bluuebunny/crossref_metadata_2025_split huggingface dataset:
Emergency Department Revisits for Patients with Kidney Stones in California
Authors: Scales Charles D. , Lin Li , Saigal Christopher S. , Bennett Carol J. , Ponce Ninez A. , Mangione Carol M. , Litwin Mark S. ,   the NIDDK Urologic Diseases in America Project
Published: March 2015

AbstractObjectivesKidney stones affect nearly one in 11 persons in the United States, and among those experiencing symptoms, emergency care is common. In this population, little is known about the incidence of and factors associated with repeat emergency department (ED) visits. The objective was to identify associations between potentially mutable factors and the risk of an ED revisit for patients with kidney stones in a large, all‐payer cohort.MethodsThis was a retrospective cohort study of all patients in California initially treated and released from EDs for kidney stones between February 2008 and November 2009. A multivariable regression model was created to identify associations between patient‐level characteristics, area health care resources, processes of care, and the risk of repeat ED visits. The primary outcome was a second ED visit within 30 days of the initial discharge from emergent care.ResultsAmong 128,564 patients discharged from emergent care, 13,684 (11%) had at least one additional emergent visit for treatment of their kidney stone. In these patients, nearly one in three required hospitalization or an urgent temporizing procedure at the second visit. On multivariable analysis, the risk of an ED revisit was associated with insurance status (e.g., Medicaid vs. private insurance; odds ratio [OR] = 1.52, 95% confidence interval [CI] = 1.43 to 1.61; p < 0.001). Greater access to urologic care was associated with lower odds of an ED revisit (highest quartile OR = 0.88, 95% CI = 0.80 to 0.97; p < 0.01 vs. lowest quartile). In exploratory models, performance of a complete blood count was associated with a decreased odds of revisit (OR = 0.86, 95% CI = 0.75 to 0.97; p = 0.02).ConclusionsRepeat high‐acuity care affects one in nine patients discharged from initial emergent evaluations for kidney stones. Access to urologic care and processes of care are associated with lower risk of repeat emergent encounters. Efforts are indicated to identify preventable causes of ED revisits for kidney stone patients and design interventions to reduce the risk of high‐cost, high‐acuity, repeat care.
Migration and farm technical efficiency: evidence from Kosovo
Authors: Sauer Johannes , Gorton Matthew , Davidova Sophia 
Published: March 2015

AbstractThis article investigates the effect of migration on farm technical efficiency drawing on a large and representative sample of agricultural households in Kosovo. A two‐stage estimation procedure is applied: a frontier technique to estimate the effect of migration on farm efficiency, followed by a propensity score based matching approach to robustly estimate the sample average effect on efficiency for different levels of migration intensity. Migration is found to have an efficiency decreasing effect, which is amplified for better educated workers. The observed negative effect of migration on efficiency is evident even at low levels of migration intensity.
Seasonal variation in understorey bird species diversity and abundance in the Uluguru Nature Reserve, Tanzania
Authors: Werema Chacha 
Published: March 2015

AbstractThe Uluguru Mountains form a component block of the Eastern Arc Mountains of Tanzania and Kenya and are known for a high degree of endemic vertebrate and plant taxa. Among the Eastern Arc Mountains, the Uluguru Mountains rank second in the number of endemic species. Although the forests in these mountains have received considerable ornithological attention, studies on how forest bird communities in the available low elevation forests are affected by seasons remain patchy and sporadic. Such studies are important because in the Uluguru Mountains, forest destruction in the lower slopes has been severe to an extent that there is very little substantial forest survives below 900 m above sea level. Using mist netting, seasonal variation in understorey bird communities in the remaining low elevation forests in the Uluguru Nature Reserve was assessed between 2005 and 2011. Species diversity and relative abundance of the birds were higher during the cold season in comparison with the hot season possibly due to seasonal elevational movements of some species. Elevational migrants made a large proportion of the avifauna in the study area. The results suggest that low altitude forests are important cold season refugia of elevational migrants and these forests need continual protection.
Does faecal diversion prevent morbidity after ileocecal resection for Crohn's disease? Retrospective series of 80 cases
Authors: Mege Diane , Bege Thierry , Beyer‐Berjot Laura , Loundou Anderson , Grimaud Jean‐Charles , Brunet Christian , Berdah Stéphane 
Published: March 2015

AbstractBackgroundAfter ileocecal resection for Crohn's disease, a temporary faecal diversion is indicated in high‐risk patients. The impact of a temporary stoma on post‐operative morbidity has been poorly assessed so far. The aim was to analyse post‐operative morbidity of temporary faecal diversion after ileocecal resection for Crohn's disease.MethodsPatients undergoing temporary faecal diversion combined with ileocecal resection were retrospectively included. Patients presenting with complications were compared with patients with an uneventful post‐operative course, to identify any predictive factor for morbidity.ResultsEighty faecal diversions were performed (43 males, 33.5 (18–75) years), including 63 split stoma (79%) and 17 covering loop ileostomies (21%). Fifty‐two patients (65%) presented with a perforating disease. Post‐operative complications occurred in 15 patients (19%), 15 days after surgery (1–30). The main complications were intra‐abdominal abscess (n = 6), functional renal failure (n = 6), fistula (n = 2) and stomal prolapse (n = 2). Two patients required surgery. Previous bowel resections (60% versus 28%, P = 0.01) were significantly associated with post‐operative morbidity.ConclusionsTemporary faecal diversion is useful in high‐risk patients after ileocecal resection for Crohn's disease. Patients' information about post‐operative risks remains an important issue. Risk factors for post‐operative morbidity despite faecal diversion are previous bowel resections.
Extended pelvic lymph node dissection for clinically localized prostate cancer: a West Australian experience
Authors: Picardo Alarick , Vivian Justin 
Published: March 2015

AbstractBackgroundThe role and type of pelvic lymph node dissection for clinically localized prostate cancer is controversial in Australia. Our study aims to determine the incidence of pelvic lymph node involvement and the complication rate of extended lymphadenectomy in a group of West Australian patients who underwent a robotic assisted radical prostatectomy plus extended pelvic lymph node dissection.MethodForty‐nine patients underwent a robotic assisted radical prostatectomy with extended pelvic lymph node dissection between 2008 and 2012 by a single private urological surgeon. The inclusion criteria for the extended lymph node dissection were clinical localized, intermediate and high‐risk prostate cancer based on preoperative D'Amico classification.ResultsOf the 49 patients, eight patients had positive nodes giving a nodal positivity rate of 16.33%. Six patients had a complication giving a total complication rate of 12.24%. Three of these complications have been attributed to the nodal dissection, thus giving an extended pelvic lymph node dissection complication rate of 6.12%.ConclusionRates of nodal involvement in our West Australian cohort are in keeping with those published in the literature. Extended pelvic lymph node dissection can be performed with an acceptable complication rate. Further research is required to investigate the therapeutic role of pelvic lymph node dissection.
Neutrophil–lymphocyte ratio as predictor of mortality and morbidity in cardiovascular surgery: a systematic review
Authors: Tan Tze Ping , Arekapudi Anil , Metha Jigesh , Prasad Arun , Venkatraghavan Lashmi 
Published: March 2015

AbstractBackgroundNeutrophil–lymphocyte ratio (NLR) is an emerging biomarker of inflammation and predicts poorer outcome in cancer surgery. The prognostic value of NLR in cardiovascular surgery is unclear.MethodsSystematic review and meta‐analysis of studies of in cardiovascular surgical patients were conducted to assess the role of perioperative NLR in predicting post‐operative mortality and morbidity. Electronic searches were conducted on Ovid Medline, EMBASE, Cochrane Central Register of Controlled Trials and Cochrane Database of Systemic Reviews for all prospective clinical studies reporting on NLR and post‐operative morbidity and mortality in cardiovascular surgical patient population. Our primary end point was all‐cause post‐operative mortality and the secondary end point was post‐operative morbidity. Mortality outcome from prospective studies were pooled for a meta‐analysis using a random‐effect model.ResultsOf the 999 citations identified, five studies with 3487 patients met the inclusion criteria. In a pooled analysis of three prospective studies of 3108 patients, a preoperative increase in NLR (>3.3 in cardiac surgery, >5 in vascular surgery) was associated with increased mortality at a mean follow‐up of 34.8 months (hazard ratio 1.85, 95% confidence interval 1.46–2.36; P < 0.00001). Raised NLR value was also associated with increased cardiac mortality, amputation in vascular operations and raised risk of post‐operative re‐intubation.ConclusionsElevated NLR were associated with increased long‐term mortality and morbidity after major cardiac and vascular surgery. NLR may guide perioperative management and risk‐stratification of patients.
Endoscopic sphincterotomy with sphincteroplasty for the management of choledocholithiasis: a single‐centre experience
Authors: Ho Simon , Rayzan Daniel , Fox Adrian , Kalogeropoulos George , Mackay Sean , Hassen Sayed , Banting Simon , Cade Richard 
Published: March 2015

AbstractBackgroundBalloon dilatation of the ampulla at endoscopic retrograde cholangiopancreatography (ERCP) is increasingly utilized in the management of large bile duct stones. The aim of this study was to review and compare the outcomes of using endoscopic sphincterotomy with endoscopic balloon dilatation (sphincteroplasty) in a combined approach as a single‐stage (immediate) or a two‐stage procedure (delayed).MethodsA retrospective review of medical records for all patients undergoing ERCP and balloon dilatation for choledocholithiasis between January 2010 and December 2012 was undertaken. Outcomes measured included patient demographics, stone size, degree of dilatation performed, success of stone extraction, number of procedures required for duct clearance and procedure‐related complications.ResultsOne hundred and thirty‐six ERCPs were performed with balloon sphincteroplasty. One hundred and four had a previous sphincterotomy with a delayed balloon dilatation and 32 had sphincterotomy with immediate dilatation. The overall clearance rate of the common bile duct for immediate and delayed groups was 93% (28/30) and 93% (81/87), respectively. Bile duct clearance after the first procedure was achieved in 70% (21/30) of patients in the immediate group and 74% (64/87) in the delayed group. There were six complications in the delayed group and four in the immediate group. The most frequently used balloon size was 10 mm for both groups with mean sizes of 10.34 (2.93) and 11.73 (2.87) in the immediate and delayed groups, respectively.ConclusionOur study suggests that use of a combined approach is safe and effective and may provide benefits over using endoscopic balloon dilatation or endoscopic sphincterotomy alone in the treatment of choledocholithiasis.
Antibiotic prevention of postcataract endophthalmitis: a systematic review and meta‐analysis
Authors: Kessel Line , Flesner Per , Andresen Jens , Erngaard Ditte , Tendal Britta , Hjortdal Jesper 
Published: March 2015

AbstractEndophthalmitis is one of the most feared complications after cataract surgery. The aim of this systematic review was to evaluate the effect of intracameral and topical antibiotics on the prevention of endophthalmitis after cataract surgery. A systematic literature review in the MEDLINE, CINAHL, Cochrane Library and EMBASE databases revealed one randomized trial and 17 observational studies concerning the prophylactic effect of intracameral antibiotic administration on the rate of endophthalmitis after cataract surgery. The effect of topical antibiotics on endophthalmitis rate was reported by one randomized trial and one observational study. The quality and design of the included studies were analysed using the Cochrane risk of bias tool. The quality of the evidence was evaluated using the GRADE approach. We found high‐to‐moderate quality evidence for a marked reduction in the risk of endophthalmitis with the use of intracameral antibiotic administration of cefazolin, cefuroxime and moxifloxacin, whereas no effect was found with the use of topical antibiotics or intracameral vancomycin. Endophthalmitis occurred on average in one of 2855 surgeries when intracameral antibiotics were used compared to one of 485 surgeries when intracameral antibiotics were not used. The relative risk (95% CI) of endophthalmitis was reduced to 0.12 (0.08; 0.18) when intracameral antibiotics were used. The difference was highly significant (p < 0.00001). Intracameral antibiotic therapy is the best choice for preventing endophthalmitis after cataract surgery. We did not find evidence to conclude that topical antibiotic therapy prevents endophthalmitis.
In search for better pharmacological prophylaxis for acute mountain sickness: looking in other directions
Authors: Lu H. , Wang R. , Xiong J. , Xie H. , Kayser B. , Jia Z.P. 
Published: March 2015

AbstractDespite decades of research, the exact pathogenic mechanisms underlying acute mountain sickness (AMS) are still poorly understood. This fact frustrates the search for novel pharmacological prophylaxis for AMS. The prevailing view is that AMS results from an insufficient physiological response to hypoxia and that prophylaxis should aim at stimulating the response. Starting off from the opposite hypothesis that AMS may be caused by an initial excessive response to hypoxia, we suggest that directly or indirectly blunting‐specific parts of the response might provide promising research alternatives. This reasoning is based on the observations that (i) humans, once acclimatized, can climb Mt Everest experiencing arterial partial oxygen pressures (PaO2) as low as 25 mmHg without AMS symptoms; (ii) paradoxically, AMS usually develops at much higher PaO2 levels; and (iii) several biomarkers, suggesting initial activation of specific pathways at such PaO2, are correlated with AMS. Apart from looking for substances that stimulate certain hypoxia triggered effects, such as the ventilatory response to hypoxia, we suggest to also investigate pharmacological means aiming at blunting certain other specific hypoxia‐activated pathways, or stimulating their agonists, in the quest for better pharmacological prophylaxis for AMS.
Diverse functions of perlecan in central nervous system cells in vitro
Authors: Nakamura Ryosuke , Nakamura Fumio , Fukunaga Shigeharu 
Published: March 2015

AbstractTherapeutic treatment targeting one cell type is considered ineffective in remedying any injury to the central nervous system (CNS). Perlecan, a multi‐functional, heparan sulfate proteoglycan, shows diverse effects on distinct cell types, suggesting that it is one of the candidates that can augment the regenerative mechanisms in the injured CNS. Therefore, we examined the functions of perlecan in CNS cells in vitro by using perlecan purified from bovine kidney. Perlecan‐coated cell culture plates, unlike their type I/III collagen‐coated counterparts, did not inhibit the adhesion of neural stem/progenitor cells (NS/PCs) and neurons. The coated perlecan and the perlecan added to the culture medium suppressed astrocyte proliferation; however, perlecan added to the medium promoted NS/PC proliferation. Neurons were promoted to extend their neurites on the perlecan‐coated substrate, and perlecan added to the medium also showed a similar effect. NS/PC proliferation and neurite extension is a major regenerative reaction in CNS injury, whereas excess proliferation of astrocytes cause hypertrophy of glial scars, which repels neurons. Our in vitro study suggests that perlecan is an attractive candidate to promote regenerative mechanisms and to suppress reactions that hamper regenerative processes in cases of CNS injury.
The skin structure of greater rhea (Rheidae, Palaeognathae)
Authors: Picasso Mariana B. J. , Mario Rubén , Barbeito Claudio G. 
Published: March 2015

AbstractThe aim of this study was to describe the histological structure of the skin of greater rhea (Rhea americana), a ratite bird native to South America. Skin samples were taken from three regions of the trunk (alar, dorsal and pelvic) in 14 specimens which ages ranged from 7 days to adulthood. Serial sections were obtained and subjected to different staining procedures (haematoxylin and eosin, orcein, Masson's trichrome and Gomori), and a morphometric analysis was carried out on stained slides. In general, both epidermis and dermis showed increased thickness of its layers with age. Some differences between regions can be detected both in epidermis and in dermis; for example in adults and 7‐day‐old birds, the stratum corneum of the alar region was thicker than of the dorsal region. In general, the skin of greater rhea was similar to that described in ratites and other birds (a thin epidermis compared to dermis, dermis with scarce elastic fibres, a slender and vascularized stratum superficiale, collagen fibres arranged in three directions). The scarcity of elastic fibres and the general cross‐weaved arrangement of the collagen fibres in the dermis of the adult greater rhea provide strength and flexibility to the dermis, two important features in leather industry.
Tyrosine phosphorylation as evidence of epididymal cauda participation in the sperm maturation process of Corynorhinus mexicanus bat
Authors: Rodríguez‐Tobón Ahiezer , Fierro Reyna , León‐Galván Miguel Angel , Rosado Adolfo , Cortés‐Barberena Edith , Arenas‐Ríos Edith 
Published: March 2015

AbstractThe bat Corynorhinus mexicanus provides an interesting experimental model for the study of epididymal sperm maturation because after spermatogenesis and the regression of the testes, this bat stores sperm in the epididymal cauda for several months. Earlier research conducted by our group suggested that sperm maturation in this species must be completed in the caudal region of the epididymis. One of the major signal transduction events during sperm maturation is the tyrosine phosphorylation of sperm proteins. The aim of the present study was to comparatively evaluate tyrosine phosphorylation in spermatozoa obtained from the caput, corpus and cauda of the epididymis during the sperm storage period. The maturation status of the sperm was determined by the percentage of capacitation and tyrosine phosphorylation in sperm obtained from the epididymis. The highest proportion of tyrosine phosphorylation was registered after the sperm had reached the cauda epididymis during the middle of the storage period. In conclusion, in Corynorhinus mexicanus and most likely in other chiropteran species with an asynchronous male reproductive pattern, epididymal sperm maturation ends in the caudal region of the epididymis and is related to the time that the sperm remains in the epididymis before mating activity.
Time‐trends in the prescribing of gastroprotective agents to primary care patients initiating low‐dose aspirin or non‐steroidal anti‐inflammatory drugs: a population‐based cohort study
Authors: Warlé‐van Herwaarden Margaretha F. , Koffeman Aafke R. , Valkhoff Vera E. , ’t Jong Geert W. , Kramers Cornelis , Sturkenboom Miriam C. , De Smet Peter A. G. M. 
Published: March 2015

AimsLow‐dose aspirin (LDA) and non‐steroidal‐anti‐inflammatory drugs (NSAIDs) both increase the risk of upper gastrointestinal events (UGIEs). In the Netherlands, recommendations regarding the prescription of gastroprotective agents (GPAs) in LDA users were first issued in 2009 in the HARM‐Wrestling consensus. National guidelines on gastroprotective strategies (GPSs) in NSAID users were issued in the first part of the preceding. The aim of the present study was to examine time‐trends in GPSs in patients initiating LDA and those initiating NSAIDs between 2000 and 2012.MethodsWithin a large electronic primary healthcare database, two cohorts were selected: (i) patients newly prescribed LDA and (ii) patients newly prescribed NSAIDs between 2000 and 2012. Patients who had been prescribed a GPA in the previous six months were excluded. For both cohorts, patients’ risk of a UGIE was classified as low, moderate or high, based on the HARM‐Wrestling consensus, and the presence of an adequate GPSwas determined.ResultsA total of 37 578 patients were included in the LDA cohort and 352 025 patients in the NSAID cohort. In both cohorts, an increase in GPSs was observed over time, but prescription of GPAs was lower in the LDA cohort. By 2012, an adequate GPS was present in 31.8% of high‐risk LDA initiators, vs. 48.0% of high‐risk NSAID initiators.ConclusionsDespite a comparable risk of UGIEs, GPSs are prescribed less in high‐risk LDA initiators than in high‐risk NSAID initiators. For both groups of patients, there is still room for improvement in guideline adherence.
Effects of food on pharmacokinetics of immediate release oral formulations of aspirin, dipyrone, paracetamol and NSAIDs – a systematic review
Authors: Moore Robert Andrew , Derry Sheena , Wiffen Philip J. , Straube Sebastian 
Published: March 2015

AimsIt is common to advise that analgesics, and especially non‐steroidal anti‐inflammatory drugs (NSAIDs), be taken with food to reduce unwanted gastrointestinal adverse effects. The efficacy of single dose analgesics depends on producing high, early, plasma concentrations; food may interfere with this. This review sought evidence from single dose pharmacokinetic studies on the extent and timing of peak plasma concentrations of analgesic drugs in the fed and fasting states.MethodsA systematic review of comparisons of oral analgesics in fed and fasting states published to October 2014 reporting kinetic parameters of bioavailability, time to maximum plasma concentration (tmax), and its extent (Cmax) was conducted. Delayed‐release formulations were not included.ResultsBioavailability was not different between fasted and fed states. Food typically delayed absorption for all drugs where the fasting tmax was less than 4 h. For the common analgesics (aspirin, diclofenac, ibuprofen, paracetamol) fed tmax was 1.30 to 2.80 times longer than fasted tmax. Cmax was typically reduced, with greater reduction seen with more rapid absorption (fed Cmax only 44–85% of the fasted Cmax for aspirin, diclofenac, ibuprofen and paracetamol).ConclusionThere is evidence that high, early plasma concentrations produces better early pain relief, better overall pain relief, longer lasting pain relief and lower rates of remedication. Taking analgesics with food may make them less effective, resulting in greater population exposure. It may be time to rethink research priorities and advice to professionals, patients and the public.