bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of complication rates for unilateral and bilateral percutaneous nephrolithotomy (PCNL) using a modified Clavien grading system
Authors: Kadlec Adam O. , Greco Kristin A. , Fridirici Zachary C. , Hart Spencer T. , Vellos Ted G. , Turk Thomas M. 
Published: October 2012

What's known on the subject? and What does the study add?Standardised complication reporting for urological procedures has been encouraged. Percutaneous nephrolithotomy (PCNL) has an acceptably low complication rate, with high‐grade complications being rare. A recent review shows that complication rates for PCNL vary from 15% to 60%, but the Clavien system has not been used in all studies. Also, no study has directly compared unilateral and bilateral procedures.In a direct comparison retrospective study, we showed that bilateral procedures had a higher overall complication rate and suggest that this is probably due to an increased number of percutaneous tracts.OBJECTIVE
To compare complication rates of unilateral vs bilateral percutaneous nephrolithotomy (PCNL) using the modified Clavien grading system.
PATIENTS AND METHODS
Single‐institution retrospective chart review.
Identified patients who had synchronous bilateral PCNL (B‐PCNL) over an 11‐year period (2000–2011).
B‐PCNL patients were matched by age, gender, and stone burden per renal unit with patients who underwent unilateral PCNL (U‐PCNL) over the same period.
Complications were recorded and classified using the modified Clavien classification system, and then compared with a two‐sided chi‐square test of proportions.
RESULTS
In all, 47 B‐PCNL patients [mean (range) age 54 (14–84) years] and 78 U‐PCNL patients [mean (range) age 54 (17–91 years] were compared. The mean (range) stone burden per renal unit was 2.8 (0.7–7.0) cm and 2.9 (0.7–9.0) cm, respectively.
The overall complication rate was higher for B‐PCNL (53.2% vs 30.8%, P= 0.013). Rates of Grade I and Grade II complications trended toward being higher in the B‐PCNL group. Low‐grade complications (Grade I and II combined) occurred more often in the B‐PCNL group (P= 0.011); the most common low‐grade complication was fever.
Two procedures terminated for poor visualisation due to bleeding were successfully completed in delayed fashion with no transfusion and were classified as Grade I complications.
There were equivalently low rates of Grade III complications. There were no Grade IV or V complications.
CONCLUSIONS
B‐PCNL carries a higher overall complication rate than U‐PCNL when the modified Clavien system is used for classification.
Patients undergoing U‐PCNL who have more than one tract dilatation have a higher complication rate than those who have only one tract dilatation.
High‐grade complications are uncommon for both procedures.
Comparison of transperitoneal and retroperitoneal laparoscopic nephrectomy for renal cell carcinoma: a systematic review and meta‐analysis
Authors: Fan Xinxiang , Xu Kewei , Lin Tianxin , Liu Hao , Yin Zi , Dong Wen , Huang Hai , Huang Jian 
Published: October 2012

What's known on the subject? and What does the study add?
Laparoscopic nephrectomy is now considered to be the reference procedure for kidney cancer. It can be performed via a transperitoneal or retroperitoneal approach. Each approach has its advantages and disadvantages. No definitive conclusions regarding objective difference between the two approaches have been reached to date.
This meta‐analysis indicates that in appropriately selected patients, especially patients with posteriorly located renal tumors, the retroperitoneal approach may be faster and equally safe compared with the transperitoneal approach.
Objective
To evaluate the efficiency and safety of the retroperitoneal and transperitoneal approaches in laparoscopic radical/partial nephrectomy (RN/PN) for renal cell carcinoma.
Methods
A systematic search of PUBMED, EMBASE, and the Cochrane Library was performed to identify prospective randomized controlled trials and retrospective observational studies that compared the outcomes of the two approaches.
Outcomes of interest included perioperative and postoperative variables, surgical complications and oncological variables.
Results
Twelve studies assessing transperitoneal laparoscopic RN (TLRN) vs retroperitoneal laparoscopic RN (RLRN) and six studies assessing transperitoneal laparoscopic PN (TLPN) vs retroperitoneal laparoscopic PN (RLPN) were included.
The RLRN approach had a shorter time to renal artery control (weighted mean difference [WMD] 68.65 min; 95% confidence interval [CI] 40.80–96.50; P < 0.001) and a lower overall complication rate (odds ratio 2.12; 95% CI 1.30–3.47; P = 0.003) than TLRN. RLPN had a shorter operating time (WMD 48.85 min; 95% CI 29.33–68.37; P < 0.001) and a shorter length of hospital stay (WMD 1.01 days; 95% CI 0.39–1.63; P = 0.001) than TLPN.
There were no significant differences between the retroperitoneal and transperitoneal approaches in other outcomes of interest.
Conclusions
This meta‐analysis indicates that, in appropriately selected patients, especially patients with posteriorly located renal tumours, the retroperitoneal approach may be faster and equally safe compared with the transperitoneal approach.
Despite our rigorous methodology, conclusions drawn from our pooled results should be interpreted with caution because of the inherent limitations of the included studies.
A comparative study of thulium laser resection of the prostate and bipolar transurethral plasmakinetic prostatectomy for treating benign prostatic hyperplasia
Authors: Peng Bo , Wang Guang‐chun , Zheng Jun‐hua , Xia Sheng‐qiang , Geng Jiang , Che Jian‐ping , Yan Yang , Huang Jian‐hua , Xu Yun‐Fei , Yang Bin 
Published: October 2012

What's known on the subject? and What does the study add?
Thulium laser is a new generation of surgical laser. It is a minimally invasive technology with several advantages, including rapid vaporization and minimal tissue damage and bleeding. However, details regarding the safety and efficacy of thulium laser in treating BPH remains unknown.
We performed a comparative study in 100 patients with BPH of the safety and efficacy of thulium laser resection of the prostate (TMLRP, n = 50) and bipolar transurethral plasmakinetic prostatectomy (TUPKP, n = 50). We found that the efficacy and indications were the same in TMLRP and TUPKP. In TUPKP, the morbidity of urethrostenosis was low, and was nearly bloodless in surgery and had higher safety. Nevertheless, TUPKP is more suitable for patients with larger prostate volume.
Objective
To compare the safety and short‐term efficacy of thulium laser resection of the prostate (TMLRP) and bipolar transurethral plasmakinetic prostatectomy (TUPKP) for the treatment of patients with benign prostatic hyperplasia (BPH).
Methods
A total of l00 patients diagnosed with BPH were randomly divided into two groups, treated with either TMLRP (50, group 1) or TUPKP (50, group 2).
There was no significant difference in preoperative variables such as age, prostate volume, prostate‐specific antigen (PSA) level, International Prostate Symptom Score (IPSS), maximum urinary flow rate (Qmax) and postvoid residual urine volume (PVR) between the two groups.
The perioperative parameters and therapeutic effects were recorded and compared between the two groups.
Results
There were significant differences in the following parameters between the two groups (TMLRP vs TUPKP [mean ± SD]): operation duration, 61.2 ± 24.2 vs 30.14 ± 15.9 min; catheterization time, 1.8 ± 0.4 vs 3.2 ± 0.6 d; postoperative hospital stay, 3.3 ± 0.8 vs 4.1 ± 1.3 d.
The volume of blood loss and postoperative bladder irrigation were significantly lower in TMLRP group than in the TUPKP group.
At 1 month after the operation, there were four cases of urethral stricture in the TUPKP group.
At 3 months after the operation, IPSS, quality of life (QoL), Qmax and PVR were significantly improved, with no significant difference between the two groups.
Conclusions
TMLRP is superior to TUPKP in terms of safety, blood loss, recovery time and complication rate, and is as efficacious as TUPKP for treating BPH.
Operation duration was significantly longer in the TMLRP group than in the TUPKP group.
Health Technology Assessment in nursing: a literature review
Authors: Ramacciati N. 
Published: October 2012

BackgroundThe Health Technology Assessment (HTA) approach, which provides scientific support for the decisions taken within the health field, is of increasing importance worldwide. In a context of limited resources, HTA has the potential of being an efficient tool for addressing the sustainability problems and the allocation choices arising from the constant increase in demand.AimThis study aims to investigate HTA use in nursing, both in terms of quantifying HTA evaluations of nursing phenomena which have been conducted and in terms of the extent to which nursing has used the HTA approach. The Italian context has been analysed because of the growing diffusion of the HTA in Italy along with the recent developments in the nursing profession.MethodsA narrative review of international literature was undertaken using the following databases: HTA, PubMed, CINAHL, ILISI.ResultsSeventy evaluation studies on nursing were identified from the HTA database (1.12% of all studies in the database). The areas of nursing intervention and the country of origin of the studies were identified. Two nursing studies on the HTA approach were found in the PubMed, CINAHL and HTA databases. The first focused on the evaluation of nursing technology process and analysed 126 studies in six main thematic areas; the second was a systematic review on HTA in nursing and analysed 192 studies (46 meta‐analyses, 31 Finnish primary studies, 117 international primary studies). Three Italian studies were identified from the ILISI database and Italian grey literature.DiscussionIn the international literature, although analyses regarding the efficacy of nursing interventions have been conducted, there are to date very few research projects that focus exclusively on the HTA process as applied to nursing. The recent development of a standardized nursing language coupled with the open debate as to which research method (qualitative vs. quantitative) best serves to ‘read’ nursing phenomena may explain the scarce diffusion of HTA in the field of nursing.
Preschool children’s interpretation of object‐initial sentences: Neural correlates of their behavioral performance
Authors: Schipke Christine S. , Knoll Lisa J. , Friederici Angela D. , Oberecker Regine 
Published: October 2012

AbstractThe acquisition of the function of case‐marking is a key step in the development of sentence processing for German‐speaking children since case‐marking reveals the relations between sentential arguments. In this study, we investigated the development of the processing of case‐marking and argument structures in children at 3, 4;6 and 6 years of age, as well as its processing in adults. Using EEG, we measured event‐related potentials (ERPs) in response to object‐initial compared to subject‐initial German sentences including transitive verbs and case‐marked noun phrases referring to animate arguments. We also tested children’s behavioral competence in a sentence‐picture matching task. Word order and case‐marking were manipulated in German main clauses. Adults’ behavioral performance was close to perfect and their ERPs revealed a negativity for the processing of the topicalized accusative marked noun phrase (NP1) and no effect for the second NP (NP2) in the object‐initial structure. Children’s behavioral data showed a significant above‐chance outcome in the subject‐initial condition for all age groups, but not for the object‐initial condition. In contrast to adults, the ERPs of 3‐year‐olds showed a positivity at NP1, indicating difficulties in processing the non‐canonical object‐initial structures. Children at the age of 4;6 did not differ in the processing patterns of object‐initial vs. subject‐initial sentences at NP1 but showed a slight positivity at NP2. This positivity at NP2, which implies syntactic integration difficulties, is more pronounced in 6‐year‐olds but is absent in adults. At NP1, however, 6‐year‐olds show the same negativity as adults. In sum, the behavioral and electrophysiological findings demonstrate that children in each age group use different strategies, which are indicative of their developmental stage. While 3‐year‐olds merely detect differences in the two sentence structures without being able to use this information for sentence comprehension, 4;6‐year‐olds proceed to use mainly a word‐order strategy, processing NP1 in both conditions in the same manner, which leads to processing difficulties upon detecting case‐marking cues at NP2. At the age of 6, children are able to use case‐marking cues for comprehension but still show enhanced effort for correct thematic‐role assignment.
Learning without representational change: development of numerical estimation in individuals with Williams syndrome
Authors: Opfer John E. , Martens Marilee A. 
Published: October 2012

AbstractExperience engenders learning, but not all learning involves representational change. In this paper, we provide a dramatic case study of the distinction between learning and representational change. Specifically, we examined long‐ and short‐term changes in representations of numeric magnitudes by asking individuals with Williams syndrome (WS) and typically developing (TD) children to estimate the position of numbers on a number line. As with TD children, accuracy of WS children's numerical estimates improved with age (Experiment 1) and feedback (Experiment 2). Both long‐ and short‐term changes in estimates of WS individuals, however, followed an atypical developmental trajectory: as TD children gained in age and experience, increases in accuracy were accompanied by a logarithmic‐to‐linear shift in estimates of numerical magnitudes, whereas in WS individuals, accuracy increased but logarithmic estimation patterns persisted well into adulthood and after extensive training. These findings suggest that development of numerical estimation in WS is both arrested and atypical.
Visceral fat and metabolic inflammation: the portal theory revisited
Authors: Item F. , Konrad D. 
Published: October 2012

SummaryAbdominal (central) obesity strongly correlates with (hepatic) insulin resistance and type 2 diabetes. Among several hypotheses that have been formulated, the ‘portal theory’ proposes that the liver is directly exposed to increasing amounts of free fatty acids and pro‐inflammatory factors released from visceral fat into the portal vein of obese patients, promoting the development of hepatic insulin resistance and liver steatosis. Thus, visceral obesity may be particularly hazardous in the pathogenesis of insulin resistance and type 2 diabetes. Herein, we will critically review existing evidence for a potential contribution of portally drained free fatty acids and/or cytokines to the development of hepatic insulin resistance.
mTOR signalling: the molecular interface connecting metabolic stress, aging and cardiovascular diseases
Authors: Yang Z. , Ming X‐F. 
Published: October 2012

SummaryThe continuing increase in the prevalence of obesity and metabolic disorders such as type‐II diabetes and an accelerating aging population globally will remain the major contributors to cardiovascular mortality and morbidity in the 21st century. It is well known that aging is highly associated with metabolic and cardiovascular diseases. Growing evidence also shows that obesity and metabolic diseases accelerate aging process. Studies in experimental animal models demonstrate similarity of metabolic and cardiovascular phenotypes in metabolic diseases and old age, e.g. insulin resistance, oxidative stress, chronic low grade inflammation, cardiac hypertrophy, cardiac fibrosis, and heart failure, as well as vascular dysfunctions. Despite intensive research, the molecular mechanisms linking metabolic stress, aging, and ultimately cardiovascular diseases are still elusive. Although the mammalian target of rapamycin (mTOR) signalling is a well known regulator of metabolism and lifespan in model organisms, its central role in linking metabolic stress, aging and cardiovascular diseases is recently emerging. In this article, we review the evidence supporting the role of mTOR signalling as a molecular interface connecting metabolic stress, aging and cardiovascular diseases. The therapeutic potentials of targeting mTOR signalling to protect against metabolic and age‐associated cardiovascular diseases are discussed.
Adaptive thermogenesis in human body weight regulation: more of a concept than a measurable entity?
Authors: Dulloo A. G. , Jacquet J. , Montani J‐P. , Schutz Y. 
Published: October 2012

SummaryAccording to Lavoisier, ‘Life is combustion’. But to what extent humans adapt to changes in food intake through adaptive thermogenesis – by turning down the rate of heat production during energy deficit (so as to conserve energy) or turning it up during overnutrition (so as to dissipate excess calories) – has been one of the most controversial issues in nutritional sciences over the past 100 years. The debate nowadays is not whether adaptive thermogenesis exists or not, but rather about its quantitative importance in weight homoeostasis and its clinical relevance to the pathogenesis and management of obesity. Such uncertainties are likely to persist in the foreseeable future primarily because of limitations to unobtrusively measure changes in energy expenditure and body composition with high enough accuracy and precision, particularly when even small inter‐individual variations in thermogenesis can, in dynamic systems and over the long term, be important in the determining weight maintenance in some and obesity and weight regain in others. This paper reviews the considerable body of evidence, albeit fragmentary, suggesting the existence of quantitatively important adaptive thermogenesis in several compartments of energy expenditure in response to altered food intake. It then discusses the various limitations that lead to over‐ or underestimations in its assessment, including definitional and semantics, technical and methodological, analytical and statistical. While the role of adaptive thermogenesis in human weight regulation is likely to remain more a concept than a strictly ‘quantifiable’ entity in the foreseeable future, the evolution of this concept continues to fuel exciting hypothesis‐driven mechanistic research which contributes to advance knowledge in human metabolism and which is bound to result in improved strategies for the management of a healthy body weight.
Molecular pathways linking metabolic inflammation and thermogenesis
Authors: Solinas G. 
Published: October 2012

SummaryObesity is caused by chronic positive energy balance because of higher energy intake relative to energy expenditure. Thermogenesis, the capacity of an organism to produce heat, is an important component of energy expenditure. Thus targeting the molecular mechanisms controlling thermogenesis could be an effective strategy for the prevention or treatment of obesity. Thermogenesis is modulated by three major factors: environmental temperature, nutrient quantity and quality, and by systemic inflammation. Obesity is now recognized to be a state of chronic low‐grade systemic inflammation, which has been proposed to play a major role in the pathogenesis of obesity and obesity‐associated diseases. This review discussed the molecular pathways that are recruited during metabolic inflammation and that are also implicated in the control of thermogenesis and energy balance. It emerges that the complex signalling network recruited during metabolic inflammation exerts a balanced action on the modulation of thermogenesis and energy balance, with some pathways promoting weight gain whereas other pathways have opposite actions. It is thus concluded that immunomodulation of metabolic inflammation, rather than an anti‐inflammatory intervention aiming at its suppression, may be a more promising strategy to increase thermogenesis for the treatment or prevention of obesity and its associated diseases.
Implementation: Making Hard Work of Something Simple
Authors: Graycar Adam , McCann Bernadette 
Published: October 2012

Early in 2012 the Rural Property Addressing Project in South Australia announced that it had substantially met its outcomes, and that the whole of the project was soon to be completed. In 2003, one of the recommendations to cabinet from the South Australian Premier's Bushfire Summit was to endorse the development of a standard property addressing system for rural properties across the state. This was formally endorsed by cabinet, and was a direct response to the fact that essential services such as ambulance, medical and social care were hindered in providing services to the residents of Eyre Peninsula during and after the bushfires.Overall, this was not a controversial decision, nor was it a huge implementation challenge, yet it took nine years to come into effect. This is a classic case of the tyranny of small decisions.This article outlines some of the implementation challenges faced by this apparently simple project, and provides some thoughts for implementation challenges of the future. The take‐away message is that if something so comparatively simple was made so complex, how can we adapt our public services to the cross‐cutting challenges of the future?
Effect of different semiochemicals blends on spruce bark beetle, Ips typographus (Coleoptera: Scolytidae)
Authors: Xie Shou‐An , Lv Shu‐Jie 
Published: October 2012

AbstractThe spruce bark beetle, Ips typographus, is a recent new introduction to the Qilian Mountains of China. An outbreak of these beetles has infested over 0.03 million hectares of spruce forests in this area. Although primary attraction to volatiles has been clearly demonstrated for I. typographus, the existence and role of attraction to insect‐produced pheromones have been widely debated. Currently, commercial lures for I. typographus include only the volatiles ipsdienol, cis‐verbenol, trans‐verbenol, 2‐methyl‐3‐buten‐2‐ol and 2‐phenylethanol in Europe. Several potential pheromone candidates have been identified for I. typographus. Our GC–MS and GC–FID analyses volatiles from hindgut extracts of I. typographus in different attack phases demonstrated that the 2‐methyl‐3‐buten‐2‐ol, ipsdienol, cis‐verbenol and trans‐verbenol as major hindgut components, and ipsenol, 2‐phenylethanol, trans‐ myrtenol and verbenone as minor components. We tested various combinations of semiochemical candidates, to determine an optimal blend. Our results suggest that addition of 2‐methyl‐3‐buten‐2‐ol to either ipsenol alone, or to blends of ipsenol and other semiochemical candidates, significantly enhanced attraction of I. typographus. Therefore, a simple lure consisting of ipsenol and 2‐methyl‐3‐buten‐2‐ol would be an optimal blend of I. typographus in the Qilian Mountains, China. We conclude that this optimal semiochemical blend may provide an effective biological pest control method for use in forest ecosystem against I. typographus.
The signs that bind: identifying individuals, families and friends in Hismaic inscriptions
Authors: Corbett Glenn J. 
Published: October 2012

Among the thousands of Hismaic inscriptions found in the Ḥismā desert of southern Jordan are the signatures of countless authors and artists who carved their names, thoughts and drawings into stone. These signed carvings, which typically give not only the name of the author but also, on occasion, the name of his father, grandfather and even great‐grandfather, provide an extraordinary record of the actual individuals who roamed the desert wadis 2000 years ago. This article, which focuses on a collection of Hismaic inscriptions and drawings from the Wādī Ḥafīr canyon of southern Jordan, illustrates how traditional epigraphic study of these names, combined with aGIS‐based landscape approach, can provide a much clearer picture of not only who was carving the inscriptions and where, but also how the various authors may have been related or acquainted.