bluuebunny/crossref_metadata_2025_split huggingface dataset:
Upper urinary tract recurrence after radical cystectomy for bladder cancer: Incidence and risk factors
Authors: Takayanagi Akio , Masumori Naoya , Takahashi Atsushi , Takagi Yoshio , Tsukamoto Taiji 
Published: November 2011

Objectives:  To examine the incidence of and the risk factors for upper urinary tract recurrence in patients undergoing a radical cystectomy for bladder cancer, and to examine the clinical course of patients harboring upper urinary tract recurrence.Methods:  This retrospective study included 362 patients who underwent radical cystectomy for bladder cancer. Patients with a history of upper urinary tract recurrence and concomitant upper urinary tract recurrence at cystectomy were excluded.Results:  After a median follow up of 48 months (range 0–214) after radical cystectomy, 11 patients (3.0%) developed upper urinary tract recurrence. The median time to upper urinary tract recurrence was 48.4 months (range 11.6–78.6). The overall probability of upper urinary tract recurrence was 3.3% at 5 years. The median overall survival period after upper urinary tract recurrence was 23.5 months (range 4.3–53.9), with a better overall survival for patients who received a radical operation than for those who did not (38.6 months vs 11.9 months, respectively; P = 0.03). At multivariable analysis, the presence of carcinoma in situ (P < 0.01) and invasion of the urethra (P = 0.02) were independent risk factors for upper urinary tract recurrence. The 5‐year upper urinary tract recurrence was significantly higher for patients positive for either of these risk factors than for those without risk factors (12.0% vs 0.9%, respectively; P < 0.001).Conclusions:  This study shows that the presence of carcinoma in situ and cancer invading the urethra are risk factors for upper urinary tract recurrence. Close follow up is needed for early detection of upper urinary tract recurrence in patients at higher risk.
Rebuilding Mediterranean fisheries: a new paradigm for ecological sustainability
Authors: Colloca Francesco , Cardinale Massimiliano , Maynou Francesc , Giannoulaki Marianna , Scarcella Giuseppe , Jenko Klavdija , Bellido Josè Maria , Fiorentino Fabio 
Published: November 2011

AbstractIn Mediterranean European countries, 85% of the assessed stocks are currently overfished compared to a maximum sustainable yield reference value (MSY) while populations of many commercial species are characterized by truncated size‐ and age‐structures. Rebuilding the size‐ and age‐structure of exploited populations is a management objective that combines single species targets such as MSY with specific goals of the ecosystem approach to fisheries management (EAF), preserving community size‐structure and the ecological role of different species. Here, we show that under the current fishing regime, stock productivity and fleet profitability are generally impaired by a combination of high fishing mortality and inadequate selectivity patterns. For most of the stocks analysed, a simple reduction in the current fishing mortality (Fcur) towards an MSY reference value (FMSY), without any change in the fishing selectivity, will allow neither stock biomass nor fisheries yield and revenue to be maximized. On the contrary, management targets can be achieved only through a radical change in fisheries selectivity. Shifting the size of first capture towards the size at which fish cohorts achieve their maximum biomass, the so‐called optimal length, would produce on average between two and three times higher economic yields and much higher biomass at sea for the exploited stocks. Moreover, it would contribute to restore marine ecosystem structure and resilience to enhance ecosystem services such as reservoirs of biodiversity and functioning food webs.
Digital or didactic: Using learning technology to confront the challenge of large cohort teaching
Authors: Saunders Fiona C. , Gale Andrew W. 
Published: November 2011

AbstractThis paper investigates whether the selective use of technology can begin to overcome the challenge of large cohort teaching and deliver an enhanced student learning experience. It describes the initial development and evaluation of a campus‐based management course taught to 270 third year engineering undergraduates at The University of Manchester. The course is structured around weekly keynote lectures, supplemented with extensive use of a virtual learning environment (VLE) and key Web 2.0 applications.The preliminary findings are that technology is not a panacea: face‐to‐face contact with teaching staff remains the priority for most students. Nevertheless, the VLE was found to improve the student learning experience provided that
Use of technology does not reduce face‐to‐face teaching time;
Teaching faculty acknowledges that students are, for the most part, highly strategic learners, engaging deeper with those technology tools that help them achieve their desired course outcomes;
Close attention is paid to learning design, aligning technology tools with the desired learning outcomes.
Further work is now required to explore more effectively the use of the VLE and Web 2.0 as a vehicle for promoting collaborative learning. In addition, the authors will be redesigning course activities, both assessed and unassessed, to start to address the more lofty ambition of moving students from an acquisitive to a participative model of learning.Practitioner NotesWhat is already known about this topic
There is an ongoing debate about the effectiveness of learning technology in enhancing the student learning experience.
There are a number of published case studies describing and evaluating the effectiveness of VLEs in enhancing student learning across a range of disciplines, the majority of which involve small‐ to medium‐sized cohorts.
Learning technology can be used to achieve more constructivist pedagogical principles.
What this paper adds
A well‐conducted case study of the use of learning technology to enhance large cohort teaching.
A critical review of the literature on the use of learning technology to enhance student learning.
An empirical contribution to the debate on whether learning technology can enhance the student learning experience.
Implications for practice and/or policy
Technology is not a panacea to enable higher education institutions to do more with less.
Technology can enhance the student learning experience provided that it does not reduce face‐to‐face teaching time.
In utilising learning technology, close attention should be paid to learning design, aligning technology tools with the desired learning outcomes.
Survival of drug resistant tuberculosis patients in Lithuania: retrospective national cohort study
Authors: Balabanova Yanina , Radiulyte Birute , Davidaviciene Edita , Hooper Richard , Ignatyeva Olga , Nikolayevskyy Vladyslav , Drobniewski Francis A 
Published: November 2011

ObjectiveTo establish risk factors influencing survival of patients with multidrug-resistant and extensively drug-resistant tuberculosis (MDR/XDRTB).DesignAll MDR/XDRTB cases (n=1809) reported from 2002 to 2008 in Lithuania with a known outcome were included in the survival analysis.ResultsMedian survival for MDRTB and XDRTB patients was 4.1 (95% CI 3.7 to 4.4) and 2.9 (95% CI 2.2 to 3.9) years. In a multivariable analysis adjusting for other patient characteristics, the difference in survival between MDRTB and XDRTB patients was not significant (HR=1.29 (0.91 to 1.81)). Older age (HR=4.80 (3.16 to 7.29)) for 60+ vs <30 years, rural living (HR=1.20 (1.02 to 1.40)), alcohol use (HR=1.49 (1.13 to 1.96)) for alcoholic versus moderate use, unemployment (HR=1.79 (1.31 to 2.46)), lower education levels (HR=1.50 (1.08 to 2.07)) for primary level versus tertiary level, cavitary disease (HR=1.54 (1.29 to 1.83)) and being smear positive at the time of MDR/XDRTB diagnosis (HR=1.47 (1.19 to 1.82)) were associated with poorer survival. HIV positivity significantly affected survival (HR=3.44 (1.92 to 6.19)) for HIV positive versus HIV negative; HR=1.60 (1.28 to 2.01) for HIV not tested versus HIV negative). There was no difference in survival of patients who acquired MDR/XDRTB during treatment compared with patients with primary MDR/XDRTB (HR=1.01 (0.85 to 1.19)). Treatment with a second-line drug improved survival (HR=0.40 (0.34 to 0.47)). In a subgroup with genotyped TB strains, a Beijing family of strains was associated with poorer survival (HR=1.71 (1.19 to 2.47)).ConclusionsSocial factors, rural living, HIV infection and Beijing strain family impact on survival. Survival of MDR/XDRTB patients is short. Rapid drug resistance identification, early administration of appropriate treatment and achieving high cure rates, expansion of HIV testing and antiretroviral treatment are necessary for optimal management of MDR/XDRTB.
Electrochemical Instability in Liquid–Liquid Two-Phase Systems
Authors: Kitazumi Yuki , Kakiuchi Takashi 
Published: November 2011

Abstract
On the basis of the dependency of adsorption and partitioning of ionic surfactant on the phase-boundary potential (Δ OWφ ), it is possible to understand in a unified manner various instability phenomena at the liquid|liquid interface in the presence of ionic surfactants, such as spontaneous emulsification, oscillation of Δ OWφ and interfacial tension, and irregularly increased currents on voltammograms of the transfer of surface-active ions across the interface. These instabilities are associated with the electrochemical instability, which defines a thermodynamically unstable condition at the liquid|liquid interface in terms of Δ OWφ and is a fundamental concept to understand the instabilities in the presence of ionic surfactants. The characteristic manifestations of the electrochemical instability, that is, the irregularly increased current on voltammograms in the transfer of surface-active ions, the spontaneous emulsification, and the spontaneous oscillation of Δ OWφ can be designed based on the criterion of the electrochemical instability.
Varicella in Infants After Implementation of the US Varicella Vaccination Program
Authors: Chaves Sandra S. , Lopez Adriana S. , Watson Tureka L. , Civen Rachel , Watson Barbara , Mascola Laurene , Seward Jane F. 
Published: November 2011

OBJECTIVE:To describe varicella disease in infants since implementation of the varicella vaccination program in the United States.PATIENTS AND METHODS:From 1995 to 2008, demographic, clinical, and epidemiologic data on cases of varicella in infants were collected prospectively through a community-based active surveillance project. We examined disease patterns for infants in 2 age groups: 0 to 5 and 6 to 11 months.RESULTS:Infant varicella disease incidence declined 89.7% from 1995 to 2008. Infants aged 0 to 5 months had milder clinical disease than those aged 6 to 11 months: ≥50 lesions, 49% vs 58% (P = .038); fever (body temperature &gt; 38°C), 12% vs 21% (P = .014); and varicella-related complications, 6% vs 14% (P = .009), respectively. Age was an independent predictor of the occurrence of complications.CONCLUSIONS:The varicella vaccination program has resulted in substantial indirect benefits for infants, who are not eligible for vaccination. Presence of maternal varicella-zoster virus antibodies might explain attenuated disease in very young infants likely born to mothers with history of varicella. Although varicella disease incidence has declined, exposure to varicella-zoster virus continues to occur. Improving varicella vaccination coverage in all age groups will further reduce the risk of varicella exposure and protect those not eligible for varicella vaccination.
Implementing Medication Reconciliation in Outpatient Pediatrics
Authors: Rappaport David I. , Collins Brian , Koster Alex , Mercado Arnel , Greenspan Jay , Lawless Steven , Hossain Jobayer , Sharif Iman 
Published: November 2011

OBJECTIVE:
To describe the implementation of a system-wide, electronic medical record (EMR)-based quality improvement intervention targeting medication reconciliation (MedRec) in outpatient pediatrics and to test variables associated with the performance of MedRec.

METHODS:
This was a retrospective study using serial cross-sections of outpatient pediatric visits over a 5-year period set in a multispecialty children's integrated health care network in Florida, Delaware, Pennsylvania, and New Jersey. We reviewed 2 745 523 outpatient pediatric visits between 2005 and 2010. In 2007, the performance of MedRec was identified as critical to improving patient safety at our organization. A comprehensive intervention involved changes in the EMR, automated generation of medication lists, educational modules, and provider compliance reports. In 2009, quality-based financial incentives to physicians to perform MedRec were added. The outcome measure was documentation of MedRec performance.

RESULTS:
MedRec improved consistently over time, from a nadir of 0% in 2005 to a maximum of 71% in 2010. Performance of MedRec varied according to practice location as the intervention was rolled out. Throughout the study period, documentation of MedRec was consistently less likely for sick visits (adjusted odds ratio [aOR] for each year ranged from 0.44 to 0.68) but more likely if the provider placed a medication order during the visit (aOR: 1.70–2.15). Beginning in 2009, visits with providers eligible for the quality-based financial incentive were more likely to have had MedRec performed (aOR: 2.02 [2009] and 2.31 [2010]).

CONCLUSIONS:
A system-wide, EMR-based, outpatient pediatric quality improvement intervention was successful in improving documentation of the performance of MedRec, a national patient safety goal.
Experimental Study of the Effect of Strong Alkali on Lowering the Interfacial Tension of Oil/Heavy Alkylbenzene Sulfonates System
Authors: Liu Bixin , Hou Jirui , Tang Hongjiao , Xu Haixia , Zheng Zigang 
Published: November 2011

AbstractExperimental studies were conducted to explore the fundamental mechanisms of alkali to lower the interfacial tension of oil/heavy alkylbenzene sulfonates (HABS) system. Sodium hydroxide was used as the strong alkali chemical to investigate the interfacial tension (IFT) of oil/HABS system. The influences of salt and alkali on the interfacial activity were studied by the measurement of interfacial tension and partition coefficient. Moreover, the alkali/surfactant solutions were measured by dynamic laser scattering. The results showed that compared with the salt, the function of alkali to lower the interfacial tension and improve partition coefficient is more significant. The micelles formed by surfactants could be disaggregated because of adding alkali, so the size of micelles decreases and the number of mono‐surfactants increases, then more surfactant molecules move to the interface of oil/surfactant system and the adsorption of surfactants at oil‐water interfaces increases, which can lead to the decrease of IFT.
Selective Synthesis of 2‐Aryl‐1‐benzylated‐1H‐benzimidazoles
Authors: Shaterian Hamid Reza , Fahimi Nafiseh , Azizi Kobra 
Published: November 2011

AbstractAn efficient and simple procedure was developed for the green synthesis of various 2‐aryl‐1‐ben‐zylated‐1H‐benzimidazoles in high yields by condensation of o‐phenylenediamine with aldehydes with P2O5/SiO2 as catalyst under solvent‐free and ambient conditions.
Management of Children With Sickle Cell Disease: A Comprehensive Review of the Literature
Authors: Kavanagh Patricia L. , Sprinz Philippa G. , Vinci Samuel R. , Bauchner Howard , Wang C. Jason 
Published: November 2011

OBJECTIVE:Sickle cell disease (SCD) affects 70 000 to 100 000 people in the United States, and 2000 infants are born with the disease each year. The purpose of this study was to review the quality of the literature for preventive interventions and treatment of complications for children with SCD to facilitate the use of evidence-based medicine in clinical practice and identify areas in need of additional research.METHODS:We searched the Ovid Medline database and the Cochrane Library for articles published between January 1995 and April 2010 for English-language abstracts on 28 topics thought to be important for the care of children with SCD. We also added pertinent references cited by studies identified in our search. Each abstract was reviewed independently by 2 authors. Data from articles retrieved for full review were abstracted by using a common form.RESULTS:There were 3188 abstracts screened, and 321 articles underwent full review. Twenty-six articles (&lt;1% of abstracts initially screened), which consisted of 25 randomized controlled trials and 1 meta-analysis, were rated as having level I evidence. Eighteen of the 28 topics selected for this review did not have level I evidence studies published. The management and prevention of pain episodes accounted for more than one-third of the level I studies.CONCLUSIONS:Although significant strides have been made in the care of children with SCD in the past 2 decades, more research needs to be performed, especially for acute events associated with SCD, to ensure that the health and well-being of children with SCD continues to improve.
Associations of Gestational Diabetes, Existing Diabetes, and Glycosuria With Offspring Obesity and Cardiometabolic Outcomes
Authors: Patel Sumaiya , Fraser Abigail , Davey Smith George , Lindsay Robert S. , Sattar Naveed , Nelson Scott M. , Lawlor Debbie A. 
Published: November 2011

OBJECTIVE
To assess associations of gestational diabetes, existing diabetes, and glycosuria with adiposity and cardiometabolic risk factors in offspring at adolescence.

RESEARCH DESIGN AND METHODS
Multivariable regression analyses were conducted in a prospective pregnancy cohort (n = 2,563–4,198 for different outcomes). Obstetric data were abstracted from clinical records. Offspring outcomes were assessed at mean age 15.5 years. Compared with those lost to follow-up, participants included in the analysis were of higher socioeconomic position. Outcomes included BMI, waist circumference, fat mass determined by dual-energy X-ray absorptiometry scan, systolic and diastolic blood pressure (sBP and dBP, respectively), fasting glucose, insulin, lipids, and C-reactive protein (CRP).

RESULTS
Maternal existing diabetes, gestational diabetes, and glycosuria were associated with higher offspring BMI and fat mass (z scores); however, this effect was attenuated in the confounder-adjusted model, and the CIs included the null value. Existing diabetes and gestational diabetes were associated with higher offspring fasting glucose levels (0.24 mmol/L [95% CI 0.03–0.45] and 0.20 mmol/L [0.02–0.39], respectively). Glycosuria was associated with higher fasting insulin (adjusted ratio of geometric means 1.12 [1.01–1.25]), but there were no clear associations of existing or gestational diabetes with offspring fasting insulin. There was little evidence of an association of maternal diabetes or glycosuria with offspring dBP, sBP, lipids, or CRP.

CONCLUSIONS
Maternal pregnancy glycosuria, gestational diabetes, and existing diabetes show some associations with higher offspring fasting glucose and insulin assessed in adolescence but are not clearly associated with a wider range of cardiometabolic risk factors.
Immunogenicity and Safety of MMRV and PCV-7 Administered Concomitantly in Healthy Children
Authors: Leonardi Michael , Bromberg Kenneth , Baxter Roger , Gardner Julie L. , Klopfer Stephanie , Nicholson Ouzama , Brockley Michael , Trammel James , Leamy Vicky , Williams Wendy , Kuter Barbara , Schödel Florian 
Published: November 2011

OBJECTIVE:
We assessed the immunogenicity and safety of a combination measles, mump, rubella, and varicella vaccine (MMRV) (ProQuad [Merck & Co, Inc, West Point, PA]) administered to healthy children concomitantly with a pneumococcal 7-valent conjugate vaccine (PCV-7) (Prevnar [Pfizer, Philadelphia, PA]).

PATIENTS AND METHODS:
Healthy 12- to 15-month-old children who lacked vaccination and clinical histories for measles, mumps, rubella, varicella, and zoster but had written documentation of receipt of a 3-dose primary series of PCV-7 were randomly assigned in a 2:1:1 ratio to receive either the MMRV and PCV-7 (group 1), PCV-7 followed 6 weeks later by MMRV (group 2), or MMRV followed 6 weeks later by PCV-7 (group 3). The primary safety analysis was 56 days (28 days after each visit). Immunogenicity was evaluated 6 weeks after each vaccination.

RESULTS:
A total of 1027 children were enrolled (group 1: 510; group 2: 258; group 3: 259). For all 3 groups, the antibody response rate was ≥96.8% for measles, mumps, and rubella, ≥88.0% for varicella-zoster virus, and ≥98.3% for all of the 7 Streptococcus pneumoniae serotypes. The immune responses to all antigens present in MMRV and PCV-7 were similar whether administered concomitantly or sequentially. The incidence of local and systemic adverse experiences (AEs) was comparable between group 1 and groups 2 and 3 combined. No vaccine-related serious AEs were reported.

CONCLUSIONS:
Concomitant administration of the MMRV and PCV-7 is highly immunogenic and generally well tolerated. Similar immune responses between the groups support concomitant administration of the MMRV and PCV-7 to healthy children 12 to 15 months of age.
Ethanol consumption increases the expression of endothelial nitric oxide synthase, inducible nitric oxide synthase and metalloproteinases in the rat kidney
Authors: Tirapelli Luis F , Martins-Oliveira Alisson , Batalhão Marcelo E , Tirapelli Daniela P , Carnio Evelin C , Tanus-Santos José E , Queiroz Regina H , Padovan Claudia M , Tirapelli Carlos R 
Published: November 2011

Abstract

Objectives
The effects of longterm ethanol consumption on the levels of nitric oxide (NO) and the expression of endothelial NO synthase (eNOS), inducible NO synthase (iNOS) and metalloproteinase-2 (MMP-2) were studied in rat kidney.

Methods
Male Wistar rats were treated with 20% ethanol (v/v) for 6 weeks. Nitrite and nitrate generation was measured by chemiluminescence. Protein and mRNA levels of eNOS and iNOS were assessed by immunohistochemistry and quantitative real-time polymerase chain reaction, respectively. MMP-2 activity was determined by gelatin zymography. Histopathological changes in kidneys and indices of renal function (creatinine and urea) and tissue injury (mitochondrial respiration) were also investigated.

Results
Chronic ethanol consumption did not alter malondialdehyde levels in the kidney. Ethanol consumption induced a significant increase in renal nitrite and nitrate levels. Treatment with ethanol increased mRNA expression of both eNOS and iNOS. Immunohistochemical assays showed increased immunostaining for eNOS and iNOS after treatment with ethanol. Kidneys from ethanol-treated rats showed increased activity of MMP-2. Histopathological investigation of kidneys from ethanol-treated animals revealed tubular necrosis. Indices of renal function and tissue injury were not altered in ethanol-treated rats.

Conclusions
Ethanol consumption increased renal metalloproteinase expression/activity, which was accompanied by histopathological changes in the kidney and elevated NO generation. Since iNOS-derived NO and MMPs contribute to progressive renal injury, the increased levels of NO and MMPs observed in ethanol-treated rats might contribute to progressive renal damage.