bluuebunny/crossref_metadata_2025 huggingface dataset:
Fractionated Repetitive Extracorporeal Shock Wave Therapy: A New Standard in Shock Wave Therapy?
Authors: Kisch Tobias , Sorg Heiko , Forstmeier Vinzent , Mailaender Peter , Kraemer Robert
Published: July 2015

Background. ESWT has proven clinical benefit in dermatology and plastic surgery. It promotes wound healing and improves tissue regeneration, connective tissue disorders, and inflammatory skin diseases. However, a single treatment session or long intervals between sessions may reduce the therapeutic effect. The present study investigated the effects of fractionated repetitive treatment in skin microcirculation.Methods. 32 rats were randomly assigned to two groups and received either fractionated repetitive high-energy ESWT every ten minutes or placebo shock wave treatment, applied to the dorsal lower leg. Microcirculatory effects were continuously assessed by combined laser Doppler imaging and photospectrometry.Results. In experimental group, cutaneous tissue oxygen saturation was increased 1 minute after the first application and until the end of the measuring period at 80 minutes after the second treatment(P<0.05). The third ESWT application boosted the effect to its highest extent. Cutaneous capillary blood flow showed a significant increase after the second application which was sustained for 20 minutes after the third application(P<0.05). Placebo group showed no statistically significant differences.Conclusions. Fractionated repetitive extracorporeal shock wave therapy (frESWT) boosts and prolongs the effects on cutaneous hemodynamics. The results indicate that frESWT may provide greater benefits in the treatment of distinct soft tissue disorders compared with single-session ESWT.
Missing Values and Optimal Selection of an Imputation Method and Classification Algorithm to Improve the Accuracy of Ubiquitous Computing Applications
Authors: Sim Jaemun , Lee Jonathan Sangyun , Kwon Ohbyung
Published: July 2015

In a ubiquitous environment, high-accuracy data analysis is essential because it affects real-world decision-making. However, in the real world, user-related data from information systems are often missing due to users’ concerns about privacy or lack of obligation to provide complete data. This data incompleteness can impair the accuracy of data analysis using classification algorithms, which can degrade the value of the data. Many studies have attempted to overcome these data incompleteness issues and to improve the quality of data analysis using classification algorithms. The performance of classification algorithms may be affected by the characteristics and patterns of the missing data, such as the ratio of missing data to complete data. We perform a concrete causal analysis of differences in performance of classification algorithms based on various factors. The characteristics of missing values, datasets, and imputation methods are examined. We also propose imputation and classification algorithms appropriate to different datasets and circumstances.
Energy and Momentum of Bianchi TypeVIhUniverses
Authors: Tripathy S. K. , Mishra B. , Pandey G. K. , Singh A. K. , Kumar T. , Xulu S. S.
Published: July 2015

We obtain the energy and momentum of the Bianchi typeVIhuniverses using different prescriptions for the energy-momentum complexes in the framework of general relativity. The energy and momentum of the BianchiVIhuniverses are found to be zero for the parameterh=-1of the metric. The vanishing of these results supports the conjecture of Tryon that the universe must have a zero net value for all conserved quantities. This also supports the work of Nathan Rosen with the Robertson-Walker metric. Moreover, it raises an interesting question: “Why is theh=-1case so special?”
Captopril Pretreatment Produces an Additive Cardioprotection to Isoflurane Preconditioning in Attenuating Myocardial Ischemia Reperfusion Injury in Rabbits and in Humans
Authors: Tian Yi , Li Haobo , Liu Peiyu , Xu Jun-mei , Irwin Michael G. , Xia Zhengyuan , Tian Guogang
Published: July 2015

Background. Pretreatment with the angiotensin‐converting inhibitor captopril or volatile anesthetic isoflurane has, respectively, been shown to attenuate myocardial ischemia reperfusion (MI/R) injury in rodents and in patients. It is unknown whether or not captopril pretreatment and isoflurane preconditioning (Iso) may additively or synergistically attenuate MI/R injury. Methods and Results. Patients selected for heart valve replacement surgery were randomly assigned to five groups: untreated control (Control), captopril pretreatment for 3 days (Cap3d), or single dose captopril (Cap1hr, 1 hour) before surgery with or without Iso (Cap3d+Iso and Cap1hr+Iso). Rabbit MI/R model was induced by occluding coronary artery for 30 min followed by 2‐hour reperfusion. Rabbits were randomized to receive sham operation (Sham), MI/R (I/R), captopril (Cap, 24 hours before MI/R), Iso, or the combination of captopril and Iso (Iso+Cap). In patients, Cap3d+Iso but not Cap1hr+Iso additively reduced postischemic myocardial injury and attenuated postischemic myocardial inflammation. In rabbits, Cap or Iso significantly reduced postischemic myocardial infarction. Iso+Cap additively reduced cellular injury that was associated with improved postischemic myocardial functional recovery and reduced myocardial apoptosis and attenuated oxidative stress. Conclusion. A joint use of 3‐day captopril treatment and isoflurane preconditioning additively attenuated MI/R by reducing oxidative stress and inflammation.
Inflammatory Cytokine Profile Associated with Metabolic Syndrome in Adult Patients with Type 1 Diabetes
Authors: Ferreira-Hermosillo Aldo , Molina-Ayala Mario , Ramírez-Rentería Claudia , Vargas Guadalupe , Gonzalez Baldomero , Isibasi Armando , Archundia-Riveros Irma , Mendoza Victoria
Published: July 2015

Objective. To compare the serum concentration of IL-6, IL-10, TNF, IL-8, resistin, and adiponectin in type 1 diabetic patients with and without metabolic syndrome and to determine the cut-off point of the estimated glucose disposal rate that accurately differentiated these groups.Design. We conducted a cross-sectional evaluation of all patients in our type 1 diabetes clinic from January 2012 to January 2013. Patients were considered to have metabolic syndrome when they fulfilled the joint statement criteria and were evaluated for clinical, biochemical, and immunological features.Methods. We determined serum IL-6, IL-8, IL-10, and TNF with flow cytometry and adiponectin and resistin concentrations with enzyme linked immunosorbent assay in patients with and without metabolic syndrome. We also compared estimated glucose disposal rate between groups.Results. We tested 140 patients. Forty-four percent fulfilled the metabolic syndrome criteria (n=61), 54% had central obesity, 30% had hypertriglyceridemia, 29% had hypoalphalipoproteinemia, and 19% had hypertension. We observed that resistin concentrations were higher in patients with MS.Conclusion. We found a high prevalence of MS in Mexican patients with T1D. The increased level of resistin may be related to the increased fat mass and could be involved in the development of insulin resistance.
Serum Pharmacochemistry Analysis Using UPLC-Q-TOF/MS after Oral Administration to Rats of Shenfu Decoction
Authors: He Jia-le , Zhao Jia-wei , Ma Zeng-chun , Wang Yu-guang , Liang Qian-de , Tan Hong-ling , Xiao Cheng-rong , Tang Xiang-lin , Gao Yue
Published: July 2015

The purpose of this study was to study the serum pharmacochemistry of SFD as well as the material basis through analyzing the constituents absorbed in blood. The SFD was orally administrated to Wistar rats at 20 g·kg−1, and Ultra Performance Liquid Chromatography (UPLC) fingerprints of SFD were created. Serum samples were collected for analysis, and further data processing used MarkerLynx XS software. 19 ginsenosides and 16 alkaloids were detected in SFD. The absorption of alkaloids (mainly monoester diterpenoid alkaloids) increased whenAconitum carmichaeliDebx. was combined withPanax ginseng, while the ginsenosides remained stable. Diester diterpenoid alkaloids were not present in the serum samples. A suitable serum pharmacochemistry method was successfully established to study pharmacological effects and potential improvements in formulation. This may also be useful for toxicity reduction. We suspect that the increased absorption of the monoester diterpenoid alkaloids from the mixture ofPanaxandRadix, compared to thePanaxonly extract, may be the reason for the combination of the two herbs in popular medicine formulas in China.
Cardiovascular Disease and Sleep-Disordered Breathing in Acromegaly
Authors: Powlson Andrew S. , Gurnell Mark
Published: July 2015

Treatment goals in acromegaly include symptom relief, tumour control and reversal of the excess morbidity and mortality associated with the disorder. Cardiovascular complications include concentric biventricular hypertrophy and cardiomyopathy, hypertension, valvular heart disease and arrhythmias, while metabolic disturbance (insulin resistance/diabetes mellitus, dyslipidaemia) further increases the risk of cardiovascular and cerebrovascular events. Sleep-disordered breathing (in the form of sleep apnoea) is also common in patients with acromegaly and may exacerbate cardiovascular dysfunction, in addition to contributing to impaired quality of life. Accordingly, and in keeping with evidence that cardiorespiratory complications in acromegaly are not automatically reversed/ameliorated simply through the attainment of ‘safe' growth hormone and insulin-like growth factor 1 levels, recent guidelines have emphasised the need not only to achieve stringent biochemical control, but also to identify and independently treat these comorbidities. It is important, therefore, that patients with acromegaly are systematically screened at diagnosis, and periodically thereafter, for the common cardiovascular and respiratory manifestations and that biochemical targets do not become the only treatment goal.
Chileotrecha romero (Kraus, 1966) comb. nov. and Pseudocleobis patagonicus (Roewer, 1934) comb. nov. transferral from Mummuciidae to Ammotrechidae (Arachnida, Solifugae)
Authors: BOTERO-TRUJILLO RICARDO , IURI HERNÁN A.
Published: July 2015

The solifuge species Mummucina romero Kraus, 1966, from Chile, and Mummucia patagonica Roewer, 1934, from Argentina, are here transferred from Mummuciidae Roewer, 1934 to Ammotrechidae Roewer, 1934. Chileotrecha romero (Kraus, 1966) comb. nov. and Pseudocleobis patagonicus (Roewer, 1934) comb. nov. are proposed. Comments on their morphology are made and previous distributional records are discussed. Pseudocleobis patagonicus is proposed as a nomen dubium. In addition, we confirm that female and immature specimens of the family Mummuciidae, just like males, can be reliably recognized based on features that had been suggested by Maury (1984).
Examining Online Social Network Use and Its Effect on the Use of Privacy Settings and Profile Disclosure
Authors: Stern Tziporah , Salb David
Published: July 2015

Online social networks (OSN) have become a part of our daily lives whether they are used for socialization and communication or to promote business interests. OSN have become an important tool for businesses to advertise, create brand awareness, and promote their products and services. Business use of OSN for advertising purposes is highly reliant on targeted ads which display advertisements to OSN users based on their demographics and use of OSN, apps, and websites. Thus, one of the most valuable commodities of OSN is the population of users and the information they share. To investigate the relationship between OSN site use, use of privacy settings, and how they relate to profile disclosure, a model is built based on the theory of reasoned action and the privacy calculus model. To validate the model, a survey is conducted and the results are analyzed with partial least squares. Risk and benefit were both shown to be significant antecedents of attitude. Both attitude and subjective norm, from the theory of reasoned action model, significantly affected OSN site use, while omitting intentions. OSN site use was significantly related to both profile disclosure and use of privacy settings. Last, use of privacy settings significantly affected profile disclosure. These results imply that use of privacy settings does not decrease the rate of disclosure. Giving users tools to protect their private information is important in protecting the privacy of OSN users, and it will lead to increases in safe disclosure of information helping OSN target ads effectively.
Religion and Negative Attitudes towards Homosexuals
Authors: Roggemans Lilith , Spruyt Bram , Droogenbroeck Filip Van , Keppens Gil
Published: July 2015

Public opinion research has repeatedly shown that religious persons report more prejudice against homosexuality when compared to their non-religious counterparts. This article contributes to a better understanding of this relationship by studying attitudes of youth in two of the three largest cities of Flanders ( N: 1907). The ethnic and religious heterogeneous population of these cities allows us to empirically disentangle the relevance of both religious involvement (strong versus weak) and the specific religious conviction with respect to negative attitudes towards homosexuals. This offers us a more detailed view on the exact nature of the relationship between religiosity and the latter attitudes among youth than what has been achieved so far. For both Christian and Muslim believers, we found more negative attitudes towards homosexuality, even after controlling for authoritarianism and a more traditional view on gender roles. Although boys appeared, in general, more negative towards homosexuality than girls, the gender gap amongst young Muslims was twice as large when compared to non-Muslims.
The Quest for Ordinary Lives: The Integrated Post-School Vocational Functioning of 50 Workers with Significant Disabilities
Authors: Brown Lou , Shiraga Betsy , Kessler Kim
Published: July 2015

An extensive report is made of the work histories of 50 adults with significant disabilities who are served by Community Work Services, Inc., in Madison, Wisconsin. The primary purpose is to share information about the integrated vocational functioning of these adults, 90% of whom exited high school 15–24 years ago. A second purpose is to celebrate the inspiring achievements of a remarkable group of workers, their family members and the professionals who served them. A third is to affirm the validity and feasibility of integrated vocational functioning. Hopefully, by documenting what was and is operational, opportunities for and improvements in integrated services can be generated and more ordinary lives can be realized.
ASEAN and the Dynamics of Resistance to Sovereignty Violation: The Case of the Third Indochina War (1978–1991)
Authors: Southgate Laura
Published: July 2015

This article investigates the history of ASEAN’s relationship to external intervention in regional affairs. It addresses a specific question: What was the basic cause of the success of ASEAN resistance to the Vietnamese challenge to ASEAN’s sovereignty from 1978-1991? ASEAN’s history is understood in terms of a realist theoretical logic, in terms of the relationship between an ASEAN state with the most compelling interests at stake in a given issue, which I call a ‘vanguard state,’ and selected external powers. Using the Third Indochina War (1978–1991) as a case study, this article contends that ASEAN’s ability to resist violations to the sovereignty of Thailand from a Soviet-backed Vietnam is a consequence of high interest convergence between Thailand, and a designated external power, China.
Bipartite structure of the inactive mouse X chromosome
Authors: Deng Xinxian , Ma Wenxiu , Ramani Vijay , Hill Andrew , Yang Fan , Ay Ferhat , Berletch Joel B. , Blau Carl Anthony , Shendure Jay , Duan Zhijun , Noble William S. , Disteche Christine M.
Published: July 2015

Background

In mammals, one of the female X chromosomes and all imprinted genes are expressed exclusively from a single allele in somatic cells. To evaluate structural changes associated with allelic silencing, we have applied a recently developed Hi-C assay that uses DNase I for chromatin fragmentation to mouse F1 hybrid systems.

Results

We find radically different conformations for the two female mouse X chromosomes. The inactive X has two superdomains of frequent intrachromosomal contacts separated by a boundary region. Comparison with the recently reported two-superdomain structure of the human inactive X shows that the genomic content of the superdomains differs between species, but part of the boundary region is conserved and located near theDxz4/DXZ4locus. In mouse, the boundary region also contains a minisatellite,Ds-TR, and bothDxz4andDs-TRappear to be anchored to the nucleolus. Genes that escape X inactivation do not cluster but are located near the periphery of the 3D structure, as are regions enriched in CTCF or RNA polymerase. Fewer short-range intrachromosomal contacts are detected for the inactive alleles of genes subject to X inactivation compared with the active alleles and with genes that escape X inactivation. This pattern is also evident for imprinted genes, in which more chromatin contacts are detected for the expressed allele.

Conclusions

By applying a novel Hi-C method to map allelic chromatin contacts, we discover a specific bipartite organization of the mouse inactive X chromosome that probably plays an important role in maintenance of gene silencing.
Osteoprotegerin and tumor necrosis factor-related apoptosis-inducing ligand as prognostic factors in rheumatoid arthritis: results from the ESPOIR cohort
Authors: Audo Rachel , Daien Claire , Papon Laura , Lukas Cédric , Vittecoq Olivier , Hahne Michael , Combe Bernard , Morel Jacques
Published: July 2015

Introduction

We previously reported that low ratio of osteoprotegerin (OPG) to tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) was associated with Disease Activity Score in 28 joints (DAS28) remission at 6 months in patients with early rheumatoid arthritis (RA). Here, we aimed to evaluate the value of baseline OPG/TRAIL ratio in predicting clinical and radiological outcomes in patients with early RA in the ESPOIR cohort.

Methods

OPG and TRAIL serum concentrations were assessed in the ESPOIR cohort patients. Patients with definite RA were included in this study. Patients were excluded if they had high erosion score at baseline (>90th percentile) or received biological therapy during the first 2 years of follow-up. Data were analyzed by univariate analysis and multivariate logistic regression to predict 1-year DAS28 remission and 2-year radiographic disease progression.

Results

On univariate analysis of 399 patients, OPG/TRAIL ratio at baseline was significantly lower in patients with than without remission at 1 year (p = 0.015). On multivariate logistic regression including age, gender, body mass index and DAS28, low OPG/TRAIL ratio was independently associated with remission at 1 year (odds ratio 1.68 [95 % confidence interval 1.01–2.79]). On univariate analysis, high OPG/TRAIL ratio at baseline was associated with rapid progression of erosion at 2 years (p = 0.041), and on multivariate logistic regression including age, anti-citrullinated protein antibody positivity and C-reactive protein level, OPG/TRAIL ratio independently predicted rapid progression of erosion at 2 years.

Conclusions

OPG/TRAIL ratio at baseline was an independent predictor of 1-year remission and 2-year rapid progression of erosion for patients with early rheumatoid arthritis. Thus, OPG/TRAIL ratio could be included in matrix prediction scores to predict rapid radiographic progression. Further confirmation in an independent cohort is warranted.
Transforming growth factor-β increases interleukin-13 synthesis via GATA-3 transcription factor in T-lymphocytes from patients with systemic sclerosis
Authors: Baraut Julie , Farge Dominique , Jean-Louis Francette , Masse Ingrid , Grigore Elena Ivan , Arruda Lucas C. M. , Lamartine Jérôme , Verrecchia Franck , Michel Laurence
Published: July 2015

Introduction

Transforming growth factor (TGF)-β and interleukin (IL)-13 play a crucial role in the pathogenesis of systemic sclerosis (SSc), partly through activation of collagen production that leads to fibrosis. The aim of the present study was to determine whether TFG-β alters IL-13 production in T lymphocytes from patients with SSc from that seen in those of healthy donors.

Methods

IL-13 mRNA and protein synthesis under TFG-β exposure was measured in circulating T lymphocytes from healthy donors and patients with SSc and also in the Jurkat Th2 T-cell line, using quantitative real-time PCR and fluorescence-activated cell sorting analysis, respectively. The involvement of Smad and GATA-3 transcription factors was assessed by using specific inhibitors and small interfering RNA, and the binding capacity of GATA-3 to the IL-13 gene promoter was evaluated by chromatin immunoprecipitation assay.

Results

TGF-β induced a significant decrease in IL-13 mRNA and protein levels in lymphocytes from healthy donors (mean [±SD] inhibition of 30 % ± 10 % and 20 % ± 7 %, respectively; p < 0.05). In contrast, TGF-β promoted a significant increase in IL-13 mRNA levels and IL-13 synthesis by CD4+ and CD8+ T-cell subtypes from patients with SSc, with respective increases of 2.4 ± 0.3-fold, 1.6 ± 0.05-fold and 2.7 ± 0.02-fold. The involvement of the Smad signaling pathway and upregulation of GATA-3 binding capacity on the IL-13 promoter in lymphocytes from patients with SSc contributed to the effect of TGF-β on IL-13 production.

Conclusions

These results demonstrate that TGF-β upregulates IL-13 synthesis through GATA-3 expression in the T lymphocytes of patients with SSc, confirming that the GATA-3 transcription factor can be regarded as a novel therapeutic target in patients with SSc.
The effects of joint aspiration and intra-articular corticosteroid injection on flexion reflex excitability, quadriceps strength and pain in individuals with knee synovitis: a prospective observational study
Authors: Rice David Andrew , McNair Peter John , Lewis Gwyn Nancy , Dalbeth Nicola
Published: July 2015

Introduction

Substantial weakness of the quadriceps muscles is typically observed in patients with arthritis. This is partly due to ongoing neural inhibition that prevents the quadriceps from being fully activated. Evidence from animal studies suggests enhanced flexion reflex excitability may contribute to this weakness. This prospective observational study examined the effects of joint aspiration and intra-articular corticosteroid injection on flexion reflex excitability, quadriceps muscle strength and knee pain in individuals with knee synovitis.

Methods

Sixteen patients with chronic arthritis and clinically active synovitis of the knee participated in this study. Knee pain flexion reflex threshold, and quadriceps peak torque were measured at baseline, immediately after knee joint aspiration alone and 5 ± 2 and 15 ± 2 days after knee joint aspiration and the injection of 40 mg of methylprednisolone acetate.

Results

Compared to baseline, knee pain was significantly reduced 5 (p = 0.001) and 15 days (p = 0.009) post intervention. Flexion reflex threshold increased immediately after joint aspiration (p = 0.009) and 5 (p = 0.01) and 15 days (p = 0.002) post intervention. Quadriceps peak torque increased immediately after joint aspiration (p = 0.004) and 5 (p = 0.001) and 15 days (p <0.001) post intervention.

Conclusions

The findings from this study suggest that altered sensory output from an inflamed joint may increase flexion reflex excitability in humans, as has previously been shown in animals. Joint aspiration and corticosteroid injection may be a clinically useful intervention to reverse quadriceps muscle weakness in individuals with knee synovitis.
New in Tax Administration
Authors: Смирнов  , Smirnov E.
Published: July 2015

On June 2, 2015 the Federal law No. 113-FZ dated 02.05.2015 and providing an increase of tax agents’

responsibility for observance of requirements related to the legislation on taxes and fees came into force.
Material and Production Stocks Audit As a Tool of Anti-Crisis Management in Agro-Industrial Complex Organizations
Authors: Фазульянова  , Fazulyanova Zulfiya
Published: July 2015

In this paper has been revealed one of anti-crisis management’s effective instruments – audit, in particular, the

audit of material and production stocks. Problems which decision is possible when carrying out the audit by the owner

have been emphasized, risks which decrease is possible at timely carrying out audit have been considered.
Online Store: Account and Taxation Features
Authors: Парасоцкая  , Parasotskaya N.
Published: July 2015

The article studies new analytical solutions associated with the Internet evolving from placing all content at one

spot and its use mainly in static formats to the contemporary multimedia model of content placed where it’s needed and

presented in the way to stimulate interaction with a user.
A combined vascular surgical and clinical genetics approach to diffuse aneurysmal disease
Authors: Jones KA , Choong AMTL , Canham N , Renton S , Pollitt R , Nesbitt M , Kopcke D , Islam L , Buckley J , Ghali N , Vandersteen A
Published: July 2015

We report two patients who presented with extensive aneurysmal disease, in association with minimal external physical signs. Patient 1 remained genetically undiagnosed despite multiple structural, biochemical and genetic investigations. He made a good recovery following surgery for popliteal and left axillary artery aneurysms. Patient 2 was diagnosed with vascular type Ehlers–Danlos syndrome, associated with a high degree of tissue and blood vessel fragility, and is being managed conservatively. Early multidisciplinary assessment of such patients facilitates accurate diagnosis and management.
Oral pathology in the Faculty of Dental Surgery
Authors: Odell Edward
Published: July 2015

It might seem odd that an oral pathologist like myself is involved with the work of the Faculty of Dental Surgery. After all, pathologists have their own royal college, and surgeons and pathologists might not seem an immediately compatible mix – all those jokes about the surgeon, the physician and the pathologist (the pathologist is always last) must have some basis in truth. Why am I here?
Slovenian doctors shine in ATLS® courses
Authors: Dyson Ruth , Winter Bob
Published: July 2015

The first day of February 2008 saw the College hosting the Advanced Trauma Life Support (ATLS®) 20th-anniversary celebrations. A stimulating and productive conference was attended by 140 people and provided an opportunity to update the audience on forthcoming developments in ATLS®, including details of the eighth edition to be released in early 2009. The conference was followed by a Caribbean themed party in the evening with steel bands and dancing.
College response
Authors: Smith Karen
Published: July 2015

There appear to be two separate but linked issues raised by this survey. The first is the issue of online functionality and usability. The ISCP has been live for just 16 months and was developed over a period of five years. All four surgical royal colleges in the UK and Ireland, all nine specialist associations as well as the main trainee groups of ASiT and BOTA, were represented on the groups that developed the framework, standards, syllabuses and systems that together form the ISCP. The ENT syllabus was written by the ENT SAC, along with the specialist workplace-based assessments (WBAs) for the specialty.
Quality matters
Authors: O'Sullivan Julia
Published: July 2015

There is a plethora of educational opportunities available to general dental practitioners (GDPs) and dental care professionals (DCPs), both short continuing professional development events and longer programmes, some of which lead to a formal qualification. However, it is not always clear whether these events and courses are of an appropriate standard and what processes are in place to accredit them.
Clinical research fellow wins award for museum learning
Authors: Casey Heather
Published: July 2015

Tom Palser, surgical trainee and recent clinical fellow to the National Oesphago-Gastric Cancer Audit, has been presented the Marsh Volunteers for Museum Learning Award for London, after volunteering at the Hunterian Museum. The award recognises the innovative ways in which an individual encourages public engagement with a museum collection.
Childhood Hydrocephalus: A Snapshot of the Clinical Workload and its Implications on the Nhs Budget
Authors: Jeelani Nuo , DeSilva P , Jeelani A , Thompson D , Hayward R
Published: July 2015

The diagnosis and management of hydrocephalus, a condition described since the time of Hippocrates, 1 continues to pose a significant burden on current neurosurgical practice. 2 With a reported incidence of 1 in 1,000 newborn infants, 3 this condition is seen and handled by a wide spectrum of healthcare professionals from community-based social workers to specialists in tertiary referral centres. Furthermore, this is a condition that is usually not cured but rather managed and as such typically remains with the patient throughout his or her life, resulting in enormous socio-economic costs. An extensive review of the US national inpatient sample database for 2000 put the cost of treating hydrocephalus using ventricular shunts at $1 billion per year.
Do Information Sheets Improve Patient Satisfaction in the Out-Patient Department?
Authors: Pothier David D , Frosh Adam
Published: July 2015

INTRODUCTION

Time spent waiting to see a doctor in the out-patient department is a significant source of dissatisfaction for patients. Out-patient staff are often repeatedly questioned about the running of the clinic and why a delay has developed. These complaints and requests often result in further delays to the clinic.

PATIENTS AND METHODS

An information sheet was written to answer these questions. We set out to determine if the distribution of these sheets increased patient satisfaction with waiting times in the outpatient setting. Twelve sequential ENT clinics at the Lister Hospital, Stevenage were randomised into two groups. Patients attending clinics in Group A (n = 103) received an information sheet while those attending clinics in Group B (n = 124) received no information sheet. At the end of their clinic visit, all patients completed a questionnaire in which they were asked to provide a rating of their levels of satisfaction with various experiences in the out-patient department on a rating score from 1 to 5.

RESULTS

We found levels of satisfaction regarding waiting times to be significantly higher in the group who received information sheets (P < 0.001). No verbal complaints were received by the nursing staff at clinics where the information sheet was distributed. Four verbal complaints were received at the clinics where no sheets were distributed.

CONCLUSIONS

We believe that the use of information sheets is a cost-effective method of improving patient satisfaction and that this is a useful tool both in the primary care setting and in hospital out-patient departments.
The effects of a non-operative multimodal programme on osteoarthritis of the knee
Authors: Patel Shelain , Hossain Fahad S , Paton Bruce , Haddad Fares S
Published: July 2015

INTRODUCTION

The purpose of this study was to determine if a multimodal programme including physiotherapy and education could improve the symptoms of osteoarthritis of the knee across various severities of disease.

PATIENTS AND METHODS

Seventy-two patients with osteoarthritis of the knee confirmed on radiographic evidence were referred over a 13-month period for a lower limb programme which consisted of 12 classes over 6 weeks of group physiotherapy and included education on osteoarthritis, diet and exercise. Six patients went on to have joint arthroplasty at a mean time of 6.5 months with three placed on the waiting list during follow-up.

RESULTS

Pre-intervention, the mean WOMAC score was 42.0 and the mean Oxford Knee Score was 32.8. Post-intervention at a mean follow-up of 12 months, the mean WOMAC score was 31.6 and the mean Oxford Knee Score 24.3. The change in scores following intervention was statistically significant (P < 0.01). Using the WOMAC scoring system, the greatest effect size was seen in patients with Kellgren–Lawrence grade IV whilst using the Oxford knee scoring system, the greatest effect size was seen in patients with Kellgren–Lawrence grade II.

CONCLUSIONS

At 12 months, a multimodal programme of non-operative interventions has an excellent impact upon the symptoms of osteoarthritis of the knee with improved patient-reported scores. The level of improvement cannot be inferred from the radiographic grade of osteoarthritis. This modality could be considered for all patients with mild-to-moderate osteoarthritis of the knee.
Curating the world’s peer-reviewed literature
Authors: David A Rew
Published: July 2015

New technologies are transforming academic publishing, including surgical research. The author considers a variety of the new systems, platforms and search engines that are fuelling this information revolution, as well as the bibliometrics and citation analysis necessary for filtering quality material for the increasingly inundated researcher.
Peri-operative care series
Authors: Game F
Published: July 2015

Diabetes is a common disease worldwide with a multitude of complications and high mortality. Moreover, its prevalence is increasing and many of our patients will have diabetes. We have known for almost 50 years that patients with diabetes undergo surgical procedures at a higher rate than patients who do not have the condition 1 and that they spend 45% longer in a hospital bed than patients with diabetes admitted to a medical ward. 2
Activation of CD40 with platelet derived CD154 promotes necro-apoptosis of hepatocytes
Authors: Bhogal RH , Adams DH , Afford SC
Published: July 2015

Affiliated to the Association of Surgeons in Training and the British Transplantation Society, the Carrel Club is the transplant trainee surgical society. The Carrel Club held a joint meeting with the Chapter of Transplant Surgeons, a subsidiary organisation of the British Transplantation Society, at the Manchester Hilton Hotel on 31 January and 1 February 2013. As part of the meeting, ten abstracts were presented. A selection is printed below. The winner of the Best Presentation award was Mr Mownah.
The changing face of donation in the UK: kidney donation after circulatory death
Authors: Summers DM , Johnson RI , Hudson A , Randhawa G , Mallik M , Murphy P , Collett D , Watson CJ , Neuberger J , Bradley JA
Published: July 2015

Affiliated to the Association of Surgeons in Training and the British Transplantation Society, the Carrel Club is the transplant trainee surgical society. The Carrel Club held a joint meeting with the Chapter of Transplant Surgeons, a subsidiary organisation of the British Transplantation Society, at the Manchester Hilton Hotel on 31 January and 1 February 2013. As part of the meeting, ten abstracts were presented. A selection is printed below. The winner of the Best Presentation award was Mr Mownah.
Hepatic artery embolisation for liver metastases from neuroendocrine disease
Authors: Vallance A , Wilson CH , Bernstone G , Rose J , Williams R , Jackson R , Perros P , James RA , French JJ , Manas DM
Published: July 2015

The 2013 Alpine Liver and Pancreatic Surgery meeting was held in Madonna di Campiglio, Italy. The meeting was organised by the Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland. The following abstracts were selected for presentation at the meeting.
Determining complete clinical response of radiologically disappearing colorectal liver metastases after chemotherapy and how they should be managed
Authors: Hunter D , Shrestha AK , Pai M , Spalding D
Published: July 2015

The 2013 Alpine Liver and Pancreatic Surgery meeting was held in Madonna di Campiglio, Italy. The meeting was organised by the Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland. The following abstracts were selected for presentation at the meeting.
Selective internal radiation treatment for hepatic malignancy
Authors: Burns J , Wilson CH , Rose J , Williams R , Jackson R , Driver I , Manas DM , French JJ
Published: July 2015

The 2013 Alpine Liver and Pancreatic Surgery meeting was held in Madonna di Campiglio, Italy. The meeting was organised by the Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland. The following abstracts were selected for presentation at the meeting.
Outcomes after laparoscopic enucleation of pancreatic neoplasms in a single institution
Authors: Marchegiani G , Butturini G , Daskalaki D , Damoli I , Accordini F , Salvia R , Malleo G , Bassi C
Published: July 2015

The 2013 Alpine Liver and Pancreatic Surgery meeting was held in Madonna di Campiglio, Italy. The meeting was organised by the Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland. The following abstracts were selected for presentation at the meeting.
Distal pancreatectomy with or without splenectomy: indications, pitfalls and long-term outcomes
Authors: Marchegiani G , Butturini G , Damoli I , Daskalaki D , Malleo G , Esposito A , Salvia R , Bassi C
Published: July 2015

The 2013 Alpine Liver and Pancreatic Surgery meeting was held in Madonna di Campiglio, Italy. The meeting was organised by the Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland. The following abstracts were selected for presentation at the meeting.
The use of self-expanding metal stents in the management of large bowel obstruction and malignant fistulating disease: a large district general experience
Authors: George R , Ganesan D , Amarnath TS , Balamurugan R
Published: July 2015

The following abstracts won prizes at the 153rd East Midlands Surgical Society meeting held on 9 November 2012 at Leicester General Hospital. First prize was won by George et al. The paper by Ogunbiyi et al was placed second and the paper by Khanna et al was placed third.
High prevalence of vitamin D deficiency in elderly patients with advanced osteoarthritis scheduled for total knee replacement associated with poorer preoperative functional state
Authors: Jansen JA , Haddad FS
Published: July 2015

Vitamin D deficiency has been reported previously in patients with osteoarthritis undergoing total hip arthroplasty. We found a high prevalence of vitamin D deficiency in elderly patients with advanced knee osteoarthritis scheduled for total knee replacement and also a significant association with a lower preoperative functional state. A review of the literature is given on vitamin D deficiency in patients with knee osteoarthritis and the association with lower outcome scores after arthroplasty is discussed.
Impact of change of knee prosthesis on early clinical outcomes in a large volume arthroplasty centre
Authors: Moonot P , D’Mello O , Tzinga N , Sisak K , Fiddian NJ , Harvey AH
Published: July 2015

Introduction

The aim of our study was to investigate the effect of changing the default knee prosthesis in a high volume dedicated arthroplasty unit from DePuy’s PFC® Sigma® to Smith & Nephew’s Genesis™ II.

Methods

A retrospective analysis was performed of prospective data on primary total knee replacements (TKRs) from January 2009 until December 2011. This provided information on the operative time, length of stay, pain at mobilisation, radiography analysis, any complications, and readmission at 30 and 60 days.

Results

The total numbers of primary TKRs using the PFC® and Genesis™ II prostheses were 1,061 and 1,268 respectively. The results showed a slight increase (maximum of five minutes) in the operative time for all the surgeons except one surgeon, whose operative time reduced by an average of seven minutes. There was no significant adverse outcome after the change in the knee implant. There was no clinically significant increase in the length of stay, pain at mobilisation or complication rates. There was a twofold increase in the wastage of the implant in the Genesis™ II group in the initial learning period.

Conclusions

Through a competitive process of implant tendering, we have successfully introduced a new implant into a large elective orthopaedic unit. This has resulted in significant financial savings without adversely affecting our clinical practice or patient outcome.
On-site cytotechnician evaluation of the adequacy of fine needle aspiration in a neck lump clinic
Authors: Reddy VM , Bennett WO , Bassett E , Cunliffe DJ , Fryer LC , Reece PH , Hickey SA
Published: July 2015

Introduction

The gold standard for assessing neck lumps is a one-stop clinic with an on-site cytopathologist who can provide an immediate fine needle aspiration (FNA) report. However, this has considerable resource implications and is not available in all units. In our department, surgeons perform FNAs guided by palpation. The FNA is evaluated for specimen adequacy by an on-site cytotechnician. This study evaluated the impact of the cytotechnician on the adequacy of neck lump FNA.

Methods

FNA performed between June 2010 and February 2012 was examined. The FNA performed at a neck lump clinic with an assessment of adequacy by an on-site cytotechnician were considered the test group. All other neck lump FNAs from other sources without an assessment of adequacy by an on-site cytotechnician were considered the control group.

Results

Of the FNAs, 134 met the inclusion criteria for this study. Of these, 87 FNAs (65%) were analysed for adequacy by the on-site cytotechnician and the remaining 47 (35%) were not. The results demonstrated an FNA inadequacy with and without on-site cytotechnician assessment of 29.9% and 40.4% respectively. This is equivalent to an absolute risk reduction of an inadequate FNA of 10.5%, which equates to a number needed to treat of 9.5, ie the cytotechnician needs to assess 9.5 (ie the cytotechnician […] specimen).

Conclusions

In neck lump clinics where on-site cytopathology is not available, an on-site cytotechnician is a compromise measure that does reduce the number of inadequate FNAs.
Renal cell carcinoma metastases to gallbladder
Authors: McWhirter D , den Dulk M , Terlizzo M , Malik HZ , Fenwick SW , Poston GJ
Published: July 2015

A 74-year old man underwent a radical cholecystectomy for presumed gallbladder cancer. The histology of the resected specimen in fact revealed the lesion to be metastatic renal cell carcinoma from his resected right nephrectomy performed 14 years previously.
Manual of Endoscopic Sinus and Skull Base Surgery
Authors: Simmen Daniel , Jones Nicholas
Published: July 2015

If you would like to submit a book to the Annals for review, please send two copies to: Publications Department, The Royal College of Surgeons of England, 35–43 Lincoln’s Inn Fields, London WC2A 3PE. Book reviews are published at the discretion of the editor.
A survey of trainees supported by oral and maxillofacial surgery units while studying for a second degree
Authors: O’Connor R , Bhandari R
Published: July 2015

Training in oral and maxillofacial surgery (OMfs) in the UK and other european countries is unique, requiring degrees in both dentistry and medicine. This rewards trainees with a varied skillset but carries a financial burden that has been exacerbated by increasing tuition fees and the pay freeze for national health service (nhs) employees. 1 although not a new concept, working through university is a necessity for many. however, work is often undertaken ad hoc or as a locum in dental or medical disciplines unrelated to omfs.
General practitioner access to magnetic resonance imaging for suspected knee ligament and meniscal injuries
Authors: Bidwai ASC , Butterworth HJ , Sherry PG
Published: July 2015

Knee magnetic resonance imaging (MRI) has been shown to be sensitive and specific for the detection of knee meniscal lesions and cruciate ligament injuries, and it is more reliable than clinical examination itself. 1 This has led to the suggestion that general practitioners (GPs) could use knee MRI in the assessment of these pathologies, making appropriate and informed decisions. 2
‘One on, one off’ as a model for safe and efficient paediatric ENT surgery
Authors: Walker DT , Cartwright S , Spraggs PDR , Spraggs JD
Published: July 2015

Elective surgery accounts for a significant proportion of hospital income and resource utilisation. With the National Health Service needing to make savings of £20 billion by 2014, the operating theatre is a key area for targeted reform. At an average running cost of £15 per minute, time wasted in theatre represents a major financial escalator, and occurs nationwide in most lists, in most theatres, in most trusts and on most days of the year.
Trauma and orthopaedic research publications produced during the past five years from a single training deanery
Authors: Gould FJ , Kent J , Manning WA , Reed MR
Published: July 2015

It is important for trainees in trauma and orthopaedics (T&O) not only to gain surgical case numbers and workplace-based assessments but also to participate in research. This is mandated as part of the T&O curriculum and trainees are now required to produce at least two publications prior to completion of training. 1 Peer-reviewed publications are used frequently as a discriminator for those applying for consultant posts and suggest candidates who are interested in what they do and keen to share their experience with others. 2
An evaluation of the use of direct observation of procedural skills in the intercollegiate surgical curriculum programme
Authors: Mathew A , Beard JD , Bussey M
Published: July 2015

The Intercollegiate Surgical Curriculum Programme (ISCP) ( www.iscp.ac.uk ) is a UK-wide collaborative project involving all the surgical royal colleges and the specialty associations involved in surgical training. Workplace-based assessment (WBA) refers to the assessment of day-to-day working practice 1 and is an integral part of the ISCP assessment framework. The main aim of WBA is to aid learning through constructive feedback. Several WBAs have been adopted by the ISCP including the mini-clinical evaluation exercise (mini-CEX), direct observation of procedural skills (DOPS), case-based discussion (CBD) and procedure-based assessment (PBA). A systematic review of WBAs concluded that there was no clear evidence to show that DOPS can lead to improvements in performance but identified studies that showed largely positive results in terms of learner satisfaction. 2
‘Sit on your blisters’
Authors: Mortensen Neil
Published: July 2015

We’ve made our beds – now let’s hope there are enough to lie in.
No surprises?
Authors: Marx Clare
Published: July 2015

Why the surprise majority must not lead to simply ’more of the same’.
Current usage patterns of procedure-based assessments in the orthopaedic community
Authors: Roushdi I , Tennent D
Published: July 2015

Are PBAs a useful formative or summative assessment tool?
Rejected results: Addressing transparency in clinical trials
Authors: Fitzgerald JE , Chapman SJ , Harrison EM , Bhangu A
Published: July 2015

Do surgeons have a duty to j make trial data It publicly available?
An update on ISCP Version 10
Authors: Griffiths Gareth
Published: July 2015

A new iteration of the ISCP is now in BETA testing
Cochrane fluoride reviews: an overview of the evidence on caries prevention with fluoride treatments
Authors: Marinho Valéria CC
Published: July 2015

There is a long history of widespread use of fluoride in a variety of treatment modalities for caries prevention – in particular of fluoride toothpaste, the most significant and ubiquitous form of caries control used globally. The effects of topical fluoride therapy are comprehensively assessed and summarised in a number of Cochrane reviews compiling the evidence on this topic. Cochrane reviews have answered important questions regarding the effects of fluoride on caries, and have become influential as a foundation for preventive practice in dentistry.
Regulating pain
Authors: Simmons Gerald
Published: July 2015

Americans are hooked on prescription pain killers and strict regulation doesn’t seem to have helped. The latest solution: prevent dentists from handing out anything stronger than paracetamol. Worth a try.