bluuebunny/crossref_metadata_2025 huggingface dataset:
Implementation and external validation of Preoperative Aspects and Dimensions Used for an Anatomical (PADUA) score for predicting complications in 74 consecutive partial nephrectomies
Authors: Tyritzis Stavros I. , Papadoukakis Stefanos , Katafigiotis Ioannis , Adamakis Ioannis , Anastasiou Ioannis , Stravodimos Konstantinos G. , Alamanis Christos , Mitropoulos Dionisios , Constantinides Constantinos A.
Published: October 2011

Study Type – Prognosis (case series)

Level of Evidence 4

What's known on the subject? and What does the study add?

Partial nephrectomy (PN) is the gold standard operation for small renal tumours.

The decision for or against a PN has been based mostly on preoperative radiological evaluation of the tumour. Three nephrometry scoring systems have been recently proposed for prediction of postoperative complications of PN (RENAL, C‐index and PADUA).

We validate externally the accuracy of the PADUA system and suggest for the first time a novel scoring system, based on the original PADUA system, which implements three other significant factors for the postoperative course of a partial.

OBJECTIVE

To externally validate the Preoperative Aspects and Dimensions Used for an Anatomical (PADUA) classification of renal tumours managed by partial nephrectomy (PN).

PATIENTS AND METHODS

Seventy‐four consecutive patients in a single academic tertiary institution underwent open PN.

Incidence of 90‐day complications was stratified by several clinicopathological variables, such as gender, age of the patient, hospital stay, pathology report, tumour characteristics and positive surgical margins. PADUA scores were given to each case.

The severity of complications was also categorized with the Clavien system.

RESULTS

The optimal threshold of PADUA for the prediction of complications was 8 with a sensitivity equal to 90.9% and a specificity equal to 77.8% (area under the curve [AUC], 0.89; 95% confidence interval [CI], 0.73–1.00).

Multivariate analysis revealed that that PADUA is an independent predictor for the risk of complications.

Also, PADUA score ≥8 identified a group of patients with almost 20‐fold higher risk of complications (hazard ratio [HR]= 19.82; 95% CI, 1.79–28.35; P= 0.015).

Patients with papillary histology had greater risk for complications than those with clear‐cell tumours (HR = 4.88; 95% CI, 1.34–17.76; P= 0.016).

CONCLUSIONS

The PADUA score is a simple anatomical system that predicts the risk of postoperative complications. This is the first external validation of this system for open PN from a single centre.

The authors believe that PADUA is an efficient tool, since the only variable of the present study that predicted a higher incidence of complications was the histology type, which is determined after surgery.

However, it should be applied to laparoscopic and robot‐assisted series and it could also include the ischaemia time and surgeon experience in the overall scoring to be complete.
BEYOND VIOLENCE, BEYOND THE TEXT: THE ROLE OF GESTURE IN WALTER BENJAMIN AND GIORGIO AGAMBEN, AND ITS AFFINITY WITH THE WORK OF RENÉ GIRARD
Authors: DICKINSON COLBY
Published: October 2011

Though the work of René Girard has highlighted the interrelations between sacrifice and sacrality in the contemporary world, it has yet to engage the work of Walter Benjamin and his heir, Giorgio Agamben, whose project concerning the Homo Sacer has aroused interest in contemporary political thought. By focusing on Benjamin's early description of mimesis and its relation to language, a position can be elaborated that steers mimesis clear of its indebtedness to language and towards a ‘purer’ realm of gesture. Benjamin's formulation of a more proper ‘divine’ language of gestures could then be said to coalesce with certain historical‐religious proclamations, something that Agamben's work challenges us to consider as a viable, albeit ‘profane’, political and ethical option for humanity.
Topical fluticasone propionate: intervention and maintenance treatment options of atopic dermatitis based on a high therapeutic index
Authors: Korting H.C. , Schöllmann C.
Published: October 2011

Fluticasone propionate (FP), a medium potent glucocorticoid (class III) of carbothioate nature with a favourable benefit/risk ratio, has emerged as a standard medication for the topical treatment of inflammatory skin disorders, in particular atopic dermatitis (AD). FP is available as a 0.05% cream and a 0.005% ointment formulation. The glucocorticoid is characterized by high lipophilicity, high affinity binding to the glucocorticoid receptor and a rapid hepatic biotransformation. Though skin blanching following topical application of FP surpasses that given with glucocorticoids of medium strength, clinical trials show a low potential of FP for local and systemic adverse effects. Even in paediatric patients with AD as well as in difficult‐to‐treat areas like face, eyelids and intertriginous areas, FP proved to be both effective and safe. Thus, the therapeutic effects of FP clearly outweigh the unwanted effects. Correspondingly, a therapeutic index of 2.0 can be attributed to this glucocorticoid. In this respect, topical FP does not differ from other topical glucocorticoids with increased benefit‐to‐risk ratio, e.g. prednicarbate, methylprednisolone aceponate and mometasone furoate. However, randomized controlled trials do not only support conventional intervention but also innovative maintenance treatment.
The prevalence of interdigital erythrasma in southern region of Turkey
Authors: Inci M. , Serarslan G. , Ozer B. , Inan M.U. , Evirgen O. , Erkaslan Alagoz G. , Duran N.
Published: October 2011

Background  Erythrasma is a skin infection which is caused by Corynebacterium minutissimum. Interdigital erythrasma is the most common form.

Objective  The aim of this study was to detect the frequency and risk factors of interdigital erythrasma in patients with clinically suspected tinea pedis.

Methods  This study was conducted between June and December 2010 and included 122 patients who had interdigital foot lesions. All patients were examined using a Wood’s lamp. The smears were stained using Gram’s method. Direct examination was performed using 20% potassium hydroxide. Sabouraud dextrose agar and brain heart infusion agar were used for cultures. Moreover, the demographical characteristics of patients, concomitant diseases and clinical findings were also recorded. Cases that were found to be positive on Wood’s lamp examination and/or Gram staining/culture were considered as erythrasma.

Results  The rate of erythrasma was found to be 46.7%. The mean age was 43.6 years, and the disease was more prevalent in men. The most common clinical finding was desquamation. Mycological examination was found as positive in 40.35% of the patients. No growth was observed in bacteriological cultures. It was found that using only Wood’s lamp examination or Gram staining resulted in 11 (9%) and 19 positive patients (15.6%), respectively, whereas using both Wood’s lamp examination and Gram staining concurrently resulted in 27 positive patients (22.1%).

Conclusion  Interdigital erythrasma is a commonly seen condition and can clinically mimic tinea pedis. A Wood’s lamp is a good diagnostic tool, but Gram staining, particularly in those with a negative Wood’s lamp result, may be a useful method.
Genetic structure and phylogeography of platypuses revealed by mitochondrial DNA
Authors: Gongora Jaime , Swan Amelia B. , Chong Amanda Y. , Ho Simon Y. W. , Damayanti Chandramaya S. , Kolomyjec Stephen , Grant Tom , Miller Emily , Blair David , Furlan Elise , Gust Nick
Published: October 2011

The platypus Ornithorhynchus anatinus is an endemic monotreme species with a wide latitudinal distribution in eastern Australia, including Tasmania. Understanding of the phylogeography within this species is very limited at present and represents a gap in the documentation of Australia's unique biodiversity. We analysed mitochondrial DNA sequences (partial control region and complete cytochrome b, including portions of flanking tRNAs) of 74 individuals from across the distribution of the species. Phylogenetic analysis of the concatenated sequences corroborated the primary split within the platypus, showing two major clades: one from mainland Australia and the other from Tasmania/King Island. Estimates of divergence times suggest that these clades last shared a common mitochondrial ancestor ∼0.7–0.94 Ma. Using an extended dataset of partial control region sequences from 284 individuals, we found evidence of genetic structure between river basins, primarily within mainland Australia, as well as an additional divergent lineage in North‐eastern Australia. Overall, few haplotypes were shared between river basins. Analyses of molecular variance of the control region sequences indicated low rates of gene flow and significant divergence, particularly at the river basin and geographical area scales.
Watching flesh: poison and the fantasy of temporal control in Renaissance England
Authors: WILSON MIRANDA
Published: October 2011

During the Renaissance, English writers often depict poison as a weapon capable of transforming a victim's body into a timepiece, with death predictable to the year, month, day, and hour. English literary works, especially dramatic ones, however, contain numerous instances of poisons that fail to act precisely, or to act as intended. These failures serve as a useful departure point for exploring Renaissance ideas of clock‐time. The dream of temporal control represented by poison promises an alignment between timepieces and bodies. When poisons fail to create this promised synchronicity, they reveal both the interdependence of bodies and horological devices and the difficulties in regulating either one.
‘Amethystus Princeps Sobrietatis’: signing a sixteenth‐century pledge
Authors: HERDMAN EMMA
Published: October 2011

Against the backdrop of Montaigne's philosophical and ethical discussion of drunkenness, ecstasy and excess in ‘De l'yvrongnerie’, this article introduces the literary society founded in the 1570s by Johann Posthius and Paul Melissus in reaction to the licentiousness they perceived in Germany's long‐established drinking culture. Through analysis of the anthology of neo‐Latin verse that they consequently compiled, the Collegii Posthimelissaei Votum, their humanist society may be seen to have been founded out of a combination of religious, patriotic and vocational concerns. The significance of the Collegium's symbol, the amethyst, is examined in the light of the religious background to the vow – a background which is then balanced against the equal influences upon the Collegium of the satirical tradition surrounding Germany's drinking culture, and of the two founders' respective professions: medicine and poetry. Yet the anthology reveals that the Collegium was also motivated by more private concerns: the promotion of sober poetry both as a metaphorically purer form of wine and as a metonym for the friendship between sober poets that in itself resembles a form of ecstasy found in Montaigne.
Alcohol Promotes Mammary Tumor Development via the Estrogen Pathway in Estrogen Receptor Alpha‐Negative HER2/neu Mice
Authors: Wong Amy W. , Dunlap Sarah M. , Holcomb Valerie B. , Nunez Nomeli P.
Published: October 2011

Background:  Alcohol consumption is an established risk factor for breast cancer. Yet, the mechanism by which alcohol affects breast cancer development remains unresolved. The transition from the premenopausal to the postmenopausal phase is associated with a drastic reduction in systemic estrogen levels. It is not clear whether the risk of breast cancer attributable to alcohol consumption is modified by the different levels of estrogen found in pre‐ and postmenopausal women. The objective of this study is to determine whether the effects of alcohol on mammary tumor development are dependent on the presence of ovarian estrogen.

Methods:  As a model of breast cancer, we used mouse mammary tumor virus (MMTV)‐neu transgenic mice that overexpress the human epidermal growth factor receptor 2 (HER2/neu) in the mammary epithelium, resulting in the development of estrogen receptor alpha (ERα)‐negative mammary tumors. The mammary tumorigenesis process in these mice is similar to that of patients with HER2 breast cancer. Nonovariectomized (NOVX) and ovariectomized (OVX) MMTV‐neu mice were exposed to 0, 5, and 20% ethanol in the drinking water. Breast cancer development and progression were determined alongside the effects of alcohol on estrogen availability and signaling.

Results:  Our data show that 20% alcohol consumption promoted tumor development in MMTV‐neu mice only in the presence of ovarian hormones. Tumor promotion was associated with increased systemic estrogen levels, increased expression of aromatase (the rate‐limiting enzyme in estrogen synthesis), and increased expression of ERα in the tumors of 20% alcohol‐consuming MMTV‐neu mice. Additionally, we show that ovariectomy (removal of the ovaries and ovarian hormone production) blocked the effects of 20% alcohol on tumor development.

Conclusions:  Our results support the notion that alcohol consumption promotes HER2 breast cancer development via the estrogen signaling pathway. Additionally, they suggest that the effects of alcohol on breast cancer may be prevented by blocking estrogen signaling.
Post‐Treatment Outcomes in a Double‐Blind, Randomized Trial of Sertraline for Alcohol Dependence
Authors: Kranzler Henry R. , Armeli Stephen , Tennen Howard
Published: October 2011

Background:  Pharmacotherapy studies in alcohol dependence (AD) are generally of short duration and do not include post‐treatment follow‐up. We examined the durability of treatment effects in a placebo‐controlled trial of sertraline for AD.

Methods:  As previously reported, patients received 12 weeks of treatment with sertraline (n = 63) or placebo (n = 71), followed by assessments at 3 and 6 months post‐treatment (Kranzler et al., 2011, J Clin Psychopharmacol 31:22–30). We examined the main and interaction effects with time of 3 between‐subject factors (medication group, age of onset of AD [late‐onset alcoholics, LOAs, vs. early‐onset alcoholics, EOAs], and the tri‐allelic 5‐HTTLPR genotype) on drinking days (DDs) and heavy drinking days (HDDs).

Results:  The medication group effect, which was significant during treatment, remained significant during the 3‐month follow‐up period for L’/L’ LOAs, with the sertraline group having fewer DDs than the placebo group (p = 0.027). However, the medication group effect seen in L’/L’ EOAs during treatment was no longer significant (p = 0.48). There were no significant effects in S’ carriers at the 3‐month follow‐up visit, or in either genotype group at the 6‐month follow‐up.

Conclusions:  The beneficial effects of sertraline observed in LOAs during treatment persisted during the 3‐month post‐treatment period. Additional studies are needed to validate these pharmacogenetic findings, which together with the effects seen during active treatment support the use of sertraline only in LOAs.
Human immunodeficiency virus prevalence, incidence, and residual risk of transmission by transfusions at Retrovirus Epidemiology Donor Study‐II blood centers in Brazil
Authors: Sabino Ester C. , Gonçalez Thelma T. , Carneiro‐Proietti Anna Bárbara , Sarr Moussa , Ferreira João Eduardo , Sampaio Divaldo A. , Salles Nanci A. , Wright David J. , Custer Brian , Busch Michael ,   for the NHLBI Retrovirus Epidemiology Donor Study‐II (REDS‐II), International Component
Published: October 2011

BACKGROUND: In Brazil nationally representative donor data are limited on human immunodeficiency virus (HIV) prevalence, incidence, and residual transfusion risk. The objective of this study was to analyze HIV data obtained over 24 months by the Retrovirus Epidemiology Donor Study‐II program in Brazil.

STUDY DESIGN AND METHODS: Donations reactive to third‐ and fourth‐generation immunoassays (IAs) were further confirmed by a less‐sensitive (LS) IA algorithm and Western blot (WB). Incidence was calculated for first‐time (FT) donors using the LS‐EIA results and for repeat donors with a model developed to include all donors with a previous negative donation. Residual risk was projected by multiplying composite FT and repeat donor incidence rates by HIV marker–negative infectious window periods.

RESULTS: HIV prevalence among FT donors was 92.2/105 donations. FT and repeat donor and composite incidences were 38.5 (95% confidence interval [CI], 25.6‐51.4), 22.5 (95% CI, 17.6‐28.0), and 27.5 (95% CI, 22.0‐33.0) per 100,000 person‐years, respectively. Male and community donors had higher prevalence and incidence rates than female and replacement donors. The estimated residual risk of HIV transfusion transmission was 11.3 per 106 donations (95% CI, 8.4‐14.2), which could be reduced to 4.2 per 106 donations (95% CI, 3.2‐5.2) by use of individual‐donation nucleic acid testing (NAT).

CONCLUSION: The incidence and residual transfusion risk of HIV infection are relatively high in Brazil. Implementation of NAT will not be sufficient to decrease transmission rates to levels seen in the United States or Europe; therefore, other measures focused on decreasing donations by at‐risk individuals are also necessary.
Preemptive use of plerixafor in difficult‐to‐mobilize patients: an emerging concept
Authors: Jantunen Esa , Lemoli Roberto M.
Published: October 2011

Mobilized peripheral blood (PB) is the preferred source of stem cells (PBSCs) for autologous stem cell transplantation (ASCT). The use of cytokines, alone or in combination with chemotherapy (chemomobilization), is currently the most common strategy applied to collect PBSCs. However, a significant proportion of patients with lymphoid malignancies fail to mobilize enough PBSCs to proceed to ASCT. Plerixafor has been recently introduced for clinical use to enhance PBSC mobilization and has been shown to be more effective than granulocyte–colony‐stimulating factor (G‐CSF) alone in patients with multiple myeloma or non‐Hodgkin's lymphoma. There is limited experience on combining plerixafor with chemotherapy plus G‐CSF in patients who mobilize poorly. This review attempts to summarize the published experience on the preemptive use of plerixafor after chemomobilization or G‐CSF mobilization to enhance stem cell collection and to prevent mobilization failure. Current evidence suggests that addition of plerixafor is safe and effective in the large majority of the patients with low blood CD34+ cell counts after mobilization and/or poor yield after the first collection(s). Circulating CD34+ cell counts can be increased by severalfold with plerixafor and the majority of the patients considered difficult to mobilize can be successfully collected. Although more studies are needed to evaluate proper patient selection and optimal timing for the addition of plerixafor after chemotherapy, its mechanism of action inducing the rapid release of CD34+ cells from the marrow to the PB makes this molecule suitable for its “preemptive” use in patients who are difficult to mobilize.
Hepatitis B virus transmission by blood transfusion during 4 years of individual‐donation nucleic acid testing in South Africa: estimated and observed window period risk
Authors: Vermeulen Marion , Dickens Caroline , Lelie Nico , Walker Evangelia , Coleman Charl , Keyter Mark , Reddy Ravi , Crookes Robert , Kramvis Anna
Published: October 2011

BACKGROUND: Since October 2005, a total of 2,921,561 blood donations have been screened by the South African National Blood Service for hepatitis B virus (HBV) by individual‐donation nucleic acid testing (ID‐NAT). Over 4 years, 149 hepatitis B surface antigen–negative acute‐phase HBV NAT–positive donations were identified (1:19,608). The lookback program identified one probable HBV transmission.

STUDY DESIGN AND METHODS: The complete genomes of HBV isolated from the donor and recipient were sequenced, cloned, and analyzed phylogenetically. The HBV window period (WP) transmission risk was estimated assuming a minimum infectious dose of 3.7 HBV virions and an incidence rate correction factor of 1.34 for transient detectability of HBV DNA.

RESULTS: Of 149 acute‐phase HBV NAT yields, 114 (1:25,627) were classified as pre–antibody to hepatitis B core antigen (anti‐HBc) WP and 35 (1:83,473) as post–anti‐HBc WP. The acute‐phase transmission risk in the HBV DNA–negative pre‐ and post–anti‐HBc WPs (of 15.3 and 1.3 days, respectively) was estimated at 1:40,000 and 1:480,000, respectively. One HBV transmission (1:2,900,000) was identified in a patient who received a transfusion from an ID‐NAT–nonreactive donor in the pre–anti‐HBc WP. Sequence analysis confirmed transmission of HBV Subgenotype A1 with 99.7% nucleotide homology between donor and recipient strains. The viral burden in the infectious red blood cell unit was estimated at 32 (22‐43) HBV DNA copies/20 mL of plasma.

CONCLUSION: We report the first known case of transfusion‐transmitted HBV infection by blood screened using ID‐NAT giving an observed HBV transmission rate of 0.34 per million. The estimated pre–acute‐phase transmission risk in the ID‐NAT screened donor population was 73‐fold higher than the observed WP transmission rate.
Interdonation intervals and patterns of return among blood donors in Brazil
Authors: de Almeida Neto Cesar , Mendrone Jr Alfredo , Custer Brian , Liu Jing , Carneiro‐Proietti Anna Bárbara , Leão Silvana A. Carneiro , Wright David J. , Murphy Edward L. , Sabino Ester Cerdeira ,   for the NHLBI Retrovirus Epidemiology Donor Study‐II (REDS‐II), International Component
Published: October 2011

BACKGROUND: In Brazil, most donations come from repeat donors, but there are little data on return behavior of donors.

STUDY DESIGN AND METHODS: Donors who made at least one whole blood donation in 2007 were followed for 2 years using a large multicenter research database. Donation frequency, interdonation intervals, and their association with donor demographics, status, and type of donation were examined among three large blood centers in Brazil, two in the southeast and one in the northeast.

RESULTS: In 2007, of 306,770 allogeneic donations, 38.9% came from 95,127 first‐time donors and 61.1% from 149,664 repeat donors. Through December 31, 2009, a total of 28.1% of first‐time donors and 56.5% of repeat donors had donated again. Overall, the median interdonation interval was approximately 6 months. Among men it was 182 and 171 days for first‐time and repeat donors, and among women, 212 and 200 days. Predictors of return behavior among first‐time donors were male sex (odds ratio [OR], 1.17; 95% confidence interval [CI], 1.13‐1.20), community donation (OR, 2.26; 95% CI, 2.20‐2.33), and age 24 years or less (OR, 0.62‐0.89 for donors ≥25 years). Among repeat donors predictors were male sex (OR, 1.35; 95% CI, 1.32‐1.39), age 35 years or more (OR, 1.08‐1.18 vs. ≤24 years), and community donation (OR, 2.39; 95% CI, 2.33‐2.44). Differences in return by geographic region were evident with higher return rates in the northeast of Brazil.

CONCLUSION: These data highlight the need to develop improved communication strategies for first‐time and replacement donors to convert them into repeat community donors.
RhIG for the treatment of immune thrombocytopenia: consensus and controversy (CME)
Authors: Despotovic Jenny M. , Lambert Michele P. , Herman Jay H. , Gernsheimer Terry B. , McCrae Keith R. , Tarantino Michael D. , Bussel James B.
Published: October 2011

Anti‐D immune globulin (RhIG) is a front‐line option in North America for the treatment of immune thrombocytopenia (ITP) in children and adults. Recently, addition of a Food and Drug Administration‐mandated black box warning highlighted the risks of intravascular hemolysis, renal failure, and disseminated intravascular coagulation after anti‐D infusion, prompting concern within the medical community regarding its use. A working group convened in response to this warning to prepare a consensus document regarding the safety of RhIG because there has been no increased incidence of adverse events since the initial discovery of these reactions many years ago. The efficacy of anti‐D is well documented and only briefly reviewed. The estimated incidence and proposed mechanisms for the rare, major treatment‐related complications are discussed, and signal detection data associated with heightened risk of acute hemolytic reactions are presented. The importance of considering host factors, given the rarity of severe reactions, is emphasized. Safety profiles of parallel treatment options are reviewed. The working group consensus is that RhIG has comparable safety and efficacy to other front‐line agents for the treatment of children and adults with ITP. Safety may be further improved by careful patient selection.
Restructuring in the forest sector and the re‐shaping of women's work identities
Authors: Mills Suzanne E.
Published: October 2011

This article explores how women forest workers’ perceptions of restructuring are related to their work identities. Drawing on semi‐structured interviews with 29 women working in subsidiaries of a multinational forest company in northern Saskatchewan, I describe how women workers selectively drew on traditional mill worker and flexible worker identities to legitimize and delegitimize restructuring. Women's understandings of themselves as workers were shaped by their paradoxical relationships to standard forest processing work. Some women with previous experience working in low‐waged service industries adopted worker subjectivities that legitimized restructuring and valued flexibility, individual empowerment, and mobility. Other women delegitimized restructuring, referencing traditional characterizations of forest work that valued community stability, collective resistance, and security. Many women, however, neither consistently legitimized nor delegitimized restructuring throughout their interviews. This last group's ambiguous portrayal of work and restructuring demonstrates the identity dilemmas faced by new entrants to declining industrial sectors. Restructuring interrupted women's narratives of having found a “good job” in forestry and prompted the renegotiation of their understandings of mill work. This article contributes to our understanding of restructuring in resource industries by drawing attention to how worker identities, gender, and industrial change are interrelated.
Animal‐Related Fatalities—Part I: Characteristic Autopsy Findings and Variable Causes of Death Associated with Blunt and Sharp Trauma
Authors: Bury Danielle , Langlois Neil , Byard Roger W.
Published: October 2011

Abstract:  Animals may be responsible for an array of potentially lethal injuries. Blunt force injuries characteristically involve larger animals such as cattle or horses that may kick, crush, or trample a victim causing head and facial injuries. Farm workers in particular are at high risk of lethal injuries involving the head and torso. Significant blunt trauma may be found in vehicle occupants after collisions with large animals such as camels or moose. Rarely, zookeepers may be crushed by particularly massive animals such as elephants. Sharp force injuries usually involve carnivore bites, most often from dogs with a “hole and tear” pattern of wounding. Injuries from animals such as alligators and sharks may have a significant component of crushing. Incised wounds may result in death from exsanguination and air embolism. On occasion, blunt or sharp trauma from animal activity may be confused with postmortem damage or with inflicted injury from an assault.
Patterns of Trauma in Conflict Victims from Timor Leste
Authors: Komar Debra A. , Lathrop Sarah
Published: October 2011

Abstract:  Understanding population‐level trauma patterns has implications for the recognition of war crimes and crimes against humanity. Trauma data were abstracted from autopsy and anthropology reports for 105 victims from the 1999 conflict in Timor Leste. A significant number of individuals displayed no evidence of injury. No trauma was found in 25% of the sample, while a further 5% had only minor, nonlethal wounds. Where trauma was evident, sharp force injuries were most common (35%), followed by gunshot (20%) and blunt force (13.33%). Timorese frequencies of trauma differ significantly from percentages found in prior reports of mass killings from Cambodia, Bosnia, Croatia, and Afghanistan but closely resemble reported trauma patterns in Rwanda. Decomposition and percentage of body recovered were shown to have a significant impact on the presence/absence of trauma. Complete, fleshed remains were 10.4 times more likely than skeletal remains to have evidence of major or lethal trauma.
AWP1/ZFAND6 Functions in Pex5 Export by Interacting with Cys‐Monoubiquitinated Pex5 and Pex6 AAA ATPase
Authors: Miyata Non , Okumoto Kanji , Mukai Satoru , Noguchi Masafumi , Fujiki Yukio
Published: October 2011

During biogenesis of the peroxisome, a subcellular organelle, the peroxisomal‐targeting signal 1 (PTS1) receptor Pex5 functions as a shuttling receptor for PTS1‐containing peroxisomal matrix proteins. However, the precise mechanism of receptor shuttling between peroxisomes and cytosol remains elusive despite the identification of numerous peroxins involved in this process. Herein, a new factor was isolated by a combination of biochemical fractionation and an in vitro Pex5 export assay, and was identified as AWP1/ZFAND6, a ubiquitin‐binding NF‐κB modulator. In the in vitro Pex5 export assay, recombinant AWP1 stimulated Pex5 export and an anti‐AWP1 antibody interfered with Pex5 export. AWP1 interacted with Pex6 AAA ATPase, but not with Pex1–Pex6 complexes. Preferential binding of AWP1 to the cysteine‐ubiquitinated form of Pex5 rather than to unmodified Pex5 was mediated by the AWP1 A20 zinc‐finger domain. Inhibition of AWP1 by RNA interference had a significant effect on PTS1‐protein import into peroxisomes. Furthermore, in AWP1 knock‐down cells, Pex5 stability was decreased, similar to fibroblasts from patients defective in Pex1, Pex6 and Pex26, all of which are required for Pex5 export. Taken together, these results identify AWP1 as a novel cofactor of Pex6 involved in the regulation of Pex5 export during peroxisome biogenesis.
Evidence‐based (S3) guideline for the treatment of androgenetic alopecia in women and in men
Authors: Blumeyer Anja , Tosti Antonella , Messenger Andrew , Reygagne Pascal , del Marmol Veronique , Spuls Phyllis I. , Trakatelli Myrto , Finner Andreas , Kiesewetter Franklin , Trüeb Ralph , Rzany Berthold , Blume‐Peytavi Ulrike
Published: October 2011

Androgenetic alopecia is the most common hair loss disorder, affecting both men and women. Initial signs of androgenetic alopecia usually develop during teenage years leading to progressive hair loss with a pattern distribution. Moreover, its frequency increases with age and affects up to 80 % Caucasian men and 42 % of women.

Patients diagnosed with androgenetic alopecia may undergo significant impairment of quality of life. Despite the high prevalence and the variety of therapeutic options available, there have been no national or international evidence‐based guidelines for the treatment of androgenetic alopecia in men and women so far. Therefore, the European Dermatology Forum (EDF) initiated a project to develop an evidence‐based S3 guideline for the treatment of andro‐genetic alopecia. Based on a systematic literature research the efficacy of the currently available therapeutic options was assessed and therapeutic recommendations were passed in a consensus conference.

The purpose of the guideline is to provide dermatologists as well as general practitioners with an evidence‐based tool for choosing an efficacious and safe therapy for patients with androgenetic alopecia.
Serum S100B and neuron‐specific enolase levels in normothermic and hypothermic infants after perinatal asphyxia
Authors: Roka Aniko , Kelen Dorottya , Halasz Jozsef , Beko Gabriella , Azzopardi Denis , Szabo Miklos
Published: October 2011

Aim:  Serum S100B and neuron‐specific enolase (NSE) levels are elevated after perinatal asphyxia, but the influence of hypothermia on these proteins has not been previously reported. The aim of this study was to evaluate the effect of systemic hypothermia on these protein levels after perinatal asphyxia, time course, and association with perinatal factors and neurodevelopmental outcome at 2 years of age.

Methods:  Serum S100B and NSE levels were measured at fixed time points in asphyxiated infants treated with standard intensive care on hypothermia (HT: n = 13) or normothermia (NT: n = 11).

Results:  Serum S100B and NSE levels were grossly elevated in both HT and NT groups. Compared with the values at 6 h of age, S100B values decreased over time in both groups (NT: p = 0.002, HT: p = 0.04). Serum S100B values were lower in HT infants compared with those in NT infants (p = 0.047 at 48 h). Serum S100B and NSE values were significantly higher in infants who died or developed severe neurological impairment (S100B, p < 0.05 at all time points; NSE, p = 0.036 at 24 h of age).

Conclusion:  Both NSE and S100B levels are highly elevated following asphyxia. Serum S100B levels were lower in the HT group and strongly correlated with the neurodevelopmental outcome.
The Structure of Chinese Cultural Traditions: An Empirical Study of Business Employees in China
Authors: Pan Yaotian , Rowney Julie A. , Peterson Mark F.
Published: October 2011

Five schools of Chinese cultural traditions that implicitly influence current management thought in China are used to create a four-factor Structure of Chinese Cultural Traditions (SCCT) model. A sample of 2658 people in businesses in Beijing was used to develop the dimensions that were then cross-validated in a nation-wide sample of 718 business employees. The four dimensions show plausible patterns of convergent and discriminant validity with generic domains of values represented by the Schwartz Value Survey (SVS). We suggest that the Structure of Chinese Cultural Traditions provides a unique model of Chinese culture that complements other generic measures, thereby allowing a deep understanding of Chinese culture.
Penile Duplex Ultrasonography in Men with Peyronie’s Disease: Is it Veno-Occlusive Dysfunction or Poor Cavernosal Arterial Inflow that Contributes to Erectile Dysfunction?
Authors: Chung Eric , De Young Ling , Brock Gerald B.
Published: October 2011

Introduction

At least 20% of men with Peyronie’s disease (PD) suffer from erectile dysfunction (ED). The fundamental mechanism is thought to arise from the progression of penile fibrosis, which was initially limited to the PD plaque within the tunica albuginea. However, recent studies have highlighted the possibility of fibrosis of the cavernosal vessel media wall leading to impairment of arterial inflow.

Aim

To evaluate the penile duplex ultrasonographic findings in PD of impotent men and to determine whether early features of PD might predict clinical progression.

Main Outcome Measures

Patient demographic, comorbidities, International Index of Erectile Function-5 scores, surgical intervention, and physical findings were documented. Penile curvature, plaque size, and peak systolic velocity (PSV) and end-diastolic velocity (EDV) on color duplex ultrasonography (CDU) were recorded.

Methods

We performed a retrospective review of all men presenting with penile curvature and length loss who underwent penile CDU between January 2001 and January 2010.

Results

A total of 1,120 men underwent penile CDU during the 10-year period. Complete information was obtained in 810 men; 250 men complained of decreased penile rigidity, while 150 men were unable to sustain erection. Comorbidities were similar between men with PD with and without ED. Tunical thickening (65%) was the most common CDU feature, and mean cumulative calcifications was 24.2 mm2 (1–360 mm2, standard deviation 76). The PSV and EDV on the right cavernosal artery were 14.2 cm/second and 3.5 cm/second, while the left cavernosal artery measurements were 15.1 cm/second and 3.2 cm/second. Multivariate logistic regression model showed strong correlation between plaque size and development of ED. Both veno-occlusive dysfunction and impaired cavernosal arterial inflow were associated with ED.

Conclusions

Veno-occlusive dysfunction and impaired cavernosal arterial inflow contributed to the development of ED, and larger plaque size is a strong predictor of surgical intervention.
Tadalafil 2.5 or 5 mg Administered Once Daily for 12 Weeks in Men with Both Erectile Dysfunction and Signs and Symptoms of Benign Prostatic Hyperplasia: Results of a Randomized, Placebo-Controlled, Double-Blind Study
Authors: Egerdie Russell Blair , Auerbach Stephen , Roehrborn Claus G. , Costa Pierre , Garza Martin Sanchez , Esler Anne L. , Wong David G. , Secrest Roberta J.
Published: October 2011

Introduction

Erectile dysfunction (ED) and lower urinary tract symptoms suggestive of benign prostatic hyperplasia (BPH-LUTS) commonly coexist in aging men. Tadalafil, a phosphodiesterase type 5 inhibitor approved for treating ED, is currently being evaluated for treating BPH-LUTS.

Aims

This multinational Phase 3 study assessed effects of tadalafil 2.5 or 5 mg once daily on ED and BPH-LUTS in men with both conditions during 12 weeks of double-blinded therapy.

Methods

Men were ≥45 years old, sexually active, and experiencing ED for ≥3 months and BPH-LUTS for >6 months. Randomization (baseline) followed a 4-week placebo lead-in; changes from baseline were assessed via analysis of covariance and compared to placebo. A gatekeeping procedure controlled for multiple comparisons of co-primary and key secondary measures at end point (last post-baseline observation).

Main Outcome Measures

The co-primary measures were the International Index of Erectile Function-erectile function (IIEF-EF) domain and International Prostate Symptom Score (IPSS) score; key secondary measures were the Sexual Encounter Profile Question 3 (SEP Q3) and BPH Impact Index (BII). Treatment-emergent adverse events, serious adverse events, orthostatic vital signs, clinical laboratory and uroflowmetry parameters, and postvoid residual volume were assessed.

Results

Tadalafil 2.5 mg (N = 198) and 5 mg (N = 208) significantly improved IIEF-EF domain scores (both P < 0.001) vs. placebo (N = 200) at end point. For IPSS, improvements were significant with tadalafil 5 mg (P < 0.001), but not 2.5 mg, for observations from 2 weeks through end point (least-squares mean ± standard error change from baseline at end point, placebo −3.8 ± 0.5, tadalafil 2.5 mg −4.6 ± 0.4, and 5 mg −6.1 ± 0.4). Tadalafil 5 mg significantly improved SEP Q3 and BII (P < 0.001). Overall, tadalafil was well tolerated with no clinically adverse changes in orthostatic vital signs or uroflowmetry parameters.

Conclusions

Tadalafil 5 mg significantly improved both ED and BPH-related outcomes through 12 weeks and was well tolerated.
Investigative Models in Erectile Dysfunction: A State-of-the-Art Review of Current Animal Models
Authors: Chung Eric , De Young Ling , Brock Gerald B.
Published: October 2011

Introduction

Erectile dysfunction (ED) is a common male sexual disorder producing a significant negative impact on the physical and psychosocial health of men and their partners. The development of ED is frequently attributable to both psychogenic factors as well as physiological alterations in neural, vascular, hormonal, and endothelial function. While the complex nature of human sexual function cannot possibly be replicated fully, the use of animal models provides a valid alternative to the investigation and evaluation of sexual dysfunction.

Aim

To review the existing English literature pertaining to the use of experimental models (predominantly rodent models) for the evaluation of ED.

Main Outcome Measures

Summary of relevant animal models of ED and the advantages and disadvantages of each animal model.

Methods

A Medline search using the key words “animal models of erectile dysfunction” was carried out and all relevant peer-reviewed English language was evaluated.

Results

While larger animals such as dogs, monkeys, cats, and rabbits were used in the early period of investigation (1960–1990), in recent times, rodents have largely replaced other animals as the predominant animal model for investigating erectile function. The most frequently reported models of ED can be classified as traumatic (cavernous nerve injury and arterial ligation) and metabolic (diabetic, hypercholesterolemia/lipidemia, and castration). Other models that have been studied include organic (smoking, hypertension, and chronic renal failure) and nonorganic (psychological) models.

Conclusions

The development and utilization of the various rodent models has allowed for significant advances in the field of sexual dysfunction. Neurophysiological studies using the various animal models have provided important insights into human sexual dysfunction. At present, animal models play a significant role in evaluating novel therapeutics and surgical techniques and will likely continue to remain a vital research tool in the future.
Urban drainage in Ireland – embracing sustainable systems
Authors: O'Sullivan John J. , Bruen Michael , Purcell Padraig J. , Gebre Fasil
Published: October 2011

The current approach to stormwater management in Ireland requires that outflows from new developments are restricted to greenfield values that would have occurred prior to development. This typically involved the use of holding tanks constructed within developments to attenuate stormwater from where it was released at a reduced rate via a control structure to a nearby drainage network or watercourse. Improved drainage policies now require that sustainable drainage systems (SuDS) are used to meet this objective. This study presents an evaluation of perceived issues that may impede the adoption of new policies. The findings are based on surveys and focus groups of practitioners involved with the planning and design of drainage systems. Although the study indicates that benefits of SuDS are reasonably well understood, their use, for many reasons, has remained less popular. Concerns with ongoing maintenance and long‐term responsibility of SuDS remain impediments to the embracing of these systems in drainage strategies.
The self in the Cartesian brain
Authors: Gallagher Shaun
Published: October 2011

The following considers the role of our increased understanding of the neurobiological function of the brain in relation to classical Cartesian representations versus embodied self theories. The movement toward a multifaceted, narrative account of the self is discussed.
To be or not to be: The self as illusion
Authors: Tippett Krista , Metzinger Thomas , Thompson Evan , van Lommel Pim
Published: October 2011

Moderated by Krista Tippett, creator and host of America Public Media's On Being, philosophers Thomas Metzinger (University of Mainz, Germany) and Evan Thompson (University of Toronto) join cardiologist and expert on near‐death experiences Pim van Lommel (Hospital Rijnstate, the Netherlands) to examine recent developments in neuroscience and philosophy that shed light on whether our conscious experience of a unified self is reality or illusion. The following is an edited transcript of the discussion that occurred December 7, 2010, 6:00–7:30 PM, at the New York Academy of Sciences in New York City.
Penile cancer: an update
Authors: Turner Bruce , Henderson Sarah
Published: October 2011

Penile cancer is a rare disease with devastating physical and psychological effects on patients. The aim of this review is to update specialist nurses regarding the epidemiology, aetiology and management.
British Association of Urological Surgeons' suprapubic catheter practice guidelines
Authors: Harrison Simon CW , Lawrence William T , Morley Roland , Pearce Ian , Taylor Joby
Published: October 2011

The insertion of a suprapubic catheter is an increasingly common urological procedure. However the procedure, whilst beneficial for the patient, is not without significant risk, a situation that is exacerbated by the lack of consensus and practice guidelines. This article is an abridged version of the British Association of Urological Surgeons Suprapubic catheter best practice guidelines published by Harrison et al. in 2011.
Efficacy of tele‐nursing consultations in rehabilitation after radical prostatectomy: a randomised controlled trial study
Authors: Jensen Bente Thoft , Kristensen Susanne Ammitzbøll , Christensen Sofie Vistoft , Borre Michael
Published: October 2011

The dramatic increase in prostate cancer incidence causes higher demands for public health care. To meet these demands, fast track pathways have been introduced in radical prostatectomy. However, the short length of hospital admission leaves less time for patient education. The aim of this study was to investigate whether nurse‐led telephone consultations (TCs) could optimize resources and secure rehabilitation and patient satisfaction in the post‐operative period. This study is a prospective randomized controlled trial. A random sample of 95 consecutively enrolled patients was randomized to either intervention or standard follow‐up. The intervention was an additional TC 3 days post‐operatively. The care and patient education offered during hospitalization was similar for all patients. Randomization took place at discharge and was controlled externally. Data were collected from medical records and questionnaires 2 weeks post‐operatively. We found no difference in the overall efficacy regarding patient satisfaction, sense of security and post‐operative discomfort. Some patients had unmet needs and TCs provided better rehabilitation regarding management of bowel function, pain, catheter and wound care. There was no difference in the need of post‐operative contact to other health care affiliates. In general, patients were sufficiently educated in managing early rehabilitation and they expressed high satisfaction and sense of security in the post‐operative period after discharge regardless of TC. Therefore, TCs will not be the standard procedure, but the results have increased awareness in daily clinical practice and optimized the clinical pathway in general. The results indicate commitment and high adherence to clinical guidelines among the nursing staff.
The effects of a nerve‐sparing procedure on urinary incontinence and sexual function among radical prostatectomy patients
Authors: Lin Yu‐Hua , Lin Victor Chia‐Hsiang , Yu Tsan‐Jung , Chen Tai‐Been , Yang Mei‐Sang , Kao Chia‐Chan
Published: October 2011

Urinary incontinence (UI) and sexual dysfunction are common complications among patients after radical prostatectomy (RP). Although a nerve‐sparing procedure has been recommended to reduce these two complications, the benefits of this procedure still need to be examined in Taiwan. The purposes of this study were to describe and compare the changes over time in the urinary and sexual function of prostate cancer patients treated with or without nerve‐sparing RP. In this study, a longitudinal pre‐test and four post‐test study designs were employed. In all, 62 prostate cancer patients who had undergone an RP were recruited from two hospitals in southern Taiwan. Structure questionnaires and one‐hour pad tests were administered to the patients upon their first visit to the urological clinic (as baseline data) and at follow‐up visits at the clinic 3, 6, 9 and 12 months after RP. All of the patients experienced UI and sexual dysfunction from the first month after undergoing an RP to 12 months. A two‐way multivariate analysis of variance with repeated measurements indicated that the nerve‐sparing procedure (F = 4·41, p < 0·01) and time (F = 12·47, p < 0·001) significantly affected the combined dependent of UI and sexual function. The results of a univariate analysis of variance indicated that the International Index of Erectile Function (IIEF) scores were significantly different for patients who underwent the nerve‐sparing procedure (F = 7·72, p = 0·001), but pad weights were not altered by the effects of the nerve‐sparing procedure. Regarding the effects of time, the results demonstrated that both pad weights and IIEF scores changed significantly over time (F = 12·47, p < 0·001). This study demonstrates that nerve‐sparing positively affects sexual dysfunction, but that it exhibits limited benefit for UI in RP patients. These results can assist health care providers in providing patients with pre‐operation information.