bluuebunny/crossref_metadata_2025_split huggingface dataset:
Simulation analysis of the consequences of shifting the balance of health care: a system dynamics approach
Authors: Taylor Kathryn , Dangerfield Brian , Le Grand Julian 
Published: October 2005

Objectives: The shift in the balance of health care, bringing services 'closer to home', is a well-established trend. This study sought to provide insight into the consequences of this trend, in particular the stimulation of demand, by exploring the underlying feedback structure. Methods: We constructed a simulation model using the system dynamics method, which is specifically designed for the analysis of feedback structure. The model was calibrated to two cases of the shift in cardiac catheterization services in the UK. Data sources included archival data, observations and interviews with senior health care professionals. Key model outputs were the basic trends displayed by waiting lists, average waiting times, cumulative patient referrals, cumulative patient activity and cumulative overall costs. Results: Demand was stimulated in both cases via several different mechanisms. We revealed the roles for clinical guidelines and capacity changes, and the typical responses to imbalances between supply and demand. Our analysis also demonstrated the potential benefits of changing the goals that drive activity by seeking a waiting list goal rather than a waiting time goal. Conclusions: Appreciating the wider consequences of shifting the balance of care is essential if services are to be improved overall. The underlying feedback mechanisms of both intended and unintended effects need to be understood. Using a systemic approach, more effective policies may be designed through coordinated programmes rather than isolated initiatives, which may have only a limited impact.
Use of evidence in decision models: an appraisal of health technology assessments in the UK since 1997
Authors: Cooper Nicola , Coyle Douglas , Abrams Keith , Mugford Miranda , Sutton Alexander 
Published: October 2005

Objectives: To review the sources and quality of evidence used in the development of economic decision models in health technology assessments (HTAs). Methods: All economic decision models developed as part of the NHS Research and Development HTA Programme between 1997 and 2003 were reviewed. Quality of evidence was assessed using a hierarchy of data sources developed for economic analyses. Results: Decision models are parameterized using diverse sources of evidence (e.g. randomized controlled trials, observational studies, expert opinion). Evidence on the main clinical effect was mostly identified and quality assessed as part of the companion systematic review/meta-analysis of the HTA and therefore reported in a transparent and reproducible way. For the other model inputs (i.e. adverse events, baseline clinical data, resource use and utilities), the search strategies for identifying relevant evidence were rarely made explicit and in a number of reports the sources of specific evidence were unclear due to poor reporting. Conclusions: A more formal and replicable approach to identification and assessment of quality of model inputs is required to reduce the 'black box' nature of decision models, and lead to less scepticism regarding model outputs.
Demystifying knowledge translation: learning from the community
Authors: Bowen Sarah , Martens Patricia ,   The Need to Know Team
Published: October 2005

Objectives: While there is increasing interest in research related to so-called Knowledge Translation, much of this research is undertaken from the perspective of researchers. The objective of this paper is to explore, through the participatory evaluation of Manitoba's The Need to Know Project, the characteristics of effective knowledge translation initiatives from the perspective of community partners. Methods: The multi-method evaluation adopted a utilization-focused approach, where stakeholders participated in identifying evaluation questions, and methods were made transparent to participants. Over 100 open-ended, semi-structured interviews were conducted with project stakeholders over the first three years of the project. These interviews explored the perspectives of participants on all aspects of project development. Formal feedback processes allowed further refinement of emerging theory. Results: This research suggests that there has been insufficient emphasis on personal factors in knowledge translation. The themes of 'quality of relationships' and 'trust' connected many different components of knowledge translation, and were essential for collaborative research. Organizational barriers and lack of confidence in researchers present greater challenges to knowledge translation than individual interest or community capacity. The costs of participation in collaborative research for community partners and the benefits for researchers, also require greater attention. Conclusions: Participation of community partners in The Need to Know Project has provided unique perspectives on knowledge translation theory. It has identified limitations to the common interpretations of knowledge translation principles and highlighted the characteristics of collaborative research initiatives that are of greatest importance to community partners.
Where Schizophrenic Patients Commit Suicide: A Review of Suicide among Inpatients and Former Inpatients
Authors: Pompili Maurizio , Mancinelli Iginia , Ruberto Amedeo , Kotzalidis Giorgio D. , Girardi Paolo , Tatarelli Roberto 
Published: October 2005

Objective: To review the literature on suicide of inpatients with schizophrenia, to identify suicide risk factors as well as typical patterns of behavior and to suggest a rationale and strategies for future interventions. Method: A computerized MedLine, Excerpta Medica and PsycLit search supplemented by an examination of cross-references and reviews. Results: Up to half the suicides among patients with schizophrenia occur during inpatient admission. Inpatient suicides were found among those of a young age group who were predominantly single, childless and socially isolated. The vast majority experienced an illness characterized by long duration and prolonged psychiatric hospitalizations or multiple admissions and discharges. Up to 50% of the suicides occurred in the first few weeks and months following discharge from the hospital. The paranoid subtype of schizophrenia, where positive symptoms prevail and negative symptoms are few, is associated with a suicide risk that is three times greater than that associated with nonparanoid subtypes and eight times greater than the risk associated with the deficit subtype. Conclusions: Treatment of suicide is a major problem among inpatients with schizophrenia. Evidence suggests that suicide is generally carried-out by patients who have been recently discharged or by those who manage to get away from the hospital. Strategies aimed at preventing this phenomenon have been introduced to the medical personnel, but suicide in these patients does not seem to have been reduced. We emphasize the need to establish guidelines for the prevention of suicide in hospitalized patients with schizophrenia.
Beton‐Beton Verbindungssystem in einer Festen Hochgeschwindigkeits‐Fahrbahn
Authors: Block Klaus , Dreier Friedrich 
Published: October 2005

AbstractBei Beton‐Beton Verbindungen für Hochgeschwindigkeits‐Fahrbahnen müssen diese Elemente nicht nur den Anforderungen an die Ermüdungstragfähigkeit, sondern auch an maximale Verformungen genügen. Der Nachweis der Verformungen ist im Regelfall entscheidend für die Ausführung. Da rein rechnerische Nachweise wegen der komplexen Aufgabenstellung derzeit noch nicht geführt werden können, ist eine versuchsgestützte Bemessung erforderlich. Im Zuge der Bearbeitung eines praktischen Anwendungsfalls zeigte sich, daß bei steigender Kraftschwingbreite die Verformungen überproportional zunehmen und von einer Vielzahl von Parametern abhängen. Dabei kommt der Beanspruchungsgeschichte eine besondere Bedeutung zu. In dieser Arbeit wird gezeigt, wie die Aufgabenstellung konstruktiv gelöst werden kann und wie vorzugehen ist, um zuverlässige Ergebnisse zu erhalten.
Zur Ermittlung der rißbreitenbeschränkenden Bewehrung bei Zwang in erhärtenden Betonbauteilen: Die Problematik einer “ausreichenden” Mindestbewehrung
Authors: Röhling Stefan 
Published: October 2005

AbstractWenn zwangsbedingte Zugspannungen auftreten können, ist zur Gewährleistung der Gebrauchstauglichkeit und Dauerhaftigkeit wie bisher nach DIN 1045 (Ausgabe 7.88), Abschnitt 17.6, auch weiterhin nach DIN 1045‐1 (2001‐07), Abschnitt 11.2, die sich einstellende Rißbreite in Abhängigkeit vom Verwendungszweck und den Beanspruchungen bzw. Umweltbedingungen des Bauwerkes zu begrenzen.Die Einhaltung einer vorgegebenen Rißbreite nimmt innerhalb der Nachweise zur Gebrauchstauglichkeit und Dauerhaftigkeit der Tragwerke eine Schlüsselstellung ein.Die parallellaufende Festlegung von konstruktiven oder betontechnologischen Maßnahmen zur Verminderung der Zwangsspannungen ist dabei stets sinnvoll, da die vorgegebenen Rißbreiten dann zuverlässig eingehalten und in Verbindung mit der Bemessung der Mindestbewehrung sowie den Aufwendungen für die Rißverpressung eine kostenseitige Optimierung erreicht werden kann.Obwohl im folgenden nur auf die Rißbreitenbeschränkung bei frühem Zwang abgestellt wird, ist in der Tragwerksplanung die weitere Entwicklung der Spannungssituation ebenfalls zu berücksichtigen. Beispielsweise kann bei Außenbauteilen im Winter nach der Herstellung des Bauteiles eine Zwangsbeanspruchung auftreten, die bei höherer Zugfestigkeit zu einer Rißkraft führt, für die die rißbreitenbeschränkende Bewehrung dann nicht ausreicht.
Statische und dynamische Berechnung von Turbinenfundamenten aus Stahlbeton
Authors: Hüffmann Günter , Nawrotzki Peter , Uzunoglu Timur 
Published: October 2005

AbstractDer vorliegende Aufsatz gibt einen Abriß über den aktuellen Stand der Technik bei der Auslegung und Berechnung von Turbinenfundamenten aus Stahlbeton aus der Sicht des Bauingenieurs. Dabei werden mögliche Fundamenttypen sowie auftretende Lasten und die an Turbinenfundamente gestellten Anforderungen ausführlich diskutiert. Aktuelle Berechnungsmethoden zur Ermittlung der Eigenfrequenzen und Schwingamplituden sowie die Behandlung von Sonderfällen in Erdbebengebieten werden erläutert. Baupraktische Aspekte und Kenndaten von ausgeführten Gas‐ und Dampfturbinenfundamenten runden den Beitrag ab.
Effects of i and i+3 residue identity on Cis–Trans isomerism of the aromatici+1–prolyli+2 amide bond: Implications for type VI β‐turn formation
Authors: Meng Hai Yun , Thomas Krista M. , Lee Aaron E. , Zondlo Neal J. 
Published: October 2005

AbstractCis–trans isomerization of amide bonds plays critical roles in protein molecular recognition, protein folding, protein misfolding, and disease. Aromatic–proline sequences are particularly prone to exhibit cis amide bonds. The roles of residues adjacent to a tyrosine–proline residue pair on cis–trans isomerism were examined. A short series of peptides XYPZ was synthesized and cis–trans isomerism was analyzed. Based on these initial studies, a series of peptides XYPN, X = all 20 canonical amino acids, was synthesized and analyzed by NMR for i residue effects on cis–trans isomerization. The following effects were observed: (a) aromatic residues immediately preceding Tyr–Pro disfavor cis amide bonds, with Ktrans/cis= 5.7–8.0, W > Y > F; (b) proline residues preceding Tyr–Pro lead to multiple species, exhibiting cis–trans isomerization of either or both X–Pro amide bonds; and (c) other residues exhibit similar values of Ktrans/cis (= 2.9–4.2), with Thr and protonated His exhibiting the highest fraction cis. β‐Branched and short polar residues were somewhat more favorable in stabilizing the cis conformation. Phosphorylation of serine at the i position modestly increases the stability of the cis conformer. In addition, the effect of the i+3 residue was examined in a limited series of peptides TYPZ. NMR data indicated that aromatic residues, Pro, Asn, Ala, and Val at the i+3 residue all favor cis amide bonds, with aromatic residues and Asn favoring more compact ϕ at Tyrcis and Ala and Pro favoring more extended ϕ at Tyrcis. D‐Alanine at the i+3 position particularly disfavors cis amide bonds. © 2005 Wiley Periodicals, Inc. Biopolymers 84: 192–204, 2006This article was originally published online as an accepted preprint. The “Published Online” date corresponds to the preprint version. You can request a copy of the preprint by emailing the Biopolymers editorial office at biopolymers@wiley.com
Targeted chemotherapy with cytotoxic bombesin analogue AN‐215 can overcome chemoresistance in experimental renal cell carcinomas
Authors: Keller Gunhild , Schally Andrew V. , Nagy Attila , Halmos Gabor , Baker Benjamin , Engel Jorg B. 
Published: October 2005

AbstractBACKGROUNDMultidrug resistance (MDR) mediated by membrane transporters, such as P‐glycoprotein (MDR‐1) and MDR‐associated protein (MRP), remains a challenge in the therapy of renal cell carcinoma (RCC). Chemotherapy targeted to hormone receptors may provide a new approach to overcome chemoresistance. The cytotoxic analogue of bombesin/gastrin‐releasing peptide (GRP), AN‐215, consists of a superactive derivative of doxorubicin, AN‐201, which is linked to a bombesin analogue carrier: RC‐3094.METHODSThe authors examined the expression of bombesin/GRP receptors in 3 human RCC cell lines (A‐498, ACHN. and 786‐0) by using reverse‐transcriptase‐polymerase chain reaction (RT‐PCR) analysis and radioligand‐binding assays. They also evaluated the effects of AN‐215 and its cytotoxic radical AN‐201 in the same RCC models in vivo, and they studied the effects of AN‐215 and AN‐201 on the expression levels of MDR‐1 and subtype 1 of MRP (MRP‐1) by using real‐time PCR.RESULTSA N‐215 significantly (P < 0.05) inhibited the growth of A‐498, ACHN, and 786‐0 RCC xenografted into nude mice by 59.2–67.6%, whereas the cytotoxic radical AN‐201 alone had no significant antitumor effects. The efficacy of AN‐215 was independent of the expression patterns of MDR‐1 and MRP‐1 in these RCC cell lines. The induction of MDR‐1 by AN‐215 was similar (Experiment 2) or weaker (Experiment 1) compared with AN‐201. Both AN‐215 and AN‐201 caused only a minor induction of MRP‐1.CONCLUSIONSThe current findings indicated that targeted chemotherapy with cytotoxic bombesin/GRP analogue AN‐215 can inhibit the growth of RCC, providing a new treatment modality for patients with advanced RCC. Cancer 2005. © 2005 American Cancer Society.
Differences in the quality of breast cancer care among vulnerable populations
Authors: Haggstrom David A. , Quale Chris , Smith‐Bindman Rebecca 
Published: October 2005

AbstractBACKGROUNDIt is unknown whether differences in the quality of breast cancer care among women from racial and ethnic minority groups, the elderly, and rural areas have changed over time across the continuum of care.METHODSThe linked Surveillance, Epidemiology, and End Results‐Medicare database identified 22,701 women ages 66–79 years diagnosed with early stage breast cancer from 1992–1999. Multiple breast cancer processes of care were measured, including breast‐conserving surgery, radiation therapy, documentation of estrogen receptor status, surveillance mammography, and a combined measure of “adequate care”.RESULTSAfrican‐American and Hispanic women were significantly less likely to receive adequate care than White women in unadjusted comparisons (54.7% and 58.0% vs. 68.4% for African‐American and Hispanic vs. White women) and adjusted comparisons (adjusted odds ratio [AOR] 0.67; 95% confidence interval [95% CI] 0.59–0.76, and AOR 0.77; 95% CI 0.66–0.90 for African‐American and Hispanic women, respectively). The proportion of Asian/Pacific Islander women receiving adequate care was similar to White women. When considering only women diagnosed with breast cancer from 1997–1999, African‐American women remained less likely than White women to receive adequate care (AOR 0.63; 95% CI 0.50–0.79). Women ages 75–79 years were less likely to receive adequate care compared with women ages 66–69 years (AOR 0.74; 95% CI 0.69–0.80), and women from rural (vs. metropolitan) areas were less likely to receive adequate care (AOR 0.81; 95% CI 0.73–0.89).CONCLUSIONSThe quality of breast cancer care is lower among vulnerable populations across the continuum of care, and many of these differences have not improved in more recent years. Cancer 2005. © 2005 American Cancer Society.
A stabilized finite element formulation to solve high and low speed flows
Authors: Costa Gustavo K. , Lyra Paulo R. M. 
Published: October 2005

AbstractIt is well known that numerical methods designed to solve the compressible Euler equations, when written in terms of conservation variables behave poorly in the incompressible limit, that is, when density variations are negligible. However, a change to pressure based variables seem to, partly, eliminate the problem by making the Jacobian matrices fully invertible whatever the flow regime may be. Despite this apparent benefit, the stabilization matrix plus discontinuity capturing operator (for the compressible regime) still need attention, since they tend to be ill behaved for either conservation or pressure variables. In this paper, we introduce a simple way of balancing two stabilizing matrices, one of them suitable for low Mach flows and the other one for supersonic flows, so that a wide range of flow regimes are covered with only one formulation. Comparison between conservation and pressure variables is made and numerical examples are shown to validate the method. Copyright © 2005 John Wiley & Sons, Ltd.
Crystal Structure and Carbon Vacancy Hardening of (W0.5Al0.5)C1−x Prepared by a Solid‐State Reaction
Authors: Yan Junmin , Ma Xianfeng , Zhao Wei , Tang Huaguo , Zhu Changjun , Cai Shuguang 
Published: October 2005

AbstractNovel solid solutions of aluminum in tungsten carbide (WC) with or without carbon vacancies, which can be expressed by the chemical formula (W0.5Al0.5)C1−x (x=0.0–0.5), have been synthesized by the solid‐state reaction of W0.5Al0.5 alloy and the proper amount of carbon at around 1673 K in vacuum. The reaction time decreases from 73 to 50 h on increasing the carbon vacancy concentration from 0 to 50 %. The formation of the intended products is certified, by X‐ray diffraction, environmental scanning electron microscopy–energy‐dispersive X‐ray analysis, and inductively coupled plasma–atomic emission spectroscopy, even though the carbon vacancy concentration reaches the astonishing value of 50 %. The as‐prepared (W0.5Al0.5)C1−x samples have been identified as the hexagonal WC‐type structure belonging to the space group P6m2 (Z=1). Moreover, the crystallographic results reveal that the substituting aluminum atoms in the WC are located in the 1a site (the W atom position of the WC structure) and the cell parameters decrease slightly with increasing vacancy concentration. The hardness of the (W0.5Al0.5)C1−x system increases up to a maximum 2659 kg mm−2 at a carbon vacancy concentration of about 35 %, and the density of (W0.5Al0.5)C1−x is far lower than that of WC.
Charge Trapping and Photoadsorption of O2 on Dehydroxylated TiO2 Nanocrystals—An Electron Paramagnetic Resonance Study
Authors: Berger Thomas , Sterrer Martin , Diwald Oliver , Knözinger Erich 
Published: October 2005

AbstractThe interaction of photogenerated charges with molecular oxygen was investigated on TiO2 nanocrystals by means of paramagnetic resonance (EPR) spectroscopy. Compared to photoactivation experiments in vacuum at P<10−6 mbar and T=140 K, the presence of O2 enhances the concentration of persistently trapped electron and hole centres—by a factor of ten—due to the formation of adsorbed O2− species. The photoadsorption of oxygen was also tracked quantitatively by pressure measurements, and the number of trapped charges, hole centres and O2− was found to correspond to ten electron–hole pairs per TiO2 nanocrystal. Conversely, in experiments at P<10−6 mbar with one trapped electron–hole pair per particle, charge separation is not persistent and completely reversible with respect to temperature. Heating to 298 K causes the total annihilation of photogenerated and trapped charges.
Apertureless Near‐Field Vibrational Imaging of Block‐Copolymer Nanostructures with Ultrahigh Spatial Resolution
Authors: Raschke Markus B. , Molina Leopoldo , Elsaesser Thomas , Kim Dong Ha , Knoll Wolfgang , Hinrichs Karsten 
Published: October 2005

AbstractNanodomains formed by microphase separation in thin films of the diblock copolymers poly(styrene‐b‐2‐vinylpyridine) (PS‐b‐P2VP) and poly(styrene‐b‐ethyleneoxide) (PS‐b‐PEO) were imaged by means of infrared scattering‐type near‐field microscopy. When probing at 3.39 μm (2950 cm−1), contrast is obtained due to spectral differences between the CH stretching vibrational resonances of the respective polymer constituents. An all‐optical spatial resolution better than 10 nm was achieved, which corresponds to a sensitivity of just several thousand CH groups facilitated by the local‐field enhancement at the sharp metallic probe tips. The results demonstrate that infrared spectroscopy with access to intramolecular dimensions is within reach.
Structure Determination of Resorcinol Rotamers by High‐Resolution UV Spectroscopy
Authors: Myszkiewicz Grzegorz , Meerts W. Leo , Ratzer Christian , Schmitt Michael 
Published: October 2005

AbstractThe rotationally resolved S1←S0 electronic origins of several deuterated resorcinol rotamers cooled in a molecular beam have been recorded. An automated assignment of the observed spectra has been performed using a genetic algorithm approach with an asymmetric rotor Hamiltonian. The structures of resorcinol A and resorcinol B were derived from the rotational constants of twenty deuterated species for both electronic states. The lifetimes of different resorcinol isotopomers in the S1 state are also reported. As is the case for phenol, these lifetimes mainly depend on the position of deuteration. A nearly perfect additivity of the zero‐point energies after successive deuterations in resorcinol rotamers has been discovered and subsequently used in the full assignment of the previously reported low‐resolution spectra of deuterated resorcinol A. An analogous spectrum is also predicted for the resorcinol B rotamer.
An algorithm for isentropic flow
Authors: Glaister P. 
Published: October 2005

AbstractAn efficient algorithm is presented for the solution of the equations of isentropic gas dynamics with a general convex gas law. The scheme is based on solving linearized Riemann problems approximately, and in more than one dimension incorporates operator splitting. In particular, only two function evaluations in each computational cell are required. The scheme is applied to a standard test problem in gas dynamics for a polytropic gas.
Locally mass‐conserving Taylor–Hood elements for two‐ and three‐dimensional flow
Authors: Thatcher R. W. 
Published: October 2005

AbstractBy supplementing the pressure space for Taylor–Hood elements, elements that satisfy continuity locally are produced. These elements are shown to satisfy the Babuska–Brezzi compatibility condition by using the patch argument.Two examples are presented, one illustrating the convergence rates and the other illustrating a difficulty with a Taylor–Hood element that is overcome by the element presented here.