bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of variations in depth of neuromuscular blockade on rating of surgical conditions by surgeon and anesthesiologist in patients undergoing laparoscopic renal or prostatic surgery (BLISS trial): study protocol for a randomized controlled trial
Authors: Boon Martijn , Martini Christian H , Aarts Leon PHJ , Bevers Rob FM , Dahan Albert 
Published: March 2013

Abstract

Background
Surgical conditions in laparoscopic surgery are largely determined by the depth of neuromuscular relaxation. Especially in procedures that are confined to a narrow working field, such as retroperitoneal laparoscopic surgery, deep neuromuscular relaxation may be beneficial. Until recently, though, deep neuromuscular block (NMB) came at the expense of a variety of issues that conflicted with its use. However, with the introduction of sugammadex, rapid reversal of a deep NMB is feasible. In the current protocol, the association between the depth of NMB and rating of surgical conditions by the surgeon and anesthesiologist is studied.

Methods/design
This is a single-center, prospective, randomized, blinded, parallel group and controlled trial. Eligible patients are randomly assigned to one of two groups: (1) deep NMB (post-tetanic count, one or two twitches; n = 12) and (2) moderate NMB (train-of-four, 1 to 2 twitches, n = 12) by administration of high-dose rocuronium in Group 1 and a combination of atracurium and mivacurium in Group 2. The NMB in Group 1 is reversed by 4 mg/kg sugammadex; the NMB in Group 2 by 1 mg neostigmine and 0.5 mg atropine. Patients are eligible if they are over 18 years, willing to sign the informed consent form, and are scheduled to undergo an elective laparoscopic renal procedure or laparoscopic prostatectomy. A single surgeon performs the surgeries and rates the surgical conditions on a five-point surgical rating scale (SRS) ranging from 1 (poor surgical conditions) to 5 (excellent surgical conditions). The intra-abdominal part of the surgeries is captured on video and a group of five anesthesiologists and ten surgical experts will rate the videos using the same SRS. The primary analysis will be an intention-to-treat analysis. Evaluation will include the association between the level of NMB and SRS, as obtained by the surgeon performing the procedure and the agreement between the scoring of the images by anesthesiologists and surgeons.

Discussion
We aim to show that under the right conditions the perceived opposing goals of surgeons and anesthesiologists (optimal surgical conditions vs. optimal postoperative conditions) may be met without compromise to either.

Trial registration
ClinicalTrials.gov identifier NCT01631149.
Attitudes and local ecological knowledge of experts fishermen in relation to conservation and bycatch of sea turtles (reptilia: testudines), Southern Bahia, Brazil
Authors: Braga Heitor de Oliveira , Schiavetti Alexandre 
Published: March 2013

AbstractBackgroundThe use of ethnoecological tools to evaluate possible damage and loss of biodiversity related to the populations of species under some degree of threat may represent a first step towards integrating the political management of natural resources and conservation strategies. From this perspective, this study investigates fishermen’s ecological knowledge about sea turtles and attitudes towards the conservation and bycatch in Ilhéus, Southern Bahia, Brazil.MethodsFishermen experts semi-structured interviews were performed using snowball sampling method. The interviews consisted of a series of questions relating to the fishermen’s profile, structure and work equipment, the local ecological knowledge of fishermen about sea turtles and bycatch, a projective test, attitudes towards turtle conservation and beliefs and taboos regarding turtles. Indicators for quantitative comparisons of respondents in terms of their broad knowledge and attitudes towards turtle conservation were created. Correlation analyses were made between indicators of knowledge and attitude as well as the relationship between education level and knowledge and attitudes.ResultsThirty experts were interviewed for the study. The local ecological knowledge and attitudes of fishermen towards the conservation of sea turtles were respectively medium (0.43) and moderate (0.69) according to experts (based on Likert scale and Cronbach’s Alpha). Potential areas of spawning were reported from Barra Grande to Una covering the entire coast of Ilhéus. Methods for identifying the animal, behavior, and popular names were described by fishermen. The most recent captures of turtles were attributed to fishing line, but according to the respondents, lobster nets and shrimp traps are more likely to capture turtles. Knowledge and attitudes were weakly inversely correlated (r = −0.38, p = 0.04), and the education level of the respondent showed a positive correlation with positive attitudes towards turtle conservation (H = 8.33; p = 0.04). Life history, habitat, specific and exogenous taboos, beliefs and the use of hawksbill turtle to make glasses and other handcrafts are also reported in the study.ConclusionsMonitoring of spawning areas, preservation of traditional practices, strategies to moderate the use of fishery resources and the local ecological knowledge/attitudes can provide data to improve the conservation practices and management of sea turtles.
Stereotactic body radiation therapy with concurrent full-dose gemcitabine for locally advanced pancreatic cancer: a pilot trial demonstrating safety
Authors: Gurka Marie K , Collins Sean P , Slack Rebecca , Tse Gary , Charabaty Aline , Ley Lisa , Berzcel Liam , Lei Siyuan , Suy Simeng , Haddad Nadim , Jha Reena , Johnson Colin D , Jackson Patrick , Marshall John L , Pishvaian Michael J 
Published: March 2013

Abstract

Background
Concurrent chemoradiation is a standard option for locally advanced pancreatic cancer (LAPC). Concurrent conventional radiation with full-dose gemcitabine has significant toxicity. Stereotactic body radiation therapy (SBRT) may provide the opportunity to administer radiation in a shorter time frame with similar efficacy and reduced toxicity. This Pilot study assessed the safety of concurrent full-dose gemcitabine with SBRT for LAPC.

Methods
Patients received gemcitabine, 1000 mg/m2 for 6 cycles. During week 4 of cycle 1, patients received SBRT (25 Gy delivered in five consecutive daily fractions of 5 Gy prescribed to the 75-83% isodose line). Acute and late toxicities were assessed using NIH CTCAE v3. Tumor response was assessed by RECIST. Patients underwent an esophagogastroduodenoscopy at baseline, 2, and 6 months to assess the duodenal mucosa. Quality of life (QoL) data was collected before and after treatment using the QLQ-C30 and QLQ-PAN26 questionnaires.

Results
Between September 2009 and February 2011, 11 patients enrolled with one withdrawal during radiation therapy. Patients had grade 1 to 2 gastrointestinal toxicity from the start of SBRT to 2 weeks after treatment. There were no grade 3 or greater radiation-related toxicities or delays for cycle 2 of gemcitabine. On endoscopy, there were no grade 2 or higher mucosal toxicities. Two patients had a partial response. The median progression free and overall survival were 6.8 and 12.2 months, respectively. Global QoL did not change between baseline and immediately after radiation treatment.

Conclusions
SBRT with concurrent full dose gemcitabine is safe when administered to patients with LAPC. There is no delay in administration of radiation or chemotherapy, and radiation is completed with minimal toxicity.
Breast reconstruction and post-mastectomy radiation practice
Authors: Chen Susie A , Hiley Crispin , Nickleach Dana , Petsuksiri Janjira , Andic Fundagul , Riesterer Oliver , Switchenko Jeffrey M , Torres Mylin A 
Published: March 2013

Abstract

Purpose
The goal of this study was to explore the perspectives and practice of radiation oncologists who treat breast cancer patients who have had breast reconstruction.

Methods
In 2010, an original electronic survey was sent to all physician members of the American Society of Radiation Oncology, National Cancer Research Institute-Breast Cancer Studies Group in the United Kingdom, Thai Society of Therapeutic Radiology and Oncology, Swiss Society of Radiation Oncology, and Turkish Radiation Oncology Society. We identified factors associated with radiation oncologists who treat breast cancer patients with reconstruction performed prior to radiation and obtained information regarding radiation management of the breast reconstruction.

Results
358 radiation oncologists responded, and 60% of the physicians were from the United States. While 64% of participants agree or strongly agree that breast image affects a woman’s quality of life during radiation, 57% feel that reconstruction challenges their ability to deliver effective breast radiation. Compared with other countries, treatment within the United States was associated with a high reconstruction rate (>/= 50% of mastectomy patients) prior to radiation (p < 0.05). Delayed-immediate reconstruction with a temporary tissue expander was more common in the United States than in other countries (52% vs. 23%, p = 0.01). Among physicians who treat patients with tissue expanders, the majority (60%) prefer a moderately inflated implant with 150-250 cc of fluid rather than a completely deflated (13%) or inflated expander (28%) during radiation. Among radiation oncologists who treat reconstructions, 49% never use bolus and 40% never boost a breast reconstruction. United States physicians were more likely than physicians from other countries to boost or bolus the reconstruction irrespective of the type of reconstruction seen in their clinic patients (p < 0.01).

Conclusions
Great variation in practice is evident from our study of radiation treatment for breast cancer patients with reconstruction. Further research on the impact and delivery of radiation to a reconstructed breast may validate some of the observed practices, highlight the variability in treatment practice, and help create a treatment consensus.
Novel mutations in the ferritin-L iron-responsive element that only mildly impair IRP binding cause hereditary hyperferritinaemia cataract syndrome
Authors: Luscieti Sara , Tolle Gabriele , Aranda Jessica , Campos Carmen Benet , Risse Frank , Morán Érica , Muckenthaler Martina U , Sánchez Mayka 
Published: March 2013

Abstract

Background
Hereditary Hyperferritinaemia Cataract Syndrome (HHCS) is a rare autosomal dominant disease characterized by increased serum ferritin levels and early onset of bilateral cataract. The disease is caused by mutations in the Iron-Responsive Element (IRE) located in the 5′ untranslated region of L-Ferritin (FTL) mRNA, which post-transcriptionally regulates ferritin expression.

Methods
We describe two families presenting high serum ferritin levels and juvenile cataract with novel mutations in the L-ferritin IRE. The mutations were further characterized by in vitro functional studies.

Results
We have identified two novel mutations in the IRE of L-Ferritin causing HHCS: the Badalona +36C > U and the Heidelberg +52 G > C mutation. Both mutations conferred reduced binding affinity on recombinant Iron Regulatory Proteins (IPRs) in EMSA experiments. Interestingly, the Badalona +36C > U mutation was found not only in heterozygosity, as expected for an autosomal dominant disease, but also in the homozygous state in some affected subjects. Additionally we report an update of all mutations identified so far to cause HHCS.

Conclusions
The Badalona +36C > U and Heidelberg +52 G > C mutations within the L-ferritin IRE only mildly alter the binding capacity of the Iron Regulatory Proteins but are still causative for the disease.
Adenocarcinoma of the seminal vesicles complicated by antineutrophil cytoplasmic antibody vasculitis: a case report and review of the literature
Authors: Lote Hazel , Mannion Ethna , Cook Terence , Cairns Thomas , Savage Philip 
Published: March 2013

AbstractIntroductionAdenocarcinoma of the seminal vesicles is a very rare malignancy, with less than 100 cases reported worldwide. It is documented to have a poor prognosis, with the majority of patients developing metastatic disease, most commonly in the prostate, bladder and rectum. Currently there is no standard treatment for metastatic disease and the limited reports of treatment with radiotherapy, chemotherapy and hormonal (anti-androgenic) therapy show that they are generally of modest benefit. The association between malignancy and an increased risk of autoimmune vasculitis has been demonstrated in a number of malignancies, but to date there have been no documented cases of adenocarcinoma of the seminal vesicles associated with anti-neutrophil cytoplasmic antibody vasculitis.Case presentationIn this report we describe the case of a 55-year-old Caucasian man with metastatic adenocarcinoma of the seminal vesicles. He previously had received chemotherapy treatment for advanced testicular cancer and later presented with hemospermia. He subsequently developed c-antineutrophil cytoplasmic antibody vasculitis requiring intensive immunosuppression and renal dialysis.ConclusionAdenocarcinoma of the seminal vesicles is a rare diagnosis and our case is more unusual in that our patient previously had chemotherapy treatment for advanced testicular cancer and went on to develop severe antineutrophil cytoplasmic antibody vasculitis when diagnosed with metastatic seminal vesicle cancer. This case illustrates that autoimmune vasculitis can occur in any patient with malignancy and an early referral to the renal team combined with renal biopsy can assist in the earlier diagnosis and more successful management of these rare events. This case should be of interest to oncologists, renal physicians, urologists and general physicians who encounter patients presenting with hemospermia or vasculitis.
Functional heterologous expression of an engineered full length CipA from Clostridium thermocellum in Thermoanaerobacterium saccharolyticum
Authors: Currie Devin H , Herring Christopher D , Guss Adam M , Olson Daniel G , Hogsett David A , Lynd Lee R 
Published: March 2013

Abstract

Background
Cellulose is highly recalcitrant and thus requires a specialized suite of enzymes to solubilize it into fermentable sugars. In C. thermocellum, these extracellular enzymes are present as a highly active multi-component system known as the cellulosome. This study explores the expression of a critical C. thermocellum cellulosomal component in T. saccharolyticum as a step toward creating a thermophilic bacterium capable of consolidated bioprocessing by employing heterologously expressed cellulosomes.

Results
We developed an inducible promoter system based on the native T. saccharolyticum xynA promoter, which was shown to be induced by xylan and xylose. The promoter was used to express the cellulosomal component cipA*, an engineered form of the wild-type cipA from C. thermocellum. Expression and localization to the supernatant were both verified for CipA*. When a ΔcipA mutant C. thermocellum strain was cultured with a CipA*-expressing T. saccharolyticum strain, hydrolysis and fermentation of 10 grams per liter SigmaCell 101, a highly crystalline cellulose, were observed. This trans-species complementation of a cipA deletion demonstrated the ability for CipA* to assemble a functional cellulosome.

Conclusion
This study is the first example of an engineered thermophile heterologously expressing a structural component of a cellulosome. To achieve this goal we developed and tested an inducible promoter for controlled expression in T. saccharolyticum as well as a synthetic cipA. In addition, we demonstrate a high degree of hydrolysis (up to 93%) on microcrystalline cellulose.
Effects of ectopic HER-2/neu gene expression on the COX-2/PGE2/P450arom signaling pathway in endometrial carcinoma cells: HER-2/neu gene expression in endometrial carcinoma cells
Authors: Li Shu , Ma XiaoXin , Ma Li , Wang Cuicui , He YuanQi , Yu ZhiJuan 
Published: March 2013

Abstract

Objectives
To investigate the role of HER-2/neu-mediated COX-2/P450arom signal in estrogen-dependent endometrial carcinoma.

Methods
The recombinant eukaryotic expression vector, pcDNA3.1-HER-2/neu, was constructed and transfect to Ishikawa endometrial carcinoma cells. The expression of COX-2 and P450arom in transfected cells were detected by real-time PCR and western blotting. The levels of estrogen in cell supernatants were detected by ELISA.

Results
Over-expression of HER-2/neu in transfected cells was confirmed by real-time PCR and western blotting. The levels of autocrine estrogen in transfected cells was significantly increased which combination with the enhancement of COX-2 and P450arom expression in transfected cells.

Conclusion
HER-2/neu induced the improvement of autocrine estrogen in endometrial carcinoma cell through triggering the COX-2/P450arom signal.
Consumption of a low glycaemic index diet in late life extends lifespan of Balb/c mice with differential effects on DNA damage
Authors: Nankervis Scott A , Mitchell Jenee M , Charchar Fadi J , McGlynn Maree A , Lewandowski Paul A 
Published: March 2013

Abstract

Background
Caloric restriction is known to extend the lifespan of all organisms in which it has been tested. Consequently, current research is investigating the role of various foods to improve health and lifespan. The role of various diets has received less attention however, and in some cases may have more capacity to improve health and longevity than specific foods alone. We examined the benefits to longevity of a low glycaemic index (GI) diet in aged Balb/c mice and examined markers of oxidative stress and subsequent effects on telomere dynamics.

Results
In an aged population of mice, a low GI diet extended average lifespan by 12%, improved glucose tolerance and had impressive effects on amelioration of oxidative damage to DNA in white blood cells. Telomere length in quadriceps muscle showed no improvement in the dieted group, nor was telomerase reactivated.

Conclusion
The beneficial effects of a low GI diet are evident from the current study and although the impact to telomere dynamics late in life is minimal, we expect that earlier intervention with a low GI diet would provide significant improvement in health and longevity with associated effects to telomere homeostasis.
The severity of experimental arthritis is independent of IL-36 receptor signaling
Authors: Lamacchia Céline , Palmer Gaby , Rodriguez Emiliana , Martin Praxedis , Vigne Solenne , Seemayer Christian A , Talabot-Ayer Dominique , Towne Jennifer E , Gabay Cem 
Published: March 2013

Abstract
Introduction
Interleukin (IL)-36 refers to three related IL-1 family cytokines, IL-36α, IL-36β, and IL-36γ, that bind to the IL-36 receptor (IL-36R). IL-36 exerts proinflammatory effects in skin and lung and stimulates T cell responses. In the present study, we examined the expression and function of IL-36R and its ligands in experimental arthritis.

Methods
Collagen-induced arthritis (CIA), antigen-induced arthritis (AIA), and K/BxN serum transfer-induced arthritis were induced according to standard protocols. Messenger RNA levels for IL-36R and its ligands in the joints of mice with CIA were determined by RT-qPCR. Mice with CIA were injected with a blocking monoclonal anti-IL-36R, a blocking anti-IL-1RI, or their isotype-matched control antibodies at the time of arthritis onset. Anti-IL-36R or control antibodies were also injected at the time of AIA induction. Finally, IL-36R-deficient mice were examined in AIA and serum transfer-induced arthritis. The development and severity of arthritis were assessed by clinical and histological scoring.

Results
IL-36R, IL-36Ra and IL-36γ mRNA were detected in the joints of mice with CIA, but their levels did not correlate with arthritis severity. As opposed to anti-IL-1RI antibody treatment, the injection of an anti-IL-36R antibody was devoid of effect on the development and severity of CIA. The severity of joint inflammation and structural damage in AIA was also unaltered by anti-IL-36R antibody treatment. Finally, the severity of AIA and K/BxN serum transfer-induced arthritis was similar in IL-36R-deficient and wild-type mice.

Conclusions
The development and severity of experimental arthritis are independent of IL-36R signaling.
Cortisol levels and neuropsychiatric diagnosis as markers of postoperative delirium:a prospective cohort study
Authors: Kazmierski Jakub , Banys Andrzej , Latek Joanna , Bourke Julius , Jaszewski Ryszard 
Published: March 2013

Abstract
Introduction
The pathophysiology of delirium after cardiac surgery is largely unknown. Thepurpose of this study was to investigate whether increased concentration ofpreoperative and postoperative plasma cortisol predicts the development ofdelirium after coronary artery bypass graft surgery. A second aim was to assesswhether the association between cortisol and delirium is stress related ormediated by other pathologies, such as major depressive disorder (MDD) orcognitive impairment.

Methods
The patients were examined 1 day preoperatively with the Mini InternationalNeuropsychiatric Interview and the Montreal Cognitive Assessment and the TrailMaking Test to screen for depression and for cognitive impairment, respectively.Blood samples for cortisol levels were collected both preoperatively andpostoperatively. The Confusion Assessment Method for the Intensive Care Unit wasused within the first 5 days postoperatively to screen for a diagnosis ofdelirium.

Results
Postoperative delirium developed in 36% (41 of 113) of participants. Multivariatelogistic regression analysis revealed two groups independently associated with anincreased risk of developing delirium: those with preoperatively raised cortisollevels; and those with a preoperative diagnosis of MDD associated with raisedlevels of cortisol postoperatively. According to receiver operating characteristicanalysis, the most optimal cutoff values of the preoperative and postoperativecortisol concentration that predict the development of delirium were 353.55 nmol/land 994.10 nmol/l, respectively.

Conclusion
Raised perioperative plasma cortisol concentrations are associated with deliriumafter coronary artery bypass graft surgery. This may be an importantpathophysiological consideration in the increased risk of postoperative deliriumseen in patients with a preoperative diagnosis of MDD.