bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intraoperative imprint cytology for breast cancer sentinel nodes: is it worth it?
Authors: Richards Angela D. M. , Lakhani Sunil R. , James Daniel T. , Ung Owen A. 
Published: October 2012

AbstractBackgroundRe‐operative surgery is stressful for patients and is an additional burden to an already stretched public health system. Intraoperative confirmation of breast cancer metastases in sentinel lymph nodes (SLNs) provides the necessary information for the surgeon to proceed with immediate axillary dissection, avoiding the need for a second operation, its associated cost, morbidity and adjuvant treatment delays. Our challenge was to implement a technique that was rapid, inexpensive and had a negligible false positive rate. The aim of this study was to determine whether touch imprint cytology (TIC) could reduce returns to theatre without compromising patient safety and pathology department and operating theatre efficiency.MethodsIntraoperative TIC was performed on bisected SLNs from 134 patients. Post‐operatively, specimens were examined as haematoxylin and eosin‐stained, paraffin‐embedded 2‐mm sections. Further sectioning and immunohistochemisty was performed on negative SLNs.ResultsThe sensitivity of TIC for metastases was 23.8%, the specificity was 100% and the accuracy was 76.1%. Ten patients with macrometastases and none with micrometastastes were detected intraoperatively. The sensitivity of TIC for detecting macrometastases was 34.5%, the accuracy was 78.4% and the specificity was 100%.ConclusionTen patients avoided a subsequent surgery. The technique caused no theatre delays and the minimal cost was compensated for by the avoidance of a second procedure for a third of patients who definitively required axillary clearance. No patients had an unnecessary axillary clearance and no patients with micrometastases or isolated tumour cells were subjected to an immediate axillary clearance. It would be justifiable to continue this simple, low‐cost and non‐disruptive approach.
Part‐time general surgical training in South Australia: its success and future implications (or: pinnacles, pitfalls and lessons for the future)
Authors: Neuhaus Susan , Igras Emma , Fosh Beverley , Benson Sarah 
Published: October 2012

AbstractBackgroundFlexible training options are sought by an increasing number of Australasian surgical trainees. Reasons include increased participation of women in the surgical workforce, postgraduate training and changing attitudes to family responsibilities. Despite endorsement of flexible training by the Royal Australasian College of Surgeons and Board in General Surgery, part‐time (PT) training in General Surgery in Australia and New Zealand is not well established. A permanent ‘stand‐alone’ PT training position was established at the Royal Adelaide Hospital in 2007 under the Surgical Education and Training Program. This position offered 12 months of General Surgical training on a 0.5 full‐time (FT) equivalent basis with pro rata emergency and on‐call commitments and was accredited for 6 months of General Surgical training. This paper reviews the PT training experience in South Australia.MethodsDe‐identified logbook data were obtained from the South Australian Regional Subcommittee of the Board in General Surgery with consent of each of the trainees. Totals of operative cases were compared against matched FT trainees working on the same unit.ResultsOverall, PT trainees achieved comparable operative caseloads compared with their FT colleagues. All trainees included in this review have subsequently passed the Royal Australasian College of Surgeons Fellowship Examination in General Surgery and returned to FT workforce positions.ConclusionThis paper presents two validated models of PT training. Training, resource and regulatory requirements and individual and institutional barriers to flexible training are substantial. Successful PT models offer positive and beneficial training alternatives for General Surgical trainees and contribute to workforce flexibility.
Bone tissue engineering with periosteal‐free graft and pedicle omentum
Authors: Bigham‐Sadegh Amin , Oryan Ahmad , Mirshokraei Pezhman , Shadkhast Mohamad , Basiri Ehsan 
Published: October 2012

AbstractBackgroundThe histological characteristics of periosteum make it a specific tissue with a unique capacity to be engineered. Higher flexibility of the greater omentum is useful for reconstructive surgery as it facilitates not only filling of the site of infections such as myelitis, but also is effective in filling complicated defects of the soft and hard tissues, and these criteria make it suitable for tissue engineering. The present study was designed to evaluate bone tissue engineering with periosteal‐free graft concurrent with pedicle omentum and compare it with subcuticular periosteal grafting in a dog model. This is the first report in which periosteum‐free graft has been used as bone tissue engineering.MethodsEight young female indigenous dogs were used in this experiment. In omental group (n= 4), end of omentum was wrapped by periosteum of the radial bone in the abdomen of each dog, while in the subcutaneous group (n= 4), the harvested periosteum was sutured on the subcutaneous layer. Lateral view radiographs were taken from the abdominal cavity post‐operatively at 2, 4, 6 and 8 weeks post surgery. Eight weeks after operation, the dogs were re‐anaesthetized and the omental or subcutical grafted periosteom was found and removed for histopathological evaluation.Results and discussionRadiological, gross and histopathological evaluations revealed a superior bone formation in the wrapped omentum with periosteum compared with that of the subcuticular periosteal grafting. This is a novel and efficient technique in producing mature trabecular bone and could be used as a potential source of bone tissue engineering for autotransplantation.
In Defense of Veritistic Value Monism
Authors: Ahlstrom‐Vij Kristoffer 
Published: October 2012

AbstractRecently, veritistic value monism, i.e. the idea that true belief is unique in being of fundamental epistemic value, has come under attack by pluralist philosophers arguing that it cannot account fully for the domain of epistemic value. However, the relevant arguments fail to establish any such thing. For one thing, there is a presumption of monism due to considerations about axiological parsimony. While such a presumption would be defeated by evidence that the relevant kind of monism cannot account fully for the domain of epistemic value, an examination of the most promising pluralist counterexamples casts serious doubt upon the claim that there is any such evidence.
Differences between HIV‐infected and uninfected adults in the contributions of smoking, diabetes and hypertension to acute coronary syndrome: two parallel case–control studies
Authors: Calvo‐Sánchez M , Perelló R , Pérez I , Mateo MG , Junyent M , Laguno M , Blanco JL , Martínez‐Rebollar M , Sánchez M , Mallolas J , Gatell JM , Domingo P , Martínez E 
Published: October 2012

ObjectivesThe aim of the study was to assess the separate contributions of smoking, diabetes and hypertension to acute coronary syndrome (ACS) in HIV‐infected adults relative to uninfected adults.MethodsTwo parallel case–control studies were carried out. In the first study, HIV‐positive adults diagnosed with ACS between 1997 and 2009 (HIV+/ACS) were matched for age, gender and known duration of HIV infection with HIV‐positive adults without ACS (HIV+/noACS), each individual in the HIV+/ACS group being matched with three individuals in the HIV+/noACS group. In the second study, each individual in the HIV+/ACS group in the first study was matched for age, gender and calendar date of ACS diagnosis with three HIV‐negative individuals diagnosed with ACS between 1997 and 2009 (HIV–/ACS). Each individual in the HIV–/ACS group was then matched for age and gender with an HIV‐negative adult without ACS (HIV–/noACS). After matching, the ratio of numbers of individuals in the HIV+/ACS, HIV+/noACS, HIV–/ACS and HIV–/noACS groups was therefore 1 : 3 : 3 : 3, respectively. We performed logistic regression analyses to identify risk factors for ACS in each case–control study and calculated population attributable risks (PARs) for smoking, diabetes and hypertension in HIV‐positive and HIV‐negative individuals.ResultsThere were 57 subjects in the HIV+/ACS group, 173 in the HIV+/noACS group, 168 in the HIV–/ACS group, and 171 in the HIV–/noACS group. Independent risk factors for ACS were smoking [odds ratio (OR) 4.091; 95% confidence interval (CI) 2.086–8.438; P < 0.0001] and a family history of cardiovascular disease (OR 7.676; 95% CI 1.976–32.168; P = 0.0003) in HIV‐positive subjects, and smoking (OR 4.310; 95% CI 2.425–7.853; P < 0.0001), diabetes (OR 5.778; 95% CI 2.393–15.422; P = 0.0002) and hypertension (OR 6.589; 95% CI 3.554–12.700; P < 0.0001) in HIV‐negative subjects. PARs for smoking, diabetes and hypertension were 54.35 and 30.58, 6.57 and 17.24, and 9.07 and 38.81% in HIV‐positive and HIV‐negative individuals, respectively.ConclusionsThe contribution of smoking to ACS in HIV‐positive adults was generally greater than the contributions of diabetes and hypertension, and was almost twice as high as that in HIV‐negative adults. Development of effective smoking cessation strategies should be prioritized to prevent cardiovascular disease in HIV‐positive adults.
Final 192‐week efficacy and safety of once‐daily darunavir/ritonavir compared with lopinavir/ritonavir in HIV‐1‐infected treatment‐naïve patients in the ARTEMIS trial
Authors: Orkin C , DeJesus E , Khanlou H , Stoehr A , Supparatpinyo K , Lathouwers E , Lefebvre E , Opsomer M , Van de Casteele T , Tomaka F 
Published: October 2012

ObjectiveThis paper presents the final analysis of once‐daily darunavir/ritonavir (DRV/r) vs. lopinavir/ritonavir (LPV/r) in treatment‐naïve HIV‐1‐infected adults.MethodsARTEMIS (AntiRetroviral Therapy with TMC114 ExaMined In naïve Subjects; NCT00258557) was a randomized, open‐label, phase‐III, 192‐week trial. Patients were stratified by baseline HIV‐1 RNA and CD4 count, and randomized to once‐daily DRV/r 800/100 mg or LPV/r 800/200 mg total daily dose (either once or twice daily) plus tenofovir/emtricitabine.ResultsOf 689 randomized patients receiving treatment (DRV/r: 343; LPV/r: 346), 85 and 114 patients in the DRV/r and LPV/r arms, respectively, had discontinued by week 192. Noninferiority was shown in the primary endpoint of virological response (HIV‐1 RNA < 50 copies/mL) [DRV/r: 68.8%; LPV/r: 57.2%; P < 0.001; intent to treat (ITT)/time to loss of virological response; estimated difference in response 11.6% (95% confidence interval 4.4–18.8%)]. Statistical superiority in virological response of DRV/r over LPV/r was demonstrated for the primary endpoint (P = 0.002) and for the ITT non‐virological‐failure‐censored analysis (87.4% vs. 80.8%, respectively; P = 0.040). No protease inhibitor (PI) primary mutations developed and only low levels of nucleoside reverse transcriptase inhibitor (NRTI) resistance developed in virological failures in both groups. Significantly fewer discontinuations because of adverse events were observed with DRV/r (4.7%) than with LPV/r (12.7%; P = 0.005). Grade 2–4 treatment‐related diarrhoea was significantly less frequent with DRV/r than with LPV/r (5.0% vs. 11.3%, respectively; P = 0.003). DRV/r was associated with smaller median increases in total cholesterol and triglyceride levels than LPV/r. Changes in low‐ and high‐density lipoprotein cholesterol were similar between groups. Similar increases in aspartate aminotransferase and alanine aminotransferase for DRV/r and LPV/r were observed.ConclusionOver 192 weeks, once‐daily DRV/r was noninferior and statistically superior in virological response to LPV/r, with a more favourable gastrointestinal profile, demonstrating its suitability for long‐term use in treatment‐naïve patients.
Different slopes for different folks: Alpha and deltaEEGpower predict subsequent video game learning rate and improvements in cognitive control tasks
Authors: Mathewson Kyle E. , Basak Chandramallika , Maclin Edward L. , Low Kathy A. , Boot Walter R. , Kramer Arthur F. , Fabiani Monica , Gratton Gabriele 
Published: October 2012

AbstractWe hypothesized that control processes, as measured using electrophysiological (EEG) variables, influence the rate of learning of complex tasks. Specifically, we measured alpha power, event‐related spectral perturbations (ERSPs), and event‐related brain potentials during early training of theSpaceFortress task, and correlated these measures with subsequent learning rate and performance in transfer tasks. Once initial score was partialled out, the best predictors were frontal alpha power and alpha and deltaERSPs, but not P300. By combining these predictors, we could explain about 50% of the learning rate variance and 10%–20% of the variance in transfer to other tasks using only pretrainingEEGmeasures. Thus, control processes, as indexed by alpha and deltaEEGoscillations, can predict learning and skill improvements. The results are of potential use to optimize training regimes.
Positive and normative use of fuzzy DEA‐BCC models: A critical view on NATO enlargement
Authors: Hatami‐Marbini Adel , Tavana Madjid , Saati Saber , Agrell Per J. 
Published: October 2012

AbstractData envelopment analysis (DEA) is a widely used mathematical programming approach for comparing the input and output of a set of comparable decision‐making units (DMUs) by evaluating their relative efficiency. The traditional DEA methods require accurate measurement of both the inputs and outputs. However, the real evaluation of the DMUs is often characterized by imprecision and uncertainty in data definitions and measurements. The development of fuzzy DEA (FDEA) with imprecise and ambiguous data has extended the scope of application for efficiency measurement. The purpose of this paper is to develop a fuzzy DEA framework with a BCC model for measuring crisp and interval efficiencies in fuzzy environments. We use an α‐level approach to convert the fuzzy Banker, Charnes, and Cooper (BCC) (variable returns to scale) model into an interval programming model. Instead of comparing the equality (or inequality) of the two intervals, we define a variable in the interval to satisfy our constraints and maximize the efficiency value. We present a numerical example to show the similarities and differences between our solution and the solutions obtained from four fuzzy DEA methods in the literature. In addition, a case study for NATO enlargement is presented to illustrate the applicability of the proposed method.
Comorbidity of Migraine and Mood Episodes in a Nationally Representative Population‐Based Sample
Authors: Nguyen Tuong‐Vi , Low Nancy C. 
Published: October 2012

Objective.— To examine the lifetime comorbidity of migraine with different combinations of mood episodes: (1) manic episodes alone; (2) depressive episodes alone; (3) manic and depressive episodes; (4) controls with no lifetime history of mood episodes, as well as sociodemographic and clinical correlates of migraine for each migraine–mood episode combination.Background.— Migraine has been found to be comorbid with bipolar disorder and major depressive disorder in clinical and population‐based samples. However, variability in findings across studies suggests that examining mood episodes separately may be fruitful in determining which of these mood episodes are specifically associated with migraine.Methods.— Using a cross‐sectional, population‐based sample from the Canadian Community Health Survey 1.2 (n = 36,984), sociodemographic and clinical correlates of migraine were examined in each combination of mood episodes as well as controls. Logistic regression analyses controlling for age, sex, and education level compared the lifetime prevalence of migraine (1) between controls and each combination of mood episodes, and then (2) among the different combinations of mood episodes.Results.— Migraine comorbidity in all combinations of mood episodes was associated with lower socioeconomic status, earlier onset of affective illness, more anxiety, suicidality and use of mental health resources. Compared with controls, the adjusted odds ratio of having migraine was 2.0 (95% confidence interval [CI] 1.4‐2.8) for manic episodes alone, 1.9 (95% CI 1.6‐2.1) for depressive episodes alone, and 3.0 (95% CI 2.3‐3.9) for subjects with both manic and depressive episodes. Compared with those with manic episodes alone and depressive episodes alone, the odds of having migraine were significantly increased in subjects with both manic and depressive episodes (odds ratio 1.5 vs manic episodes alone; 1.8 vs depressive episodes alone). In addition, migraine comorbidity was associated with different correlates depending on the specific combination of mood episodes; in subjects with both manic and depressive episodes, migraine comorbidity was associated with an earlier onset of mental illness, while in subjects with either manic or depressive episodes alone, migraine comorbidity was associated with increased suicidality and anxiety.Conclusions.— Migraine comorbidity appears to delineate a subset of individuals with earlier onset of affective illness and more psychiatric complications, suggesting that migraine assessment in mood disorder patients may be useful as an indicator of potential clinical severity. Differences in the prevalence of migraine as well as sociodemographic and clinical correlates associated with specific combinations of mood episodes underscore the importance of examining this comorbidity by specific type of mood episode.
Putting On The Breaks: Regulating Organelle Movements in Plant CellsF
Authors: Vick Julianna K. , Nebenführ Andreas 
Published: October 2012

AbstractA striking characteristic of plant cells is that their organelles can move rapidly through the cell. This movement, commonly referred to as cytoplasmic streaming, has been observed for over 200 years, but we are only now beginning to decipher the mechanisms responsible for it. The identification of the myosin motor proteins responsible for these movements allows us to probe the regulatory events that coordinate organelle displacement with normal cell physiology. This review will highlight several recent developments that have provided new insight into the regulation of organelle movement, both at the cellular level and at the molecular level.
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[ Andreas Nebenführ (Corresponding author)]
A Prospective Test of the Late Effects of Potentially Antineuroplastic Drugs in a Stroke Rehabilitation Study
Authors: Nadeau Stephen E. , Lu Xiaomin , Dobkin Bruce , Wu Samuel S. , Dai Yunfeng E. , Duncan Pamela W. ,   and LEAPS Investigative Team
Published: October 2012

Background Extensive data, primarily from animal studies, suggest that several classes of drugs may have antineuroplastic effects that could impede recovery from brain injury or reduce the efficacy of rehabilitation. Aims The Locomotor Experience Applied Post-Stroke trial, a randomized controlled study of 408 subjects that tested the relative efficacy of two rehabilitation techniques on functional walking level at one-year poststroke, provided us the opportunity to prospectively assess the potential antineuroplastic effects of several classes of drug. Methods Subjects were randomized to receive one of the two rehabilitation therapies at two-months poststroke. Drugs taken were recorded at time of randomization. Outcome was assessed at one-year poststroke. Regression models were used to determine the amount of variance in success in improving functional walking level, gains in walking speed, and declines in lower extremity, upper extremity, and cognitive impairment accounted for by α1 noradrenergic blockers + α2 noradrenergic agonists, benzodiazepines, voltage-sensitive sodium channel anticonvulsants, and α2δ voltage-sensitive calcium channel blockers. Results The maximum variance accounted for by any drug class was 1·66%. Drug effects were not statistically significant when using even our most lenient standard for correction for multiple comparisons. Conclusions Drugs in the classes we were able to assess do not appear to exert a clinically important effect on outcome over the period between two- and 12 months poststroke. However, the potential antineuroplastic effects of certain drugs remain an incompletely settled scientific question.
Impact of Collateral Circulation on Early Outcome and Risk of Hemorrhagic Complications after Systemic Thrombolysis
Authors: Brunner Freimuth , Tomandl Bernd , Hanken Katrin , Hildebrandt Helmut , Kastrup Andreas 
Published: October 2012

Background In stroke patients, collateral flow can rapidly be assessed on computed tomography angiography (CTA). Aims In this study, the impact of baseline collaterals on early outcome and risk of symptomatic intracerebral hemorrhages after systemic thrombolysis in patients with proximal arterial occlusions within the anterior circulation were analyzed. Methods Collateralization scores were determined on the CT angiography source images (0 = absent; 1 ≤ 50%, 2 > 50% but <100%, and 3 = 100% collateral filling) of patients with distal intracranial carotid artery and/or M1 segment occlusions treated from 2008 to December 2011. A collateral score of 0 to 1 was designated as poor and 2 to 3 as good collateral vessel status. Outcome variables included in hospital mortality, favorable outcome at discharge (modified Rankin score ≤ 2), and rates of symptomatic intracerebral hemorrhage based on the European–Australasian Acute Stroke Study II definition. Results Among 246 subjects (mean age of 74 years; median National Institutes of Health Stroke Scale N at admission 14), 205 patients (83%) had good collaterals, whereas 41 patients (17%) had poor collaterals, respectively. Patients with poor collaterals had significantly higher rates of in-hospital mortality (41% vs. 12%, P < 0·001), of symptomatic intracerebral hemorrhage (15% vs. 4·9%, P < 0·05) and had significantly lower rates of favorable early clinical outcome (0% vs. 28%, P < 0·001) compared with those with good collaterals. The grade of collateralization was independently associated with in-hospital mortality ( P < 0·001), early clinical outcome ( P < 0·01), and rates of symptomatic intracerebral hemorrhage ( P < 0·01). Conclusion Patients with proximal arterial occlusions within the anterior circulation and poor baseline collaterals have a poor early functional outcome and high rates of symptomatic intracerebral hemorrhage after systemic thrombolysis. Since similar findings have also been reported after endovascular therapy, strategies to improve collateral blood flow should be assessed in this patient population.