bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of the Surgical Education and Training programme on the Fellowship Examination
Authors: Beasley Spencer W. , Hardware Narelle 
Published: April 2013

AbstractIntroduction of an increasingly competence‐based Royal Australasian College of Surgeons (RACS) Surgical Education and Training (SET) programme has influenced the nature and conduct of the Fellowship Examination (FEX). The FEX is the final summative assessment taken near the completion of SET training, and is aligned to the other SET assessment processes. It mainly tests two of the nine RACS surgical competencies, focusing on professional judgement and the clinical application of knowledge. It is used to help determine whether candidates are safe to practise unsupervised at consultant level. There have been refinements to a number of the processes including standard setting, blueprinting, developing marking descriptors and improving the reliability and validity of the examination. An Examiners' Training Course has also been introduced.
The significance of pretransplant donor-specific antibodies reactive with intact or denatured human leucocyte antigen in kidney transplantation
Authors: Otten H G , Verhaar M C , Borst H P E , van Eck M , van Ginkel W G J , Hené R J , van Zuilen A D 
Published: April 2013

SummaryAntibodies recognizing denatured human leucocyte antigen (HLA) can co-react with epitopes on intact HLA or recognize cryptic epitopes which are normally unaccessible to HLA antibodies. Their specificity cannot be distinguished by single antigen beads (SAB) alone, as they carry a mixture of intact and denatured HLA. In this study, we selected pretransplant sera containing donor-specific HLA class I antibodies (DSA) according to regular SAB analysis from 156 kidney transplant recipients. These sera were analysed using a SAB preparation (iBeads) which is largely devoid of denatured HLA class I, and SAB coated with denatured HLA class I antigens. A total of 241 class I DSA were found by regular SAB analysis, of which 152 (63%) were also found by iBeads, whereas 28 (11%) were caused by reactivity with denatured DNA. Patients with DSA defined either by regular SAB or iBeads showed a significantly lower graft survival rate (P = 0·007) compared to those without HLA class I DSA, whereas reactivity to exclusively denatured HLA was not associated with decreased graft survival. In addition, DSA defined by reactivity to class I SAB or class I iBeads occurred more frequently in female patients and in patients with historic HLA sensitization, whereas reactivity to denatured HLA class I was not associated with any of these parameters. Our data suggest that pretransplant donor-specific antibodies against denatured HLA are clinically irrelevant in patients already sensitized against intact HLA.
Calcitonin measurement in aspiration needle washout fluids has higher sensitivity than cytology in detecting medullary thyroid cancer: a retrospective multicentre study
Authors: Trimboli Pierpaolo , Cremonini Nadia , Ceriani Luca , Saggiorato Enrico , Guidobaldi Leo , Romanelli Francesco , Ventura Claudio , Laurenti Oriana , Messuti Ilaria , Solaroli Erica , Madaio Raffaele , Bongiovanni Massimo , Orlandi Fabio , Crescenzi Anna , Valabrega Stefano , Giovanella Luca 
Published: April 2013

SummaryObjectiveOnly few studies analysed the capability of cytology in detecting medullary thyroid cancer (MTC), and they reported a low accuracy of this diagnostic technique. Recently, calcitonin (CT) measurement in aspiration needle washout (FNA‐CT) of thyroid and neck lesions has been reported as a sensitive tool for MTC. The aim of this study is to compare the sensitivity of FNA‐CT and cytology in detecting MTC and to assess a cut‐off value of FNA‐CT for clinical practice.PatientsThirty‐eight MTC lesions from 36 patients were retrospectively studied, diagnosed and treated in four different centres. Furthermore, 52 nonmedullary lesions from subjects undergone biopsy following increased serum CT were collected as a control group.ResultsCytology detected MTC in 21/37 lesions with 56·8% sensitivity. The median FNA‐CT value was 2000 pg/ml (range 58–10 000 pg/ml) in MTC and 2·7 pg/ml (range <2–13 pg/ml) in controls (P < 0·001). Using a cut‐off of 39·6 pg/ml, MTC lesions could be identified with 100% sensitivity and specificity. As the most important finding, 14 histologically proved MTC lesions could be detected by FNA‐CT, despite they were cytologically diagnosed as benign or nonconclusive.ConclusionsThis study shows, as the first in a multicentre series, that FNA‐CT sensitivity is higher than that of cytology in diagnosing MTC. To avoid false‐negative MTC by cytology, CT measurement in aspiration needle washout is to be performed in all patients undergoing biopsy following high serum CT.
Supervised surgical training and its effect on the short‐term outcome in laparoscopic colorectal surgery
Authors: Krishna A. , Russell M. , Richardson G. L. , Rickard M. J. F. X. , Keshava A. 
Published: April 2013

AbstractAimLaparoscopic colorectal surgery requires supervised training. In this paper we examine the short‐term outcome following a component‐based training in laparoscopic colorectal surgery.MethodSurgical outcome following laparoscopic colorectal resection was recorded on a prospective database. Patients were divided into three groups, including those performed by the fellows, those completed by the consultant and those completed by a combination of both. Analysis of data was carried out for all colorectal resections and the subgroup with colorectal cancer.Results511 operations were examined between June 2006 and January 2011. There was no statistically significant difference in operating time between fellows and consultants but it was significantly longer for procedures where consultants and fellows performed components. Conversion rate, postoperative morbidity, recovery and length of stay were similar for all three groups for the whole patient cohort and also the subgroup of cancer patients. In the cancer subgroup, there was no difference in the pathological stage in the three groups.ConclusionClosely supervised training in laparoscopic colorectal surgery is not associated with any adverse effect on the short‐term outcome.
Neutrophil gelatinase‐associated lipocalin and end‐stage renal disease: it is not all about the kidneys!
Authors: Rau Simon , Habicht Antje , Kauke Teresa , Hillmer Andreas , Wessely Matthias , Stangl Manfred , Guba Markus , Fischereder Michael , Schönermarck Ulf 
Published: April 2013

AbstractIntroductionNeutrophil gelatinase‐associated lipocalin (NGAL) is a powerful biomarker for the early detection of acute kidney injury. However, recent data suggest that NGAL also plays an important role in chronic kidney disease (CKD), reflecting the level of acute kidney damage within the CKD condition. To study whether elevated NGAL levels in CKD are a consequence of damaged tubular cells or rather due to extrarenal production, we investigated NGAL levels in anephric patients on dialysis.MethodsPlasma NGAL levels were investigated in 14 dialysis patients who underwent bilateral nephrectomy (anephric group), 18 anuric dialysis patients with remaining kidneys (dialysis group) and 12 healthy patients (healthy group).ResultsPlasma NGAL levels were significantly lower in the healthy group compared with the anephric group (143 vs. 981 ng/mL; P < 0·001) or the dialysis group (143 vs. 838 ng/mL; P < 0·001), respectively. However, NGAL levels did not differ between the anephric group and the dialysis group (981 vs. 838 ng/mL; P = 0·19).DiscussionAssuming that NGAL is highly expressed in chronically damaged kidneys due to tubular stress, there should be significantly less NGAL in anephric patients compared with anuric dialysis patients with remaining kidneys. In contrast to this hypothesis, we found no difference in NGAL expression between these two groups, proving the entire extrarenal NGAL production in anephric patients and suggesting that the tubular NGAL expression seems to be negligible in anuric dialysis patients.
Interactive effects of life history and season on size‐dependent growth in juvenile Atlantic salmon
Authors: Sigourney Douglas B. , Letcher Benjamin H. , Obedzinski Mariska , Cunjak Richard A. 
Published: April 2013

AbstractSize‐dependent growth (SDG) is an important process in structuring populations as well as determining life history outcomes. Despite its importance, there have been few investigations from observational studies focusing on the interaction between life history decisions and SDG. In this study, we used data on individually tagged Atlantic salmon from both the laboratory and the field to investigate differences in SDG among two life history groups, parr and smolts. In the laboratory, we found little evidence of SDG in parr but seasonally dependent SDG in the smolt group. Smolts showed at strong compensatory response over the winter months just prior to the smolt transformation window. In the field, we found little evidence of SDG early in ontogeny (i.e., age 0+ fall and winter). There was some evidence of depensatory growth (positive SDG) during the age 1+ spring among both life history groups that may reflect random habitat variation or the monopolisation of resources. After the age 1+ spring, we found that smolts were more likely to show a compensatory effect (negative SDG) than parr. This effect was strongest, as they approached the smolt window in the spring of their age 2+ year. These results suggest (i) SDG is common in Atlantic salmon; however, the form and extent of life history depends on (ii) season and (iii) life history. For individuals that adopt a smolt life history, trade‐offs between freshwater survival and sea survival may lead to a convergent growth pattern, as they approach the smolt migration window.
Intra‐Articular Use of a Platelet‐Rich Product in Normal Horses: Clinical Signs and Cytologic Responses
Authors: Textor Jamie A. , Tablin Fern 
Published: April 2013

AbstractObjectives(1) To report the clinical and synovial effects of a platelet‐rich product (PRPr) in normal equine joints, (2) to assess the persistence of platelets within synovial fluid after intra‐articular injection, (3) to compare responses to different preparations of that product, and (4) to evaluate a gravity filtration system for PRPr preparation in horses.Study DesignExperimental.MethodsA platelet‐rich saline product (PRPr) was prepared from 7 normal horses using a proprietary preparation device and was divided into 3 treatments: resting, CaCl2‐activated (23 mM, final), and bovine thrombin‐activated (10 U/mL, final). Each horse had 3 concurrent randomly assigned intra‐articular PRPr treatments administered in their metacarpophalangeal/metatarsophalangeal joints; the fourth limb was injected with saline (0.9% NaCl) solution as a control. Clinical assessments, cytologic analysis of synovial fluid and hemograms were performed at 6, 24, 48, and 96 hours after injection. PRPr composition and growth factor content were analyzed.ResultsThe gravity filtration system produced a moderately concentrated PRPr. At 6 and 24 hours, when compared to control values, all PRPr treatments caused a significant increase in synovial WBC concentration (P < .0059) and neutrophil percentage (P < .0005). Bovine thrombin‐activated PRPr injection consistently caused increased effusion scores and periarticular signs. At all time points, the synovial WBC concentration after thrombin‐activated PRPr was significantly greater (P < .001) than for the control, CaCl2‐activated or resting PRPr. Intact platelets could be observed in synovial fluid for up to 5 days after intra‐articular PRPr injection.ConclusionsResting and CaCl2‐activated PRPr may be safely used to treat equine joints, but bovine thrombin activation is not recommended at 10 U/mL. A PRPr can be prepared using a gravity filtration system, eliminating the need for centrifugation.
Exercise and negative energy balance in males who perform mental work
Authors: Lemay V. , Drapeau V. , Tremblay A. , Mathieu M.‐E. 
Published: April 2013

SummaryWhat is already known about this subject
Achievement of a stressful mental task leads to increased energy intake over a short period of time.
Given that mental work does not increase energy expenditure, a positive energy balance is observed.
What this study adds
The single fact of waiting and relaxing after mental work does not reduce energy intake.
Thirty minutes of physical activity performed at moderate/high intensity between mental work and a meal is enough to create a energy deficit compare to a situation where the meal directly follows mental work.
BackgroundAlthough energy expenditure during mental work is not higher than energy expenditure at rest, a stressful mental task is related to an increase in energy intake. It is suggested that mental work produces physiological changes, thereby influencing food intake.ObjectiveBecause physical activity can influence hunger, the aim of the study was to determine if the introduction of an active pause could counteract the negative effects of mental work on energy intake and energy balance.MethodTwelve male students, of normal weight, between 15 and 20 years old were evaluated. All subjects participated in three different sessions realized in a randomized order: (i) without pause = relaxation/mental work/meal; (ii) relaxation pause = mental work/relaxation/meal; and (iii) exercise pause = mental work/exercise/meal. Energy expenditure was measured with indirect calorimetry, energy intake was measured with a cold buffet‐type meal of 40 items, and appetite‐related sensations were measured with visual analogue scales. The effect of introducing an active pause in energy intake and energy balance was studied.ResultsThe introduction of an active pause did not influence energy intake; although, higher appetite‐related sensations were observed (16–26 mm on a 150‐mm scale; P < 0.05). After accounting for the energy expenditure related to physical activity, a lower energy balance was measured for the exercise pause visit compared with the visit without a pause (−1137 kJ; P < 0.05).ConclusionThis study indicates that being active between mental work and a meal could represent a strategy to create a negative energy balance following mental work via an increased energy expenditure and a maintenance of energy intake. Globally, these results could help individuals attain and/or maintain a healthy body weight in a context where mental work is omnipresent.
Association between sweet drink intake and adiposity in Danish children participating in a long‐term intervention study
Authors: Jensen B. W. , Nielsen B. M. , Husby I. , Bugge A. , El‐Naaman B. , Andersen L. B. , Trolle E. , Heitmann B. L. 
Published: April 2013

SummaryWhat is already known about this subject
In several studies direct associations between intake of sugar‐sweetened beverages and adiposity have been reported.
However, most previous studies were conducted among Americans and assessed the intake in the sub‐categories of soft drinks and sugar‐sweetened beverages, only, rather than the total intake of sweet drinks.
What this study adds
We examined associations between total intake of sweet drinks and body mass index (BMI) and body fat in a non‐US population.
Using a longitudinal design increased sweet drink consumption was generally unassociated with subsequent change in BMI or sum of four skin‐folds.
BackgroundIn some previous studies direct associations between intake of soft drinks, sugar‐sweetened beverages and adiposity have been reported. The majority of these studies were, however, conducted in the USA and it is uncertain if the results are applicable to non‐US countries.ObjectiveTo assess the association between sweet drink intake at age 6 and 9 years and the subsequent 3‐ to 7‐year changes in body mass index (BMI) and sum of four skin‐folds (Σ4SF).MethodsInformation on sweet drink intake (7 days food record) and physical activity (accelerometer) was obtained at age 6 years (n = 366) [Correction made here after initial online publication.] and 9 years (n = 269). Weight, height and Σ4SF were measured at age 6, 9 and 13 years. Additional information on socio‐economic status, maternal BMI and pubertal status was obtained.ResultsNo associations were observed between sweet drink intake at age 6 years and change in BMI or logΣ4SF from age 6 to 9 years or 6 to 13 years. Also, no associations were observed between change in sweet drink intake from age 6 to 9 years and subsequent change in BMI or logΣ4SF from age 9 to 13 years. A weak direct association was observed between sweet drink intake at age 9 years and change in logΣ4SF from age 9 to 13 years (per 100 g ∼ 3.38 fl oz) (β: 0.014, 95% confidence interval [CI]: −0.001 to 0.029, P = 0.06), while no association was seen for BMI. In supplementary analyses a similar association was observed for soft drinks (β: 0.087, 95% CI: 0.048 to 0.126, P = 0.001) but only in the intervention group.ConclusionWe observed associations between intake of sweet drinks and soft drinks and change in skin‐fold thickness in a group of Danish children. However, as the associations did not remain significant when multiple testing was considered or was only significant among children from the intervention group, the results do not confirm or refute the direct association reported in previous studies.
Differences in generosity between smokers and nonsmokers in an upcoming smoking ban
Authors: Lueke Adam , Fitzgerald Carey J. , Wickwire John , Welton Craig 
Published: April 2013

AbstractThe stigmatization of smokers has become a social norm as new information about its health effects continues to be uncovered. This study investigated smokers in terms of their generosity as a means of stigma management. A field study was undertaken in which the experimenters frequented local establishments in the eight days prior to the 2010 Michigan antismoking legislation taking effect. Experimenters, sometimes while smoking and sometimes while not smoking, approached patrons of the establishments who were either smokers or nonsmokers and asked them for a dollar. Results indicated smokers were more likely to give a dollar than nonsmokers, regardless of whether or not the experimenters were smoking. This was interpreted as a strategy smokers use to combat social stigma.
The effects of periodontal treatment on pregnancy outcomes
Authors: Michalowicz Bryan S. , Gustafsson Anders , Thumbigere‐Math Vivek , Buhlin Kåre 
Published: April 2013

AbstractBackgroundPreterm infants are at greater risk than term infants for physical and developmental disorders. Morbidity and mortality increases as gestational age at delivery decreases. Observational studies indicate an association between poor periodontal health and risk for preterm birth or low birthweight, making periodontitis a potentially modifiable risk factor for prematurity.AimTo identify randomized controlled trials (RCTs) published between January 2011 and July 2012 and discuss all published RCTs testing whether periodontal therapy reduces rates of preterm birth and low birthweight.MethodsSearch of databases including PubMed, ISI Web of Science and Cochrane Library.ResultsThe single RCT identified showed no significant effect of periodontal treatment on birth outcomes.DiscussionAll published trials included non‐surgical periodontal therapy; only two included systemic antimicrobials as part of test therapy. The trials varied substantially in terms of sample size, obstetric histories of subjects, study preterm birth rates and the periodontal treatment response. The largest trials – also judged to be high‐quality and at low risk of bias – have yielded consistent results, and indicate that treatment does not alter rates of adverse pregnancy outcomes.ConclusionNon‐surgical periodontal therapy, scaling and root planing, does not improve birth outcomes in pregnant women with periodontitis.
Periodontitis and systemic diseases: a record of discussions of working group 4 of the Joint EFP/AAP Workshop on Periodontitis and Systemic Diseases
Authors: Linden Gerry J. , Herzberg Mark C. ,   working group 4 of the joint EFP/AAP workshop
Published: April 2013

AbstractBackgroundThere has been an explosion in research into possible associations between periodontitis and various systemic diseases and conditions.AimTo review the evidence for associations between periodontitis and various systemic diseases and conditions, including chronic obstructive pulmonary disease (COPD), pneumonia, chronic kidney disease, rheumatoid arthritis, cognitive impairment, obesity, metabolic syndrome and cancer, and to document headline discussions of the state of each field. Periodontal associations with diabetes, cardiovascular disease and adverse pregnancy outcomes were not discussed by working group 4.ResultsWorking group 4 recognized that the studies performed to date were largely cross‐sectional or case‐control with few prospective cohort studies and no randomized clinical trials. The best current evidence suggests that periodontitis is characterized by both infection and pro‐inflammatory events, which variously manifest within the systemic diseases and disorders discussed. Diseases with at least minimal evidence of an association with periodontitis include COPD, pneumonia, chronic kidney disease, rheumatoid arthritis, cognitive impairment, obesity, metabolic syndrome and cancer. The working group agreed that there is insufficient evidence to date to infer causal relationships with the exception that organisms originating in the oral microbiome can cause lung infections.ConclusionsThe group was unanimous in their opinion that the reported associations do not imply causality, and establishment of causality will require new studies that fulfil the Bradford Hill or equivalent criteria. Precise and community‐agreed case definitions of periodontal disease states must be implemented systematically to enable consistent and clearer interpretations of studies of the relationship to systemic diseases. The members of the working group were unanimous in their opinion that to develop data that best inform clinicians, investigators and the public, studies should focus on robust disease outcomes and avoid surrogate endpoints. It was concluded that because of the relative immaturity of the body of evidence for each of the purported relationships, the field is wide open and the gaps in knowledge are large.