masses
Authors: Fajardo Rafael , Montalvo Jorge , Velázquez David , Arch Jorge , Bezaury Paulina , Gamino Rosa , Herrera Miguel F. 
Published: April 2004

ABSTRACTThe size of adrenal tumors has been shown to be a good predictor of malignancy. There is still some controversy about the concordance between radiologic and real pathologic measurements. The aim of this study is to determine the correlation between direct and corrected radiologic computed tomography scan dimensions and the measurements of the resected specimen. A total of 41 adrenal tumors were included. Direct and corrected measurements of the largest diameter were contrasted with the pathologic dimensions. The Linos formula was used for the corrected measurements. Proper statistics were used considering a two‐tailed significance level of 0.05. The intraclass correlations using direct and corrected measurements were 0.89 [95% confidence interval (95%CI) 0.81–0.94, p = 0.00001) and 0.90 (95%CI 0.82–0.95, p = 0.00001), respectively. The bivariate analysis using Pearson’s correlation between two‐dimensional group variables showed r = 0.82 (p < 0.0001) when direct and pathologic measurements were compared and r = 0.83 (p < 0.0001) when the corrected values were compared with the real dimensions. In this study, we demonstrate good correlation between radiologic and pathologic measurements of adrenal tumors. The Linos formula turned out to be significantly more accurate than direct radiologic measurements when means of the groups were compared, whereas when individual correlations were determined the two were similar. The Linos formula and radiologic measurements can be used to determine the proper management of adrenal incidentalomas in individual patients.
Biliopancreatic Diversion in the Surgical Treatment of Morbid Obesity
Authors: Van Hee Robrecht H.G.G. 
Published: April 2004

AbstractBiliopancreatic diversion is a malabsorptive technique of bariatric surgery that has gained wide acceptance in the Western world. It is performed in one of two ways: In its classic form it consists of partial gastrectomy with a Roux‐en‐Y gastroenterostomy; in its duodenal switch form a vertical sleeve gastrectomy is combined with a duodenoenterostomy. Both techniques realize diversion of biliopancreatic juice, thereby creating a mild form of malabsorption. Weight loss has been approximately 70% of initial excess weight, exceeding that obtained with most other bariatric procedures. Iron, calcium, and vitamin deficiencies may occur, especially with classic biliopancreatic diversion, and must be prevented with adequate supplements during vigorous follow‐up. Weight loss is followed by a substantial reduction in the co‐morbidities that are present in many morbidly obese patients. Biliopancreatic diversion should be included in each obesity clinic program and be proposed for morbidly obese patients who are having difficulty with the prospect of continuous restraint of food intake or problems due to failed gastric restrictive interventions. The postoperative results in such patients have been good and have substantially improved quality of life and self‐esteem in this category of morbidly obese patients.
Building Our Future: A Plea for Leadership
Authors: Souba Wiley W. 
Published: April 2004

ABSTRACTIn recent years the spastic nature of the health care marketplace has continued to increase, which has greatly escalated the demands of leadership in academic medical centers. The expectations of leaders, including surgery chairs, have increased considerably, whereas their capacity for independent action has undeniably diminished. In such a predicament, it is useful to revisit fundamentals, using them as a guide to build a sound future. Five leadership principles are critical to building a better future: (1) recognizing that the work of leadership involves an inward journey of self‐discovery and self‐development; (2) establishing clarity around a set of core values that guide the organization as it pursues its goals; (3) communicating a clear sense of purpose and vision that inspires widespread commitment to a shared sense of destiny; (4) building a culture of excellence and accountability throughout the entire organization; and (5) creating a culture that emphasizes the development of leaders and leadership as an organizational capacity. Leadership and learning are inextricably linked. We must change the perception that learning in academic surgery is about correcting a deficit rather than a natural part of human growth and development. Our ability to learn, grow, and contribute to an organization is what provides each of us with meaning and identity. This feeling of being part of something special that is larger than ourselves is a powerful force and an important dividend of great leadership.
Zonal and topographical differences in articular cartilage gene expression
Authors: Darling Eric M. , Hu Jerry C. Y. , Athanasiou Kyriacos A. 
Published: April 2004

AbstractArticular cartilage is composed of phenotypically different zones. In young articular cartilage, there are only two distinct zones: superficial and growth. The zones have different mechanical properties and play specific roles within functional cartilage tissue. In small animal models, it is difficult to separate the zones quickly and efficiently using only a dissecting microscope. Surface abrasion is a method that has been developed to harvest cells from articular cartilage to produce highly purified samples in a simple, reproducible process. Using this harvesting technique, the superficial zone has been separated from the underlying growth zone. Superficial cells comprised approximately 4% of the total cells obtained. Superficial and growth zone chondrocytes from articular cartilage were analyzed using real‐time RT‐PCR. Expressed superficial zone protein was 3‐fold greater in the superficial zone population than in the growth zone population (p < 0.01). This, along with histological evidence, indicates that surface abrasion is successful as a zonal separation technique. Additionally, type II collagen was expressed 8‐fold more abundantly in the growth zone than in the superficial zone (p < 0.005). There was no difference in aggrecan expression between the two zones. Regional variations among the femoral groove and medial and lateral condyles were also examined. No significant variations in SZP, type II collagen, or aggrecan were found, which makes the pooling of zonal cells from different regions an acceptable option for tissue engineering studies. © 2004 Orthopaedic Research Society. Published by Elsevier Ltd. All rights reserved.
New Risk‐Based Capital Standards in the European Union: A Proposal Based on Empirical Data
Authors: Schmeiser Hato 
Published: April 2004

AbstractIn response to criticism concerning the current solvency system, the European Commission is developing new rules for insurance companies operating in the member states of the European Union (EU). Under this so‐called Solvency II concept, an insurer is allowed to verify its solvency by using an internal risk management model previously approved by the regulatory authority. In this article we develop such an internal risk management approach for property‐liability insurers that is based on dynamic financial analysis (DFA). The proposed concept uses a simulation technique and models the central risk factors from the investment and underwriting areas of an insurance company. On the basis of the data provided by a German insurer, the ruin probabilities under different scenarios and varying planning horizons are calculated.
Smoking cessation and weight gain
Authors: Filozof C. , Fernández Pinilla M. C. , Fernández‐Cruz A. 
Published: April 2004

SummaryCigarette smoking is the single most important preventable cause of death and illness. Smoking cessation is associated with substantial health benefits. Weight gain is cited as a primary reason for not trying to quit smoking. There is a great variability in the amount of weight gain but younger ages, lower socio‐economic status and heavier smoking are predictors of higher weight gain. Weight change after smoking cessation appears to be influenced by underlying genetic factors. Besides, weight gain after smoking cessation is largely because of increased body fat and some studies suggest that it mostly occurs in the subcutaneous region of the body. The mechanism of weight gain includes increased energy intake, decreased resting metabolic rate, decreased physical activity and increased lipoprotein lipase activity. Although there is convincing evidence for the association between smoking cessation and weight gain, the molecular mechanisms underlying this relationship are not well understood. This review summarizes current information of the effects of nicotine on peptides involved in feeding behaviour. Smoking was shown to impair glucose tolerance and insulin sensitivity and cross‐sectional studies have demonstrated that smokers are insulin‐resistant and hyperinsulinaemic, as compared with non‐smokers. Smoking cessation seems to improve insulin sensitivity in spite of the weight gain. Nicotine replacement – in particular nicotine gum – appears to be effective in delaying post‐cessation weight gain. In a group of women who failed to quit smoking because of weight gain, a dietary intervention (intermittent very‐low‐calorie diet) plus nicotine gum showed to both increase success rate in terms of smoking cessation and prevent weight gain. On the other hand, body weight gain at the end of treatment was significantly lower in the patients receiving bupropion or bupropion plus nicotine patch, compared with placebo. Studies with new drugs available for the treatment of obesity – sibutramine and orlistat – are warranted.
Discrepancies between classification systems of childhood obesity
Authors: Neovius M. , Linné Y. , Barkeling B. , Rössner S. 
Published: April 2004

SummaryDespite growing concern about weight‐related problems among children, no universally accepted classification system for childhood obesity exists. There is a number of proposed international body mass index (BMI)‐based systems in use and national variants also exist in many countries. The absence of a universally accepted standard and confusion concerning which classification system to use on national levels complicate monitoring of the development of the obesity epidemic, stratification for selective interventions in public health, screening in clinical practice and comparisons between studies. Some proposed international classification systems have not only been recommended for global monitoring and comparisons between studies, but also for clinical and national epidemiological use in some countries. Possible discrepancies may thereby lead to inefficiencies in health care delivery and prevention programmes. The problems associated with misclassification of individuals at risk may lead to overconsumption of health care resources by lower‐risk individuals and underconsumption by higher‐risk individuals, which is costly both in terms of foregone health improvements and in terms of wasteful monetary usage. The aim of this paper was to review the specific problems associated with BMI as a measure of adiposity in childhood, the most commonly used classification systems for childhood obesity based on BMI, and how their performance can be evaluated.
Marital Conflict, Children's Representations of Family Relationships, and Children's Dispositions Towards Peer Conflict Strategies
Authors: Schudlich Tina D. Du Rocher , Shamir Haya , Cummings E. Mark 
Published: April 2004

AbstractThe links among marital relations and children's representations were examined. Forty‐seven children between the ages of 5 and 8 completed the Family Stories Task (FAST) to obtain their narrative representations of family relations and performed a variation of a puppet procedure (Mize & Ladd, 1988) to assess children's dispositions towards peer conflict strategies. Their parents completed a set of questionnaires regarding marital quality. Results demonstrated relations between marital conflict and children's dispositions towards peer conflict strategies in conflict situations. Children's more negative dispositions towards peer conflict and aggressive behavior in the peer conflict scenarios were each associated with more overt conflict behaviors by mothers and fathers, respectively, and more covert conflict behavior by mothers. In addition, children's internal representations of parent–child relations served as a mediator between marital conflict and children's notions about conflict behavior towards peers.
Children's Anger, Emotional Expressiveness, and Empathy: Relations with Parents’ Empathy, Emotional Expressiveness, and Parenting Practices
Authors: Strayer Janet , Roberts William 
Published: April 2004

AbstractIn Roberts and Strayer (1996) we described how emotional factors were strongly related to children's empathy, which in turn strongly predicted prosocial behavior. This paper focuses on how these child emotional factors, assessed across methods and sources, related to parental factors (empathy, emotional expressiveness, encouragement of children's emotional expressiveness, warmth and control) for a subset of 50 two‐parent families from our earlier sample. Parents reported on their emotional characteristics and parenting; children (5 to 13 years old; 42% girls) also described parenting practices. Children's age and parenting factors accounted for an average of 32% of the variance in child emotional factors, which, with role‐taking, strongly predicted children's empathy. In contrast to earlier, less comprehensive studies, we found important paths between parents’ and children's empathy, mediated by children's anger. These countervailing pathways largely neutralized each other, resulting in the low correlations usually seen when parents’ and children's empathy are examined in isolation. Thus our findings are an important confirmation and extension of the theoretically expected link between parents’ and children's empathy.
Gender Differences in Preschool Aggression During Free Play and Structured Interactions: An Observational Study
Authors: Ostrov Jamie M. , Keating Caroline F. 
Published: April 2004

AbstractWe observed 48 children from rural preschools (M=64 months old) in two different social contexts to test hypotheses about the type (relational, physical, verbal, nonverbal), contextual independence, and sociometry of girls’ and boys’ aggressive tactics. We predicted and generally found that (1) girls displayed more relational aggression than boys while boys displayed more physical and verbal aggression than girls, and that children received more physical and verbal aggression from male peers, and tended to receive more relational aggression from female peers, (2) behavioral observations of aggression corresponded with teacher reports of children's aggressive styles, (3) aggression observed during free play predicted children's aggressive styles in a structured setting at both the group and individual levels, and (4) aggressive tactics were associated with projected sociometric characteristics (dominance and peer acceptance).