bluuebunny/crossref_metadata_2025_split huggingface dataset:
One-Hour Postload Hyperglycemia Is a Stronger Predictor of Type 2 Diabetes Than Impaired Fasting Glucose
Authors: Fiorentino Teresa Vanessa , Marini Maria Adelaide , Andreozzi Francesco , Arturi Franco , Succurro Elena , Perticone Maria , Sciacqua Angela , Hribal Marta Letizia , Perticone Francesco , Sesti Giorgio 
Published: August 2015

Context:
Subjects with normal glucose tolerance (NGT) but 1-h postload glucose ≥ 155 mg/dL (NGT-1h-high) exhibit an intermediate cardiometabolic risk profile between individuals with NGT and impaired glucose tolerance (IGT).

Objective:
This study aimed to evaluate whether NGT-1h-high subjects have different cardiometabolic characteristics and an increased risk of type 2 diabetes compared with individuals with isolated impaired fasting glucose (IFG).

Setting, Design, and Patients:
A cross-sectional analysis was performed on 595 nondiabetic subjects who underwent an oral glucose tolerance test and an euglycemic hyperinsulinemic clamp in an ambulatory care setting. In addition, a longitudinal analysis was performed on 392 individuals, who were reexamined after a followup of 5.2 ± 0.9 y.

Main Outcome Measures:
Insulin sensitivity, beta-cell function, and risk of developing diabetes were measured.

Results:
Subjects with NGT-1h-high have a significant reduction of peripheral insulin sensitivity and beta-cell function, assessed by the disposition index, compared with either 1-h postload glucose &lt; 155 mg/dL (NGT-1h-low) or IFG individuals, but not compared with IGT. Among the 392 subjects studied in the longitudinal analysis the incidence rate of type 2 diabetes over the follow-up period was 2.9, 16.7, 12.5, and 31.4% for subjects with NGT-1h-low, NGT-1h-high, IFG, and IGT, respectively. In a Cox proportional hazard regression analysis the risk of developing diabetes for NGT-1h-high subjects was 4.02 (95% confidence interval [CI] 1.06–15.26); an even higher risk (6.67; 95% CI, 2.09–21.24) was observed in subjects with IGT, but not in the isolated IFG group (1.91; 95% CI, 0.44–8.29).

Conclusions:
NGT-1h-high subjects exhibit a higher risk of developing diabetes than those with IFG or NGT-1h-low, likely due to decreased insulin sensitivity and beta-cell function.
Meta-analysis of elective surgical complications related to defunctioning loop ileostomy compared with loop colostomy after low anterior resection for rectal carcinoma
Authors: Geng Hong Zhi , Nasier Dilidan , Liu Bing , Gao Hua , Xu Yi Ke 
Published: August 2015

Introduction Defunctioning loop ileostomy (LI) and loop colostomy (LC) are used widely to protect/treat anastomotic leakage after colorectal surgery. However, it is not known which surgical approach has a lower prevalence of surgical complications after low anterior resection for rectal carcinoma (LARRC). Methods We conducted a literature search of PubMed, MEDLINE, Ovid, Embase and Cochrane databases to identify studies published between 1966 and 2013 focusing on elective surgical complications related to defunctioning LI and LC undertaken to protect a distal rectal anastomosis after LARRC. Results Five studies (two randomized controlled trials, one prospective non-randomized trial, and two retrospective trials) satisfied the inclusion criteria. Outcomes of 1,025 patients (652 LI and 373 LC) were analyzed. After the construction of a LI or LC, there was a significantly lower prevalence of sepsis (p=0.04), prolapse (p=0.03), and parastomal hernia (p=0.02) in LI patients than in LC patients. Also, the prevalence of overall complications was significantly lower in those who received LIs compared with those who received LCs (p<0.0001). After closure of defunctioning loops, there were significantly fewer wound infections (p=0.006) and incisional hernias (p=0.007) in LI patients than in LC patients, but there was no significant difference between the two groups in terms of overall complications. Conclusions The results of this meta-analysis show that a defunctioning LI may be superior to LC with respect to a lower prevalence of surgical complications after LARRC.
Distal tibial fractures are a poorly recognised complication with fibula free flaps
Authors: Durst A , Clibbon J , Davis B 
Published: August 2015

The fibula free flap is ideal for complex jaw reconstructions, with low reported donor and flap morbidity. We discuss a distal tibial stress fracture two months following a vascularised fibula free flap procedure. Despite being an unrecognised complication, a literature review produced 13 previous cases; only two were reported in the reconstructive surgery literature, with the most recent claiming to be the first. The majority of these studies treated this fracture non-operatively; none reported their patient follow-up. Each case presented with ipsilateral leg pain, which has been cited as an early donor site morbidity in as many as 40% of fibula free flap cases. It is known that the fibula absorbs at least 15% of leg load on weight bearing. Studies have shown severe valgus deformities in up to 25% of patients with fibulectomies. We treated our patient operatively, first correcting his worsening valgus deformity with an external fixator, then reinforcing his healed fracture with a long distal tibial plate. We believe that this complication is underreported, unexpected and not mentioned during the consenting process. By highlighting the management of our case and the literature, we aim to increase awareness (and thus further reporting and appropriate management) of this debilitating complication.
Ultrasonography alone can reliably locate parathyroid tumours and facilitates minimally invasive parathyroidectomy
Authors: Butt HZ , Husainy MA , Bolia A , London NJM 
Published: August 2015

Introduction Minimally invasive parathyroidectomy (MIP) is performed via a short incision (≤3cm). Previous studies have employed multiple imaging modalities including ultrasonography, sestamibi imaging and/or intraoperative parathyroid hormone assay. We present our eight-year experience of MIP using ultrasonography alone. Methods One hundred parathyroidectomies performed by a single surgeon between April 2004 and December 2012 were identified in a prospectively maintained database. All patients underwent ultrasonography including preoperative marking of the lesion by a single radiologist. No other localising diagnostic tests were performed. Results Of the 100 patients (69% female) who underwent parathyroidectomy, 93 had MIP. The median age of all cases was 58 years (range: 19–90 years). All patients exhibited an elevated parathyroid hormone level (median: 19pmol) in the presence of hypercalcaemia (median: 2.86mmol/l, range: 2.54–3.94mmol/l). Conventional surgery was indicated in seven patients owing to the need for concurrent thyroidectomy. The median operative time was 30 minutes (range: 10–130 minutes). Ultrasonography localised parathyroid tumour position correctly in 98% of patients who underwent MIP, and in 97% across both MIP and non-MIP groups. Postoperative complications requiring treatment included pancreatitis and symptomatic hypocalcaemia. Follow-up review at 6–8 weeks demonstrated that 86% of open cases (6/7) and 94% of MIP cases (87/93) were rendered normocalcaemic. Conclusions Our study is the first to demonstrate that the sole use of ultrasonography including preoperative marking can localise parathyroid tumours correctly in 98% of cases suitable for MIP.
One-year mortality in patients with bone and soft tissue sarcomas as an indicator of delay in presentation
Authors: Nandra R , Hwang N , Matharu GS , Reddy K , Grimer R 
Published: August 2015

Introduction For many cancers, one-year mortality following diagnosis is a reflection of either advanced stage at diagnosis, multiple co-morbidities and/or complications of treatment. One-year mortality has not been reported for soft tissue or bone sarcomas. This study reports 1-year sarcoma mortality data over a 25-year period, investigates prognostic factors and considers whether a delay in presentation affects 1-year mortality. Methods A total of 4,945 newly diagnosed bone sarcoma and soft tissue sarcoma patients were identified from a prospectively maintained, single institution oncology database. Of these, 595 (12%) died within 1 year of diagnosis. Both patient factors and tumour characteristics available at diagnosis were analysed for effect. Results There was significant variation in one-year mortality between different histological subtypes. There has been no significant change in mortality rate during the last 25 years (mean: 11.7%, standard deviation: 2.8 percentage points). Soft tissue sarcoma patients who survived over one year reported a longer duration of symptoms preceding diagnosis than those who died (median: 26 vs 20 weeks, p<0.001). Prognostic factors identified in both bone and soft tissue sarcomas mirrored those for mid to long-term survival, with high tumour stage, large tumour size, metastases at diagnosis and increasing age having the greatest predictive effect. Conclusions One-year mortality in bone and soft tissue sarcoma patients is easy to measure, and could be a proxy for late presentation and therefore a potential performance indicator, similar to other cancers. It is possible to predict the risk of one-year mortality using factors available at diagnosis. Death within one year does not correlate with a long history but is associated with advanced disease at diagnosis.
Is abdominal tuberculosis a surgical problem?
Authors: Pattanayak S , Behuria S 
Published: August 2015

Introduction Abdominal tuberculosis (TB) has always been a diagnostic challenge, even for the astute surgeon. In developing countries, extrapulmonary TB often presents as an acute abdomen in surgical emergencies such as perforations and obstructions of the gut. Abdominal TB in different forms has been found more often as an aetiology for the chronic abdomen. This paper aims to evaluate TB as a surgical problem. Methods A comprehensive review of the literature on abdominal TB was undertaken. PubMed searches for articles listing abdominal TB/different types/diagnosis/treatment (1980–2012) were performed. Results TB is still a global health problem and the abdomen is one of the most common sites of extrapulmonary TB. Presentation may vary from an acute abdomen to a number of different chronic presentations, which can mimic other abdominal diseases. While some may benefit from antitubercular therapy, others may develop surgical problems such as strictures or obstruction, which may necessitate surgical intervention. Conclusions Abdominal TB should always be considered one of the differential diagnoses of acute or chronic abdomen in endemic areas.
Is there an association between body temperature and serum lactate levels in hip fracture patients?
Authors: Murtuza F , Farrier AJ , Venkatesan M , Smith R , Khan A , Uzoigwe CE , Chami G 
Published: August 2015

Introduction Hyperlactataemia is associated with adverse outcomes in trauma cases. It is thought to be the result of anaerobic respiration during hypoperfusion. This produces much less energy than complete aerobic glycolysis. Low body temperature in the injured patient carries an equally poor prognosis. Significant amounts of energy are expended in maintaining euthermia. Consequently, there may be a link between lactate levels and dysthermia. Hyperlactataemia may be indicative of inefficient energy production and therefore insufficient energy to maintain euthermia. Alternatively, significant amounts of available oxygen may be sequestered in thermoregulation, resulting in anaerobic respiration and lactate production. Our study investigated whether there is an association between lactate levels and admission body temperature in hip fracture patients. Furthermore, it looked at whether there is a difference in the mean lactate levels between hip fracture patients with low (<36.5°C), normal (36.5–37.5°C) and high (>37.5°C) body temperature on admission, and for patients who have low body temperature, whether there is a progressive rise in serum lactate levels as body temperature falls. Methods The admission temperature and serum lactate of 1,162 patients presenting with hip fracture were recorded. Patients were divided into the euthermic (body temperature 36.5–37.5°C), the pyrexial (>37.5°C) and those with low body temperature (<36.5°C). Admission lactate and body temperature were compared. Results There was a significant difference in age between the three body temperature groups (p=0.007). The pyrexial cohort was younger than the low body temperature group (mean: 78 vs 82 years). Those with low body temperature had a higher mean lactate level than the euthermic (2.2mmol/l vs 2.0mmol/l, p=0.03). However, there was no progressive rise in serum lactate level as admission temperature fell. Conclusions The findings suggest that in hip fracture patients, the body attempts initially to maintain euthermia, incurring an oxygen debt. This would explain the difference in lactate level between the low body temperature and euthermic cohorts. The fact that there is no correlation with the degree of temperature depression and lactate levels indicates that the body does not fuel thermohomeostasis indefinitely with oxygen. Instead, in part, it abandons thermoregulatory mechanisms. Consequently, in this population, active rewarming may be indicated rather than depending on patients’ own thermogenic ability.
The impact of a dedicated orthoplastic operating list on time to soft tissue coverage of open lower limb fractures
Authors: Fernandez MA , Wallis K , Venus M , Skillman J , Young J , Costa ML 
Published: August 2015

An observational study was conducted of 105 patients presenting with an open fracture of the tibia or ankle to determine the impact of a dedicated orthoplastic operating list on our management of these injuries over the time period January 2012 to July 2014. There were 51 patients before and 54 after the introduction of the orthoplastic list. Significant improvements were noted in our ability to deliver a service in line with national guidelines across all Gustilo–Anderson grades of injury. Among patients with the most severe grades of injury (Gustilo types IIIB and IIIC), there was a trend towards an improved time to first skeletal stabilisation (29.5 vs 14.2 hours, p=0.068), an improvement in time to soft tissue coverage (173.6 vs 88.1 hours, p=0.009) and a trend towards a reduced length of inpatient stay (32.6 vs 23.2 days, p=0.138). Where the 72-hour target had been breached, there was a significant improvement in the proportion of patients covered within 7 days of injury (48.2% vs 83.3%, p=0.017). Our compliance with national management standards increased significantly to reflect these improvements in care. These results support the implementation of dedicated orthoplastic operating sessions to meet the growing burden of patients presenting with open fractures at specialist centres.
Triple assessment is not necessary in most young women referred with breast symptoms
Authors: Yue D , Swinson C , Ravichandran D 
Published: August 2015

Introduction A palpable lesion in the breast is usually subjected to triple assessment (clinical examination [CE], imaging and core biopsy [CB] or fine needle aspiration [FNA]) to minimise the risk of missing breast cancer. However, breast cancer is rare in young women, and triple assessment (especially CB) is invasive and expensive. Our aim was to see whether CB/FNA could be avoided in young women with benign findings on CE and imaging. Methods This study analysed data from a prospectively entered database on female patients aged under 25 years who attended a rapid diagnosis breast clinic over a 68-month period. Results Among 10,301 patients seen, 955 females (9.3%) were aged <25 years. The most common presenting complaint was a lump, followed by pain and nipple discharge. CE was normal or revealed benign findings in all except 15 patients, in whom it was indeterminate. Ultrasonography was performed in 692 patients (72%) and was normal (n=289) or benign (n=382) in all except 21 patients, in whom it was indeterminate. In six patients, both were indeterminate. A total of 317 patients (35%) had triple assessment: FNA in 106, CB in 239 and both in 9 cases. No cancers were diagnosed. Conclusions It would appear safe to omit FNA/CB in patients aged under 25 years when clinical and ultrasonography findings are normal or benign. This approach would have avoided needle biopsies in all but 30 patients (3%) in the study.
The effect of carfentrazone-ethyl on soil microorganisms and soil enzymes activity / Wpływ karfentrazonu etylu na mikroorganizmy i aktywność enzymów glebowych
Authors: Tomkiel Monika , Baćmaga Małgorzata , Wyszkowska Jadwiga , Kucharski Jan , Borowik Agata 
Published: August 2015

Abstract
The aim of this study was to determine the effect of carfentrazone-ethyl (CE) doses of 0.265, 5.280, 10.560, 21.180, 42.240 μg kg-1 soil DM on fungi, Acnomycetes, organotrophic bacteria, total oligotrophic bacteria and spore-forming oligotrophic bacteria, and on the activity of dehydrogenases, catalase, urease, alkaline phosphatase, acid phosphatase, arylsulfatase and β-glucosidase. Carfentrazone-ethyl had a stimulating effect on total oligotrophic bacteria and organotrophic bacteria, but it inhibited the growth of Azotobacter, fungi, spore-forming oligotrophic bacteria and Actinomycetes. The analyzed substance modified the structure of soil microbial communities, and it induced the most profound changes in fungi. The highest values of the colony development (CD) index and the eco-physiological (EP) index were observed in organotrophic bacteria. The optimal dose of carfentrazone-ethyl stimulated the activity of dehydrogenases, catalase, urease, alkaline phosphatase, acid phosphatase and β-glucosidase, but it had no effect on arylsulfatase. The highest doses of the analyzed substance inhibited the activity of dehydrogenases (reduction from 11.835 to 11.381 μmol TPF), urease (reduction from 0.545 to 0.500 mmol N-NH4) and arylosulfatase (reduction from 0.210 to 0.168 mmol PNP). Dehydrogenases were most resistant to CE, whereas acid phosphatase and arylsulfatase were least resistant to the analyzed compound
Assessment of the influence of composts on microbiological and biochemical parameters of substrates and the morphological traits of scarlet sage / Ocena wpływu kompostów na parametry mikrobiologiczne i biochemiczne podłoży oraz cechy morfologiczne szałwii błysz czącej
Authors: Wolna-Maruwka Agnieszka , Mocek-Płóciniak Agnieszka , Głuchowska Katarzyna , Schroeter-Zakrzewska Anita , Borowiak Klaudia , Niewiadomska Alicja , Starzyk Justyna , Dach Jacek 
Published: August 2015

Abstract
The aim of the research was to assess the microbiological (number of heterotrophic bacteria, actinobacteria and moulds) and biochemical (urease and acid phosphatase activity) state of peat with the admixture of composts produced from sewage sludge. An additional aim of the research was to demonstrate the influence of those substrates on the morphological traits of scarlet sage (height, number and length of shoots, number of buds and inflorescences, greenness index (SPAD)). Composts produced from sewage sludge, wheat, maize and lupine straw were mixed with peat, where their percentage varied from 25% to 75%.
The substrate which included the composts applied in the experiment had a higher number of heterotrophic bacteria and a higher acid phosphatase activity level than the control substrate (peat). The multiplication of moulds and actinobacteria was more intensive than in the peat only in the combinations with K3 (sewage sludge 50%+sawdust 20%+ lupine straw 30%) and K4 (sewage sludge 50%+sawdust 20%+fresh maize straw 30%) composts, whereas the highest urease activity level was observed in the soils produced from K1 (sewage sludge 50%+sawdust 20%+white straw 30%) compost.
The most optimal development of plants was observed in the substrate with compost produced from wheat straw. Composts produced from municipal sewage sludge were found to be suitable for growing scarlet sage. However, their effect depends on the percentage of high peat in the substrate.
Variability of the Warta River water discharge in the city of Poznań as influenced by the Jeziorsko reservoir / Zmienność przepływów rzeki Warty w Poznaniu w aspekcie eksploatacji zbiornika Jeziorsko
Authors: Miler Antoni T. 
Published: August 2015

Abstract
The data set of the Warta discharges in Poznań (Poland) is one of the largest in the world as the daily observations of river stages have been conducted without interruptions since January, 1st, 1822. The Poznań measurement profile is situated in the 243.6 km and closes the catchment area of approximately 25 thousand square kilometers. The data used as the input in the paper were daily values of the Warta discharges in Poznań in the years 1822-2012. The climate in Poznań, a city situated in the centre of the Wielkopolska (Greater Poland) region, is relatively stable (Miler et al. 2005). Also the Warta River runoff shows considerable stability, especially in terms of mean annual values. Short-term trends are random in character. It was found that the Jeziorsko reservoir (total storage volume of 203 000 000 m3, officially put to use on September, 9th, 1987) significantly reduced daily variability of the flows and reduced peak discharge of the flood wave in the summer of 1997 on the Warta River at Poznań. The calculated periodogram for mean annual discharges of the Warta River in Poznań shows that there are main periodicities of ca. 10 year lengths. The research of the Provincial Inspectorate for Environmental Protection (WIOŚ) in Poznań shows a gradual improvement of water quality in the Warta River in Poznań.
Ras Transformation Overrides a Proliferation Defect Induced by Tpm3.1 Knockout
Authors: Coombes Jason D. , Schevzov Galina , Kan Chin-Yi , Petti Carlotta , Maritz Michelle F. , Whittaker Shane , Mackenzie Karen L. , Gunning Peter W. 
Published: August 2015

AbstractExtensive re-organisation of the actin cytoskeleton and changes in the expression of its binding proteins is a characteristic feature of cancer cells. Previously we have shown that the tropomyosin isoform Tpm3.1, an integral component of the actin cytoskeleton in tumor cells, is required for tumor cell survival. Our objective was to determine whether cancer cells devoid of Tpm3.1 would evade the tumorgenic effects induced by H-Ras transformation. The tropomyosin isoform (Tpm) expression profile of a range of cancer cell lines (21) demonstrates that Tpm3.1 is one of the most broadly expressed Tpm isoform. Consequently, the contribution of Tpm3.1 to the transformation process was functionally evaluated. Primary embryonic fibroblasts isolated from wild type (WT) and Tpm3.1 knockout (KO) mice were transduced with retroviral vectors expressing SV40 large T antigen and an oncogenic allele of the H-Ras gene, H-RasV12, to generate immortalized and transformed WT and KO MEFs respectively. We show that Tpm3.1 is required for growth factor-independent proliferation in the SV40 large T antigen immortalized MEFs, but this requirement is overcome by H-Ras transformation. Consistent with those findings, we found that Tpm3.1 was not required for anchorage independent growth or growth of H-Ras-driven tumors in a mouse model. Finally, we show that pERK and Importin 7 protein interactions are significantly decreased in the SV40 large T antigen immortalized KO MEFs but not in the H-Ras transformed KO cells, relative to control MEFs. The data demonstrate that H-Ras transformation overrides a requirement for Tpm3.1 in growth factor-independent proliferation of immortalized MEFs. We propose that in the SV40 large T antigen immortalized MEFs, Tpm3.1 is partly responsible for the efficient interaction between pERK and Imp7 resulting in cell proliferation, but this is overidden by Ras transformation.