bluuebunny/crossref_metadata_2025_split huggingface dataset:
Urethral diverticula: a diagnostic dilemma
Authors: Rufford Jane , Cardozo Linda 
Published: November 2004

OBJECTIVETo review the urethral diverticula encountered in a tertiary‐referral urogynaecology unit.PATIENTS AND METHODSThe case‐notes of all women who had a diverticulectomy between March 1996 and May 2001 were reviewed. Demographic details, symptoms at presentation, duration of symptoms before diagnosis, investigations, operative details, postoperative complications and symptoms at follow‐up were considered.RESULTSIn all, 18 women had had a urethral diverticulectomy. The median (range) time from presentation to diagnosis was 9.5  (2–96) months. The symptoms before surgery were variable; after surgery there were significant improvements in the symptoms of frequency, terminal dribbling and recurrent urinary tract infections (P < 0.05). There was no improvement in urgency, urge incontinence, nocturia and stress incontinence. Eleven of the 18 diverticula were palpable on vaginal examination. Video cysto‐urethrography was used in 15 women and the diverticulum was seen in 14. In addition, seven women had additional lower urinary tract pathology.CONCLUSIONSUrethral diverticula have no classical presentation; they often present with many symptoms and it is important that the diagnosis is not overlooked. Video cysto‐urethrography is a good diagnostic test and allows the simultaneous evaluation of function of the whole of the lower urinary tract.
A new autologous keratinocyte dressing treatment for non‐healing diabetic neuropathic foot ulcers
Authors: Moustafa M. , Simpson C. , Glover M. , Dawson R. A. , Tesfaye S. , Creagh F. M. , Haddow D. , Short R. , Heller S. , MacNeil S. 
Published: November 2004

AbstractAims   To evaluate the use of a new cell‐tailored carrier surface (TranCell) for delivery of autologous keratinocytes to promote wound healing in patients with chronic neuropathic foot ulcers.Methods   TranCell is a sterile medical grade polymer coated with a plasma‐polymerized functional surface containing 20% carboxylic acid which enables keratinocytes to attach and proliferate. Six diabetic patients with neuropathic ulcers resistant to conventional therapy were treated with weekly applications of autologous keratinocytes delivered on TranCell. A split‐thickness skin biopsy was taken from each patient followed by isolation, expansion and freezing down of keratinocytes. Keratinocytes were thawed and seeded on TranCell 48 h prior to application. This procedure was repeated weekly in addition to conventional therapy until wound healing was achieved.Results   Complete healing was achieved in six out of nine ulcers in six patients, a reduction in ulcer size was achieved in one ulcer and no response was seen in one ulcer. Treatment was discontinued in one patient due to development of Methicillin‐Resistant Staphylococcus aureus (MRSA) after only three applications of TranCell. Wound healing took 6–17 applications over 6–20 weeks. There were no recurrences in the healed ulcers after a follow‐up of 6 months.Conclusions   TranCell delivery of autologous cells is a promising treatment for chronic diabetic foot ulcers with no side‐effects and no recurrence in the healed ulcers.
Functional status before and after diagnosis of Type 2 diabetes
Authors: Nichols G. A. , Brown J. B. 
Published: November 2004

AbstractAims  We examined functional health status prior to the diagnosis of Type 2 diabetes, and measured the effect on functional health status of receiving the diagnosis.Methods  After the ADA reduced its fasting plasma glucose level for diagnosing diabetes from > 7.8 to > 7.0 mmol/l, we identified 1014 members of a large HMO who met the new criteria, and an age‐ and gender‐matched comparison group who did not. We mailed questionnaires to these subjects in 1998, and again in 1999 to 623 who met the new criteria, after some had been notified of their diabetes, while others had not. We used the SF‐12® Health Survey to measure physical and mental subjective health status.Results  Mean age of respondents meeting new diagnostic criteria (n = 498) was 67.3 + 10.4 years, 43.6% were women. Comparison group respondents (n = 589) were 66.7 + 10.6 years, 45.2% women. The groups were not statistically different on either characteristic. Prior to the diagnosis of Type 2 diabetes, physical functioning was already lower in subjects who met the new criteria than in the comparison group (39.5 vs. 42.1, P < 0.001), mental functioning was similar (51.4 vs. 51.9, P = 0.406). Among those who newly met diagnostic criteria for diabetes, there was no difference in the change in health status (mental or physical) in those who reported receiving a diagnosis (n = 105) compared with those who did not (n = 168).Conclusions  Physical health status is already reduced prior to diabetes diagnosis, perhaps because of obesity or other aspects of the insulin resistance syndrome. Receiving a diabetes diagnosis after adjusting the diagnostic criteria does not adversely affect either mental or physical health status.
The adiponectin gene SNP+45 is associated with coronary artery disease in Type 2 (non‐insulin‐dependent) diabetes mellitus
Authors: Lacquemant C. , Froguel P. , Lobbens S. , Izzo P. , Dina C. , Ruiz J. 
Published: November 2004

AbstractBackground  The ACRP30/adiponectin gene on chromosome 3q27, a region linked to the metabolic syndrome, encodes for the abundant adipocyte‐specific secreted protein. Consistent rodent and human studies suggested that this adipokine may be a molecular link between metabolic and cardiovascular diseases.Aims  In order to investigate the role of single nucleotide polymorphisms (SNPs) within the APM1 gene in the susceptibility to coronary artery disease (CAD), we performed a case‐control study on Caucasian Type 2 (non‐insulin‐dependent) diabetic patients, a population at high‐risk for CAD.Methods  Five APM1 SNPs were genotyped in 162 Type 2 diabetic French and Swiss subjects with CAD and in 315 Type 2 diabetic French and Swiss subjects without CAD.Results  In univariate analysis, SNP+45 T>G was associated with CAD (OR 1.9 95% CI 1.2–2.9 P = 0.0036). In multivariate analysis, SNP+45 T>G remained associated with CAD (OR 1.2 95% CI 0.8–1.9 P = 0.017), independently of classical cardiovascular risk factors including components of the metabolic syndrome. SNP haplotype analyses revealed a CAD protective combination of all SNP wild‐type alleles (OR 0.5 95% CI 0.3–0.7 P = 0.0006).Conclusions  Our study, performed in diabetic subjects, revealed an association between individual SNP+45 in the APM1 gene and CAD. Furthermore, the susceptibility for CAD due to SNP+45 was independent of classic cardiovascular risk factors. Further studies will be necessary to confirm the role of SNP+45 in the development of CAD. However, ACRP30/adiponectin may contribute to atherosclerosis susceptibility in high‐risk populations such as Type 2 diabetic subjects.
Impaired fasting glucose vs. glucose intolerance in pre‐menopausal women: distinct metabolic entities and cardiovascular disease risk?
Authors: Piché M. E. , Després J. P. , Pascot A. , Nadeau A. , Tremblay A. , Weisnagel S. J. , Bergeron J. , Lemieux S. 
Published: November 2004

AbstractBackground  Impaired glucose tolerance (IGT) is associated with an increased cardiovascular disease risk. Less is known about cardiovascular disease risk among subjects with impaired fasting glucose (IFG) or with combined IFG and IGT.Aims  To compare body composition, body fat distribution, plasma glucose‐insulin homeostasis and plasma lipid‐lipoprotein profile between pre‐menopausal women having either a normal glucose tolerance (NGT), isolated IFG, isolated IGT or combined IFG and IGT.Methods Three hundred and thirty‐four women with NGT, 11 women with IFG, 35 women with IGT and 10 women with both IFG and IGT were studied.Results  Women with IFG were characterized by a higher visceral adipose tissue (AT) accumulation than women with NGT (P < 0.05). Also, they were characterized by a higher subcutaneous AT area and by higher body fat mass than NGT and IGT women (P < 0.05). However, their lipid‐lipoprotein profile was comparable with that of NGT women, except for reduced HDL‐cholesterol concentrations (P < 0.05). After adjustment for visceral AT, women with IFG had lower total cholesterol, LDL‐cholesterol and apolipoprotein B (apoB) levels than the three other groups. They also had lower HDL2‐cholesterol than NGT women and lower total cholesterol/HDL‐cholesterol ratio than IGT women. Women with IGT showed higher triglyceride and apoB concentrations and a higher total cholesterol/HDL‐cholesterol ratio than women with NGT (P < 0.05). Overall, women with combined IFG and IGT showed body fatness characteristics and alterations in their metabolic risk profile which were essentially similar to women with isolated IGT.Conclusions  These results indicate that there are significant differences in anthropometric and metabolic variables between pre‐menopausal women with IFG vs. IGT and that the association between body fatness‐body fat distribution indices and the metabolic profile may differ between IFG and IGT women.
Diabetic foot ulcer and multidrug‐resistant organisms: risk factors and impact
Authors: Hartemann‐Heurtier A. , Robert J. , Jacqueminet S. , Ha Van G. , Golmard J. L. , Jarlier V. , Grimaldi A. 
Published: November 2004

AbstractAims  The primary objective was to characterize factors allowing the colonization of diabetic foot wounds by multidrug‐resistant organisms (MDRO), and the secondary objective was to evaluate the influence of MDRO colonization/infection on wound healing.Methods  In 180 patients admitted to a specialized diabetic foot unit, microbiological specimens were taken on admission. Potential risk factors for MDRO‐positive specimens were examined using univariate and multivariate analyses. Prospective follow‐up data from 75 patients were used to evaluate the influence of MDRO colonization/infection on time to healing.Results  Eighteen per cent of admission specimens were positive for MDRO. MDRO‐positive status was not associated with patient characteristics (age, sex, type of diabetes, complications of diabetes), wound duration, or wound type (neuropathic or ischaemic). In the multivariate analysis, the only factors significantly associated with positive MDRO status on admission were a history of previous hospitalization for the same wound (21/32 compared with 48/148; P = 0.0008) or the presence of osteomyelitis (22/32 compared with 71/148; P = 0.025). In the longitudinal study of 75 wounds, MDRO‐positive status on admission or during follow‐up (6 months at least or until healing, mean 9 ± 7 months) was not associated with time to healing (P = 0.71).Conclusion  MDROs are often present in severe diabetic foot wounds. About one‐third of patients with a history of previous hospitalization for the same wound, and 25% of patients with osteomyelitis, had MDRO‐positive specimens. This suggests that hygiene measures, or isolation precautions in the case of admission of patients presenting with these characteristics, should be aggressively implemented to prevent cross‐transmission. Positive MDRO status is not associated with a longer time to healing.
Variations in glucose self‐monitoring during oral hypoglycaemic therapy in primary care
Authors: Gulliford M. , Latinovic R. 
Published: November 2004

AbstractObjective  To describe the prescription of glucose self‐monitoring materials in the first 12 months after initiation of oral hypoglycaemic therapy.Methods  Cohort study of subjects registered with UK general practices and prescribed oral hypoglycaemic drugs for the first time between January 1993 and December 1998. Analyses were adjusted for age, sex, year, prevalent coronary heart disease and clustering by practice.Results  Data were analysed for 11 688 subjects registered with 262 practices. The proportion who received no prescriptions for monitoring increased from 24% in 1993 to 30% in 1998; urine glucose monitoring only decreased from 45 to 27%; while blood glucose monitoring only increased from 19 to 32%. In those under 45 years, 25% were not prescribed monitoring, increasing to 53% in those aged 85 years and over. In the same age groups, the proportion prescribed blood glucose monitoring only declined from 37 to 16%. At different general practices, the proportion of patients prescribed monitoring strips ranged from 12 to 100%. Practices with more registered diabetic patients were more likely to prescribe urine glucose monitoring only. Monitoring prescriptions varied widely between England, Scotland, Wales and Northern Ireland. Among eight English regions, the proportion prescribed blood glucose monitoring only ranged from 18 to 37%.Conclusions  Prescription of glucose monitoring varies according to patient and practice characteristics and geographical location. Monitoring patterns are changing over time. These variations may reflect uncertainty concerning the effectiveness of monitoring, and diversity of patient and professional preferences with respect to monitoring.
Dynamic Costs of the Draft
Authors: Lau Morten I. , Poutvaara Panu , Wagener Andreas 
Published: November 2004

AbstractWe propose a dynamic general-equilibrium model with human capital accumulation to evaluate the economic consequences of compulsory services (such as military draft or social work). Our analysis identifies a so far ignored dynamic cost arising from distortions in time allocation over the life cycle.We provide conservative estimates for the excess burden that arises when the government relies on forced labor rather than on income taxation to finance public expenditures. Our results suggest that eliminating the draft could produce considerable dynamic gains, both in terms of GDP and lifetime utility.
Business Cycle Volatility in Germany
Authors: Buch Claudia M. , Pierdzioch Christian , Doepke Joerg 
Published: November 2004

Abstract
Stylized facts suggest that output volatility in OECD countries has declined in recent years. The causes and the nature of this decline have so far been analyzed mainly for the United States. In this paper, we analyze whether structural changes in output volatility in Germany can be detected. We report evidence that output volatility has declined in Germany. It is difficult to answer the question whether this decline in output volatility reflects good economic and monetary policy or merely ‘good luck’.
Testing for a Finite Mixture Model with Two Components
Authors: Chen Hanfeng , Chen Jiahua , Kalbfleisch John D. 
Published: November 2004

SummaryWe consider a finite mixture model with k components and a kernel distribution from a general one-parameter family. The problem of testing the hypothesis k=2 versusk⩾3 is studied. There has been no general statistical testing procedure for this problem. We propose a modified likelihood ratio statistic where under the null and the alternative hypotheses the estimates of the parameters are obtained from a modified likelihood function. It is shown that estimators of the support points are consistent. The asymptotic null distribution of the modified likelihood ratio test proposed is derived and found to be relatively simple and easily applied. Simulation studies for the asymptotic modified likelihood ratio test based on finite mixture models with normal, binomial and Poisson kernels suggest that the test proposed performs well. Simulation studies are also conducted for a bootstrap method with normal kernels. An example involving foetal movement data from a medical study illustrates the testing procedure.
Transforming Qualitative Survey Data: Performance Comparisons for the UK*
Authors: Driver Ciaran , Urga Giovanni 
Published: November 2004

AbstractThis paper assesses different ways of converting qualitative data obtained in surveys into quantitative indices for a number of economic variables. The research reported here focuses on the main UK employers’ business survey for manufacturing – the CBI industrial trends survey. Six response variables are investigated – plant and machinery investment, output, employment, exports, price and cost. We find that the balance statistic is a satisfactory method of transforming three of the variables: investment, output and exports.
An algorithm‐based genotypic resistance score is associated with clinical outcome in HIV‐1‐infected adults on antiretroviral therapy
Authors: Ormaasen V , Sandvik L , Åsjø B , Holberg‐Petersen M , Gaarder PI , Bruun JN 
Published: November 2004

ObjectivesThe aim of this study was to evaluate the association between genotypic drug resistance and the occurrence of HIV‐related diseases and death in HIV‐1‐infected adults on antiretroviral therapy.MethodsWe performed an observational study on patients from an out‐patient clinic in a university hospital. Genotypic drug resistance analysis after virological treatment failure was performed in 141 patients receiving two or more antiretroviral drugs. All patients had follow up of at least 6 months after the resistance test. An algorithm was developed to estimate the level of genotypic drug resistance and to assign an actual resistance score (ARS) for the drugs prescribed to each patient. The patient population was divided into quartiles according to patients' ARS values. Our endpoint was the risk of developing an HIV‐related disease [Centers for Disease Control and Prevention (CDC) category B or C] during the period starting 6 months prior to and ending 6 months after the genotypic resistance test, or death during the 6 months following the resistance test.ResultsThere was a significant association between the level of resistance to the drugs prescribed (ARS) and our clinical endpoint: the odds ratio for an endpoint (with 95% confidence interval) was 3.20 (1.28–7.99), adjusted for CD4 cell count and HIV RNA, in patients in the highest ARS quartile compared with patients in the other three quartiles.ConclusionsOur study indicates that patients with high‐level genotypic drug resistance are at increased risk of developing an HIV‐related disease. This association could not be explained by differences in CD4 cell count or HIV RNA levels.
The Ethics of History: From the Double Binds of (Moral) Meaning to Experience
Authors: ANKERSMIT F. R. 
Published: November 2004

Fidelities. Now that she has brought it out, she recognizes it as the word on which all hinges.J. M. Coetzee, Elizabeth Costello, 224.
ABSTRACTThe point of departure of this essay is a paradox in traditional conceptions of historical objectivity. This paradox can best be analyzed in terms of the notion of the “double bind”: the requirement of historical objectivity is formulated in such a way that it is impossible to satisfy the requirement. The substance of this essay is an investigation of how J. M. Coetzee deals with the moral impasses of this double bind in his most recent novel, Elizabeth Costello (2003). In essence Coetzee forces his way through the double bind by an appeal to a direct experience of the world. The Spinozism implied by this strategy is indicated at the end of the essay. The analysis of Coetzee's novel is preceded by a discussion of Kafka's “Before the Law,” since the relevant part of Coetzee's novel clearly is a paraphrase of the Kafka parable. Moreover, insight into the textual double binds in the Kafka parable contributes to an understanding of the moral double binds that are addressed in Elizabeth Costello.
How to Overcome Ethnocentrism: Approaches to a Culture of Recognition by History in the Twenty‐First Century1
Authors: RÜSEN JÖRN 
Published: November 2004

Die wahre Liberalität ist Anerkennung.Goethe2ABSTRACTMuch international and intercultural discourse about historiography is influenced by a way of historical thinking deeply rooted in human historical consciousness and that works throughout all cultures and in all times: ethnocentrism. Ethnocentric history conceives of identity in terms of “master‐narratives” that define togetherness and difference as essential for identity in a way that causes tension and struggle. These narratives conceive of history in terms of “clashes of civilizations,” and they reinforce the idea that international and intercultural relations are merely struggles for power.The main elements of ethnocentrism are: asymmetrical evaluation, teleological continuity, and centralized perspective. This essay articulates possibilities for overcoming these three elements by replacing asymmetrical evaluation with normative equality; teleological continuity with reconstructive concepts of development that emphasize contingency and discontinuity; and centralized perspectives with multi‐perspectivity and polycentric approaches to historical experience. Adopting these possibilities would lead to a new mode of universal history rooted in a concept of humankind that can help solve the problem of ethnocentrism. This idea of humankind conceptualizes the unity of the human species as being manifest in a variety of cultures and historical developments. This is in fact the traditional concept of historicism, which can be further developed towards a historiography that responds to the challenges of globalization and cultural differences.The essay outlines theoretical and methodological means in historical studies that bring this idea of humankind into the work of historians, thus enabling them to contribute to a new culture of recognition. The article is based on the assumption that the creation of such a culture is the most important task of scholarly work in the humanities in general, and historical studies in particular, at the beginning of the twenty‐first century.
Dynamism and embeddedness: towards a lower road? British subsidiaries of American multinationals
Authors: Clark Ian , Almond Phil 
Published: November 2004

ABSTRACTThis article examines the effects of changes in the dynamics of the American national business system on industrial relations settlements in the UK subsidiaries of American multinational corporations (MNCs). While institutionalist analyses of country‐of‐origin and host‐country effects must take account of changes in national business systems, such as the rise of the shareholder value ideology in the USA, empirical analysis reveals a pattern of pathway adjustment rather than radical change in employment relations at the UK subsidiary level. This suggests that although US MNCs are embedded within the American business system, their subsidiaries are not passive ciphers but autonomous sites through which influences must pass.
Regulierungswettbewerb im Deutschen Reich (1871–1914): Welche Erfahrungen sind für die Europäische Union relevant?
Authors: Ambrosius Gerold 
Published: November 2004

Abstract The question to what extent national regulations should compete or be harmonised within the European Union is important for the further process of integration. The past experiences of economically and politically integrated areas are neglected in this discussion. On the basis of an evolutionary concept of institutional competition this paper outlines how regulatory competition between the ‘Bundesstaaten’ of the German Empire of 1871 - in its political structure comparable with the European Union - and between the Empire and foreign countries performed up to First World War. The special case study deals with the regulation of food of wine, beer and meat, but the article tries to work out general hypotheses about institutional competition between different jurisdictions. Especially the limits of regulatory competition are brought out.