bluuebunny/crossref_metadata_2025_split huggingface dataset:
Young women's perceptions of fertility‐related information and fertility distress before surgery for ovarian cysts
Authors: Lind Tekla , Lampic Claudia , Hammarström Margareta , Rodriguez‐Wallberg Kenny 
Published: August 2013

AbstractObjectiveTo investigate young women's reproductive desire and perceptions of fertility‐related information when scheduled for ovarian cyst surgery with a possible impact on fertility.DesignCross‐sectional study.SettingUniversity Hospital.PopulationWomen of reproductive age (n = 106, mean age 32.3 years, range 18–44 years) with a diagnosis of ovarian cyst and scheduled ovarian cyst surgery between March 2011 and September 2012 were included.MethodsThe women answered a questionnaire after the presurgery consultation with the gynecologist. The questionnaire included study‐specific measures of reproductive desire, perception of fertility‐related information received, worry about future fertility and sociodemographic characteristics.Main outcome measureReproductive desire and recalled information on the impact of surgery on fertility.ResultsA high proportion of the women (72%) reported a desire for having children in the future and more than half of them (58%) recalled receiving information about the impact of surgery on fertility. In a multivariable logistic regression model adjusted for parity, education and age, a desire to have children increased the likelihood of recalling having received fertility‐related information (odds ratio 3.2, 95% CI 1.1–9.2).ConclusionsAlmost half of women with reproductive desire had ovarian surgery without recalling a discussion of fertility issues. Development of written information or interactive information might improve women's perception of fertility‐related information.
Preoperative serum albumin is associated with mortality and complications after radical cystectomy
Authors: Garg Tullika , Chen Ling Y. , Kim Philip H. , Zhao Philip T. , Herr Harry W. , Donat S. Machele 
Published: August 2013

Objective
To determine the association between preoperative serum albumin and mortality and postoperative complications after radical cystectomy (RC) and urinary diversion.
Patients and Methods
We conducted a retrospective review of 1097 RCs performed for the treatment of bladder cancer between 1992 and 2005.
All data were entered prospectively into a hospital‐based complications database.
We used multivariable logistic regression to assess the association between preoperative serum albumin and complications and mortality ≤90 days of RC, while controlling for preoperative patient and disease characteristics.
Results
Low preoperative serum albumin was identified in 14% of the cohort.
Preoperative serum albumin was a predictor of postoperative complications (adjusted odds ratio [OR] per unit increase in albumin: 0.61, 95% confidence interval [CI] 0.42–0.90) and 90‐day mortality (OR 0.33, 95% CI 0.14–0.75) when controlling for sex, race, age‐adjusted Charlson score, body mass index, prior history of abdominal surgery, clinical stage, and neoadjuvant chemotherapy.
As serum albumin decreased, the risk of complications and mortality increased.
Conclusions
In addition to age‐adjusted Charlson score, low preoperative serum albumin is a significant predictor of complications and mortality after RC.
Serum albumin testing can be used to identify individuals at high‐risk of morbidity and mortality.
Paraneoplastic neurological syndromes
Authors: Leypoldt F , Wandinger K-P 
Published: August 2013

Summary
Paraneoplastic neurological syndromes are immune-mediated erroneous attacks on the central or peripheral nervous systems, or both, directed originally against the tumour itself. They have been known for more than 40 years, but recently the discovery of new subgroups of paraneoplastic encephalitis syndromes with a remarkably good response to immune therapy has ignited new clinical and scientific interest. Knowledge of these subgroups and their associated autoantibodies is important in therapeutic decision-making. However, the abundance of new autoantibodies and syndromes can be confusing. This review paper summarizes current knowledge and new developments in the field of paraneoplastic neurological syndromes, their classification, pathophysiology and treatment.
The DULK (Dutch leakage) and modified DULK score compared: actively seek the leak
Authors: den Dulk M. , Witvliet M. J. , Kortram K. , Neijenhuis P. A. , de Hingh I. H. , Engel A. F. , van de Velde C. J. H. , de Brauw L. M. , Putter H. , Brouwers M. A. M. , Steup W.‐H. 
Published: August 2013

AbstractAimA standardized postoperative score, the DULK (Dutch leakage) score, has been demonstrated to be a useful clinical tool in the diagnosis of anastomotic leakage. It is complicated, however, and a simplification (the modified DULK score) based on fewer parameters derived from multiple logistic regression analyses has been developed. These include clinical condition, abdominal pain not localized at the wound, C‐reactive protein level and respiratory rate. The accuracy of each was compared.MethodData of all patients from five Dutch centres operated on between 16 October 2007 and 1 November 2009 with an anastomosis in the colon or rectum were entered into a prospectively maintained database.ResultsIn total, 782 patients were included of whom 81 (10.4%) had a clinically relevant anastomotic leakage. The DULK score gave an overall sensitivity of 97% for anastomotic leakage, overall specificity of 53%, a positive predictive value (PPV) of 16% and a negative predictive value (NPV) of 99%. The modified DULK score used clinical condition, abdominal pain not localized at the wound, C‐reactive protein level and respiratory rate. With at least one parameter present, overall sensitivity was 97%, overall specificity 57%, PPV 17% and NPV 99.5%. With at least two points PPV was 41% and with three points 57%.ConclusionBoth the original and modified DULK scores are useful for the early diagnosis of clinically relevant anastomotic leakage. The modified DULK score offers the benefit of fewer parameters and so can easily be used in a clinical environment to estimate the likelihood of anastomotic leakage. However, the early diagnosis of anastomotic leakage remains difficult.
Completion surgery following transanal endoscopic microsurgery: assessment of quality and short‐ and long‐term outcome
Authors: Hompes R. , McDonald R. , Buskens C. , Lindsey I. , Armitage N. , Hill J. , Scott A. , Mortensen N. J. , Cunningham C. ,   The Association of Coloproctology of Great Britain and Ireland Transanal Endoscopic Microsurgery Collaboration
Published: August 2013

AbstractAimPatients with unfavourable pathology after transanal endoscopic microsurgery (TEM) should be offered completion surgery (CS) if appropriate. The aim of this retrospective cohort study was to assess the short‐term outcome and long‐term oncological results of CS and identify factors compromising the quality of resection specimens.MethodData were retrieved and analysed on patients who underwent CS from a comprehensive national TEM database (1992–2008) and the institutional prospective database from the Oxford University Hospitals (2008–2011).ResultsThere were 36 patients eligible for analysis. Postoperative complications occurred in 19 and were minor (grade I–II) in 13 and major (grade III–V) in six patients. The quality of the resected specimen was graded as good in 23 (64%), moderate in six (16.6%) and poor in seven (19.4%). Full‐thickness excision by TEM (P = 0.03), an interval to CS greater than 7 weeks (P = 0.05) and distally located lesions (P = 0.04) were associated with increased risk for an inferior surgical specimen. Overall survival after CS was 91% at 1 year and 83% at 5 years. Patients with a ‘good’ TME specimen had significantly improved disease‐free survival compared with patients with an ‘inferior’ specimen (100 vs 51%, P = 0.001).ConclusionPatients having full‐thickness TEM excision, distally placed lesions and a long interval (> 7 weeks) to CS were likely to have an inferior TME specimen. The results confirm that CS after TEM does not negatively influence local recurrence and survival, but the reduced disease‐free survival in patients with an inferior specimen is of concern.
Climate change, non‐indigenous species and shipping: assessing the risk of species introduction to a high‐Arctic archipelago
Authors: Ware Chris , Berge Jørgen , Sundet Jan H. , Kirkpatrick Jamie B. , Coutts Ashley D. M. , Jelmert Anders , Olsen Steffen M. , Floerl Oliver , Wisz Mary S. , Alsos Inger G. 
Published: August 2013

AbstractAimAnticipated changes in the global ocean climate will affect the vulnerability of marine ecosystems to the negative effects of non‐indigenous species (NIS). In the Arctic, there is a need to better characterize present and future marine biological introduction patterns and processes. We use a vector‐based assessment to estimate changes in the vulnerability of a high‐Arctic archipelago to marine NIS introduction and establishment.LocationGlobal, with a case study of Svalbard, Norway.MethodsWe base our assessment on the level of connectedness to global NIS pools through the regional shipping network and predicted changes in ocean climates. Environmental match of ports connected to Svalbard was evaluated under present and future environmental conditions (2050 and 2100 predicted under the RCP8.5 emissions scenario). Risk of NIS introduction was then estimated based on the potential for known NIS to be transported (in ballast water or as biofouling), environmental match, and a qualitative estimate of propagule pressure.ResultsWe show that Svalbard will become increasingly vulnerable to marine NIS introduction and establishment. Over the coming century, sea surface warming at high latitudes is estimated to increase the level of environmental match to nearly one‐third of ports previously visited by vessels travelling to Svalbard in 2011 (n = 136). The shipping network will then likely connect Svalbard to a much greater pool of known NIS, under conditions more favourable for their establishment. Research and fishing vessels were estimated to pose the highest risk of NIS introduction through biofouling, while ballast water discharge is estimated to pose an increased risk by the end of the century.Main conclusionsIn the absence of focused preventative management, the risk of NIS introduction and establishment in Svalbard, and the wider Arctic, will increase over coming decades, prompting a need to respond in policy and action.
Symptom patterns can distinguish diverticular disease from irritable bowel syndrome
Authors: Cuomo Rosario , Barbara Giovanni , Andreozzi Paolo , Bassotti Gabrio , Casetti Tino , Grassini Mario , Ierardi Enzo , Maconi Giovanni , Marchi Santino , Sarnelli Giovanni , Savarino Vincenzo , Usai Paolo , Vozzella Letizia , Annibale Bruno 
Published: August 2013

AbstractBackgroundDiverticular disease (DD) and irritable bowel syndrome (IBS) share a similar symptom pattern. However, comparative studies are flawed by different age at onset of symptoms. We aimed to verify whether clinical features distinguish DD from IBS.Materials and methodsPatients with DD or IBS, matched for age and gender (1/1) were consecutively recruited. Data on demographic parameters, voluptuary habits, inheritance of disease and symptoms were collected. Moreover, the association between pain > 24 h, and clinical parameters were evaluated.ResultsNinety patients with DD and 90 patients with IBS (DD: F/M: 46/44; age: 50.9 years; IBS: 46/44; 50.4) were selected from an overall population of 1275 patients. Only nine patients with DD (10%) fulfilled the criteria for IBS diagnosis. Abdominal pain > 24 h was more prevalent in SDD than in patients with IBS (20 vs. 6 patients; P < 0·01). Furthermore, compared with IBS, patients with DD showed more episodes of pain > 24 h requiring medical attention (80% vs. 33%; P < 0·01).ConclusionsAbdominal pain lasting for more than 24 h discriminates patients with DD compared with those with IBS. Identifying this symptom could be an appropriate strategy to define the diagnosis and management.
Ligand‐independent epidermal growth factor receptor hyperactivation increases sebaceous gland size and sebum secretion in mice
Authors: Dahlhoff Maik , de Angelis Martin Hrabe , Wolf Eckhard , Schneider Marlon R. 
Published: August 2013

AbstractThe epidermal growth factor receptor (EGFR) system is an established regulator of the development and homeostasis of the hair follicle and interfollicular epidermis. Here, we evaluated EGFR actions on the sebaceous glands (SGs) by employing Dsk5 mice, a mutant line in which the EGFR is constitutively activated in a ligand‐independent manner. Compared to control littermates, Dsk5 mice showed increased sebum levels and enlarged SGs, which contained a higher number of cells and showed stronger proliferation. c‐myc transcript levels were increased in Dsk5 skin, suggesting that c‐myc mediates the proliferative stimuli of the EGFR in the SG. Analysis of differentiation markers revealed deregulated expression of Scd1 and Scd3, indicating that sebaceous lipogenesis is affected in Dsk5 mice. In conclusion, our study indicates that the EGFR is an important regulator of presebocyte proliferation, contributing to the final cell number, to the size and to the lipid output of SGs.
Plant species identity surpasses species richness as a key driver of N2O emissions from grassland
Authors: Abalos Diego , De Deyn Gerlinde B. , Kuyper Thomas W. , van Groenigen Jan Willem 
Published: August 2013

AbstractGrassland ecosystems worldwide not only provide many important ecosystem services but they also function as a major source of the greenhouse gas nitrous oxide (N2O), especially in response to nitrogen deposition by grazing animals. To explore the role of plants as mediators of these emissions, we tested whether and how N2O emissions are dependent on grass species richness and/or specific grass species composition in the absence and presence of urine deposition. We hypothesized that: (i) N2O emissions relate negatively to plant productivity; (ii) four‐species mixtures have lower emissions than monocultures (as they are expected to be more productive); (iii) emissions are lowest in combinations of species with diverging root morphology and high root biomass; and (iv) the identity of the key species that reduce N2O emissions is dependent on urine deposition. We established monocultures and two‐ and four‐species mixtures of common grass species with diverging functional traits: Lolium perenne L. (Lp), Festuca arundinacea Schreb. (Fa), Phleum pratense L. (Php) and Poa trivialis L. (Pt), and quantified N2O emissions for 42 days. We found no relation between plant species richness and N2O emissions. However, N2O emissions were significantly reduced in specific plant species combinations. In the absence of urine, plant communities of Fa+Php acted as a sink for N2O, whereas the monocultures of these species constituted a N2O source. With urine application Lp+Pt plant communities reduced (P < 0.001) N2O emissions by 44% compared to monocultures of Lp. Reductions in N2O emissions by species mixtures could be explained by total biomass productivity and by complementarity in root morphology. This study shows that plant species composition is a key component underlying N2O emissions from grassland ecosystems. Selection of specific grass species combinations in the context of the expected nitrogen deposition regimes may therefore provide a key for mitigation of N2O emissions.
Extinction debt and the species–area relationship: a neutral perspective
Authors: Halley John M. , Sgardeli Vasiliki , Triantis Kostas A. 
Published: August 2013

AbstractAimTo estimate the magnitude of delayed relative to imminent extinctions and to assess the importance of delay as a potential source of error in forecasts of extinction. To formulate a simple mechanistic model using neutral theory that links extinction debt with the species–area relationship (SAR).LocationWorld‐wide.MethodsWe use the neutral model of biodiversity to describe how a community subject to immigration responds to an insular contraction. We investigate the species richness at different times after the habitat‐loss event. We compare this with observed species losses in avian studies.ResultsFrom the model, two SARs emerge: one with a shallow slope for a habitat area before habitat loss and another with a steeper slope for the habitats that remain after habitat loss. From these curves, the first predicts imminent extinctions while the second predicts total extinctions. The difference between the two curves gives the delayed extinctions, namely the number of species that are lost during the relaxation of the community to equilibrium. The model agrees well with observed relaxation rates in communities of birds. The lag times for relaxation are often very large, with half‐lives in the order of thousands of years for remnant areas above 5000 km2. In many parameter combinations explored, the majority of extinctions are delayed extinctions, and may exceed imminent extinctions by orders of magnitude.Main conclusionsExtinction debt is a major reason for failures to observe extinctions following habitat loss. Our modelling approach supports the view that a significant proportion of extinctions are delayed, so that the predictions of SARs (as currently applied) are liable to underestimate total extinctions. SARs are a valuable instrument for conservation but must be used with caution.
Island mammal extinctions are determined by interactive effects of life history, island biogeography and mesopredator suppression
Authors: Hanna Emily , Cardillo Marcel 
Published: August 2013

AbstractAimUnderstanding extinction on islands is critical for biodiversity conservation. Introduced predators are a major cause of island extinctions, but there have been few large‐scale studies of the complexity of the effects of predators on island faunas, or how predation interacts with other factors. Using a large database of island mammal populations, we describe and explain patterns of island mammal extinctions as a function of introduced predators, life history and geography.LocationThree hundred and twenty‐three Australian islands.MethodsWe built a database of 934 island mammal populations, extinct and extant, including life history and ecology, island geography and the presence of introduced predators. To test predictors of extinction probability, we used generalized linear mixed models to control partially for phylogenetic non‐independence, and decision trees to more fully explore interactive effects.ResultsThe decision trees identified large mammals (> 2.7 kg) as having higher extinction probabilities than small species (< 2.7 kg). In large species, extinction patterns are consistent with island biogeography theory, with distance from the mainland being the primary predictor of extinction. For small species, the presence of introduced black rats is the primary predictor of extinction. As predicted by mesopredator suppression theory, extinction probabilities are lower on islands with both black rats and a larger introduced predator (cats, foxes or dingoes), compared with islands with rats but no larger predator. Similarly, extinction probabilities are lower on islands with both a mid‐sized (cats or foxes) and a larger (dingoes) predator, compared with islands with cats or foxes only.Main conclusionsIsland mammal extinctions result from complex interactions of introduced predators, island geography and prey biology. One conservation implication of our results is that eradication of introduced apex predators (cats, foxes or dingoes) from islands could precipitate the expansion of black rat populations, potentially leading to extinction of native mammal species whose remaining populations are confined to islands.
Signalling pathways in succinate dehydrogenase B‐associated renal carcinoma
Authors: Fleming Stewart , Mayer Nick J , Vlatkovic Ljiljana J , McLean Joanne , McConachie Michelle , Baty David 
Published: August 2013

AimsRenal tumours have recently been described in association with mutations in the gene encoding the B subunit of succinate dehydrogenase, a mitochondrial Krebs cycle and electron transport chain enzyme (SDHB‐associated renal cell carcinomas). The aim of this study was to investigate the roles of different signalling pathways in the pathogenesis of these tumours.Methods and resultsWe used immunohistochemistry and antibodies against phospho‐specific epitopes to examine the activity of three potential signalling pathways in tumour cells of three genetically confirmed cases of SDHB‐associated renal cell carcinomas. We found no evidence supporting a role for either the mTOR [p‐mTOR (Ser2448), p‐S6 riboprotein (Ser235/236)] or hypoxia‐inducible (carbonic anhydrase 9 and EGFR) pathways. However, there was immunohistochemical reactivity for phosphorylated AMP‐dependent kinase (p‐AMPK Thr172) and glycogen synthase kinase 3 (GSK3) phosphorylation (p‐GSK3 Ser12), and nuclear expression of cyclin D1.ConclusionsWe suggest that these tumours may arise through a mechanism involving ATP depletion, activation of AMPK, and induction of cyclin D1, and that this may be a unique pathway of tumour development that has the potential for therapeutic intervention in these rare tumours.
Conceptualizing the clinical and professional development of child and adolescent mental health nurses
Authors: Rasmussen Philippa , Henderson Ann , Muir‐Cochrane Eimear 
Published: August 2013

AbstractAspects of mental health nursing and its subspecialties are not easily defined. Child and adolescent mental health (CAMH) nursing is a subspecialty of mental health nursing, and some of its characteristics are tacit. This paper presents a deeper understanding of the meaning that CAMH nurses make of their role and work in the inpatient setting. The research was undertaken through a PhD candidature. The epistemological framework for the research was social constructionism. Interpretive enquiry was the methodology, as it allowed for the interpretation of multiple realities, which resulted in a rich description of the role and work of CAMH nurses. Methods of data collection were document analysis, focus group interviews, and individual interviews. Participants included nurses and multidisciplinary staff. Iterative and aggregative analyses were utilized for the documents. The focus group and individual interview data were analysed utilizing a thematic analysis process. This paper presents the findings of the combined analysis and the resultant holistic conceptual framework for the work of the CAMH nurse in the inpatient unit. The findings have contributed new knowledge to mental health nursing, specifically CAMH nursing, making the parameters of practice more explicit. Implications for practice, education, and research are identified.
Mixed type symmetric duality for multiobjective variational problems with cone constraints
Authors: Ahmad I. , Husain Z. , Al‐Homidan S. 
Published: August 2013

AbstractIn this study, a pair of multiobjective variational mixed symmetric dual programs involving cone constraints is presented and usual duality results are established using the notion of generalized ‐convexity. Self‐duality is discussed under additional condition of skew symmetry, and a time‐independence (static) version of the problems is also incorporated.