bluuebunny/crossref_metadata_2025 huggingface dataset:
Acute lymphoblastic leukemia: A single center experience with Berlin, Frankfurt, and Munster-95 protocol
Authors: Radhakrishnan Venkatraman , Gupta Sumant , Ganesan Prasanth , Rajendranath Rejiv , Ganesan Trivadi S. , Rajalekshmy Kamalalayan Raghavan , Sagar Tenali Gnana
Published: December 2015

Background: There is a paucity of data on the outcome following the treatment for acute lymphoblastic leukemia (ALL) from developing countries. Materials and Methods: Two hundred and thirty-eight consecutive patients with ALL <30 years of age diagnosed between January 2005 and December 2011 were analyzed retrospectively. Patients were treated modified Berlin, Frankfurt, and Munster 95 protocol. Event-free survival (EFS) was calculated using Kaplan-Meier survival analysis and variables were compared using log-rank test. Results: The EFS was 63.4% at a median follow-up was 32.7 months. On univariate analysis National Cancer Institute (NCI) risk stratification, sex, white blood cell count, day 8 blast clearance, and income were significantly associated with EFS. However, on multivariate analysis only female sex (P = 0.01) and day 8 blast clearance (P = 0.006) were significantly associated with EFS. Seventy-four of 238 (31%) patients had recurrent leukemia. The common sites of relapse were bone marrow in 55/74 (75%) patients and central nervous system in 11/74 (20%) patients. Conclusion: Compared to western data, there was an increased proportion of NCI high-risk patients and T-cell immunophenotype in our study. There has been an improvement in outcome of patients with ALL at our center over the last 2 decades. Female sex and clearance of blast in peripheral blood by day 8 of induction was associated with better EFS.
Le rôle des contraintes dans l’évolution des sociétés de macaques
Authors: Thierry Bernard
Published: December 2015

N’existe-t-il aucune limite aux formes des systèmes sociaux que les animaux peuvent produire pour s’adapter à leur environnement, ou bien des contraintes définissent-elles l’espace des possibles, restreignant les systèmes sociaux à un nombre fini de formes ? L’étude des sociétés de macaques révèle qu’elles sont constituées par un ensemble de traits covariants. Le niveau d’asymétrie des conflits, l’intensité de l’agression, la fréquence des réconciliations, le degré de permissivité de la mère, l’importance des liens de parenté ou le tempérament individuel varient de manière corrélée d’une espèce à l’autre. Le couplage des traits comportementaux à différents niveaux du génotype et du phénotype a pour effet de circonscrire les macaques à un nombre limité de styles sociaux. Ceux-ci s’ordonnent sur une échelle à quatre degrés allant d’espèces caractérisées par des relations sociales intolérantes et de strictes hiérarchies, à d’autres dont les sociétés sont plus tolérantes et les rapports de dominance moins inégaux. Les différences interspécifiques observées dans le style social des macaques ne s’expliquent pas par des variations du milieu. En revanche, l’échelle de tolérance sociale montre une forte corrélation avec la phylogenèse des macaques, ce qui révèle que le coeur du système d’interconnexions particulier à chaque espèce n’a pas été modifié depuis plusieurs centaines de milliers d’années. Ces résultats nous apprennent que les liaisons entre traits comportementaux agissent comme des contraintes qui limitent la réponse évolutive des systèmes sociaux aux pressions écologiques.

Résumé
Apprentissage et tâche cognitive en laboratoire chez le macaque
Authors: Pouget Pierre
Published: December 2015

Au cours des XIXe et XXe siècles, de très nombreux travaux scientifiques sur le animaux se sont attachés à mieux comprendre les capacités de raisonnement, de production du langage, ou encore de l’acquisition de comportements sociaux tel que le maternage ou l’attachement (cf. Harlow & Zimmermann, 1959 ; Seidenberg & Pettito, 1979). Au-delà des désaccords théoriques et historiques qui ont pu être associés aux interprétations de ces études pionnières, ces nombreux travaux ont mis en exergue les espoirs et les limites posés par l’évaluation de l’intelligence des animaux en général et des singes en particulier. Grâce aux développements de nouvelles techniques et méthodologies expérimentales, les neuroscientifiques ont désormais accès aux substrats physiologiques des facultés cognitives les plus intimes et les plus complexes des primates. Comme le montrent de récentes études éthologiques et neuroscientifiques sur l’intelligence, le langage ou la résolution de tâches complexes, les recherches sur les primates non-humains contribuent plus que jamais à reconstituer la phylogenèse qui a conduit à l’émergence et l’expression de ces fonctions chez l’Homme.
The effect of a permafrost disturbance on growing-season carbon-dioxide fluxes in a high Arctic tundra ecosystem
Authors: Cassidy A. E. , Christen A. , Henry G. H. R.
Published: December 2015

Abstract. Soil carbon stored in high-latitude permafrost landscapes is threatened by warming, and could contribute significant amounts of carbon to the atmosphere and hydrosphere as permafrost thaws. Permafrost disturbances, especially active layer detachments and retrogressive thaw slumps, have increased in frequency and magnitude across the Fosheim Peninsula, Ellesmere Island, Canada. To determine the effects of retrogressive thaw slumps on net ecosystem exchange (NEE) of CO2 in high Arctic tundra, we used two eddy covariance (EC) tower systems to simultaneously and continuously measure CO2 fluxes from a disturbed site and the surrounding undisturbed tundra. During the 32-day measurement period in the 2014 growing season the undisturbed tundra was a small net sink (NEE = −0.12 g C m−2 d−1); however, the disturbed terrain of the retrogressive thaw slump was a net source (NEE = +0.39 g C m−2 d−1). Over the measurement period, the undisturbed tundra sequestered 3.84 g C m−2, while the disturbed tundra released 12.48 g C m−2. Before full leaf out in early July, the undisturbed tundra was a small source of CO2, but shifted to a sink for the remainder of the sampling season (July), whereas the disturbed tundra remained a source of CO2 throughout the season. A static chamber system was also used to measure fluxes in the footprints of the two towers, in both disturbed and undisturbed tundra, and fluxes were partitioned into ecosystem respiration (Re) and gross primary production (GPP). Average GPP and Re found in disturbed tundra were smaller (+0.41 μmol m−2 s−1 and +0.50 μmol m−2 s−1, respectively) than those found in undisturbed tundra (+1.21 μmol m−2 s−1 and +1.00 μmol m−2 s−1, respectively). Our measurements indicated clearly that the permafrost disturbance changed the high Arctic tundra system from a sink to a source for CO2 during the growing season.
What is the P value of Siberian soils?
Authors: Brédoire F. , Bakker M. R. , Augusto L. , Barsukov P. A. , Derrien D. , Nikitich P. , Rusalimova O. , Zeller B. , Achat D. L.
Published: December 2015

Abstract. Climate change is particularly strong in Northern Eurasia and substantial ecological changes are expected in this wide region. The reshaping and the migration northward of bioclimatic zones may offer opportunities for agriculture development in western and central Siberia. However, the bioclimatic vegetation models currently employed for projections still do not consider soil fertility whereas it is highly critical for plant growth. In the present study, we surveyed the phosphorus (P) status in the south-west of Siberia where soils are developed on loess parent material. We selected six sites differing by pedoclimate conditions and sampled the soil at different depths down to one meter in aspen (Populus tremula L.) forest as well as in grassland areas. The P status was assessed by conventional methods and by isotope dilution kinetics. We found that P concentrations and stocks, as well as their distribution through the soil profile, were rather homogeneous at the studied regional scale, although there were some differences among sites (particularly in organic P). The young age of the soils, together with slow kinetics of soil forming processes, have probably not yet conducted to a sufficiently wide range of soil physico-chemical conditions to observe more diverging P status. The comparison of our dataset to similar vegetation contexts on the global scale revealed that the soils of south-western Siberia, and more generally of Northern Eurasia, has often (very) high levels of total, organic and inorganic P. The amount of plant-available P in topsoils, estimated by the isotopically exchangeable phosphate ions, was not particularly high, but intermediate at the global scale. However, large stocks of plant-available P are stored in subsurface layers which have currently low fine root exploration intensities. These results suggest that the P resource is unlikely to constrain vegetation growth and agriculture development in the present and near future conditions.
Heterotrophic bacterial production and metabolic balance during the VAHINE mesocosm experiment in the New Caledonia lagoon
Authors: Van Wambeke F. , Pfreundt U. , Barani A. , Berthelot H. , Moutin T. , Rodier M. , Hess W. R. , Bonnet S.
Published: December 2015

Abstract. N2 fixation fuels ~ 50 % of new primary production in the oligotrophic South Pacific Ocean. The VAHINE mesocosm experiment designed to track the fate of diazotroph derived nitrogen (DDN) in the New Caledonia lagoon. Here, we examined the temporal dynamics of heterotrophic bacterial production during this experiment. Three replicate large-volume (~ 50 m3) mesocosms were deployed and were intentionally fertilized with dissolved inorganic phosphorus (DIP) to stimulate N2 fixation. We specifically examined relationships between N2 fixation rates and primary production, determined bacterial growth efficiency and established carbon budgets of the system from the DIP fertilization to the end of the experiment (days 5–23). Heterotrophic bacterioplankton production (BP) and alkaline phosphatase activity (APA) were statistically higher during the second phase of the experiment (P2: days 15–23), when chlorophyll biomass started to increase compared to the first phase (P1: days 5–14). Among autotrophs, Synechococcus abundances increased during P2, possibly related to its capacity to assimilate leucine and to produce alkaline phosphatase. Bacterial growth efficiency based on the carbon budget was notably higher than generally cited for oligotrophic environments (27–43 %), possibly due to a high representation of proteorhodopsin-containing organisms within the picoplanctonic community. The carbon budget showed that the main fate of gross primary production (particulate + dissolved) was respiration (67 %), and export through sedimentation (17 %). BP was highly correlated with particulate primary production and chlorophyll biomass during both phases of the experiment but slightly correlated, and only during P2 phase, with N2 fixation rates. Our results suggest that most of the DDN reached the heterotrophic bacterial community through indirect processes, like mortality, lysis and grazing.
Proof of concept: temperature sensing waders for environmental sciences
Authors: Hut R. , Tyler S. , van Emmerik T.
Published: December 2015

Abstract. A prototype temperature sensing pair of waders is introduced and tested. The water temperature at the stream-bed is interesting both for scientist studying the hyporheic zone as well as for, e.g., fishers spotting good fishing locations. A temperature sensor incorporated in waders worn by members of the public can give scientists an additional source of information on streamwater-groundwater interaction. A pair of waders was equipped with a thermistor and calibrated in the lab. Tests with both the waders and a reference thermometer in a deep polder ditch with a known localized groundwater contribution (i.e. boil) showed that the temperature sensing waders are capable of identifying the boil location. However, the temperature sensing waders showed a less pronounced response to changing water temperature compared to the reference thermometer, most likely due to the heat capacity of the person in the waders. This research showed that data from temperature sensing waders worn by the public and shared with scientists can be used by to decide where the most interesting places are to do more detailed and more expensive, research.
A global empirical system for probabilistic seasonal climate prediction
Authors: Eden J. M. , van Oldenborgh G. J. , Hawkins E. , Suckling E. B.
Published: December 2015

Abstract. Preparing for episodes with risks of anomalous weather a month to a year ahead is an important challenge for governments, non-governmental organisations, and private companies and is dependent on the availability of reliable forecasts. The majority of operational seasonal forecasts are made using process-based dynamical models, which are complex, computationally challenging and prone to biases. Empirical forecast approaches built on statistical models to represent physical processes offer an alternative to dynamical systems and can provide either a benchmark for comparison or independent supplementary forecasts. Here, we present a simple empirical system based on multiple linear regression for producing probabilistic forecasts of seasonal surface air temperature and precipitation across the globe. The global CO2-equivalent concentration is taken as the primary predictor; subsequent predictors, including large-scale modes of variability in the climate system and local-scale information, are selected on the basis of their physical relationship with the predictand. The focus given to the climate change signal as a source of skill and the probabilistic nature of the forecasts produced constitute a novel approach to global empirical prediction. Hindcasts for the period 1961–2013 are validated against observations using deterministic (correlation of seasonal means) and probabilistic (continuous rank probability skill scores) metrics. Good skill is found in many regions, particularly for surface air temperature and most notably in much of Europe during the spring and summer seasons. For precipitation, skill is generally limited to regions with known El Niño–Southern Oscillation (ENSO) teleconnections. The system is used in a quasi-operational framework to generate empirical seasonal forecasts on a monthly basis.
Soot on Snow experiment: bidirectional reflectance factor measurements of contaminated snow
Authors: Peltoniemi J. I. , Gritsevich M. , Hakala T. , Dagsson-Waldhauserová P. , Arnalds Ó. , Anttila K. , Hannula H.-R. , Kivekäs N. , Lihavainen H. , Meinander O. , Svensson J. , Virkkula A. , de Leeuw G.
Published: December 2015

Abstract. In order to quantify the effects of absorbing contaminants on snow, a series of spectral reflectance measurements were conducted. Chimney soot, volcanic sand, and glaciogenic silt were deposited on a natural snow surface in a controlled way as a part of the Soot on Snow (SoS) campaign. The bidirectional reflectance factors of these soiled surfaces and untouched snow were measured using the Finnish Geodetic Institute's Field Goniospectropolariradiometer, FIGIFIGO. A remarkable feature is the fact that the absorbing contaminants on snow enhanced the metamorphism of snow under strong sunlight in our experiments. Immediately after deposition, the contaminated snow surface appeared darker than the natural snow in all viewing directions, but the absorbing particles sank deep into the snow in minutes. The nadir measurement remained the darkest, but at larger zenith angles, the surface of the contaminated snow changed back to almost as white as clean snow. Thus, for a ground observer the darkening caused by impurities can be completely invisible, overestimating the albedo, but a nadir-observing satellite sees the darkest points, underestimating the albedo. Through a reciprocity argument, we predict that at noon, the albedo perturbation should be lower than in the morning or afternoon. When sunlight stimulates sinking more than melting, the albedo should be higher in the afternoon than in the morning, and vice versa when melting dominates. However, differences in the hydrophobic properties, porosity, clumping, or size of the impurities may cause different results than observed in these measurements.
An intervention to improve discharge summary completion rates within an Australian teaching hospital
Authors: Gardiner Fergus William
Published: December 2015

Objective: This study was designed to improve patient discharge summary completion rates directly following patient hospital discharge. The primary reason for this was to improve continuity of patient care and reduce hospital readmissions within 28 days.Methods: The researcher benchmarked the discharge summary completion rate before conducting individual feedback directly to clinicians. Content was deemed complete if the information was present and appropriate. Partially completed, unclear, or absent information was deemed outstanding. This information was gained by looking at the hospital’s patient records. The researcher benchmarked the readmission data. This data included establishing monthly patient discharges (excluding deaths) and the number of unplanned and unexpected readmissions within 28 days related to the primary admission. This information was used to compare pre-intervention to invention readmission rates.Results: The hospital’s total discharge completion rate statistically changed from 91.92% pre-intervention to 99.18% postintervention, with the biggest change occurring in Obstetrics and Gynaecology (O&G). O&G discharge completion rate improved from 46.94% pre-intervention to 98.84% post-intervention. A two sample t-test indicated that this difference was significant, t(2.0905) = 0.0458, p = .05. The readmission rates statistical changed from 0.49% pre-intervention to 0.26% during the intervention period. A two sample t-test indicated that this difference was significant, t(2.3679) = 0.04205, p = .05.Conclusions: This study provided evidence of the effectiveness of conducting audit and feedback sessions as it relates to patient discharge summaries and readmissions.
Clinical outcomes following laparoscopic management of pT3 renal masses: A large, multi-institutional cohort
Authors: Nayak Jasmir G , Patel Premal , Bjazevic Jennifer , Lui Zhihui , Saarela Olli , Kapoor Anil , Rendon Ricardo , Kawakami Jun , Tanguay Simon , Breau Rodney H , Black Peter C , Drachenberg Darrel E
Published: December 2015

Introduction: We described the clinical and oncological outcomes of patients treated by laparoscopic surgery for non-metastatic pT3 renal cell carcinoma (RCC).

Methods: We queried a multi-institutional database for patients diagnosed with non-metastatic pathological T3 RCC from 13 Canadian centres treated laparoscopically (radical or partial nephrectomy) between 2008 and 2014. Clinical and pathological outcomes were evaluated. Progression was defined as the development of recurrence or metastatic disease. Log-rank testing and Kaplan-Meier statistical methods assessed for differences and estimated progression-free survival (PFS).

Results: In total, 176 patients were identified with a median age of 64 years. The median tumour size was 7.0 cm. Pre-clinical stage was cT1 to cT4 in 39%, 28%, 30% and 3%, respectively. The median blood loss was 150 mL (range: 0–6000) and the median operative time was 124 minutes (range: 60–360). Most lesions were clear cell RCC (80%). After a median follow-up of 17.6 months (range: 0.2–75.0), disease progression occurred in 26% (46/176) of patients, consisting of local recurrence in 7% (3/46), and metastatic disease in 93% (43/46). The 3-year PFS was 67%, with a median PFS of 49 months. Of those who progressed, the median time to progression was 10.3 months.

Conclusions: This study is the largest cohort of pT3 RCC patients treated laparoscopically in the literature and suggests that for properly selected patients, laparoscopic management of locally advanced renal masses yields acceptable short-term oncological outcomes.
Investigating the ability of multiparametric MRI to exclude significant prostate cancer prior to transperineal biopsy
Authors: Serrao Eva M , Barrett Tristan , Wadhwa Karan , Parashar Deepak , Frey Julia , Koo Brendan C , Warren Anne Y , Doble Andrew , Kastner Christof , Gallagher Ferdia A
Published: December 2015

Introduction: We characterized false negative prostate magnetic resonance imaging (MRI) reporting by using histology derived from MRI-transrectal ultrasound (TRUS)-guided transperineal (MTTP) fusion biopsies.

Methods: In total, 148 consecutive patients were retrospectively reviewed. Men underwent multiparametric MRI (mpMRI), reported by a consultant/attending radiologist in line with European Society of Urogenital Radiology (ESUR) standards. MTTP biopsy of the lesions was performed according to the Ginsburg recommendations. Cases with an MRI-histology mismatch were identified and underwent a second read by an experienced radiologist. A third review was performed with direct histology comparison to determine a true miss from an MRI-occult cancer. Statistical analysis was performed with McNemar’s test.

Results: False negative lesions were identified in 29 MRI examinations (19.6%), with a total of 46 lesions. Most false negative lesions (21/46) were located in the anterior sectors of the prostate. The second read led to a significant decrease of false-negative lesions with 7/29 further studies identified as positive on a patientby- patient basis (24.1% of studies, p = 0.016) and 11/46 lesions (23.9%; p = 0.001). Of these, 30 lesions following the first read and 23 lesions after the second read were considered significant cancer according to the University College London criteria. However, on direct comparison with histology, most lesions were MRI occult.

Conclusion: We demonstrate that MRI can fail to detect clinically relevant lesions. Improved results were achieved with a second read but despite this, a number of lesions remain MRI-occult. Further advances in imaging are required to reduce false negative results.
Evaluation of risk factors and treatment options in patients with ureteral stricture disease at a single institution
Authors: Tran Henry , Arsovska Olga , Paterson Ryan F , Chew Ben H
Published: December 2015

Introduction: Ureteral strictures are a significant cause of morbidity and mortality, resulting in potential kidney damage requiring several surgical procedures. Non-malignant causes include radiation, trauma from calculi impaction, pelvic surgery, or ureteroscopy (URS). We identified risk factors in our patients with ureteral strictures and the success of their treatment outcomes.

Methods: A retrospective chart review of 25 patients with 29 ureteral strictures was performed to determine the success of their treatment.

Results: Twenty-five (25) patients with 29 benign ureteral strictures were identified. Most cases (60%) were caused by impacted stones where the median stone size was 1.15 cm (0.37‒1.8 cm). Intervention for stones prior to stricture development included shockwave lithotripsy, URS, and percutaneous nephrolithotomy. Five patients with strictures from impacted stones had ureteric complications during stone treatment including perforation +/- urinoma (n=3), fractured guidewire left in situ (n=1), and ureteric orifice resection (n=1). Other stricture etiologies included radiation (28%) and endometriosis (4%). Treatment modalities used included ureteroureterostomy (n=2), ureteral re-implant (n=3), urinary diversion (n=3), autotrasplant (n=1), laser endoureterotomy +/- balloon dilation (n=8), nephrectomy (n=2), balloon dilation +/- stent (n=3), ureterovesical junction (UVJ) resection + stent (n=1), chronic stent changes (n=4), or surveillance (n=3).

Conclusions: Our evaluation highlights important principles. Patients with complicated ureteroscopies or severely impacted calculi warrant close followup with imaging after stone treatment due to possibility of rapid renal deterioration from stricture formation. Radiation-induced strictures are difficult to manage, possibly requiring subsequent urinary diversion. Finally, endoscopic management of benign ureteral strictures via balloon dilation and laser endoureterotomy is an excellent choice in properly selected patients, with opportunity for subsequent salvage treatments if needed.
Changing patients’ profile presenting for surgical management of benign prostatic hyperplasia over the past 16 years: A single-centre perspective
Authors: Elkoushy Mohamed A , Elshal Ahmed M , Elhilali Mostafa M
Published: December 2015

Introduction: We assessed the change of patients’ profile presenting for symptomatic benign prostatic hyperplasia (BPH) over 16 years and its impact on surgical outcomes over this time.

Methods: We reviewed a prospectively maintained database of patients treated with laser for symptomatic BPH since March 1998. Patients were divided into 3 consecutive time-based groups: Group 1 for patients who underwent surgery before April 2004; Group 2, between April 2004 and March 2009; and for Group 3 from April 2009 to August 2014. We reviewed demographic and preoperative data, including prostate volume; international prostate symptoms score (IPSS), quality of life (QoL), and peak flow rate (Qmax). We also recorded any perioperative and long-term complications.

Results: A total of 1835 patients were included in our study, including 542 (29.5%) in Group 1, 614 (33.5%) in Group 2, and 679 (37%) in Group 3. Preoperative prostate volume was positively correlated with age at surgery (r = 0.62, p < 0.001), total energy used (r = 0.47, p < 0.001), and total operative time (r = 0.47, p < 0.001). Patients in Group 3 were significantly older (75.28 ± 8.47 in Group 3 vs. 71.11 ± 8.9 in Group 2 vs. 65.3 ± 9.04 years in Group 1, p 72 years), prostate volume (>80 cc), operative time (>95 minutes), and preoperative PSA (>6 ng/dL) were significantly associated with postoperative urinary incontinence.
Conclusions: Patients presenting for surgery due to symptomatic BPH over the last 16 years were significantly older, more morbid, and had larger prostates and more abnormal voiding parameters. Over time, patients used prostatic medications more frequently. Despite the changes in patient profiles, perioperative safety and complication rates between groups were comparable, likely due to advancements in laser technology and techniques. Age (>72 years), prostate volume (>80 cc), operative time (>95 minutes), and preoperative PSA (>6 ng/dL) were significantly associated with reversible postoperative urinary incontinence.
The use of prophylactic single-dose fosfomycin in patients who undergo transrectal ultrasound-guided prostate biopsy: A prospective, randomized, and controlled clinical study
Authors: Sen Volkan , Aydogdu Ozgu , Bozkurt Ibrahim Halil , Yonguc Tarik , Sen Pinar , Polat Salih , Degirmenci Tansu , Bolat Deniz
Published: December 2015

Introduction: We aimed to demonstrate the efficacy, safety, and convenient use of fosfomycin trometamol in the preoperative antibiotic prophylaxis (PAP) of transrectal ultrasound-guided biopsy of the prostate (TRUSBP) in this prospective, randomized study.

Methods: Between May 2014 and May 2015, a total of 300 patients who underwent TRUSBP were examined prospectively. Patients were randomized into two groups: group 1 consisted of 150 patients who were administered a single dose of 3 g oral fosfomycin as a PAP the night before the procedure; group 2 consisted of 150 patients who were administered 500 mg oral ciprofloxacin 60 min before the procedure as a PAP. Post-procedural febrile and afebrile infectious complications and pathological characteristics of the two groups were compared prospectively.

Results: The mean age of the patients was 63.5±0.6 years in group 1 and 62.9±0.6 years in group 2. A total of two patients (1.3%) in group 1 and nine patients (6.0%) in group 2 experienced afebrile urinary tract infection (UTI). Afebrile UTI rate was significantly higher in group 2 (1.3% s. 6.0%, p=0,032). Febrile UTI was detected in two patients in group 2 and one patient in group 1. Urine cultures revealed 35.7% fluoroquinolone resistance. As a limitation, although the sample size was appropriate due to the power calculation, we believe that comprehensive studies including larger patient cohorts are needed to support our findings.

 Conclusions: Due to its ease-of-use with only a single dose and lower rates of infectious complications (resistant and febrile UTIs), fosfomycin trometamol is a strong alternative for antibiotic prophylaxis in TRUSBP.
Nightly sildenafil use after radical prostatectomy has adverse effects on urinary convalescence: Results from a randomized trial of nightly vs on-demand dosing regimens
Authors: Hyndman Matthew Eric , Bivalacqua Trinity J , Feng Zhaoyong , Mettee Lynda Z , Su Li-Ming , Trock Bruce J , Pavlovich Christian P
Published: December 2015

Introduction: This is a report on urinary function results from a randomized trial of nightly versus on-demand sildenafil after nerve-sparing radical prostatectomy (RP), a secondary objective. We analyzed the effects of these sildenafil administration schemes on urinary health-related quality of life after RP.

Methods: In total, 100 potent men were equally randomized to nightly and on-demand sildenafil 50 mg after minimally-invasive RP for 1 year. Health-related quality of life questionnaires were administered at various postoperative intervals. Urinary function was assessed using appropriate expanded prostate cancer index composite (EPIC) subscales. Analyses of covariance and linear mixed-effects modeling were used to compare the effects of treatment over time on urinary recovery, controlling for age, nervesparing score, and time from surgery.

Results: The nightly (n = 50) and on-demand (n = 50) sildenafil groups were well-matched at baseline. Nightly sildenafil patients had worse EPIC urinary bother and urinary irritative/obstructive subscale scores at 3 and 6 months after RP, even after controlling for multiple variables. On mixed-model analyses, the differences between groups for these EPIC subscales (4.9 and 2.5, respectively) were greater than documented thresholds for clinical significance. Increasing nerve-sparing score was associated with improvements in EPIC urinary summary, bother, incontinence, and function scores; time from surgery was associated with improvements in all EPIC urinary health-related quality of life subscales.

Conclusions: In this specific population and drug dose, we found that on-demand short-acting phosphodiesterase-5 inhibitor (PDE5i) dosing may be more effective after RP to maximize early urinary health-related quality of life. In preoperatively potent men, nightly sildenafil 50 mg impaired urinary health-related quality of life more than on-demand use in the early months after nerve-sparing RP, independent of effects on urinary continence.
Muscle invasive bladder cancer culminating with leptomeningeal carcinomatosis
Authors: Swallow Tom W , Mabbutt Scott , Bell Charles RW
Published: December 2015

This case reports highlights a rare metastatic manifestation of transitional cell carcinoma of the bladder. The onset of symptoms associated with meningeal irritation should be investigated. However, there is little consensus in the treatment of leptomeningeal carcinomatosis and it should be considered a poor prognostic sign with symptomatic management.
Robotic partial nephrectomy for renal tumours in obese patients: Perioperative outcomes in a multi-institutional analysis
Authors: Abdullah Newaj , Dalela Deepansh , Barod Ravi , Larson Jeff , Johnson Michael , Mass Alon , Zargar Homayoun , Allaf Mohamad , Bhayani Sam , Stifelman Michael , Kaouk Jihad , Rogers Craig
Published: December 2015

Introduction: We sought to evaluate the association of obesity with surgical outcomes of robotic partial nephrectomy (RPN) using a large, multicentre database. 

Methods: We identified 1836 patients who underwent RPN from five academic centres from 2006-2014.  A total of 806 patients were obese (body mass index [BMI] ≥30 kg/m2). Patient characteristics and outcomes were compared between obese and non-obese patients. Multivariable analysis was used to assess the association of obesity on RPN outcomes.

Results: A total of 806 (44%) patients were obese with median BMI of 33.8kg/m2. Compared to non-obese patients, obese patients had greater median tumour size (2.9 vs. 2.5 cm, p<0.001), mean RENAL nephrometry score (7.3 vs. 7.1, p = 0.04), median operating time (176 vs. 165 min, p=0.002), and median estimated blood loss (EBL, 150 vs. 100 ml, p=0.002), but no difference in complications. Obesity was not an independent predictor of operative time or EBL on regression analysis. Among obese patients, males had a greater EBL (150 vs. 100 ml, p<0.001), operative time (180 vs. 166 min, p<0.001) and warm ischemia time (WIT, 20 vs. 18, p=0.001) and male sex was an independent predictor of these outcomes on regression analysis.

Conclusion: In this large, multicentre study on RPN, obesity was not associated with increased complications and was not an independent predictor of operating time or blood loss.  However, in obese patients, male gender was an independent predictor of greater EBL, operative time, and WIT.  Our results indicate that obesity alone should not preclude consideration for RPN.
Misuse of ultrasound for palpable undescended testis by primary care providers: A prospective study
Authors: Wong Nathan C , Bansal Rahul K , Lorenzo Armando J , DeMaria Jorge , Braga Luis H
Published: December 2015

Introduction: Although previous evidence has shown that ultrasound is unreliable to diagnose undescended testis, many primary care providers (PCP) continue to misuse it. We assessed the performance of ultrasound as a diagnostic tool for palpable undescended testis, as well as the diagnostic agreement between PCP and pediatric urologists.

Methods: We performed a prospective observational cohort study between 2011 and 2013 for consecutive boys referred with a diagnosis of undescended testis to our tertiary pediatric hospital. Patients referred without an ultrasound and those with non-palpable testes were excluded. Data on referring diagnosis, pediatric urology examination and ultrasound reports were analyzed.

Results: Our study consisted of 339 boys. Of these, patients without an ultrasound (n = 132) and those with non-palpable testes (n = 38) were excluded. In the end, there were 169 pateints in this study. Ultrasound was performed in 50% of referred boys showing 256 undescended testis. The mean age at time of referral was 45 months. When ultrasound was compared to physical examination by the pediatric urologist, agreement was only 34%. The performance of ultrasound for palpable undescended testis was: sensitivity = 100%; specificity = 16%; positive predictive value = 34%; negative predictive value = 100%; positive likelihood ratio = 1.2; and negative likelihood ratio = 0. Diagnosis of undescended testis by PCP was confirmed by physical examination in 30% of cases, with 70% re-diagnosed with normal or retractile testes.

Conclusion: Ultrasound performed poorly to assess for palpable undescended testis in boys and should not be used. Although the study has important limitations, there is an increasing need for education and evidence-based guidelines for PCP in the management of undescended testis.
Urethral injury in laparoscopic-assisted abdominoperineal resection
Authors: Stitt Laurel , Avila Flores Francisco , Dhalla Sonny S
Published: December 2015

We present a 71-year-old man who underwent laparoscopic-assisted abdominoperineal resection for recurrence of rectal cancer, which was complicated by a urethral injury. Traumatic urinary catheter insertion was ruled out as an alternative etiology. This case highlights the importance of recognizing urethral injury as a possible complication of laparoscopic-assisted abdominoperineal resection surgery.
The value of a core clinical rotation in urology for medical students
Authors: Patel Premal , Nayak Jasmir G , McGregor Thomas B
Published: December 2015

Introduction: In 2013, our institution underwent a change to the undergraduate medical curriculum whereby a clinical urology rotation became mandatory. In this paper, we evaluated the perceived utility and value of this change in the core curriculum.

Methods: Third year medical students, required to complete a mandatory 1-week clinical urology rotation, were asked to complete a survey before and after their rotation. Fourth year medical students, not required to complete this rotation, were also asked to complete a questionnaire. Chi-squared and Fisher’s exact test were used for data analysis.

Results: In total, 108 third year students rotated through urology during the study period. Of these, 66 (61%) completed the prerotation survey and 54 (50%) completed the post-rotation survey. In total, there were 110 fourth year students. Of these, 44 (40%) completed the questionnaire. After completing their mandatory rotations, students felt more comfortable managing and investigating common urological problems, such as hematuria and renal colic. Students felt they had a better understanding of how to insert a Foley catheter and felt comfortable independently inserting a Foley catheter. Importantly, students felt they knew when to consult urology and were also more likely to consider a career in urology. Compared to fourth year students, third year students felt urology was an important component to a family medicine practice and felt they had a better understanding of when to consult urology.

 Conclusion: The introduction of a mandatory urology rotation for undergraduate medical students leads to a perceived improvement in fundamental urological knowledge and skill set of rotating students. This mandatory rotation provides a valuable experience that validates its inclusion.
Acquired hemophilia A: A rare cause of gross hematuria
Authors: Hosier Gregory W , Mason Ross J , Robinson K Sue , Bailly Gregory G
Published: December 2015

Acquired hemophilia A is a rare condition caused by spontaneous development of factor VIII inhibitor. This condition most commonly presents with multiple hemorrhagic symptoms and isolated hematuria is exceedingly rare. Early diagnosis is important, as this condition carries a high mortality rate (13‒22%). We present a case of an 82-year-old man with isolated hematuria caused by a factor VIII inhibitor who was successfully treated with recombinant activated factor VII concentrate, as well as prednisone and cyclophosphamide.
Large retroperitoneal hemangioma encompassing the renal vein
Authors: Mossanen Matthew , Dighe Manjiri , Gore John , Mann Gary
Published: December 2015

Retroperitoneal hemangioma (RH) is a rare and benign vascular malformation. RH may be detected incidentally or present with symptoms due to local invasion of adjacent structures. Management options include surgical resection, as well as serial observation with routine imaging. We describe a retroperitoneal hemangioma encompassing the renal vein that was discovered during diagnosis of acute appendicitis, and characterize diagnostic magnetic resonance imaging (MRI) findings seen with this condition.
Developing Students’ Intelligent Character through Linguistic Politeness: The Case of English as a Foreign Language for Indonesian Students
Authors: Mariani Nanik
Published: December 2015

English is a foreign language that must be taught at school, particularly in secondary school. Based on a preliminary observation of several secondary schools in Banjarmasin, it appears that the English taught focuses most on concepts or language formulas. Most of the students who interact in English during the learning process do not use expressions that contain linguistic politeness, as is required. The learning of linguistic politeness is not emphasized, while it is an effort to develop students’ intelligent characters. This study primarily focuses on the investigation of teachers’ linguistic politeness while interacting with the students, students’ linguistic politeness, while interacting with the teachers, the students’ linguistic politeness while interacting with their peers during the learning process in the classroom, how the teacher forms the students’ linguistic politeness in the classroom, and how the linguistic politeness can develop students’ intelligent characters. This study is one of classroom action research. Two cycles, in which each cycle consists of two meetings, are employed. After linguistic politeness is taught in four meetings through students’ wheel and role play, it can be stated that during the English learning process in the classroom, the students have the opportunity to speak and practice linguistic politeness in English while interacting with their teachers and or other students. The forming of linguistic politeness in English can develop the students’ intelligent characters from the beginning to the end of the learning activities. The students also become accustomed to employing polite vocabulary or expression in English that can improve their spiritual and emotional development, the aim of which is to lead to intelligence, primarily emotional intelligence.
Evaluation of Different Light Conditions in the Working Environment for Handling Photosensitive and Thermolabile Compounds
Authors: Hernandez Duran Tania , Ravela Neel , Sanchez Rivero Sandra , De Jesus Castro Sandoval Teresita , Hoogmartens Jos , Pendela Murali
Published: December 2015

Lighting in the working environment plays a significant role on the degree of degradation of photosensitive, thermolabile compounds and on working efficiency. Light emitting diodes (LEDs) are semiconductor light emitting devices that are promising artificial light sources with easy modulation of light wave signals and are also known for low heat generation. Therefore, the effect of polychromatic LED light was tested in the working environment using the drug compounds montelukast, nifedipine, and clavulanic acid, which are known to be photosensitive or thermolabile. As a control, other lighting sources like a sodium lamp, a classic (incandescent, tungsten) lamp, and indirect sunlight were also used in this study. All the experiments were carried out with methanolic solutions at room temperature. An Acquity UPLC/MS/MS system was used for quantification of the main analytes and degradation products. Under the tested conditions, LED lighting proved to be more suitable for handling photosensitive and thermolabile compounds.
Validated HPLC and Ultra-HPLC Methods for Determination of Dronedarone and Amiodarone Application for Counterfeit Drug Analysis
Authors: El-Bagary Ramzia I , Elkady Ehab F , Mowaka Shereen , Attallah Maria
Published: December 2015

Two simple, accurate, and precise chromatographic methods have been developed and validated for the determination of dronedarone (DRO) HCl and amiodarone (AMI) HCl either alone or in binary mixtures due to the possibility of using AMI as a counterfeit of DRO because of its lower price. First, an RP-HPLC method is described for the simultaneous determination of DRO and AMI. Chromatographic separation was achieved on a BDS Hypersil C18 column (150 × 4.6 mm, 5 μm). Isocratic elution based on potassium dihydrogen phosphate buffer with 0.1% triethylamine pH 6–methanol (10 + 90, v/v) at a flow rate of 2 mL/min with UV detection at 254 nm was performed. The second method is RP ultra-HPLC in which the chromatographic separation was achieved on an AcclaimTM RSLC 120 C18 column (100 × 2.1 mm, 2.2 μm) using isocratic elution with potassium dihydrogen phosphate buffer with 0.1% triethylamine pH 6–methanol (5 + 95, v/v) at a flow rate of 1 mL/min with UV detection at 254 nm. Linearity, accuracy, and precision of the two methods were found to be acceptable over the concentration ranges of 5–80 μg/mL for both DRO and AMI. The results were statistically compared using one-way analysis of variance. The optimized methods were validated and proved to be specific, robust, precise, and accurate for the QC of the drugs in their pharmaceutical preparations.
Lipid Characterization of White, Dark, and Milk Chocolates by FT-Raman Spectroscopy and Capillary Zone Electrophoresis
Authors: de Oliveira Leandra Natália , Castro Jesus Coelho de Renata , de Oliveira Marcone Augusto Leal , de Oliveira Luiz Fernando C
Published: December 2015

There are few studies about different types of chocolate and their chemical characterization by Fourier transform (FT)-Raman spectroscopy and capillary zone electrophoresis (CZE). The aim of this study was to evaluate the lipid profile of different types of Brazilian chocolate through characterization by FT-Raman spectroscopy and identification and quantification of major fatty acids (FAs) by CZE to confirm FT-Raman spectrometry results. It was found that the main spectroscopic profile difference of the chocolate samples analyzed was related to the presence of saturated or unsaturated FAs. Well defined bands at approximately 1660, 1267, and 1274 cm–1 corresponding to vibrational modes of unsaturated FAs (UnFAs) were found only in the spectra of samples with cocoa butter in their composition according to label specifications, mainly in dark chocolate samples. The FA identification and quantification by CZE found the presence of stearic (18:0) and palmitic (16:0) acids as the major saturated FAs in all chocolate samples. Dark chocolate samples showed the highest levels of oleic (cis-9 18:1) and linoleic (cis, cis -9,12 18:2) UnFAs monitored and the lowest levels of 14:0 in their chemical composition. Samples coded as 02 (with not only cocoa butter in their composition according to label) had the highest levels of 14:0 (FA not present in cocoa butter composition) corresponding to label information and inferring the presence of other fat sources, called cocoa butter substitutes, mainly for milk and white chocolate samples. This study suggests FT-Raman spectroscopy is a powerful technique that can be used to chemically characterize the chocolate lipid fraction, and CZE is a tool able to confirm Raman spectroscopy results and identify and quantify the major FAs in chocolate samples.
A Highly Sensitive Oligonucleotide Hybridization Assay for Klebsiella pneumoniae Carbapenemase with the Probes on a Gold Nanoparticles Modified Glassy Carbon Electrode
Authors: Pan Hong-Zhi , Yu Hong- Wei , Wang Na , Zhang Ze , Wan Guang-Cai , Liu Hao , Guan Xue , Chang Dong
Published: December 2015

To develop a new electrochemical DNA biosensor for determination of Klebsiella pneumoniae carbapenemase, a highly sensitive and selective electrochemical biosensor for DNA detection was constructed based on a glassy carbon electrode (GCE) modified with gold nanoparticles (Au-nano). The Au-nano/GCE was characterized by scanning electromicroscopy, cyclic voltammetry, and electrochemical impedance spectroscopy. The hybridization detection was measured by differential pulse voltammetry using methylene blue as the hybridization indicator. The dynamic range of detection of the sensor for the target DNA sequences was from 1 × 10–11 to 1 × 10–8 M, with an LOD of 1 × 10–12 M. The DNA biosensor had excellent specificity for distinguishing complementary DNA sequence in the presence of non-complementary and mismatched DNA sequence. The Au-nano/GCE showed significant improvement in electrochemical characteristics, and this biosensor was successfully applied for determination of K. pneumoniae.