bluuebunny/crossref_metadata_2025_split huggingface dataset:
Randomised, double blind, placebo controlled comparison of ginkgo biloba and acetazolamide for prevention of acute mountain sickness among Himalayan trekkers: the prevention of high altitude illness trial (PHAIT)
Authors: Gertsch Jeffrey H , Basnyat Buddha , Johnson E William , Onopa Janet , Holck Peter S 
Published: March 2004

AbstractObjective To evaluate the efficacy of ginkgo biloba, acetazolamide, and their combination as prophylaxis against acute mountain sickness.Design Prospective, double blind, randomised, placebo controlled trial.Setting Approach to Mount Everest base camp in the Nepal Himalayas at 4280 m or 4358 m and study end point at 4928 m during October and November 2002.Participants 614 healthy western trekkers (487 completed the trial) assigned to receive ginkgo, acetazolamide, combined acetazolamide and ginkgo, or placebo, initially taking at least three or four doses before continued ascent.Main outcome measures Incidence measured by Lake Louise acute mountain sickness score ≥ 3 with headache and one other symptom. Secondary outcome measures included blood oxygen content, severity of syndrome (Lake Louise scores ≥ 5), incidence of headache, and severity of headache.Results Ginkgo was not significantly different from placebo for any outcome; however participants in the acetazolamide group showed significant levels of protection. The incidence of acute mountain sickness was 34% for placebo, 12% for acetazolamide (odds ratio 3.76, 95% confidence interval 1.91 to 7.39, number needed to treat 4), 35% for ginkgo (0.95, 0.56 to 1.62), and 14% for combined ginkgo and acetazolamide (3.04, 1.62 to 5.69). The proportion of patients with increased severity of acute mountain sickness was 18% for placebo, 3% for acetazoalmide (6.46, 2.15 to 19.40, number needed to treat 7), 18% for ginkgo (1, 0.52 to 1.90), and 7% for combined ginkgo and acetazolamide (2.95, 1.30 to 6.70).Conclusions When compared with placebo, ginkgo is not effective at preventing acute mountain sickness. Acetazolamide 250 mg twice daily afforded robust protection against symptoms of acute mountain sickness.
An outbreak of gastroenteritis from a non-chlorinated community water supply
Authors: Kuusi M , Klemets P , Miettinen I , Laaksonen I , Sarkkinen H , Hänninen M L , Rautelin H , Kela E , Nuorti J P 
Published: March 2004

Study objective:To determine the source and the extent of a community wide outbreak of gastroenteritis.Design:A matched case-control study with postal questionnaires. Subtyping of campylobacter strains by pulsed field gel electrophoresis (PFGE).Setting:A rural municipality with a population of 8600 in southern Finland, August 2000. Two thirds of the population receive non-chlorinated ground water from the municipal water supply.Participants:Cases were randomly selected among residents of the municipality who contacted the municipal health centre because of gastroenteritis and had illness onset between 31 July and 20 August 2000. Community controls were identified from the population registry and matched according to sex, year of birth, and postal code.Main results:Four hundred and sixty three persons contacted the municipal health centre because of gastroenteritis.Campylobacter jejuniwas isolated from stool samples of 24 persons. One hundred and thirty seven cases and 388 controls were enrolled in the case-control study. In multivariate analysis, drinking unboiled water from the municipal supply was significantly associated with illness (odds ratio 11.1, 95% confidence interval 1.4 to 90.2).C jejuniwas isolated from one tap water sample. The water isolate and all but one of the patient isolates were indistinguishable by PFGE.Conclusions:Combining epidemiological investigation with molecular subtyping methods provided strong evidence that water was the source of the outbreak. Non-chlorinated small ground water systems may be susceptible to waterborne outbreaks and constitute a risk to rural populations.
Social capital and collective efficacy in Hungary: cross sectional associations with middle aged female and male mortality rates
Authors: Skrabski Á , Kopp M , Kawachi I 
Published: March 2004

Objectives:Social capital, collective efficacy, and religious involvement have each been linked to population health. This study examined the relations between these measures and male/female mortality rates in Hungary.Design:Cross sectional, ecological study.Setting:150 sub-regions of Hungary.Participants and methods:12 643 people were interviewed in 2002 (the “Hungarostudy 2002” survey). Social capital was measured by lack of social trust, reciprocity between citizens, and membership in civil organisations. Collective efficacy was measured by survey items from the Project on Human Development in Chicago Neighborhoods. Religious involvement was measured by church attendance.Main outcome measure:Gender specific all cause mortality rates for the middle aged population (45–64 years) in the 150 sub-regions of Hungary, provided by the Central Statistical Office (CSO).Results:Social capital, collective efficacy, as well as religious involvement were each significantly associated with middle age mortality. After education, collective efficacy showed the strongest association with mortality in both men and women. Among men, socioeconomic status, collective efficacy, social distrust, competitive attitude, reciprocity, and membership of civic organisations explained 68.0% of the sub-regional variations in mortality rates. Among women the same variables explained only 29.3% of the variance in mortality rates. Religious involvement was protective among women.Conclusion:Collective efficacy and social capital are significant predictors of mortality rates in both men and women across sub-regions of Hungary. Gender differences in the relative importance of social factors may help to explain the differential impact of economic transformation on mortality rates for men and women in Central-Eastern European countries.
Providing treatment for hepatitis C in an Australian district centre
Authors: Ewart A , Harrison L , Joyner B , Safe A 
Published: March 2004

AbstractHepatitis C virus (HCV) poses a major public health problem world wide. The introduction of combined therapy (interferon and ribavirin) and the recent development of pegylated interferon have offered the opportunity to alter the natural history of HCV, potentially reducing morbidity and mortality. Until recently, treatment has been confined to larger Australian cities. This paper describes the establishment of a clinic for the treatment of HCV in a regional Australian city. The facilities of the sexual health clinic were utilised. Factors contributing to the success of the clinic include the specialist nurse, a multidisciplinary approach, and the service model of shared care with general practitioners. The patient population and the outcomes of managing HCV in a regional centre are described. The sustained viral response rate is comparable to the published data from specialist centres.
Breast cancer recurrence: follow up after treatment for primary breast cancer
Authors: Hiramanek N 
Published: March 2004

Abstract

Background
Breast cancer will affect one in 12 Australian women in their lifetime. After potentially curative treatment, it is usual for patients to be followed up for many years. However, controversies surround follow up, and its value is uncertain.

Aim
This study reviews the evidence and describes the role of routine follow up in the management of breast cancer in a tertiary hospital. By establishing how recurrence of breast cancer presents and identifying the proportion of patients with recurrence who were diagnosed as a consequence of regular follow up, the value of this system in detecting recurrence can be indirectly assessed.

Design
A retrospective review was undertaken of all patients attending the radiotherapy outpatient clinic for treatment of invasive breast cancer in 1997. Hospital records were reviewed to ascertain patient and tumour characteristics, treatment received, site of recurrence and its mode of detection, whether patients were symptomatic at the time of recurrence, and whether they presented at a scheduled appointment.

Results
Out of 286 patients who presented to the radiotherapy outpatient clinic, 220 were entered into the study. Recurrence was recorded in 42 patients (a complete dataset was available for 38 of these patients). In total, 74% (31/42) of recurrences were symptomatic, and 76% (32/42) presented at unscheduled appointments, the majority (17/32) of which were initiated by the patient. Only seven patients had asymptomatic recurrences.

Conclusion
Based on current evidence, long term routine hospital follow up after treatment for breast cancer appears to be inefficient in detecting recurrence.
How to assess epidemiological studies
Authors: Zaccai J H 
Published: March 2004

Abstract
Assessing the quality of an epidemiological study equates to assessing whether the inferences drawn from it are warranted when account is taken of the methods, the representativeness of the study sample, and the nature of the population from which it is drawn. Bias, confounding, and chance can threaten the quality of an epidemiological study at all its phases. Nevertheless, their presence does not necessarily imply that a study should be disregarded. The reader must first balance any of these threats or missing information with their potential impact on the conclusions of the report.
Implementation of British Thoracic Society guidelines for acute exacerbation of chronic obstructive pulmonary disease: impact on quality of life
Authors: Dheda K , Crawford A , Hagan G , Roberts C M 
Published: March 2004

Abstract

Background
The British Thoracic Society (BTS) guidelines have not been examined collectively for their impact on chronic obstructive pulmonary disease (COPD). Whether intensive outpatient follow up of COPD patients after acute admission, using these guidelines, improved quality of life compared to the “usual practice” of primary care follow up was investigated.

Methods
Altogether 103 patients with a new diagnosis of COPD were admitted and screened over a four year period. Seventy patients were excluded because of another dominant medical condition or a mandatory requirement for intervention. Patients were randomised to regular primary care (control group, n = 15) or chest clinic follow up (intervention group, n = 10). Spirometry, oxygen saturation, St George’s Respiratory Questionnaire (SGRQ), and Short Form 36 questionnaire were measured at baseline and six months. The intervention group was reviewed at least four times in the six month period and received spirometry, ambulatory oxygen assessment, smoking cessation advice, nebuliser assessment, a steroid trial, advice about nutrition/exercise, and introduction to a patient support group.

Results
There was no significant difference between baseline measurements in the two groups. There was a significant mean (SD) improvement in the SGRQ symptom score from baseline to six months in the intervention group [20.98 (20.36)] compared with the controls [0.23 (12.55)] (p = 0.004). At six months the SGRQ symptom score, impact score, and total score was significantly better in the intervention than the control group (p = 0.01, 0.02, and 0.02).

Conclusion
Aggressive implementation of BTS guidelines after initial hospitalisation may improve respiratory health specific quality of life scores in patients with COPD. Larger studies are needed to confirm this finding.
How to avoid being sued in clinical practice
Authors: Panting G 
Published: March 2004

Abstract
Challenges to clinical management are a fact of professional life. Every doctor must expect to become embroiled in complaints and claims from time to time and be prepared to justify why they managed a particular case in the way that they did. Good medical practice is defensible practice, which depends upon staying within the limits of your own expertise, keeping up to date and conducting audit, ensuring your administration is effective and that patients are not allowed to slip through the net, that you communicate effectively with patients, their carers and colleagues, and that medical records recall all salient facts relating to the patient.
If things go wrong, be open, investigate the facts, explain the situation fully to the patient, and do not be afraid to apologise.
INTERPLAY BETWEEN THE ALGEBRAIC STRUCTURE OF A GROUP AND ARITHMETIC PROPERTIES OF ITS SPECTRUM
Authors: BANAKH TARAS 
Published: March 2004

We investigate the interplay between the algebraic structure of a group G and arithmetic properties of its spectrum σ(G) which consists of the eigenvalues of all the inner automorphisms of G. A complex number λ is called an eigenvalue of a group automorphism A:G→G if φ◦A|H=λ·φ for some non-trivial homomorphism [Formula: see text] defined on an A-invariant subgroup H⊂G. It is shown that many properties of a group G (such as the presence of a finitely generated subgroup of infinite rank, nilpotence, periodicity, polycyclicity, etc.) are coded in its spectrum. In this paper the spectra are applied to the investigation of the so-called reversive properties of groups. The paper ends with a list of related open problems.
CRITICAL POINTS OF MASTER FUNCTIONS AND FLAG VARIETIES
Authors: MUKHIN E. , VARCHENKO A. 
Published: March 2004

We consider critical points of master functions associated with integral dominant weights of Kac–Moody algebras and introduce a generating procedure constructing new critical points starting from a given one. The set of all critical points constructed from a given one is called a population. We formulate a conjecture that a population is isomorphic to the flag variety of the Langlands dual Kac–Moody algebra and prove the conjecture for algebras slN+1, so2N+1, and sp2N. We show that populations associated with a collection of integral dominant slN+1-weights are in one to one correspondence with intersection points of suitable Schubert cycles in a Grassmannian variety.
Overexpression of Uncoupling Protein 2 in THP1 Monocytes Inhibits β2Integrin-Mediated Firm Adhesion and Transendothelial Migration
Authors: Ryu Je-Won , Hong Kyung Hee , Maeng Jin Hee , Kim Jae-Bum , Ko Jesang , Park Joong Yeol , Lee Ki-Up , Hong Myeong Ki , Park Seong Wook , Kim You Ho , Han Ki Hoon 
Published: March 2004

Objective—Uncoupling protein 2 (UCP2) belongs to the mitochondrial anion carrier family and regulates production of reactive oxygen species in macrophages. Previous studies have shown that selective genetic disruption of UCP2 in bone marrow cells results in excess accumulation of monocytes/macrophages in the vascular wall of hypercholesterolemic low-density lipoprotein receptor-deficient (LDLR−/−) mice. Here we investigated whether UCP2 regulates expression of genes involved in monocyte recruitment.Methods and Results—UCP2 overexpression in THP1 monocytes, which induced a 10-fold increase in mitochondrial UCP2 protein levels, reduced steady-state level of intracellular reactive oxygen species (ROS) and H2O2-induced ROS production. THP1 monocytes with UCP2 overexpression showed lower intracellular calcium levels and less H2O2-triggered intracellular calcium mobilization, and less protein and mRNA levels of β2integrins, most notably CD11b. UCP2 overexpression reduced β2integrin-mediated firm adhesion of monocytes to either tumor necrosis factor-α (TNF-α)–stimulated human aortic endothelial cell (HAEC) monolayers or to plates coated with intercellular adhesion molecule-1, not vascular cell adhesion molecule-1. UCP2 overexpression also inhibited cell spreading and actin polymerization in monocytes treated with TNF-α and monocyte chemoattractant protein-1 (MCP-1), and reduced MCP-1–induced transmigration of monocytes through HAEC monolayers.Conclusions—Mitochondrial UCP2 in circulating monocytes may prevent excessive accumulation of monocytes/macrophages in the arterial wall, thereby reducing atherosclerotic plaque formation.
Measurement of Carotid Plaque Volume by 3-Dimensional Ultrasound
Authors: Landry Anthony , Spence J. David , Fenster Aaron 
Published: March 2004

Background and PurposeMeasurement of carotid plaque volume and its progression are important tools for research and patient management. In this study, we investigate the observer variability in the measurement of plaque volume as determined by 3-dimensional (3D) ultrasound (US). We also investigate the effect of interslice distances (ISD) and repeated 3D US scans on measurement variability.Materials and MethodsForty 3D US patient images of plaques (range, 37.43 to 604.1 mm3) were measured by manual planimetry. We applied ANOVA to determine plaque volume measurement variability and reliability. Plaque volumes were measured with 9 ISDs to determine the effect of ISD on measurement variability. Additional plaque volumes were also measured from multiple 3D US scans to investigate repeated scan acquisition variability.ResultsIntraobserver and interobserver measurement reliabilities were 94% and 93.2%, respectively. Plaque volume measurement variability decreased with increasing plaque volume (range, 27.1% to 2.2%). Measurement precision was constant for ISDs between 1.0 and 3.0 mm, whereas plaque volume measurement variability increased with ISD. Repeated 3D US scan measurements were not different from single-scan measurements (P=0.867).ConclusionsThe coefficient of variation in the measurement of plaque volume decreased with plaque size. The volumetric change that must be observed to establish with 95% confidence that a plaque has undergone change is ≈20% to 35% for plaques <100 mm3and ≈10% to 20% for plaques >100 mm3. Measurement precision was unchanged for ISDs <3.0 mm, whereas measurement variability increased with ISD. Repeated 3D US scans did not affect plaque volume measurement variability.
THE FIGURE OF EVE IN ROMANS 7:5-25
Authors: Busch Austin 
Published: March 2004

AbstractRom. 7:7-25 functions as a prosopopoiia in which Paul rhetorically assumes the identity of Eve in the scene of the primeval transgression. While most Hellenistic biblical interpreters associated Eve with "feminine" passivity, Paul in Romans 7 (and to a lesser degree in 2 Corinthians 11) calls this simplistic association into question by drawing attention to an element of ("masculine") activity in her experience that other interpreters either overlooked or could not satisfactorily account for in their interpretations of her story. In Rom. 7:7-13 Eve in the scene of the primeval transgression (Genesis 2-3) becomes a figure of passivity and activity paradoxically conflated. In the following verses (7:14-25) Paul manipulates this conflation in order to illustrate the ego or self split under sin. Observing the unique way in which Paul employs the figure of Eve in Rom. 7:5-25 allows us to read the passage as a meditation on the primeval transgression offering a new perspective on the relationship between the self under sin and the law. This relationship bears deep structural similarities to the relationship of the infant to its mirror image that Jacques Lacan examines in his lecture "The Mirror Stage as Formative of the Function of the I" and a comparison between the two will clarify Paul's discussion of the connection between the self, the law, and sin in Rom. 7:5-25.
Ironic Representation, Authorial Voice, and Meaning in Qohelet
Authors: Sharp Carolyn 
Published: March 2004

AbstractThe book of Qohelet presents a literarily noteworthy double voicing and differing perspectives by means of the sage "Qohelet" and the Epilogist. Interpreters have responded with redactional schemas, on the one hand, and with literary defenses of the rhetorical unity of the book, on the other. Aligned with literary studies that discern a rhetorical purpose underlying the fictional character of the sage, the present essay argues for a governing metanarratological irony mediated by the construction of the persona of "Qohelet." Building on appraisals of key functions of irony by Kierkegaard, Booth, and Hutcheon, this study analyzes ways in which ironic representation and authorial voice work rhetorically in the book of Qohelet. Clues to the pervasive irony informing the representation of the persona of "Qohelet" can be discerned in the unreliability of "Qohelet's" voice, in the hyperbole that shades over into caricature regarding "Qohelet's" claims about himself, and in the epistemologically illegitimate way in which "Qohelet" grounds his global skepticism in his avowedly unique and un(con)testable personal experience. Intertextual allusions to the Garden of Eden story are mustered in support of the position that the book's ironic perspective inscribes in the body of "Qohelet" and in the corpus of the text the catastrophic effects of the human choice to privilege the sapiential quest over halakhic obedience. Implications of the present analysis press a challenge to postmodernist hermeneutical strategies that fail to address adequately the issue of the competent decoding of authorial intention in ironic texts.
An Overview of the International H2O Project (IHOP_2002) and Some Preliminary Highlights
Authors: Weckwerth Tammy M. , Parsons David B. , Koch Steven E. , Moore James A. , LeMone Margaret A. , Demoz Belay B. , Flamant Cyrille , Geerts Bart , Wang Junhong , Feltz Wayne F. 
Published: March 2004

The International H2O Project (IHOP_2002) is one of the largest North American meteorological field experiments in history. From 13 May to 25 June 2002, over 250 researchers and technical staff from the United States, Germany, France, and Canada converged on the Southern Great Plains to measure water vapor and other atmospheric variables. The principal objective of IHOP_2002 is to obtain an improved characterization of the time-varying three-dimensional water vapor field and evaluate its utility in improving the understanding and prediction of convective processes. The motivation for this objective is the combination of extremely low forecast skill for warm-season rainfall and the relatively large loss of life and property from flash floods and other warm-season weather hazards. Many prior studies on convective storm forecasting have shown that water vapor is a key atmospheric variable that is insufficiently measured. Toward this goal, IHOP_2002 brought together many of the existing operational and new state-of-the-art research water vapor sensors and numerical models.
The IHOP_2002 experiment comprised numerous unique aspects. These included several instruments fielded for the first time (e.g., reference radiosonde); numerous upgraded instruments (e.g., Wyoming Cloud Radar); the first ever horizontal-pointing water vapor differential absorption lidar (DIAL; i.e., Leandre II on the Naval Research Laboratory P-3), which required the first onboard aircraft avoidance radar; several unique combinations of sensors (e.g., multiple profiling instruments at one field site and the German water vapor DIAL and NOAA/Environmental Technology Laboratory Doppler lidar on board the German Falcon aircraft); and many logistical challenges. This article presents a summary of the motivation, goals, and experimental design of the project, illustrates some preliminary data collected, and includes discussion on some potential operational and research implications of the experiment.