bluuebunny/crossref_metadata_2025_split huggingface dataset:
Failed back (surgery) syndrome: time for a paradigm shift
Authors: Vleggeert-Lankamp Carmen LAM , Arts Mark P , Jacobs Wilco CH , Peul Wilco C 
Published: February 2013

Summary points 1. The group of patients with so-called ‘failed back surgery syndrome’ (FBSS) is very diverse. Published studies evaluating the outcome of surgical treatment vary widely in terms of surgical interventions that were performed. Results from these papers cannot be generally applied to all people who have persisting complaints after low back surgery. 2. The literature search that was performed demonstrated that the articles that scored as acceptable on assessment bias demonstrated a low to moderate patient-perceived recovery percentage. The only randomized controlled trial on this topic did not demonstrate a difference between instrumented fusion and cognitive intervention and exercise. 3. Current research does not show repeat surgery to be successful in ‘FBSS patients’, but clinical practice indicates that, in a small, carefully selected group, repeat surgery can yield rewarding results. However, parameters that make a patient prone to recover from a subsequent surgical intervention cannot be found in the literature. 4. The term ‘failed back surgery syndrome’ implies a causative role of surgery in a problem situation; failed back surgery syndrome is frequently regarded as failed back surgery. The literature does not, however, provide evidence for this. 5. It is important to inform the patient adequately to shape realistic expectations. Preoperative evaluation of parameters evaluating the psychological condition could help to better predict the outcome of surgery. 6. The term ‘failed back surgery syndrome’ has been demonstrated to be an ill-defined term, serving as a container for all kinds of back and leg problems, and wrongly implying a definite role for the surgical intervention in the aetiology. We suggest shifting the paradigm to ‘failed back syndrome’. With this term we suggest defining those patients with back and radicular leg pain without a structural deficit, or with a structural deficit that has a low a priori chance of benefiting from a surgical intervention.
Validation of ICD-9-CM codes for identification of acetaminophen-related emergency department visits in a large pediatric hospital
Authors: de Achaval Sofia , Feudtner Chris , Palla Shana , Suarez-Almazor Maria E 
Published: February 2013

Abstract

Background
Acetaminophen overdose is a major concern among the pediatric population. Our objective was to assess the validity of International Classification of Disease (ICD-9-CM) codes for identification of pediatric emergency department (ED) visits resulting from acetaminophen exposure or overdose.

Methods
We conducted a retrospective medical record review of ED visits at Texas Children’s Hospital in Houston, Texas, between January 1, 2005, and December 31, 2010. Visits coded with 1 or more ICD-9 codes for poisoning (965, 977, and their subcodes and supplemental E-codes E850, E858, E935, E947, and E950 and their subcodes) were identified from an administrative database, and further review of the medical records was conducted to identify true cases of acetaminophen exposure or overdose. We then examined the sensitivity, positive predictive value, and percentage of false positives identified by various codes and code combinations to establish which codes most accurately identified acetaminophen exposure or overdose.

Results
Of 1,215 ED visits documented with 1 or more of the selected codes, 316 (26.0%) were a result of acetaminophen exposure or overdose. Sensitivity was highest (87.0%) for the combination of codes 965.4 (poisoning by aromatic analgesics, not elsewhere classified) and E950.0 (suicide and self-inflicted poisoning by analgesics, antipyretics, and antirheumatics), with a positive predictive value of 86.2%. Code 965.4 alone yielded a sensitivity of 85.1%, with a positive predictive value of 92.8%. Code performance varied among age groups and depending on the type of exposure (intentional or unintentional).

Conclusion
ICD-9 codes are useful for ascertaining which ED visits are a result of acetaminophen exposure or overdose within the pediatric population. However, because ICD-9 coding differs by age group and depending on the type of exposure, hypothesis-driven strategies must be utilized for each pediatric age group to avoid misclassification.
The effect of alkaline phosphatase and intrahepatic metastases in large hepatocellular carcinoma
Authors: Kim Jong Man , Kwon Choon Hyuck David , Joh Jae-Won , Park Jae Berm , Ko Justin Sangwook , Lee Joon Hyeok , Kim Sung Joo , Park Cheol-Keun 
Published: February 2013

Abstract

Background
Hepatectomy is the standard treatment for HCC. However, large HCC poses a difficult challenge because of the technical complexity of surgical resection and the fear of postoperative hepatic decompensation. We analyzed the outcome and prognostic factors in patients with large hepatocellular carcinoma (HCC ≥10 cm) after surgery.

Methods
We retrospectively investigated the medical records of 91 patients who had undergone hepatectomy between January 2006 and June 2010. A survival analysis was performed utilizing the Kaplan-Meier method and prognostic factors were evaluated using Cox regression analysis.

Results
Of the 91 patients evaluated, most tumors were associated with hepatitis B virus (HBV). The median tumor size was 12.3 cm (range, 10 to 21 cm), with microvascular invasion present in most patients. The postoperative mortality rate was 2.2%. The median disease-free survival and overall survival were six months and 41 months. The one-year, two-year, and three-year disease-free survival rates were 33.5%, 29.3%, and 18.8%, respectively. The one-year, two-year, and three-year overall survival rates were 73.9%, 63.7%, and 54.8%, respectively. Of the 89 surviving patients, 69 patients (77.5%) developed HCC recurrence during the mean follow-up period of 23.4 ± 15.9 months. On multivariate analysis, the statistically significant factors that predicted HCC recurrence were ALP ≥ 80 IU/mL (P = 0.009) and intrahepatic metastases (P = 0.013).

Conclusions
Our study suggests that preoperative ALP levels (≥ 80 IU/L) and intrahepatic metastases could be utilized to monitor and predict recurrence in HCC patients.
Should trainee doctors use the developing world to gain clinical experience? The annual Varsity Medical Debate – London, Friday 20th January, 2012
Authors: Gilbert Barnabas J , Miller Calum , Corrick Fenella , Watson Robert A 
Published: February 2013

AbstractThe 2012 Varsity Medical Debate between Oxford University and Cambridge University provided a stage for representatives from these famous institutions to debate the motion “This house believes that trainee doctors should be able to use the developing world to gain clinical experience.” This article brings together many of the arguments put forward during the debate, centring around three major points of contention: the potential intrinsic wrong of ‘using’ patients in developing countries; the effects on the elective participant; and the effects on the host community. The article goes on to critically appraise overseas elective programmes, offering a number of solutions that would help optimise their effectiveness in the developing world.
The Influence of Rapid Onsite Evaluation on the Adequacy Rate of Fine-Needle Aspiration Cytology
Authors: Schmidt Robert L. , Witt Benjamin L. , Lopez-Calderon Leslie E. , Layfield Lester J. 
Published: February 2013

Abstract
Rapid onsite evaluation (ROSE) has the potential to improve the adequacy rates of fine-needle aspiration (FNA) cytology. Studies have obtained variable results on the influence of ROSE. We conducted a systematic review and meta-analysis of studies on the influence of ROSE on FNA adequacy. We synthesized evidence across all anatomic locations. We only included studies that contained a control arm and compared cohorts with ROSE against cohorts without ROSE at a single location. We screened 2,179 studies and identified 25 studies that met our inclusion criteria. On average, ROSE improves the adequacy rate by 12%, but there was considerable variability across studies. The adequacy rate with ROSE depends on the non-ROSE adequacy rate. Sixty-five percent of the variability in the adequacy rate with ROSE was found to occur because of differences in the adequacy rate without ROSE. Studies with high non-ROSE adequacy rates showed low improvement after ROSE was implemented. Studies must account for the effect of the non-ROSE adequacy rate to determine the effect of ROSE on FNA adequacy rates.
The role of the central nervous system in glucose homeostasis
Authors: Muntean Cristina , Mota Maria , Popa Simona , Mitrea Adina 
Published: February 2013

Abstract Central nervous system, mainly the hypothalamus and the brainstem are importantkeys in glucose homeostasis. Not only do they use glucose as primary fuel for theirfunctioning but they are part of intricate neuronal circuits involved in glucose uptakeand production as was first shown by Claude Bernard. Moreoverelectrophysiological analysis of hypothalamus revealed the existence of glucosensingneurons whose firing rates are controlled by glucose extracellular level. Furtherinformation was obtained regarding the importance of leptin, insulin and free fattyacids as afferent signals received by these neural structures. As for the main efferentpathways, autonomic system is the one connecting CNS with the effector organs (theliver, the pancreas and the adrenal glands).
Prevalence and risk of appearence of skin lesions considered to be cutaneous markers of diabetes in a population group in bihor county
Authors: Kovacs Denisa , Demian Luiza , Babeş Aurel 
Published: February 2013

Abstract Objectives: The aim of the study was to calculate the prevalence rates and risk ofappearance of cutaneous lesions in diabetic patients with both type-1 and type-2diabetes. Material and Method: 384 patients were analysed, of which 47 had type-1diabetes (T1DM), 140 had type-2 diabetes (T2DM) and 197 were non-diabeticcontrols. Results: The prevalence of the skin lesions considered markers of diabeteswas 57.75% in diabetics, in comparison to 8.12% in non-diabetics (p<0.01). The riskof skin lesion appearance is over 7 times higher in diabetic patients than in nondiabetics.In type-1 diabetes the prevalence of skin lesions was significantly higherthan in type-2 diabetes, and the risk of skin lesion appearance is almost 1.5 timeshigher in type-1 diabetes than type-2 diabetes compared to non-diabetic controls.Conclusions: The diabetic patients are more susceptible than non-diabetics todevelop specific skin diseases. Patients with type-1 diabetes are more affected.
Chronic complications of type 1 diabetes mellitus in children
Authors: Cobuz Maricela , Cobuz Claudiu 
Published: February 2013

Abstract Objectives: To evaluate the frequency of chronic complications and identify thepredicting factors that may be used for their early detection. Material and Method: The research group included 144 T1DM children with disease duration > 5 years ordisease onset during puberty. Complication screening included: full ophthalmologicexamination, UAE level determination, diabetic neuropathy assessment. Results: Retinopathy prevalence was 12.5 %. Factors associated with retinopathy were:hyperglycemia, duration of diabetes and dyslipidemia. Microalbuminuria wasdetected in 23 patients (15.97%) and correlated with HbA1c or insulin therapyregimen. Diabetic neuropathy prevalence (45.8%) was studied in relation to UAE.Peripheral somatic neuropathy was significantly correlated with the diabeticnephropathy stage. Autonomic neuropathy was detected only in 13.8% patients, yetits prevalence increased with the increase in UAE. Conclusions: Chronic diabeticcomplications are relatively less frequent as compared to adults, yet their evolutionis distinct due to the age-specific characteristics.
Variation in the strength of association among pollination systems and floral traits: Evolutionary changes in the floral traits of Bornean gingers (Zingiberaceae)
Authors: Sakai Shoko , Kawakita Atsushi , Ooi Kazuyuki , Inoue Tamiji 
Published: February 2013

• Premise of the study: Diversification of floral traits in angiosperms is often attributed to have been driven by adaptations to pollinators. Nevertheless, phylogenetic studies on the relationships among evolutionary changes in floral traits and pollination systems are still limited. We examined the relationships between floral trait changes and pollinator shifts in Bornean gingers (Zingiberaceae). These plants have strongly zygomorphic flowers pollinated by spiderhunter birds, bees of the genus Amegilla, and halictid bees.• Methods: We identified pollination systems through field observations and recorded petal color, quantity of floral rewards, and seven measures of flower morphology in 28 ginger species. Phylogenetic trees were constructed from nucleotide sequences of the matK and ITS regions. We examined the correlations between the evolution of pollination systems and floral traits using phylogenetically independent contrasts.• Key Results: Significant association was found between pink color and spiderhunter pollination, orange and Amegilla pollination, and yellow and white and halictid pollination. Sugar production was higher in spiderhunter‐pollinated species and lower in halictid‐pollinated. Meanwhile, there was a significant association only for a subset of the floral morphological characters measured. Floral tube length, which is often thought to evolve to match the lengths of pollinator probing apparatuses, did not show any correlation.• Conclusions: There is considerable variation in the strength of association among pollination systems and floral traits. Lack of significant correlation in some traits could partly be explained by floral functions other than pollination, such as adaptations to prevent herbivore damage to the ovules. Further studies on these factors may improve understanding of plant–pollinator interactions.
Compliance to Therapy with Dapoxetine in Patients Affected by Premature Ejaculation
Authors: Pavone Carlo , Gesolfo Cristina Scalici , Abbadessa Daniela , Scaduto Giovanna , Caruana Giovanni , Siracusa Giuseppe , Gambino Giuseppa , Marguglio Vincenzo 
Published: February 2013

Introduction Premature ejaculation (PE) is a sexual dysfunction with high prevalence. According to some reports, it is present in about 20-30% of the male population. Since 2009 PE has been treated with a novel inhibitor of serotonin re-uptake, Dapoxetine, which has been reported to be specifically active for PE. Materials and Methods 59 patients have been selected among the patients affected by PE observed at the outpatient department of Urology and Andrology of the “Paolo Giaccone” University Policlinic Hospital of Palermo. Diagnosis was confirmed unequivocally in all patients, who were suitable for drug treatment and accepted to participate in the study. They were divided in 2 groups: one receiving Dapoxetine (41 patients), another (18 patients) receiving Citalopram. Patients were followed up by telephone at monthly intervals, in order to compare compliance, efficacy and side effects. Results Compliance to treatment was obtained in 56% of patients treated with Dapoxetine and in 61% of those treated with Citalopram. In the Dapoxetine group side effects were reported in 14.6% versus 38.4% in the Citalopram group. Benefit from the treatment was reported in 82% and 69.2%, respectively.
El lugar de María Intercesora en las imágenes de la Escala de Salvación. Interpretación iconográfica de sus aspectos formales.
Authors: Mocholí Martínez Mª Elvira 
Published: February 2013

ABSTRACT: Iconographic studies often overlook the formal questions of an image, which nevertheless can be essential to interpret the continuity of an iconographic type. This is the case of the Scala Salutis, in which Christ and His Mother intercede with God on behalf of humanity. Mary’s place in these works depends on the varying manners in which she was regarded between the end of the Middle Ages and the 16th century, when this iconographic type reached its highest level of development. And it will be precisely her physical position in the images, along with other significant elements, that determines the given type. KEY WORDS: Mary Intercessor, Scala Salutis, History of Iconographic Types. RESUMEN: A menudo, los estudios iconográficos pasan por alto las cuestiones formales de la imagen, que sin embargo pueden ser fundamentales para interpretar la continuidad de un tipo iconográfico. Es el caso de la Scala Salutis, en el que Cristo y su Madre interceden ante Dios a favor de la humanidad. El lugar de María en estas obras depende de su variable consideración entre finales de la Edad Media y el siglo XVI, cuando este tipo iconográfico llega a su mayor grado de desarrollo. Y será precisamente su posición física en las imágenes, junto a otros elementos significantes, la que determine dicho tipo. PALABRAS CLAVES: María intercesora, Scala Salutis, Historia de los tipos iconográficos.
Los emblemas de las Biblias del Oso y del Cántaro. Hipótesis interpretativa
Authors: Alonso Rey María Dolores 
Published: February 2013

ABSTRACT: The first Bible translated completely into Spanish, by Casiodoro de Reina, was published in Basel in 1569. It is known as The Bible of the Bear in reference to the emblem featured on its title-page. The interpretation of this emblem has been largely unsatisfactory. This study proposes a new interpretative hypothesis based on the comparison of the emblems in the first two Protestant Spanish Bibles: The Bible of the Bear and The Bible of the Pitcher. The latter work is a revision of the Reina Bible published by Valera in 1602. The emblems in both Bibles have in common iconic elements, a compositive structure, Biblical quotations and meanings. KEYWORDS: Protestant Spanish bibles, Emblematics, Tree, Mallet, Honey. RESUMEN: En 1569 se publicó en Basilea la primera biblia traducida integralmente en español por Casiodoro de Reina. Se conoce con el nombre de La Biblia del Oso por el emblema que la orna. Este emblema ha sido interpretado de manera poco satisfactoria. Proponemos una nueva hipótesis interpretativa apoyándonos en la emblemática y analizando conjuntamente los emblemas de las dos primeras biblias protestantes españolas: La Biblia del Oso y La Biblia del Cántaro. Esta última es la revisión de la biblia de Reina realizada por Valera en 1602. Los emblemas de ambas biblias tienen en común elementos icónicos, estructura compositiva, cita bíblica y significados. PALABRAS CLAVES: Biblias protestantes españolas, emblemática, árbol, mazo, miel.
Biocatalytic Methods for CC Bond Formation
Authors: Fesko Kateryna , Gruber‐Khadjawi Mandana 
Published: February 2013

AbstractCarbon‐carbon bond formation is among the most challenging transformations in the organic synthetic chemistry. Enzymes capable to perform this reaction are of great interest. The enzymes for stereoselective CC bond formations have been investigated very intensively during the last two decades. New recombinant DNA technologies have paved the way for improved catalysts and broaden the application scope of the already known enzymes and reactions. On the other side new discoveries have brought more enzyme players in the arena of CC bond formation reactions. Novel enzymatic CC bond formation reactions have been applied, implying the most important benefit of biocatalysis, namely the high selectivity.
On the Design of Zinc‐Finger Models with Cyclic Peptides Bearing a Linear Tail
Authors: Jacques Aurélie , Mettra Bastien , Lebrun Vincent , Latour Jean‐Marc , Sénèque Olivier 
Published: February 2013

AbstractCyclic peptides with a linear tail (CPLT) have been successfully used to model two zinc fingers (ZFs) adopting the treble‐clef‐ and loosened zinc‐ribbon folds. In this article, we examine the factors that may influence the design of such ZF models: mutations in the sequence, size of the cycle, and size of the tail. For this purpose, several peptides derived from the CPLT‐based models of the treble‐clef‐ and loosened zinc‐ribbon ZF were synthesized and studied. CPLT‐based models appear to be robust toward mutations, accommodate various cycle sizes, and are sensible to the size of the linking region of the tail located between the cycle and the coordinating amino acids. Based on these criteria, we describe the design of a new CPLT‐based model for the zinc‐ribbon ZFs, LZR, and compare it to a linear analogue, LZRlin. The model complex Zn⋅LZR is able to fold correctly around the metal ion contrary to Zn⋅LZRlin, suggesting that CPLT‐based models are more likely to yield structurally meaningful models of ZF sites than linear peptide models. Finally, we draw some rules that could allow the design of new CPLT‐based metallopeptides with a controlled fold.
Crystal Structures of a Bioactive 6′‐Hydroxy Variant of Sisomicin Bound to the Bacterial and Protozoal Ribosomal Decoding Sites
Authors: Kondo Jiro , Koganei Mai , Maianti Juan Pablo , Ly Vu Linh , Hanessian Stephen 
Published: February 2013

AbstractParasitic infections recognized as neglected tropical diseases are a source of concern for several regions of the world. Aminoglycosides are potent antimicrobial agents that have been extensively studied by biochemical and structural studies in prokaryotes. However, the molecular mechanism of their potential antiprotozoal activity is less well understood. In the present study, we have examined the in vitro inhibitory activities of some aminoglycosides with a 6′‐hydroxy group on ring I and highlight that one of them, 6′‐hydroxysisomicin, exhibits promising activity against a broad range of protozoan parasites. Furthermore, we have conducted X‐ray analyses of 6′‐hydroxysisomicin bound to the target ribosomal RNA A‐sites in order to understand the mechanisms of both its antibacterial and antiprotozoal activities at the molecular level. The unsaturated ring I of 6′‐hydroxysisomicin can directly stack on G1491, which is highly conserved in bacterial and protozoal species, through π–π interaction and fits closer to the guanidine base than the typically saturated and hydroxylated ring I of other structurally related aminoglycosides. Consequently, the compound adopts a lower energy conformation within the bacterial and protozoal A‐sites and makes pseudo pairs to either A or G at position 1408. The A‐site‐selective binding mode strongly suggests that 6′‐hydroxysisomicin is a potential lead for the design of next‐generation aminoglycosides targeting a wide variety of infectious diseases.