bluuebunny/crossref_metadata_2025 huggingface dataset:
Fine needle aspiration cytology of nodular fasciitis of the breast
Authors: Sakuma Takahiko , Matsuo Koji , Koike Shinya , Tagami Kouichiro
Published: May 2014

We report a case of nodular fasciitis (NF) of the breast, which was cytologically diagnosed as a spindle cell proliferation with undetermined malignant potential. Owing to small size of the lesion (5.9 × 3.7 × 4.1 mm), only fine needle aspiration (FNA) cytology was performed under ultrasound guidance. The FNA smears were cellular, rich in single/clustered spindle cells but mammary ductal epithelial/myoepithelial cells were absent. These cytologic findings suggested spindle cell growth of mesenchymal origin. Pattern‐less arrangement of spindle cells, heterogeneous composition of the stromal matrix, lack of nuclear/cellular atypia, occasional mitosis but no aberrant mitotic figures, and lymphocyte infiltration indicated reactive rather than neoplastic nature of the lesion. Nonetheless, lumpectomy was conducted because the possibility of neoplasm was not completely ruled out. The histologic diagnosis of the resected nodule was NF. FNA specimens were reviewed thoroughly in an attempt to define the key cytomorphologic features of NF that are important for the correct diagnosis. Differential diagnoses from the lesions that show similar cytologic pictures are discussed in detail. Although NF arising from the breast is rare, cytopathologists should be aware of its clinical and cytopathologic characteristics. Knowledge of the possibility of NF in the breast and its cytologic findings may help cytopathologists to discern its reactive, not neoplastic, characteristics of the lesion. If the referring surgeon is alerted NF as a possibility along with other differential diagnoses, close observation would become a management option. In‐depth discussion of cytologic features and a review of the pertinent literature are also included. Diagn. Cytopathol. 2015;43:222–229. © 2014 Wiley Periodicals, Inc.
Shape‐ and Size‐Controlled Synthesis of Mn3O4 Nanocrystals at Room Temperature
Authors: Chen Chao , Jian Hong , Mai Kaiguang , Ren Zhimin , Wang Jia , Fu Xinxin , Fan Chenyao , Sun Chunxiao , Qian Guodong , Wang Zhiyu
Published: May 2014

A versatile synthetic method has been developed for the fabrication of Mn3O4 nanocrystals with different sizes and shapes, such as square nanoplates, mesocrystal nanodisks, and nanopolyhedra. Manganese(II) acetate tetrahydrate and hydrazine monohydrate were the only two reactants used in aqueous solution, and no surfactant was employed. The key advantages of our approach are (1) the room‐temperature synthesis, (2) the facile operation, (3) the flexibility in shape‐ and size‐control, and (4) the ease of scale‐up. The exposed surfaces of the as‐prepared nanoparticles were carefully characterized and indexed. The catalytic properties of the nanoplates for the degradation of methylene blue were evaluated in detail. The catalytic properties are closely related to the shape and size of the Mn3O4 nanocrystals, and nanoplates with a size of 50 nm exhibited the best catalytic performance. The magnetic properties were investigated with a superconducting quantum interference device magnetometer.
Giant Photoconductivity in NMQ[Ni(dmit)2]
Authors: Naito Toshio , Karasudani Tomoaki , Nagayama Naoki , Ohara Keishi , Konishi Kensuke , Mori Shigeki , Takano Takahiro , Takahashi Yukihiro , Inabe Tamotsu , Kinose Shota , Nishihara Sadafumi , Inoue Katsuya
Published: May 2014

The simple molecular salt NMQ[Ni(dmit)2] (NMQ = N‐methylquinolinium, dmit = 1,3‐dithiol‐2‐thione‐4,5‐dithiolate) functions as a diamagnetic insulator with an activation energy Ea(dark) of 0.20 eV. However, at 300 K, it exhibits ca. 40 times higher conductivity (σUV) under UV irradiation [(375 ± 5) nm, 15.7 mW cm–2] than it does under dark conditions (σdark). The ratio σUV/σdark rapidly increases with decreasing temperature and reaches ca. 880 at 200 K. From the temperature dependence of σUV, the activation energy under irradiation Ea(UV) is 0.12 eV. These observations cannot be explained as the result of sample heating during UV irradiation. Rather, the X‐ray photoelectron spectra of the sulfur and nickel atoms, the calculated band structure, and the UV/Vis spectra of the salt can all be explained consistently as follows: charge transfer between the Ni(dmit)2 moieties upon exposure to 375 nm UV light induces melting of the charge‐ordered state and produces the unusually large photoconductivity of NMQ[Ni(dmit)2].
Lanthanide Complexes Assembled from 3‐Fluorophthalate and 1,10‐Phenanthroline: Syntheses, Crystal Structure, Photoluminescence, and White‐Light Emission
Authors: Cha Yu‐E , Li Xia , Ma Dou , Huo Rui
Published: May 2014

Two different crystal forms, [Ln4(Fpht)6(phen)6(H2O)4]·nH2O (Ln = Eu 1, n = 14; Tb 2, n = 12) and [Ln(Fpht)(HFpht)(phen)(H2O)] (Ln = La 3, Eu 4, Tb 5) were obtained from the one‐pot reaction of LnIII ions with 3‐fluorophthalic acid (H2Fpht) and 1,10‐phenanthroline (phen). Complexes 1 and 2 are centrosymmetric tetranuclear molecules with two crystallographically different LnIII ion environments, [Ln(1)O6N2] and [Ln(2)O4N4]. The complexes have a tridentate bridging Fpht ligand and a bidentate terminal Fpht ligand. Complexes 3–5 show 2D networks with [LnO7N2] polyhedra. There are two kinds of ligands, Fpht and HFpht, which adopt chelating‐bridging/monodentate and bidentate‐bridging coordination modes, respectively. The LaIII complex shows ligand‐centered fluorescence. EuIII and TbIII complexes display red 5D0 → 7F0–4 and green 5D4 → 7F6–2 characteristic luminescence, respectively. Intriguingly, white‐light emission was produced when EuIII and TbIII were codoped into the 2D LaIII complex.
Photolabile Protecting Groups for Nitroxide Spin Labels
Authors: Seven Ibrahim , Weinrich Timo , Gränz Markus , Grünewald Christian , Brüß Silke , Krstić Ivan , Prisner Thomas F. , Heckel Alexander , Göbel Michael W.
Published: May 2014

Nitroxide spin labels can be protected against critical conditions of DNA/RNA or peptide synthesis by reduction and alkylation with light‐sensitive groups such as nitrobenzyl‐ or aminocoumarins. High chemical stability qualifies tetraethylisoindoline 5 and, with some restrictions, (2,2,6,6‐tetramethylpiperidin‐1‐yl)oxy (TEMPO) precursor 4 as building blocks for spin‐labeled biopolymers. The yield of recovered nitroxides (80–95 %) is sufficient for PELDOR experiments. A protected TEMPO phosphoramidite was successfully used to synthesize a short spin‐labeled DNA with high yield and purity.
Scaling and Learning Effects of Biofuels Conversion Technologies
Authors: Festel Gunter , Würmseher Martin , Rammer Christian
Published: May 2014

The convergence in production costs between biofuels and fossil fuels may be driven by an increase of the market price for crude oil on the one hand and by a decrease of the production costs for alternative fuels on the other. Whereas the price for fossil fuels mainly depends on the price of crude oil, the conversion costs often have a decisive impact on fuels produced from biomass. This study shows that the total conversion costs can be primarily reduced by scaling effects. Therefore, for all discussed types of biofuels, the total conversion costs can be reduced by a factor of ten, solely through scale economies associated with upscaling of the production plant size from 10 kt to 500 kt. In contrast, between 2005 and 2020, the expected reduction of the conversion costs attributable to learning effects is approximately one half, resulting from the learning curve factors during this time period. Although 2nd generation biofuels have been closely linked to higher conversion costs in comparison to 1st generation biofuels, this gap is expected to almost vanish over the next decade.
Synthesis, Reactivities, and Coordination Chemistry of Tris(2‐isopropoxyphenyl)phosphine
Authors: Takeda Nobuhiro , Tagawa Tomonori , Unno Masafumi
Published: May 2014

A phosphine bearing three 2‐isopropoxyphenyl groups, P{C6H4[2‐O(i‐Pr)]}3 (1), was synthesized. Phosphine 1 readily reacted with CH2Cl2 and ClCH2CH2Cl at 25°C to give the corresponding phosphonium salts [RCH2P{C6H4[2‐O(i‐Pr)]}3]X (2: R=X=Cl, 3: R=CH2Cl, X=BF4). Platinum, palladium, and rhodium complexes with ligand 1, [PtCl2(1)2] (4), [PdCl2(1)2] (5), [{PdCl(1)}2(μ‐Cl)2] (6), and [RhCl(cod)(1)] (7) were synthesized and their structures were determined by X‐ray crystallography, which revealed that ligand 1 works as a monodentate ligand in these complexes.
Synthesis, Structure, and Thermolysis of Tetracoordinated 1λ4,2‐Selenazetidines Bearing Two Chiral Centers at the 3‐ and 4‐Positions
Authors: Daicho Yuya , Kano Naokazu , Yukimoto Mariko , Minoura Mao , Kawashima Takayuki
Published: May 2014

The title trans and cis isomers (trans‐3 and cis‐3) were successfully synthesized as stable compounds by taking advantage of the Martin ligand. The X‐ray crystallographic analysis of trans‐3 showed that it has a distorted pseudotrigonal bipyramidal structure, and that the two phenyl groups at the 3‐ and 4‐positions are cis to each other. The thermolysis of trans‐3 in the presence of excess dimethyl acetylenedicarboxylate (DMAD) gave a mixture of the corresponding aziridines (trans‐7 and cis‐7) and cycloadducts (11a and 11b) of the azomethine ylides formed by ring opening of the aziridines with DMAD. Heating of cis‐7 and excess DMAD under the same conditions gave diastereomeric mixtures of both the aziridines and the cycloadducts, which means that the stereochemistry of the aziridine formation from the 1,2‐selenazetidine cannot be determined in this system.
What Currently Limits Charge Carrier Mobility in Crystals of Molecular Semiconductors?
Authors: Schweicher Guillaume , Olivier Yoann , Lemaur Vincent , Geerts Yves Henri
Published: May 2014

Charge carrier mobility is a central property that characterizes the performances of organic semiconductors and is mostly measured in field‐effect transistors. High mobility values are sought by many research teams. This article, that provides an overview of best performing molecular semiconductors is constructed on the question: What currently limits charge carrier mobility in crystals of molecular semiconductors? With this in mind, we confront, in a critical way, the current theoretical understanding to the most salient experimental results with the hope to reach a deeper understanding based on first principles and order of magnitudes of the main physical parameters.
Investigation of Gallic Acid Induced Anticancer Effect in Human Breast Carcinoma MCF‐7 Cells
Authors: Wang Ke , Zhu Xue , Zhang Kai , Zhu Ling , Zhou Fanfan
Published: May 2014

Gallic acid (GA), a polyhydroxylphenolic compound abundantly distributed in plants, fruits, and foods, has been reported to have various biological activities including an anticancer effect. In this study, we extensively investigated the anticancer effect of GA in human breast carcinoma MCF‐7 cells. Our study indicated that treatment with GA resulted in inhibition of proliferation and induction of apoptosis in MCF‐7 cells. Then, the molecular mechanism of GA's apoptotic action in MCF‐7 cells was further investigated. The results revealed that GA induced apoptosis by triggering the extrinsic or Fas/FasL pathway as well as the intrinsic or mitochondrial pathway. Furthermore, the apoptotic signaling induced by GA was amplified by cross‐link between the two pathways. Taken together, our findings may be useful for understanding the mechanism of action of GA on breast cancer cells and provide new insights into the possible application of such compound and its derivatives in breast cancer therapy.
Therapeutic apheresis in renal transplantation; current practices
Authors: Keith Douglas S.
Published: May 2014

Apheresis is an important treatment modality for the removal of pathologic antibodies and circulating proteins in kidney transplantation. The use of apheresis has been shown to be a necessary preconditioning component in ABO incompatible kidney transplant. Removal of pathologic anti‐A and anti‐B antibodies has been accomplished with a variety of apheresis modalities including plasma exchange, fractional plasma exchange, and immunoaborption techniques. Using these modalities in conjunction with potent modern immunosuppression, ABO incompatible kidney transplants have achieved graft and patient survivals similar to that seen in ABO compatible transplants. Apheresis has also been an important modality in the removal of anti‐human leukocyte antigen (HLA) antibodies both for the purposes of desensitization and treatment of antibody mediated rejection of the kidney. Although good randomized controlled trials are lacking in the treatment of acute antibody mediated rejection, most treatment regimens include the use of apheresis as an essential component for reduction of anti‐HLA antibody titers. Similarly, a variety of desensitization protocols have been developed to allow highly sensitized kidney transplant candidates to be successfully transplanted in the presence of donor‐specific HLA antibodies. Most of these protocols involve apheresis to improve the removal of pathologic antibodies. Finally, aphereis has been used with mixed success for the treatment of recurrent focal segmental glomerulosclerosis. Evidence indicates that in some cases a circulating factor exists which apheresis can remove and ameliorate the nephrotic proteinuria. J. Clin. Apheresis 29:206–210, 2014. © 2014 Wiley Periodicals, Inc.
Comparison of PAT based approaches for making real‐time pooling decisions for process chromatography – use of feed forward control
Authors: Mendhe Rakesh , Thukkaram Muralikrishnan , Patil Nitin , Rathore Anurag S.
Published: May 2014

BACKGROUND

Process analytical technology (PAT) is gradually being implemented in the biopharmaceutical industry due to the potential for continuous real‐time quality assurance resulting in improved operational control and compliance. Process chromatography remains the primary unit operation for purification of biotech therapeutics for separation of the various host cell related, process related, and product related impurities and variants. The latter often have very similar physicochemical properties to that of the product and hence in the absence of baseline separation, a robust pooling strategy is required to ensure consistent product quality.

RESULTS

This paper presents an evaluation of a variety of PAT based and pseudo‐PAT based approaches for pooling a real commercial process chromatography column. The pseudo‐PAT approaches that have been evaluated include ultraviolet (UV) absorbance, % peak height, retention time, and relative retention time. These approaches do not involve direct measurement of product quality attributes, but are operationally simpler to implement. Two other PAT based approaches have also been considered. The first involves use of a feed forward control based model that uses as an input the retention time of a characteristic peak that elutes prior to the main peak. The second PAT based approach involves use of a rapid HPLC method that can facilitate near‐real‐time decision making on pooling.

CONCLUSIONS

The paper provides a comparison of the advantages and drawbacks of the various approaches that have been examined and establishes the feasibility of multiple approaches that can facilitate implementation of PAT for pooling of process chromatography columns. © 2014 Society of Chemical Industry
Synthesis of Arylated Benzofurans by RegioselectiveSuzuki–Miyaura Cross‐Coupling Reactions of 2,3‐Dibromobenzofurans‐ and 2,3,5‐Tribromobenzofurans
Authors: Hussain M. , Thai Hung N. , Abbas N. , Khera R. A. , Malik I. , Patonay T. , Kelzhanova N. , Abilov Z. A. , Villinger A. , Langer P.
Published: May 2014

Arylated benzofurans were prepared by regioselective Suzuki–Miyaura cross‐coupling reactions of 2,3‐dibromobenzofuran. The reactions proceeded with very good site‐selectivity in favor of the more electron deficient position 2. The Suzuki–Miyaura reactions of 2,3,5‐tribromobenzofuran also proceeded in favor of position 2.
Regioselective Synthesis of Nitrofuran Containing Novel Spiropyrrolidine Library through 1,3‐Dipolar Cycloaddition Reactions
Authors: Mallya Sahana , Kalluraya Balakrishna , Girisha K. S.
Published: May 2014

A novel series of nitrofuran containing spiropyrrolidines has been synthesized with high regioselectivity in moderate to excellent yields via 1,3‐dipolar cycloaddition reaction of azomethine ylides with various substituted chalcones.
Efficient Domino Approach to Polysubstituted 2‐Hydroxyindole‐3,4‐(2H,5H)‐diones
Authors: Xiang Yan , Xu Hai‐Wei , Fan Wei , Jiang Bo , Tu Shu‐Jiang
Published: May 2014

Concise and efficient domino [3 + 2] heterocyclization promoted by HCOOH has been established for unprecedented synthesis of 15 examples of 2‐hydroxyindole‐3,4‐(2H,5H)‐diones in good yields. The present methodology shows attractive properties such as mild reaction conditions, concise one‐pot operation, short reaction periods of 15–20 min, and easy purification. The resulting 2‐hydroxyindole‐3,4(2H,5H)‐diones are of importance for organic and medicinal research.
One‐Pot Multicomponent Synthesis of Novel Substituted Imidazo[1,2‐a]Pyridine Incorporated Thiazolyl Coumarins and their Antimicrobial Activity
Authors: Gali Rajitha , Banothu Janardhan , Bavantula Rajitha
Published: May 2014

A series of novel substituted imidazo[1,2‐a]pyridine incorporated thiazolyl coumarin derivatives (4a, 4b, 4c, 4d, 4e, 4f, 4g, 4h, 4i, 4j, 4k, 4l, 4m, 4n, 4o, 4p, 4q, 4r, 4s, 4t) were synthesized in good yields via one‐pot multicomponent condensation of substituted imidazo[1,2‐a]pyridine‐3‐carbaldehyde (3a, 3b, 3c, 3d, 3e), thiosemicarbazide (2), and substituted 3‐(2‐bromoacetyl)‐2H‐chromen‐2‐ones (1a, 1b, 1c, 1d)/2‐(2‐bromoacetyl)‐3H‐benzo[f]chromen‐3‐one (1e) in refluxing ethanol with catalytic amount of acetic acid. All the synthesized compounds (4a, 4b, 4c, 4d, 4e, 4f, 4g, 4h, 4i, 4j, 4k, 4l, 4m, 4n, 4o, 4p, 4q, 4r, 4s, 4t) have been characterized by IR, NMR, and mass spectral studies as well as elemental analyses and evaluated for their in vitro antimicrobial activity against different bacterial and fungal strains. All the compounds displayed moderate antibacterial activity with minimum inhibitory concentration 150 µg/mL, but none of the compounds have shown any antifungal activity.
Breast conserving therapy for DCIS—Does size matter?
Authors: Kantor Olga , Winchester David J.
Published: May 2014

The incidence of ductal carcinoma in situ has increased dramatically with the use of screening mammography. Most patients can be considered for breast conserving therapy, depending upon patient and pathologic variables. In addition to other factors, tumor size is important to provide proper patient selection for breast conserving surgery and predict risk of local recurrence. J. Surg. Oncol. 2014 110:75–81. © 2014 Wiley Periodicals, Inc.
Brief Narrative Exposure Therapy for Posttraumatic Stress in Iraqi Refugees: A Preliminary Randomized Clinical Trial
Authors: Hijazi Alaa M. , Lumley Mark A. , Ziadni Maisa S. , Haddad Luay , Rapport Lisa J. , Arnetz Bengt B.
Published: May 2014

Many Iraqi refugees suffer from posttraumatic stress. Efficient, culturally sensitive interventions are needed, and so we adapted narrative exposure therapy into a brief version (brief NET) and tested its effects in a sample of traumatized Iraqi refugees. Iraqi refugees in the United States reporting elevated posttraumatic stress (N = 63) were randomized to brief NET or waitlist control conditions in a 2:1 ratio; brief NET was 3 sessions, conducted individually, in Arabic. Positive indicators (posttraumatic growth and well‐being) and symptoms (posttraumatic stress, depressive, and somatic) were assessed at baseline and 2‐ and 4‐month follow‐up. Treatment participation (95.1% completion) and study retention (98.4% provided follow‐up data) were very high. Significant condition by time interactions showed that those receiving brief NET had greater posttraumatic growth (d = 0.83) and well‐being (d = 0.54) through 4 months than controls. Brief NET reduced symptoms of posttraumatic stress (d = −0.48) and depression (d = −0.46) more, but only at 2 months; symptoms of controls also decreased from 2 to 4 months, eliminating condition differences at 4 months. Three sessions of brief NET increased growth and well‐being and led to symptom reduction in highly traumatized Iraqi refugees. This preliminary study suggests that brief NET is both acceptable and potentially efficacious in traumatized Iraqi refugees.
Neuromuscular junction disorders mimicking myopathy
Authors: Mongiovi Phillip C. , Elsheikh Bakri , Lawson Victoria H. , Kissel John T. , Arnold W. David
Published: May 2014

Introduction: Small‐amplitude, short‐duration motor unit action potentials are non‐specific findings seen in myopathies and neuromuscular junction (NMJ) disorders. NMJ studies (repetitive nerve stimulation and single‐fiber electromyography) can determine if such findings are related to NMJ abnormalities but are not considered routinely in atypical cases. Methods: Medical records of 338 patients with confirmed NMJ disorders were reviewed to identify cases with a clinical or electrodiagnostic impression of myopathy during initial evaluation. A history of muscle biopsy with findings that did not support a myopathic process was required for inclusion. Results: Four patients met the inclusion criteria. NMJ studies were abnormal in all cases. One patient had elevated acetylcholine receptor antibodies. Three patients were antibody negative: 2 demonstrated immunotherapy responsiveness, and 1 had a Rapsyn mutation. Conclusions: NMJ disorders may mimic myopathies, and NMJ studies should be performed to clarify so‐called “myopathic” electromyographic findings to avoid unnecessary testing and delayed diagnosis. Muscle Nerve 50: 854–856, 2014
Containment control of linear multi‐agent systems with multiple leaders of bounded inputs using distributed continuous controllers
Authors: Li Zhongkui , Duan Zhisheng , Ren Wei , Feng Gang
Published: May 2014

This paper considers the containment control problem for multi‐agent systems with general linear dynamics and multiple leaders whose control inputs are possibly nonzero and time varying. Based on the relative states of neighboring agents, a distributed static continuous controller is designed, under which the containment error is uniformly ultimately bounded and the upper bound of the containment error can be made arbitrarily small, if the subgraph associated with the followers is undirected and, for each follower, there exists at least one leader that has a directed path to that follower. It is noted that the design of the static controller requires the knowledge of the eigenvalues of the Laplacian matrix and the upper bounds of the leaders’ control inputs. In order to remove these requirements, a distributed adaptive continuous controller is further proposed, which can be designed and implemented by each follower in a fully distributed fashion. Extensions to the case where only local output information is available and to the case of multi‐agent systems with matching uncertainties are also discussed. Copyright © 2014 John Wiley & Sons, Ltd.
Robust non‐fragile H ∞  ∕ L2 − L ∞ control of uncertain linear system with time‐delay and application to vehicle active suspension
Authors: Kong Yongsu , Zhao Dingxuan , Yang Bin , Han Chenghao , Han Kyongwon
Published: May 2014

This paper presents an approach to design robust non‐fragile H ∞  ∕ L2 − L ∞  static output feedback controller, considering actuator time‐delay and the controller gain variations, and it is applied to design vehicle active suspension. According to suspension design requirements, the H ∞  and L2 − L ∞  norms are used, respectively, to reflect ride comfort and time‐domain hard constraints. By employing a delay‐dependent Lyapunov function, existence conditions of delay‐dependent robust non‐fragile static output feedback H ∞  controller and L2 − L ∞  controller are derived, respectively, in terms of the feasibility of bilinear matrix inequalities. Then, a new procedure based on LMI optimization and a hybrid algorithm of the particle swarm optimization and differential evolution is used to solve an optimization problem with bilinear matrix inequality constraints. Simulation results show that the designed active suspension system still can guarantee their own performance in spite of the existence of the model uncertainties, the actuator time‐delay and the controller gain variations. Copyright © 2014 John Wiley & Sons, Ltd.
Tubing Erosion of an Inflatable Penile Prosthesis Long after Implantation
Authors: Morales Alvaro
Published: May 2014

Introduction

Erosion through skin of connecting tubing of an inflatable penile prosthesis (IPP) has not been previously reported.

Aim

The aim of this study was to present a case of tubing erosion, review the pertinent literature, and discuss the possible causes and management options, including preservation of the device and its components.

Methods

A 42-year-old male failing to respond to medical treatment for erectile dysfunction underwent insertion of an AMS 700 IPP in 1986. Six years later, a revision was necessary because of a leak in the right cylinder and 4 years after, the pump was replaced. Fourteen years after the original implant, he presented with a portion of the tube connecting the pump to the right cylinder eroding through the skin. There was no infection. The skin area involved was resected and the original pump and tubing were buried in a new scrotal pocket after thorough irrigation.

Results

The IPP remained in place, allowing vaginal penetration and without infection for another 11 years. Three years later, it was de-functionalized, converted into a fixed volume device. It eventually was replaced 25 years after originally implanted with a semirigid prosthesis because it did not provide sufficient rigidity and because of concerns about the presence of “screws” detected during pelvic imaging.

Conclusions

Mechanical failures in the early IPP models, as illustrated in this case, were expected. However, the long survival of the device is remarkable. Erosion of the connecting tubing through the skin is unique and, under exceptional circumstances, may be managed conservatively without replacing components of the IPP. Clinicians unfamiliar with procedures involving inflatable devices need to be aware of “foreign bodies” visible in radiological examinations in men who have had revisions of an IPP.
Adherence to Phosphodiesterase Type 5 Inhibitors in the Treatment of Erectile Dysfunction in Long-Term Users: How Do Men Use the Inhibitors?
Authors: Carvalheira Ana , Forjaz Vera , Pereira Nuno Monteiro
Published: May 2014

Introduction

The high effectiveness of phosphodiesterase type 5 inhibitors (PDE5-i) in the treatment of erectile dysfunction (ED) has been demonstrated. However, previous research shows that PDE5-i treatments have high discontinuation rates.

Aim

The main goals of this study were to (i) characterize the way men use PDE5-i and (ii) analyze the adherence to treatment, identifying the factors that influence PDE5-i use.

Methods

A total of 148 men with clinical diagnosis for ED who maintained the treatment with PDE5-i for over 3 years were interviewed. Interviews concerning their ongoing treatment were carried out using a standardized questionnaire with quantitative and qualitative items.

Main Outcome Measures

Physiological measures included the intracavernous alprostadil injection test, associated with penile rigidometry and penile Doppler ultrasound. The qualitative measure included two questions: “Do you use the drug in every sexual intercourse?" and “How do you use the inhibitor?"

Results

ED causes were classified as venogenic (31%), arteriogenic (23%), psychogenic (18%), iatrogenic (13%), neurogenic (8%), and diabetic (7%). Participation rate was 71.8%. Of the 148 patients studied, 75% claimed not to use PDE5-i in every intercourse. Most used tadalafil (66%), followed by sildenafil (20%), vardenafil (10%), and 4% alternated the type of medicine. Four main categories emerged concerning the factors that determine the intake of PDE5-i in some intercourse situations and not in others: (i) psychological factors; (ii) medication-related factors; (iii) circumstantial factors; and (iv) relational factors.

Conclusion

The analysis of men's narratives revealed a combination of factors that influence the adherence to PDE5-i. The psychological and medication-related factors were the most prevalent. This study highlighted the importance of taking these factors into account, both at the time of prescription and during the follow-up in order to improve adherence.
Single‐Port and Multi‐Port Laparoscopic Left Lateral Liver Sectionectomy for Treating Benign Liver Diseases: A Prospective, Randomized, Controlled Study
Authors: Hu Minggen , Zhao Guodong , Wang Fei , Xu Dabin , Liu Rong
Published: May 2014

Background

The use of single‐port laparoscopy for left‐lateral liver sectionectomy (LLLS) has been reported in the literature, but the effectiveness and safety of LLLS has not been validated in randomized, controlled trials. This prospective randomized controlled trial compared the effectiveness and safety of single‐port and multi‐port laparoscopic LLLS for the surgical treatment of benign liver disease.

Methods

Altogether, 38 patients aged 17–65 years (16 men, 22 women) with benign liver diseases were hospitalized for elective laparoscopic LLLS between January 2010 and December 2012. Patients were randomly assigned to either single‐port (n = 19) or multi‐port (n = 19) laparoscopic LLLS. Main outcome measures were operative time, volume of intraoperative blood loss, complication rates, and postoperative hospitalization.

Results

Baseline characteristics of the two groups were comparable. Single‐port and multi‐port laparoscopies were successfully completed in all but one patient (1/19, 5.3 %) who required conversion from a single‐port to a multi‐port procedure. The two groups had similar mean operative times and volumes of intraoperative blood loss. There were no clinically significant postoperative complications or deaths. The single‐port group had a significantly shorter postoperative hospitalization than the multi‐port group (2.5 ± 1.7 vs. 4.0 ± 2.1 days; p < 0.05).

Conclusions

Single‐port laparoscopic LLLS is a technically feasible, effective, safe alternative to multi‐port laparoscopy for the treatment of benign liver diseases in cautiously selected patients.
Study of Serum Leptin in Well‐differentiated Thyroid Carcinoma: Correlation with Patient and Tumor Characteristics
Authors: Rehem Rania Abdel , Elwafa Waleed Abo , Elwafa Reham Abo , Abdel‐Aziz Tarek Ezzat
Published: May 2014

Background

There is a proven relationship between obesity and several cancers including breast, endometrium, colorectal, and esophagus. With the increasing incidence of both obesity and thyroid cancer, we designed the present study to investigate a causal relationship between leptin, which is one of the well known adipokines, and well‐differentiated thyroid cancer (WDTC).

Methods

Serum leptin levels were measured in 30 patients with WDTC and compared to 30 healthy control subjects before and 1 month after surgery. Other parameters studied included age, sex, body mass index, menopausal status in women, lymph node status, tumor size, and disease multifocality.

Results

There were no differences between the two groups regarding age and sex. Preoperative leptin levels were higher in the WDTC patients when compared to the control patients [19.25 (1.50–109.60) vs 0.90 (0.50–11.80) ng/ml, p < 0.001, group 1 vs group 2, respectively]. A significant drop in leptin levels 1 month after surgery occurred in the WDTC group, falling from 19.25 (1.50–109.60) to 0.90 (0.60–8.90) ng/ml (p < 0.001). This did not occur in the control group (p = 0.274). Lymph node involvement, tumor size, and multifocality had no effect on leptin levels, although trends were observed (p = 0.48, 0.079, and 0.064), respectively.

Conclusions

Serum leptin levels were significantly higher in WDTC patients when compared to control group patients, with a significant drop after surgery. Leptin may play a role in diagnosis of WDTC; however, its prognostic value is still undetermined.
Two Anatomical Pathways for Retroperitoneoscopic Pancreatectomy: Indications for the Posterior and Lateral Approaches
Authors: Zhao Guodong , Hu Minggen , Liu Rong , Zhiming Zhao , Xu Yong , Zhou Huinian , Wang Xuefei , Zhang Xinning
Published: May 2014

Background

Retroperitoneoscopic pancreatectomy (RP) is a novel surgical procedure that is safe and feasible in animal models and clinical practice. However, the optimal approach for RP has not been established.

Objective

This study aimed to introduce the posterior and lateral approaches for RP.

Methods

This prospective study included 19 patients with suspected pancreatic lesions who underwent RP. RP was performed using either a posterior or a lateral approach.

Results

The posterior, lateral, and jointed approaches were used in 13 (68.4 %), 3 (15.8 %), and 3 (15.8 %) cases, respectively. Patients underwent enucleation (N = 8), distal pancreatectomy (N = 4), and resection of cystic pancreatic lesions (N = 2) and non‐pancreatic lesions (N = 5). All retroperitoneoscopic procedures were successfully accomplished with no conversion to open or laparoscopic surgery. Intraoperative complications occurred in two (12.5 %) cases, including one case with injury to the peritoneum and one case with injury to the peritoneum and splenic vein. Postoperative grade A pancreatic fistulas occurred in six cases, and were cured by delayed drainage. No disease recurrence or abnormal symptoms were observed during the mean follow‐up period of 14.06 ± 9.60 months.

Conclusions

RP using the posterior or lateral approach is feasible and effective, but has different indications. The posterior approach is useful for distal pancreatectomy, as well as resection of pancreatic lesions in the posterior or superoposterior region of the distal pancreas. The lateral approach is useful for resection of pancreatic lesions in the anterior or inferior region of the body and tail. The two approaches can be used in combination or conversion.
The Impact of Resident‐ and Self‐Evaluations on Surgeon’s Subsequent Teaching Performance
Authors: Boerebach Benjamin C. M. , Arah Onyebuchi A. , Heineman Maas Jan , Busch Olivier R. C. , Lombarts Kiki M. J. M. H.
Published: May 2014

Background

This study evaluates how residents’ evaluations and self‐evaluations of surgeon’s teaching performance evolve after two cycles of evaluation, reporting, and feedback. Furthermore, the influence of over‐ and underestimating own performance on subsequent teaching performance was investigated.

Methods

In a multicenter cohort study, 351 surgeons evaluated themselves and were also evaluated by residents during annual evaluation periods for three subsequent years. At the end of each evaluation period, surgeons received a personal report summarizing the residents’ feedback. Changes in each surgeon’s teaching performance evaluated on a five‐point scale were studied using growth models. The effect of surgeons over‐ or underestimating their own performance on the improvement of teaching performance was studied using adjusted multivariable regressions.

Results

Compared with the first (median score: 3.83, 20th to 80th percentile score: 3.46–4.16) and second (median: 3.82, 20th to 80th: 3.46–4.14) evaluation period, residents evaluated surgeon’s teaching performance higher during the third evaluation period (median: 3.91, 20th to 80th: 3.59–4.27), p < 0.001. Surgeons did not alter self‐evaluation scores over the three periods. Surgeons who overestimated their teaching performance received lower subsequent performance scores by residents (regression coefficient b: −0.08, 95 % confidence limits (CL): −0.18, 0.02) and self (b: −0.12, 95 % CL: −0.21, −0.02). Surgeons who underestimated their performance subsequently scored themselves higher (b: 0.10, 95 % CL: 0.03, 0.16), but were evaluated equally by residents.

Conclusions

Residents’ evaluation of surgeon’s teaching performance was enhanced after two cycles of evaluation, reporting, and feedback. Overestimating own teaching performance could impede subsequent performance.
Sources of low-arsenic groundwater in the Bengal Basin: investigating the influence of the last glacial maximum palaeosol using a 115-km traverse across Bangladesh
Authors: Hoque M. A. , McArthur J. M. , Sikdar P. K.
Published: May 2014

Pollution of groundwater in the Bengal Basin (Bangladesh and West Bengal, India) by arsenic (As) puts at risk the health of more than 100 million consumers. Using 1,580 borehole lithological logs and published hydrochemistry on 2,387 wells, it was predicted that low-As (<10 μg/L) groundwater exists, in palaeo-interfluvial aquifers of brown sand capped by a protective palaeosol, beneath at least 45,000 km2 of the Bengal Basin. The aquifers were predicted to be at a depth of as little as 25 m below ground level (mbgl), and typically no more than 50 mbgl. The predictions were confirmed along an east–west traverse 115 km in length (i.e. across half of Bangladesh) by drilling 28 new boreholes to 91-m depth to reveal subsurface sedimentology, and by mapping As distribution in groundwater. The aquifers identified occur at typically <40 mbgl and so are accessible with local drilling methods. A protective palaeosol that caps the palaeo-interfluvial aquifers prevents downward movement into them of As-polluted groundwater present in shallower palaeo-channel aquifers and ensures that the palaeo-interfluvial aquifers will yield low-As groundwater for the foreseeable future. Their use, in place of the shallower As-polluted palaeo-channel aquifers, would rapidly mitigate the health risks from consumption of As-polluted groundwater.
De Quervain's Tenosynovitis: A Review of the Rehabilitative Options
Authors: Goel Ritu , Abzug Joshua M.
Published: May 2014

de Quervain's tenosynovitis is an overuse disease that involves a thickening of the extensor retinaculum, which covers the first dorsal compartment. A case study approach was utilized in this article to demonstrate many of the available medical and occupational therapy modalities to treat this condition. A 34-year-old right hand-dominant female who works in a daycare facility presents with radial side wrist pain during lifting activity for the past 4–6 weeks. The patient was diagnosed with de Quervain's tenosynovitis and conservative care was initiated. Conservative care involved anti-inflammatory medication and corticosteroid injections as well as occupational therapy to include splinting, activity modification, modalities, manual treatment, and therapeutic exercise. Although conservative care assisted the patient with her symptoms initially, she returned with increased pain and discomfort after 2 months time. At that point, surgery was discussed and performed to release the first dorsal compartment as well as the sub-compartment. The patient was provided with a splint postoperatively and initiated occupational therapy for edema and scar management, therapeutic exercise, and desensitization. Ultimately, the patient was able to return to work pain free.
Musculoskeletal education: an assessment of the clinical confidence of medical students
Authors: Truntzer Jeremy , Lynch Alison , Kruse David , Prislin Michael
Published: May 2014

Musculoskeletal (MSK) conditions account for nearly 15–30 % of encounters in a primary care practice. Yet, studies demonstrate that medical students and residents lack the knowledge and confidence to care for many MSK conditions. This study addresses the design of focused MSK educational practices towards improving students’ knowledge, interest, and confidence for conducting MSK examinations. Students attending a voluntary educational symposium on sports medicine were recruited to participate. The symposium was directed toward teaching elements of the MSK exam. Participants completed validated pre- and post-workshop surveys that assessed confidence in performing MSK examinations as well as satisfaction and perceived importance of MSK education. Additionally, mean survey responses from a convenience group of students who did not participate in the symposium were compared against the intervention group. Thirteen students participated in the educational symposium. Hundred and nine students completed the general survey. In the non-intervention group, students demonstrated knowledge and confidence improvements through the second year of medical school but did not show similar improvement in subsequent years. No difference in MSK confidence scores between fourth-year students going into high versus low MSK focused specialities was observed. In the intervention group students demonstrated improvements in confidence with respect to the knee, shoulder and ankle exams (p < 0.01). Areas not covered such as concussions and neuromuscular impairments failed to show significant change.
Applications for Radio‐frequency Identification Technology in the Perioperative Setting
Authors: Zhao Tiyu , Zhang Xiaoxiang , Zeng Lili , Xia Shuyan , Hinton Antentor Othrell , Li Xiuyun
Published: May 2014

We implemented a two‐year project to develop a security‐gated management system for the perioperative setting using radio‐frequency identification (RFID) technology to enhance the management efficiency of the OR. We installed RFID readers beside the entrances to the OR and changing areas to receive and process signals from the RFID tags that we sewed into surgical scrub attire and shoes. The system also required integrating automatic access control panels, computerized lockers, light‐emitting diode (LED) information screens, wireless networks, and an information system. By doing this, we are able to control the flow of personnel and materials more effectively, reduce OR costs, optimize the registration and attire‐changing process for personnel, and improve management efficiency. We also anticipate this system will improve patient safety by reducing the risk of surgical site infection. Application of security‐gated management systems is an important and effective way to help ensure a clean, convenient, and safe management process to manage costs in the perioperative area and promote patient safety.
Novel aspects of RNA regulation in Staphylococcus aureus
Authors: Fechter Pierre , Caldelari Isabelle , Lioliou Efthimia , Romby Pascale
Published: May 2014

A plethora of RNAs with regulatory functions has been discovered in many non‐pathogenic and pathogenic bacteria. In Staphylococcus aureus, recent findings show that a large variety of RNAs control target gene expression by diverse mechanisms and many of them are expressed in response to specific internal or external signals. These RNAs comprise trans‐acting RNAs, which regulate gene expression through binding with mRNAs, and cis‐acting regulatory regions of mRNAs. Some of them possess multiple functions and encode small but functional peptides. In this review, we will present several examples of RNAs regulating pathogenesis, antibiotic resistance, and host‐pathogen interactions and will illustrate how regulatory proteins and RNAs form complex regulatory circuits to express the virulence factors in a dynamic manner.
Evidence-Based Patient Decontamination: An Integral Component of Mass Exposure Chemical Incident Planning and Response
Authors: Leary Adam D. , Schwartz Michael D. , Kirk Mark A. , Ignacio Joselito S. , Wencil Elaine B. , Cibulsky Susan M.
Published: May 2014

Decontaminating patients who have been exposed to hazardous chemicals can directly benefit the patients’ health by saving lives and reducing the severity of toxicity. While the importance of decontaminating patients to prevent the spread of contamination has long been recognized, its role in improving patient health outcomes has not been as widely appreciated. Acute chemical toxicity may manifest rapidly—often minutes to hours after exposure. Patient decontamination and emergency medical treatment must be initiated as early as possible to terminate further exposure and treat the effects of the dose already absorbed. In a mass exposure chemical incident, responders and receivers are faced with the challenges of determining the type of care that each patient needs (including medical treatment, decontamination, and behavioral health support), providing that care within the effective window of time, and protecting themselves from harm. The US Department of Health and Human Services and Department of Homeland Security have led the development of national planning guidance for mass patient decontamination in a chemical incident to help local communities meet these multiple, time-sensitive health demands. This report summarizes the science on which the guidance is based and the principles that form the core of the updated approach. (Disaster Med Public Health Preparedness. 2014;0:1–7)
Early Marriages Last Longer: Pre-electoral Coalitions and Government Survival in Europe
Authors: Chiru Mihail
Published: May 2014

While the existence of pre-electoral coalitions fundamentally modifies the bargaining environment in which potential cabinet formulas are negotiated, the survival chances of cabinets that include them follow predictable yet different patterns to those of ‘regular’ coalition governments. This article combines original and existing data sets on Western and Central and Eastern European cabinets with information about pre-electoral coalitions (1944–2008) in order to estimate the impact of such alliances on government survival rates. In doing so, I employ a Cox Proportional Hazard model and a ‘competing risks’ research design which distinguishes between replacement and early election hazards. The findings indicate that both Western and post-communist cabinets formed by pre-electoral coalitions exhibit considerably lower rates of discretionary terminations. This effect is reversed in the case of incumbent pre-electoral coalitions. Last but not least, Western European cabinets that replicate pre-electoral coalitions are significantly less likely to end through dissolution and early elections.
Record of climatic fluctuations and high pH weathering conditions in a thick Ordovician palaeosol developed in rhyolite of the Dunn Point Formation, Arisaig, Nova Scotia, Canada
Authors: JUTRAS P. , LEFORTE M. J. , HANLEY J. J.
Published: May 2014

A thick Ordovician intra-rhyolitic palaeosol was studied to investigate the peculiarities of early Palaeozoic continental environments, shortly before the development of vascular plants, and to compare its pedogenic patterns with those of previously studied intra-basaltic profiles from the same succession. Well-defined K-eluviation from the top of the palaeosol is proportionally met by K-illuviation at the base of the profile, a pedogenic behaviour that was masked in the underlying intra-basaltic profiles due to subsequent eodiagenetic K-enrichment associated with rhyolite emplacement. Greater stability of K (and eventually Mg) than Si in the intra-rhyolitic profile suggests high pH soil water at the time of pedogenesis despite the low base contents of the acidic host rock, and despite evidence for humid weathering conditions. We also observe that, at the base and at the top of the profile, Al2O3/Zr ratios are substantially lower than those of the host rock, suggesting Al-leaching and therefore extreme weathering conditions, whereas the middle portion of the profile shows Al2O3/Zr ratios that are similar to those of the host rock, suggesting Al stability and therefore less extreme conditions. We interpret these variations in Al2O3/Zr ratios as signatures of a cyclic change from sub-humid periods during which Al was stable throughout the profile, to more humid periods with a well-defined seasonality, during which only the juvenile zone of weathering at the base of the profile could have developed sufficiently high pH during dry seasons for Al to be leached, leaving the Al2O3/Zr signatures from previous stages untouched higher in the profile.