bluuebunny/crossref_metadata_2025_split huggingface dataset:
Talking around embodiment: the views of GPs following participation in medical anthropology courses
Authors: Jaye C 
Published: June 2004

Objectives:To explore the ways in which general practitioners talk around the concept of “embodiment” after participating in introductory courses in medical anthropology, and to contribute to the debate about what persons and bodies mean for biomedicine.Design:This study used a qualitative interview methodology.Participants:Participants were general practitioners who had all completed at least one introductory course in medical anthropology.Results:In talking around embodiment, respondents articulated several interconnected dimensions of meaning. These included a Cartesian derived perspective of personhood involving complex relationships between intertwined components of soul, body, and mind; phenomenological perspectives on experience; the social meanings of the body; the ways in which individual bodies are acted upon by regulatory social and political bodies, and an implicit articulation of embodiment as relational, fluid, and processual. A theme of integrity or wholeness was discernible as a common thread linking all these understandings.Conclusions:Critical interpretive medical anthropology crosses social science and humanities boundaries with its explicit orientation around the paradigm of embodiment as a means of understanding lived experience, social and personal meanings of the body, and the political economy of the body. Perhaps its major contribution to postgraduate medical education is its power to encourage or facilitate reflection that is grounded in practice. This study shows that it is possible for medical practitioners to problematise the Cartesianism of biomedicine and its effects on both patients and doctors, and to conceptualise the integrative framework encapsulated in the notion of embodiment as lived medicine.
Rocking bed and prolonged independence from nocturnal non-invasive ventilation in neurogenic respiratory failure associated with limb weakness
Authors: Cormican L J , Higgins S , Davidson A C , Howard R , Williams A J 
Published: June 2004

Abstract
A 40 year old mother of three with autosomal dominant scapuloperoneal muscular dystrophy presented with severe neurogenic respiratory failure requiring nocturnal non-invasive ventilation (NIV). Because of the development of profound proximal muscular weakness as a consequence of the progressive nature of her neurological disease, she eventually was unable to apply and remove the facial interface to set up her NIV circuit. She therefore became dependent on her children and carers to start and stop NIV during the night. A rocking bed was successfully employed as an alternative to nocturnal NIV. Ventilation was facilitated by the passive movement of the diaphragm as a consequence of the movement of the abdominal contents under the effect of gravity. Benefit was demonstrated objectively by pulse oximetry and subjectively by the improvement in the patient’s symptomatology and continued independence at night. The ease of use of a rocking bed should be borne in mind when the necessity for nocturnal ventilatory support in neuromuscular disease results in the potential loss of independence for a patient.
Clinical presentation of acute chest syndrome in sickle cell disease
Authors: Taylor C , Carter F , Poulose J , Rolle S , Babu S , Crichlow S 
Published: June 2004

Abstract
In this study the records of 45 patients with sickle cell disease involved in 63 presentations of acute chest syndrome at the Princess Margaret Hospital in Nassau, the Bahamas, between 1997 and 2001 were examined. Patients were divided into three groups on the basis of age (&lt;13 years, 13–18 years, ⩾19 years) with a view to assessing clinical presentation. The incidence of symptoms, physical signs, and laboratory findings were enumerated and significant differences between age groups determined. The data were analysed using analysis of variance, t test, and χ2 test and compared with existing knowledge on the subject.
This study proposed to evaluate the clinical presentation of acute chest syndrome with emphasis on historical and physical findings, and to encourage the physician to maintain a high index of suspicion for the condition in susceptible patients. It was found that presentation varied significantly with age groups, children presenting most classically with fever and cough and adults, with chest pain. The 13–18 age group emerged as the group which presented most frequently with the typical symptoms of chest infection, thus potentially making diagnosis easier. Of note, the most frequent finding was a normal examination, while the second commonest physical finding was crepitations on auscultation of the chest.
Implications of Harold Shipman for general practice
Authors: Baker R 
Published: June 2004

Abstract
Harold Shipman was an English general practitioner who murdered at least 215 of his patients between 1974 and 1998. A public inquiry is underway, but general practitioners and all doctors also need to consider the implications for their profession. The aim of this paper is to stimulate debate. Issues identified as important to consider include: trust between doctors; attitudes towards failing systems such as cremation certification; acceptance of the duty of accountability; ensuring patients can have reasonable confidence in their doctors; commitment to preventing such a case occurring again; and relationships with patients. It is argued that restricting debate to methods to detect doctors who murder would limit the opportunity to improve medical practice and would constitute a failure to fulfil the duty owed by doctors to Shipman’s victims and their families.
Dramatic levodopa responsiveness of dystonia in a sporadic case of spinocerebellar ataxia type 3
Authors: Nandagopal R , Moorthy S G K 
Published: June 2004

Abstract
A genetically confirmed case of spinocerebellar ataxia type 3 (SCA 3), presenting with disabling foot dystonia, peripheral neuropathy, and minimal cerebellar signs is reported. The dystonia improved dramatically with levodopa treatment in the absence of additional parkinsonian feature. A trial of levodopa for dystonia in SCA 3 may be of therapeutic benefit, at least in the initial stage of the disease.
Activity analysis of telemedicine in the UK
Authors: Debnath D 
Published: June 2004

Abstract

Background
Telemedicine is a new way of delivering health care to people, particularly in remote areas. The UK has experienced a surge of telematic projects in recent years. However, there is little information available in the literature regarding the past and present of telemedicine in the UK.

Objectives
To evaluate the state of telemedicine in the UK.

Methods
All the projects that took place in UK since 1991 were considered for the study and evaluated according to the population and area served.

Results
A total of 216 projects were identified. The number of projects was highest in England (172). Emergency medicine, medical specialties, and educational projects received most consideration (9.7% each). With the exception of Wales, the number of projects increased steadily with time. The projects, when correlated in accordance with the area (per 10 000 sq km) and population (per million), were found to be highest in England (49.5%) and Northern Ireland (36.2%) respectively. No dedicated educational project took place in Scotland, Northern Ireland, and Wales.

Conclusions
The UK embraced telemedicine in the early 1990s and the overall growth had been steady. Scotland, in spite of being the most likely beneficiary in UK, has lagged behind in telemedicine schemes and merits more projects. The issue of tele-education needs urgent review. Multisite trials and a combined approach involving the government, health professionals, technologists, and patients’ representatives would facilitate such developments and help widen the application of telemedicine.
Virius Nicomachus Flavianus, Der Praefectus und Consul des Carmen contra paganos
Authors: Coşkun Altay 
Published: June 2004

AbstractAfter a general caveat concerning the interpretation of polemical pamphlets, various chronologically relevant aspects of the so-called Carmen contra paganos are revisited. In particular, the recent identification of the anonymous praefectus and consul with Vettius Agorius Praetextatus is challenged by reasserting the classical identification with Virius Nicomachus Flavianus. Thus the composition of the poem can be dated to the aftermath of the battle at the Frigidus (5-6/9/394) on firm grounds. At the same time, new light can be shed on the careers of Leucadius rationalis rei privatae fundorum domus divinae per Africam ca. 388/90 and Marcianus proconsul Campaniae ca. 393/94. This way, the author's methods of distorting as well as various modern misconceptions emerge. As a conclusion, some new paths of further research on the poem and on late Roman religious conflicts can be suggested.
High-pressure and high-temperature powder diffraction on molybdenum diphosphide, MoP2
Authors: Soto Victor , Knorr Karsten , Ehm Lars , Baehtz Carsten , Winkler Björn , Avalos-Borja Miguel 
Published: June 2004

Abstract
The isothermal compressibility and bulk thermal expansion of molybdenum diphosphide, MoP2, were measured by in-situ X-ray powder diffraction from ambient conditions to 6.8 GPa and 839 K, respectively. A small anisotropy of the compressibilities in MoP2 appears to be governed by non-bonding interactions in this layer-like material. The thermal expansion data are compared to molybdenum phosphide, MoP, which was measured to 1262 K.
The effects of pressure, temperature and composition on the crystal structures ofα-quartz homeotypes
Authors: Haines Julien , Cambon Olivier 
Published: June 2004

Abstractα-Quartz and its homeotypes are of great importance for both materials and Earth sciences. The properties of these materials depend strongly on their crystal structures and particularly the intertetrahedral bridging angle and the tetrahedral tilt angle. These angles are highly dependent on composition and the external parameters pressure and temperature. The behavior of the eleven knownα-quartz homeotypes, along with examples ofα-quartz-type solid solutions, are compared. The distortion inα-quartz-type structures decreases as a function of temperature and increases as a function of pressure. Thermal stability depends on initial structural distortion and on the electronic configuration of the cation. Pressure stability also depends on the former and on cation size. Transitions to new crystalline and/or amorphous forms, often with increased cation coordination number, are commonly observed at high-pressure. The combined use of high-pressure and high-temperature can be used to synthesize novelα-quartz homeotypes in compounds with small cations.
Multianvil high-pressure / high-temperature synthesis in solid state chemistry
Authors: Huppertz Hubert 
Published: June 2004

Abstract
During the last 60 years, new high pressure techniques and their exploitation have permitted the extension of attainable pressure/volume conditions, increased versatility of the apparatus, and hydrostaticity of the attained pressure in a remarkable way. In preparative solid state chemistry, high-pressure/high-temperature synthesis always played a minor role due to technical difficulties and costs. Piston-cylinder and Belt-apparatus both were limited to the working range up to 3 and 10 GPa, respectively. New technical developments, which allow synthesis up to 25 GPa, open up an enormous field of sample synthesis in solid state chemistry. In the following, a short overview on the most important developments in multianvil-techniques is given with respect to their applications for solid state chemistry under high-pressure conditions.
Putting the squeeze on NaCl: modelling and simulation of the pressure driven B1-B2 phase transition
Authors: Leoni Stefano , Zahn Dirk 
Published: June 2004

Abstract
We used a geometric approach to derive models for the transition B1 (NaCl) to B2 (CsCl) type structure. This enabled us to construct several dynamical transition states, corresponding to different mechanistic pathways. From this, transition trajectories were obtained, which served as starting points for path sampling molecular dynamics simulations. We point out the difference of this approach from approaches based on energy calculations, and demonstrate that a preferred mechanism can be clearly discriminated.
Ab initio investigations of TlI-type compounds under high pressure
Authors: Becker Daniel , Beck Horst P. 
Published: June 2004

Abstract
In this work, we present a theoretical study (based on DFT-calculations) in a wide pressure range of the structural and electronic properties and the stability of compounds crystallising in a TlI- or CrB-type structure. Both structure types have the characteristic structural feature of zigzag chains with unusual short homonuclear distances. The main focus of this study is to elucidate the nature of bonding within these zigzag chains at ambient and elevated pressure. For this purpose we discuss the evolution of the distances within the zigzag chains with pressure, the transition pressure of the phase transition to a CsCl-type arrangement (high-pressure phase) and compressibilities of the low- and high-pressure phases. For a better understanding of the structure and bonding, the band structures of these compounds are evaluated. The calculations are complemented by an orbital analysis using the crystal orbital Hamilton population (COHP) and an analysis of the electronic density topology with the electron localisation function (ELF). Our study indicates that there is a bonding electron pair in compounds crystallising in the CrB-type structure and that the nature of the electron pair does not change significantly at elevated pressure up to the phase transition. However, the “character” of the additional electron pair in the In-monohalides (TlI-type structure) changes with increasing pressure from nonbonding to bonding. The phase transition to a CsCl- type structure implies a fundamental change to nonbonding stereochemically inert electron pairs for all compounds.
Polymorphic forms of Rb2Te: in-situ high-pressure DAC X-ray diffraction investigations and structure modelling with CASTEP
Authors: Stöwe Klaus 
Published: June 2004

Abstract
We report on high pressure X-ray diffraction investigations of Rb2Te in diamond anvil cells DAC (Mo Kα

1 radiation, Rietveld refinement of the diffraction diagrams), which resulted in a polymorphic transformation series for the compound Rb2Te from an anti-fluorite type into an anti-cotunnite type (transition pressure 0.5 GPa) and further on into a Ni2In type structure (transition pressure 1.5 GPa). Among the compounds of the composition A2B Rb2Te has up to now an exceptional position in so far, as this sequence of polymorphic forms is also observed as a high-temperature transformation series. Geometry optimizations on the basis of DFT calculations with the program CASTEP confirmed the phase transitions observed experimentally. Since the anti-cotunnite and the Ni2In type are structurally related — between both structure types there is a group-subgroup relation with the Ni2In type as aristo-type (1st Landau criterion) — the transition between the two types can be characterized as continuous in real space coordinates. According to experimental data as well as results of the CASTEP calculations the phase transition takes place with a discontinuity in the volume versus pressure curve. The geometry optimizations give direct insight in the continuous mechanism of the transition and offer the possibility to compare intermediate structural arrangements with other structures to be discussed in this context, as e.g. the post-cotunnite or the Co2Si structure-type.
Electronic structure and bonding in antimony and its high pressure phases
Authors: Ormeci Alim , Rosner Helge 
Published: June 2004

Abstract
The effects of pressure on the electronic structure and on the bonding properties of Sb are studied by first-principles electronic structure methods. A commensurate approximate structure is used in the calculations for the modulated incommensurate Sb-II phase. It is found that the overlap of s and p bands increases with increasing pressure resulting in pressure-induced metallization of Sb. Analyses based on the electron localization function show that there is no chemical bond between the chain atoms of a previously suggested Sb-II structure. The high total energy of this structure with respect to other structures considered is a result of the absence of this binding.
Frequency, Severity, and Treatment of Agitation in Young versus Elderly Patients in the ICU
Authors: Fraser Gilles L. , Prato B. Stephen , Riker Richard R. , Berthiaume Donald , Wilkins Micheline L. 
Published: June 2004

Study Objective. To study the frequency, duration, severity, and treatment of agitation in patients in the intensive care unit (ICU) to determine if the elderly represent a distinct population.Design. Prospective cohort study.Setting. Tertiary care, 10‐bed, multidisciplinary ICU.Patients. All patients older than 18 years of age admitted for longer than 24 hours during a 4‐month period.Interventions. None.Measurements and Main Results. One hundred thirty patients were studied for 916 patient‐days; 63 (48%) were elderly (> 65 yrs). Nurses and physicians described agitated behavior in 92 patients (70.8%) during 534 (58.3%) patient‐days, and it was severe or dangerous in 60 patients (46.1%) during 273 (30%) patient‐days. There were no age‐related differences in frequency, severity, and duration of agitation. Opiates, benzodiazepines, and haloperidol were administered during 72%, 62%, and 29% of agitated patient‐days, respectively. Haloperidol was administered more often to elderly patients (p=0.015); otherwise no between‐group differences were noted. Daily dosing requirements were less in the elderly for intermittent intravenous lorazepam, haloperidol, and morphine but not for midazolam (p=0.15). When these dosages were corrected for body mass, no statistical differences between young and old were found.Conclusion. In the ICU, the elderly are not a distinct population for agitation.
Differential Transcription Factor Expression in Human Mononuclear Cells in Response to Amphotericin B: Identification with Complementary DNA Microarray Technology
Authors: Cleary John D. , Rogers P. David , Chapman Stanley W. 
Published: June 2004

Study Objective. To identify genes differentially expressed in human monocytic cells exposed to amphotericin B in vitro.Design. In vitro experiment.Setting. Hospital laboratory.Material. Human mononuclear cell line, THP‐1.Intervention. Human mononuclear cells were exposed to amphotericin B or media alone for 6 hours. After exposure, total RNA was isolated and reverse transcribed to complementary DNA. Differences in probe hybridization observed during blotting were measured, and genes with altered regulation were described by using human complementary DNA microarray technology.Measurements and Main Results. Of 588 genes represented on the array, 16 transcripts were found to be upregulated and 4 transcripts were downregulated in response to amphotericin B. These findings suggest that amphotericin B alters the expression of genes in human monocytic cells that play a role in many cellular functions, including immune response, signal transduction, and cell differentiation.Conclusion. Amphotericin B induces alterations in human cell gene transcription. These changes could be used to evaluate differences in toxicity or efficacy observed in patients receiving this agent.
A Prospective and Retrospective Analysis of the Nephrotoxicity and Efficacy of Lipid‐Based Amphotericin B Formulations
Authors: Cannon Joan P. , Garey Kevin W. , Danziger Larry H. 
Published: June 2004

Study Objective. To determine the usage patterns of the lipid‐based amphotericin B formulations at our institution and to compare the observed nephrotoxicity and efficacy of these formulations.Design. Prospective and retrospective observational study.Setting. Urban 350‐bed teaching hospital.Patients. Sixty‐seven nonhemodialysis patients who were prescribed greater than 3 days of amphotericin B lipid complex (ABLC) or liposomal amphotericin B (L‐AmB) from 1996–1999.Measurements and Results. Forty‐six patients received ABLC and 21 received L‐AmB. Oncology patients accounted for most prescriptions of both formulations. Amphotericin B lipid complex most frequently was prescribed for treatment of documented fungal infections (50%), followed by treatment of neutropenic fever (33%). Liposomal amphotericin B most frequently was prescribed for treatment of neutropenic fever (62%), followed by treatment of documented fungal infections (29%). Seventy‐eight percent of patients treated with ABLC and 90% of those who received L‐AmB were started on the lipid‐based formulation due to being refractory or intolerant to prior antifungal therapy. Two (4.4%) patients receiving ABLC and four (19%) patients receiving L‐AmB experienced nephrotoxicity at the end of therapy (NS). Of the patients with a documented fungal infection, 20 out of 23 (87%) of those treated with ABLC and 4 out of 5 (80%) of those treated with L‐AmB had a complete or partial response to therapy (NS). One patient with febrile neutropenia had a breakthrough fungal infection while receiving L‐AmB.Conclusion. No significant differences in nephrotoxicity or efficacy were found between ABLC and L‐AmB. Until further studies indicate clinically significant differences in nephrotoxicity between the two liposomal amphotericin B formulations, it is recommended that economics continue to be the major determinant for product selection.
Lipid‐Lowering Efficacy, Safety, and Costs of a Large‐Scale Therapeutic Statin Formulary Conversion Program
Authors: Taylor Allen J. , Grace Karen , Swiecki Jennifer , Hyatt Richard , Gibbs Henry , Sheikh Munazza , O'Malley Patrick G. , Lowenthal Susan Pitman , West Mark , Spain John , Maneval Kent , Jones David L. 
Published: June 2004

Study Objective. To assess the lipid‐lowering efficacy, safety, and costs of a large‐scale statin formulary conversion program.Design. Prospective, observational study.Setting. Tertiary academic medical center.Patients. A total of 980 patients consented to participate; 942 patients completed the study.Intervention. Patients were converted from their current statin therapy to either cerivastatin 0.4 or 0.8 mg/day, or simvastatin 80 mg/day, using a conversion algorithm.Measurements and Main Results. Efficacy and safety were evaluated at baseline and after 6 weeks of therapy; costs were also measured. Overall attainment of the National Cholesterol Education Program (NCEP) goal for low‐density lipoprotein cholesterol (LDL) increased from 64.8% to 74.5% of patients (p<0.001); mean LDL decreased from 115 ± 30 mg/dl to 106 ± 25 mg/dl (p<0.001). Adverse events occurred in 3% of patients, and included myositis (0.6%) and increased hepatic transaminases (0.1%). Overall costs were reduced by $115/patient treatment‐year.Conclusion. Statin therapeutic interchange can improve lipid control at reduced costs. The possibility of uncommon but potentially serious adverse effects suggests that these programs require appropriate monitoring.
Imaging of the Paranasal Sinuses
Authors: Boll Daniel T. , Coffey Michael , Lewin Jonathan S. 
Published: June 2004

AbstractMRI in most instances, can better distinguish between soft tissues when compared with CT. The distinction of soft tissues becomes most clinically relevant when evaluating for possible sinonasal tumors and when inspecting for extension of tumor or inflammation into the orbit or intracranial spaces. It is in these areas that MRI has found its major application in sinus imaging. This unit presents MRI techniques for imaging the sinuses with and without contrast enhancement. The parameters given in this unit are derived from experience at 1.5 T and may need to be slightly altered depending on the field strength and the equipment manufacturer.