bluuebunny/crossref_metadata_2025_split huggingface dataset:
In pursuit of excellence: an integrated care pathway for C1 inhibitor deficiency
Authors: Manson A L , Price A , Dempster J , Clinton-Tarestad P , Greening C , Enti R , Hill S , Grigoriadou S , Buckland M S , Longhurst H J 
Published: February 2013

Summary
There are estimated to be approximately 1500 people in the United Kingdom with C1 inhibitor (C1INH) deficiency. At BartsHealth National Health Service (NHS) Trust we manage 133 patients with this condition and we believe that this represents one of the largest cohorts in the United Kingdom. C1INH deficiency may be hereditary or acquired. It is characterized by unpredictable episodic swellings, which may affect any part of the body, but are potentially fatal if they involve the larynx and cause significant morbidity if they involve the viscera. The last few years have seen a revolution in the treatment options that are available for C1 inhibitor deficiency. However, this occurs at a time when there are increased spending restraints in the NHS and the commissioning structure is being overhauled. Integrated care pathways (ICP) are a tool for disseminating best practice, for facilitating clinical audit, enabling multi-disciplinary working and for reducing health-care costs. Here we present an ICP for managing C1 inhibitor deficiency.
Intra‐operative cardiac arrests during liver transplantation – a retrospective review of the first 15 yr in Asian population
Authors: Lee Sang Hyun , Gwak Mi Sook , Choi Soo Joo , Shin Young Hee , Ko Justin Sangwook , Kim Gaab Soo , Lee Suk Young , Kim Myung Hee , Park Hui Gyeong , Lee Suk‐Koo , Jeon Hee Jung 
Published: February 2013

AbstractAlthough many report intra‐operative cardiac arrests (ICAs) in liver transplantation (LT), the incidence, major causes, and outcome remain unclear. We aimed to investigate retrospectively, the incidence, nature, and outcome of ICA in Asian population and to identify risk factors for ICA. Consecutive 1071 LTs in an institution during 1996–2011 (adult 920, pediatric 151/living donor liver transplantation, LDLT 841, deceased donor liver transplantation, DDLT 230) were reviewed. ICA occurred in 14 adult LTs (1.5%), but none in pediatrics. ICA occurred 1.0% and 3.3% in LDLT and DDLT, respectively. Stages of ICA incidence were three at pre‐anhepatic, one at anhepatic, and 10 at neohepatic stage. Post‐reperfusion syndrome (PRS) with hyperkalemia and bleeding were the major causes of ICA. While LDLT showed miscellaneous causes for ICA at various stages, DDLT incurred ICAs at neohepatic stage only. Interestingly, we did not find pulmonary thromboembolism (PTE) to incur ICA. Risk factor analysis showed no association of pre‐operative patient condition, donor types, and intra‐operative parameters. In this review, the incidence of ICA was low in Asian population with LDLT predominance, and while PTE was not the cause of ICA, the neohepatic stage with PRS and bleeding was the most vulnerable period to anticipate ICA.
Characterization for industrial purposes of the fibre anatomy of perennial ryegrass and tall fescue stem and leaf at three stages in the primary growth
Authors: King C. , McEniry J. , Richardson M. , O'Kiely P. 
Published: February 2013

AbstractCharacterization of grass fibre is important in assessing its potential for industrial fibre applications. Stem and leaf sections were sampled from triplicate field plots of two grass species, perennial ryegrass (PRG) and tall fescue at three dates (monthly from 12 May) in the primary growth, and were used to (a) isolate individual fibre cells and (b) prepare transverse sections. Microscopy and image analysis software were used to determine the length and width of individual fibre cells and the proportion of lignified fibre in stem and leaf transverse sections. The length and width of individual fibre cells were greater (P < 0·001) in stem than in leaf sections, while individual fibre cell length was greater (P < 0·01) for tall fescue than PRG. Harvest date and grass species had little effect (P > 0·05) on the proportion of lignified fibre in the transverse‐sectional area. However, there was a greater (P < 0·001) proportion of lignified fibre in the transverse‐sectional area of grass stems than leaves, with tall fescue having a greater (P < 0·05) stem and leaf transverse‐sectional area and area of lignified fibre in transverse section than PRG. Tall fescue harvested at a later stage of growth, with higher proportions of stem than leaf tissue, may be more suitable for industrial fibre applications.
Silage fermentation characteristics of three common grassland species in response to advancing stage of maturity and additive application
Authors: McEniry J. , King C. , O'Kiely P. 
Published: February 2013

AbstractThis study investigated the effects of advancing stage of maturity and additive treatment on the fermentation characteristics of three common grassland species. Perennial ryegrass (PRG; Lolium perenne L., var. Gandalf), timothy (Phleum pratense L., var. Erecta) and red clover (Trifolium pratense L., var. Merviot) were harvested at three dates in the primary growth (11 May, 8 June and 6 July; Harvests 1–3) and ensiled with the following additive treatments: (1) control (i.e. no treatment), (2) formic acid‐based additive, (3) homofermentative lactic acid bacterial (LAB) inoculant and (4) heterofermentative LAB inoculant. Additive application to the PRG (irrespective of harvest date), the late‐harvest timothy (Harvest 3) and the red clover (Harvests 2 and 3) herbages had little impact on silage fermentation characteristics, where a lactic acid dominant fermentation already prevailed. However, the application of the formic acid‐based additive to the Harvest 1 and 2 timothy and Harvest 1 red clover herbages, where the silage fermentation characteristics were poorer, resulted in an increase in the proportion of lactic acid in total fermentation products and a decrease in pH. In contrast, the heterofermentative LAB inoculant had a negative impact on silage fermentation characteristics where a poor preservation prevailed in the corresponding control silage.
Cirrhosis histology and Laennec staging system correlate with high portal pressure
Authors: Rastogi Archana , Maiwall Rakhi , Bihari Chhagan , Ahuja Arvind , Kumar Ashish , Singh Tarandeep , Wani Zeeshan Ahmad , Sarin Shiv Kumar 
Published: February 2013

AimsTo correlate cirrhosis histology and Laennec fibrosis scoring with portal pressure, as determined by hepatic venous pressure gradient (HVPG).Methods and resultsOne hundred and four patients with biopsy‐proven cirrhosis and known HVPG were included in the study. Semiquantitative scoring of 12 histological parameters and quantitative assessment by morphometry for septal thickness and nodule diameter and image analysis for fibrosis were performed. Laennec histological subgrading and clinical staging of cirrhosis were also performed. There were significant positive correlations between HVPG and Laennec histological grade of cirrhosis (P < 0.001), micronodularity (P < 0.001), the presence of thick fibrous septa (P = 0.015), the amount of collagen in the space of Disse (P < 0.001), and the extent of fibrosis by image analysis (P = 0.003). Multivariate analysis, to predict high HVPG (≥16 mmHg), showed that degree of collagen in the space of Disse [P = 0.007, odds ratio (OR) 19.3], histological grade of cirrhosis (P = 0.017, OR 3.9) and micronodularity (P = 0.02, OR 3.5) independently predicted high HVPG.ConclusionsHistological subclassification of cirrhosis, collagen in the space of Disse and micronodularity are independent predictors of high portal pressure. The Laennec histological subclassification of cirrhosis correlates well with clinical severity of cirrhosis, and can provide useful prognostic information.
Preoperative pelvic floor physiotherapy improves continence after radical retropubic prostatectomy
Authors: Patel Manish I , Yao Jinna , Hirschhorn Andrew D , Mungovan Sean F 
Published: February 2013

ObjectivesUrinary incontinence is a predictable sequela of radical retropubic prostatectomy, and is most severe in the early postoperative phase. The present study aimed to evaluate the effect of a physiotherapist‐guided pelvic floor muscle training program, commenced preoperatively, on the severity and duration of urinary continence after radical retropubic prostatectomy.MethodsA retrospective analysis of men undergoing radical retropubic prostatectomy by one high‐volume surgeon (n = 284) was carried out. The intervention group received physiotherapist‐guided pelvic floor muscle training from 4 weeks preoperatively (n = 152), whereas the control group was provided with verbal instruction on pelvic floor muscle exercise by the surgeon alone (n = 132). Postoperatively, all patients received physiotherapist‐guided pelvic floor muscle training. The primary outcome measure was 24‐h pad weight at 6 weeks and 3 months postoperatively. Secondary outcome measures were the percentage of patients experiencing severe urinary incontinence, and patient‐reported time to one and zero pad usage daily.ResultsAt 6 weeks postoperatively, the 24‐h pad weight was significantly lower (9 g vs 17 g, P < 0.001) for the intervention group, which also showed less severe urinary incontinence (24‐h pad weight >50 g; 8/152 patients vs 33/132 patients, P < 0.01). There was no significant difference between groups in the 24‐h pad weight at 3 months (P = 0.18). Patient‐reported time to one and zero pad usage was significantly less for the intervention group (P < 0.05). Multivariate Cox regression showed that preoperative physiotherapist‐guided pelvic floor muscle training reduced time to continence (1 pad usage daily) by 28% (P < 0.05).ConclusionsA physiotherapist‐guided pelvic floor muscle training program, commenced 4 weeks preoperatively, significantly reduces the duration and severity of early urinary incontinence after radical retropubic prostatectomy.
Renal pyelic fusion with crossed solitary ureter: Case report and review of literature
Authors: Enganti Bhavatej , Chitekela Nookinaidu , Nallabothula Anil Kumar , Lakshmi Vijaya , Dandu Rambabu , Samavedi Srinivas , Subramanian Srinivasan 
Published: February 2013

Abstract: Renal fusion anomalies are detected incidentally on imaging, with horseshoe kidney being the most common followed by crossed renal ectopia. We report a rare congenital anomaly of renal pyelic fusion with a solitary ureter. Both the renal units were in the normal position and location. This rare anomaly was associated with lumbar vertebral defects, neurogenic bladder, vesico‐ureteric reflux, upper tract dilatation and recurrent urinary tract infections.
Complex trait divergence contributes to environmental niche differentiation in ecological speciation of Boechera stricta
Authors: Lee Cheng‐Ruei , Mitchell‐Olds Thomas 
Published: February 2013

AbstractEcological factors may contribute to reproductive isolation if differential local adaptation causes immigrant or hybrid fitness reduction. Because local adaptation results from the interaction between natural selection and adaptive traits, it is crucial to investigate both to understand ecological speciation. Previously, we used niche modelling to identify local water availability as an environmental correlate of incipient ecological speciation between two subspecies in Boechera stricta, a close relative of Arabidopsis. Here, we performed several large‐scale glasshouse experiments to investigate the divergence of various physiological, phenological and morphological traits. Although we found no significant difference in physiological traits, the Western subspecies has significantly faster growth rate, larger leaf area, less succulent leaves, delayed reproductive time and longer flowering duration. These trait differences are concordant with previous results that habitats of the Western genotypes have more consistent water availability, while Eastern genotypes inhabit locations with more ephemeral water supplies. In addition, by comparing univariate and multivariate divergence of complex traits (QST) to the genomewide distribution of SNP FST, we conclude that the aspects of phenology and morphology (but not physiology) are under divergent selection. In addition, we also identified several highly diverged traits without obvious water‐related functions.
Dermatofibrosarcoma Protuberans in Childhood Treated with Slow Mohs Micrographic Surgery
Authors: Barysch Marjam J. , Weibel Lisa , Neuhaus Kathrin , Subotic Ulrike , Schärer Leo , Donghi Davide , Hafner Juerg , Braun Ralph , Läuchli Severin , Dummer Reinhard , Schiestl Clemens 
Published: February 2013

AbstractDermatofibrosarcoma protuberans (DFSP) in childhood is a rare tumor with high recurrence rates. Wide local excision can result in disfiguring mutilation, whereas Mohs micrographic surgery (MMS) reduces surgical margins. MMS in children is not performed routinely, as the required infrastructures such as a histopathology lab in close proximity to the operating room is often lacking. We retrospectively reviewed children diagnosed with DFSP treated at our hospital over 2 years. We recorded surgical treatment details, including margins, duration of inpatient stay, outcome, follow‐up, and molecular genetic tumor tissue analysis. Four children with a median age of 6.8 years (range 6.0–8.8 years) were identified who had a diagnostic delay of a median of 2.5 years (range 0.5–4.0 years); all underwent complete tumor excision using the slow MMS technique using vacuum‐assisted closure systems between repeated excisions and before wound closure. The median maximal safety margins were 1.5 cm (range 1.0–3.0 cm). By using vacuum‐assisted closure systems, no dressing changes were needed, pain was limited, and full mobility was maintained in all children. The median total time in the hospital was 11 days (range 10–14 days). No relapses occurred during a median follow‐up of 25.8 months (range 11.3–32.6 months). Collagen 1A1/platelet‐derived growth factor B (COL1A1/PDGFB) translocation on chromosomes 17 and 22 was detected in all three analyzable specimens. Lesions suspected of being DFSP warrant prompt histologic evaluation; interdisciplinary management is mandatory in particular for children. Micrographic surgery allows smaller surgical margins than wide excision and should be considered as the treatment of choice in children with DFSP. The interim usage of vacuum‐assisted closure systems increases patient comfort. Translocations in the COL1A1/PDGFB gene imply susceptibility to targeted treatment modalities for therapy‐resistant cases.
Public Health Nursing Competency Instrument: Scale Reduction and Reliability of Factors
Authors: Reckinger Dawn , Cross Sharon , Block Derryl E. , Josten LaVohn , Savik Kay 
Published: February 2013

AbstractObjectivesTo reduce the number of items of the Public Health Nursing Competency Instrument (PHNCI) and to report the psychometric properties of the abbreviated instrument.Design and SampleThe 193‐item PHNCI was administered via an online survey tool. A national sample of 2,269 public health nurses was recruited from 25 states.MeasuresAll items of the PHNCI scale were positively stated and participants were asked to rate their skill level via a 4‐point Likert scale.ResultsA principal component exploratory factor analysis with oblique rotation and examination of scree plot resulted in a final abbreviated scale which included 81 items and six factors: (1) Evaluation Competencies, (2) Individual/Family/Community Competencies, (3) Systems' Competencies, (4) Partnership/Collaboration Competencies, (5) Planning Competencies, and (6) Assessment Competencies. The six factors in the resulting PHNCI Abbreviated (PHNCIa) demonstrated acceptable internal consistency, ranging from 0.92 to 0.98.ConclusionThe six factors of the PHNCIa integrate important concepts of both the nursing process and the intervention wheel. The instrument can be used by educators, administrators, managers, and staff members to assess strengths and challenge areas, guide discussions on performance and expectations, and enhance professional development efforts. Next steps for future research are presented.
Comparison of abdominal ultrasound and magnetic resonance imaging for detection of abdominal lymphadenopathy in dogs with metastatic apocrine gland adenocarcinoma of the anal sac
Authors: Anderson C. L. , MacKay C. S. , Roberts G. D. , Fidel J. 
Published: February 2013

AbstractImaging studies in humans with anal and rectal cancer indicate that magnetic resonance imaging (MRI) is a more sensitive technique than abdominal ultrasound (AUS) for the detection of abdominal lymphadenopathy. The purpose of this retrospective study was to directly compare the efficacy of these two techniques in detecting abdominal lymphadenopathy in dogs with apocrine gland adenocarcinoma of the anal sac (AGAAS). Six dogs with histologically confirmed AGAAS and histopathologic confirmation of metastasis to abdominal lymph nodes (LNs) had AUS and abdominal MRI. AUS identified lymphadenopathy in two of six dogs, whereas MRI identified lymphadenopathy in all the six dogs. Lymphadenopathy was predominantly sacral in location, with involvement of the medial iliac and hypogastric LNs in only two cases. These data suggest that MRI is more sensitive than AUS for detecting sacral abdominal lymphadenopathy in dogs with AGAAS. As such, MRI could be considered in any patient with AGAAS for initial staging of this disease.
Investigation of the effect of probiotic exposure on filaggrin expression in an experimental model of canine atopic dermatitis
Authors: Marsella Rosanna , Santoro Domenico , Ahrens Kim , Thomas Amanda L. 
Published: February 2013

BackgroundAtopic dermatitis (AD) results from complex interactions between an impaired skin barrier and immunological stimulation. Filaggrin is a key protein for the skin barrier, and its expression is decreased in subsets of atopic dogs and can be modified by inflammation; thus, immunomodulatory approaches may alter its expression. Probiotics have been explored for the prevention and treatment of allergies, owing to their immunomodulatory properties; however, it is currently unknown whether they can modulate filaggrin expression.ObjectiveThe purpose of this study was to evaluate whether probiotics can modulate filaggrin expression in an experimental model of canineAD.Animals and methodsEighteen atopic (11 probiotic exposed and seven control) and five normal beagles were challenged for three consecutive days withDermatophagoides farinae. Skin biopsies were taken before (day 0), at the peak (day 3) and after the end of the allergen challenge (day 10). Immunohistochemistry for filaggrin was done using a polyclonal antibody specific for canine filaggrin, and staining was scored both subjectively (for intensity, granularity and continuity) and objectively, by tracing the stratum granulosum and calculating the percentage of filaggrin per unit traced area.ResultsAnalysis of variance of the percentage of filaggrin in the stratum granulosum showed a significant effect of group (P = 0.0414,AD < normal), time (P = 0.0066, days 3 and 10 > day 0) and marginal group × time interaction (P = 0.0606). Within the atopic group, exposure to probiotics did not change filaggrin expression. No significant differences were found in the subjective scores among groups.Conclusions and clinical importanceIt is concluded that probiotic exposure early in life does not alter filaggrin expression in thisADmodel.
Performance of emergency physicians in point-of-care echocardiography following limited training
Authors: Bustam Aida , Noor Azhar Muhaimin , Singh Veriah Ramesh , Arumugam Kulenthran , Loch Alexander 
Published: February 2013

ObjectivesThe aim of this study was to evaluate if emergency medicine trainees with a short duration of training in echocardiography could perform and interpret bedside-focused echocardiography reliably on emergency department patients.MethodsFollowing a web-based learning module and 3 h of proctored practical training, emergency medicine trainees were evaluated in technical and interpretative skills in estimating left ventricular function, detection of pericardial effusion and inferior vena cava (IVC) diameter measurements using bedside-focused echocardiography on emergency department patients. An inter-rater agreement analysis was performed between the trainees and a board-certified cardiologist.Results100 focused echocardiography examinations were performed by nine emergency medicine trainees. Agreement between the trainees and the cardiologist was 93% (K=0.79, 95% CI 0.773 to 0.842) for visual estimation of left ventricular function, 92.9% (K=0.80, 95% CI 0.636 to 0.882) for quantitative left ventricular ejection fraction by M-mode measurements, 98% (K=0.74, 95% CI 0.396 to 1.000) for the detection of pericardial effusion, and 64.2% (K=0.45, 95% CI 0.383 to 0.467) for IVC diameter assessment. The Bland–Altman limits of agreement for left ventricular function was −9.5% to 13.7%, and a Pearson's correlation yielded a value of 0.82 (p<0.0001, 95% CI 0.734 to 0.881). The trainees detected pericardial effusion with a sensitivity of 60%, specificity of 100%, positive predictive value of 100% and negative predictive value of 97.9%.ConclusionsEmergency medicine trainees were found to be able to perform and interpret focused echocardiography reliably after a short duration of training.
YAPA
Authors: Baudet Mathieu , Cortier Véronique , Delaune Stéphanie 
Published: February 2013

Reasoning about the knowledge of an attacker is a necessary step in many formal analyses of security protocols. In the framework of the applied pi-calculus, as in similar languages based on equational logics, knowledge is typically expressed by two relations: deducibility and static equivalence. Several decision procedures have been proposed for these relations under a variety of equational theories. However, each theory has its particular algorithm, and none has been implemented so far.
We provide a generic procedure for deducibility and static equivalence that takes as input any convergent rewrite system. We show that our algorithm covers most of the existing decision procedures for convergent theories. We also provide an efficient implementation and compare it briefly with the tools ProVerif and KiSs.
Multitasking without compromise
Authors: Czajkowski Grzegorz , Daynès Laurent 
Published: February 2013

The Multitasking Virtual Machine (called from now on simply MVM) is a modification of the Java™ virtual machine. It enables safe, secure, and scalable multitasking. Safety is achieved by strict isolation of applications from one another. Resource control mechanisms augment security by preventing some denial-ofservice attacks. Improved scalability results from an aggressive application of the main design principle of MVM: share as much of the runtime as possible among applications and replicate everything else. The system can be described as a 'no compromise' approach -- all the known APIs and mechanisms of the Java programming language are available to applications. MVM is implemented as a series of carefully tuned modifications to the Java HotSpot™ virtual machine, including the dynamic compiler.
This paper presents the design of MVM, focusing on several novel and general techniques: an in-runtime design of lightweight isolation, an extension of a copying, generational garbage collector to provide best-effort management of a portion of the heap space, and a transparent and automated mechanism for safe execution of user-level native code. MVM demonstrates that multitasking in a safe language can be accomplished with a high degree of protection, without constraining the language, and with competitive performance characteristics.