bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of different strategies for identifying asymptomatic left ventricular dysfunction and pre‐clinical (stage B) heart failure in the elderly. Results from ‘PREDICTOR’, a population based‐study in central Italy
Authors: Mureddu Gian Francesco , Tarantini Luigi , Agabiti Nera , Faggiano Pompilio , Masson Serge , Latini Roberto , Cesaroni Giulia , Miceli Maria , Forastiere Francesco , Scardovi Angela Beatrice , Uguccioni Massimo , Boccanelli Alessandro 
Published: June 2013

AimsTo evaluate the accuracy and cost‐effectiveness of different screening strategies to identify systolic and/or diastolic asymptomatic LV dysfunction (ALVD), as well as pre‐clinical (stage B) heart failure (HF), in a community of elderly subjects in Italy.Methods and resultsA sample of 1452 subjects aged 65–84 years were chosen from the original cohort of 2001 randomly selected residents of the Lazio Region (Italy), as a part of the PREDICTOR survey. All subjects underwent physical examination, biochemistry/NT‐proBNP assessment, 12‐lead ECG, and Doppler transthoracic echocardiography (TE). Five strategies were evaluated including ECG, NT‐proBNP, TE, and their combinations. Subjects older than 75 years, and with at least two additional risk factors, were defined as being high‐risk for HF (435), whereas the remaining 1017 were defined at low risk. Screening characteristics and cost‐effectiveness (cost per case) of the five strategies to predict systolic (EF <50%) or diastolic ALVD and pre‐clinical HF (stage B) were compared. NT‐proBNP was the most accurate and cost‐effective screening strategy to identify systolic and moderate to severe diastolic LV dysfunction without a difference between the high‐risk and low‐risk groups. Adding ECG to the NT‐proBNP assessment did not improve the detection of pre‐clinical LV dysfunction. TE‐based screening was the least cost‐effective strategy. In fact, all screening strategies were inadequate to identify stage B HF.ConclusionsIn a community of elderly people, NT‐proBNP is the most accurate and cost‐ effective pre‐screening strategy to identify systolic and moderate to severe diastolic LV dysfunction.
Intravenous ferric carboxymaltose in iron‐deficient chronic heart failure patients with and without anaemia: a subanalysis of the FAIR‐HF trial
Authors: Filippatos Gerasimos , Farmakis Dimitrios , Colet Josep Comin , Dickstein Kenneth , Lüscher Thomas F. , Willenheimer Ronnie , Parissis John , Gaudesius Giedrius , Mori Claudio , von Eisenhart Rothe Barbara , Greenlaw Nicola , Ford Ian , Ponikowski Piotr , Anker Stefan D. 
Published: June 2013

AimsTherapy with i.v. iron in patients with chronic heart failure (CHF) and iron deficiency (ID) improves symptoms, functional capacity, and quality of life. We sought to investigate whether these beneficial outcomes are independent of anaemia.Methods and resultsFAIR‐HF randomized 459 patients with CHF [NYHA class II or III, LVEF ≤40% (NYHA II) or ≤45% (NYHA III)] and ID to i.v. iron as ferric carboxymaltose (FCM) or placebo in a 2:1 ratio. We analysed the efficacy and safety according to the presence or absence of anaemia (haemoglobin ≤120 g/L) at baseline. Of 459 patients, 232 had anaemia at baseline (51%). The effect of FCM on the primary endpoints of self‐reported Patient Global Assessment (PGA) and NYHA class at week 24 was similar in patients with and without anaemia [odds ratio (OR) for improvement, 2.48 vs. 2.60,P= 0.97 for PGA and 1.90 vs. 3.39,P= 0.51 for NYHA). Results were also similar for the secondary endpoints, including PGA and NYHA at weeks 4 and 12, 6 min walk test distance, Kansas City Cardiomyopathy Questionnaire overall score, and European Quality of Life‐5 Dimensions Visual Analogue Scale at most time points. Regarding safety, no differences were noticed in the rates of death or first hospitalization between FCM and placebo both in anaemic and in non‐anaemic patients.ConclusionsTreatment of ID with FCM in patients with CHF is equally efficacious and shows a similar favourable safety profile irrespective of anaemia. Iron status should be assessed in symptomatic CHF patients both with and without anaemia and treatment of ID should be considered.
The paradox of the “paradox of the plankton”
Authors: Record Nicholas R. , Pershing Andrew J. , Maps Frédéric 
Published: June 2013

Abstract
Record, N. R., Pershing, A. J., and Maps, F. 2014. The paradox of the “paradox of the plankton”. – ICES Journal of Marine Science, 71: 236–240. One of the central orienting questions in biodiversity theory and ecology is the “paradox of the plankton”, which asks how it is possible for many species to coexist on limited resources given the tendency for competition to exclude species. Over the past five decades, ecologists have offered dozens of solutions to the paradox, invoking game theory, chaos, stochastics, and many other concepts. Despite the plentitude of solutions to the paradox, ecologists continue to offer up novel solutions. Ocean modellers are now faced with the opposite paradox: given the overabundance and the diversity of solutions to the paradox, what is the appropriate way to build coexistence into ecosystem models? Ocean ecosystem models have a very standardized form—nutrient–phytoplankton–zooplankton (NPZ)-type systems of differential equations—where competitive exclusion is a common model behaviour. We suggest approaching the problem from the perspective of community-level patterns. We offer a prototype for building coexistence into NPZ models. The model allows for diverse assemblages of phytoplankton or zooplankton groups to persist and produces accurate community-level patterns. The approach is simple, adding only one additional parameter, and allows us to test the effects of trait distributions and environmental variables on diversity.
Minimally Invasive Diagnosis and Treatment of Endometrial Cancer After LeFort Colpocleisis
Authors: Harmanli Oz , Celik Hatice , Jones Keisha A. , Yadav Parul , Myers Tashanna 
Published: June 2013

Background
Endometrial carcinoma is rare after LeFort colpocleisis. Standards for its diagnosis and treatment have not been established.

Case
A 74-year-old woman presented with postmenopausal bleeding 14 months after LeFort colpocleisis. Here, we describe the use of the colpocleisis channels in our novel 2-stage approach. In the first stage, endometrial carcinoma was diagnosed with vaginohysteroscopy and dilatation and curettage via the channels. In the second stage, the cancer was optimally treated with total robotic hysterectomy, bilateral salpingo-oophorectomy, and lymph node dissection. Assistance and specimen retrieval were achieved through the vaginal channels. The patient recovered without compromise to the pelvic floor.

Conclusions
Endometrial cancer after LeFort colpocleisis can be diagnosed and treated with minimally invasive approaches without disrupting the colpocleisis or the pelvic floor support.
Transobturator Taping for the Treatment of Incontinence After Neobladder Reconstruction
Authors: Jindal Tarun , Mukherjee Satyadip , Mandal Soumendra Nath , Karmakar Dilip 
Published: June 2013

Abstract
Incontinence in the patients with neobladder is a distressing condition. Although conservative management may be helpful in some, a significant number of patients require some form of surgical intervention. Any surgical intervention, especially from the abdominal route can be significantly morbid in these patients because of extensive surgery done previously. There is a need for a technique that can take care of the postoperative incontinence without subjecting the patient to significant surgical risk. Artificial sphincters have been used in male patients but their use in female patients can be technically difficult. There are limited options available for women like transurethral bulking agents and pubovaginal slings. These procedures do not have very good results and female patients often end up with a cutaneous stoma. We, in this report, describe a female patient with incontinence after orthotopic neobladder reconstruction that could be successfully treated with transobturator taping.
A Case of Silicone Mesh Extrusion Into the Bladder Associated With Robotic Sacrocolpopexy
Authors: Mukati Marium , Shobeiri S. Abbas 
Published: June 2013

Background
Over the past several years, the daVinci robot has been used in gynecologic surgery as a new surgical approach. The literature is being slowly populated with pros and cons of this technology.

Case
We report a 60-year-old woman with a history of pelvic organ prolapse who had a robotic sacrocolpopexy. She presented with mesh extrusion into her vagina, which was removed by exploratory laparotomy. Two years later, she presented with mesh erosion into her bladder, which was removed.

Conclusion
This case report provides an example of significant mesh complication associated with robotic sacrocolpopexy 4 years after surgery and then again 2 years later.
Can Visuospatial Ability Predict Performance and Learning Curves on a Robotic Surgery Simulator?
Authors: Suozzi Brent A. , O’Sullivan David M. , Finnegan Kyle T. , Steinberg Adam C. 
Published: June 2013

Objective
This study aimed to examine the correlation between visuospatial ability, measured with the Perceptual Ability Test (PAT), and da Vinci robot simulator performance on the da Vinci Skills Simulator.

Methods
Twenty-five consenting medical students naive to both the PAT and the da Vinci robot completed the PAT and then performed a single simulation (Ring-walk 2) 10 consecutive times. Raw PAT scores were compared with composite simulator scores for all subjects. Participants were divided into those with high and low visuospatial ability based on whether they scored above or below (or equal) to the median on the PAT. We compared the mean composite simulator scores and the time to complete each exercise between the high and the low PAT performers.

Results
The mean (SD) raw PAT score (out of 90) was 45.5 (18.3) (median, 43.0). The mean composite simulator score was 65.5 (24.1) (median, 72.2). The high (n = 12) and low (n = 13) PAT performers had a mean (SD) (median) simulator score of 79.1 (9.8) (80.3) and 53.0 (26.7) (65.9), respectively. On average, the high PAT performers scored 26.1 points (95% confidence interval, 9.2–43.0, P = 0.005), or 49.2%, higher on the simulation than the low PAT performers. The high PAT performers completed the exercise in 96.5 seconds (95% confidence interval, 26.0–167.0; P = 0.009), or 36.2%, faster than the low PAT performers.

Conclusions
Better visuospatial ability relates to improved performance on a robotic surgery simulator.
Pelvic Floor Muscle Training for Urinary Incontinence
Authors: Betschart Cornelia , Mol Suzanne E. , Lütolf-Keller Béatrice , Fink Daniel , Perucchini Daniele , Scheiner David 
Published: June 2013

Objectives
Previous studies examining the effectiveness of pelvic floor muscle training (PFMT) for urinary incontinence in premenopausal and postmenopausal women have shown ambiguous results. The aim of this study was to compare subjective PFMT outcome in premenopausal versus postmenopausal women.

Methods
This is a retrospective study including premenopausal and postmenopausal women after PFMT for urodynamically proven stress urinary incontinence, mixed urinary incontinence, or urgency urinary incontinence from January 2003 to December 2008, with assessment of the need of an incontinence surgery in a follow-up time of least 24 months. Patients evaluated the change of their urinary incontinence on a 4-point Likert scale (1, no improvement; 2, slightly better; 3, no relevant incontinence; 4, excellent outcome; no incontinence at all) and their goal attainment on a 3-point Likert scale (1, less than expected; 2, as expected; and 3, more than expected).

Results
Successful outcome was reported by 59% of the premenopausal patients and 70% of the postmenopausal patients (P = 0.16), the attainment of the subjective goal by 68% and 81% (P = 0.09), and the need of an incontinence operation in a follow-up of 30 to 102 months by 15% and 14% (P = 1.0), respectively. None of the outcome parameters reached significance.

Conclusions
In comparing premenopausal to postmenopausal women, we could not detect any statistically significant difference with regard to patients’ satisfaction for the outcome of PFMT.
Robotic Versus Vaginal Urogynecologic Surgery
Authors: Robinson Barbara L. , Parnell Brent A. , Sandbulte Jennifer T. , Geller Elizabeth J. , Connolly AnnaMarie , Matthews Catherine A. 
Published: June 2013

Objectives
The primary objective was to compare perioperative complications after robotic surgery (RS) versus vaginal surgery (VS) for apical prolapse repair in elderly women. The secondary objectives were to (1) assess whether tools designed to predict surgical morbidity, the American Society of Anesthesiologists (ASA) class and the Charlson Comorbidity Index (CCI), are useful in the elderly urogynecologic population and (2) to classify complications during urogynecologic apical procedures using the Dindo classification system.

Methods
We reviewed medical records of women 65 years or older who underwent RS or VS between March 2006 and April 2011. Procedures included robotic sacrocolpopexy and sacrocervicopexy, vaginal uterosacral ligament suspension, sacrospinous ligament suspension, colpocleisis, and Uphold vaginal mesh placement. We assessed preoperative risks using ASA and CCI classification and complications using Dindo grade.

Results
There were 136 eligible cases (RS, 70; and VS, 66) during the 5-year study period. Women who underwent RS were younger (70 vs 74 years; P < 0.001). Vaginal surgery had more severe comorbidities as measured by the CCI (P = 0.012) but similar ASA profiles (P = 0.10). Robotic surgery had longer operative times (P < 0.001) but a lower estimated blood loss (P < 0.001). There were fewer postoperative complications in RS (P = 0.005). However, complication severity based on Dindo grade was similar between RS and VS, with most surgeries having no complications.

Conclusions
In the elderly women, RS was associated with fewer postoperative complications than VS. Overall, all procedures were associated with few complications, and either route may be reasonable in the elderly population.
The Blind Photographer. Observations on the Bewildering Nature of Feigned Vision Loss
Authors: Margo Curtis E. , Harman Lynn E. , Drucker Mitchell 
Published: June 2013

Abstract:
The diagnosis of feigned vision loss in adults taxes the doctor–patient relationship because the relationship should be based on trust, honesty, and the mutual desire to improve the medical condition. Even under ideal circumstances, physicians rarely have a complete understanding of the factors that lead patients to simulate disease they do not have. We describe the historical figure of John Howard Griffin (1920–1980) who likely perpetuated feigned vision loss for a decade. His writings provide a unique perspective on motivation (or inspiration) behind factitious disease.
Cost of capital in SMEs
Authors: Britzelmaier Bernd , Kraus Patrick , Häberle Michael , Mayer Benjamin , Beck Valentin 
Published: June 2013

PurposeThe purpose of this paper is to discuss the applicability of value based management (VBM) concepts for small to medium‐sized enterprises (SMEs) and to identify obstacles for its implementation. Estimating cost of capital is central to all VBM concepts, it is hence intended to critically analyse approaches that allow estimating cost of capital for non‐publicly traded firms.Design/methodology/approachThe paper is based on literature review and a case study approach. A case study on estimating the cost of capital has been conducted with a single manufacturing firm in Germany.FindingsVBM may provide useful management concepts for SMEs. Estimating the cost of capital has been found to be a critical element of implementing VBM concepts. Due to the absence of capital market data, cost of equity in SMEs has to be derived by means of alternative procedures. Results of a case study implicate that a combination of different methods may provide reasonable results in practice.Research limitations/implicationsThe applied research approach and the heterogeneity of the SME sector do not allow generalizing the results of this research.Originality/valueThe paper addresses a major barrier for implementing VBM in SMEs. It proposes a combination of analogy and qualitative approaches for estimating the cost of equity in SMEs.
Impact of host nutritional status on infection dynamics and parasite virulence in a bird‐malaria system
Authors: Cornet Stéphane , Bichet Coraline , Larcombe Stephen , Faivre Bruno , Sorci Gabriele 
Published: June 2013

Summary

Host resources can drive the optimal parasite exploitation strategy by offering a good or a poor environment to pathogens. Hosts living in resource‐rich habitats might offer a favourable environment to developing parasites because they provide a wealth of resources. However, hosts living in resource‐rich habitats might afford a higher investment into costly immune defences providing an effective barrier against infection. Understanding how parasites can adapt to hosts living in habitats of different quality is a major challenge in the light of the current human‐driven environmental changes.

We studied the role of nutritional resources as a source of phenotypic variation in host exploitation by the avian malaria parasite Plasmodium relictum. We investigated how the nutritional status of birds altered parasite within‐host dynamics and virulence, and how the interaction between past and current environments experienced by the parasite accounts for the variation in the infection dynamics. Experimentally infected canaries were allocated to control or supplemented diets. Plasmodium parasites experiencing the two different environments were subsequently transmitted in a full‐factorial design to new hosts reared under similar control or supplemented diets.

Food supplementation was effective since supplemented hosts gained body mass during a 15‐day period that preceded the infection. Host nutrition had strong effects on infection dynamics and parasite virulence. Overall, parasites were more successful in control nonsupplemented birds, reaching larger population sizes and producing more sexual (transmissible) stages. However, supplemented hosts paid a higher cost of infection, and when keeping parasitaemia constant, they had lower haematocrit than control hosts.

Parasites grown on control hosts were better able to exploit the subsequent hosts since they reached higher parasitaemia than parasites originating from supplemented hosts. They were also more virulent since they induced higher mass and haematocrit loss.

Our study highlights that parasite virulence can be shaped by the host nutritional status and that parasite can adapt to the environment provided by their hosts, possibly through genetic selection.
Role of the LysR‐type transcriptional regulator PecT and DNA supercoiling in the thermoregulation of pel genes, the major virulence factors in Dickeya dadantii
Authors: Hérault Elodie , Reverchon Sylvie , Nasser William 
Published: June 2013

SummaryBacteria are colonizers of various environments and host organisms, and they are often subjected to drastic temperature variations. Dickeya dadantii is a pathogen infecting a wide range of plant species. Soft rot, the visible symptom, is mainly due to the production of pectate lyases (Pels) that destroy plant cell walls. The production of Pels is controlled by a complex regulation system that responds to various stimuli, such as the presence of pectin, growth phase and temperature. Despite numerous regulatory studies, the thermoregulation mechanism of Pel production remains unexplained. Here, we show that PecT, a previously identified repressor, modulates pel gene expression in a temperature‐dependent manner, and we demonstrate that PecT binding on pel promoters increases concomitantly with temperature. High temperatures relax the DNA in D. dadantii, and remarkably, artificial relaxation of DNA at low temperatures increases PecT binding to DNA. Deletion of pecT augmented the capacity of D. dadantii to initiate soft‐rot symptoms at high temperatures. These results reveal that DNA topology and PecT act in concert to fine‐tune D. dadantii virulence in response to temperature. This novel combination between DNA topology and a conventional transcriptional regulator extends our understanding of the thermoregulation mechanisms involved in bacterial virulence.
Rates of subsequent surgery following endometrial ablation among English women with menorrhagia: population‐based cohort study
Authors: Bansi‐Matharu L , Gurol‐Urganci I , Mahmood TA , Templeton A , van der Meulen JH , Cromwell DA 
Published: June 2013

ObjectiveTo assess the risk of further surgery amongst women who had an initial endometrial ablation (EA) for the treatment of heavy menstrual bleeding (HMB).DesignA retrospective cohort study using a national administrative database.SettingPopulation‐based study of hospital care in the English National Health Service.PopulationA cohort of 114 910 women who had EA for HMB between January 2000 and December 2011.MethodsMultiple Cox regressions were performed to identify the risks of a further procedure, adjusted for age, social deprivation, year and type of initial EA, and presence of fibroids/polyps.Main outcome measuresTime to repeat EA or hysterectomy after initial surgery.ResultsOf 114 910 women undergoing EA, 16.7% had at least one subsequent procedure within 5 years. Higher rates of subsequent surgery were associated with younger age at initial EA, with women aged under 35 years having an adjusted hazard ratio of 2.83 (95% CI 2.67–2.99), compared with women aged over 45 years. Women who had radiofrequency ablation were less likely to have subsequent surgery as compared with first‐generation techniques (HR 0.69, 95% CI 0.63–0.76). The rate of a subsequent hysterectomy within 5 years was 13.5%. Younger women (OR 0.59, 95% CI 0.51–0.69) and those who had balloon, microwave, or radiofrequency ablation were less likely to have a second EA procedure, rather than a hysterectomy.ConclusionsOne in six women have further surgery after EA for HMB, which is a higher rate than reported in clinical trials. This risk of further surgery decreases with age.