bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Randomized Controlled Trial Comparing Post‐operative Pain in Single‐Incision Laparoscopic Cholecystectomy Versus Conventional Laparoscopic Cholecystectomy
Authors: Chang Stephen Kin Yong , Wang Yi Liang , Shen Liang , Iyer Shridhar Ganpathi , Madhavan Krishnakumar 
Published: December 2014

AbstractIntroductionAn increasing body of evidence is being published about single‐incision laparoscopic cholecystectomy (SILC), but there are no well‐powered trials with an adequate evaluation of post‐operative pain. This randomized trial compares SILC against four‐port laparoscopic cholecystectomy (LC) with post‐operative pain as the primary endpoint.MethodsHundred patients were randomized to either SILC (n = 50) or LC (n = 50). Exclusion criteria were (1) Acute cholecystitis; (2) ASA 3 or above; (3) Bleeding disorders; and (4) Previous open upper abdominal surgery. Patients and post‐operative assessors were blinded to the procedure performed. The site and severity of pain were compared at 4 h, 24 h, 14 days and 6 months post‐procedure using the visual analog scale; non‐inferiority was assumed when the lower boundary of the 95 % confidence interval of the difference was above −1 and superiority when p ≤ 0.05.ResultsThe study arms were demographically similar. At 24 h post‐procedure, SILC was associated with less pain at extra‐umbilical sites (rest: p = 0.004; movement: p = 0.008). Pain data were inconclusive at 24 h at the umbilical site on movement; SILC was otherwise non‐inferior for pain at all other points. Operating duration was longer in SILC (79.46 vs 58.88 min, p = 0.003). 8 % of patients in each arm suffered complications (p = 1.000). Re‐intervention rates, analgesic use, return to function, and patient satisfaction did not differ significantly.ConclusionsSILC has improved short‐term pain outcomes compared to LC and is not inferior in both short‐term and long‐term pain outcomes. The operating time is longer, but remains feasible in routine surgical practice.
Conditional discrimination in Octopus vulgaris
Authors: Tokuda Koji , Masuda Reiji , Yamashita Yoh 
Published: December 2014

AbstractConditional discrimination in the octopus (Octopus vulgaris) was studied using successive discrimination training. The experimental animals were divided into two groups, and a barrel-shaped white object (stimulus) was presented to each group. One of the groups was rewarded with food for responding to the stimulus, but only when the tank was aerated, whereas the other group was rewarded with food for responding to the stimulus when the aeration was switched off. The number of trials in which octopuses responded to the stimulus, and the latency of the responses, were significantly different between trials with the aeration on and trials with the aeration off, in both groups. Therefore, the octopuses learned to conditionally discriminate.
Constructing a recombinant hyaluronic acid biosynthesis operon and producing food-grade hyaluronic acid in Lactococcus lactis
Authors: Sheng Juzheng , Ling Peixue , Wang Fengshan 
Published: December 2014

Abstract
Hyaluronic acid (HA), a natural high molecular weight polysaccharide, is produced by Streptococcus zooepidemicus. However, Streptococcus has several drawbacks including its potential to produce exotoxins, so there is demand for an alternative HA source. Here, a recombinant HA biosynthesis operon, as well as the HA biosynthesis operon of S. zooepidemicus were introduced into L. lactis using the nisin-controlled expression system, respectively. HA was successfully synthesized by recombinant L. lactis. Furthermore, overexpression of the endogenous enzymes directing the synthesis of precursor sugars was effective at increasing HA production, and increasing the supply of UDP-activated monosaccharide donors aided synthesis of monodisperse HA polysaccharides. Besides GRAS host strain (L. lactis) and NICE system, the selecting marker (lacF gene) of the recombinant strain is also food grade. Therefore, HA produced by recombinant L. lactis overcomes the problems associated with Streptococcus and provides a source of food-grading HA appropriate for widespread biotechnological applications.
Nichtinvasive Pränataldiagnostik
Authors: Eiben Bernd , Glaubitz Ralf , Kagan Karl Oliver 
Published: December 2014

ZusammenfassungDas Ersttrimesterscreening zur Risikobestimmung für die Trisomien 21, 18 und 13 hat sich in den letzten 15 Jahren in Deutschland etabliert. Die optimale Durchführung setzt die Einhaltung bestimmter Messkriterien beim Ultraschall und bei der biochemischen Analyse voraus sowie die Benutzung evaluierter Risikoberechnungsprogramme wie dem Berechnungsprogramm PRC der Fetal Medicine Foundation Deutschland (FMF-D). Durch die neue Version des Berechnungsprogramms PRC konnten die Trisomie-21-, -18- und -13-Detektionsraten erhöht werden bei gleichzeitiger Senkung der Falsch-positiv-Raten, was einen großen Fortschritt verglichen mit der mütterlichen Altersindikation darstellt.Durch die Analyse der zellfreien fetalen DNA aus dem mütterlichen Plasma können seit 2 Jahren aber wesentlich bessere Screeningvorhersagen getroffen werden. Über 99 % aller Trisomie-21-Schwangerschaften können mit dieser Methodik als Risikogruppe beschrieben werden. Die Falsch-positiv-Rate liegt unter 1 %. Durch diese Methode ist ein Paradigmenwechsel in der Pränataldiagnostik zu erwarten.
Preventive treatments for breast cancer: recent developments
Authors: Alés-Martínez J. E. , Ruiz A. , Chacón J. I. , Lluch Hernández A. , Ramos M. , Córdoba O. , Aguirre E. , Barnadas A. , Jara C. , González S. , Plazaola A. , Florián J. , Andrés R. , Sánchez Rovira P. , Frau A. 
Published: December 2014

Abstract

Breast cancer is a burden for western societies, and an increasing one in emerging economies, because of its high incidence and enormous psychological, social, sanitary and economic costs. However, breast cancer is a preventable disease in a significant proportion. Recent developments in the armamentarium of effective drugs for breast cancer prevention (namely exemestane and anastrozole), the new recommendation from the National Institute for Health and Care Excellence to use preventative drugs in women at high risk as well as updated Guidelines from the US Preventive Services Task Force and the American Society of Clinical Oncology should give renewed momentum to the pharmacological prevention of breast cancer. In this article we review recent major developments in the field and examine their ongoing repercussion for breast cancer prevention. As a practical example, the potential impact of preventive measures in Spain is evaluated and a course of practical actions is delineated.
Forced Resettlement, Ethnicity, and the (Un)Making of the Ndebele Identity in Buhera District, Zimbabwe
Authors: Musoni Francis 
Published: December 2014

Abstract:This study examines the historical development of hostility between the Shona-speaking inhabitants of Buhera district in south-central Zimbabwe and Ndebele speakers who settled in the area after being forcibly removed from various parts of Matabeleland and Midlands provinces between the 1920s and 1950s. It shows how competition for productive farmlands, which became visible beginning in the 1940s, produced and sustained the Ndebele–Shona hostility in Buhera. While other scholars view this hostility primarily from an ethnic perspective, this article argues that ethnicity was just one of many factors that shaped relations between these people.
Submesoscale baroclinic instability in the balance equations
Authors: Grooms Ian 
Published: December 2014

AbstractOcean submesoscale baroclinic instability is studied in the framework of the balance equations. These equations are an intermediate model that includes balanced ageostrophic effects with higher accuracy than the quasigeostrophic approximation, but rules out unbalanced wave motions. As such, the balance equations are particularly suited to the study of baroclinic instability in submesoscale ocean dynamics. The linear baroclinic instability problem is developed in generality and then specialized to the case of constant vertical shear. It is found that non-quasigeostrophic effects appear only for perturbations with cross-front variation, and that perturbation energy can be generated through both baroclinic production and shear production. The Eady problem is solved analytically in the balance equation framework. Ageostrophic effects are shown to increase the range of unstable modes and the growth rate of the instability for perturbations with cross-front variation. The increased level of instability is attributed to both ageostrophic baroclinic production and shear production of perturbation energy; these results are verified in the primitive equations. Finally, submesoscale baroclinic instability is examined in a case where the buoyancy frequency increases rapidly near the bottom boundary, mimicking the increase of stratification at the base of the oceanic mixed layer. The qualitative results of the Eady problem are repeated in this case, with increased growth rates attributed to the production of perturbation energy by the ageostrophic velocity. The results show that submesoscale baroclinic instability acts to reduce lateral buoyancy gradients and their associated geostrophic shear simultaneously through lateral buoyancy fluxes and vertical momentum fluxes.
DATA PROTECTION AND THE RIGHT TO REPUTATION: FILLING THE “GAPS” AFTER THE DEFAMATION ACT 2013
Authors: Erdos David 
Published: December 2014

AbstractDefamation law has historically occupied a position of overwhelming dominance in the vindication of the traditional right to reputation. Nevertheless, liberalisation of this legal framework including through the Defamation Act 2013 has led to a concern that, when analysed from a fundamental rights perspective, “gaps” in the protection provided for natural persons may have emerged. In this new context, there has been a renewed focus on whether data protection may fill the potential lacunae. Data protection law contains a number of important limitations and exceptions and its jurisprudence has been both limited and sometimes confused. Nevertheless, this article argues that its broad purpose and complex structure ensure it will play a significantly augmented role in the future, especially in actions against website operators facilitating the dissemination of information posted by a third party, the publication of opinion, or where either injunctive relief or the correction of inaccurate information is sought (in particular in cases of continuing online disclosure).
THE GHOST OF THE RULE IN HOLLINGTON v HEWTHORN: EXORCIST REQUIRED
Authors: Spencer J.R. 
Published: December 2014

AT an airfield in Dorset, a vintage aircraft took to the air and then – as too often seems to happen – fell out of it. The fatal consequences led to Rogers v Hoyle [2014] EWCA Civ 257, [2014] 3 W.L.R. 145 – proceedings brought on behalf of the dependants of the deceased passenger, Orlando Rogers, against the pilot, Scott Hoyle, whose negligence they claimed had caused the crash. As required by law, the accident had been officially investigated by the Department of Transport's Air Accident Investigation Department (the AAID). Its report contained findings about the cause of the accident which were helpful to the claimants' case, so they sought to adduce it as evidence. To this the defendant objected and sought to persuade the courts to exclude it. That he failed in his attempt is unsurprising because, as Leggatt J. put it at first instance, “If any non lawyer was told that the law does not permit a court to have regard to the AAIB report when deciding how the accident was caused, I am sure that he or she would express astonishment at the suggestion”. But if the sensible outcome was so obvious, why were lengthy judgments at two levels, with over 70 authorities cited and discussed, needed to produce it?
PRESCRIPTIVE ACQUISITION OF RIGHTS OVER PUBLIC AUTHORITY LAND
Authors: Taylor Aaron 
Published: December 2014

THE “tripartite” test for the prescriptive acquisition of rights over land, derived from the Roman law of servitudes, has long been a source of confusion. The crucial distinction that underlies it is between use of land that is “as [if] of right” – nec vi, nec clam, nec precario (without force, stealth, or licence) – and use that is “by right” – that is, with a licence. This distinction has been affirmed by the Supreme Court in R. (Barkas) v North Yorkshire County Council & Another [2014] UKSC 31. The court held that use of land pursuant to a statutory entitlement is necessarily use “by right”, and so was not “as of right”.
ENGLAND'S UNIQUE APPROACH TO THE SELF-REGULATION OF THIRD PARTY FUNDING: A CRITICAL ANALYSIS OF RECENT DEVELOPMENTS
Authors: Mulheron Rachael 
Published: December 2014

AbstractThird Party Funding is governed by a unique and unparalleled legal framework in English law. That framework consists of: the recent 2014 Code of Conduct for Litigation Funders, its supervision by the Association of Litigation Funders, and sporadic judicial oversight of Litigation Funding Agreements – and with some unenacted legislation in the background for good measure. The purpose of this article is to analyse and critique this unique regulatory regime in several key respects. These include: the capital adequacy required of Funders; the key anti-champerty factors either judicially stipulated or contained within the 2014 Code; the efficacy and fairness of the so-called “Arkin cap”; the grounds upon which a Funder may legitimately withdraw funding; and the impact of recent contingency fee reforms. Overall, Third Party Funding represents an evolving and controversial landscape, both legally and politically.
Disability and Survival of Multiple Sclerosis in Saskatoon, Saskatchewan
Authors: Hader Walter J. 
Published: December 2014

Background:A population-based prevalent group of 150 clinical definite patients ascertained on 1 January 1977, in Saskatoon, Saskatchewan, was followed for 30 years.Objectives:To outline the clinical characteristics, determine the levels of disability at 15, 25, 35, 40, and 45 years after onset, to estimate the survival after onset and life expectancy.Methods:Clinical records were maintained, and the cohort reviewed each decade for 30 years. The disability levels according to the Kurtzke Extended Disability Status Scale were recorded and survival times were estimated. SPSS and Kaplan-Meier methods were used for analysis.Results:On prevalence day, 1 January 1977, there were 48(32%) men and 102(68%) women, with an average age of onset of 32.2±10 years and 28.4±8.6 years. The average duration of disease was 15.7 years. On 1 January 2007, 39(26%) patients were living, 105(70%) deceased, and 6(4%) were missing The disability levels recorded in 1977 and 2007, at 15 and 45 years after onset, were mild (EDSS≤2.5), 33.3% and 8.0%; moderate (EDSS3-5.5), 17.3% and 2.7%; severe (EDSS6-7.5), 6.6% and 4.7%; maximum (EDSS8-9.5), 22.7% and 10.7%. The median survival time after onset was 33 (95% CI: 27.3-38.6) years for men and 38 (95% CI: 34.1-41.9) years for women. The median duration of life was 68.9 years for men and 69.5 years for women, and a decreased life expectancy of 7.7 and 12.8 years.Conclusions:Multiple sclerosis is a progressive neurological disorder and long-term survival is associated with moderate to severe disability and decreased life expectancy.
External Ventricular Drains and Mortality in Patients with Severe Traumatic Brain Injury
Authors: Griesdale Donald E. G. , McEwen Jonathan , Kurth Tobias , Chittock Dean R. 
Published: December 2014

Purpose:To determine our institutional adherence to the Brain Trauma Foundation guidelines with respect to intracranial pressure (ICP) monitoring, and examine the relationship between external ventricular drain (EVD) use and mortality.Materials & Methods:Retrospective cohort study of 171 patients with severe traumatic brain injury (TBI). Propensity score adjusted logistic regression was used to model the association between EVD use and mortality.Results:EVDs were inserted in 98 of 171 patients. Of the 73 patients without an EVD, 63 (86%) would have qualified for ICP monitoring under the current guidelines. EVDs werein situfor a median of 8 days (SD 6). In adjusted analyses, EVD use was associated with hospital mortality (OR 2.8, 95% CI: 1.1 - 7.1, p=0.04) and 28-day mortality (OR 2.1, 95% CI: 0.80 - 5.6, p=0.13). We observed significant modification of the association between EVD and 28-day mortality by GCS within 12 hours (p-interaction = 0.04), indicating strong association only among those patients with GCS score of at least 6 (OR 5.0, 95% CI: 1.5 - 16.7, p<0.01).Conclusions:The association of EVD with 28-day mortality was only apparent among patients with GCS score of ≥ 6. Further research is warranted to further refine which patients may benefit from ICP monitoring.
Prevalence of Mental Disorders in a Canadian Household Population with Dementia
Authors: Nabalamba Alice , Patten Scott B. 
Published: December 2014

Background:Medical and mental health comorbidity in Alzheimer's disease and other dementias presents difficult challenges for health service delivery. However, existing studies have been conducted in clinical samples and may not be informative for planning community services. The Canadian Community Health Survey (CCHS) provides an opportunity to characterize associations between dementias and mental and physical comorbidity in a household population aged 55 and over.Methods:Data were obtained from the 2005 CCHS-cycle 3.1. Weighted estimates for mood and anxiety disorders and other characteristics in Canadian population with dementia were calculated and were compared to those in people without the condition.Results:According to the CCHS, the prevalence of Alzheimer's disease and other dementia increases with age, more or less doubling every decade. The increase among women is monotonic, whereas among men in the household population the rate of dementia peaks at age 85-89 and falls thereafter. Mood and anxiety disorders were found to be substantially more frequent among people with Alzheimer's disease and other forms of dementia compared to those without the disease (mood disorders: 19.5% vs. 5.3% and anxiety disorders: 16.3% vs. 4.0%). Heart disease, stroke and obesity were associated with dementia as was a lower level of education. Furthermore, people with dementia were more likely than those without the disease to report activity restrictions.Conclusions:The high prevalence of mood and anxiety disorders in household population with Alzheimer's disease and other dementia demonstrates the burden of disease that is likely to worsen quality of life over time.
Neuropathology in Canada: Overview of Development and Current Status
Authors: Del Bigio Marc R. , Johnson Edward S. 
Published: December 2014

Background:The expansion of neurosurgery and neurology in Montreal and Toronto in the early 20th century was the stimulus for the development of neuropathology in Canada. Rooted in the disciplines of the neurosciences and laboratory medicine, neuropathology evolved into an independent discipline with the founding of the Canadian Association of Neuropathologists in 1960, and the recognition as a specialty by the Royal College of Physicians and Surgeons in Canada in 1965, fostering the development of several successful training programs. Nonetheless, a paucity of data remains concerning the background of training, scopes of practice, and career paths.Method:We conducted a survey of all physicians in Canada who have either practiced neuropathology or undergone relevant training.Results:In 2009, 53 physicians were engaged in the practice of neuropathology, either exclusively or a substantial proportion of their time. Most work in tertiary hospitals, but a few service non-academic medical centers. Three routes of training were identified: direct from medical school (often with relevant research training), indirect from another clinical neuroscience specialty, and following or in conjunction with certification in one of the other pathology specialties. Practice profiles differ slightly, and some of the neuropathologists entering from pathology have mixed anatomical pathology/neuropathology responsibilities. Many of those with prior exposure in the neurosciences are more productive with regard to research and publications.Conclusions:Existing multiple options for neuropathology training have facilitated recruitment and allowed development of a mosaic of specialists able to fulfill the diversity of needs in Canadian medical and scientific communities.
Intra-Arterial vs Intra-Venous Thrombolysis for Anterior Cerebral Occlusion
Authors: Zhang Bin , Sun Xiaojiang , Li Minghua , Wang Feng , Xu Dan , Duan Hao , Fang Chun 
Published: December 2014

Background:The safety and effectiveness of intra-arterial thrombolysis (IAT) in comparison to intravenous thrombolysis (IVT) for the treatment of ischemic stroke is uncertain. Our study aims to assess and compare IAT to IVT for clinically relevant outcomes in patients with occlusion of the anterior cerebral circulation.Methods:Patients with acute ischemic stroke were enrolled for either treatment; those whose symptoms occurred within 4.5 hrs after stroke were treated with IVT, whereas those who presented <4.5 hrs but had contraindications to IVT or presented between 4.5 and 6 hrs were treated with IAT. Evaluated endpoints included: disability at 90 days as measured by the modified Rankin Scale (mRS), incidence of mortality, and incidence of symptomatic intracranial haemorrhage.Results:78 patients with anterior cerebral circulation occlusion were included in the study (55 in IVT, 23 in IAT). After 90 days, 82.6% patients treated with IAT reached independence in comparison to 56.4% in the IVT group (P=0.028, RR=2.66, 95% CI: 1.10-7.04). The incidence of all intracranial haemorrhages in the IAT and IVT groups respectively were 30.4% and 12.7% (P=0.103, RR=2.391, 95% CI: 0.946-6.047); symptomatic intracranial haemorrhage occurred in 8.7% and 9.1% of patients (P=1.00, RR= 0.957, 95% CI: 0.200-4.579), and mortality in 8.7% and 16.4% (P=0.492, RR=1.882, 95% CI: 0.440-8.045).Conclusion:Results suggest that IAT is more effective than IVT in allowing patients to achieve independence. While inconclusive, the safety of IAT within 6 hrs is comparable to IVT within 4.5 hrs.
Risk of Multiple Sclerosis after Idiopathic Optic Neuritis in a Pakistani Population
Authors: Kazim Syed Faraz , Islam Muhammad , Khan Mustafa , Hameed Bilal , Shafqat Saad 
Published: December 2014

Background and objective:Optic neuritis (ON) is associated with a 38% ten-year risk of developing multiple sclerosis (MS) in Western populations, but the corresponding risk in non-Western populations is unclear. We conducted this study to estimate the risk of progression to MS after an episode of ON in a South Asian population.Methods:Two hundred and fifty-three patients with idiopathic ON were identified by reviewing records of visual evoked potentials and chart notes from a single academic center spanning the years 1990-2007. A structured telephone interview was then conducted to identify patients who had subsequently received a diagnosis of MS. The diagnosis was corroborated from chart notes, where possible. Cumulative probability of conversion to MS was calculated using Kaplan-Meier survival analysis.Results:The five-year risk of developing MS was 14.6% and the ten-year risk was 24%. Patients (N=218) who had one or more typical demyelinating lesions on baseline brain magnetic resonance imaging (MRI) had a 68% 10-year risk; those with no lesions or non-typical lesions had a 14% risk (p<0.001). Female gender, recurrent ON, and occurrence of ON in winter months were also associated with increased risk (p≤ 0.001). Severity of ON and likelihood of detecting cerebrospinal fluid (CSF) oligoclonal bands were higher in patients who developed MS.Conclusion:Idiopathic ON in Pakistan carries a lower risk of progression to MS compared with Western data. As in Western populations, however, presence of abnormal baseline brain MRI and CSF oligoclonal bands correlate with increased MS risk.