bluuebunny/crossref_metadata_2025 huggingface dataset:
Prostate cancer
Authors: Montironi Rodolfo , Cheng Liang , Lopez-Beltran Antonio , Mazzucchelli Roberta , Santoni Matteo , Scarpelli Marina
Published: November 2017

The incidence of prostate cancer (PCa) has risen dramatically in the last years. This event may be partially explained by the employment of digital rectal examination (DRE), serum prostate-specific antigen (PSA), and transrectal ultrasonography. In developed countries, PCa is the most frequent non-skin malignancy in males. It is estimated that one in six males will be diagnosed with PCa during their lifetime, the risk of death due to metastatic PCa being 1 in 30. Multiple factors contribute to the development of PCa, as well as to its progression to an androgen-independent state: dietary factors, inherited susceptibility factors, gene defects, and androgens and their receptors. The chapter will discuss the following topics: high-grade prostatic intraepithelial neoplasia (PIN); atypical small acinar proliferation; morphological criteria for the identification of PCa; reporting of PCa biopsies; prognostic factors in radical prostatectomies (RPs); and specimens.
Screening for prostate cancer
Authors: Schröder Fritz H.
Published: November 2017

Screening for a disease must be clearly defined and differentiated from early detection. ‘Screening’ refers to the application of tests to the whole population or to defined segments such as males within certain defined high risk age groups. If applied in such a fashion ‘screening’ for prostate cancer may also be described epidemiologically as ‘secondary prevention’. While high-quality randomized studies show that screening reduces prostate cancer mortality by 21–44%, there is wide agreement that the introduction of population-based screening is at present premature because harms, mainly the high rate of overdiagnosis seen currently outweighs the benefits. This chapter attempts to put current knowledge into perspective with a set of recognized prerequirements for the application of screening, established by Wilson and Jungner in 1968.
Clinical features, assessment, and imaging of prostate cancer
Authors: Bjartell Anders , Ulmert David
Published: November 2017

In contemporary practice, most patients with prostate cancer are diagnosed following a prostate-specific antigen (PSA) test and are asymptomatic at the time of diagnosis. Although serum PSA has a low specificity for prostate cancer, it can be used to single out patients with advanced disease. While most men do not have a palpable tumour at digital rectal examination (DRE), those with palpable or an elevated PSA test require transrectal ultrasonography-guided prostate biopsy in order to make a diagnosis of cancer. Tumours are staged clinically as localized, locally advanced, or metastatic. The urologist and the patient need the correct staging information for decision-making. A combination of several parameters (PSA value, Gleason grade and tumour extent on biopsy, and DRE findings) can be used in a variety of tools to predict the extent of the disease and treatment outcomes.
Technology and prostatectomy
Authors: Novara Giacomo , Mottrie Alexander , Zattoni Filiberto , Ficarra Vincenzo
Published: November 2017

Radical prostatectomy (RP) is the gold standard surgical treatment for patients with clinically localized prostate cancer and life expectancy more than 10 years. In the last decades, the desire to reduce the invasiveness of traditional retropubic RP has produced an increasing interest towards laparoscopic techniques, but acceptance was limited primarily because of the steep learning curve. Conversely, robot-assisted laparoscopic RP (RARP) had a rapid and wide diffusion in the world. Surgical technique for RARP is currently very well standardized and reported in the literature. According to the available data, the procedure can be performed routinely with a relatively small risk of complications and excellent functional outcomes. Clinical patient characteristics, surgical experience and technique, and cancer characteristics may affect the risk of complications as well as continence and potency recovery.
Molecular biology of bladder cancer
Authors: Said Neveen , Theodorescu Dan
Published: November 2017

Bladder cancer is the most common malignancy involving the urinary system, caused primarily by tobacco use and exposure to industrial chemicals with an estimated 73,510 patients affected and 14,880 deaths in 2012. This chapter will summarize what is known about the most common molecular derangements in human bladder cancer. It will focus on the function and biological/clinical relevance of these genes in models of urothelial cancer and in patients with this disease. It is not meant as a comprehensive review of all the functions of the aforementioned genes in normal physiology or other cancer types. Furthermore, the selection of what genes/pathways are described is by necessity empirical and so we apologize to any author whose work was not described or quoted.
Treatment of metastatic bladder cancer
Authors: Calabrò Fabio , Sternberg Cora N.
Published: November 2017

Although bladder cancer is considered a chemosensitive malignancy, the prognosis of patients with metastatic disease is poor, with a median survival of approximately 12–14 months in good prognosis patients and with cure in only a minority. The addition of new drugs to the standard cisplatin-based regimens has not improved these outcomes. In this chapter, we highlight the role of chemotherapy and the impact of the new targeted agents in the treatment of metastatic bladder carcinoma. A better understanding of the underlying biology and the molecular patterns of urothelial bladder cancer has led to clinical investigation of several therapeutic targets. To date, these agents have yet to demonstrate an improvement in overall survival. Urothelial cancer is extremely sensitive to checkpoint inhibition with both anti PD-1 and anti PDL1 antibodies. The future seems brighter with the advent of these new therapies.
Squamous cell bladder cancer
Authors: Mayr Roman , Burger Maximilian
Published: November 2017

In the developed countries, over 90% of the bladder cancer cases are transitional cell carcinoma (TCC), with squamous cell carcinoma (SCC), adenocarcinomas, and rare types of bladder cancer comprising the remaining 10% of bladder cancer cases. In Western regions, pure SCC of the bladder constitutes 1.2–4.5% of all bladder tumours. SCC can occur in both non-bilharzial and bilharzial bladders; the two subtypes differ in epidemiology, pathogenesis, and clinical outcome. Squamous cell carcinoma in the bilharzial bladder is an endemic disease in many regions of the Middle East, Africa, Southeast Asia, and South America. The knowledge of SCC of the bladder is nevertheless important due to different aetiology, clinical pathways, and clinical outcome.
Genetics and molecular biology of renal cancer
Authors: Jafri Mariam , Maher Eamonn R
Published: November 2017

Renal cell carcinoma (RCC) is the exemplar of how the understanding of the molecular pathogenesis of rare inherited disorders can inform an understanding of the key pathways involved in the pathogenesis of sporadic cancer. In this chapter we describe the clinical and pathological features of the inherited kidney cancer syndromes: von Hippel Lindau disease (VHL); Birt-Hogg-Dube syndrome; hereditary leiomyomatosis and renal cancer syndrome; succinate dehydrogenase disorders; hereditary papillary renal cancer; and translocation-associated kidney cancer. Though individually rare, recognition of individuals with familial kidney cancer is important as they present specific clinical challenges to the urological surgeon because of their propensity to develop multicentric/bilateral tumours. Furthermore, different familial RCC predisposition syndromes are associated with different extra renal clinical features and have specific surveillance needs. Despite differences in clinical features, there is some overlap in the molecular pathophysiology between the disorders and these highlight the key signalling pathways for RCC oncogenesis.
Ablative technologies for renal cancer
Authors: Faddegon Stephen , Olweny Ephrem O. , Cadeddu Jeffrey A.
Published: November 2017

Nearly two-thirds of newly detected renal masses are clinical stage 1, with T1a tumours accounting for 60% of the newly detected stage 1 tumours. Guideline panels convened by the American Urological Association and the European Association of Urology recommend nephron-sparing surgery as the gold standard treatment for small renal masses, with active surveillance and thermal ablation recommended as alternative strategies in select patients. However, there is a dearth of studies directly comparing outcomes for energy-based ablation to those for traditional surgical treatments for small renal masses, and future prospective randomized trials will be invaluable in this regard. Ongoing research in renal tumour ablation targets several areas, including but not limited to achieving larger ablation sizes, decreasing morbidity, and development of novel technologies for renal tumour ablation.
Pathology of testicular tumours
Authors: Goepel John
Published: November 2017

Tumours of the testis are uncommon and are usually germ cell tumours. They present most often as a scrotal mass in a young man, and are the most frequent malignant tumour in this age group. The incidence has risen over recent decades and is higher in Western Europe. A history of testicular maldescent is a significant risk factor. About 50% are pure seminoma; the remainder non-seminomas may have a single but more usually a mixed histology. Non-seminomas are all called teratoma in the British system. Metastasis readily occurs to paraaortic lymph nodes or the lungs, and some patients present with advanced metastatic disease. Radical orchidectomy is the usual treatment of the primary tumour, with chemotherapy for metastatic disease. There are other tumours that arise in the testis, which will require a different management strategy. Finally, there are tumours that arise in paratesticular tissue or the spermatic cord.
Infertility
Authors: Kayes Oliver , Amoako Akwasi
Published: November 2017

Surgical sperm retrieval combined with the advent of in vitro fertilization and intracytoplasmic sperm injection has enabled many men with obstructive and non-obstructive azoospermia to father their own biological children. Several sperm retrieval techniques have been described to obtain sperm from the vas deferens, epididymis, and testicular parenchyma for use in assisted reproduction technologies. The current techniques have variable success rates but have not been subjected to randomized control trials hence the paucity of good evidence to inform the choice of one technique over the others. In experienced hands, sufficient and good quality sperm can usually be harvested for treatment and/or cryopreservation. This chapter summarizes the current techniques of surgical sperm retrieval, sperm retrieval success rate, and the role of adjuvant therapies in increasing chance of successful sperm retrieval.
Infertility
Authors: Reisman Yacov
Published: November 2017

Vasectomy is now well recognized worldwide as one of the safest and most effective contraceptive methods. A history should be taken and an examination should be carried out on every person requesting sterilization. Preoperative counselling should include alternative methods of contraception, complication and failure rates, and the need for postoperative semen analysis. There are no absolute contraindications to sterilization, provided that they make the request themselves, are of sound mind, and are not acting under external duress. Relative contraindications may be the absence of children, age <30 years, severe illness, no current relationship, and scrotal pain. Although various vasectomy techniques have been described, all share three essential steps: isolation of the vas deferens, delivery and interruption of the vas, and management of the vasal ends.
The management of fertility in spinal cord injury
Authors: Fode Mikkel , Sønksen Jens
Published: November 2017

While spinal cord injury (SCI) does not affect female fertility, the condition most often results in infertility in males due to anejaculation and reduced semen quality. Anejaculation is caused by disruption of the autonomic nerve fibres, which are normally responsible for the ejaculation. The reason for the poor sperm quality has not been firmly established. If spinal cord injured men cannot ejaculate by sexual intercourse or masturbation, ejaculation can be induced by either penile vibratory stimulation or electroejaculation. Only if these methods fail should surgical sperm retrieval be considered. The method of insemination depends largely on the total motile sperm count and patient preference. With the right treatment, it is possible for most SCI men to have children.
Mechanism of penile erection
Authors: Cellek Selim
Published: November 2017

Sexual stimuli (tactile, visual, olfactory, and imaginative) are processed and integrated in the central nervous system which then activates certain autonomic and somatic pathways within the peripheral nervous system. This coordinated activation of the central and peripheral nervous systems leads to penile erection which is actually a result of relaxation of vascular and cavernosal smooth muscle in the penis. In the flaccid (detumescent) penis, the smooth muscle tone is heightened. Penile erection (tumescence) requires a decrease in the smooth muscle tone. The tone of the penile smooth muscle therefore is the main determinant of erectile function. In this chapter, the current information on the control of erectile function by this central-peripheral-smooth muscle axis will be reviewed.
Male genital injury
Authors: Garaffa Giulio , Sansalone Salvatore , Ralph David J
Published: November 2017

Male genital trauma, a relatively rare condition in the Western world, usually affects young men and encompasses a wide spectrum of injuries, which in the most severe cases may lead to a complete long-term loss of sexual and urinary function. When managing genital trauma, it is paramount to identify possible associated bony, vascular, bowel, and urinary tract injuries, which are present in up to 83% of cases, and should require immediate treatment, as they may be potentially life-threatening. The management of the genital trauma should be deferred to a later stage, when associated injuries have been successfully dealt with and the patient condition is stable. Therefore, a prompt and effective management of genital injuries is paramount to prevent devastating effects on patient’s self-image and quality of life. Classification of genital injuries is extremely complex, as an offending mechanism can lead to a broad spectrum of lesions.
Urinary tract infection in children
Authors: Thomas David F.M
Published: November 2017

Urinary tract infection (UTI) is one of the commonest conditions of childhood, affecting an estimated 10% of girls and 3% of boys in the first 16 years of life. Whereas asymptomatic bacteriuria and low-grade lower tract infection pose little or no risk of renal damage, pyelonephritis can cause severe systemic illness and poses a significant threat of long-term renal morbidity. The principal aim of investigation is to identify underlying abnormalities of the urinary tract, notably vesicoureteric reflux. Guidelines on investigation and management published by the National Institute of Clinical Excellence will be reviewed in this chapter. Treatment of dysfunctional voiding and other features of ‘elimination syndrome’ plays an important role in the prevention of urinary tract infection in this age group.
Vesicoureteric reflux
Authors: Thomas David F.M.
Published: November 2017

The term vesicoureteric reflux (VUR) describes the retrograde flow of urine from the bladder into the upper urinary tract. VUR is not a disease entity in its own right. Nevertheless, it has the potential to cause significant morbidity by preventing effective emptying of the urinary tract and by facilitating the transport of bacteria into the upper tract and renal parenchyma. Mechanisms of renal damage associated with VUR include pyelonephritic scarring and congenital dysplasia or hypoplasia. The long-term complications of pyelonephritic scarring may include hypertension, renal failure, and an increased risk of complications during pregnancy. VUR of mild or moderate severity is best managed conservatively and surgical intervention is generally reserved for failed medical management and high grade or complex VUR. Although the introduction of endoscopic correction has revolutionized surgical management, there remains a role for open surgery for the correction of higher grades of reflux.
Disorders of the urethra
Authors: Hutton Kim , Ram Ashok Daya
Published: November 2017

Most disorders of the urethra in children are congenital in origin and affect boys more commonly than girls. They include; posterior urethral valves (PUV), anterior urethral valves, anterior urethral diverticulum, syringocele, urethral atresia, megalourethra, urethral web, urethral polyp, and urethral duplication. Urethral strictures may be congenital or acquired. Most cases of PUV are now diagnosed prenatally. Postnatal management comprises bladder drainage, correction of any metabolic disturbance, prevention of infection (UTI), and endoscopic valve ablation. Careful follow up is required with the aim of preventing urosepsis and preserving renal function. Persisting bladder dysfunction (‘valve’ bladder) can threaten renal function and should be managed aggressively. Chronic renal failure ultimately affects a third of boys with PUV, of whom 10–20% require renal transplantation during the course of childhood. PUV may also present clinically with recurrent UTI, urinary incontinence, or unexplained lower urinary tract symptoms.
Abnormalities of the bladder
Authors: Cuckow Peter
Published: November 2017

Anatomical and functional reconstruction of the bladder exstrophy/epispadias complex of anomalies presents paediatric urologists with one of their greatest challenges. Nevertheless, very considerable advances have been made during the last 30 years. Children with classic bladder exstrophy now have an excellent prospect of becoming fully continent—either by primary reconstruction or with a catheterizeable stoma. Achieving continence and normal voiding in children with primary epispadias can be difficult because of the dysplastic nature of their sphincteric and bladder neck tissues. Urachal anomalies may present symptomatically in childhood or incidentally during ultrasound examination of the lower urinary tract. Small bladder diverticula which are secondary to outflow obstruction or bladder dysfunction tend to resolve following treatment of the underlying cause, whereas surgical excision is usually required for larger, symptomatic diverticula.
Undescended testis and inguinoscrotal conditions in children
Authors: Thomas David F.M
Published: November 2017

The testis descends in response to androgen stimulation in the third trimester of pregnancy. Germ cell maturation which normally occurs in early childhood is impaired or absent in undescended testes. The well-documented phenomenon of secondary ascent is now thought to account for a sizeable proportion of boys undergoing orchidopexy in later childhood. Inguinal hernias and communicating hydroceles are caused by persistence of a patent processus vaginalis. Surgery is always indicated for inguinal hernias but the majority of communicating hydroceles resolve spontaneously. Testicular torsion accounts for 90% acute scrotal symptoms in adolescents, in whom urgent surgical exploration is mandatory unless there is compelling evidence of an alternative diagnosis. Treatment is rarely justified for asymptomatic varicoceles in this age group.
Renal function
Authors: O’Callaghan Chris A
Published: November 2017

The kidneys play a central role in homeostasis by maintaining extracellular fluid composition and volume. They do this by continuous filtration of plasma in the renal glomeruli and then subsequent modification of the filtered fluid as it passes along the nephron. The filtration process excludes large molecules, but most small molecules and ions are freely filtered. The filtrate that is produced in the glomeruli has a similar composition to plasma with respect to small molecules and ions. Most of the water and solutes are reabsorbed along the tubules and this process requires high levels of metabolic activity. In addition, a range of compounds and ions are secreted into the tubules along the nephron. Renal function is central to homeostasis and an appreciation of normal renal physiology is essential to understand the role of the kidney in a wide variety of disease processes.
Acute kidney injury
Authors: Sharples Edward
Published: November 2017

Acute kidney injury (AKI) is a common, major cause of morbidity and mortality in hospitalized patients, and contributes significantly to length of stay and hence costs. Large epidemiological studies consistently demonstrate an incidence of AKI of 5–18% depending on the definition of AKI utilized. Even relatively small changes in renal function are associated with increased mortality, and this has led to strict definition and staging of AKI. Early recognition with good clinical assessment, diagnosis, and management are critical to prevent progression of AKI and reduce the potential complications, including long-term risk of end-stage renal failure. In this chapter, the pathophysiology, causes, and early management of AKI are discussed. Hypovolaemia and sepsis are the most common causes in hospitalized patients, across medical and surgical specialities. Other common causes are discussed, as well as diagnostic criteria.
Ultrasound
Authors: Wells Toby , Freeman Simon J
Published: November 2017

Ultrasound is an invaluable tool in the diagnosis and management of many urological disorders. It has the advantages of not involving ionizing radiation, allowing rapid real time imaging and being relatively inexpensive. It can also be performed at the patient’s bedside if necessary. There are limitations, however, and it is best used as an adjunct to clinical assessment, often alongside other complementary imaging modalities. While many ultrasound studies are undertaken by urological surgeons, it is often performed by imaging specialists; close liaison between these two groups is essential. A brief, clinically relevant, introduction to ultrasound physics is included and the use of Doppler techniques and ultrasound contrast agents will be discussed. It is not possible to cover all the urological conditions for which ultrasound is used in one chapter, so some recommended texts are included in the reading list for further study.
Plain radiography, excretion radiography, and contrast radiography
Authors: Kawashima Akira , LeRoy Andrew J.
Published: November 2017

Radiology is an integral component in the evaluation of the urinary tract. Plain radiography is both a primary abdominal examination technique and an initial component of subsequent excretion and contrast radiographic studies. Excretion radiography is performed by means of antegrade opacification of the renal collecting systems, ureters, and bladder following IV contrast administration. Contrast radiography is obtained following direct injection of contrast media into the urinary tracts in an antegrade or retrograde fashion. Although ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) are increasingly used to compensate for the limitations of excretion radiography, conventional urographic examinations remain important in the diagnosis of some urinary tract conditions.
Recent US bluetongue virus serotype 3 isolates found outside of Florida indicate evidence of reassortment with co-circulating endemic serotypes
Authors: Schirtzinger Erin E. , Jasperson Dane C. , Ostlund Eileen N. , Johnson Donna J. , Wilson William C.
Published: November 2017

Since 1999, 11 serotypes of bluetongue virus (BTV) similar to Central American or Caribbean strains have been isolated in the southeastern United States, predominantly in Florida. The majority of the incursive serotypes have remained restricted to the southeastern US. In recent years, BTV serotype 3 (BTV-3) has been isolated in areas increasingly distant from Florida. The current study uses whole genome sequencing of recent and historical BTV-3 isolates from the US, Central America and the Caribbean with additional sequences from GenBank to conduct phylogenetic analyses. The individual segments of the BTV genome were analysed to determine if recent BTV-3 isolates are reassortants containing genomic segments from endemic US serotypes or if they retain a majority of Central American/Caribbean genotypes. The analyses indicate that BTV-3 isolates Mississippi 2006, Arkansas 2008 and Mississippi 2009 are closely related reassortants that contain five to six genomic segments that are of US origin and two to three segments of Central American/Caribbean origin. In contrast, the BTV-3 South Dakota 2012 isolate contains seven genomic segments that are more similar to isolates from Central American and the Caribbean. These different evolutionary histories of the BTV-3 isolates suggest that there are at least two different lineages of BTV-3 that are currently circulating in the US.
Preparation and characterization of two new CuII supramolecular coordination polymers incorporating sulfobenzoate and flexible heterocyclic ligands
Authors: Chu Xin , Zhang Kou-Lin
Published: November 2017

The assembly of CuII with the multifunctional ligand 2-amino-4-sulfobenzoic acid (H2asba) in the presence of the auxiliary flexible ligands 1,4-bis(triazol-1-ylmethyl)benzene (bbtz) and 1,4-bis(imidazol-1-ylmethyl)benzene (bix) under ambient conditions resulted in two new supramolecular coordination polymers, namely poly[[(3-amino-4-carboxybenzenesulfonato-κO)aquabis[μ2-1,4-bis(triazol-1-ylmethyl)benzene-κ2
N
4:N
4′]copper(II)] 3-amino-4-carboxybenzenesulfonate tetrahydrate], {[Cu(C7H6NO5S)(C12H12N6)2(H2O)](C7H6NO5S)·4H2O}
n
, (1), and poly[[bis(μ2-2-amino-4-sulfonatobenzoato-κ3
O
1:N,O
1′)tetraaqua[μ2-1,4-bis(triazol-1-ylmethyl)benzene-κ2
N
4:N
4′]dicopper(II)] tetrahydrate], {[Cu2(C7H5NO5S)2(C14H14N4)(H2O)4]·4H2O}
n
, (2). Single-crystal X-ray structure diffraction analysis of (1) reveals that the bbtz ligand acts as a bridge, linking adjacent CuII ions into a two-dimensional cationic (4,4) topological network, in which the coordinated 3-amino-4-carboxybenzenesulfonate (Hasba−) anion uses its sulfonate group to bind with the CuII ion in a monodentate fashion and the carboxylate group remains protonated. The lattice Hasba− anion resides in the two-dimensional layer and balances the charge. The carboxylate group of the 2-amino-4-sulfonatobenzoate (asba2−) ligand in (2) is involved in bidentate coordination, connecting adjacent CuII ions into carboxylate-bridged chains which are further bridged by the auxiliary flexible bix ligand in a trans–gauche (TG) mode, resulting in the formation of a two-dimensional network architecture. The amino group of the asba2− ligand in (2) also takes part in the coordination with the central CuII ion. The six-coordinated CuII centres in (1) and (2) exhibit distorted octahedral coordination geometries. Extensive hydrogen bonding exists in both (1) and (2). The interlayer hydrogen bonds in both compounds further extend adjacent two-dimensional layers into three-dimensional supramolecular network architectures. Furthermore, a detailed analysis of the solid-state UV–Vis–NIR (NIR is near IR) diffuse reflectance data indicates that (1) and (2) may have potential as wide band gap indirect semiconductor materials. Compounds (1) and (2) show reversible and irreversible dehydration–rehydration behaviours, respectively.
Synthesis, crystal structures and properties of the new compounds K7–x
Ag1+x
(XO4)4 (X = Mo, W)
Authors: Spiridonova Tatyana S. , Solodovnikov Sergey F. , Savina Aleksandra A. , Solodovnikova Zoya A. , Stefanovich Sergey Yu. , Lazoryak Bogdan I. , Korolkov Iliya V. , Khaikina Elena G.
Published: November 2017

Two new isostructural compounds, namely heptapotassium silver tetrakis(tetraoxomolybdate), K7–x
Ag1+x
(MoO4)4 (0 ≤ x ≤ 0.4), and heptapotassium silver tetrakis(tetraoxotungstate), K7–x
Ag1+x
(WO4)4 (0 ≤ x ≤ 0.4), have been synthesized and found to crystallize in the polar space group P63
mc (Z = 2) with the unit-cell dimensions a = 12.4188 (2) and c = 7.4338 (2) Å for K6.68Ag1.32(MoO4)4 (single-crystal data), and a = 12.4912 (5) and c = 7.4526 (3) Å for K7Ag(WO4)4 (Rietveld analysis data). Both structures represent a new structure type, with characteristic [K1(XO4)6] `pinwheels' of K1O6 octahedra and six XO4 tetrahedra (X = Mo, W) connected by common opposite faces into columns along the c axes. The octahedral columns are linked to each other through Ag1O4 tetrahedra along with the K2 and K3/Ag2 polyhedra, forming the polar rods (...Ag1O4–X1O4–empty octahedron–Ag1O4...). Ag1 is located almost at the centre of the largest face of its coordination tetrahedron and seems to have some mobility. The new structure type is related to the Ba6Nd2Al4O15 and CaBaSiO4 types, and to other structures of the α-K2SO4–glaserite family. The differential scanning calorimetry (DSC) and second harmonic generation (SHG) results show that both compounds undergo first-order phase transformations to high-temperature centrosymmetric phases.
Syntheses and crystal structures of two heterometallic iodoplumbates containing mixed-valence copper(I/II)
Authors: Fan Le-Qing , Zhu Xiao-Tong
Published: November 2017

Mixed-valence copper(I/II) atoms have been introduced successfully into a Pb/I skeleton to obtain two heterometallic iodoplumbates, namely poly[bis(tetra-n-butylammonium) [bis(μ3-dimethyldithiocarbamato)dodeca-μ3-iodido-hexa-μ2-iodido-tetracopper(I)copper(II)hexalead(II)]], {(C16H36N)2[Cu4
ICuIIPb6(C3H6NS2)2I18]}
n
, (I), and poly[[μ3-iodido-tri-μ2-iodido-iodido[bis(1,10-phenanthroline)copper(I)]copper(I)copper(II)lead(II)] hemiiodine], {[CuICuIIPbI5(C12H8N2)2]·0.5I2}
n
, (II), under solution and solvothermal conditions, respectively. Compound (I) contains two-dimensional anionic layers, which are built upon the linkages of CuII(S2CNMe2)2 units and one-dimensional anionic Pb/I/CuI chains. Tetra-n-butylammonium cations are located between the anionic layers and connected to them via C—H...I hydrogen-bonding interactions. Compound (II) exhibits a one-dimensional neutral structure, which is composed of [PbI5] square pyramids, [CuII4] tetrahedra and [CuIIN4I] trigonal bipyramids. Face-to-face aromatic π–π stacking interactions between adjacent 1,10-phenanthroline ligands stabilize the structure and assemble compound (II) into a three-dimensional supramolecular structure. I2 molecules lie in the voids of the structure.
Clinical leadership in paramedic services: a narrative synthesis
Authors: O’Meara Peter , Wingrove Gary , Nolan Michael
Published: November 2017

Purpose

In North America, delegated practice “medical direction” models are often used as a proxy for clinical quality and safety in paramedic services. Other developed countries favor a combination of professional regulatory boards and clinical governance frameworks that feature paramedics taking lead clinician roles. The purpose of this paper is to bring together the evidence for medical direction and clinical governance in paramedic services through the prism of paramedic self-regulation.

Design/methodology/approach

This narrative synthesis critically examines the long-established North American Emergency Medical Services medical direction model and makes some comparisons with the UK inspired clinical governance approaches that are used to monitor and manage the quality and safety in several other Anglo-American paramedic services. The databases searched were CINAHL and Medline, with Google Scholar used to capture further publications.

Findings

Synthesis of the peer-reviewed literature found little high quality evidence supporting the effectiveness of medical direction. The literature on clinical governance within paramedic services described a systems approach with shared responsibility for quality and safety. Contemporary paramedic clinical leadership papers in developed countries focus on paramedic professionalization and the self-regulation of paramedics.

Originality/value

The lack of strong evidence supporting medical direction of the paramedic profession in developed countries challenges the North American model of paramedics practicing as a companion profession to medicine under delegated practice model. This model is inconsistent with the international vision of paramedicine as an autonomous, self-regulated health profession.
Identifying the major reversals of the BIST-30 index by extreme outliers
Authors: Erol Ümit
Published: November 2017

Purpose

The purpose of this paper is to show that major reversals of an index (specifically BIST-30 index) can be detected uniquely on the date of reversal by checking the extreme outliers in the rate of change series using daily closing prices.

Design/methodology/approach

The extreme outliers are determined by checking if either the rate of change series or the volatility of the rate of change series displays more than two standard deviations on the date of reversal. Furthermore; wavelet analysis is also utilized for this purpose by checking the extreme outlier characteristics of the A1 (approximation level 1) and D3 (detail level 3) wavelet components.

Findings

Paper investigates ten major reversals of BIST-30 index during a five year period. It conclusively shows that all these major reversals are characterized by extreme outliers mentioned above. The paper also checks if these major reversals are unique in the sense of being observed only on the date of reversal but not before. The empirical results confirm the uniqueness. The paper also demonstrates empirically the fact that extreme outliers are associated only with major reversals but not minor ones.

Practical implications

The results are important for fund managers for whom the timely identification of the initial phase of a major bullish or bearish trend is crucial. Such timely identification of the major reversals is also important for the hedging applications since a major issue in the practical implementation of the stock index futures as a hedging instrument is the correct timing of derivatives positions.

Originality/value

To the best of the author’ knowledge; this is the first study dealing with the issue of major reversal identification. This is evidently so for the BIST-30 index and the use of extreme outliers for this purpose is also a novelty in the sense that neither the use of rate of change extremity nor the use of wavelet decomposition for this purpose was addressed before in the international literature.
The novel language‐systematic aphasia screening SAPS: screening‐based therapy in combination with computerised home training
Authors: Krzok Franziska , Rieger Verena , Niemann Katharina , Nobis‐Bosch Ruth , Radermacher Irmgard , Huber Walter , Willmes Klaus , Abel Stefanie
Published: November 2017

Background

SAPS—‘Sprachsystematisches Aphasiescreening’—is a novel language‐systematic aphasia screening developed for the German language, which already had been positively evaluated. It offers a fast assessment of modality‐specific psycholinguistic components at different levels of complexity and the derivation of impairment‐based treatment foci from the individual performance profile. However, SAPS has not yet been evaluated in combination with the new SAPS‐based treatment.

Aims

To replicate the practicality of SAPS and to investigate the effectiveness of a SAPS‐based face‐to‐face therapy combined with computerised home training in a feasibility study. To examine the soundness of the treatment design, to determine treatment‐induced changes in patient performance as measured by SAPS, to assess parallel changes in communicative abilities, and to differentiate therapy effects achieved by face‐to‐face therapy versus add‐on effects achieved by later home training.

Methods & Procedures

Sixteen participants with post‐stroke aphasia (PWAs) were included into the study. They were administered the SAPS and communicative testing before and after the treatment regimen. Each PWA received one therapy session followed by home training per day, with the individual treatment foci being determined according to initial SAPS profile, and duration of treatment and possible change of focus dependent on performance assessed by continuous therapy monitoring.

Outcomes & Results

The combination of therapy and home training based on the SAPS was effective for all participants. We showed significant improvements for impairment‐based SAPS performance and, with high inter‐individual variability, in everyday communication. These two main targets of speech and language therapy were correlated and SAPS improvements after therapy were significantly higher than after home training.

Conclusions & Implications

SAPS offers the assessment of an individual performance profile in order to derive sufficiently diversified, well‐founded and specific treatment foci and to follow up changes in performance. The appending treatment regimen has shown to be effective for our participants. Thus, the study revealed feasibility of our approach.
Case report and literature review of Ewing's sarcoma in the gastrointestinal tract
Authors: Bong Christopher , Thomson Iain , Lampe Guy
Published: November 2017

We present a case of a young female patient with extraosseous Ewing's sarcoma (EES) arising in the lesser sac, as confirmed by membranous staining for CD99 and an ESWR1 gene translocation on fluorescence in situ hybridization. We also provide comprehensive review of the English literature of Ewing's sarcoma (ES) occurring in the gastrointestinal tract (GIT). A systematic review of the PubMed database was carried out with the following MeSH terms: Ewing's AND sarcoma AND (oesophagus, stomach, small bowel OR intestine, large bowel OR intestine, colon, sigmoid, rectum, pancreas, peritoneum, lesser sac, greater sac, liver and gallbladder). Fifty‐seven cases were collated from 46 articles. The most common overall symptom was pain (60.71 per cent), which occurred in patients as young as 2 years and as old as 72 years. The median age was 31 years, and the mean age was 29 years. No bimodal distribution was demonstrated. More females appeared to be affected than males. EES of the GIT is rare. It differs from ES with respect to patient age and sex. No standard therapy for EES has been widely adopted.
Evaluation of first‐line bismuth‐containing 7‐day concomitant quintuple therapy for Helicobacter pylori eradication
Authors: Ye Jian Fang , Hong Jun Bo , Zhu Yin , Xie Yong , Shu Xu , Luo Ling Yu , Xie Chuan , Zhu Zhen Hua , Lu Nong Hua
Published: November 2017

OBJECTIVE

Helicobacter pylori (H. pylori) infection is difficult to cure, mainly due to antibiotic resistance. This study aimed to determine the efficacy and safety of 7‐day bismuth‐containing concomitant quintuple regimen for H. pylori eradication.

METHODS

Conducted from August 2015 to February 2016 at the First Affiliated Hospital of Nanchang University, this prospective trial enrolled 70 untreated patients who were positive for H. pylori. The patients received 7‐day quintuple therapy consisting of bismuth subcitrate 220 mg, esomeprazole 20 mg, clarithromycin 500 mg, amoxicillin 1 g and metronidazole 400 mg, each was given twice daily. All patients underwent a 13C‐urea breath test at 4 weeks after treatment.

RESULTS

A total of 70 patients at a mean age of 43.5 years, including 36 men, were included in this trial. One person who violated the protocol was further excluded. The treatment compliance rate was 99.6%. The overall eradication rates of the 7‐day bismuth‐containing concomitant quintuple therapy were 75.4% (intention‐to‐treat analysis) and 86.7% (per‐protocol analysis). The prevalence of side effects was 31.9%, including a bitter taste (23.2%), nausea (4.3%), dizziness (2.9%), diarrhea (2.9%), limb asthenia (2.9%), skin rash (1.4%), numbness of the tip of the tongue (1.4%) and insomnia (1.4%).

CONCLUSIONS

The 7‐day bismuth‐containing concomitant quintuple therapy may not be superior to traditionally widely accepted therapy due to its lack of acceptable efficacy and high rate of side effects.
ednaoccupancy: An r package for multiscale occupancy modelling of environmental DNA data
Authors: Dorazio Robert M. , Erickson Richard A.
Published: November 2017

In this article, we describe ednaoccupancy, an r package for fitting Bayesian, multiscale occupancy models. These models are appropriate for occupancy surveys that include three nested levels of sampling: primary sample units within a study area, secondary sample units collected from each primary unit and replicates of each secondary sample unit. This design is commonly used in occupancy surveys of environmental DNA (eDNA). ednaoccupancy allows users to specify and fit multiscale occupancy models with or without covariates, to estimate posterior summaries of occurrence and detection probabilities, and to compare different models using Bayesian model‐selection criteria. We illustrate these features by analysing two published data sets: eDNA surveys of a fungal pathogen of amphibians and eDNA surveys of an endangered fish species.
Histological evolution from primary lung adenocarcinoma harboring EGFR mutation to high‐grade neuroendocrine carcinoma
Authors: Zhao Jikai , Shao Jinchen , Zhao Ruiying , Li Rong , Yu Keke , Zhu Lei , Zhang Jie
Published: November 2017

Background

Although patients with EGFR mutated lung adenocarcinoma benefit greatly from tyrosine kinase inhibitors (TKIs), they inevitably develop acquired resistance after an average of 10–14 months of continuous treatment.

Methods

We retrospectively analyzed the clinical and histopathological data of eight patients with primary lung adenocarcinoma harboring EGFR mutations that transformed into high‐grade neuroendocrine carcinoma after TKI therapy. Morphology scanning for neuroendocrine differentiation and immunohistochemistry for neuroendocrine markers CD56, chromogranin, and synaptophysin were performed on primary adenocarcinoma tissues and repeated biopsies. Mutations of EGFR exons 19–21 were reexamined using the amplification refractory mutation system.

Results

The carcinoma in seven patients transformed to small cell lung carcinoma; two of these patients enrolled in theAZD9291 study after acquiring a T790M missense mutation. The carcinoma in one patient transformed to large cell neuroendocrine carcinoma. None of the eight primary tumors exhibited neuroendocrine morphologic features and only one surgical specimen displayed a weak stain for neuroendocrine marker synaptophysin. Drug resistant high‐grade neuroendocrine carcinomas retained their initial activating EGFR mutations.

Conclusions

Lung adenocarcinoma in eight patients transformed into high‐grade neuroendocrine carcinoma and retained the original activating EGFR mutations after targeted therapy by TKIs. Furthermore, the prognosis of the transformed carcinoma was worse than the original primary genetic and morphologic type.
Modelling temperature‐dependent development rate and phenology in arthropods: The devRate package for r
Authors: Rebaudo François , Struelens Quentin , Dangles Olivier
Published: November 2017

Thermal biologists are interested in generating paired data on development rates and temperatures, but they are in need of automated tools to accurately analyse this data.

Fed with a database of more than 30 existing development models, the devRate package provides tools for plotting and visualizing data, selecting the most appropriate model, and mapping and forecasting ectotherm phenology using temperature time‐series data. Most proposed models are for arthropods, mainly insects (e.g. Lepidoptera, Coleoptera, Hemiptera, Diptera, Hymenoptera).

This paper presents the main functions of the package and provides an example using an empirical dataset.

The devRate package provides investigators with a unique set of tools and a database that allows them to fit development rate models, and to compare arthropod response to temperature.
Ketone body 3‐hydroxybutyrate mimics calorie restriction via the Nrf2 activator, fumarate, in the retina
Authors: Izuta Yusuke , Imada Toshihiro , Hisamura Ryuji , Oonishi Erina , Nakamura Shigeru , Inagaki Emi , Ito Masataka , Soga Tomoyoshi , Tsubota Kazuo
Published: November 2017

Calorie restriction (CR) being the most robust dietary intervention provides various health benefits. D‐3‐hydroxybutyrate (3HB), a major physiological ketone, has been proposed as an important endogenous molecule for CR. To investigate the role of 3HB in CR, we investigated potential shared mechanisms underlying increased retinal 3HB induced by CR and exogenously applied 3HB without CR to protect against ischemic retinal degeneration. The repeated elevation of retinal 3HB, with or without CR, suppressed retinal degeneration. Metabolomic analysis showed that the antioxidant pentose phosphate pathway and its limiting enzyme, glucose‐6‐phosphate dehydrogenase (G6PD), were concomitantly preserved. Importantly, the upregulation of nuclear factor erythroid 2 p45‐related factor 2 (Nrf2), a regulator of G6PD, and elevation of the tricarboxylic acid cycle's Nrf2 activator, fumarate, were also shared. Together, our findings suggest that CR provides retinal antioxidative defense by 3HB through the antioxidant Nrf2 pathway via modification of a tricarboxylic acid cycle intermediate during 3HB metabolism.
Determination of MoCA Cutoff Score in Patients with Alcohol Use Disorders
Authors: Ewert Valérie , Pelletier Stéphanie , Alarcon Régis , Nalpas Bertrand , Donnadieu‐Rigole Hélène , Trouillet Raphaël , Perney Pascal
Published: November 2017

Background

The Montreal Cognitive Assessment (MoCA) score is a convenient and promising tool for estimating alcoholic patients’ global cognitive functioning, a major challenge for all specialized alcohol treatment centers. However, whether or not the score should be corrected for education level and whether the proposed cutoff is relevant in patients with alcohol use disorders (AUD) should be determined.

Methods

We compared the MoCA scores in patients hospitalized for AUD with and without cognitive impairment assessed by a battery of neuropsychological (NP) tests. Sensitivity, specificity, and cutoff of the MoCA score were analyzed using receiver operating characteristic curve analysis.

Results

Thirty‐one patients with and 25 without cognitive impairment were included in the study. There were 40 men and 16 women, with a mean age of 49.5 years. The mean uncorrected MoCA score was 23.1 ± 3.3 in those with and 27.0 ± 1.9 in those without cognitive impairment. NP tests were significantly correlated with the MoCA score. Uncorrected MoCA scores identified more than 80% of the patients with a cutoff score equal to 26, to obtain similar accuracy with the corrected score required using a cutoff score equal to 27.

Conclusions

Our results confirm that the MoCA test is a convenient and reliable screening tool to measure cognition defects in alcoholic patients. As using the 1‐point education adjustment increases the cutoff score by 1 point, it is suggested to use the noncorrected score and the usual cutoff, that is, 26. Being easy to administer and only moderately time‐consuming, the MoCA score should be used extensively in addiction treatment centers.