bluuebunny/crossref_metadata_2025_split huggingface dataset:
Caenorhabditis elegans DAF‐21 (HSP90) is characteristically and predominantly expressed in germline cells: Spatial and temporal analysis
Authors: Inoue Tadao , Takamura Katsumi , Yamae Hisanori , Ise Naoto , Kawakami Manabu , Tabuse Yo , Miwa Johji , Yamaguchi Yasunori 
Published: September 2003

Three monoclonal antibodies against antigens that exist in the Caenorhabditis elegans germ line have previously been described. In the present study, a full‐length mRNA for one of these antigens was isolated, and by sequencing its corresponding cDNA, it was predicted that the protein would show a high homology with the 90 kDa heat shock protein (HSP90) in other species, and with the protein of daf‐21, a previously identified hsp90 homologue. The spatial and temporal distribution of the antigen (DAF‐21) was analyzed in C. elegans, and the localization of daf‐21 mRNA, as detected by in situ hybridization, agreed with that detected by the monoclonal antibody. Under normal conditions, daf‐21 mRNA is characteristically distributed in postembryonic germ cells derived from Z2 and Z3 cells in both hermaphrodites and males. Under heat stress conditions, however, daf‐21 mRNA was not only detected in germ cells, but also apparently expressed all over the body. In addition, the DAF‐21 protein seemed to be localized in the perinuclear region of somatic cells.
Entry overload, emergency department overcrowding, and ambulance bypass
Authors: Fatovich D M , Hirsch R L 
Published: September 2003

Objectives:To describe an experience of emergency department (ED) overcrowding and ambulance bypass.Methods:A prospective observational study at Royal Perth Hospital, a major teaching hospital. Episodes of ambulance bypass and their characteristics were recorded.Results:From 1 July 1999 to 30 June 2001, there were 141 episodes of ambulance bypass (mean duration 187 min, range 35–995). Monday was the most common day with 39 (28%) episodes. Entry block alone was the most common reason bypass was activated (n=38, 30.4%). The mean number of patients in ED at these times was 40 (occupancy 174%), including nine in the corridor, seven awaiting admission, and 14 waiting to be seen. Episodes attributable to entry block were typically preceded by a presentation rate of ⩾10 patients per hour for ⩾2 hours (OR 6.2, 95% CI 4.3 to 8.5). Mid-afternoon to early evening was the most common time for activation. Ambulance bypass is increasing in frequency and duration.Conclusions:Entry overload resulting in entry block results from overwhelming numbers of patients presenting to the ED in a short space of time. Entry block impairs access to emergency care. Unless something is done in the near future, the general public may no longer be able to rely on EDs for quality and timely emergency care. A “whole of system” approach is necessary to tackle the problem.
How well does decision support software perform in the emergency department?
Authors: Graber M A , VanScoy D 
Published: September 2003

Objective:To determine how well general decision support systems perform given the data collected in an emergency department (ED).Methods:A convenience sample of 25 patients was selected from those patients having a diagnostic question on presentation to the ED. All interactions with the patients were audiotaped and abstracted into a structured data form. All other data such as written notes, laboratory, and EKG results were also abstracted. All data were entered into two general diagnostic decision support programs (Quick Medical Reference (QMR Version 3.82, Knowledge Base 10–07–1998 Copyright University of Pittsburgh and The Hearst Corporation) and Iliad (Version 4.5 Copyright 1996 Applied Medical Informatics)). The diagnoses generated by the computer programs were compared with the final diagnoses of the ED attending.Results:The final ED diagnosis was found in the differential diagnosis generated by Iliad and QMR 72% and 52% of the time respectively. The final ED diagnosis was found in the top 10 diagnoses 51% and 44% of the time and in the top five diagnoses 36% and 32% of the time for each program respectively. This approximates to the performance of these programs in other clinical settings.Conclusions:Diagnostic decision support software has the same success in finding the “correct” diagnosis in the ED as in other clinical settings where more extensive clinical data are available. The accuracy is not sufficiently high to permit the use of these programs as an arbiter in any individual case. However, they may be useful, prompting additional investigation in particularly difficult cases.
Cost effectiveness of diagnostic strategies for patients with acute, undifferentiated chest pain
Authors: Goodacre S , Calvert N 
Published: September 2003

Objectives:Patients presenting to hospital with acute, undifferentiated chest pain have a low, but important, risk of significant myocardial ischaemia. Potential diagnostic strategies for patients with acute, undifferentiated chest pain vary from low cost, poor effectiveness (discharging all home) to high cost, high effectiveness (admission and intensive investigation). This paper aimed to estimate the relative cost effectiveness of these strategies.Methods:Decision analysis modelling was used to measure the incremental cost per quality adjusted year of life (QALY) gained for five potential strategies to diagnose acute undifferentiated chest pain, compared with the next most effective strategy, or a baseline strategy of discharging all patients home without further testing.Results:Cardiac enzyme testing alone costs £17 432/QALY compared with discharge without testing. Adding two to six hours of observation and repeat enzyme testing costs an additional £18 567/QALY. Adding exercise testing to this strategy costs £28 553/QALY. A strategy of overnight admission, enzyme, and exercise testing has an incremental cost of £120 369/QALY, while a strategy consisting of overnight admission without exercise testing is subject to extended dominance. Sensitivity analysis revealed that the results are sensitive to variations in the direct costs of running each strategy and to variation in assumptions regarding the effect of diagnostic testing upon quality of life of those with non-cardiac disease.Conclusion:Observation based strategies incur similar costs per QALY to presently funded interventions for coronary heart disease, while strategies requiring hospital admission may be prohibitively poor value for money. Validation of the true costs and effects of observation based strategies is essential before widespread implementation.
The epidemiology of assault across the West Midlands
Authors: Downing A , Cotterill S , Wilson R 
Published: September 2003

Objectives:The purpose of this study is to look at accident and emergency (A&E) attendances and admissions after assault in the West Midlands NHS region across a wide range of acute units.Methods:This study used data from two sources, the A&E Minimum Data Set and the Hospital Episode Statistics database. Analyses were based on data from 12 of the 21 acute trusts in the West Midlands NHS region for the period 1 April 1999 to 31 March 2000.Results:Analyses were performed on 15 969 A&E attendances and 1596 admissions. Some 67.4% of attenders and 84.2% of those admitted were male. The mean age of the patients was between 27 and 29 years. Attendance peaked between 2100 and 0259, especially on Friday and Saturday night. The most common injury was to the head. Some 75.3% of A&E attenders were discharged home. The average stay in hospital was two days and six deaths were recorded. Those living in the most deprived areas were nearly four times more likely to be admitted than those in the least deprived areas (175.9 per 1000 compared with 45.1 per 1000).Conclusions:This study shows assault is predominately a male phenomenon, worst in the evenings and at weekends, and is positively related to deprivation. It is probable that the levels recorded will be an underestimate, however with some additions to the information collected hospital records could create the basis for a comprehensive surveillance system.
How evidence based are therapeutic decisions taken on a medical admissions unit?
Authors: Hardern R D , Leong F T , Page A-V , Shepherd M , Teoh R C M 
Published: September 2003

Objectives:To audit the proportion of drug treatments started on a medical admissions unit that is justified by published evidence, and the proportion for which no justification could be found.Methods:Retrospective review of randomly selected case notes to identify drug treatments started and the problem(s) for which they were prescribed, followed by literature searches.Results:A total of 132 treatment-problem pairs were found, comprising 85 unique treatment-problem pairs. An evidence base was found in support of 78 of the treatments started (59.1%). A further 41 treatment-problem pairs could be argued to be reasonable practice (sometimes included in guidelines), even though no published trial data support them. Ninety per cent of drug treatments started on the medical admissions unit have either an evidence base or are accepted practice.Conclusions:Regular audit of this nature could be carried out on units admitting acute medical patients. Similar audits in internal medicine have delivered consistent results (50%–60%); there is a baseline level against which units can compare themselves. Clinical audit is an integral feature of clinical governance; all wards admitting acute medial patients could conduct similar audits on a random sample of patients.
Review of prehospital sodium bicarbonate use for cyclic antidepressant overdose
Authors: Calkins T , Chan T C , Clark R F , Stepanski B , Vilke G M 
Published: September 2003

Objective:To describe the clinical presentation of patients with cyclic antidepressant (CA) and use of sodium bicarbonate (NaHCO3) in the treatment of this overdose in the prehospital setting.Methods:A three year retrospective observational review of records was performed using the San Diego County Quality Assurance Network database for prehospital providers. All adult patients who were treated with NaHCO3by paramedics for a CA overdose were included. Demographic data, presenting cardiovascular and neurological symptoms, paramedic treatments, and any changes in status were reviewed.Results:Twenty one patients were treated by paramedics with NaHCO3for CA overdose. Seventeen patients (80%) presented with mental status changes, including 11 presenting with a GCS<8. Seven of the 21 (33%) presented with a cardiac arrhythmia expected to possibly respond to NaHCO3treatment. Seven of the 21 (33%) were hypotensive, and five (24%) patients had reported seizure activity. Only 2 of the 21 patients (10%) treated with NaHCO3had recorded improvements after administration of the drug, while the other 19 remained stable without any deterioration. Sixteen of 21 patients (76%) were given NaHCO3for indications on standing order, while five patients were treated outside the standing order indications by base physician order with none of the five patients having any change in status ater treatment.Conclusions:After prehospital NaHCO3use in patients with CA overdose, there were no complications reported, two patients improved in status and the others remained unchanged. Base hospital physician orders of NaHCO3for indications beyond the standing orders were not associated with changes in patient status.
Diabetic ketoacidosis in pregnancy
Authors: Kamalakannan D , Baskar V , Barton D M , Abdu T A M 
Published: September 2003

Abstract
The occurrence of diabetic ketoacidosis in pregnancy compromises both the fetus and the mother. It usually occurs in the later stages of pregnancy and is also seen in newly presenting type 1 diabetes patients. Despite improvement in its incidence rates and outcomes over the years, it still remains a major clinical problem since it tends to occur at lower blood glucose levels and more rapidly than in non-pregnant patients often causing delay in the diagnosis. This article illustrates a typical case of diabetic ketoacidosis in pregnancy and reviews the literature to provide an insight into its pathophysiology and management.
Bilateral popliteal aneurysms complicating adult polycystic kidney disease in a patient with a marfanoid habitus
Authors: Al-Hakim W , Goldsmith D J A 
Published: September 2003

Abstract
A man born in 1944 presented with an episode of macroscopic haematuria during a urinary tract infection in 1988. He was unusually tall at 2 metres. An intravenous pyelogram and an abdominal ultrasound disclosed the presence of bilaterally enlarged polycystic kidneys and a polycystic liver. There was a family history of renal disease. Plasma creatinine (180 μmol/l) and blood pressure (150/100 mm Hg) were both raised. Despite good blood pressure control his renal function declined progressively and he started renal dialysis treatment in 1995. He received a renal allograft in 1996.
In 1994 he had noticed a painful swelling behind his left knee. Computed tomography with contrast showed a large popliteal aneurysm. This was replaced with a vein graft. The right popliteal artery showed milder changes, and this was repaired in 1999.
Popliteal aneurysms develop most often in older vasculopaths with multiple risk factors; connective tissue disorders have rarely been associated with their presence in younger patients. Polycystic kidney disease has been associated with several aneurysms, most notably cerebral, but not popliteal. The patient’s marfanoid habitus also may have played a part. This case emphasises the mixed aetiology of popliteal aneurysms.
Power Laws, Scale Invariance and the Generalized Frobenius Series: Applications to Newtonian and TOV Stars Near Criticality
Authors: Visser Matt , Yunes Nicolas 
Published: September 2003

We present a self-contained formalism for calculating the background solution, the linearized solutions and a class of generalized Frobenius-like solutions to a system of scale-invariant differential equations. We first cast the scale-invariant model into its equidimensional and autonomous forms, find its fixed points, and then obtain power-law background solutions. After linearizing about these fixed points, we find a second linearized solution, which provides a distinct collection of power laws characterizing the deviations from the fixed point. We prove that generically there will be a region surrounding the fixed point in which the complete general solution can be represented as a generalized Frobenius-like power series with exponents that are integer multiples of the exponents arising in the linearized problem. While discussions of the linearized system are common, and one can often find a discussion of power-series with integer exponents, power series with irrational (indeed complex) exponents are much rarer in the extant literature. The Frobenius-like series we encounter can be viewed as a variant of the rarely-discussed Liapunov expansion theorem (not to be confused with the more commonly encountered Liapunov functions and Liapunov exponents). As specific examples we apply these ideas to Newtonian and relativistic isothermal stars and construct two separate power series with the overlapping radius of convergence. The second of these power series solutions represents an expansion around "spatial infinity," and in realistic models it is this second power series that gives information about the stellar core, and the damped oscillations in core mass and core radius as the central pressure goes to infinity. The power-series solutions we obtain extend classical results; as exemplified for instance by the work of Lane, Emden, and Chandrasekhar in the Newtonian case, and that of Harrison, Thorne, Wakano, and Wheeler in the relativistic case. We also indicate how to extend these ideas to situations where fixed points may not exist — either due to "monotone" flow or due to the presence of limit cycles. Monotone flow generically leads to logarithmic deviations from scaling, while limit cycles generally lead to discrete self-similar solutions.
Ordinal Explanation of the Periodic System of Chemical Elements
Authors: Scerri Eric R. , Kreinovich Vladik , Wojciechowski Piotr , Yager Ronald R. 
Published: September 2003

Textbooks often claim that quantum mechanics explained the periodic system: namely, the actual configuration of electronic orbits that is responsible for the element's chemical properties can be described as the one that minimizes the total energy, and the energy of each configuration can be computed by using quantum mechanics. However, a careful analysis of this explanation reveals that, in addition to the basic equations of quantum mechanics, we need some heuristic rules that do not directly follow from quantum physics. One reason why additional heuristics are necessary is that the corresponding numerical equations are extremely difficult to solve, and as we move to atoms with larger and larger atomic numbers Z, they become even more difficult. Moreover, as Z grows, we must take relativistic effects into consideration, and this means going from partial differential equations to even more mathematically difficult operator equations. In this paper, we show that if instead of the (often impossible) numerical optimization, we consider the (available) ordinal information, we can then explain the observed periodic system.
On Considering Constraints of Different Importance in Fuzzy Constraint Satisfaction Problems
Authors: Torra I Reventós Vicenç 
Published: September 2003

Several real-world applications (e.g., scheduling, configuration, …) can be formulated as Constraint Satisfaction Problems (CSP). In these cases, a set of variables have to be settled to a value with the requirement that they satisfy a set of constraints. Classical CSPs are defined only by means of crisp (Boolean) constraints. However, as sometimes Boolean constraints are too strict in relation to human reasoning, fuzzy constraints were introduced. When fuzzy constraints are considered, human reasoning usually performs some compensation between alternatives. Thus other operators than t-norms are advisable. Besides of that, not all constraints can be considered with equal importance. In this paper we show that the WOWA operator can consider both aspects: compensation between constraints and constraints of different importance.
Photochemical Synthesis of Diazacryptophane
Authors: Inokuma Seiichi , Kimura Koichi , Nishimura Jun 
Published: September 2003

Abstract
Azacryptophane was obtained by irradiation of the precursor diammonium chloride in the presence of γ-CD (γ-cycodextrin) in aqueous solution. In the liquid-liquid extraction, the azacryptophane showed a moderate affinity toward all alkali metal picrates without any significant selectivity, whereas it selectively extracted both Ag+ and Pb2+ cations in series of heavy metal nitrates.
Synthesis of Novel Water-soluble Molecular Bowls and Their Unique Complexing Behavior with 1-Anilinonaphthalene-8-sulfonate
Authors: Goto Kei , Akine Shigehisa , Hayashi Tomoko , Okazaki Renji 
Published: September 2003

Abstract
Novel water-soluble bowl-shaped cyclophanes 1 and 2 were synthesized. Complexation study in 25% aqueous methanol revealed that 1 and 2 form 2:1 (host/guest) complexes with 1-anilinonaphthalene-8-sulfonate (ANS). The emission wavelength of ANS encapsulated by 1 and 2 as well as the related monocyclic cyclophanes was usefully employed to demonstrate that the host/guest ratio of the complex significantly affects the micropolarity of the guest-binding site of these cyclophanes.
Lewis-Acid-Assisted “Tandem Claisen Rearrangement”: Application to the Synthesis of a New Type of Macrocycle Containing Phenolic Moieties
Authors: Uzawa Hirotaka , Hiratani Kazuhisa , Minoura Norihiko , Takahashi Toshikazu 
Published: September 2003

Abstract
Tandem Claisen rearrangement promoted by Et2AlCl and 2-methyl-2-butene has produced better results than thermal rearrangement at synthesizing a new type of macrocycles containing phenolic moieties, from the corresponding macrocyclic polyether compound in a dramatically fast reaction with a good yield under mild conditions.
Preparation of Nonnatural Branched Chitin and Chitosan
Authors: Kurita Keisuke , Kojima Taku , Munakata Tetsuya , Akao Hirofumi , Mori Tomonori , Nishiyama Yasuhiro , Shimojoh Manabu 
Published: September 2003

Abstract
N-Acetyl-D-glucosamine and D-glucosamine branches were introduced into chitin and chitosan, respectively, by a series of regioselective modification reactions based on N-phthaloyl-chitosan. Unlike insoluble chitin and chitosan, the resulting nonnatural branched amino polysaccharides showed a remarkable water solubility. Moreover, the branched chitosan exhibited significant antimicrobial activity.
Graphite-Catalyzed Acylative Cleavage of Ethers with Acyl Halides
Authors: Suzuki Yoshitada , Matsushima Masayuki , Kodomari Mitsuo 
Published: September 2003

Abstract
Graphite is found to catalyze acylative cleavage of ethers such as benzylic, allylic, tert-butylic and cyclic ethers with acyl halides to give the corresponding esters in good to excellent yields. Benzylic ether was cleaved chemoselectively, when a variety of other functional groups was present, to produce the corresponding ester along with benzyl halide.
Conversion of 2-Methylthio-4-trifluroacetyl-5,6-dihydro-4H-1,3,4-thiadiazines into α,β-Unsaturated Esters via Carbanion-Induced Ring Opening and Desulfurization
Authors: Shimada Kazuaki , Otaki Akihiro , Yanakawa Masaki , Mabuchi Shosuke , Yamakado Naoya , Shimoguchi Takeshi , Takikawa Yuji 
Published: September 2003

Abstract
A convenient conversion of 2-methylthio-5,6-dihydro-4H-1,3,4-thiadiazines 1 into α,β-unsaturated esters was achieved through the procedure including trifluoroacetylation of 1, carbanion-induced ring opening of trifluoroacetamides 2, and reductive removal of heteroatom functionality of the resulting S-alkenyl hydrazinecarbodithioates 3. Treatment of 3 with a base under an aqueous condition also gave the corresponding 6-alkylidene-4H-1,3,4-thiadiazin-5-ones 6.
Photolysis of 1,2,3,4-Benzenetetracarboxylic Dianhydride in a Low-temperature Argon Matrix. Formation of C6H2 Reactive Intermediates
Authors: Moriyama Masaya , Yabe Akira 
Published: September 2003

Abstract
The photolysis of 1,2,3,4-benzenetetracarboxylic dianhydride in an argon matrix produced 1,3,5-hexatriyne via C6H2 reactive intermediates, similarly to the case of the photolysis of 1,2,4,5-benzenetetracarboxylic dianhydride. Formation of C6H2 reactive intermediates by elimination of CO2 and CO was discussed.
Synthesis and Ring-opening of 1,2-Digerma[2]ferrocenophane Catalyzed by Palladium or Platinum Complexes
Authors: Mochida Kunio , Shibayama Nene , Goto Midori 
Published: September 2003

Abstract
1,2-Digerma[2]ferrocenophane (1) was prepared and was fully characterized by spectroscopic methods. Palladium or platinum complexes-catalyzed ring-opening polymerization of 1 under mild conditions yielded high molecular weight poly(ferrocenyltetramethyldigermane) in good yields.
Synthesis and Mesomorphic Properties of 1,10-Dialkylpermethyldecasilanes
Authors: Yatabe Tetsuo , Kanaiwa Takeshi , Sakurai Hideki , Okumoto Hajime , Kaito Akira , Tanabe Yoshikazu 
Published: September 2003

Abstract
Decasilanes, R(SiMe2)10R where R=Et, Pr, and Bu, show the enantiotropic mesophase with a multilayer interdigitated structure. In the mesophase, the silicon chains adopt an almost all-trans conformation, and the decasilanes show absorption bands with maxima at 293 (R=Et) and 294 nm (R=Pr and Bu).
Efficient Coupled Oxidation of Heme Performed by the H63M Variant of Outer Mitochondrial Membrane Cytochrome b5
Authors: Rodríguez Juan Carlos , Desilva Thamara , Rivera Mario 
Published: September 2003

Abstract
Replacement of the heme axial ligand His 63 for Met in the electron transfer protein cytochrome b5 renders a variant capable of performing the efficient coupled oxidation of heme. The experimental evidence shows that the coupled oxidation of heme catalyzed by the H63M variant is arrested after the formation of verdoheme. This may result from the formation of a hexacoordinated (His, Met) veredoheme complex.