bluuebunny/crossref_metadata_2025 huggingface dataset:
Fabrication of hydrodynamic torque converter impellers by using the selective laser sintering method
Authors: Kotlinski Jaroslaw , Migus Marcin , Kesy Zbigniew , Kesy Andrzej , Hugo Philip , Deez Brent , Schre Kristian , Dimitrov Dimitri
Published: October 2013

Purpose

– The main aim of the paper is the application of the selective laser sintering (SLS) method for fabrication of hydrodynamic torque converter (HTC) impellers.

Design/methodology/approach

– Establishing of assumptions for the impeller design process based on the HTC characteristics analysis, creation of the virtual solid model of HTC impellers, fabrication of HTC impellers by using the SLS method, investigation of the performance of HTC with fabricated impellers by using a test rig.

Findings

– The test results show that the SLS method can be successfully used for the fabrication of HTC impellers with 3D and flat blades.

Research limitations/implications

– The method application is limited to small diameters of HTC impellers depending on working area dimensions of SLS machine.

Practical implications

– The method can decrease the time and cost of fabrication of HTC impellers by using the SLS method.

Originality/value

– The application of the SLS method for fabrication of HTC impellers with 3D and flat blades.
Influence of oxidation on the cracks of DZ125L nickel-based superalloy thin-walled parts in laser metal direct forming
Authors: He Bin , Li Dichen , Zhang Anfeng , Lu Zhongliang , Ge Jiangbo , Tat Khoa Doan
Published: October 2013

Purpose

– The purpose of this paper is to investigate the influence of the oxidation on the cracks of DZ125L nickel-based superalloy thin-walled parts in laser metal direct forming (LMDF).

Design/methodology/approach

– Thin-walled cylinders were fabricated in protective atmosphere with different oxygen contents in order to reveal the influence of oxidation on the morphology of cracks. The influence of oxidation on the cracks was investigated in detail by measuring the wall thicknesses of cylinders, the residual stress in the top surface of the cylinders and the composition of the cracks. Finally, the validity of the results was verified by fabricating a thin-walled turbine blade in protective atmosphere.

Findings

– The experimental results showed that wall thickness fluctuation of cylinders, unequal residual stress distribution of cylinders and the oxides in the crack were all the critical factors which led to crack of DZ125L thin-walled parts. Thin-walled turbine blades with no cracks can be fabricated when the oxygen content was about less than 150 ppm in protective atmosphere.

Research limitations/implications

– The appropriate oxygen content in protective atmosphere is helpful for fabricating thin-walled parts of nickel-based superalloy like DZ125L, and the results can show what will happen at different oxygen levels. Moreover, the results show that the cracks can be eliminated as the oxygen content reduce to less than 150 ppm rather less than 10 ppm or even less, which can reduce the cost of protective gas as forming thin-walled parts of nickel-based superalloy such as DZ125L.

Practical implications

– The appropriate oxygen content in protective atmosphere is helpful for fabricating thin-walled parts of nickel-based superalloy like DZ125L. However, when heavy solid parts of some other material other than DZ125L were fabricated, the oxygen content of less than 150 ppm may be not suitable.

Originality/value

– The influence of oxidation on the cracks of DZ125L thin-walled parts in LMDF was investigated in detail, and a DZ125L thin-walled turbine blade with no cracks was fabricated by adjusting the oxygen content in protective atmosphere.
Social enterprise in the development agenda. Opening a new road map or just a new vehicle to travel the same route?
Authors: Carlos Perez de Mendiguren Castresana Juan
Published: October 2013

Purpose

– The paper aims to analyse the narrative that promotes “social enterprise” and “social entrepreneurship” as innovative ways of obtaining economic growth, social development and environmental sustainability for all people on the planet. It assesses their influence on current debates on the development agenda and explores some critical issues that can contribute to re-politicizing the agenda beyond the Millennium Development Goals (MGD).

Design/methodology/approach

– Using a conceptual approach, the article identifies the discourses on which the central elements of the dominant discourse on “inclusive business” in development rest, and the empirical evidence on the results obtained from this focus. It subsequently employs different critical theoretical approaches to reformulate some of the debates and objectives that would make it possible to re-orientate the agenda from a perspective of social justice and sustainability.

Findings

– As it is posed, the idea of “inclusive business” for development does enable advance in a direction that would revise the premises on development, include the normative dimension in debates, and present a new evaluative space for economic activity from the perspective of equity, social justice and human development. Making the best use of this opportunity involves deepening the proposals of the solidarity economy in continuous dialogue with other emancipatory experiences and currents of critical thought.

Originality/value

– The paper questions some central elements of the orthodox conception of inclusive business and introduces analytical perspectives that are not commonly found in the literature on the topic.
Continuous reconfiguration in the transient advantage economy
Authors: Gunther McGrath Rita
Published: October 2013

Purpose

– The author identified a set of companies that have figured out how to cope, even to thrive, within the new transient advantage economy and explains how they did it.

Design/methodology/approach

– Her research team analyzed nearly 5,000 companies. Of that whole population, only ten companies were able to grow their net income by at least 5 percent a year for ten years in a row. These ten “outliers” have out-performed competitors while adapting to rapidly changing market forces.

Findings

– Organizations that have mastered transient-advantage environments have learned to continually free up resources from old advantages in order to fund the development of new ones. Additionally, innovation is continuous, mainstream and part of everyone's job.

Research limitations/implications

– The 5,000 companies analyzed included every publicly traded firm on any stock exchange with a market capitalization of over $1 billion. The article studies the practices of the ten most successful over ten years.

Practical implications

– The most successful firms, over the entire study period, had no dramatic downsizings, restructurings or sell-offs.

Originality/value

– The author found that the key leadership and management challenge is maintaining an organizational system that can manage the complementary forces of innovation and stability.
Trade‐off between light interception efficiency and light use efficiency: implications for species coexistence in one‐sided light competition
Authors: Onoda Yusuke , Saluñga Jema B. , Akutsu Kosuke , Aiba Shin‐ichiro , Yahara Tetsukazu , Anten Niels P. R.
Published: October 2013

Taller plant species can pre‐empt solar energy and suppress growth of subordinate species in vegetation stands, which is described through one‐sided competition. Yet, in much of the world's vegetation species of different statures coexist. This study aims to clarify the mechanisms underlying this apparent paradox.

We quantified how co‐occurring species and individuals intercepted and used light for growth in a mature, warm‐temperate evergreen forest. This was performed by determining the 3D distribution of foliage and light with a ground‐based lidar system in combination with nondestructive measurements of plant growth.

Taller trees intercepted light more efficiently per unit of above‐ground biomass than shorter trees did (=higher light interception efficiency, LIE). However, taller trees tended to have lower biomass production per unit light interception (=lower light use efficiency, LUE). Reduced LUE in taller trees was associated with their higher biomass allocation to nonphotosynthetic organs and probably with over‐saturated light intensity for photosynthesis at high canopy positions. Due to the increased LIE and decreased LUE with tree heights, a trade‐off between LIE and LUE was found, and this trade‐off resulted in trees of different statures having similar relative growth rates.

Synthesis. Light competition drives trees to grow taller, and the light interception efficiency is higher in taller trees; however, this benefit comes at a cost of decreased efficiency of light use for growth. This trade‐off allows trees of different statures to grow at proportionally comparable rates and may promote coexistence of tree species in one‐sided light competition.
The Unsolved Puzzle: Pacific Asia's Voting Cohesion in the United Nations General Assembly—A Response to Peter Ferdinand
Authors: Burmester Nicolas , Jankowski Michael
Published: October 2013

Research Highlights and Abstract

This article

Offers a refined research design for analysing voting cohesion in the United Nations General Assembly; Demonstrates that ASEAN's integration process is unlikely to explain the observed high level of voting cohesion in Pacific Asia; Specifies the ASEAN-China and ASEAN-Japan alignment; Shows that the alignment of South Korea is closer with the USA than with North Korea in contested votes in the United Nations General Assembly.

In this paper, we propose a refined research agenda for analysing voting cohesion in the United Nations General Assembly. Although we respond specifically to Ferdinand, our four points of critique and suggestions concerning the research design are applicable to a larger corpus of literature. First, we include a longer period of observation to interpret the effects of regional integration. Second, we demonstrate the necessity to control for the year of accession of member states. Third, we propose to look at time series rather than arithmetical means to compare changes in voting cohesion. Finally, we exclude nearly unanimous votes from our analysis to enhance the explanatory values of our cases. This refined design has important effects on the analysis of Pacific Asia's voting cohesion in the UNGA. We conclude from our findings that regional integration is unlikely to explain the high level of voting cohesion within ASEAN and the region.
Response to a Response
Authors: Ferdinand Peter
Published: October 2013

Research Highlights

This article

Restates the differences in focus between the original article and the Response, which justifies the choice of 1974 as the starting date for analysis. Accepts the more nuanced analysis of the voting convergence of the ASEAN states. Restates the considerations leading to the decision to include all the UNGA resolutions in the period chosen as the basis of the analysis, rather than a filtered selection. Argues that these two articles provide hypotheses for further qualitative as well as quantitative analysis of the factors determining the voting behaviour of Pacific Asian states.
Is Selection Bias Inherent in Housing Transactions? An Equilibrium Approach
Authors: Chernobai Anna , Chernobai Ekaterina
Published: October 2013

We develop an equilibrium model for residential housing transactions in an economy with houses that differ in their quality and households that differ in their planned holding horizon. We show that, in equilibrium, a clientele effect persists, with long‐horizon buyers overwhelmingly choosing higher quality properties and short‐horizon buyers settling for lower quality properties. This clientele effect creates a sample selection bias: the properties that are on the market are predominantly of lower quality. Since these are the preferred choice of short‐horizon buyers, they demonstrate a faster turnover. Both the clientele effect and the selection bias are more pronounced with an increase in the variance of house quality and in the variance of the planned holding horizon. Our theoretical model supports empirical evidence on the existence of such bias in home price indices and explains it by the differences in ex ante holding horizons.
Foreclosure's Wake: The Credit Experiences of Individuals Following Foreclosure
Authors: Brevoort Kenneth P. , Cooper Cheryl R.
Published: October 2013

While a substantial literature has examined the causes of mortgage foreclosure, there has been relatively little work on the consequences of foreclosure for the borrowers themselves. Using a large sample of anonymous credit bureau records, observed quarterly from 1999 through 2010, we examine the credit experiences of 330,000 borrowers before and after a foreclosure start. Our analysis documents the substantial declines in credit scores that accompany a foreclosure start and examines the length of time it takes individuals to return their credit scores to predelinquency levels. The results suggest that, particularly for prime borrowers, credit score recovery comes slowly, if at all. The lack of recovery appears to be driven by persistently higher delinquency rates on consumer credit (such as auto and credit card loans) in the years that follow their foreclosure start. Our results also indicate that the experiences of individuals whose mortgages entered foreclosure from 2007 to 2009 have followed a similar path to borrowers foreclosed earlier in the decade, though their postforeclosure‐start delinquency rates have been higher and, consequently, credit score recovery appears to be taking longer.
Markov Switching Dynamics in REIT Returns: Univariate and Multivariate Evidence on Forecasting Performance
Authors: Case Brad , Guidolin Massimo , Yildirim Yildiray
Published: October 2013

We document the presence of Markov switching regimes in expected returns, variances and the implied reward‐to‐risk ratio of real estate investment trust (REIT) returns and compare them to properties of stocks and bonds. Our evidence suggests that regime switching techniques are more successful over the period 1972–2008 than other time‐series models are. When the analysis is extended to a multivariate setting in which REIT, stock and bond returns are modeled jointly, we find that the data call for the specification of four separate regimes. These result from the absence of synchronicity among the regimes that characterize univariate REIT, stock and bond returns.
Are Adjustable‐Rate Mortgage Borrowers Borrowing Constrained?
Authors: Johnson Kathleen W. , Li Geng
Published: October 2013

Past research argues that changes in adjustable‐rate mortgage (ARM) payments may lead households to cut back on consumption. These outcomes are more likely if ARM borrowers are borrowing constrained, and we show in this article that ARM borrowers exhibit attitudes toward borrowing and behavior that are consistent with being borrowing constrained. Although the demographic and financial characteristics of ARM and fixed‐rate mortgage (FRM) borrowers are somewhat similar, ARM borrowers differ from FRM borrowers in their uses of credit and attitudes toward it. In addition, we find the consumption growth of households with an ARM is more sensitive to past income than the consumption growth of other households, suggesting the ARM borrowers may be subject to borrowing constraints that hinder their ability to smooth consumption.
Surgical management of renal cell carcinoma with inferior vena cava thrombus
Authors: Lok Hon‐Ting , Chan Eddie S.Y. , Hou Simon S.M. , Yip Sidney K.H. , Ng Chi‐Fai
Published: October 2013

Aim

The aim of the present study was to evaluate the short‐term outcome of renal cell carcinoma with inferior vena cava (IVC) thrombus treated by radical nephrectomy and IVC thrombectomy.

Patients and Methods

Ten consecutive patients who underwent surgery for renal cell carcinoma with IVC thrombus between August 2008 and November 2011 were studied retrospectively in terms of clinical presentation, intraoperative details, surgical approaches, pathology and outcomes.

Results

Ten patients were treated surgically for renal cell carcinoma. They all had renal vein and IVC involvement (Neves–Zincke classification: level I: n = 1, level II: n = 3, level III: n = 3, level IV: n = 3). The majority presented with gross haematuria (80 per cent) and various degrees of anaemia (70 per cent). Mean operation time was 404 min. Intraoperative blood loss ranged from 400 mL to 13500 mL. One postoperative death was recorded, and intraoperative and postoperative morbidities (tumour thrombus pulmonary embolism, IVC thrombosis, retroperitoneal fluid collection) complicated recovery in four patients. Evidence of disease progression was observed in seven patients (70 per cent) upon follow up.

Conclusion

Renal cell carcinoma with IVC extension is a challenging disease entity. Despite the technical demand and high morbidity, radical nephrectomy plus IVC thrombectomy can be performed with reasonable outcomes in a local centre with multidisciplinary support.
Changes in free amino acids and polyamine levels in Satsuma leaves in response to Asian citrus psyllid infestation and water stress
Authors: Malik Nasir S. A. , Perez Jose L. , Kunta Madhurababu , Patt Joseph M. , Mangan Robert L.
Published: October 2013

The effects of biotic and abiotic stresses on changes in amino acids and polyamine levels in Satsuma orange (Citrus unshiu; cultivar Owari) leaves were investigated. Asian citrus psyllids Diaphorina citri (Kuwayama) (ACP) infestation was used to induce biotic stress while a water deficit was imposed to induce abiotic stress. Potted trees were infested by placing 50 psyllids on 3 citrus leaves enclosed in nylon mesh bags for 5 d. A parallel set of plants were kept water stressed by maintaining the soil at 20% water holding capacity for 5 d. Levels of total free amino acids were higher in water stressed and ACP infested leaves. Polyamine putrescine increased in infested leaves but not in water stressed leaves. Proline was the most abundant amino acid and its levels significantly increased by both biotic and abiotic stresses. Proline levels in infested leaves were significantly higher than the water stressed leaves. Histidine, methionine, asparagine, arginine, serine, and leucine levels also increased significantly in infested leaves, but in water stressed leaves only leucine, methionine, and threonine increased. Levels of amino acids, such as tyrosine, isoleucine, phenylalanine, glutamic acid, and alanine, declined in infested leaves. Under water stress asparagine, phenylalanine, serine, and histidine also declined compared to controls. This indicates that while proteolysis occurred under both stresses, metabolic conversion of amino acids was different under the two stresses. In ACP infested leaves some amino acids may be used as feeding material and/or converted into secondary metabolites for defense.
Pilot Projects for Improving Product Tracing along the Food Supply System
Authors: Bhatt Tejas , Hickey Caitlin , McEntire Jennifer C.
Published: October 2013

In September 2011, the U.S. Food and Drug Administration (FDA) asked the Institute of Food Technologists (IFT) to execute product tracing pilot projects as described in Section 204 of the FDA Food Safety Modernization Act (FSMA). IFT collaborated with representatives from more than 100 organizations—including the U.S. Dept. of Agriculture, state departments of agriculture and public health, industry, and consumer groups, as well as not‐for‐profit organizations—to implement the pilots. The objectives of the pilot projects were 1) to identify and gather information on methods to improve product tracing of foods in the supply chain and 2) to explore and evaluate methods to rapidly and effectively identify the recipient of food to prevent or mitigate a foodborne illness outbreak and to address credible threats of serious adverse health consequences or death to humans or animals as a result of such food being adulterated or misbranded. IFT conducted evaluations to determine the impact of currently available technologies, types of data and formats, and the data acquisition process, as well as the use of technology on the ability to follow product movement through the supply chain. Results from the pilots found inconsistencies in the terminology, numbering systems, formatting, legibility, and occasionally the language that sometimes required IFT to contact the submitting firm to gain clarity, thus increasing the time required to capture data before any meaningful analysis could begin. However, the pilot participants appeared to have many of the tools and processes in place which are required to allow the capture and communication of critical track and trace information (such as, key data elements) at critical points of product transfer and transformation (such as, critical tracking events). IFT determined that costs associated with implementing a product tracing system can vary widely as determined by numerous factors: the size of the firm/facility, the method of product tracing already in use (manual or electronic), and the range of each firm's capabilities to implement or improve its product tracing system, to name a few. IFT found that there are several areas (such as uniformity and standardization, improved recordkeeping, enhanced planning and preparedness, better coordination and communication, and the use of technology) in which industry improvements and enhancements to FDA's processes would enable tracebacks and traceforwards to occur more rapidly. IFT developed 10 recommendations for FDA to consider for improving the state of system‐wide food product tracing. The recommendations outlined in the report will enable FDA to conduct more rapid and effective investigations during foodborne illness outbreaks and other product tracing investigations, thus significantly enhancing protection of public health.
Liver transplantation for hepatocellular carcinoma: Recent advances in China
Authors: Lu Tian Fei , Hua Xiang Wei , Cui Xiao Lan , Xia Qiang
Published: October 2013

Orthotopic liver transplantation is currently the best treatment option for selected patients with hepatocellular carcinoma (HCC). From 1980 to 2011, 8874 patients with HCC in China underwent liver transplantation. The organ donation classification criteria of China (China criteria), which are established by the Government of China, are divided into three parts: China criteria I, donation after brain death; China criteria II, donation after cardiac death and China criteria III, donation after dual brain‐cardiac death. Data from the China Liver Transplant Registry (CLTR) System shows that patients within the Milan criteria have higher survival rates than those who are beyond these criteria. Based on CLTR data, altogether 416 patients received living‐donor liver transplantation (LDLT) in China. Their 1‐year and 3‐year survival rates were significantly higher than those of the non‐LDLT recipients. The most common early stage (<30 days after liver transplantation) complications include pleural effusion, diabetes, peritoneal effusion or abscess, postoperative infection, hypertension and intraperitoneal hemorrhage; while the most common late stage (≥30 days after liver transplantation) complications were diabetes, hypertension, biliary complications, postoperative infection, tacrolimus toxicity and chronic graft rejection. The incidence of vascular complication, which is the main reason for acute graft failure and re‐transplantation, was 2.4%. Liver transplantation is an effective treatment for patients with HCC in China.
Tusanqi and hepatic sinusoidal obstruction syndrome
Authors: Wang Ji Yao , Gao Hong
Published: October 2013

Hepatic sinusoidal obstruction syndrome (HSOS), characterized by hepatomegaly, ascites and hyperbilirubinemia, is caused by toxic injury to hepatic sinusoidal endothelial cells. One major etiology of HSOS in China is the intake of products containing pyrrolizidine alkaloids (PA) such as Tusanqi. The manifestations of patients with HSOS are usually non‐specific, presenting with abnormal liver function and portal hypertension. Diagnosis of the disease depends mostly on liver histopathology when clinical and imaging data are not sufficient. A history of Tusanqi intake is mostly important for the diagnosis. Due to a lack of effective, evidence‐based treatments for HSOS, avoiding the mistaken use of PA‐containing products including Tusanqi is important for the prevention of HSOS.
Expression of HPV‐related biomarkers and grade of cervical intraepithelial lesion at treatment
Authors: Valasoulis George , Stasinou Sofia‐Melina , Nasioutziki Maria , Athanasiou Antonis , Zografou Maria , Spathis Aris , Loufopoulos Aristotelis , Karakitsos Petros , Paraskevaidis Evangelos , Kyrgiou Maria
Published: October 2013

Objectives

New human papillomavirus (HPV)‐related biomarkers may allow better identification of clinically significant lesions that warrant excision and, conversely, identification of the false positive cases that have been overreported by traditional techniques. The aim of this study was to investigate how the expression of several HPV‐related biomarkers correlates to the severity of the lesion at treatment.

Design

Prospective observational study.

Setting

University Hospital (2009–2011).

Population

All women submitted for excisional treatment.

Methods

A liquid‐based cytology sample was obtained before treatment and was tested for HPV typing, mRNA E6 & E7 with NASBA or flow cytometry and p16. All women had histological diagnosis in the form of excisional cone (gold standard).

Main outcome measures

Correlation of HPV biomarker positivity rates to the grade of the lesion at treatment histology.

Results

Two hundred women were recruited: 23 were found to have negative histology (11.5%), 79 (39.5%) CIN1, 50 (25.0%) CIN2 and 48 (24.0%) CIN3. All biomarkers (HPV DNA typing, HR HPV, single HPV 16/18, mRNA E6 & E7 expression and p16) revealed an increased linear positivity rate with increasing severity and grade of the lesion (chi‐squared test for trend p < 0.05). This was stronger for HPV (all and high‐risk) followed by mRNA with NASBA, flow cytometry, HPV 16/18 and ultimately p16 immunostaining.

Conclusions

The linear correlation between various HPV‐related biomarkers and the grade of the lesion suggests that these biomarkers may prove to be useful in the prediction of CIN grade and, as a result, the need for treatment.
Effects of the menstrual cycle on bipolar disorder
Authors: Teatero Missy L , Mazmanian Dwight , Sharma Verinder
Published: October 2013

Objectives

Several lines of research suggest that reproductive events may affect the course of bipolar disorder (BD) in some women. With respect to the menstrual cycle, the focus has been on dysphoric symptoms [e.g., premenstrual dysphoric disorder (PMDD)], and the exacerbation of depression, in the premenstrual phase. This article reviews the literature on the potential effects of the menstrual cycle on BD.

Methods

A systematic search for published case reports and research studies available through March, 2013 was conducted. Several combinations of search terms were entered into PubMed and PsycInfo.

Results

Overall, 25 case reports, ten retrospective studies, and 11 prospective studies were identified. The majority (64%) of case reports involved hypomanic or manic episodes in the premenstrual phase. Retrospective results suggest that 25–77% and 15–27% of women with BD meet the criteria for premenstrual syndrome (PMS) and PMDD, respectively. Menstrual cycle‐related mood changes were reported by 64–68% of women with BD in retrospective studies, and were displayed by 44–65% of women in prospective studies.

Conclusions

Although research has focused on the premenstrual phase to the neglect of the periovulatory phase, it appears that a subgroup of women with BD, possibly those with hormonal sensitivity, experience menstrual cycle effects on depressive, hypomanic, and manic episodes. These phase‐episode effects appear to be heterogeneous and may have implications for treatment. Whether they might best be described using course specifiers, similar to postpartum onset and rapid cycling, or as diagnostic entities, like PMDD, requires further study.
Does body mass index impact the outcomes of tubeless percutaneous nephrolithotomy?
Authors: Kuntz Nicholas J. , Neisius Andreas , Astroza Gastón M. , Tsivian Matvey , Iqbal Muhammad W. , Youssef Ramy , Ferrandino Michael N. , Preminger Glenn M. , Lipkin Michael E.
Published: October 2013

Objective

To evaluate whether body mass index (BMI) has an impact on the outcomes of tubeless percutaneous nephrolithotomy (PCNL).

Patients and Methods

We retrospectively reviewed patients who underwent tubeless PCNL at our institution from 2006 to 2011.

Specifically, stone‐free rates, complications, and hospital length of stay (LOS) were assessed.

Patients were divided into four groups based on BMI: <25, 25–29.9, 30–34.9 and ≥35 kg/m2.

Baseline characteristics and outcomes were compared between BMI groups. Multivariable logistic regressions were used to evaluate the independent contribution of BMI as a predictor of outcomes.

Results

We identified 268 patients who fulfilled study requirements. The overall stone‐free and complication rates were 52.5% and 19.0%, respectively.

Minor and severe complication comprised 10.4% and 8.6%, respectively.

Univariate and multivariable analyses showed no association between BMI and stone‐free or complication rates.

However, patients with a normal BMI had significantly higher transfusion rates (P = 0.005), and were significantly more likely to have a prolonged LOS (≥2 days), when compared with an overweight BMI (P = 0.032)

Conclusions

BMI did not impact the stone‐free, or complication rates of tubeless PCNL.

Normal BMI was found to be a risk factor for prolonged LOS, which may be due to an increase in clinically significant bleeding in this patient population. Tubeless PCNL appears to be a safe and effective procedure for the treatment of complex renal calculi, independent of BMI.
Multicentre prospective crossover study of the ‘prostatic urethral lift’ for the treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia
Authors: Cantwell Anthony L. , Bogache William K. , Richardson Steven F. , Tutrone Ronald F. , Barkin Jack , Fagelson James E. , Chin Peter T. , Woo Henry H.
Published: October 2013

Objective

To assess the clinical effect of the ‘prostatic urethral lift’ (PUL) on lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH) through a crossover design study.

Patients and Methods

Men aged ≥50 years with an International Prostate Symptom Score of ≥13, a maximum urinary flow rate (Qmax) of ≤12 mL/s, and a prostate of 30–80 mL were enrolled into a crossover study after completing a prospective, randomised, controlled, ‘blinded’ pivotal study in which they were control subjects receiving a sham procedure.

Patients were followed for 1 year after crossover PUL at 19 centres in the USA, Canada and Australia. The sham procedure involved rigid cystoscopy with simulated active treatment sounds.

PUL involved placing permanent UroLift® (NeoTract, Inc., Pleasanton, CA, USA) implants into the lateral lobes of the prostate to enlarge the urethral lumen.

Urinary symptom relief, health‐related quality of life (HRQL) impact, urinary flow parameters, sexual function, and adverse events were assessed and compared between the sham and PUL using paired statistical analysis.

Results

Symptom, flow, HRQL and sexual function assessments showed response improvements from baseline results, similar to results from other published studies, and most parameters were markedly improved after PUL vs the sham procedure in the same patients.

Symptom, flow, and HRQL improvements were durable over the 12 months of the study.

Adverse events associated with the procedure were typically transient and mild to moderate; one patient (2%) required re‐intervention with transurethral resection of the prostate in the first year.

There were no occurrences of de novo, sustained ejaculatory or erectile dysfunction.

Conclusion

The PUL can be performed under local anaesthesia, causes minimal associated perioperative complications, allows patients to quickly return to normal activity, provides rapid and durable improvement in symptoms, and preserves sexual function.
Evaluation of urinary prostate cancer antigen‐3 (PCA3) and TMPRSS2‐ERG score changes when starting androgen‐deprivation therapy with triptorelin 6‐month formulation in patients with locally advanced and metastatic prostate cancer
Authors: Martínez‐Piñeiro Luis , Schalken Jack A. , Cabri Patrick , Maisonobe Pascal , de la Taille Alexandre ,   Triptocare Study Group
Published: October 2013

Objective

To assess prostate cancer antigen‐3 (PCA3) and TMPRSS2‐ERG scores in patients with advanced and metastatic prostate cancer at baseline and after 6 months of treatment with triptorelin 22.5 mg, and analyse these scores in patient‐groups defined by different disease characteristics.

Patients and Methods

The Triptocare study was a prospective, open‐label, multicentre, single‐arm, Phase III study of triptorelin 22.5 mg in men with locally advanced or metastatic prostate cancer, who were naïve to androgen‐deprivation therapy (ADT).

The primary objective was to model the urinary PCA3 change at 6 months, according to baseline variables.

Other outcome measures included urinary PCA3 and TMPRSS2‐ERG scores and statuses, and serum testosterone and prostate‐specific antigen (PSA) levels at baseline and at 1, 3 and 6 months after initiation of ADT.

Safety was assessed by recording adverse events and changes in laboratory parameters.

Results

The intent‐to‐treat population comprised 322 patients; 39 (12.1%) had non‐assessable PCA3 scores at baseline, and 109/322 (33.9%), 215/313 (68.7%) and 232/298 (77.9%) had non‐assessable PCA3 scores at 1, 3 and 6 months, respectively.

Baseline Gleason score was the only variable associated with non‐assessability of PCA3 score at 6 months (P = 0.017) – the hazard of having a non‐assessable PCA3 score at 6 months was 1.824‐fold higher (95% confidence interval 1.186–2.805) in patients with a Gleason score ≥8 vs those with a Gleason score ≤6.

The median PCA3 scores at baseline were significantly higher in patients aged ≥65 years vs those aged <65 years and in patients with a serum PSA level <100 ng/mL vs those with serum PSA level of >200 ng/mL. The median PCA3 score was significantly lower in patients with metastasis than in patients with no metastasis or unknown metastasis status.

TMPRSS2‐ERG scores ≥35 were considered positive (n = 149 [51.6%]). Age, presence of metastasis, PSA level and Gleason score at baseline were not associated with a significant difference in the proportion of TMPRSS2‐ERG‐positive scores.

The median serum PSA levels decreased from 45.5 ng/mL at baseline to 1.2 ng/mL after 6 months, and as expected, >90% of patients achieved castrate levels of testosterone (<50 ng/dL) at 1, 3, and 6 months during triptorelin treatment. The safety profile reported from this study is consistent with the known safety profile of triptorelin.

Conclusion

These data from the Triptocare study suggest that urinary PCA3 or TMPRSS2‐ERG score are not reliable markers of cancer stage in advanced prostate cancer.

Urinary PCA3 and TMPRSS2‐ERG scores do not appear to be useful in assessing response to ADT in advanced prostate cancer, with most patients having non‐assessable scores after 6 months of treatment.
Bladder cancer incidence and mortality in patients treated with radiation for uterine cancer
Authors: Baack Kukreja Janet E. , Scosyrev Emil , Brasacchio Ralph A. , Toy Eugene P. , Messing Edward M. , Wu Guan
Published: October 2013

Objective

To estimate the effect of radiation therapy (RT) administered for uterine cancer (UtC) on bladder cancer (BC) incidence, tumour characteristics at presentation, and mortality.

Patients and Methods

In this retrospective cohort study, records of 56 681 patients diagnosed with UtC as their first primary malignancy during 1980–2005 were obtained from the Surveillance, Epidemiology and End‐Results (SEER) database. Follow‐up for incident BC ended on 31 December 2008.

Occurrences of BC diagnoses and BC deaths in patients with UtC managed with or without RT were summarised with counts and person‐time incidence rates (counts divided by person‐years of observation). Age adjustment of rates was performed by direct standardisation.

Incident BC cases were described in terms of histological types, grades and stages.

Results

With a mean follow‐up of 15 years, BC was diagnosed in 146 (0.93%) of 15 726 patients with UtC managed with RT, and in 197 (0.48%) of 40 955 patients with UtC managed without RT, with an age‐adjusted rate ratio of 2.0 (95% confidence interval [CI] 1.6–2.5).

Fatal BC occurred in 39 (0.25%) and 36 (0.09%) of patients with UtC managed with vs without RT, respectively, with an age‐adjusted rate ratio of 2.9 (95% CI 1.8–4.6).

Incident BC cases diagnosed in patients with UtC managed with vs without RT had similar distributions of histological types, grades, and stages.

Conclusions

Use of RT for UtC is associated with increased BC incidence and mortality later in life.

Heightened awareness should help identify women with new voiding symptoms or haematuria, all of which should be fully evaluated.
Hemi salvage high‐intensity focused ultrasound (HIFU) in unilateral radiorecurrent prostate cancer: a prospective two‐centre study
Authors: Baco Eduard , Gelet Albert , Crouzet Sébastien , Rud Erik , Rouvière Olivier , Tonoli‐Catez Hélène , Berge Viktor , Chapelon Jean‐Yves , Eggesbø Heidi B.
Published: October 2013

Objective

To report the oncological and functional outcomes of hemi salvage high‐intensity focused ultrasound (HSH) in patients with unilateral radiorecurrent prostate cancer.

Patients and Methods

Between 2009 and 2012, 48 patients were prospectively enrolled in two European centres. Inclusion criteria were biochemical recurrence (BCR) after primary radiotherapy (RT), positive magnetic resonance imaging and ≥1 positive biopsy in only one lobe.

BCR was defined using Phoenix criteria (a rise by ≥2 ng/mL above the nadir prostate specific antigen [PSA] level).

The following schemes and criteria for functional outcomes were used: Ingelman‐Sundberg score using International Continence Society (ICS) questionnaire (A and B), International prostate symptom score (IPSS), International Index of Erectile Function‐5 (IIEF‐5) points, the European Organisation for the Research and Treatment of Cancer (EORTC) quality of life questionnaires (QLQ C‐30).

HSH was performed under spinal or general anaesthesia using the Ablatherm® Integrated Imaging device. Patients with obstructive voiding symptoms at the time of treatment underwent an endoscopic bladder neck resection or incision during the same anaesthesia to prevent the risk of postoperative obstruction.

Results

After HSH the mean (sd) PSA nadir was 0.69 (0.83) ng/mL at a median (interquartile range) follow‐up of 16.3 (10.5–24.5) months.

Disease progression occurred in 16/48 (33%). Of these, four had local recurrence in the untreated lobe and four bilaterally, six developed metastases, and two had rising PSA levels without local recurrence or radiological confirmed metastasis. Progression‐free survival rates at 12, 18, and 24 months were 83%, 64%, and 52%.

Severe incontinence occurred in four of the 48 patients (8%), eight (17%) required one pad a day, and 36/48 (75%) were pad‐free. The ICS questionnaire showed a mean (sd) deterioration from 0.7 (2.0) to 2.3 (4.5) for scores A and 0.6 (1.4) to 1.6 (3.0) for B.

The mean (sd) IPSS and erectile function (IIEF‐5) scores decreased from a mean (sd) of 7.01 (5.6) to 8.6 (5.1) and from 11.2 (8.6) to 7.0 (5.8), respectively.

The mean (sd) EORTC QLC‐30 scores before and after HSH were 35.7 (8.6) vs 36.8 (8.6).

Conclusion

HSH is a feasible therapeutic option in patients with unilateral radiorecurrent prostate cancer, which offers limited urinary and rectal morbidity, and preserves health‐related quality of life.
Glucocorticoids suppress hypoxia‐induced COX‐2 and hypoxia inducible factor‐1α expression through the induction of glucocorticoid‐induced leucine zipper
Authors: Lim Wonchung , Park Choa , Shim Myeong Kuk , Lee Yong Hee , Lee You Mie , Lee YoungJoo
Published: October 2013

Background and Purpose

The COX‐2/PGE2 pathway in hypoxic cancer cells has important implications for stimulation of inflammation and tumourigenesis. However, the mechanism by which glucocorticoid receptors (GRs) inhibit COX‐2 during hypoxia has not been elucidated. Hence, we explored the mechanisms underlying glucocorticoid‐mediated inhibition of hypoxia‐induced COX‐2 in human distal lung epithelial A549 cells.

Experimental Approach

The expressions of COX‐2 and glucocorticoid‐induced leucine zipper (GILZ) in A549 cells were determined by Western blot and/or quantitative real time‐PCR respectively. The anti‐invasive effect of GILZ on A549 cells was evaluated using the matrigel invasion assay.

Key Results

The hypoxia‐induced increase in COX‐2 protein and mRNA levels and promoter activity were suppressed by dexamethasone, and this effect of dexamethasone was antagonized by the GR antagonist RU486. Overexpression of GILZ in A549 cells also inhibited hypoxia‐induced COX‐2 expression levels and knockdown of GILZ reduced the glucocorticoid‐mediated inhibition of hypoxia‐induced COX‐2 expression, indicating that the inhibitory effects of dexamethasone on hypoxia‐induced COX‐2 are mediated by GILZ. GILZ suppressed the expression of hypoxia inducible factor (HIF)‐1α at the protein level and affected its signalling pathway. Hypoxia‐induced cell invasion was also dramatically reduced by GILZ expression.

Conclusion and Implications

Dexamethasone‐induced upregulation of GILZ not only inhibits the hypoxic‐evoked induction of COX‐2 expression and cell invasion but further blocks the HIF‐1 pathway by destabilizing HIF‐1α expression. Taken together, these findings suggest that the suppression of hypoxia‐induced COX‐2 by glucocorticoids is mediated by GILZ. Hence, GILZ is a potential key therapeutic target for suppression of inflammation under hypoxia.
Maternal care and subsocial behaviour in spiders
Authors: Yip Eric C. , Rayor Linda S.
Published: October 2013

While most spiders are solitary and opportunistically cannibalistic, a variety of social organisations has evolved in a minority of spider species. One form of social organisation is subsociality, in which siblings remain together with their parent for some period of time but disperse prior to independent reproduction. We review the literature on subsocial and maternal behaviour in spiders to highlight areas in which subsocial spiders have informed our understanding of social evolution and to identify promising areas of future research. We show that subsocial behaviour has evolved independently at least 18 times in spiders, across a wide phylogenetic distribution. Subsocial behaviour is diverse in terms of the form of care provided by the mother, the duration of care and sibling association, the degree of interaction and cooperation among siblings, and the use of vibratory and chemical communication. Subsocial spiders are useful model organisms to study various topics in ecology, such as kin recognition and the evolution of cheating and its impact on societies. Further, why social behaviour evolved in some lineages and not others is currently a topic of debate in behavioural ecology, and we argue that spiders offer an opportunity to untangle the ecological causes of parental care, which forms the basis of many other animal societies.
Autologous Ilium Grafts: Long‐Term Results on Immediate or Staged Functional Rehabilitation of Mandibular Segmental Defects Using Dental Implants after Tumor Resection
Authors: Zou Duohong , Huang Wei , Wang Feng , Wang Shen , Zhang Zhiyong , Zhang Chenpin , Kaigler Darnell , Wu Yiqun
Published: October 2013

Background

It is a challenge for clinicians to restore oral function in patients with segmental defects of the mandible because of tumor extirpation. Dental implant therapy following vascularized autologous ilium grafts is an effective method to restore oral function in patients with mandibular segmental defects.

Purpose

The aim of this retrospective study was to investigate the long‐term clinical outcomes of ilium grafts combined with immediate or staged mandibular dental implant therapy to restore craniofacial defects resulting from tumor resection.

Materials and Methods

Over a 5‐year period (2000–2004), 32 patients who underwent mandibular segmental resection for tumors were treated with vascularized ilium grafts to augment bone volume. Seventeen patients received phase I therapy (immediate placement of implants), and 15 patients underwent phase II therapy (delayed placement of implants). A total of 110 dental implants were placed in these patients for mandibular restoration of the defective areas. Information regarding implant success and survival rates, marginal bone loss, soft tissue inflammation, complications of prosthesis, and patient satisfaction for the 8 to 12 years following oral reconstruction was obtained from patient records.

Results

Although there was mild evidence of bone graft resorption, the vascularized autogenous ilium bone grafts were successful in all patients. The cumulative patient survival and success rate of the implants were 96.4% and 91.8%, respectively. The mean peri‐implant bone resorption ranged from 1.0 to 1.2 mm over the 8‐ to 12‐year follow‐up period. The annual mean number of complications/repairs was from 0.11 to 0.07 per patient during the 8‐ to 12‐year follow‐up. Over 80% of the patients were fully satisfied with their restoration of oral function.

Conclusions

This study demonstrates that reconstruction of mandibular segmental defects because of resection of mandibular tumors using dental implants therapy combined with vascularized autogenous ilium grafts is an effective method to restore oral function.
Hepatocellular carcinoma in Child's A cirrhosis: a retrospective analysis of matched pairs following liver transplantation vs. liver resection according to the intention‐to‐treat principle
Authors: Foltys Daniel , Zimmermann Tim , Kaths Moritz , Strempel Mari , Heise Michael , Hoppe‐Lotichius Maria , Weiler Nina , Scheuermann Uwe , Ruckes Christian , Hansen Torsten , Pitton Michael , Otto Gerd
Published: October 2013

This is the first matched pair analysis on the puzzling clinical problem of whether to perform liver transplantation (LT) or liver resection (LR) for Child's A hepatocellular carcinoma (HCC) patients. A total of 201 patients diagnosed with HCC and Child's A liver cirrhosis were treated with LT transarterial chemoembolization (TACE) or LR between 1998 and 2012. To achieve the most accurate study design, two groups of 57 patients were matched retrospectively according to their tumor characteristics detected by the initial computerized tomography (CT) scan. Sixteen of 57 LT candidates were not transplanted due to tumor progress during pre‐treatment (TACE). Nevertheless, the retrospective analysis of the matched pairs according to the intention‐to‐treat principle resulted in a better five‐yr overall survival (OS) rate of 54.3% for the group of LT candidates compared with 35.7% for those receiving LR (p = 0.19). In patients meeting the University of California, San Francisco (UCSF) criteria, five‐yr OS reached 58.4% after LT and 45.1% after LR (p = 0.56). For Milan criteria (MC) patients, LT resulted in 57.9% and LR in 42% five‐yr OS rate (p = 0.29). In conclusion, the finding of a better OS rate in LT was not statistically significant. There was also a selection bias in favor of LT, which may have influenced the OS. Therefore, particularly in regard to organ scarcity, LR remains a viable treatment option for respectable HCC in Child's A cirrhosis.