bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes after extended pancreatectomy in patients with borderline resectable and locally advanced pancreatic cancer
Authors: Hartwig W , Gluth A , Hinz U , Koliogiannis D , Strobel O , Hackert T , Werner J , Büchler M W 
Published: October 2016

Abstract

Background
In the recent International Study Group of Pancreatic Surgery (ISGPS) consensus on extended pancreatectomy, several issues on perioperative outcome and long-term survival remained unclear. Robust data on outcomes are sparse. The present study aimed to assess the outcome of extended pancreatectomy for borderline resectable and locally advanced pancreatic cancer.

Methods
A consecutive series of patients with primary pancreatic adenocarcinoma undergoing extended pancreatectomies, as defined by the new ISGPS consensus, were compared with patients who had a standard pancreatectomy. Univariable and multivariable analysis was performed to identify risk factors for perioperative mortality and characteristics associated with survival. Long-term outcome was assessed by means of Kaplan–Meier analysis.

Results
The 611 patients who had an extended pancreatectomy had significantly greater surgical morbidity than the 1217 patients who underwent a standard resection (42·7 versus 34·2 per cent respectively), and higher 30-day mortality (4·3 versus 1·8 per cent) and in-hospital mortality (7·5 versus 3·6 per cent) rates. Operating time of 300 min or more, extended total pancreatectomy, and ASA fitness grade of III or IV were associated with increased in-hospital mortality in multivariable analysis, whereas resections involving the colon, portal vein or arteries were not. Median survival and 5-year overall survival rate were reduced in patients having extended pancreatectomy compared with those undergoing a standard resection (16·1 versus 23·6 months, and 11·3 versus 20·6 per cent, respectively). Older age, G3/4 tumours, two or more positive lymph nodes, macroscopic positive resection margins, duration of surgery of 420 min or above, and blood loss of 1000 ml or more were independently associated with decreased overall survival.

Conclusion
Extended resections are associated with increased perioperative morbidity and mortality, particularly when extended total pancreatectomy is performed. Favourable long-term outcome is achieved in some patients.
Systematic review to establish absolute standards for technical performance in surgery
Authors: Goldenberg M G , Garbens A , Szasz P , Hauer T , Grantcharov T P 
Published: October 2016

Abstract

Background
Standard setting allows educators to create benchmarks that distinguish between those who pass and those who fail an assessment. It can also be used to create standards in clinical and simulated procedural skill. The objective of this review was to perform a systematic review of the literature using absolute standard-setting methodology to create benchmarks in technical performance.

Methods
A systematic review was conducted by searching MEDLINE, Embase, PsycINFO and the Cochrane Database of Systematic Reviews. Abstracts of retrieved studies were reviewed and those meeting the inclusion criteria were selected for full-text review. The quality of evidence presented in the included studies was assessed using the Medical Education Research Study Quality Instrument (MERSQI), where a score of 14 or more of 18 indicates high-quality evidence.

Results
Of 1809 studies identified, 37 used standard-setting methodology for assessment of procedural skill. Of these, 24 used participant-centred and 13 employed item-centred methods. Thirty studies took place in a simulated environment, and seven in a clinical setting. The included studies assessed residents (26 of 37), fellows (6 of 37) and staff physicians (17 of 37). Seventeen articles achieved a MERSQI score of 14 or more of 18, whereas 20 did not meet this mark.

Conclusion
Absolute standard-setting methodologies can be used to establish cut-offs for procedural skill assessments.
Promotional Role of Surface Defects on Carbon‐Supported Ruthenium‐Based Catalysts in the Transfer Hydrogenation of Furfural
Authors: Gao Zhi , Yang Lan , Fan Guoli , Li Feng 
Published: October 2016

AbstractThe synthesis of highly efficient supported metal catalysts is of vital importance for the modern development of the production of chemicals. In this regard, biomass‐based chemical transformation holds potential promise through many heterogeneous catalytic processes. Herein, we report surface defect engineering on a carbon‐supported, Ru‐based catalyst by a two‐step hybridization–self‐reduction route, which involves the assembly of a hybrid composite of ternary Co‐Al‐Ru layered double hydroxide (CoAlRu‐LDH) and amorphous carbon through the carbonization of glucose and a subsequent in situ self‐reduction process. The results revealed that Ru3+ species in the resulting CoAlRu‐LDH‐C composite could be reduced in situ to Ru0 species by the carbon component in the hybrid composite, and Co‐containing spinels with a large quantity of surface oxygen vacancies could be formed simultaneously on the surface. The as‐fabricated Ru‐based catalyst showed a superior catalytic performance in the liquid‐phase transfer hydrogenation of furfural to furfuryl alcohol using benzyl alcohol as hydrogen donator to other Ru‐based catalysts derived from LDH‐C composite precursors. It was proven that surface defects (i.e., oxygen vacancies, Co2+ species) could enable the chemisorption of furfural spatially and ensure the activation of its carbonyl groups, which promoted the transfer hydrogenation greatly.
Determination of an optimally sensitive and specific chemical exchange saturation transfer MRI quantification metric in relevant biological phantoms
Authors: Ray Kevin J. , Larkin James R. , Tee Yee K. , Khrapitchev Alexandre A. , Karunanithy Gogulan , Barber Michael , Baldwin Andrew J. , Chappell Michael A. , Sibson Nicola R. 
Published: October 2016

The purpose of this study was to develop realistic phantom models of the intracellular environment of metastatic breast tumour and naïve brain, and using these models determine an analysis metric for quantification of CEST MRI data that is sensitive to only labile proton exchange rate and concentration. The ability of the optimal metric to quantify pH differences in the phantoms was also evaluated.Novel phantom models were produced, by adding perchloric acid extracts of either metastatic mouse breast carcinoma cells or healthy mouse brain to bovine serum albumin. The phantom model was validated using 1H NMR spectroscopy, then utilized to determine the sensitivity of CEST MRI to changes in pH, labile proton concentration, T1 time and T2 time; six different CEST MRI analysis metrics (MTRasym, APT*, MTRRex, AREX and CESTR* with and without T1/T2 compensation) were compared.The new phantom models were highly representative of the in vivo intracellular environment of both tumour and brain tissue. Of the analysis methods compared, CESTR* with T1 and T2 time compensation was optimally specific to changes in the CEST effect (i.e. minimal contamination from T1 or T2 variation). In phantoms with identical protein concentrations, pH differences between phantoms could be quantified with a mean accuracy of 0.6 pH units.We propose that CESTR* with T1 and T2 time compensation is the optimal analysis method for these phantoms. Analysis of CEST MRI data with T1/T2 time compensated CESTR* is reproducible between phantoms, and its application in vivo may resolve the intracellular alkalosis associated with breast cancer brain metastases without the need for exogenous contrast agents.
Short and long time MR signal behavior of randomly distributed water and fat—numerical simulations
Authors: Lam Mie K. , Bakker Chris J.G. , Moonen Chrit T.W. , Viergever Max A. , Bartels Lambertus W. 
Published: October 2016

The MR time‐signal behavior of water has been reported to be different on short and long time scales for systems of randomly distributed perturbers in water in the static dephasing regime. Up to now, the signal of the perturbers in such systems has not been taken into consideration. Water–fat emulsions are macroscopically homogeneous systems and can be considered as microscopically randomly distributed perturbing fat spheres embedded in water. In such water–fat systems, the signal of the perturber, fat, cannot be ignored. Since water and fat are within the same system, the fat signal behavior may show similarities with water, with differences in short and long time scales. This could complicate fat‐referenced MR thermometry (MRT) methods such as multi‐gradient echo‐based (MGE) MRT. Simulations were performed using a numerical phantom comprising spherical fat objects embedded in a spherical water medium. To characterize the fat signal, the theoretical signal description of water was fitted to the simulated fat signal. The simulated signals were sampled as an MGE signal and MGE MRT was used to calculate temperatures. The sampling was done with and without delay, to investigate the effect on the temperature error of the time ranges in which the signal was sampled. It was confirmed that the fat signal behavior was similar to that of water and consisted of two regimes. The separation between the short and long time scales was approximately at 55 ms for fat, as compared with 8.9 ms for water. Without delayed signal sampling, the MGE MRT temperature error was about 2.5°C. With delayed sampling such that both the water and the fat signals were either in the short or in the long time scale the error was reduced to 0.2°C.
Detection of Haemophilus influenzae type b, Streptococcus agalactiae, Streptococcus pneumoniae and Neisseria meningitidis in CSF specimens of children suspicious of Meningitis in Ahvaz, Iran
Authors: Amin Mansour , Ghaderpanah Mozhgan , Navidifar Tahereh 
Published: October 2016

AbstractMeningitis is a life‐threatening infection associated with a high mortality and morbidity worldwide. Neisseria meningitidis, Haemophilus influenzae, and Streptococcus pneumoniae are the most prevalent infectious agents that cause bacterial meningitis (BM). The objective of this study was to determine the frequencies of these three bacteria using bacterial cultures and polymerase chain reaction (PCR). In our cross‐sectional study, cerebrospinal fluid (CSF) specimens were obtained from 196 patients who were suspected of having BM and referred to the pediatric ward of Abuzar Hospital (Ahvaz, Iran). The samples were monitored by gram stain, cultures, and the PCR method. The patients' age mean was 23 ± 0.56 months. The 196 patients comprised 92 (46.9%) boys and 104 (53.06%) girls. Based on bacterial cultures, just three isolates of H. influenzae were detected. However, PCR detected this bacterium in eight patients. Streptococcus pneumoniae was detected in five (2.5%) patients by the amplification of the lytA gene and in one (0.5%) patient by ply. In this study, no N. meningitidis isolate was in the CSF samples, based on the bacterial culture or PCR results. Streptococcus agalactiae was detected only in one patient, based on PCR. In conclusion, in the present study, the PCR method was more sensitive and rapid than culture for detecting the infectious agents in BM. For this reason, this diagnosis method is recommended for BM.
Is Punishment Morally Justified? Developing Nietzsche's Critique of Compatibilism inThe Wanderer and His Shadow, Section 23
Authors: ELGAT GUY 
Published: October 2016

ABSTRACT:Nietzsche is mostly known for denying moral responsibility on account of lack of libertarian free will, thus betraying an incompatibilist approach to moral responsibility. In this paper, however, I focus on a different, less familiar argument by Nietzsche, one that I interpret as a critique of a compatibilist conception of moral responsibility. The critique shows why punishment and our moral sanctions in general are morally unjustified by the compatibilist's own lights. In addition, I articulate what I call Nietzsche's explanatory challenge, which challenges the compatibilist to explain the performance of an immoral action without appealing to conditions that would exempt or excuse the wrongdoer or otherwise relieve the wrongdoer from responsibility and would thus make punishing the wrongdoer morally unjustified. By drawing on the work of R. Jay Wallace, I reconstruct Nietzsche's anticompatibilist argument and defend it against four possible objections.
Content and Methods used to Train Tobacco Cessation Treatment Providers: An International Survey
Authors: Kruse Gina R. , Rigotti Nancy A. , Raw Martin , McNeill Ann , Murray Rachael , Piné-Abata Hembadoon , Bitton Asaf , McEwen Andy 
Published: October 2016

Introduction: There are limited existing data describing the training methods used to educate tobacco cessation treatment providers around the world.Aims: To measure the prevalence of tobacco cessation treatment content, skills training, and teaching methods reported by tobacco treatment training programmes around the world.Methods: Web-based survey in May–September 2013 amongst tobacco cessation training experts across six geographic regions and four World Bank income levels. In total, 104 individual training programmes responded.Results: Of 104 individual programmes, most reported teaching brief advice (78%) and one-to-one counselling (74%); telephone counselling was uncommon (33%). Overall, teaching of knowledge topics was more commonly reported than skills training. Programmes in lower income countries less often reported teaching about medications, behavioural treatments and biomarkers and less often reported skills-based training about interviewing clients, medication management, biomarker measurement, assessing client outcomes, and assisting clients with co-morbidities. Programmes reported a median 15 hours of training. Face-to-face training was common (85%); online programmes were rare (19%). Almost half (47%) included no learner assessment. Most (65%) offered no continuing education.Conclusions: Nearly all programmes reported teaching evidence-based treatment modalities in a face-to-face format. Few programmes delivered training online or offered continuing education. Skills-based training was less common amongst low- and middle-income countries (LMICs). There is an unmet need for tobacco treatment training protocols which emphasise practical skills and which are more rapidly scalable than face-to-face training in LMICs.
Thermo-mechanical numerical model of the transition from continental rifting to oceanic spreading: the case study of the Alpine Tethys
Authors: MAROTTA ANNA MARIA , RODA MANUEL , CONTE KATYA , SPALLA MARIA IOLE 
Published: October 2016

AbstractWe develop a two-dimensional thermo-mechanical numerical model in which the formation of oceanic crust and serpentinite due to the hydration of the uprising mantle peridotite has been implemented, with the aim of discussing the behaviour of the lithosphere of the Alps and Northern Apennines during the transition from continental rifting to ocean spreading of the Alpine Tethys. The predictions of the model are compared with natural data related to the Permian–Triassic high-temperature – low-pressure (HT-LP) metamorphism affecting the continental lithosphere and data from the JurassicP–Tevolution of the oceanic lithosphere from the Alps and the Northern Apennines. Our analysis indicates that a thinned continental crust, an ocean–continent transition zone and an oceanic lithosphere characterize the final structure of the system in a poor magma rift pre-Alpine configuration. We also find that mantle serpentinization starts before crustal break-up and that denudation occurs before ocean spreading. The mantle denudation starts several million years before the gabbros/basalt formation, generating an ocean–continent transition zone from the passive continental margin to the oceanic lithosphere of size 160–280 km. The comparative analysis shows that the extension of a hot and weak lithosphere, which promotes the development of hyperextended Alpine margins, better agrees with the natural data. Finally, our comparative analysis supports the hypothesis that the lithospheric extension preceding the opening of the Alpine Tethys did not start in a stable continental lithosphere, but developed by recycling part of the old Variscan collisional suture.
Aggregation of cloned embryos in empty zona pellucida improves derivation efficiency of pig ES-like cells
Authors: Lee Dong-Kyung , Park Chi-Hun , Choi Kwang-Hwan , Jeong Yeon-ik , Uh Kyung-Jun , Hwang Jae Yeon , Lee Sang-Goo , Lee Chang-Kyu 
Published: October 2016

SummaryThe development of embryonic stem cells (ESCs) from large animal species has become an important model for therapeutic cloning using ESCs derived by somatic cell nuclear transfer (SCNT). However, poor embryo quality and blastocyst formation have been major limitations for derivation of cloned ESCs (ntESCs). In this study, we have tried to overcome these problems by treating these cells with histone deacetylase inhibitors (HDACi) and aggregating porcine embryos. First, cloned embryos were treated with Scriptaid to confirm the effect of HDACi on cloned embryo quality. The Scriptaid-treated blastocysts showed significantly higher total cell numbers (29.50 ± 2.10) than non-treated blastocysts (22.29 ± 1.50, P < 0.05). Next, cloned embryo quality and blastocyst formation were analyzed in aggregates. Three zona-free, reconstructed, four-cell-stage SCNT embryos were injected into the empty zona of hatched parthenogenetic (PA) blastocysts. Blastocyst formation and total cell number of cloned blastocysts increased significantly for all aggregates (76.4% and 83.18 ± 8.33) compared with non-aggregates (25.5% and 27.11 ± 1.67, P < 0.05). Finally, aggregated blastocysts were cultured on a feeder layer to examine the efficiency of porcine ES-like cell derivation. Aggregated blastocysts showed a higher primary colony formation rate than non-aggregated cloned blastocysts (17.6 ± 12.3% vs. 2.2 ± 1.35%, respectively, P < 0.05). In addition, derived ES-like cells showed typical characters of ESCs. In conclusion, the aggregation of porcine SCNT embryos at the four-cell stage could be a useful technique for improving the development rate and quality of porcine-cloned blastocysts and the derivation efficiency of porcine ntESCs.
Simple dietary criteria to improve serumn-3 fatty acid levels of mothers and their infants
Authors: Hautero Ulla , Poussa Tuija , Laitinen Kirsi 
Published: October 2016

AbstractObjectiveSufficient maternal dietary intake ofn-3 fatty acids (FA) supports offspring development. We aimed to construct simple criteria for dietary counselling to improve intake ofn-3 FA.DesignSerum phospholipid FA from mothers and infants were analysed by GC one month after delivery. Dietary intake of foods during pregnancy and one month after delivery were recorded using 3 d food diaries and an index for healthy eating was calculated. Fish consumption was established by questionnaires. Dietary consumption of foods resulting in an increase in serumn-3 FA was defined.SettingA mother–child follow-up study in Southwest Finland.SubjectsMothers (n90) and 1-month-old infants (n63).ResultsAfter delivery, the mother’s consumption of fish at least three times per week resulted in an increase in total serumn-3 FA (mean difference (95 % CI): 1·7 (0·7, 2·8) % of total FA,P<0·001) and DHA (1·1 (0·5, 1·8) % of total FA,P<0·001) compared with non-consumers. Persistent fish intake once weekly throughout pregnancy increased total serumn-3 FA (P=0·001) and DHA (P<0·001). Overall, a healthy diet (middle and highest tertiles of healthy eating index scorev. the lowest tertile) resulted in higher total serumn-3 FA (P=0·004) and DHA (P=0·008). Mother’s diet along with higher serum levels ofn-3 FA were related to serum FA levels in 1-month-old infants.ConclusionsAn overall healthy diet and persistent consumption of fish at least once weekly throughout pregnancy or more frequent fish intake three times per week increasesn-3 FA in serum phospholipids of both mothers and their infants.
Internal Structure and Clinical Utility of the Anxiety Control Questionnaire-Revised (ACQ-R) Spanish Version
Authors: Osma Jorge , Barrada Juan Ramón , García-Palacios Azucena , Navarro-Haro María , Aguilar Alejandra 
Published: October 2016

AbstractPerceived control has shown predictive value for anxiety severity symptoms as well as cognitive-behavior therapy outcomes. The most commonly used measure of perceived control is the Anxiety Control Questionnaire (ACQ), and more recently the ACQ Revised (ACQ-R). However, both questionnaires have shown structural inconsistencies among several studies. Also, although the ACQ and ACQ-R seem to be multidimensional instruments, a single total score have been commonly used. This study examined the internal structure of the ACQ-R Spanish version using exploratory factor and exploratory bi-factor analysis in a sample of 382 college students and 52 people diagnosed of panic disorder (with or without agoraphobia). Also, in this study we assessed the preliminary diagnostic value of the ACQ-R scores. The results indicated that the ACQ-R Spanish version structure consisted of two factors: one related with perceived control of internal emotional reactions (Emotion Control) and another related with perceived control of external events (Threat and Stress Control). Both specific factors can be adequately summarized by a general factor (General Anxiety Perception of Control; CFI = .973, TLI = .954, RMSEA = .039; p = .002), which accounted for 70% of the common explained variance. The correlations between the ACQ-R scores and with variables like anxiety (r = –.66) or anxiety sensitivity (r = –.50) presented the expected pattern of results. Either the two dimensions structure or the total score have proved to be a good tool to distinguish between participants with panic disorder and non-clinical samples (area under the curve = 0.79).
P53 regulates disruption of neuronal development in the adult hippocampus after irradiation
Authors: Li Y-Q , Cheng ZW-C , Liu SK-W , Aubert I , Wong C S 
Published: October 2016

AbstractInhibition of hippocampal neurogenesis is implicated in neurocognitive dysfunction after cranial irradiation for brain tumors. How irradiation results in impaired neuronal development remains poorly understood. The Trp53 (p53) gene is known to regulate cellular DNA damage response after irradiation. Whether it has a role in disruption of late neuronal development remains unknown. Here we characterized the effects of p53 on neuronal development in adult mouse hippocampus after irradiation. Different bromodeoxyuridine incorporation paradigms and a transplantation study were used for cell fate mapping. Compared with wild-type mice, we observed profound inhibition of hippocampal neurogenesis after irradiation in mice deficient in p53 despite the absence of acute apoptosis of neuroblasts. The putative neural stem cells were apoptosis resistant after irradiation regardless of p53 genotype. Cell fate mapping using different bromodeoxyuridine incorporation paradigms revealed enhanced activation of neural stem cells and their consequential exhaustion in the absence of p53 after irradiation. Both p53-knockout and wild-type mice demonstrated similar extent of microglial activation in the hippocampus after irradiation. Impairment of neuronal differentiation of neural progenitors transplanted in irradiated hippocampus was not altered by p53 genotype of the recipient mice. We conclude that by inhibiting neural progenitor activation, p53 serves to mitigate disruption of neuronal development after irradiation independent of apoptosis and perturbation of the neural stem cell niche. These findings suggest for the first time that p53 may have a key role in late effects in brain after irradiation.