bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of expected treatment outcomes, obtained using risk models and international guidelines, with observed treatment outcomes in a Dutch cohort of patients with non‐muscle‐invasive bladder cancer treated with intravesical chemotherapy
Authors: Lammers Rianne J.M. , Palou Joan , Witjes Wim P.J. , Janzing‐Pastors Maria H.D. , Caris Christien T.M. , Witjes J. Alfred 
Published: October 2013

Objective
To compare the risks according to the American Urological Association (AUA), EAU, European Organization for Research and Treatment of Cancer (EORTC) and Club Urológico Español de Tratamiento Oncologico (CUETO) classifications with real outcomes in a cohort of patients in the Netherlands, and to confirm that patients who were undertreated according to these risk models have worse outcomes than adequately treated patients.
Patients and Methods
Patients treated with complete transurethral resection of bladder tumour and intravesical chemotherapy were included.
Not all patients would have received intravesical chemotherapy had they been treated to current standards, and thus comparison of the observed outcomes in our Dutch cohort vs expected outcomes based on the EORTC risk tables and CUETO scoring model was possible.
The cohort was reclassified according to the definitions of five index patients (IPs), as defined by the AUA guidelines, and three risk groups, defined according to the EAU guidelines, to compare the outcomes of undertreated patients with those of adequately treated patients.
Results
A total of 1001 patients were available for comparison with the AUA definitions and 728 patients were available for comparison with the EORTC and CUETO models.
There was a large overlap between the observed outcomes and expected recurrence and progression probabilities when comparison was made using the EORTC risk tables.
The observed recurrence outcomes were in general higher than the expected probabilities according to the CUETO risk classification, especially in the long term.
No differences in progression were found when comparing these two models to the Dutch cohort.
Patients who were undertreated according to the guidelines showed, in general, a higher risk of developing recurrence and progression.
Limitations are i.a. its retrospective nature and the differences in grading system.
Conclusion
Comparisons between the observed outcomes in our Dutch cohort and the expected outcomes based on EAU and CUETO risk models and the EORTC and AUA guidelines showed that lack of adherence to existing guidelines translates into worse outcomes.
Lateral temperature spread of monopolar, bipolar and ultrasonic instruments for robot‐assisted laparoscopic surgery
Authors: Hefermehl Lukas J. , Largo Remo A. , Hermanns Thomas , Poyet Cédric , Sulser Tullio , Eberli Daniel 
Published: October 2013

Objective
To assess critical heat spread of cautery instruments used in robot‐assisted laparoscopic (RAL) surgery.
Materials and Methods
Thermal spread along bovine musculofascial tissues was examined by infrared camera, histology and enzyme assay.
Currently used monopolar, bipolar and ultrasonic laparoscopic instruments were investigated at various power settings and application times.
The efficacy of using an additional Maryland clamp as a heat sink was evaluated.
A temperature of 45 °C was considered the threshold temperature for possible nerve damage.
Results
Monopolar instruments exhibited a mean (sem) critical thermal spread of 3.5 (2.3) mm when applied at 60 W for 1 s. After 2 s, the spread was >20 mm.
For adjustable bipolar instruments the mean (sem) critical thermal spread was 2.2 (0.6) mm at 60 W and 1 s, and 3.6 (1.3) mm at 2 s.
The PK and LigaSure forceps had mean (sem) critical thermal spreads of 3.9 (0.8) and 2.8 (0.6) mm respectively, whereas the ultrasonic instrument reached 2.9 (0.8) mm.
Application of an additional Maryland clamp as a heat sink, significantly reduced the thermal spread.
Histomorphometric analyses and enzyme assay supported these findings.
Conclusions
All coagulation devices used in RAL surgery have distinct thermal spreads depending on power setting and application time.
Cautery may be of concern due to lateral temperature spread, causing potential damage to sensitive structures including nerves.
Our results provide surgeons with a resource for educated decision‐making when using coagulation devices during robotic procedures.
Galectin 9 and PINCH, novel immunotherapy targets of renal cell carcinoma: a rationale to find potential tumour antigens and the resulting cytotoxic T lymphocytes induced by the derived peptides
Authors: Kawashima Hidenori , Obayashi Aiko , Kawamura Marie , Masaki Sakae , Tamada Satoshi , Iguchi Taro , Uchida Junji , Kuratsukuri Katsuyuki , Tanaka Tomoaki , Nakatani Tatsuya 
Published: October 2013

Objective
To analyse and then generalize the mechanism by which partial or complete response is achieved among a limited number of patients with metastatic renal cell carcinoma (RCC) treated with interferon or interleukin‐2.
Materials and Methods
An expression library of RCC (clear‐cell carcinoma) was screened using the sera of patients with metastatic RCC who benefited from partial or complete response to cytokine therapy, the postulation being that those remarkable responders obtained specific cellular immunity against RCC with the antibodies to react with the cancer antigen.
Peripheral blood mononuclear‐cells (PBMCs) from healthy volunteers were stimulated with the antigen‐derived peptides to induce specific cytotoxic T lymphocytes (CTLs). Specific activities of CTLs were measured by 51Cr‐releasing assay.
Results
Among 15 positive clones isolated, two novel genes, galectin 9 and PINCH, were expressed at much higher levels in cancerous lesions than in normal tissues in all the patients with clear‐cell carcinoma who were examined.
Both HLA‐A*2402‐restricted and HLA‐A*0201‐restricted CTLs were induced by each antigen‐derived peptide to exhibit specific and highly cytotoxic activities towards RCC cells.
Specific CTLs were induced abundantly, as shown by flow cytometry analysis of the CTLs labelled with fluorescein isothiocyanate anti‐CD107a and APC anti‐CD8.
The clonal expansion of the CTLs was shown by the clonality of T‐cell receptor Vβ repertoires.
Conclusion
A novel approach based on clinical observations yielded promising tumour antigens as immunotherapy targets of RCC.
Impact of urinary incontinence on healthcare resource utilization, health‐related quality of life and productivity in patients with overactive bladder
Authors: Tang Derek H. , Colayco Danielle C. , Khalaf Kristin M. , Piercy James , Patel Vaishali , Globe Denise , Ginsberg David 
Published: October 2013

Objective
To evaluate the impact of urinary incontinence (UI) on healthcare resource utilization (HRU), health‐related quality of life (HRQoL) and productivity measures in patients with overactive bladder (OAB).
Patients and Methods
This retrospective, cross‐sectional study used data from the Adelphi OAB/UI Disease Specific Programme, a multinational survey of patient‐ and physician‐reported data, fielded between November 2010 and February 2011.
The primary patient groups of interest were those with OAB, both with and without UI.
Health‐related quality of life and productivity measures were derived from the EuroQoL‐5D, the Incontinence Quality of Life questionnaire, the Overactive Bladder Questionnaire, and the Work Productivity and Activity Impairment Questionnaire.
Measures of HRU included OAB‐related surgeries, OAB‐related hospitalizations, incontinence pads, anticholinergic use and physician visits.
Multivariate linear regression models and literature‐based minimal clinically important differences were used to assess statistically significant and clinically meaningful differences in HRQoL and productivity measures between patients with OAB with UI and those without UI.
Results
A total of 1 730 patients were identified, with a mean age of 60.7 years, and 77.0% of them were women, 84.2% were non‐Hispanic whites, and 71% were incontinent.
Bivariate analyses showed that HRU was significantly higher among patients with OAB with UI than among those without UI in all categories except for the number of OAB‐related physician visits.
In both bivariate and multivariate analyses, incontinent patients presented with clinically and statistically significantly lower HRQoL and productivity measures with respect to all study endpoints, except for percentage of work time missed due to their OAB/UI.
Conclusions
Urinary incontinence was associated with significantly higher HRU and lower HRQoL and productivity in this population of patients with OAB from five different countries.
In addition to clinical considerations, the economic and humanistic impact of UI should be taken into account when evaluating treatment options for patients with OAB.
When Does Tool Use Become Distinctively Human? Hammering in Young Children
Authors: Kahrs Björn Alexander , Jung Wendy P. , Lockman Jeffrey J. 
Published: October 2013

This study examines the development of hammering within an ontogenetic and evolutionary framework using motion‐capture technology. Twenty‐four right‐handed toddlers (19–35 months) wore reflective markers while hammering a peg into a peg‐board. The study focuses on the motor characteristics that make tool use uniquely human: wrist involvement, lateralization, and handle use. Older children showed more distally controlled movements, characterized by relatively more reliance on the wrist, but only when hammering with their right hand. Greater age, use of the right hand, and more wrist involvement were associated with higher accuracy; handle use did not systematically change with age. Collectively, the results provide new insights about the emergence of hammering in young children and when hammering begins to manifest distinctively human characteristics.
Asthma among workers in healthcare settings: role of disinfection with quaternary ammonium compounds
Authors: Gonzalez M. , Jégu J. , Kopferschmitt M.‐C. , Donnay C. , Hedelin G. , Matzinger F. , Velten M. , Guilloux L. , Cantineau A. , de Blay F. 
Published: October 2013

SummaryIntroductionAn increased incidence of asthma has been reported among healthcare workers. The role of quaternary ammonium compounds (QACs), commonly used in cleaning/disinfection products, has not been clearly defined. The aim of this study was to analyse associations between asthma and occupational exposure to disinfectants, especially QACs.MethodsThe study was performed on a stratified random sample of the various healthcare departments of 7 healthcare settings. The study included: questionnaire, physical examination and specific IgE assays. Occupational exposure assessment was performed by means of a work questionnaire, workplace studies and a review of products ingredients. Data were analysed by logistic regression.ResultsResponse rate was 77%; 543 workers (89% female) participated; 37.1% were registered nurses (RNs), 16.4% auxiliary nurses (ANs), 17.3% cleaners; 32.8% were atopic. 335 participants were exposed to QACs. Nursing professionals reported a significantly higher risk of reported physician‐diagnosed asthma and, for RNs, of nasal symptoms at work than administrative staff working in healthcare sector. This risk was particularly marked during disinfection tasks and when exposure to QACs. Exposure to QACs increased significantly the risk of reported physician‐diagnosed asthma and nasal symptoms at work (adjusted OR = 7.5 and 3.2, respectively). No significant association was found with other exposures such as latex glove use, chlorinated products/bleach or glutaraldehyde.ConclusionRNs and ANs presented a higher risk of reported asthma than administrative staff. The highest risk was associated with tasks involving dilution of disinfection products by manual mixing, suggesting possible exposure to repeated peaks of concentrated products known to be strong respiratory irritants. Workplace interventions should be conducted to more clearly determine QAC exposure and improve disinfection procedures.
Emergence of New Onset substance use disorders among post‐weight loss surgery patients
Authors: Wiedemann A. A. , Saules K. K. , Ivezaj V. 
Published: October 2013

SummaryWhat is already known about this subject
Elevated rates of substance use disorders (SUDs), particularly (but not only) alcohol use, are observed among post‐weight loss surgery (WLS) patients.
The development of SUDs among post‐WLS patients typically occurs 1–2 years post‐surgery.
Post‐WLS patients are developing SUD at a much later time of life than is typical of SUDs in the general population, suggesting they constitute a distinct SUD phenotype that is directly related to having undergone WLS.
What this study adds
Overall, findings suggest that post‐WLS patients are overrepresented in substance abuse treatment programmes, and the majority of them report no history of SUD before WLS.
Relative to non‐WLS patients in SUD treatment, post‐WLS patients in substance abuse treatment are disproportionally diagnosed with alcohol dependence, including alcohol withdrawal.
Post‐WLS patients may be at elevated risk for development of New Onset SUD in the absence of a prior SUD history; this group is phenotypically different from those with a history of substance abuse prior to surgery, and such patients may have unique treatment needs.
A comprehensive substance abuse treatment facility began observing increased admissions who reported histories of weight loss surgery (WLS). Emerging evidence suggests that roughly half of post‐WLS patients in substance abuse treatment developed their substance use disorder (SUD) after surgery. The present study examined differences between SUD patients who developed New Onset SUD after surgery and those with a reported SUD onset before WLS (SUD Hx+ group). Participants completed a questionnaire and participated in a semi‐structured interview. Data were also obtained from participants’ electronic medical records. Of the total treatment sample (n = 4658), 2.8% reported a history of WLS. Post‐WLS patients were significantly more likely to be diagnosed with alcohol use disorders (AUDs). Among post‐WLS patients who were interviewed (n = 56), 60% were classified as New Onset SUD, while only 40% were SUD Hx+. SUD Hx+ cases reported using significantly more types of substances than New Onset cases and were more likely to report pre‐surgical binge eating disorder (BED). Post‐WLS patients are overrepresented in substance abuse treatment and are disproportionally diagnosed AUDs. Post‐WLS patients may be at elevated risk for development of New Onset SUD at a time in life (middle age) when SUD onset is relatively uncommon.
Peak Myocardial Acceleration during Isovolumic Relaxation Time Predicts the Occurrence of Rehospitalization in Chronic Heart Failure: Data from the Daunia Heart Failure Registry
Authors: Correale Michele , Totaro Antonio , Ferraretti Armando , Passero Tommaso , De Rosa Fiorella , Musaico Francesco , Ieva Riccardo , Biase Matteo Di , Brunetti Natale Daniele 
Published: October 2013

BackgroundTissue Doppler imaging (TDI) may be useful in identifying subjects at higher risk among patients with chronic heart failure (CHF). The clinical role of new developed TDI parameters, however, still needs to be documented.MethodsA total of 113 consecutive patients with CHF enrolled in the Daunia heart failure registry underwent echocardiography assessment and were followed prospectively for 234 ± 262 days. Conventional echocardiography and TDI parameters were calculated. We also calculated peak myocardial acceleration during isovolumic relaxation time (pIVA[r]) derived from TDI (pIVV(r)/AT).ResultsSubjects readmitted for worsening HF were characterized by lower levels of pIVA(r) (0.8 ± 0.3 vs. 1.3 ± 0.5 m/s2, P < 0.001). pIVA(r) levels predicted the incidence of readmission for worsening HF during follow‐up (HR 0.78, 95% confidence interval 0.64–0.96, P < 0.05), even after multivariable analysis. The assessment of pIVA(r) in addition to left ventricular ejection fraction (LVEF) and E/E′ provided additional prognostic value (Log Rank P < 0.05). The presence of abnormal pIVA(r), LVEF, and E/E′ levels identified subjects with a higher risk of hospitalization for worsening dyspnea during follow‐up than those with 2 abnormal marker levels or 0–1 (Log Rank P < 0.05).ConclusionsPeak myocardial acceleration during isovolumic relaxation time may represent an independent adjunctive tool for the risk stratification of patients with CHF.
Measurement of Left and Right Atrial Volume in Patients Undergoing Ablation for Atrial Arrhythmias: Comparison of a Manual versus Semiautomatic Algorithm of Real Time 3D Echocardiography
Authors: Müller Hajo , Reverdin Stéphane , Burri Haran , Shah Dipen , Lerch René 
Published: October 2013

AimsReal time full‐volume 3D echocardiography (3DE) allows rapid and noninvasive measurement of left (LA) and right atrial (RA) volume without geometric assumptions. Different algorithms from different commercial providers are available. Older software requires manual tracing of endocardial contours. Recently, software with semiautomatic endocardial contour‐finding algorithms has become available, which considerably speeds up the procedure. Our aim was to compare, in the same dataset, both LA and RA volumes determined by an algorithm involving manual tracing to the corresponding volumes obtained by an algorithm with semiautomatic contour detection.MethodsMaximal atrial volumes were measured in 88 patients using a multiplane interpolation method algorithm based on manual planimetry of 8 slices. These volumes were compared with volumes determined by the QLAB 8.1 software using semiautomatic border detection.ResultsLinear regression showed excellent correlation between volumes determined by manual and by semiautomatic software for both LA and RA (r2 = 0.90 and 0.89, respectively, P < 0.001). Bland–Altman analysis of manual versus semiautomatic volume determination showed narrow 95% limits of agreement (−15.9 to +12.0 mL for LA volume and −13.9 to +12.2 mL for RA volume) with a minimal bias of −1.9 ± 7.0 mL and −0.8 ± 6.5 mL, respectively, by the semiautomatic method.ConclusionThe semiautomatic border detection method shows excellent correlation for maximal LA and RA volume determination compared to the more time‐consuming, multiplane interpolation method, with only slight underestimation. The results indicate that values of LA and RA volumes obtained by either algorithm can be compared, for example, during follow‐up examinations.
The impact of activated carbon on NO3−‐N, NH4+‐N, P and K leaching in relation to fertilizer use
Authors: Raave H. , Keres I. , Kauer K. , Nõges M. , Rebane J. , Tampere M. , Loit E. 
Published: October 2013

SummaryThe ability of light‐textured soils to retain nutrients and water is small. In agriculture such soils pose a risk of nutrient leaching when amended with fertilizers. This study investigated the effects of the incorporation of activated carbon (AC) into the soil to determine (i) if it would decrease leaching of major nutrient ions and (ii) if its effect on leaching is influenced by fertilizer use. Nitrate nitrogen (NO3−‐N), ammonium nitrogen (NH4+‐N), phosphorus (P) and potassium (K) leaching through two substrates (sandy loam soil (S) and a sandy loam soil mixed with activated carbon (S + AC), which were unfertilized (NF or control) or fertilized with inorganic fertilizer (F), pig slurry (PS), pig slurry digestate (PD) or sewage sludge digestate (SD) was studied using mini‐lysimeters. In soil enriched with AC mark K‐835, water percolation and NO3−‐N and P leaching were significantly reduced, and K leaching was increased. Ammonium nitrogen leaching was not influenced by the AC amendment. The impact of AC on NO3−‐N and P leaching and water percolation did not change during the two‐year period, from which it is concluded that AC mark K‐835 prevents the leaching of NO3−‐N and P and increases soil water retention ability, and thus it is beneficial for light‐textured soils.
Factors associated with oral hygiene practices among adults with systemic sclerosis
Authors: Yuen HK , Hant FN , Hatfield C , Summerlin LM , Smith EA , Silver RM 
Published: October 2013

AbstractObjectiveTo identify factors associated with oral hygiene practices in adults with systemic sclerosis (SSc).MethodsIn this cross‐sectional study, 178 dentate adults with SSc received an oral examination which included measurement of oral aperture, assessment of manual dexterity to perform oral hygiene, as well as completion of the Center of Epidemiological Studies Depression (CES‐D) Scale and an oral health‐related questionnaire.ResultsMultivariable logistic regression modelling showed male, minority and high CES‐D scores (i.e. clinically significant symptoms of depression) were associated with less likelihood of participants brushing teeth at least twice daily, but the presence of self‐reported dry mouth symptoms increased the likelihood of toothbrushing. Having a dental visit in the past 12 months and use of an adapted flossing or interdental cleaning device were significantly associated with daily dental flossing; however, having difficulty flossing teeth reduced the likelihood of daily flossing.ConclusionsOverall, demographic variables were strongly associated with toothbrushing frequency, whereas flossing self‐efficacy and barriers were strongly associated with dental flossing frequency in adults with SSc. The results suggest that dental health professionals should take mental health into consideration when educating patients with SSc to improve their oral hygiene and consider making referrals for patients exhibiting suspected clinically significant depressive symptoms to mental health professionals for further evaluation and treatment. In addition, an appropriate adapted flossing or interdental cleaning device should be recommended to increase dental flossing practices in this patient population.
Subcutaneous connective tissue reactions to iRoot SP, mineral trioxide aggregate (MTA) Fillapex, DiaRoot BioAggregate and MTA
Authors: Bósio C. C. , Felippe G. S. , Bortoluzzi E. A. , Felippe M. C. S. , Felippe W. T. , Rivero E. R. C. 
Published: October 2013

AbstractAimTo evaluate connective tissue reactions to iRoot SP (Innovative Bioceramics, Vancouver, BC, Canada), mineral trioxide aggregate (MTA) Fillapex (FLPX) (Angelus Soluções Odontológicas, Londrina, Brazil), DiaRoot Bioaggregate (DiaDent Group International, Burnaby, BC, Canada) and white MTA (Angelus, Londrina, Brazil) in Wistar rats.MethodologyA total of 128 dentine tubes filled with the materials and 32 empty tubes (control) were implanted into 32 rats. After 7, 15, 30 and 90 days (n = 8 per period), the animals were euthanized, and the tissues were processed for histological evaluation using haematoxylin‐eosin (H&E) and Von Kossa (VK) staining. Observations were made for cellular inflammatory components and the presence of multinucleated giant cells (MNGC), macrophages and tissue necrosis. Data were analysed by Fisher's exact and Kruskal–Wallis tests (P < 0.05).ResultsIn all experimental periods, MTA FLPX and iRoot SP scored higher than the other groups for the variable macrophages (P < 0.05). After 30‐ and 90‐day experimental periods, MTA FLPX scored higher than the other groups for the variable MNGC (P < 0.05). After 90 days, the only group that exhibited samples with severe inflammatory response was MTA FLPX. VK positivity was observed in areas of necrosis in all groups, except in the control group.ConclusionsThe materials were considered biologically acceptable except MTA FLPX, which remained toxic to subcutaneous tissue even after 90 days.