bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimal timing for solids introduction – why are the guidelines always changing?
Authors: Koplin J. J. , Allen K. J. 
Published: January 2013

SummaryThere have been dramatic changes in timing of first exposure to solid foods for children over the last 40 years, ranging from exposure prior to 4 months of age for most infants in the 1960s, to guidelines recommending delaying solids until after 6 months of age introduced in the 1990s. Infant diet, specifically age of weaning and age at introduction of allergenic foods, has long been thought to play a role food allergy. However, controversy surrounding the relationship between timing of introduction of foods and development of food allergy has lead to a plethora of inconsistent infant feeding guidelines both between and within countries. The aims of this article were to discuss the history of changing guidelines for optimal timing of introduction of solids in general and allergenic solids in particular and the evidence (or lack thereof) underpinning recommendations at each of these time‐points. We present the current clinical equipoise with regards to recently revised guidelines published almost simultaneously in the UK, US and Australia and argue that guideline modification about timing of introduction (both for high risk infants but also for the general population) will require careful review of emerging literature to provide a true evidence base to inform public health practice such as infant feeding guidelines.
Intra-articular nuclear factor-κB blockade ameliorates collagen-induced arthritis in mice by eliciting regulatory T cells and macrophages
Authors: Min S-Y , Yan M , Du Y , Wu T , Khobahy E , Kwon S-R , Taneja V , Bashmakov A , Nukala S , Ye Y , Orme J , Sajitharan D , Kim H-Y , Mohan C 
Published: January 2013

SummaryNuclear factor (NF)-κB is a transcription factor implicated in the pathogenesis of autoimmune disorders such as rheumatoid arthritis (RA). Here we have examined the effect of intra-articular administration of the IKK inhibitor, NEMO-binding domain peptide (NBD), on the severity of collagen-induced arthritis (CIA). NBD peptides were injected intra-articularly into the knee joints of DBA/1J mice after the onset of disease. Collagen-injected mice given a scrambled peptide served as controls. Arthritis severity was determined by visual examination of paws. Intra-articular NBD injection reduced the arthritis score and ameliorated morphological signs of bone destruction compared to the controls. Serum levels of type-II collagen-specific immunoglobulin (Ig)G2a antibodies were lower in NBD-treated mice versus the control mice, whereas the levels of type-II collagen-specific IgG1 antibodies were increased by NBD treatment. NBD treatment diminished the proinflammatory cytokines interleukin (IL)-17 and interferon (IFN)-γ in serum, but increased the regulatory cytokine IL-10. NBD-treated CIA mice exhibited significantly higher percentages and numbers of forkhead box protein 3 (FoxP3+)CD4+CD25+ regulatory T cells than controls. Immunofluorescence analysis of NBD-treated mice revealed that FoxP3 and Ym1, a marker of alternatively activated macrophages, were juxtaposed to each other within draining inguinal lymph nodes. Intra-articular administration of NBD peptide is effective as an experimental therapy in a murine model of RA. Nevertheless, the intra-articular treatment modality is still associated with systemic effects on the immune system.
Surgical management of rectovaginal fistula in a tertiary referral centre: many techniques are needed
Authors: Tozer P. J. , Balmforth D. , Kayani B. , Rahbour G. , Hart A. L. , Phillips R. K. S. 
Published: January 2013

AbstractAimSurgery is the mainstay of treatment for rectovaginal fistula (RVF). Published success rates vary with initial success being around 50% rising to 80% with repeated surgery. Fistulae in Crohn's disease are more likely to recur.MethodA retrospective study was performed of RVF repair carried out between 2003 and 2008 in a tertiary referral centre. Patients undergoing surgery for an RVF under the senior author during the study period were identified and their clinical notes were reviewed.ResultsThirty‐five patients underwent 50 operations. The median age was 42 years and 83% were tertiary referrals. Two patients were lost to follow‐up. Healing occurred in 19 (58%) of 33 patients after a mean of 1.4 operations. The median time to success was 11 (2.5–48) months. The ‘curative’ group had an overall success of 73% (19 of 26). Seventy‐five per cent of non‐inflammatory bowel disease patients and 67% of those with Crohn's disease had successful treatment of the RVF. Twenty‐four of 35 patients (67%) underwent creation of a stoma. Sixteen of 24 (67%) were deemed fit for restoration of continuity. No demographic or disease related factors were found to influence healing.ConclusionCure of RVF can be achieved by a range of surgical approaches including abdominal and anal. A variety of different anal techniques are necessary, depending on the integrity of the anal sphincter and the presence or absence of perineal descent/internal intussusception.
Altering the therapeutic paradigm towards a distal bowel margin of < 1 cm in patients with low‐lying rectal cancer: a systematic review and commentary
Authors: Pahlman L. , Bujko K. , Rutkowski A. , Michalski W. 
Published: January 2013

AbstractAimThe 1‐cm rule of distal bowel clearance in patients with low‐lying rectal cancer undergoing anterior resection is based mainly on pathological data showing distal intramural spread. Because clinical data are contradictory, a review that includes only cancers located ≤ 5 or ≤ 6 cm from the anal verge was carried out.MethodA systematic review of the literature identified seven studies that presented results in relation to a margin of ≤ 1 cm (n = 293) vs > 1 cm (n = 315). In six studies, pre‐ or postoperative radiotherapy was implemented, and in one study patients were treated with surgery alone. Three studies, all implementing radiotherapy, reported results related to a margin of ≤ 5 mm (n = 51) vs > 5 mm (n = 125).ResultsIn none of the studies were the differences in local recurrence rate between the small and large margin groups statistically significant. The pooled analysis of six studies, in which patients received perioperative radiotherapy, showed a 1.2% [95% confidence interval (Cl) −4.5–7.0%] higher local recurrence rate in the ≤ 1 cm margin group compared with the > 1 cm margin group (P = 0.6). The corresponding figures for the ≤ 5 mm cut‐off point were 0.5% (95% CI −7.6–8.7%, P = 0.9). The 5‐year local recurrence rate in the only study in which radiotherapy had not been used was 8.6% higher in the ≤ 1 cm margin group compared with the > 1 cm margin group (P = 0.09).ConclusionClinical evidence does not support the 1‐cm rule in patients with low‐lying rectal cancer undergoing pre‐ or postoperative radiotherapy.
A systematic review of stercoral perforation
Authors: Chakravartty S. , Chang A. , Nunoo‐Mensah J. 
Published: January 2013

AbstractAimStercoral perforation is a rarely suspected life‐threatening condition. Early diagnosis is difficult but essential. A comprehensive systematic review was performed to evaluate its presentation, diagnosis and treatment.MethodA systematic review was carried out of Embase, MEDLINE, PubMed and Cochrane databases for all articles published between 1998 and 2011. Only studies describing stercoral perforation were included.ResultsTwenty‐four relevant articles were found including 137 patients (median age = 62 years) with stercoral perforation, of whom 81% had chronic constipation. Stercoral perforation was diagnosed by CT scan in 90% of 31 patients, with the commonest findings being a combination of faecal impaction (84%) and subphrenic (90%) or extraluminal air (61%). The commonest site of perforation was the sigmoid colon (50%) followed by the rectosigmoid junction (24%). The overall mortality was 34%.ConclusionStercoral perforation should be suspected in elderly and chronically constipated patients with unexplained abdominal pain and investigated appropriately with a CT scan to allow timely and optimal treatment.
A prospective study of early removal of the urethral catheter after colorectal surgery in patients having epidural analgesia as part of the Enhanced Recovery After Surgery programme
Authors: Stubbs B. M. , Badcock K. J. M. , Hyams C. , Rizal F. E. , Warren S. , Francis D. 
Published: January 2013

AbstractAimEarly removal of the urethral catheters is part of the enhanced postoperative recovery programme (ERAS). The effect of epidural anaesthesia on urinary retention was investigated in patients after colorectal resection.MethodA prospective cohort study of all patients having colorectal surgery within an ERAS programme that included insertion of an epidural catheter over the last 5 years.ResultsTwo‐hundred and ten patients had an epidural and a urethral catheter postoperatively. The duration of catheterization was not recorded in one patient who was therefore excluded from the study. One‐hundred and eighteen patients had a trial without catheter (TWOC) prior to stopping the epidural (early TWOC). Ninety‐one patients had TWOC after the epidural was stopped (late TWOC). Sixteen (7.6%) patients went into urinary retention (14 early TWOC and two late TWOC). The rate of urinary retention in the early TWOC group was significantly higher than that in the late TWOC group (11.9% vs 2.2%; χ2, P = 0.009). Those who underwent a laparoscopic resection were significantly more likely to have undergone an early TWOC (χ2, P = 0.001); however, there was no difference in retention rates between open and laparoscopic surgery (χ2, P = 0.402). Pelvic surgery was not significantly associated with an increased risk of postoperative urinary retention (χ2, P = 0.627). Male sex was not significantly associated with urinary retention (χ2, P = 0.087). In the early TWOC group 86% had the catheter removed within 24 hours of surgery.ConclusionEarly TWOC with epidural analgesia running significantly increases the risk of urinary retention; however, it was still successful in 88% of patients.
The economic impact of anastomotic leakage after anterior resections in English NHS hospitals: are we adequately remunerating them?
Authors: Ashraf S. Q. , Burns E. M. , Jani A. , Altman S. , Young J. D. , Cunningham C. , Faiz O. , Mortensen N. J. 
Published: January 2013

AbstractAimOur aim was to determine the frequency and economic impact of anastomotic leakage (AL) at local and national levels in England.MethodAll patients who underwent AR in Oxford between 2007 and 2009 were evaluated for AL. Hospital Episode Statistics (HES) data were used to determine reoperation rates after elective AR (n = 23 388) in England between 2000 and 2008. Hospital episode remuneration costs were calculated by the local commissioning department and compared with Department of Health (DH) reference index costs.ResultsThe frequency of AL following anterior resection was 10.9% (31 out of 285) in Oxford. Laparotomy for leakage was performed in 5.6% of cases. The 30‐day hospital mortality rate for all ARs was 2.1%, compared with 3.2% after AL. The national relaparotomy rate (within 28 days) and 30‐day hospital mortality in English National Health Service (NHS) trusts following AR were 5.9% and 2.9%, respectively. Institutional remunerated tariffs (£6233 (SD ± 965)) were similar to DH reference costs (£6319 (SD ± 1830)) after uncomplicated AR. However, there was a significant (P = 0.008) discrepancy between the remunerated tariff for AL (£9605 (SD ± 6908)) and the actual cost (£17 220 (SD ± 9642)). AL resulted in an additional annual cost of approximately £1.1 million to £3.5 million when extrapolated nationally.ConclusionThe estimated economic burden of anastomotic leakage following AR is approximately double that of the remunerated tariff.
In vivo measurement of human rectus femoris architecture by ultrasonography: validity and applicability
Authors: Ema Ryoichi , Wakahara Taku , Mogi Yasuyoshi , Miyamoto Naokazu , Komatsu Toshihiko , Kanehisa Hiroaki , Kawakami Yasuo 
Published: January 2013

SummaryThe architectural feature of the rectus femoris (RF) has been scarcely investigated despite its substantial contribution to knee extension torque and large plasticity in the muscularity. This study aimed to examine the reproducibility and validity of ultrasound measurements of RF architecture and interrelationships among the architectural parameters. After confirming the measurement accuracy of an examiner (measurement errors <1%), in vivo and cadaveric measurements of fascicle lengths and pennation angles of RF were performed. Day‐to‐day reproducibility of measurements was investigated in vivo including muscle thickness measurement. Validity of measurements was investigated by comparing the values between direct and ultrasound measurements for the cadaver. The intraclass correlation coefficients were 0·984, 0·960 and 0·932, and root mean square difference between measured values on 2 days was 0·8 mm, 3·1 mm and 1·4° for muscle thickness, fascicle length and pennation angle, respectively. The validity of measurements was similar or better than those of previous reports on other muscles. We also confirmed a positive correlation between the muscle thickness and the pennation angle as has been shown in other muscles. The current results warrant the use of B‐mode ultrasonography for examining the architectural characteristics of RF in vivo.
Biotic homogenization at the community scale: disentangling the roles of urbanization and plant invasion
Authors: Trentanovi Giovanni , von der Lippe Moritz , Sitzia Tommaso , Ziechmann Ulrike , Kowarik Ingo , Cierjacks Arne 
Published: January 2013

AbstractAimUrbanization as a major global trend profoundly changes biodiversity patterns, and homogenization of urban biota due to expanding exotic species and declining native species is of increasing concern. Previous studies on this topic have mostly taken place at large scales that include high habitat heterogeneity. Here, we aimed at disentangling the effects of urbanization and plant invasion on species composition through the analysis of similarity patterns of urban plant assemblages at the community scale where species interact.LocationBerlin, Germany.MethodsWe analysed how different levels of urbanization, specific components of the urban matrix and the dominance of a native (Betula pendula) versus an exotic tree species (Robinia pseudoacacia) affect alpha and beta diversity of urban woodland understorey vegetation in sixty‐eight 100‐m2 plots.ResultsExotic dominance reduced alpha diversity, but not beta diversity of the total species pool. Comparing beta diversity among different species groups revealed significant but divergent effects of exotic dominance, habitat connectivity and levels of urbanization in native and non‐native species assemblages. In particular, urbanity proved to homogenize the native species pool, whereas the beta diversity of the non‐native species pool showed a more pronounced response to exotic dominance.Main conclusionsOur data provide evidence that both the urban context and the dominance of exotic species can modify homogenization processes at the community level. These novel insights into the mechanisms of biotic homogenization of urban floras may contribute to mitigating the effects of urbanization on biodiversity.
On evaluating species distribution models with random background sites in place of absences when test presences disproportionately sample suitable habitat
Authors: Smith Adam B. 
Published: January 2013

AbstractModelling the distribution of rare and invasive species often occurs in situations where reliable absences for evaluating model performance are unavailable. However, predictions at randomly located sites, or ‘background’ sites, can stand in for true absences. The maximum value of the area under the receiver operator characteristic curve, AUC, calculated with background sites is believed to be 1 − a/2, where a is the typically unknown prevalence of the species on the landscape. Using a simple example of a species' range, I show how AUC can achieve values > 1 − a/2 when test presences do not represent each inhabited region of a species__ range in proportion to its area. Values of AUC that surpass 1 − a/2 are associated with higher model predictions in areas overrepresented in the test data set, even if they are less environmentally suitable than other regions the species occupies. Pursuit of high AUC values can encourage inclusion of spurious predictors in the final model if they help to differentiate areas with disproportionate representation in the test data. Choices made during modelling to increase AUC calculated with background sites on the assumption that higher scores connote more accurate models can decrease actual accuracy when test presences disproportionately represent inhabited areas.
Scaling species richness and endemism of tropical dry forests on oceanic islands
Authors: Gillespie Thomas W. , Keppel Gunnar , Pau Stephanie , Price Jonathan P. , Jaffré Tanguy , O'Neill Kristin 
Published: January 2013

AbstractAimWe examine variation in woody plant species richness and endemism within tropical dry forest on oceanic islands and determine what climatic and biogeographic metrics best explain native species richness and endemism across archipelagos, islands and plots.LocationOceanic islands in the Pacific.MethodsStand‐level sampling (0.1 ha) at 35 different dry forest sites across 16 islands, and five archipelagos (New Caledonia, Fiji, Marquesas, Marianas and Hawaii). Descriptors of native species richness and endemism were calculated at the plot, island and archipelago level. Biogeographic and climate metrics at the archipelago, island and plot level were drawn from the literature and computer databases. The effects of biogeographic and climate metrics were investigated using linear mixed‐effects models.ResultsDry forests of New Caledonia and Fiji had the highest native species richness, while New Caledonia and Hawaii had the highest endemism. Native species richness and endemism within tropical dry forests on oceanic islands are primarily influenced by biogeographic metrics, especially isolation of the archipelago, and not climatic metrics. Most variance in native species richness and endemism (60% and 64%) is at the archipelago level compared with the island (8%, 16%) and plot (32%, 15%) level. At the island level, species richness in tropical dry forest is affected by precipitation, while island area significantly affects endemism. The area of forest fragments is an important predictor of native species richness and endemism in plots.Main conclusionsAlthough dry forests in the Pacific have been exceptionally deforested and degraded, high native species richness and endemism remains in a number of forest fragments. Biogeographic metrics explain most of the variance in native species richness and endemism across scales, while climatic metrics are important at the island level. First‐order assessments of native richness and endemism at the archipelago, island and stand‐level are possible for forest types on oceanic archipelagos.
Integrating multiple scales in rarity assessments of invertebrate taxa
Authors: Leroy Boris , Canard Alain , Ysnel Frédéric 
Published: January 2013

AbstractAimTo provide a procedure for measuring the rarity of both invertebrate species and assemblages of species from multiple scales without the need for fine‐resolution datasets over broad areas.LocationThe western Palearctic (WP) and western France.MethodsOn the basis of different datasets from different geographical extents, we applied a multiscale rarity weight to species occurrence from multiple scales. Multiscale rarity weights were then averaged at an assemblage level in a multiscale index of relative rarity (IRR). These rarity weights were calculated using a flexible, scale‐dependent method that ensures equitable contributions of each scale to the final index. We provided a simple two‐scale example of the application, on spiders of western France, for which we obtained occurrence information from a regional‐extent dataset (regional scale) and a western Palearctic‐extent dataset (WP scale). Thus, we showed the necessity of a two‐scale approach by successively analysing species occurrence, multiscale rarity weights of species and multiscale indices of species assemblage. Finally, we presented a case study within a nature reserve.ResultsSpecies occurrences are not predictable from one scale to another, and rarity indices of assemblages are poorly congruent among scales, which supports the necessity of a two‐scale approach. Multiscale rarity weights accurately showed information on species rarity from both scales. Multiscale indices of assemblages were congruent but with additional information over each one‐scale index.Main conclusionsThe novelty of the multiscale method developed here is to accurately combine different datasets of varying extents and resolutions to provide multiscale rarity weights for species and indices for assemblages. Given the increasing availability of datasets for invertebrate taxa, this method represents a significant improvement for rarity and conservation studies on invertebrates.
Risk scores for diabetes and impaired glycaemia in the Middle East and North Africa
Authors: Handlos L. N. , Witte D. R. , Almdal T. P. , Nielsen L. B. , Badawi S. E. , Sheikh A. R. A. , Belhadj M. , Nadir D. , Zinai S. , Vistisen D. 
Published: January 2013

AbstractAimsTo develop risk scores for diabetes and diabetes or impaired glycaemia for individuals living in the Middle East and North Africa region. In addition, to derive national risk scores for Algeria, Saudi Arabia and the United Arab Emirates and to compare the performance of the regional risk scores with the national risk scores.MethodsAn opportunistic sample of 6588 individuals aged 30–75 years was screened. Screening consisted of a questionnaire and a clinical examination including measurement of HbA1c. Two regional risk scores and national risk scores for each of the three countries were derived separately by stepwise backwards multiple logistic regression with diabetes [HbA1c ≥ 48 mmol/mol (≥ 6.5%)] and diabetes or impaired glycaemia [HbA1c ≥ 42 mmol/mol (≥ 6.0%)] as outcome. The performance of the regional and national risk scores was compared in data from each country by receiver operating characteristic analysis.ResultsThe eight risk scores all included age and BMI, while additional variables differed between the scores. The areas under the receiver operating characteristic curves were between 0.67 and 0.70, and for sensitivities approximately 75%; specificities varied between 50% and 57%. The regional and the national risk scores performed equally well in the three national samples.ConclusionsTwo regional risk scores for diabetes and diabetes or impaired glycaemia applicable to the Middle East and North Africa region were identified. The regional risk scores performed as well as the national risk scores derived in the same manner.