bluuebunny/crossref_metadata_2025_split huggingface dataset:
A randomised single‐blind comparison of the effectiveness of Tristel Fuse (chlorine dioxide) as an office‐based fluid soak, with Cidex OPA (ortho‐phthaldehyde) using an automated endoscopic reprocessor (AER) as high‐level disinfection for flexible cystoscopes
Authors: Gilling Peter J. , Reuther Rana M. , Addidle Michael , Lockhart Michelle M. , Frampton Christopher M. , Fraundorfer Mark R. 
Published: October 2013

Objective
To compare the effectiveness, safety and cost of Tristel Fuse (chlorine dioxide) with Cidex OPA (ortho‐phthaldehyde; 1,2–benzenedicarboxaldehyde) in an automated endoscopic reprocessor (AER) for high‐level disinfection of flexible cystoscopes.
Patients and Methods
A randomised single‐blind study comparing the high‐level disinfectants Tristel Fuse as a simple office‐based soak and Cidex OPA using an AER was performed. Participants were ‘blinded’ to the agent used for disinfection of the flexible cystoscopes.
All patients had negative mid‐stream urine at baseline, (MSU) no symptoms suggestive of urinary tract infection (UTI) on the day of investigation, no recent antibiotic use or current indwelling urinary catheter.
Patients who underwent cystoscopic biopsy during the procedure were excluded.
A urine analysis was done before and 3–5 days after cystoscopy and multiple equipment cultures were performed.
The Urogenital Distress Inventory (UDI‐6 + two questions from the ‘long‐form’), symptom and quality‐of‐life scores were assessed before and after cystoscopy as were ease‐of‐use assessments and a full cost analysis.
Results
In all, 180 of 465 screened participants were randomised 1:1 and the mean age was 72.1 years, 17% were females and 57% of procedures were performed for bladder tumour surveillance.
The urine analysis was positive in 5.4% of patients in each group and 29% (Tristel) vs 20% (Cidex) of patients had urinary leukocyturia (p = ns) after cystoscopy.
The turnover (minutes per cycle) was 7.5 (Tristel) vs 26.7 (Cidex). The per‐procedure costs were $11.67 (American dollars) for Tristel Fuse and $21.82 for Cidex OPA with fixed costs of $4788 for Tristel Fuse and $60 514 for Cidex OPA.
Conclusions
Tristel Fuse appears to be as effective and more cost‐effective than Cidex OPA for high‐level disinfection of flexible cystoscopes. This has significant cost implications for the office urologist.
Impact of the type of ureteroileal anastomosis on renal function measured by diuretic scintigraphy: long‐term results of a prospective randomized study
Authors: Harraz Ahmed M. , Mosbah Ahmed , Abdel‐Latif Mohamed , El‐Assmy Ahmed , Gad Hossam , Shaaban Atallah A. 
Published: October 2013

Objective
To determine the long‐term effects of the direct refluxing‐type ureteroileal anastomosis technique with those of an antireflux technique on individual renal units, using diuretic scintigraphy in a prospectively randomized study.
Patients and Methods
Between 2002 and 2006, a prospective randomized study was conducted on 102 patients undergoing radical cystectomy and urinary diversion.
In every patient, both ureters were randomized to be implanted using a direct refluxing technique or an antireflux, serous‐lined extramural tunnel (SLET) technique.
Renal function (RF) was evaluated using 99mTc‐MAG‐3 diuretic scintigraphy. The serial changes in corrected glomerular filtration rate (cGFR) for each technique and for each side were compared.
Results
Over a median follow‐up of 6 years, the patients in both the direct refluxing and the SLET technique groups were found to have a significant reduction in mean (sd) cGFR between baseline and last follow‐up: cGFR decreased from 59.4 (12.4) to 45.6 (15.3) mL/min (P < 0.001) and from 54.3 (11.2) to 46.3 (12.8) mL/min (P = 0.002), respectively.
Five patients (4.9%) in the SLET group developed obstruction (four left‐sided and one right‐sided) compared with one (0.9%) in the direct refluxing group (right‐sided). The onset of obstruction was noted 1–7 months after radical cystectomy.
There was no significant difference between the groups in reductions in cGFR across the timepoints.
Comparison of the two techniques according to the side of ureter implantation showed that the direct refluxing technique trended towards better functional outcomes on the left side.
Conclusions
There was no observed difference in the RF of individual renal units between the SLET and the direct refluxing groups in the long term.
The need to incorporate an antireflux technique should be questioned and tailored according to the surgeon's experience and confidence.
Robustness as a non‐localizable relational phenomenon
Authors: Fernandez‐Leon Jose A. 
Published: October 2013

ABSTRACTA current challenge in neuroscience, systems and theoretical biology is to understand what properties allow organisms to exhibit and sustain behaviours despite perturbations (behavioural robustness). Indeed, there are still significant theoretical difficulties in this endeavour due to the context‐dependent nature of the problem. Contrary to the common view of biological robustness as a phenomenon that emerges internally, this article discusses the hypothesis that behavioural robustness is rooted in dynamical processes that distribute between internal controls, the organism body and the environment. This review highlights the varied perspectives and how they have led to the current focus on robustness as a relational phenomenon. A new perspective is proposed in which robustness is better understood in the context of agent‐environment dynamical couplings, in which such couplings are not always the full determinants of robustness. The challenges and limitations of the proposed approach are identified.
Escherichia coliinfection induces autoimmune cholangitis and anti-mitochondrial antibodies in non-obese diabetic (NOD).B6 (Idd10/Idd18) mice
Authors: Wang J J , Yang G-X , Zhang W C , Lu L , Tsuneyama K , Kronenberg M , Véla J L , Lopez-Hoyos M , He X-S , Ridgway W M , Leung P S C , Gershwin M E 
Published: October 2013

SummarySeveral epidemiological studies have demonstrated that patients with primary biliary cirrhosis (PBC) have a higher incidence of urinary tract infections (UTI) and there is significant homology of the immunodominant mitochondrial autoantigen, the E2 component of the pyruvate dehydrogenase complex (PDC-E2), between mammals and bacteria. Previous work has demonstrated that non-obese diabetic (NOD).B6 Idd10/Idd18 infected with Novosphingobium aromaticivorans developed liver lesions similar to human PBC. It was postulated that the biliary disease was dependent upon the presence of the unique N. aro glycosphingolipids in activating natural killer T (NK T) cells. To address this issue, we infected NOD.B6 Idd10/Idd18 mice with either Escherichia coli, N. aro or use of a phosphate-buffered saline (PBS) vehicle control and serially followed animals for the appearance of liver pathology and anti-mitochondrial autoantibodies (AMA). Of striking importance, the biliary disease of E. coli-infected mice was more severe than N. Aro-infected mice and the titre of AMA was higher in E. coli-infected mice. Furthermore, the immunopathology did not correlate with the ability of bacterial extracts to produce antigen-dependent activation of NK T cells. Our data suggest that the unique glycosphingolipids of N. aro are not required for the development of autoimmune cholangitis. Importantly, the data highlight the clinical significance of E. coli infection in a genetically susceptible host, and we suggest that the appearance of autoimmune cholangitis is dependent upon molecular mimicry. These data highlight that breach of tolerance to PDC-E2 is probably the first event in the natural history of PBC in genetically susceptible hosts.
Development of a standardized testing procedure for assessing the irritation potential of occupational skin cleansers
Authors: Elsner Peter , Seyfarth Florian , Antonov Dimitar , John Swen Malte , Diepgen Thomas , Schliemann Sibylle 
Published: October 2013

SummaryBackgroundFrequent skin cleaning fulfils the definition of occupational ‘wet work’. Standardized methods are required to assess the irritation potential of workplace cleansers.ObjectivesTo develop a standardized procedure for testing the irritation potential of occupational skin cleansers.MethodsIn this single‐blind, single‐centre trial in 25 healthy volunteers, the irritation potential of five generic reference cleansers was tested by three‐times‐daily washing with an automated skin cleaning device for 4 days, and quantification of cumulative skin barrier damage was performed by visual scoring, chromametry, transepidermal water loss TEWL, and corneometry. For two cleansers, reproducibility of the irritancy assessment was assessed. Furthermore, the irritation induced by four commercial workplace skin cleansers was studied.ResultsWhereas no significant changes were observed for any of the tested cleansers by either visual scoring or chromametry, significant increases in TEWL and significant decreases in stratum corneum hydration were found for all cleansers. Cleansers differed significantly in their irritation potential. On retesting of two cleansers, the first results were confirmed. Among the four commercial cleansers, one that was claimed to be mild was found to be disproportionally irritant.ConclusionsThe presented model for testing cleansing preparations allows a highly controlled, practically relevant and reproducible irritancy assessment of occupational skin cleansers.
Use of cannula ileostomy to protect a low colorectal anastomosis in patients having preoperative neoadjuvant chemoradiotherapy
Authors: Hanju H. , Jiahe X. , Caizhao L. , Sen L. , Jianjiang L. 
Published: October 2013

AbstractAimThis study evaluated the efficacy and safety of ileal diversion, using a tracheal cannula, to protect from a low colorectal anastomosis in patients treated with neoadjuvant chemoradiotherapy.MethodFifty patients who presented with rectal cancer and who had accepted neoadjuvant chemoradiotherapy were included. All underwent a low anterior resection with ileal diversion by either tracheal cannula ileostomy (n = 28) or conventional loop ileostomy (n = 22). Demographics, clinical features and operation data were recorded.ResultsTwo patients developed anastomotic dehiscence after completion of the cannula ileostomy but neither patient required any further operation. There was no difference in anastomotic dehiscence, peritonitis or requirement for further surgery in patients treated with cannula ileostomy and loop ileostomy.ConclusionCannula ileostomy is a safe, quick, effective and convenient means of intestinal diversion after low anterior resection. Its obvious advantage over loop ileostomy is a reduced overall hospital stay and avoidance of the need to close the stoma.
Motor impairment in very preterm‐born children: links with other developmental deficits at 5 years of age
Authors: Van Hus Janeline W , Potharst Eva S , Jeukens‐Visser Martine , Kok Joke H , Van Wassenaer‐Leemhuis Aleid G 
Published: October 2013

AimTo elucidate the relation between motor impairment and other developmental deficits in very preterm‐born children without disabling cerebral palsy and term‐born comparison children at 5 years of (corrected) age.MethodIn a prospective cohort study, 165 children (81 very preterm‐born and 84 term‐born) were assessed with the Movement Assessment Battery for Children ‐ 2nd edition, Touwen's neurological examination, the Wechsler Preschool and Primary Scale of Intelligence, processing speed and visuomotor coordination tasks of the Amsterdam Neuropsychological Tasks, and the Strengths and Difficulties Questionnaire.ResultsMotor impairment (≤15th centile) occurred in 32% of the very preterm‐born children compared with 11% of their term‐born peers (p=0.001). Of the very preterm‐born children with motor impairment, 58% had complex minor neurological dysfunctions, 54% had low IQ, 69% had slow processing speed, 58% had visuomotor coordination problems, and 27%, 50%, and 46% had conduct, emotional, and hyperactivity problems respectively. Neurological outcome (odds ratio [OR]=41.7, 95% confidence intervals [CI] 7.5–232.5) and Full‐scale IQ (OR=7.3, 95% CI 1.9–27.3) were significantly and independently associated with motor impairment. Processing speed (OR=4.6, 95% CI 1.8–11.6) and attention (OR=3.2, 95% CI 1.3–7.9) were additional variables associated with impaired manual dexterity. These four developmental deficits mediated the relation between preterm birth and motor impairment.InterpretationComplex minor neurological dysfunctions, low IQ, slow processing speed, and hyperactivity/inattention should be taken into account when very preterm‐born children are referred for motor impairment.
Determinants of gross motor function of young children with cerebral palsy: a prospective cohort study
Authors: Bartlett Doreen J , Chiarello Lisa A , Mccoy Sarah W , Palisano Robert J , Jeffries Lynn , Fiss Alyssa L , Rosenbaum Peter , Wilk Piotr 
Published: October 2013

AimThe aim of this study was to test a model of determinants of gross motor function of young children with cerebral palsy (CP).MethodFour hundred and twenty‐nine children with CP (242 males, 187 females; mean age 3y 2mo, SD 11mo) representing all levels of the Gross Motor Function Classification System (GMFCS) participated. Children in levels I to II and III to V were classified as Groups 1 and 2 respectively. Distribution of CP was quadriplegia, 44%; hemiplegia, 24%; diplegia, 23%; triplegia, 6%; and monoplegia, 2% (data not available for 1%). Impairment and motor function data were collected by reliable assessors; parents completed questionnaires on health conditions and adaptive behavior. Seven months later, parents were interviewed about family life and services received. One year after the study onset, motor function was re‐evaluated. Analysis involved structural equation modeling.ResultsThe well‐fitting model explained 58% and 75% of the variance in motor function at study completion for Groups 1 and 2 respectively. Primary impairments (spasticity, quality of movement, postural stability, and distribution of involvement; β=0.52–0.68) and secondary impairments (strength, range of motion limitations, and reduced endurance; β=0.25–0.26) explained the most variance. Adaptive behavior was a significant determinant only for Group 2 (β=0.21) and participation in community programs was significant only in Group 1 (β=0.13).InterpretationMotor function is supported by optimizing body structures and function for all children and enhancing adaptive behavior for children with greater motor challenges.
Value of Speckle Tracking for the Assessment of Right Ventricular Function in Patients Operated on for Tetralogy of Fallot. Comparison with Magnetic Resonance Imaging
Authors: Bernard Yvette , Morel Mathilde , Descotes‐Genon Vincent , Jehl Jerome , Meneveau Nicolas , Schiele Francois 
Published: October 2013

BackgroundRight ventricular (RV) function is a major prognostic factor in patients (pts) with operated tetralogy of Fallot (TOF). We compared the results of RV speckle tracking (two‐dimensional [2D] strain) with those of magnetic resonance imaging (MRI) in this setting.MethodsAt transthoracic echocardiogram (echo), RV fractional area change (RVFAC), tricuspid annular plane systolic excursion (TAPSE), velocity of S‐wave at tricuspid annulus with tissue Doppler, and 2D strain (longitudinal maximal systolic strain) were recorded. Their results were compared to RV indexed end‐diastolic volume (EDV), indexed end‐systolic volume (ESV), and RV ejection fraction (EF) at MRI.ResultsTwenty‐two pts (16 M) aged 11–62 years (mean 23.2 ± 10.8) were included. Parameters of RV systolic function were as follows: RVFAC = 40 ± 10%, TAPSE = 18 ± 4 mm, S‐wave = 10 ± 0.2 cm/sec, and RV EF at MRI = 43 ± 11%. Global RV systolic strain was −15.5 ± 4.2%, free wall strain was −15.1 ± 6.3%, and septal strain was −15.8 ± 3.8% on average for the whole group. Echo indexed RV end‐diastolic area correlated with EDV at MRI (r = 0.73), as well as echo indexed RV end‐systolic area and ESV at MRI (r = 0.71). Global RV 2D strain correlated well with RV EF at MRI: r = 0.68; P < 0.05, and with ESV at MRI: r = 0.63. Feasibility, intra‐ and inter‐observer reproducibility of 2D strain were adequate.ConclusionsSpeckle tracking is a promising method to estimate RV systolic function in pts operated on for TOF.
Aneurysmally Dilated Giant Coronary Sinus Mimicking Accessory Cardiac Chamber
Authors: Vijay Sudarshan Kumar , Tiwari Bhuwan C. , Misra Mukul , Joshi Lalit Mohan , Srivastava Dharmendra Kumar 
Published: October 2013

Mini‐AbstractCoronary sinus dilatation is usually the result of anomalous drainage to the sinus, either from the persistent left superior vena cava, anomalous pulmonary vein drainage or from coronary arterio‐venous fistula. Occasionally, the degree of coronary sinus enlargement is so great that the structure is mistaken for something else, such as accessory cardiac chamber or dilated descending aorta. Herein, we describe a rare case of giant coronary sinus that has an unusual enlargement as cardiac chamber.
Positive impact of chronic graft‐versus‐host disease on the outcome of patients with de novo myelodysplastic syndrome after allogeneic hematopoietic cell transplantation: a single‐center analysis of 115 patients
Authors: Hiramoto Nobuhiro , Kurosawa Saiko , Tajima Kinuko , Okinaka Keiji , Tada Kohei , Kobayashi Yujin , Shinohara Akihito , Inoue Yoshitaka , Ueda Ryosuke , Tanaka Takashi , Kim Sung‐Won , Yamashita Takuya , Heike Yuji , Fukuda Takahiro 
Published: October 2013

AbstractTo evaluate the impact of graft‐versus‐host disease (GVHD) and prognostic factors for patients with myelodysplastic syndrome (MDS) after allogeneic hematopoietic cell transplantation (allo‐HCT), we retrospectively reviewed 115 patients with MDS or acute myeloid leukemia with multilineage dysplasia (AML‐MLD) after allo‐HCT at our center. Eighty one patients received reduced‐intensity conditioning (RIC) regimens, whereas 34 received myeloablative conditioning regimens. Although the RIC group was significantly older and included more patients with poor cytogenetic risk, no difference in 4‐yr overall survival (OS) was seen between the two groups. In a multivariate analysis, covariates associated with a worse OS were the French‐American‐British stage of refractory anemia excess blasts in transformation/AML‐MLD at peak, poor cytogenetic risk, bone marrow blasts of 20% or higher at HCT and the absence of chronic GVHD (cGVHD). By using semi‐landmark analyses, we found that the presence of cGVHD significantly improved OS in high‐risk patients or the RIC group. However, there was no difference in OS between those with and without cGVHD among low‐risk MDS patients. These findings suggest that the graft‐versus‐leukemia effect may be more beneficial in high‐risk patients who do not receive intensive preparative regimens.
Methylphenidate treatment of attention deficit hyperactivity disorder in young people with learning disability and difficult‐to‐treat epilepsy: Evidence of clinical benefit
Authors: Fosi Tangunu , Lax‐Pericall Maria T. , Scott Rod C. , Neville Brian G. , Aylett Sarah E. 
Published: October 2013

SummaryPurposeTo establish the efficacy and safety of methylphenidate (MPH) treatment for attention deficit hyperactivity disorder (ADHD) in a group of children and young people with learning disability and severe epilepsy.MethodsThis retrospective study systematically reviewed the case notes of all patients treated with methylphenidate (MPH) for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM‐IV) ADHD at a specialist epilepsy center between 1998 and 2005. Treatment efficacy was ascertained using clinical global impressions (CGI) scores, and safety was indexed by instances of >25% increase in monthly seizure count within 3 months of starting MPH.Key FindingsEighteen (18) patients were identified with refractory epilepsies (14 generalized, 4 focal), IQ <70, and ADHD. Male patients predominated (13:5) and ADHD was diagnosed at a median age of 11.5 years (range 6–18 years). With use of a combination of a behavioral management program and MPH 0.3–1 mg/kg/day, ADHD symptoms improved in 61% of patients (11/18; type A intraclass correlation coefficient of CGI 0.85, 95% confidence interval [CI] 0.69–0.94). Daily MPH dose, epilepsy variables, and psychiatric comorbidity did not relate to treatment response across the sample. MPH adverse effects led to treatment cessation in three patients (dysphoria in two, anxiety in one). There was no statistical evidence for a deterioration of seizure control in this group with the use of MPH.SignificanceMethylphenidate with behavioral management was associated with benefit in the management of ADHD in more than half of a group of children with severe epilepsy and additional cognitive impairments. Eighteen percent had significant side effects but no attributable increase in seizures. Methylphenidate is useful in this group and is likely to be under employed.
Jakpot! New small molecules in autoimmune and inflammatory diseases
Authors: Ghoreschi Kamran , Gadina Massimo 
Published: October 2013

AbstractCytokines are key mediators of the development and homeostasis of haematopoietic cells, critical for host defense, but also for the development of autoimmune and inflammatory diseases such as psoriasis or rheumatoid arthritis (RA). Blocking cytokines activity by interfering with the ligand–receptor association has been successfully employed to treat several immune disorders. A subgroup of cytokines signals through receptors requiring the association with a family of cytoplasmic protein tyrosine kinases known as Janus kinases (Jaks). Jaks have recently gained significant attention as therapeutic targets in inflammation and autoimmunity, and several Jak inhibitory small molecules have been developed. The first two Jak inhibitors, tofacitinib and ruxolitinib, have been approved for the treatment of RA and primary myelofibrosis, respectively. Efficacy and safety data suggest that some of these oral Jak inhibitors as well as their topical formulations may soon enter the daily clinical practice for treating patients with psoriasis, lupus erythematosus or other inflammatory skin diseases. While biologics typically target one single cytokine, these new immunomodulators can inhibit signals from multiple cytokines intra‐cellularly and therefore could be useful when other therapies are ineffective. Thus, Jak inhibitors may replace some traditional immunosuppressive agents and help patients not responding to previous therapies.