bluuebunny/crossref_metadata_2025_split huggingface dataset:
Current international developments in population screening for colorectal cancer
Authors: Pedersen Karen E. , Elwood Mark 
Published: March 2003

Pilot programmes for screening for colorectal cancer in average‐risk individuals using faecal occult blood testing are planned to commence in Australia in 2002. The National Cancer Control Initiative was interested to compare Australia's progress in this area with that of other countries. Information on programmes or pilot programmes for colorectal screening in average‐risk individuals was sought by letter, fax or email from cancer organizations, government departments and professional bodies in 55 countries worldwide. Based on the responses received (32 replies), no country was identified as having an active programme for colorectal screening for the general population based on the characteristics of identification of eligible subjects, active recruitment and integrated screening and follow up, which would allow determination of the participation rates, detection rate and outcomes such as the stage distribution of cancer.In the United Kingdom a pilot programme is under way to test the feasibility and acceptability of screening for colorectal cancer in the general population using faecal occult blood testing. In Finland, health authorities have agreed that the evidence is sufficient to embark on a pilot programme, and Canada, the Netherlands, Denmark and Switzerland are considering pilot programmes. From our enquiries, in countries using a planned approach, only the UK appears to be ahead of Australia. The British pilots have commenced earlier and are larger and have a shorter time frame than the Australian pilots.
Influence of adhesive drapes on intraperitoneal volume and pressure during laparoscopy
Authors: Siddins Mark , Boland John , Riederer Marcus , Kanchanabat Burapa , Rao M. Mohan , Hewett Peter 
Published: March 2003

Background:  The influence of adhesive skin drapes on abdominal wall compliance during laparoscopy has not previously been studied.Methods:  The effect of removing an adhesive abdominal drape on intraperitoneal volume and pressure was studied in 15 patients undergoing a variety of laparoscopic procedures. The internal consistency of this data was evaluated by comparing the observed response to that which was predicted from analysis based on the theory of elasticity.Results:  Removal of an adhesive skin drape after induction of a 15‐mmHg pneumoperitoneum was associated with changes in intraperitoneal pressure and volume. These changes were statistically significant, highly predictable and clinically relevant.Conclusions:  On the basis of the present observations, we recommend that extensive coverage by adhesive drapes should be avoided for those patients or procedures in which elevated intraperitoneal pressure may be particularly deleterious.
Prioritizing patients for elective surgery: Clinical judgement summarized by a Linear Analogue Scale
Authors: MacCormick Andrew D. , Plank Lindsay D. , Robinson Elizabeth M. , Parry Bryan R. 
Published: March 2003

Background:  The New Zealand health reforms have resulted in the requirement that surgeons utilize Clinical Priority Access Criteria (CPAC) to ration patient access to elective surgery. The validity of the tools used as CPAC has been challenged. An alter­native tool, the Linear Analogue Scale (LAS), is therefore used in our institution. Our objectives were to determine the variables that influence the priority score generated using the LAS, and the length of time waited by patients awaiting general surgical procedures.
Methods:  A cohort of 918 patients who were listed for elective general surgical procedures at Auckland Hospital, Auckland, New Zealand between 1 July 1998 and 31 March 1999 were studied. Patients were given a priority score generated using the LAS. For each patient, the time from assessment until his or her procedure was documented. Linear and logistic regression models were used to investigate variables (age, gender, diagnosis and surgical team) that influence priority score. Cox proportional hazards models were used to investigate variables (priority score, age, gender, and diagnosis) that influence the length of time waited.
Results:  Graphical presentation showed a pattern of priority scores falling into ‘bands’ for different diagnoses. Diagnosis, and to a lesser extent surgical team, influenced priority score. Survival analysis showed ‘time waited’ to be influenced by priority score, diagnosis, and patient age and gender.
Conclusion:  The LAS may have a useful role in the difficult sphere of patient prioritization. Its strength lies in its simplicity. Further investigation of reliability and effect on patient outcomes is required.
Biliary‐enteric transanastomotic stenting with Intestofix
Authors: Ooi London Lucien Peng‐Jin , Chung Yaw‐Fui Alexander , Wong Wai‐Keong 
Published: March 2003

Background:  Biliary‐enteric transanastomotic stenting is useful under adverse local conditions or when small‐calibre bile ducts are encountered.
Methods:  A commercially available feeding jejunostomy kit, Intestofix, was inserted transjejunally through the blind loop of a Roux‐en‐Y hepatico‐jejunostomy.
Conclusions:  The stent splinted the anastomosis to reduce biliary leaks and may help to prevent subsequent stricture formation.
Evaluation of the P−POSSUM mortality prediction algorithm in Australian surgical intensive care unit patients
Authors: Organ Nicole , Morgan Thomas , Venkatesh Balasubramanian , Purdie David 
Published: March 2003

Background:  The Physiological and Operative Severity Score for enUmeration of Mortality and Morbidity (POSSUM) is an auditing tool designed to compare surgical outcomes independent of case mix. It uses patient physiological and operative data to predict morbidity and mortality for surgical patients. Thus far most evaluations of the POSSUM algorithm and its modifications have emanated from British hospitals. A single‐centre retrospective study was therefore performed to determine the applicability of this tool to the Australian surgical case mix.Methods:  All surgical patients undergoing a surgical procedure admitted to the Royal Brisbane Hospital intensive care facility in 1999 were reviewed retrospectively. Mortality predictions using the Portsmouth modification of the POSSUM algorithm (P−­POSSUM) were compared to the actual outcomes using receiver‐operator characteristic curve analysis and the Hosmer and Lemeshow Goodness‐of‐Fit test.Results:  The records of 229 admissions were reviewed. The area under the receiver‐operator characteristic curve was 0.68, significantly greater than 0.5 (P = 0.014). Predicted deaths were significantly greater than actual deaths (50 vs 28, P < 0.001), with over‐prediction of death rates in all mortality groupings except the two lowest risk deciles.Conclusion:  The P−POSSUM algorithm tends to over‐estimate mortality in surgical intensive care patients. It may require further calibration before adoption as a surgical audit tool in Australia.
Colonic epithelial atrophy induced by a fibre‐free diet in rats is reversed by minimal amounts of luminal butyrate, but only in the short term
Authors: Sengupta Shomik , Tang Choong‐Leong , Wong Cynthia S. M. , Tjandra Joe J. , Gibson Peter R. 
Published: March 2003

Background:  Luminal butyrate may be trophic to the colonic epithelium, but this effect is poorly characterized. The aim of the present study was to define the dose−response, time‐course, site‐specificity and the dependence on background diet of the effects of butyrate on epithelial proliferation in normal distal colon, using an in vivo rat model of colonic substrate delivery.Methods:  Male Sprague‐Dawley rats, maintained on a fibre‐free diet, had butyrate infused twice daily into the colonic lumen via polyethylene tubes placed at laparotomy. Varying dose levels (0−80 µmol/d; 4 d), site (caecal vs distal colonic), duration of infusions (1−5 weeks; 80 µmol/d), or dietary fibre intake were investigated. Epithelial proliferative indices were assessed stathmokinetically.Results:  Four‐day infusions of butyrate led to a progressive trophic effect (cells/crypt column increased from 37.9 ± 1.6 at 0 µmol/d to 44.7 ± 1.2 at 80 µmol/d) on fibre‐deprived colonic mucosa, related linearly to the daily butyrate dose (P < 0.001, linear regression). This effect was mediated by increases in the number and proportion of mitoses, related to the square of the butyrate dose (P < 0.001 in each case, polynomial regression). Butyrate (80 µmol/d) was associated with significantly higher cellularity (59.9 ± 1.4) and mitotic activity (4.9 ± 0.6) per crypt column compared to vehicle controls (50.3 ± 1.6 and 0.9 ± 0.2, respectively; P < 0.05, t‐tests), at 1 and 3 weeks, but not at 5 weeks. Butyrate had similar effects on distal colonic crypt cellularity (62.0 ± 1.5) when delivered caecally, but in rats fed a fibre‐containing diet, colonic crypt cellularity (55.3 ± 3.2) was similar to baseline (59.6 ± 1.9).Conclusions:  Trophic effects of butyrate are concentration‐dependent and occur at low doses in the short term, but are not sustained over longer periods. They are seen only in a fibre‐deprived state and appear to be independent of the site of administration.
Results of resections for hepatocellular carcinoma in a new hepatobiliary unit
Authors: Sim Hong Gee , Ooi London Lucien P. J. 
Published: March 2003

Background:  Hepatocellular carcinoma (HCC) is the fourth commonest cancer in Singapore. Surgical resection offers the only chance of ‘cure’. Resection tends to be difficult in HCC because of late presentation and concomitant liver cirrhosis. Specialized units with higher volume of operations are known to produce better results. The present review aims to evaluate early results with HCC resection and discuss the correlation between various tumour prognostic factors and the outcome.Methods:  The records of 81 consecutive hepatic resections for HCC in the hepatobiliary unit of the Department of General Surgery at the Singapore General Hospital from 1 January 1996 to 31 December 1998 were retrospectively reviewed.Results:  The mean age of the patients was 56.0 ± 15.4 years. There were more men (M:F: 72:9) and Chinese patients (75 Chinese patients (92.6%); four Malay patients (4.9%); two Indian patients (2.5%)) affected by the disease. Hepatitis B and C carrier status were present in 67.1% (n = 51) and 3.9% (n = 1) of the patients, respectively. Forty‐two patients (53.2%) had underlying liver cir­rhosis. Twenty‐eight patients (34.6%) underwent major hepatectomy and 53 (65.4%) underwent minor hepatectomies. Perioperative mortality was 4.9% (n = 4). The morbidity rate following hepatic resections was 28.4% (n = 23). The median follow up was 21 months (range: 1−52 months). The median survival was 43 months (95% confidence interval (CI): 34.6−51.4 months) after surgery and median time to recurrence was 9.6 months (range: 2−32 months). Overall survival was 79% and 59% at 1 and 3 years, respectively. Disease‐free survival was 59% and 30% at 1 and 3 years, respectively. Advance pathological tumour, nodes, metastases (TNM) stage (III and IV), and presence of adjacent organ involvement were risk factors for early recurrence. Advance pathological TNM stage (III and IV) and blood loss of more than 2 L were poor prognostic factors for overall survival.Conclusion:  The results of hepatectomies for HCC in the newly established unit at Singapore General Hospital have been shown to be comparable to other established specialized hepatobiliary units with similar perioperative mortality and morbidity rates.
FATIGUE CRACKING POSSIBILITY ALONG GRAIN BOUNDARIES AND PERSISTENT SLIP BANDS IN COPPER BICRYSTALS
Authors: Zhang  , Wang  , Li  
Published: March 2003

In this paper, the fatigue cracking possibility in different kinds of copper bicrystals with large‐angle grain boundaries (GBs) and copper multicrystals containing some low‐angle GBs are compared. The results showed that the fatigue cracks, in the copper bicrystals, always nucleated firstly along GBs no matter whether the GBs are perpendicular or parallel to the stress axis. Whereas, for the copper multicrystals containing low‐angle GBs, the persistent slip bands (PSBs) are always the preferential sites to initiate fatigue cracks no matter whether low‐angle GBs are perpendicular or parallel to the stress axis.Additionally, the fatigue lives of the GBs, and the [1¯23] and [3¯35] grains in the [1¯23] ⊥ [3¯35] and [5¯913] ⊥ [5¯79] bicrystals were measured at different cyclic stresses and strain amplitudes. The results show that intergranular fracture always occurred prior to transgranular fracture in those bicrystals. The fatigue lives increased in the order of the GB, the [1¯23] and the [3¯35] grains in the [1¯23] ⊥ [3¯35] bicrystal under cyclic tension–tension loading. On the other hand, the fatigue life of the GB in the [5¯913] ⊥ [5¯79] bicrystal is about two to three times higher than that in the [1¯23] ⊥ [3¯35] bicrystal. Based on these experimental results from the copper bicrystals and multicrystals, it is indicated that the possibility of fatigue cracking increased in the order of low‐angle GBs, PSBs and large‐angle GBs. It is suggested that both the PSB–GB mechanism and the step mechanism required for GB fatigue cracking were questionable, and the interaction modes of PSBs with GBs may be more important for intergranular fatigue cracking.
MODELLING FOR TRANSCRYSTALLINE AND INTERCRYSTALLINE FRACTURE BY VOID NUCLEATION AND GROWTH
Authors: Margolin BZ , Karzov GP , Shvetsova VA , Kostylev VI 
Published: March 2003

A criterion has been formulated for transcrystalline and intercrystalline fracture caused by the evolution of voids located both in a grain and on grain boundaries. The criterion is based on the idea of plastic collapse for a unit cell that is a regular structural mezovolume of polycrystalline material. The criterion does not require the introduction of any empirical parameters, such as critical void size, critical size of ligament between voids and critical void volume fraction, which are used in most models.Modelling has been performed for void nucleation and growth in a grain and on grain boundaries for elastic–plastic deformation and under creep conditions. A scheme is proposed to describe the transition from transcrystalline to intercrystalline cavitation fracture as a function of strain rate and temperature.The effect of stress triaxiality on the critical strain and the lifetime for both transcrystalline and intercrystalline fracture has been investigated. A comparison of the results predicted by the suggested criterion with available empirical data has been performed.
A probabilistic simulation of fluid leakage in multiple cracks situation
Authors: XIE L. , YU Z. 
Published: March 2003

ABSTRACT In pressure vessels and piping the leak‐before‐break (LBB) assessment method is employed to avoid any catastrophic failure prior to a detectable leakage. One of the most important parameter, the leak rate, is investigated in the present paper by means of the Monte Carlo method.A brief review is carried out with emphasis on aspects such as crack growth, crack size with detectable leakage, crack opening area and leak rate. Issues concerning the property and behaviour of multiple cracks are also covered along with a review of the characteristics of leak rate through distributed multiple cracks using a statistical simulation method.The simulation results show that the effect of multiple cracks is quite significant to the LBB concept. Both the relationship between leak rate and crack length (or time) and the statistical characteristics of the leak rate are considerably different for different initial crack conditions.
A mode II weight function for subsurface cracks in a two‐dimensional half‐space
Authors: MAZZÙ A. 
Published: March 2003

ABSTRACTThe general properties of a mode II Weight Function for a subsurface crack in a two‐dimensional half‐space are discussed. A general form for the WF is proposed, and its analytical expression is deduced from the asymptotic properties of the displacements field near the crack tips and from some reference cases obtained by finite elements models. Although the WF has general validity, the main interest is on its application to the study of rolling contact fatigue: its properties are explored for a crack depth range within which the most common failure phenomena in rolling contact are experimentally observed, and for a crack length range within the field of short cracks. The accuracy is estimated by comparison with several results obtained by FEM models, and its validity in the crack depth range explored is shown.
Corrosion fatigue behaviour and fracture mechanisms in nitrided low alloy steel
Authors: TOKAJI K. , TAKAHASHI S. 
Published: March 2003

ABSTRACTRotary bending fatigue tests have been performed in 3%NaCl aqueous solution using specimens of a low alloy steel (Cr–Mo steel) with different nitride case depths. The effect of case depth on corrosion fatigue strength, the fracture process and mechanisms were studied. The corrosion fatigue strengths of the nitrided materials increased compared with the untreated material and increased with increasing thickness of the compound layer, but tended to saturate above a certain thickness. All the materials showed lower fatigue strength in 3%NaCl aqueous solution than in laboratory air and the reduction of fatigue strength decreased with increasing thickness of the compound layer, but remained nearly constant above a certain thickness. Corrosion pits were seen underneath the compound layer, from which cracks initiated. The corrosion fatigue strengths of the specimens whose compound layer was completely removed by electropolishing were almost the same as that of the untreated material, indicating a very significant role of the compound layer in improving corrosion fatigue strength. Because of the porous nature of the compound layer, particularly in the surface‐adjacent part, the solution penetrated the compound layer and reached the base steel, thus the corrosion fatigue strength of the nitrided materials was controlled by the penetration of corrosive media.
Increased abundance of the red admiral butterfly Vanessa atalanta in Britain: the roles of immigration, overwintering and breeding within the country
Authors: Pollard  , Greatorex‐Davies  
Published: March 2003

The migratory butterflyVanessa atalantaincreased in abundance at monitored sites in Britain from 1976 to 1996. Three possible causes of the increase are improved winter survival within Britain, greater breeding success within Britain, and increased immigration.  Trends during most of the season were similar to those of immigrant or overwintered individuals in spring; thus the evidence does not support greater breeding success in Britain. As abundance in spring was not correlated with abundance in the previous autumn, when trend was taken into account, it seemed unlikely that overwintering in Britain was important. Thus the increase in abundance was probably due to increased immigration. Incidental to the main study, the mean index per site per year was closely correlated with the collated index, the usual measure of annual fluctuations. This agreement suggests that the mean index may be a useful check for trends in monitoring data for other wide‐ranging organisms.
Extinction times for closed epidemics: the effects of host spatial structure
Authors: Park Andrew W. , Gubbins Simon , Gilligan Christopher A. 
Published: March 2003

AbstractAlthough of practical importance, the relationship between the duration of an epidemic and host spatial structure is poorly understood. Here we use a stochastic metapopulation model for the transmission of infection in a spatially structured host population. There are three qualitatively different regimes for the extinction time, which depend on patch population size, the within‐patch basic reproductive number and the strength of coupling between patches. In the first regime, the extinction time for the metapopulation (i.e. from all patches) is approximately equal to the extinction time for a single patch. In the second regime, the metapopulation extinction time is maximal but also highly variable. In the third regime, the extinction time for the metapopulation (TE) is given byTE = a + bn1/2whereais the local extinction time (i.e. from last patch),bis the transit time (i.e. the time taken for infection to spread from one patch to another) andnis the total number of patches.
Antigen 43 facilitates formation of multispecies biofilms
Authors: Kjærgaard Kristian , Schembri Mark A. , Ramos Cayo , Molin Søren , Klemm Per 
Published: March 2003

Antigen 43 (Ag43) is a surface‐displayed autotransporter protein of Escherichia coli. By virtue of its self‐association characteristics, this protein is able to mediate autoaggregation of E. coli cells in static cultures. Here, we show that Ag43 can be expressed in a functional form on the surface of Pseudomonas fluorescens. Ag43 expression dramatically enhances the biofilm‐forming potential of both E. coli and P. fluorescens to abiotic surfaces in simple microtitre well assays and in flow chambers. Importantly, Ag43‐expressing E. coli and P. fluorescens cells tagged with Gfp and Rfp were shown to form interwoven biofilms in flow chambers. The three‐dimensional structures of the biofilms were analysed by laser‐confocal microscopy. Heterogeneous expression of Ag43 induced interspecies cell‐to‐cell contact that generated multispecies biofilm formation. Our data indicate that this versatile molecular tool can be used for the rational design of multispecies biofilms. More specifically, this novel technology offers opportunities for the design of multispecies consortia in which the concerted action of several bacterial species is required, e.g. waste treatment and degradation of pollutants.
Strain characterization and 16S‐23S probe development for differentiating geographically dispersed isolates of the phytopathogen Ralstonia solanacearum
Authors: Timms‐Wilson Tracey M. , Bryant Kirsty , Bailey Mark J. 
Published: March 2003

The causative agent of potato brown rot and bacterial wilt, Ralstonia solanacearum, results in serious world‐wide economic losses, particularly in the tropics. In the last decade, however, the incidence of bacterial wilt in potatoes grown in Northern Europe has increased, presenting an interesting epidemiological puzzle. Its occurrence may be as a result of changes in agricultural practice or the emergence of a novel bacterial variety, better adapted to cooler conditions. To understand the distribution and genetic diversity of this phytopathogen, we have analysed a collection of 82 isolates from Europe and tropical regions. Both phenotypic [SDS–PAGE (sodium dodecyl sulphate polyacrylamide gel electrophoresis) profiling, FAME (fatty acid methyl esters) analysis, growth profiles and EPS (exopolysaccharide) production] and genotypic [16S rRNA RFLP (restriction fragment length polymorphism), ARDRA (amplified ribosomal DNA restriction analysis) and sequence analysis of 16S−23S rRNA ITS and flanking regions] methods were compared. Principal component analysis of FAME profiles clustered isolates into three groups and ARDRA of a 0.85 kb amplified fragment from the 16S‐23S ITS region differentiated isolates into four groups. Using sequence analysis, specific primers were designed within the variable region 147–170 of the 23S rRNA. These primers, RsolT2 and RsolT3, respectively, differentiated isolates into two distinct clusters as described previously by Wullings and colleagues (Wullings et al., 1998). The European strains (Biovar 2, race 3) analysed in this study specifically hybridized with RsolT3, and showed considerable genetic homogeneity when compared with strains of other races from ‘the rest of the world’. These data indicate the possible selection and proliferation of a ‘European’‐adapted variant.