bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing the efficiency of integrated pollution control regulation
Authors: Clinch J. Peter , Kerins David 
Published: October 2002

AbstractA common criticism by economists of the command‐and‐control approach to environmental policymaking is that costs of compliance may be considerably higher than under flexible mechanisms. Unless all polluters face the same control costs, uniform emissions standards will not minimize the costs of reducing pollution. Integrated pollution control (IPC) licensing is an improvement on uniform regulation as, in principle, it takes into account the individual characteristics of the plant being allocated the licence. However, economists still tend to believe that the firm knows how to allocate resources best and that, because of the enormous information requirements, the regulator is unlikely to be able to achieve as low a cost of compliance as can a market corrected using market‐based instruments. This paper examines the efficiency of IPC regulation using the Irish system as a case study. In particular, it examines whether IPC regulation is likely to be cost minimizing. The results show that there appears to be the potential to reduce compliance costs if a flexible mechanism can be introduced which allows trading across sectors. Copyright © 2002 John Wiley & Sons, Ltd. and ERP Environment.
Buckling analysis for delaminated composites using plate bending elements based on higher‐order zig‐zag theory
Authors: Kim Jun‐Sik , Cho Maenghyo 
Published: October 2002

AbstractA finite element based on the efficient higher‐order zig‐zag theory with multiple delaminations is developed. The bending part of the formulation is constructed from the concept of DKQ element. Unlike conventional elements, a developed element has its reference in the bottom surface which simplifies zig‐zag terms on formulation. Exact patch solutions are developed on elements which have the bottom reference system. The present element passes proper bending patch tests in the arbitrary mesh configurations in isotropic materials. Zig‐zag formulation is adopted to model laminated plates with multiple delaminations. To assess the accuracy and efficiency of the present element based on higher‐order zig‐zag theory with multiple delaminations, the linear buckling problem of laminated plates with multiple delaminations has been analysed. The results have been compared with three‐dimensional elasticity solutions. The present element works as an efficient tool for analysing the behaviour of the laminated composites with multiple delaminations. Copyright © 2002 John Wiley & Sons, Ltd.
Influence of maternal smoking on the birth prevalence of Down syndrome and on second trimester screening performance
Authors: Rudnicka Alicja R. , Wald Nicholas J. , Huttly Wayne , Hackshaw Allan K. 
Published: October 2002

AbstractObjectivesTo determine the influence of maternal smoking on the birth prevalence of Down syndrome and on second trimester screening performance.MethodsFirst, a meta‐analysis of cohort and case‐control studies was performed to estimate the effect of maternal smoking on the live birth prevalence of Down syndrome. Then, data from 8779 women screened using the quadruple test (alphafetoprotein (AFP), unconjugated estriol (uE3), human chorionic gonadotrophin (free β‐hCG), and inhibin‐A levels with maternal age) were used to determine the effect of smoking on the serum markers. A Monte Carlo simulation was used to assess the impact of adjusting for smoking status on screening performance.ResultsThe relative risk of Down syndrome in smokers (versus non‐smokers) was 0.95 (95% confidence interval (CI) 0.87 to 1.03). Serum marker levels were determined as multiples of the median for non‐smokers of the same gestational age and adjusted for maternal weight (MoM). The MoM values for AFP were 5% higher (95% CI 2–7%), uE3 4% lower (95% CI 2–5%), free β‐hCG 20% lower (95% CI 17–23%) and inhibin‐A 62% higher (95% CI 57–67%) in smokers compared with non‐smokers. Adjusting marker levels for smoking resulted in less than a 1 percentage point increase in the detection rate for a 5% false positive rate with the double, triple or quadruple tests.ConclusionsThere is no evidence of an association between the birth prevalence of Down syndrome and maternal smoking. The case for adjusting screening marker levels for smoking is not compelling. But if smoking data are collected routinely adjustment could be made and this would yield similar detection and false positive rates in smokers and non‐smokers. Copyright © 2002 John Wiley & Sons, Ltd.
Burrows–Wheeler compression with variable length integer codes
Authors: Fenwick Peter 
Published: October 2002

AbstractThe final coder in Burrows–Wheeler compression is usually either an adaptive Huffman coder (for speed) or a complex of arithmetic coders for better compression. This article describes the use of conventional pre‐defined variable length codes or universal codes and shows that they too can give excellent compression. The paper also describes a ‘sticky Move‐to‐Front’ modification which gives a useful improvement in compression for most files. Copyright © 2002 John Wiley & Sons, Ltd.
Papillary Thyroid Carcinoma Managed at the Mayo Clinic during Six Decades (1940–1999): Temporal Trends in Initial Therapy and Long‐term Outcome in 2444 Consecutively Treated Patients
Authors: Hay Ian D. , Thompson Geoffrey B. , Grant Clive S. , Bergstralh Eric J. , Dvorak Catherine E. , Gorman Colum A. , Maurer Megan S. , McIver Bryan , Mullan Brian P. , Oberg Ann L. , Powell Claudia C. , van Heerden Jon A. , Goellner John R. 
Published: October 2002

It is uncertain whether more extensive primary surgery and increasing use of radioiodine remnant ablation
(RRA) for papillary thyroid carcinoma (PTC) have resulted in improved rates of cause‐specific mortality (CSM) and tumor recurrence (TR).
Details of the initial presentation, therapy, and outcome of 2444 PTC patients consecutively treated during 1940–1999 were recorded in a computerized database. Patients were followed for more than 43,000
patient‐years. The 25‐year rates for CSM and TR were 5% and 14%,
respectively. Temporal trends were analyzed for six decades. During the six decades, the proportion with initial MACIS (distant Metastasis, patient Age,
Completeness of resection, local Invasion, and tumor Size) scores <6 were 77%, 82%, 84%, 86%, 85%, and
82%, respectively (p = 0.06). Lobectomy accounted for
70% of initial procedures during 1940–1949 and 22% during
1950–1959; during 1960–1999 bilateral lobar resection (BLR) accounted for 91% of surgeries (p <0.001). RRA after BLR was performed during 1950–1969 in 3% but increased to 18%, 57%, and
46% in successive decades (p <0.001). The 40‐year rates for CSM and TR during 1940–1949 were significantly higher
(p = 0.002) than during 1950–1999. During the last 50
years the 10‐year CSM and TR rates for the 2286 cases did not significantly change with successive decades. Moreover, the 10‐year rates for CSM and TR were not significantly improved during the last five decades of the study, either for the 1917 MACIS <6 patients or the 369 MACIS ? 6 patients. Increasing use of RRA has not apparently improved the already excellent outcome, achieved before
1970, in low risk (MACIS <6) PTC patients managed by near‐total thyroidectomy and conservative nodal excision.
Targeted Parathyroidectomy in the Era of Intraoperative Parathormone Monitoring
Authors: Inabnet William B. , Dakin Gregory F. , Haber Richard S. , Rubino Francesco , Diamond Ed J. , Gagner Michel 
Published: October 2002

A combination of preoperative localization and intraoperative parathormone (PTH) monitoring permits targeted parathyroidectomy. Multiple approaches have been developed,
ranging from unilateral neck exploration (UE) to radio‐guided parathyroidectomy (RP) to endoscopic parathyroidectomy (EP). The purpose of this study was to evaluate the efficacy of these approaches in the management of primary hyperparathyroidism. From June 1998 to November 2000 a total of 110 targeted parathyroid operations were performed at a university medical center. All patients underwent technetium‐99m‐sestamibi scanning, ultrasonography, or both prior to surgery. Intraoperative PTH monitoring was utilized in all cases.
Thirty‐seven patients underwent UE, 59 underwent RP, and 14 underwent EP. Follow‐up ranged from 1 to 24 months. All patients were cured following parathyroidectomy as predicted by a more than 50% reduction of the intraoperative PTH level following removal of all hypersecreting glands. Altogether, 103 patients had a solitary adenoma (95%), and 1
patient had a parathyroid carcinoma. Six patients (5%) had multigland disease, including four cases of hyperplasia and two patients with a double adenoma. Eighty‐three patients (75%) were discharged the day of surgery. The use of preoperative localization and intraoperative PTH monitoring permits a targeted approach to the treatment of primary hyperparathyroidism. Endocrine surgeons should be facile in all minimally invasive parathyroid techniques to individualize the operative approach.
Vitamin D Status in Japanese Patients with Hyperparathyroidism: Seasonal Changes and Effect on Clinical Presentation
Authors: Yamashita Hiroyuki , Noguchi Shiro , Uchino Shinya , Watanabe Shin , Koike Eisuke , Murakami Tsukasa , Fujihira Takashi , Koga Yutaka , Masatsugu Toshihiro , Yamashita Hiroto 
Published: October 2002

The disturbance of vitamin D metabolism plays an important role in determining the clinical presentation of hyperthyroidism. We studied 72 patients (65 women, 7 men) with primary hyperparathyroidism (pHPT). Clinical presentation, biochemical indices,
and bone mineral density (BMD) were compared in three patient groups classified according to their serum 25‐hydroxyvitamin D (25OHD)
levels: 23 patients whose 25OHD level was <25 nmol/L comprised the low group, 26 whose level was 25 to 40 nmol/L made up the intermediate group, and 23 whose level was > 40 nmol/L comprised the high group. The mean serum calcium level was 10.8 ± 0.9
mg/dl, and the mean weight of the resected parathyroids was 684 ±
749 mg. The mean serum 25OHD level was 36.5 ± 16.3 nmol/L (normal
25–100 nmol/L). Levels were below normal in 23 patients (32%). No between‐group differences existed for clinical presentation,
biochemistry, or BMD. Only differences in mean patient age were statistically significant between groups. Vitamin D deficiency is common among Japanese patients with pHPT, but the effects of HPT on clinical, biochemical, and densitometric indices are not pronounced.
Our study population was at an early stage of pHPT, so the vitamin D deficiency may not be associated with the effects of HPT.
Treatment of Small Intestinal Neuroendocrine Tumors: Is an Extended Multimodal Approach Justified?
Authors: Schindl Martin , Kaczirek Klaus , Passler Christian , Kaserer Klaus , Prager Gerhard , Scheuba Christian , Raderer Markus , Niederle Bruno 
Published: October 2002

Neuroendocrine tumors (NETs) of the small bowel are known for their low malignant behavior. Although most cases are diagnosed in an advanced stage, natural life expectancy is significantly higher than with intestinal carcinomas. The question arises if there are any benefits to combining extended (radical or debulking) surgery, interventional treatment, and medical treatment with respect to life expectancy, and quality of life. A series of 58
patients (34 men, 24 women; mean age 61 ± 12 years, range 37–87
years) with NETs of the small bowel were retrospectively reviewed and prospectively followed over 63 ± 53 months. Clinical presentation, tumor characteristics, and postoperative medical treatment were documented. Quality of life was additionally analyzed using a questionnaire. Survival probability and quality of life were compared for tumor stages and type of treatment performed. In 47 of 58
(81%) patients the NET was diagnosed based on the presence of intestinal stenosis or endocrine symptoms. Of 16 patients without liver metastases, 15 (94%) were cured by radical surgery. Multiple liver metastases were evident in 40 of 58 (69%) patients and decreased the
5‐ and 10‐year cumulative survival to 64% ± 10% and 22% ± 10% (M0
vs. M1: p <0.05). The 5‐ and 10‐year survival rates after multimodal treatment (surgery, bio/immunotherapy, transarterial embolization of liver metastases) were 64% ± 11% and 28% ± 12%
compared to 61% ± 15% and 0% in patients without
(p = NS). In patients with small intestinal NETs, a consistent multimodal treatment helps to improve the overall survival and, in most patients, the quality of life.
Results of Laparoscopic Adrenalectomy for Large and Potentially Malignant Tumors
Authors: Henry Jean‐François , Sebag Frederic , Iacobone Maurizio , Mirallie Eric 
Published: October 2002

ndoscopic adrenalectomy is the procedure of choice for patients with small functioning adrenal tumors. For most surgeons invasive adrenal carcinoma is an absolute contraindication for laparoscopic adrenalectomy (LA). Whether LA should be proposed for large (> 6 cm),
potentially malignant tumors is questionable. The aim of this study was to evaluate the risks and outcome of LA performed in our department in patients with tumors > 6 cm and potentially malignant. We performed a retrospective study of 216 patients who underwent 233 LAs in our department from 1994 to
2000. We selected 19 patients with a tumor > 6 cm and potentially malignant:
8 nonfunctional tumors, 4 cortisol‐secreting tumors, 1 virilizing tumor, and 6
pheochromocytomas. In none of these patients did preoperative investigations demonstrated invasive carcinoma. The median tumor size was 70 mm. LA was performed by a transperitoneal flank approach. Conversion to open adrenalectomy was performed in two patients owing to intraoperative evidence of invasive carcinoma. The median operating time was 150 minutes (range 95–240
minutes). Capsular disruption occurred during the dissection of two pheochromocytomas. There was no postoperative morbidity. Six patients had an adrenocortical carcinoma on pathologic diagnosis: three of the eight nonfunctional tumors, one of the four cortisol‐secreting tumors, and one virilizing tumor. One patient presented with liver metastases 6 months after surgery and died. The five other patients are disease‐free with a follow‐up ranging from 8 to 83 months. The 13 patients with benign lesions (6 cortical adenomas, 1 ganglioneuroma, 6 pheochromocytomas) are disease‐free with a median follow‐up of 47 months (range 10–81 months). In experienced hands LA can be proposed for large, potentially malignant tumors. Conversion to open adrenalectomy should be performed if local invasion is observed during surgery.
At present the risk of intraabdominal recurrence is unknown.
Residual and recurrent lesions after conization for cervical intraepithelial neoplasia grade 3
Authors: Milojkovic M 
Published: October 2002

AbstractObjectives: To evaluate the importance of regular and long‐term follow‐up of patients who had conization for cervical intraepithelial neoplasia grade 3 (CIN 3); and to assess the risk of residual/recurrent lesions of the cervix uteri. Methods: Retrospective analysis of 934 patients with CIN 3 who underwent conization over the period 1 January 1985–31 December 1997. The analysis included 38 (4.1%) patients who had involved resection margins and 896 (95.9%) patients who had free resection margins. Results: Twenty‐three out of 934 (2.5%) patients had another operation (reconization in 17 and hysterectomy in six) whereas one patient had a biopsy. Residual or recurrent lesion after conization was found in 23 patients out of 934 (2.5%). Three patients had invasive cervical cancer (0.3%), 19 had CIN 3 (2.0%) and one patient had CIN 1 (0.1%). One of the 24 patients (4.2%) was diagnosed with no lesion after repeated operation. Eleven patients out of 38 (28.9%) with involved resection margins during the first conization had residual/recurrent disease, compared with eight out of 896 patients (0.9%) who had free resection margins. Conclusion: Another operation is recommended only in cases when, on the basis of cytological, colposcopical and histological findings, the gynecologist suspect the residual/recurrent lesions.
Minilaparotomy‐assisted vaginal hysterectomy
Authors: Ahmed A.A. , Stachurski J. , Abdel Aziz E. , Bone C. 
Published: October 2002

AbstractObjectives: To determine the feasibility and acceptability of minilaparotomy‐assisted vaginal hysterectomy. Methods: A prospective pilot study in a general hospital was conducted. Twenty patients who were on the waiting list for abdominal hysterectomy were included in the study. All these patients had one or more relative contraindications to vaginal hysterectomy. The hysterectomy procedure was started vaginally in all cases. A minilaparotomy incision was performed to complete the procedure if vaginal hysterectomy was not feasible. Results were analyzed on the intention to treat basis. Results: The procedure was successfully completed as intended in 19/20 patients (95%). Six patients had the procedure completed vaginally (30%). Thirteen patients had the procedure completed with minilaparotomy assistance (65%). The mean operative time was 63±24.8 min (±S.D.). The median estimated blood loss was 155 ml (range: 20–800). One bladder injury occurred. The overall post‐operative complication rate was 35% (7/20). This included urinary retention necessitating catheterization for 24 h (n=3), urinary infection (n=2), vaginal infection (n=1) and wound hematoma (n=1). The mean post‐operative pain score on a scale from 1 to 10 was 3.1. The overall patient satisfaction based on a scale from 1 to 10 was 9.23 (range: 8–10). Conclusions: Minilaparotomy‐assisted vaginal hysterectomy is a feasible and safe procedure. Our results suggest that this approach is potentially useful in increasing the proportion of hysterectomies performed vaginally.
Inducible displacements of cemented tibial components during weight‐bearing and knee extension. Observations during dynamic radiostereometry related to joint positions and 2 years history of migration in 16 TKR
Authors: Uvehammer J. , Kärrholm J. 
Published: October 2002

AbstractThe inducible displacements of the tibial component caused by active extension were studied in 16 knees 1 yr after an AMK total knee arthroplasty with either flat, concave or posterior‐stabilised (PS) designs of the joint area. Continuous change of the position of the tibial component occurred with proceeding extension. Rocking, subsidence and lift‐off at different localisations were observed. In 3 of 4 knees with flat inserts the tibial component tilted anteriorly from 45° to 35° of flexion. A similar anterior tilt was seen in 2 of 6 with concave inserts and 5 of 6 with the PS design, but the tilting started later, when the knee had 5–20° more extension. From 45–15° of flexion most components tilted into valgus. Three knees (1 concave with, 1 concave without PCL and 1 PS) showed a sudden tilt into varus direction followed by a rocking motion in the opposite direction. The other types of displacements studied showed a more uniform pattern. The inducible maximum translation (MTPM) at 20° of extension tended to be associated with increased migration between 0 and 2 yr when measured with the same parameter (Spearman's rho = 0.54, P = 0.03). Increased medial displacement of the center of the proximal tibia at 25° was associated with increased anterior tilt. This type of motion was most commonly seen with the concave design. Our observations demonstrate that the forces acting on the tibial component vary during active extension, which results in rocking movements. This will influence the migration and the patttern of wear, factors of importance for the clinical longevity of a total knee replacement (TKR). © 2001 Orthopaedic Research Society. Published by Elsevier Science Ltd. All rights reserved.
Low molecular weight heparin aggravates infectious arthritis triggered by Staphylococcus aureus
Authors: Sakiniene Egidija , Tarkowski Andrzej 
Published: October 2002

AbstractPurpose. Staphylococcus aureus is responsible for the majority of wound infections in clean surgical procedures that involve implantation of foreign material, grafts or prosthetic devices. The aim of the study was to assess the effect of low molecular weight heparin on the development and progression of S. aureus arthritis.Materials and methods. The murine model of hematogenously acquired septic arthritis was used injecting intravenously toxic shock syndrome toxin‐1 (TSST‐1) producing S. aureus of LS‐1 strain. Mice lacking prosthetic implants were treated with intraperitoneal injections of low molecular weight heparin, used routinely as anti‐thrombotic prophylaxis following joint prosthetic surgery. Evaluation of arthritis was performed clinically and histopathologically. In addition, the effect of low molecular weight heparin on T cell dependent and independent inflammation was assessed.Results. Seven days after inoculation with bacteria 18 out of 19 low molecular weight heparin treated mice displayed clinical symptoms of arthritis as compared to 9 out of 23 control animals (p < 0.05), and the severity of arthritis, expressed as arthritic index, was 2.6 ± 0.5 versus 1.6 ± 0.5 (p = 0.05). The histopathological examination confirmed the clinical findings showing that both inflammation and joint destruction were more substantial in heparin treated animals.Conclusion. Our findings indicate that the routine anti‐coagulation treatment with heparin contributes to more severe course of joint infection.S © 2002 Orthopaedic Research Society. Published by Elsevier Science Ltd. All rights reserved.
Abnormal knee joint position sense in individuals with patellofemoral pain syndrome
Authors: Baker Vanessa , Bennell Kim , Stillman Barry , Cowan Sallie , Crossley Kay 
Published: October 2002

AbstractThe purpose of this cross‐sectional study was to compare knee joint position sense (JPS) in 20 individuals with and 20 without patellofemoral pain syndrome (PFPS). Five active tests with ipsilateral limb matching responses were performed at 20° and 60° flexion under non‐weightbearing conditions, and at 40° flexion under uni‐ and bi‐lateral weightbearing conditions. The response errors were calculated as the difference between each target and response position (accuracy) and the standard deviation of these differences (reliability).JPS was: (i) significantly less accurate and less consistent in the knees with PFPS during both the non‐weightbearing and weightbearing tests when compared to the control subject knees; (ii) less accurate when the symptomatic and asymptomatic knees of the 12 uni‐lateral PFPS subjects were compared and (iii) less accurate in the asymptomatic knees of the uni‐lateral PFPS subjects and knees of the control subjects. The maximum intensity of pain experienced during each knee JPS test was not correlated to any of the JPS test results.The results confirm abnormal knee joint proprioception in individuals with PFPS. Although it cannot be determined whether the abnormality precedes or follows the development of PFPS, the results support including proprioceptive reeducation in management of PFPS. © 2002 Orthopaedic Research Society. Published by Elsevier Science Ltd. All rights reserved.