bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rural and remote health research: Does the investment match the need?
Authors: Barclay Lesley , Phillips Andrew , Lyle David 
Published: April 2018

AbstractObjectiveTo determine the percentage of research projects funded by the National Health and Medical Research Council in the period 2000–2014 that aimed specifically to deliver health benefits to Australians living in rural and remote areas and to estimate the proportion of total funding this represented in 2005–2014.DesignThis is a retrospective analysis of publicly available datasets.SettingNational Health and Medical Research Council Rural and Remote Health Research 2000–2014.Outcome measures‘Australian Rural Health Research’ was defined as: research that focussed on rural or remote Australia; that related to the National Health and Medical Research Council's research categories other than Basic Science; and aimed specifically to improve the health of Australians living in rural and remote areas. Grants meeting the inclusion criteria were grouped according to the National Health and Medical Research Council's categories and potential benefit. Funding totals were aggregated and compared to the total funding and Indigenous funding for the period 2005–2014.ResultsOf the 16 651 National Health and Medical Research Council‐funded projects, 185 (1.1%) that commenced funding during the period 2000–2014 were defined as ‘Australian Rural Health Research’. The funding for Australian Rural Health Research increased from 1.0% of the total in 2005 to 2.4% in 2014. A summary of the funding according to the National Health and Medical Research Council's research categories and potential benefit is presented.ConclusionAddressing the health inequality experienced by rural and remote Australians is a stated aim of the Australian Government. While National Health and Medical Research Council funding for rural health research has increased over the past decade, at 2.4% by value, it appears very low given the extent of the health status and health service deficits faced by the 30% who live in rural Australia.
ROLE AND PERFORMANCE OF PUBLIC ENTERPRISES: A CASE STUDY ON THE STRATEGIC RELEVANCE AND SPECIFICITY OF ENTERPRISES AT THE GERMAN FEDERAL LEVEL
Authors: WARM Stephanie , SCHAEFER Christina , FRIEDLÄNDER Benjamin 
Published: April 2018

ABSTRACTThe public sector has continually faced reforms, modernizations and institutional changes. For the special case of Germany, empirical studies illustrate a high relevance of public enterprises (PEs) for fulfilling public purposes and providing public services. An increasing pressure for effectiveness and efficiency of PEs implicates (new) requirements for analytical procedures to review public tasks in general, but also for making best institutional choices.Based on the concepts of a critical review of tasks and an in‐depth performance analysis as well as legal obligations, three major PEs at the federal level are systematically analysed according to their strategic relevance and specificity. However, the study provides a mixed picture. Requirements for the explanation of the public interest of the analysed PEs are not sufficiently met. The paper provides a conceptual framework to assess the role and performance of PEs as well as promising results and further implications, both for researchers and practitioners.
Treatment of Stones in Caliceal Diverticula: Extracorporeal Shock Wave Lithotripsy versus Percutaneous Nephrolitholapaxy
Authors: HENDRIKX A. J. M. , BIERKENS A. F. , BOS R. , OOSTERHOF G. O. N. , DEBRUYNE F. M. J. 
Published: April 2018

SummaryStones in caliceal diverticula may cause symptoms for which treatment is indicated. Both extracorporeal shock wave lithotripsy (ESWL) and percutaneous nephrolitholapaxy (PNL) are recommended.We have evaluated the results of ESWL treatment of stone‐containing caliceal diverticula and compared these with the results obtained by percutaneous surgery.In the ESWL group, 15 patients were treated with an electromagnetic lithotriptor (Siemens Lithostar). After 3 months, plain abdominal X‐rays revealed that only 2 patients were both stone‐free and symptom‐free. Of the 13 patients with residual fragments, 7 had no symptoms. The remaining 6 were treated by a lower pole resection (n= 3), a percutaneous procedure (n = 2) and long‐term administration of antibiotics (n = 1).Sixteen patients were treated percutaneously. Puncture failed in 3 and they underwent a lumbotomy. In the remaining 13 patients the stones were reached by direct puncture (n = 12) or via an adjacent calix (n = 1). After 3 months, 10 patients were stone‐free and had no symptoms. Morbidity consisted of post‐operative bleeding (n = 3) and high fever (n = 1). It was concluded that caution should be exercised in the treatment of stone‐containing caliceal diverticula. Only in symptomatic cases is treatment indicated and ESWL is the first choice. If ESWL fails (residual stones and persistent symptoms), PNL should be performed, although it is associated with a higher morbidity rate.
Does Too Much Urology Damage Your Eyesight? Study of Macular Function
Authors: PHILLIPS P. M. , DEAN F. M. , REFFIN J. , BRIGGS T. P. , MILLER R. A. , DAVEY C. C. 
Published: April 2018

SummaryA study comparing the macular function of both eyes of 130 urological surgeons was carried out to investigate whether the increased light exposure to the endoscoping eye caused any deterioration of macular function. The non‐endoscoping eye was used as a control.A sophisticated computer test of colour contrast sensitivity was used. The computer assesses the degree of brightness at which the subject is just able to detect a coloured grating, and for each eye this is expressed as a threshold for the red/green axis and the blue/yellow (tritan) axis. The subjects also completed a questionnaire about their working patterns and their general and ophthalmic history and had a brief examination of the fundus.The results do not suggest that urologists are suffering any significant macular damage as a result of their work with endoscopes.
Blue Light Emission from Urological Equipment. Can it Damage the Eyes?
Authors: BRIGGS T. P. , PARKER C. , MILLER R. A. , PHILLIPS P. M. , DEAN F. M. , DAVEY C. C. 
Published: April 2018

SummaryBlue light present in the visible spectrum at the lower wavelengths can cause damage to the retinas of monkeys and rats. In the present study the light sources and instrumentation available to the urologist were evaluated to see whether they posed a hazard. The light emitting directly from the sources, cables and telescopes was tested and these levels were found to be dangerous to the eye when compared with the safety limit recommended by the American Conference of Governmental Industrial Hygienists (ACGIH).When the light at the eyepiece of the telescopes which had been reflected off a surface was measured, the blue light levels did not appear to be harmful when compared with the ACGIH safety limit.The use of filters is discussed and the transmission of 2 types of filters shown. While the level of blue light emission from the eyepiece remains within the ACGIH level, there are no data on long‐term exposure. The addition of a blue light filter may be beneficial until such time as videoendoscopy becomes the norm. The light from light sources should be protected by a shutter and more care taken with the emission from cables and telescopes.
Samuel Pepys and his Bladder Stone
Authors: URQUHART-HAY D. 
Published: April 2018

SummarySamuel Pepys, as a young man, developed a bladder stone and, by the age of 25 years, realised that only surgery could deliver him from his agony. The chances of success in an age that was ignorant of sepsis were slender, but he opted for surgery. The operation, carried out through the perineum without anaesthetic by a master barber surgeon, was successful and Pepys survived. Although left sterile, he was far from impotent and he went on to achieve fame and fortune as Secretary to the Navy and President of the Royal Society. His greatest fame came after his death with the publication of his diary, which was to become one of the best known and best loved books in the language.
Local Hyperthermia for Prostatic Disease: in vitro Studies on Human Prostatic Cancer Cell Lines
Authors: LLOYD S. N. , CHALMERS D. , LEAKE R. E. , KIRK D. 
Published: April 2018

SummaryLocal hyperthermia for benign and malignant prostatic disease remains largely empirical. In an attempt to understand the biological action of hyperthermia, and its potentiation by antiandrogen seen in clinical practice, the interaction of the two has been studied in prostatic cancer cell lines.Human prostatic cancer cell lines LNCaP and DU 145 were studied to examine the effects of heat shock treatment (HST), androgen (5α‐dihydrotestosterone: 5αDHT) and antiandrogen (hydroxyflutamide: OH‐Flut) on cell growth and survival. Response (measured as increased DNA content) to 5αD HT demonstrated that LNCaP was androgen sensitive, whereas DU 145 was androgen insensitive; OH‐Flut stimulated LNCaP growth but had no effect on DU 145 growth. Thermotolerance was exhibited by DU 145 cells but not by LNCaP cells. The combination of HST followed by OH‐Flut markedly reduced survival of LNCaP cells compared with HST alone. This effect was not observed in DU 145 cells. The enhanced cytotoxic effect of antiandrogen and hyperthermia could minimise the effect of thermotolerance in malignant cells surviving initial hyperthermia treatment and might suggest real clinical value for the combination or sequence.
Staging of Prostate Cancer. Accuracy of Transrectal Ultrasound Enhanced by Prostate‐specific Antigen
Authors: WOLF, J. S. , SHINOHARA K. , NARAYAN P. 
Published: April 2018

SummaryTransrectal ultrasound (TRUS) has shown some promise in the staging of prostate cancer, while prostate‐specific antigen (PSA) alone is insufficient. By combining prospective TRUS evaluation with retrospective PSA analysis, we demonstrated an increased accuracy of this combined staging method over TRUS alone. In 48 men undergoing radical prostatectomy, TRUS was performed and PSA measured pre‐operatively. On the basis of TRUS, tumours were classified as contained or uncontained. An “expected” PSA value was then calculated for each patient as follows:

urn:x-wiley:14927535:media:bju1992705534:bju1992705534-math-0001

where K = 2.1 if the combined Gleason score of the initial biopsy was ≥7, or 4.2 if the score was ≤6.If a patient's pre‐operative PSA value was less than or equal to the expected PSA, his tumour was judged to be contained. Staging by both TRUS and PSA was combined, so that if the tumour was judged uncontained by either parameter, the combined prediction was uncontained. Results of the combined staging were: sensitivity 84%, specificity 82%, positive predictive value 94%, negative predictive value 60%, accuracy 83%. This PSA formula, which takes into account the size and grade of the lesion rather than an arbitrary cut‐off value, enhances the local staging of prostate cancer by TRUS.
Mitomycin C and Aminoglutethimide in the Treatment of Metastatic Prostatic Cancer: a Phase II Study
Authors: DIK P. , BLOM J. H. M. , SCHRÖDER F. H. 
Published: April 2018

SummaryIn a phase II study, 24 patients with metastatic prostatic cancer were treated with mitomycin C 15 mg/m2 i.v. every 6 weeks, combined with aminoglutethimide 250 mg twice a day. A low dose of 37.5 mg cortisone acetate was supplied daily to compensate for adrenal cortical suppression. A partial reponse was demonstrated in 4 of 24 evaluable patients with bidimensionally measurable metastases. Stable disease occurred in 8 patients over a period of more than 6 months. Within the maximum cumulative dose limit of 2 mg/kg body weight mitomycin C, toxicity was observed in 21 cases, including 2 deaths due to treatment toxicity. The poor response rate and high toxicity suggest that the addition of aminoglutethimide does not enhance the effect of mitomycin C in these patients.
Continent Urinary Reservoir in Exstrophy/Epispadias Complex
Authors: BASSIOUNY I. E. 
Published: April 2018

SummaryThe outcome of 15 children and young adults who underwent reconstruction of continent urinary reservoirs (CUR) from January 1987 to 1990 is presented. Ten patients were male and 5 female with an age range of 3 to 20 years. There were 13 patients with bladder exstrophy and 2 with incontinent epispadias. In 8 cases the urinary diversion was performed for an inadequate bladder capacity following successful closure (3), failed attempted closure (3), female epispadias (1) and following successful urethroplasty in 1 case of male epispadias. A tiny fibrotic bladder plate unsuitable for attempted closure was the indication for diversion in 3 patients. Faecal and urinary incontinence following ureterosigmoidostomy (2 patients) and trigonosigmoidostomy (2) was the reason to consider re‐diversion in 4 previously diverted patients. In 10 patients an Indiana pouch was performed. The Mitrofanoff procedure was used in 5 cases with caecum (2), sigmoid colon (2) or transverse colon (1) as the urinary reservoir. All patients are continent on clean intermittent catheterisation with stable renal function. Three patients developed large stones within the reservoir and needed open cystolithotomy. This series supports the efficacy of CUR as an alternative procedure to traditional forms of urinary diversion in the management of selected patients with exstrophy/epispadias complex.
Very long‐term Voice Handicap Index Voice Outcomes after Montgomery Thyroplasty: A cross‐sectional study
Authors: Desuter G. , Zapater E. , Van der Vorst S. , Henrard S. , van Lith‐Bijl J.T. , van Benthem P.P. , Sjögren E.V. 
Published: April 2018

ObjectiveThe aim of this multicentric cross‐sectional study was to examine the permanency of Montgomery thyroplasty (MTIS) results from a patient's perspective.DesignThe study consisted of collecting Voice Handicap Index (VHI‐30) questionnaires from patients who had previously been operated with MTIS between 2 and 12 years before. Very long‐term (>2 years) postoperative data were compared with the previously acquired preoperative and early postoperative VHI results. Influence of factors such as age, gender, size/side of the prosthesis and length of the follow‐up were also analysed.SettingMulticentric study involving three tertiary European voice centres.ParticipantsForty‐nine unilateral vocal fold paralysis (UVFP) patients, treated by MTIS, were included in the study.Main outcome measuresThe Voice Handicap Index‐30 score.Results & ConclusionsThe median VHI was significantly different over time‐points (Friedman's test P < .001), with a significant difference between preoperative and early postoperative time‐points (median VHI: 70 vs 21, respectively; P < .001) and between preoperative and very long‐term postoperative time‐points (median VHI: 70 vs 16, respectively; P < .001). The median VHI did not differ for the early and very long‐term postoperative time‐points (median VHI: 21 vs 16; P = .470).Age differences, gender differences and size/side differences of the prostheses, centres where surgery took place and length of the follow‐up showed no significant influence.Medialisation thyroplasty (MT) overall and MTIS, in particular, should be considered as a possible standard of care for UVFP when permanency of voice results is sought.
Nivolumab maintenance after salvage autologous stem cell transplantation results in long‐term remission in multiple relapsed primary CNS lymphoma
Authors: Terziev Denis , Hutter Barbara , Klink Barbara , Stenzinger Albrecht , Stögbauer Fabian , Glimm Hanno , Fröhling Stefan , Wickenhauser Claudia , Jordan Karin , Hurtz Hans‐Jürgen , Müller Lutz P. , Rüssel Jörn , Weber Thomas 
Published: April 2018

AbstractRecurrence of primary central nervous system lymphoma (PCNSL) after high‐dose chemotherapy with autologous stem cell transplantation (ASCT) usually has a poor overall prognosis with limited treatment options. Data on repeated ASCT are sparse. Checkpoint inhibitor maintenance therapy has also not been reported in PCNSL. Here, we report the first documented case of a successful third ASCT in second relapse of PCNSL. Whole‐exome sequencing identified a hypermutated tumor genotype. Additionally, immunohistochemistry on pretreatment tumor tissue revealed infiltrates of PD‐1+ cytolytic T cells. These alterations provided a rationale for subsequent nivolumab maintenance treatment. Therapy led to a long‐term, ongoing complete remission. In eligible patients with recurrent MTX‐sensitive PCNSL, multiple long‐term remissions can be induced by repetition of high‐dose MTX‐based chemotherapy followed by autologous retransplantation. Subsequent immune checkpoint inhibitor maintenance therapy might be able to prolong or maintain remission.
Fatigue surface crack propagation and intersecting cracks in connection with welding residual stresses
Authors: Chernyatin A.S. , Matvienko Yu.G. , Razumovsky I.A. 
Published: April 2018

AbstractThe effect of welding residual stress on surface fatigue crack propagation and fracture mechanics parameters of intersecting orthogonal cracks is discussed. The effect of welding residual stresses on fatigue propagation of the internal surface crack is analysed in the case of welded joint of the pipeline. To predict fatigue crack propagation, the modified Forman law taking into account the nonsingular T‐stress as the crack‐tip constraint has been employed. It is shown by means of numerical simulation (the software ANSYS and MATLAB) that welding residual stress and crack‐tip constraint effects lead to the semielliptical form of final configuration of the surface fatigue crack. Fracture mechanics parameters for intersecting surface cracks, namely, circular and semielliptical cracks in welded joint of the pipeline are also analysed by numerical simulation. It was concluded that welding residual stress intensifies the effect of intersecting orthogonal surface cracks on fracture mechanics parameters including the crack‐tip constraint.
Group Education and Multidisciplinary Management for Chronic Headaches Among Adolescents in a Military Treatment Facility: A Retrospective Chart Review
Authors: Ormond Andrew , Faux Brian M. , Zickefoose Betty A. , Aden James , Kapunan Patricia E. , Roberts Timothy A. 
Published: April 2018

ObjectiveTo assess the effect of group education on the frequency of chronic headaches among adolescents.BackgroundChronic headaches are a common problem among adolescents with significant psychosocial morbidity. Brief education on lifestyle interventions to decrease headache frequency has established benefits among adult patients but is less proven among adolescents.MethodsThis study is a chart review examining our experience with a group education program for 155 adolescents, aged 12‐17 years old, enrolled in the U.S. military medical system with at least 3 months of chronic headaches who were referred to a headache evaluation clinic. The primary outcome of our study was self‐reported number of days with a headache in the previous 30 days based on patient recall. We used a paired samples t‐test to measure the change in headache frequency between the frequency reported at the headache class and follow‐up more than 6 months after the class.ResultsMost of the adolescents seen in the program were female (114/155 [73.5%]) and suffered from migraine headaches (108/155 [69.8%]). Severe headache‐related disability was reported by 40.6% of subjects (63/155). Subjects reported an average of 19 days with headache during the previous 30 days. Females and patients with higher headache‐related disability reported a higher number of days with headache. Participation in the group education was associated with an 11.5 (SD 11.9, P < .001) day decrease in the frequency of headaches during the previous 30 days at follow‐up at least 6 months after the class, with largest decline seen in patients with the highest level of migraine‐related disability at baseline.ConclusionBased on our retrospective chart review study, group education on headache evaluation and lifestyle management has potential as an effective, low‐cost intervention for treatment of chronic headaches among adolescents.
Responding effectively to adult mental health patient feedback in an online environment: A coproduced framework
Authors: Baines Rebecca , Donovan John , Regan de Bere Sam , Archer Julian , Jones Ray 
Published: April 2018

AbstractBackgroundResponding to online patient feedback is considered integral to patient safety and quality improvement. However, guidance on how to respond effectively is limited, with limited attention paid to patient perceptions and reactions.ObjectivesTo identify factors considered potentially helpful in enhancing response quality; coproduce a best‐practice response framework; and quality‐appraise existing responses.DesignA four‐stage mixed methodology: (i) systematic search of stories published on Care Opinion about adult mental health services in the South West of England; (ii) collaborative thematic analysis of responses to identify factors potentially helpful in enhancing response quality; (iii) validation of identified factors by a patient‐carer group (n = 12) leading to the coproduction of a best‐practice response framework; and (iv) quality appraisal of existing responses.ResultsA total of 245 stories were identified, with 183 (74.7%) receiving a response. Twenty‐four (9.8%) had been heard but not yet responded to. 1.6% (n = 4/245) may lead to a change. Nineteen factors were considered influential in response quality. These centred around seven subject areas: (i) introductions; (ii) explanations; (iii) speed of response; (iv) thanks and apologies; (v) response content; (vi) signposting; and (vii) response sign‐off that were developed into a conceptual framework (the Plymouth, Listen, Learn and Respond framework). Quality appraisal of existing responses highlighted areas for further improvement demonstrating the framework's utility.ConclusionThis study advances existing understanding by providing previously unavailable guidance. It has clear practical and theoretical implications for those looking to improve health‐care services, patient safety and quality of care. Further validation of the conceptual framework is encouraged.
Impact of limited English proficiency on presentation and outcomes of patients undergoing primary percutaneous coronary intervention for ST‐elevation myocardial infarction
Authors: Biswas Sinjini , Seman Michael , Cox Nicholas , Neil Christopher , Brennan Angela , Dinh Diem , Walton Antony , Chan William , Lefkovits Jeffrey , Reid Christopher , Stub Dion 
Published: April 2018

AbstractDoctor–patient language discordance has been shown to lead to worse clinical outcomes. In this study of patients undergoing primary percutaneous coronary intervention for ST‐elevation myocardial infarction at an Australian health service, we demonstrated that limited English proficiency (LEP) is an independent predictor of prolonged symptom‐to‐door time, but does not lead to worse 30‐day mortality compared with English‐proficient patients. More effort needs to be placed in providing public health education in varied languages to encourage early presentation to hospital for patients with LEP.
Commentary: Types of bullying, types of intervention: reflections on Arseneault (2018)
Authors: Smith Peter K. 
Published: April 2018

AbstractArseneault's review is a timely reminder of the strong evidence for the negative impact of school bullying, especially although not only on the victims of it. It is particularly important in dealing with the evidence for causal links, mechanisms and possible moderating factors. In this Commentary, I raise some issues about the definition of bullying; the importance of separating out the bully/victim category; differing impacts of types of victimisation, and notably cyber victimization, perhaps interacting with gender; and evidence on school antibullying policies and impact of interventions.