bluuebunny/crossref_metadata_2025_split huggingface dataset:
Establishing the Physician‐Patient Relationship
Authors: TORRES ABEL , WAGNER RICHARD 
Published: June 2013

background.This is the first in a series of articles written to address the many medicolegal issues that impact the practice of dermatology. The topic of establishing the physician‐patient relationship was chosen as the starting point since it is the cornerstone of every medical malpractice action.methods.A format of an initial discussion of legal concepts followed by hypotheticals and a review of actual cases was chosen to enhance interactive learning. The subject matter is based on a review of medicolegal literature and actual recorded case law.results.A physician‐patient relationship may be established whether or not there is actual physical contact between the physician and patient, there is gratuitous advice, or there is an academic purpose.conclusion.The key in determining whether a physician‐patient relationship has been established is whether the patient reasonably relied upon advice given or had an expectation of treatment.
Laser Hair Transplantation
Authors: Unger Walter P. , David Laurence M. 
Published: June 2013

background. A new ultrapulse CO2 laser has been investigated for its possible use in hair transplanting. This laser, because of its ultrashort high energy pulses, produces far less thermal damage to adjacent tissues, including hair follicles, than earlier types of CO2 lasers. The potential advantages of using such a laser in minigrafting are reviewed and include less bleeding, greater density, and absence of “compression.”objective. The purpose of this study was to see if hair survival in grafts placed into laser‐prepared sites would be as good or better than that seen with scalpel slits.methods. Hair counts were used in 10 patients to compare hair survival in grafts placed into laser‐prepared sites and into scalpel‐prepared sites in a comparable but contralateral location.results. Average graft hair counts were greater in laser‐prepared sites in four of 10 patients, equal to grafts in scalpel‐prepared sites in five, and fewer in one. Hair growth occurred earlier in laser‐prepared sites in five of the 10 patients.conclusion. The authors are optimistic that the ultrapulse laser will become an important tool in hair transplanting.
Management of a Hidradenoma with Mohs Micrographic Surgery
Authors: HOUSE NANCY S. , HELM KLAUS F. , MALONEY MARY E. 
Published: June 2013

background. Hidradenomas are adnexal tumors that may grow to be very large and frequently recur after excision. Malignant transformation and metastatic spread can occur and histologic distinction of benign from malignant hidradenomas can be very difficult. Some tumors with bland histology have demonstrated aggressive behavior.objective. To decide the benefits of management with Mohs micrographic surgery of large hidradenomas.methods. The literature was reviewed, including both the clinical course of the tumor and histologic features. The case of our report was interpreted in light of the review.results. Three stages of Mohs surgery were required for complete removal of the hidradenoma. The patient remains free of recurrence.conclusions. This report highlights the difficulties in distinguishing benign from malignant hidradenomas and emphasizes the benefits of Mohs surgery for large or recurrent tumors.
The Treatment of Multiple Angiolipomas by Liposuction Surgery
Authors: KANEKO TAKEHIKO , TOKUSHIGE HIROYUKI , KIMURA NAOHIRO , MORIYA SHUJI , TODA KIYOSHI 
Published: June 2013

background. Recently, liposuction surgery has been widely accepted for body contouring or other noncosmetic applications, including lipoma and angiolipomatosis.objective. We treated a case of multiple angiolipomas at 49 years of age to confirm the Utility of liposuction.methods. Liposuction under general anesthesia was performed for angiolipomas distributed over the trunk.results. The patient has been followed for 2 years without recurrence.conclusion. We believe that liposuction is a safe and easy method of removing multiple angiolipomas.
Spindle Cell Hemangioendothelioma
Authors: ELTORKY MAHMOUD , CHESNEY THOMAS McC. , SEBES JENO , HALL J. CAMERON 
Published: June 2013

background. Spindle cell hemangioendothelioma lesions are uncommon, affect a wide age range in both sexes, and show a predilection for skin and subcutaneous tissue of the extremities.objective. To present three cases of spindle cell hemangioendothelioma and review the literature.methods. Three cases of spindle cell hemangioendothelioma are presented.results. Two of our cases first presented very early in life and progressed by local recurrences over many years. None of our cases showed evidence of metastases, but the lesions exhibited local aggressive and invasive behavior. Histologically, the lesions consist of alternating areas of dilated, thin walled cavernous vascular spaces and solid areas composed predominantly of spindle cells and clusters of epithelioid endothelial cells with intracytoplasmic vacuoles. That spindle cell hemangioendothelioma is a non‐neoplastic lesion and not a neoplasm of borderline malignancy is suggested by the following observations from our cases: the repeated presence of organized intravascular thrombi in all cases, the early clinical presentation in two cases, and the presence of some degree of vascular malformation at the periphery of lesions.conclusion. Both clinicians and pathologists should be aware of the existence of this lesion in order to diagnose and treat an affected patient correctly.
The Bipedicle Flap Revisited
Authors: FLINT IVAN D. , SIEGLE RONALD J. 
Published: June 2013

background
. There is little written in dermatologic literature on bipedicle advancement flaps.
objective
. In this paper we review the technique, case examples (many of which have not been described in the literature), benefits, and disadvantages of the bipedicle flap.
conclusions
. We believe the bipedicle flap to be a much under‐used flap in superficial soft tissue reconstruction. We suggest that this flap be actively considered as a reconstructive option for a variety of defects on multiple body sites.
Benzyl Alcohol Attenuates the Pain of Lidocaine Injections and Prolongs Anesthesia
Authors: WILLIAMS JOHN M. , HOWE NATHAN R. 
Published: June 2013

background. Benzyl alcohol is reported to be painless on injection and to provide limited dermal anesthesia. Benzyl alcohol has also been recommended as an adjuvant to lidocaine to reduce lidocaine's injection pain. There is insufficient data on pain of injection and duration of anesthesia for lidocaine containing benzyl alcohol.objective. We conducted a randomized, placebo‐controlled, double‐blinded comparison of intradermal 1% lidocaine with 0.86% benzyl alcohol and piain 1% lidocaine for pain of injection and duration of anesthesia.methods. Twenty subjects received the above two agents plus normal saline with and without 0.9% benzyl alcohol, with all Solutions adjusted to 375 ± 13 mosm/L.results. Lidocaine containing benzyl alcohol was 27% less painful upon injection and provided anesthesia 29% longer than piain lidocaine.conclusion. Benzyl alcohol is itself an effective anesthetic and can reduce the pain of injection for lidocaine without adversely affecting its anesthetic properties.
Nonrecurrent Primary Basal Cell Carcinoma of the Lower Extremity with Late Metastasis
Authors: SIEGLE RONALD J. , WOOD THOMAS 
Published: June 2013

background. Metastatic basal cell carcinoma (MBCC) is rare, with most cases of head and neck origin and from large multi‐recurrent tumors. MBCC is very rare from lower extremities and even more rare from primary tumors that were small and treated without local recurrence.objective. This paper presents a case of MBCC in a 78‐year‐old woman who had previously undergone resection without local recurrence of a small lower extremity basal cell carcinoma.conclusion. MBCC can present atypically with site of origin on lower extremities, initial tumor size small, and nonrecurrence of the primary tumor site. The clinician should be aware of this as well as understand that prompt and aggressive surgical therapy to localized metastases may extend survival
Insurance, Consumer Search, and Equilibrium Price Distributions
Authors: Akın Ş. Nuray , Platt Brennan C. 
Published: June 2013

AbstractWe examine a service market with two frictions: search is required to obtain price quotes, and insurance coverage for the service reduces household search effort. While fewer draws from a price distribution will directly raise a household's average price, the indirect effect of reduced search on price competition has a much greater impact, accounting for at least 89 percent of increased average expenditures. In this environment, a monopolist insurer will exacerbate the moral hazard by offering full insurance. A competitive insurance market typically results in partial insurance and significant price dispersion, yet a second‐best contract would offer even less insurance coverage.
Optimal Design of the Attribution of Pension Fund Performance to Employees
Authors: Müller Heinz , Schiess David 
Published: June 2013

AbstractThe article analyzes risk sharing in a defined contribution pension fund in continuous time. According to a prespecified attribution scheme, the interest rate paid on the employees' accounts is a linear function of the fund's investment performance. For each attribution scheme, the pension fund maximizes the expected utility and the employees derive utility from their savings accounts. It turns out that all Pareto‐optimal attribution schemes are characterized by the same optimal participation rate. We derive the total welfare gain that installs from replacing no participation with optimal participation. This welfare gain can be quantified and is substantial for reasonable parameter values.
Estimating Outstanding Claim Liabilities: The Role of Unobserved Risk Factors
Authors: Spierdijk Laura , Koning Ruud H. 
Published: June 2013

AbstractThis article proposes a new method for estimating claim liabilities. Our approach is based on the observation from contract theory that there is information asymmetry between the insurer and the policyholder about the risks incurred by the latter. We show that unobserved heterogeneity allows for a form of experience learning that can reduce this asymmetry, which makes it easier for the insurer to distinguish between high‐risk and low‐risk claimants. We evaluate our approach in the context of disability insurance for self‐employed and show that it results in more accurate best estimates of outstanding claim liabilities.
Comparison of seminal oxidants and antioxidants in subjects with different levels of physical fitness
Authors: Hajizadeh Maleki B. , Tartibian B. , Eghbali M. , Asri‐Rezaei S. 
Published: June 2013

SummaryThe purpose of this study was to evaluate the seminal 8‐Isoprostane, reactive oxygen species (ROS), malondialdehyde (MDA), superoxide dismutase (SOD), catalase, total antioxidant capacity (TAC) in subjects with different level of physical fitness. A total of 161 semen samples were obtained from three groups of healthy males, including elite athletes (23.8 ± 5.2 years, n = 56) who had regular training (4–5 days per week), recreationally active men (24.2 ± 4.9 years, n = 52) who participated in educational or recreational physical activities for 4–5 h per week and non‐active men (23.9 ± 5.0 years, n = 53) who did not participate in any exercise programmes for at least 6 months prior to the study. The results showed significantly higher levels of SOD, catalase and TAC as well as lower levels of 8‐Isoprostane, ROS and MDA in recreationally active men compared with either elite athletes or non‐active men (p < 0.001). Also, elite athletes revealed significantly higher seminal 8‐Isoprostane, ROS and MDA as well as lower SOD, catalase and TAC levels compared with recreationally active and non‐active men (p < 0.001). In conclusion, the results of the present study indicate that there are differences in seminal oxidants and antioxidants of elite athletes, recreationally active and non‐active men. These differences are more likely related to indices that favour decrement of oxidative stress‐induced peroxidative damage in spermatozoa from recreationally active men. Hence, recreationally active men seem to have a healthier semen production. The physiological significance of this observation is worthy of further investigation.
Growth hormone (GH) activity is associated with increased serum oestradiol and reduced Anti‐Müllerian Hormone in healthy male volunteers treated with GH and a GH antagonist
Authors: Andreassen M. , Frystyk J. , Faber J. , Kristensen L. Ø. , Juul A. 
Published: June 2013

SummaryGrowth hormone (GH) and insulin‐like growth factor I (IGF‐I) receptors are present on pituitary gonadotrophs and on testicular Leydig and Sertoli cells. Thus, the GH/IGF‐I system may modulate the pituitary‐gonadal axis in males. This is a randomized cross‐over study. Eight healthy male volunteers (mean age 35, range 29–46 years) were treated with GH for 3 weeks (1st week 0.01, 2nd week 0.02, 3rd week 0.03 mg/day/kg) or a GH receptor antagonist (Pegvisomant) (1st week 10, last 2 weeks 15 mg/day), separated by 8 weeks of washout. Before and after the two treatment periods, concentrations of luteinizing hormone (LH), follicle‐stimulating hormone, testosterone, oestradiol, sex hormone–binding globulin, inhibin B and Anti‐Müllerian Hormone (AMH) were measured. During GH treatment, IGF‐I increased [(median (IQR)] 166 (162–235) vs. 702 (572–875) μg/L, p < 0.001) together with oestradiol [(mean ± SD) 78 ± 23 vs. 111 ± 30 pm, p = 0.019], and the oestradiol/testosterone ratio (p = 0.003). By contrast, AMH (42 ± 14 vs. 32 ± 7 pm, p = 0.018), Inhibin B (211 (146–226) vs. 176 (129–204) ng/L, p = 0.059) and LH (3.8 ± 1.5 vs. 3.2 ± 1.2 U/L, p = 0.096) decreased. During pegvisomant treatment IGF‐I (204 (160–290) vs. 106 (97–157) μg/L, p = 0.001) and oestradiol (86 ± 28 vs. 79 ± 25 pm, p = 0.060) decreased. No significant changes or trends in the other reproductive hormones occurred during the two treatment regimens. GH/IGF‐I activity was positively associated with serum oestradiol, suggesting that GH/IGF‐I stimulates aromatase activity in vivo. As a novel observation, we found that high GH activity was associated with reduced levels of the Sertoli cell marker AMH. Further studies are needed to evaluate possible effects of GH on Sertoli cell function and/or spermatogenesis.
Europeanization of National Foreign Policy: The Case of Denmark's and Sweden's Relations with China
Authors: Michalski Anna 
Published: June 2013

AbstractThis article examines the link between constructed identity, socialization and interests in the Europeanization of national foreign policy. Theoretically, it contributes to the understanding of the conditions motivating Member States to have recourse to European Union (EU) opportunity structures in order to balance normative foreign policy interest with material interests. Empirically, the article contributes to understanding the influence of Europeanization on the foreign policy of Denmark and Sweden in their relations to China. It discusses perspectives on Europeanization of national foreign policy in the analysis of change in identity, institutions and policy, and explores the misfit thesis in relation to European identity construction and elite socialization, strategic calculation and the influence of alternative sources outside the EU. The research aims, study design and case selection are then presented prior to the analysis of the Europeanization of Denmark's and Sweden's relations with China.
Effect of vitamins, protein level and probiotics on immune response of moulted male broiler breeders
Authors: Khan R. U. , Rahman Z. U. , Javed I. , Muhammad F. 
Published: June 2013

SummaryThis study was planned to investigate the comparative effect of vitamins C (L‐ascorbic acid), E (DL‐α‐tocopherol acetate), probiotics, lower than normal protein level (14%) and combination of these treatments on immune response of male broiler breeders after zinc‐induced moulting. One hundred and eighty birds at the age of 65 weeks were induced to moult by mixing zinc oxide (ZnO) in feed at the rate 3000 IU/kg of feed. Upon completion of moulting, birds were divided into six groups (five replicates per group) in a completely randomized design and were fed vitamin C (500 IU/kg), vitamin E (100 IU/kg), lower protein level, probiotics (50 mg/l), and a combination of these components, while one group was kept as control. After completion of moulting phase (5 weeks), the treatment effects were tested as in vitro macrophages engulfment percentage, nitric oxide (NO) production, serum antibody titres against Newcastle disease (ND) and infectious bronchitis (IB). The results showed that in vitro macrophage engulfment percentage in unopsonized conditions was significantly higher in vitamin E‐supplemented group. In addition, in opsonized condition, the macrophage engulfment percentage was significantly higher in both vitamin E‐ and C‐supplemented groups. The NO (opsonized and unopsonized) production and antibody titre against ND and IB were significantly higher in vitamin E‐supplemented group. It was concluded that vitamin E is a better option for enhanced immune response in broiler breeders after zinc‐induced moulting.
Cerebral oedema is rare in acute‐on‐chronic liver failure patients presenting with high‐grade hepatic encephalopathy
Authors: Joshi Deepak , O'Grady John , Patel Amit , Shawcross Debbie , Connor Steven , Deasy Neil , Willars Chris , Bernal William , Wendon Julia , Auzinger Georg 
Published: June 2013

AbstractBackground & AimsAcute‐on‐chronic liver failure (ACLF) has a rapidly progressive disease course associated with significant mortality. The prevalence of clinically significant cerebral oedema in ACLF is unknown.MethodsWe aimed to describe the prevalence of cerebral oedema in a cohort of ACLF adult (>18 years). We identified patients admitted to a single, specialist intensive care unit between January 2005 and January 2011 with high‐grade hepatic encephalopathy (≥3) and a clinical picture of either ACLF or chronic liver disease (CLD). Patients who had undergone cranial CT imaging were identified and their imaging reviewed. The ACLF and CLD groups were compared.ResultsOne thousand and eight patients with CLD were admitted. One hundred and seventy‐three patients (110 male) underwent neuroimaging. Eighty‐one (48 male) fulfilled criteria for ACLF. Variceal bleeding (30%) and sepsis (31%) were the most frequent precipitants of ACLF. Of those with neuroimaging from the total cohort, 30% of CT scans were normal, 30% demonstrated increased cerebral atrophy for age, 17% small vessel disease and 16% intracranial haemorrhage (ICH). Cerebral oedema was seen in three patients with ACLF only. An increased prevalence of ICH was observed in the ACLF group (23% vs. 9%, P = 0.008).ConclusionThe prevalence of clinically relevant cerebral oedema was low (4%) but fatal. Death was attributable to tonsillar herniation. An increased prevalence of ICH was seen in ACLF patients and remains an important differential.
Sexual reproduction in Sarcotragus spinosulus from two different shallow environments
Authors: Maria Mercurio , Giuseppe Corriero , Miriam Gherardi , Rossella Baldacconi , Gaino Elda 
Published: June 2013

AbstractThe reproductive cycle of the demosponge Sarcotragus spinosulus from two different shallow environments (La Pierta and La Strea) of the Ionian coasts of Apulia (SE Italy) was studied from February 2006 to February 2007 in 20 tagged specimens. The sponge is viviparous. All the monitored specimens showed sexual reproduction, even if the process usually involved small portions of the sponge tissue. Most of the specimens showed hermaphroditism, with contemporaneous production of oocytes and spermatic cysts in the same reproductive season. Young oocytes occurred from June to September in specimens from La Pierta and from June to October in those from La Strea. Large mature eggs, measuring up to 200 μm, showed a peak in August to September, concomitant with the appearance of spermatic cysts, whose density values were about 100 times higher than those estimated for female elements. At La Pierta, embryos were present for 11 months, whereas at La Strea they were very scarce during the first 4 months of observation, with the results that there was a significant difference in the production of embryos between the two groups of sponges. Embryo development occurred in patches inside the choanosomal region. Cleavage started in September and led in June to a solid stereoblastula, which, only at La Pierta, produced parenchymella larva (371.3 + 31.3 μm on average) from June to July. In the specimens from La Strea, larvae were never observed. The slight differences in the reproductive cycle between the two groups of sponges may be explained in the light of the major variability of the environmental parameters which could have affected the specimens from La Strea negatively.
Functional genotypes are associated with commensal Escherichia coli strain abundance within‐host individuals and populations
Authors: Blyton Michaela D. J. , Banks Sam C. , Peakall Rod , Gordon David M. 
Published: June 2013

AbstractThe selective pressures that determine genotype abundance and distribution frequently vary between ecological levels. Thus, it is often unclear whether the same functional genotypes will become abundant at different levels and how selection acting at these different scales is linked. In this study, we examined whether particular functional genotypes, defined by the presence or absence of 34 genes, of commensal Escherichia coli strains were associated with within‐host abundance and/or host population abundance in a wild population of 54 adult mountain brushtail possums (Trichosurus cunninghami). Our results revealed that there was a positive correlation between a strain's relative abundance within individuals and the strain's abundance in the host population. We also found that strain abundance at both ecological levels was predicted by the same group of functional genes (agn43, focH, micH47, iroN, ygiL, ompT, kspmT2 and K1) that had associated patterns of occurrence. We propose that direct selection on the same functional genes at both levels may in part be responsible for the observed correlation between the ecological levels. However, a potential link between abundance within the host and excretion rate may also contribute.