bluuebunny/crossref_metadata_2025_split huggingface dataset:
Distress among rural residents: Does employment and occupation make a difference?
Authors: Fragar Lyn , Stain Helen J. , Perkins David , Kelly Brian , Fuller Jeffrey , Coleman Clare , Lewin Terry J. , Wilson Jacqueline M. 
Published: January 2010

AbstractObjective:  This study investigates the relationship between levels of mental health and well‐being (in terms of self‐reported levels of distress) with employment and occupational status of rural residents, to better inform the provision of mental health services to those in greatest need in rural communities. Method:  A stratified random sample of community residents in rural and remote New South Wales with over‐sampling of remote areas as first stage of a cohort study. Psychological distress was measured using Kessler‐10, inclusive of additional items addressing functional impairment (days out of role). Occupational data were classified using Australian and New Zealand Standard Classification of Occupations categories. Results:  A total of 2639 adults participated in this baseline phase. Among them, 57% were in paid employment, 30% had retired from the workforce, 6% were permanently unable to work and 2% were unemployed. The highest levels of distress and functional impairment were reported in those permanently unable to work and the unemployed group with rates of ‘caseness’ (likely mental health disorder) varying from 57% to 69%, compared with 34% of farmers and farm managers and 29% of health workers (P < 0.01).Conclusion:  The rural unemployed suffer considerable psychological distress and ‘disability’, yet they are not the target of specific mental health promotion and prevention programs, which are often occasioned by rural adversity, such as drought, and delivered through work‐based pathways. Policy‐makers and health service providers need to consider the needs of the rural unemployed and those permanently unable to work and how they might be addressed.
The role of docetaxel based therapy for prostate cancer in the era of targeted medicine
Authors: Sonpavde Guru , Sternberg Cora N 
Published: January 2010

AbstractDocetaxel based chemotherapy has been shown to modestly extend life, relieve pain and improve the quality of life in patients with metastatic castration‐resistant prostate cancer. Current trials are attempting to build on the backbone of docetaxel by combining it with novel biological agents. Trials are also investigating the role of docetaxel for earlier stages of prostate cancer. No standard second‐line systemic therapy exists and such patients are candidates for clinical trials. The increased understanding of the mechanisms of progressive castration‐resistant prostate cancer is being translated into an increasing pipeline of novel therapies.
Evaluation of local fatigue strength in spot weld by small specimen
Authors: NAKAYAMA E. , FUKUMOTO M. , MIYAHARA M. , OKAMURA K. , FUJIMOTO H. , FUKUI K. , KITAMURA T. 
Published: January 2010

ABSTRACTIt has been reported that high strength steel sheet cannot improve fatigue strength of components with a spot weld. The purpose of this study is to discuss the dominant factors on the fatigue strength of spot weld in order to clarify the reasons. A new fatigue testing technique is developed for a small specimen with a total length of less than 3 mm, and the local fatigue strength of heat‐affected zone (HAZ), which is the crack initiation site in the joint, in a mild steel sheet (270MPa‐grade) and a high strength steel sheet (590MPa‐grade) are evaluated by this technique. The fatigue strength of HAZ is almost equal in both steels although the tensile strength of the 590MPa steel is higher than that of the mild steel. The stress in the tensile‐shear spot‐welded joint under cyclic loading and the residual stress by the spot‐welding are evaluated by finite element analyses. The residual stress is tensile in both steels. However, the plastic deformation takes place in the joint of the mild steel and this releases the residual stress. On the other hand, the stress in the 590MPa steel is elastic and the residual stress decreases the allowable alternating stress. The stress under the condition of the experimental fatigue limit of the joint considering the residual stress coincides well with the fatigue limit diagram of HAZ, which means that the fatigue limit of the joint is determined by the fatigue limit of HAZ and the residual stress.
TIVA, TCI, and pediatrics: where are we and where are we going?
Authors: LERMAN JERROLD 
Published: January 2010

SummaryThe current role of TIVA in children is limited because of hardware limitations, and pharmacokinetic and monitoring issues. Nonetheless, the role of TIVA in children has been increasing in the past decade, in part because of surgical and medical indications. If TIVA is to become more widely used, it must be easy and simple to set up, without serious drawbacks and without added risks. Currently, many drugs destined for use with TIVA in children are off‐label, and their pharmacology is poorly understood. Such off‐label designations must be resolved if TIVA is to become more widely used. At the same time, many institutions have a limited number of infusion pumps, which creates a serious bottleneck and restriction on the use of TIVA.. If a true TIVA technique is used, i.v. access must be established before induction of anesthesia, which will require a means to establish i.v. access painlessly, e.g., using a topical local anesthetic. This is not a common practice in a number of jurisdictions but must be introduced if TIVA is to expand in its scope in children. Currently, I believe that we deliver a ‘partial’ TIVA technique in which TIVA occasionally follows an inhalational induction but in the future when the current obstacles have been resolved, I believe that we will be able practice a true TIVA technique ubiquitously in children.
Lymph node dissection during robotic‐assisted laparoscopic prostatectomy: comparison of lymph node yield and clinical outcomes when including common iliac nodes with standard template dissection
Authors: Katz Darren J. , Yee David S. , Godoy Guilherme , Nogueira Lucas , Chong Kian Tai , Coleman Jonathan A. 
Published: January 2010

Study Type – Therapy (case series) Level of Evidence 4OBJECTIVETo compare the perioperative outcomes of standard pelvic to full‐template lymph node (LN) dissection (LND) during robotic‐assisted laparoscopic prostatectomy (RALP).PATIENTS AND METHODSThe study included 94 patients undergoing RALP with LND between January 2007 and August 2008, by one surgeon. In February 2008 the LND template was modified to include common iliac and medial hypogastric LNs. Clinical and pathological patient characteristics were analysed, including total number of retrieved and positive LNs in each area of dissection, operative duration and complications.RESULTSOf the 94 patients, 62 underwent standard LND (group 1) and 32 underwent full‐template pelvic LND (group 2). The median (mean) number of LNs retrieved in groups 1 and 2 were 12 (13.3) and 17.5 (21.4), respectively. Of the five patients with positive LNs (5%), four were in group 2 (13%); two of these patients had positive LNs in the common iliac dissection, and for one of these patients it was the sole site of involvement. Deep venous thrombosis, pulmonary embolism or transient neuropraxia occurred in six patients (five in group 1 and one in group 2). The median additional operative time for resection of common and internal LNs was 25 min.CONCLUSIONSLN yield increased and additional sites of LN metastases were identified during full‐template pelvic LND during RALP. This modification was not associated with an increased rate of complications. Derived benefits of including additional nodal dissection and the effect on staging accuracy remain to be determined.
Long‐term oncological outcome after post‐chemotherapy retroperitoneal lymph node dissection in men with metastatic nonseminomatous germ cell tumour
Authors: Fléchon Aude , Tavernier Emmanuelle , Boyle Helen , Meeus Pierre , Rivoire Michel , Droz Jean‐Pierre 
Published: January 2010

Study Type – Prognosis (case series) Level of Evidence 4OBJECTIVETo determine whether conformity to standard recommendations of retroperitoneal lymph node dissection (RPLND) after chemotherapy for testicular and primary retroperitoneal nonseminomatous germ cell tumours (NSGCT) and completeness of surgical excision have an effect on oncological outcome.PATIENTS AND METHODSThis was a retrospective study of patients with testicular and primary retroperitoneal NSGCT, with initial involvement of RPLNs, treated between June 1992 and December 2002 in one institution. We reviewed the clinical, surgical and histological charts of 151 such patients who had a RPLND after first‐line platinum‐based chemotherapy. The recommendations used to define conformity to RPLND standards were: the indication based on initial and residual lymph node size, shrinkage, extension of dissection and completeness of resection.RESULTSRPLND conformed to standard recommendations in 70 of the 151 (46%) patients. Conformity was complete for the surgeon who operated on 48 patients and was 26% of the others. Fifteen patients (10%) relapsed in the retroperitoneum, 14 of whom had initial lymph nodes of ≥5 cm. Two patients (3%) relapsed in the group of 70 patients with conformed and complete RPLND, vs 13 (16%) in the 81 with conformed but incomplete resection or with non‐conformed and complete or incomplete RPLND. After a median (range) follow‐up of 77 (1.3–186.5) months 132 patients were alive with no evidence of disease, 18 died and one was alive with progressive disease. The limitations of this study were the relatively few patients and that it was retrospective.CONCLUSIONThere was conformity of RLNPD to the recommendations, and completeness of resection, in half of the patients operated; this might have an effect on oncological outcome. Our data suggest that patients should be treated in tertiary centres.
Levels of evidence ratings in the urological literature: an assessment of interobserver agreement
Authors: Turpen Ryan M. , Fesperman Susan F. , Sultan Shahnaz , Borawski Kristy M. , Norris Regina D. , Klink Joseph , Sur Roger L. , Breau Rodney H. , Krupski Tracey L. , Dahm Philipp 
Published: January 2010

OBJECTIVETo determine to what extent urologists with no specific training agree upon level of evidence (LoE) ratings of studies published in the urological literature, as LoE are commonly referenced as a measure of evidence quality.MATERIALS AND METHODSIn all, 86 clinical research studies published in four major urology journals were reviewed. Each article was independently reviewed by eight reviewers using a standardized data abstraction form. Articles were assessed for type of study (therapy, prognosis, diagnosis or economic) and LoE (I, II, III or IV). Reviewers received only written instructions and no formal training in the application of this classification system.RESULTSOf the 86 articles, 69% related to therapy, 16% to prognosis, and 15% to diagnosis. Eight studies (9%) provided Level I evidence, 18 studies (21%) Level II, 14 studies (16%) Level III and 46 studies (54%) Level IV evidence. The intraclass correlation coefficient (95% confidence interval) based on all reviewers (eight reviewers) was 0.67 (0.59–0.74; P= 0.001) for the type of study and 0.55 (0.48–0.64; P= 0.001) for the LoE. In an analysis limited to a subset of studies in which all reviewers agreed upon the type of study question (n= 40) the intraclass correlation coefficient was 0.79 (0.70–0.86; P= 0.001).CONCLUSIONIn the present study there was a low interobserver agreement for LoE ratings by urologists with no specific training. These findings suggest caution in the interpretation of LoE ratings and emphasize the importance of specific training for individuals that are charged with quality of evidence determinations.
Organ‐preserving neodymium‐yttrium‐aluminium‐garnet laser therapy for penile carcinoma: a long‐term follow‐up
Authors: Schlenker Boris , Tilki Derya , Seitz Michael , Bader Markus J. , Reich Oliver , Schneede Peter , Hungerhuber Edwin , Stief Christian G. , Gratzke Christian 
Published: January 2010

Study Type – Therapy (case series) Level of Evidence 4OBJECTIVETo retrospectively analyse the long‐term follow‐up of 54 patients treated with organ‐preserving laser therapy for penile carcinoma, as such therapy provides excellent cosmetic and functional results, but recurrence rates are high, which might impair the oncological outcome and worsen tumour‐related survival.PATIENTS AND METHODSBetween 1979 and 2008, 54 patients with penile carcinoma were treated with the neodymium‐doped yttrium‐aluminium‐garnet (Nd:YAG) laser at our institution; 11 were classified as having carcinoma in situ (Tis), 39 as T1 and four as T2.RESULTSThere was local recurrence in 16 patients (42%); the mean (range) time to local recurrence was 53 (9–132) months. In half the patients the time to local recurrence was >53 months, with the latest recurrence at 132 months after initial therapy of primary tumour. There was no statistically significant difference in recurrence rates with Tis or invasive penile carcinoma. In lymph‐node‐negative patients at initial presentation, there were no newly developed positive lymph nodes during the follow‐up.CONCLUSIONSOrgan‐preserving laser therapy showed a relatively high recurrence rate in patients with a long‐term follow up, but the oncological outcome and survival were not compromised by local recurrence. Therefore, laser therapy appears to be appropriate for treating premalignant lesions and early stages of penile carcinoma. Patients should be informed about the potential for late recurrence.
Human epidermal growth factor receptor 2 expression status provides independent prognostic information in patients with urothelial carcinoma of the urinary bladder
Authors: Bolenz Christian , Shariat Shahrokh F. , Karakiewicz Pierre I. , Ashfaq Raheela , Ho Richard , Sagalowsky Arthur I. , Lotan Yair 
Published: January 2010

OBJECTIVETo test whether the expression of human epidermal growth factor receptor 2 (HER‐2) is of prognostic value in a contemporary cohort of patients with urothelial carcinoma of the urinary bladder (UCB).PATIENTS AND METHODSTissue microarrays of 198 patients were constructed and immunohistochemical stainings were performed on the primary tumours and on lymphatic nodal metastases. All patients were treated with radical cystectomy (RC) and regional lymphadenectomy for UCB. HER‐2 expression was assessed using continuous HER‐2 expression scores (ranging from 0.1 to 3.9) generated using an automated cellular imaging system. Scores of ≥1.0 in at least 10% of tumour cells were regarded as HER‐2 positive. We correlated HER‐2 scores with pathological and clinical variables, including disease recurrence and cancer‐specific mortality.RESULTSOf 198 patients undergoing RC with lymphadenectomy, there was HER‐2 positivity in 55 primary tumours (27.8%) compared with 44.2% of the evaluable positive lymph nodes (P < 0.001). HER‐2 positivity was significantly associated with the presence of lymphovascular invasion (LVI; P= 0.026). With a median (range) follow‐up of 35.4 (1.3–176.1) months, 101 patients (51.0%) had UCB recurrence and 82 patients (41.4%) died from the disease. In multivariable analyses that adjusted for the effects of pathological tumour stage, grade, LVI, lymph node metastasis and adjuvant chemotherapy, HER‐2 positive patients were at increased risk for both UCB recurrence (hazard ratio [HR] 1.955, P= 0.003) and UCB‐specific mortality (HR 2.066, P= 0.004) compared with patients with negative HER‐2 expression.CONCLUSIONA positive HER‐2 status is associated with aggressive UCB and provides independent prognostic information for UCB recurrence and mortality. Assessment of HER‐2 status can be used to identify patients at high risk of disease progression who may benefit from adjuvant HER‐2‐targeted mono‐ or combined therapy after RC.
[18F]‐fluorocholine positron‐emission/computed tomography for lymph node staging of patients with prostate cancer: preliminary results of a prospective study
Authors: Poulsen Mads H. , Bouchelouche Kirsten , Gerke Oke , Petersen Henrik , Svolgaard Birgitte , Marcussen Niels , Svolgaard Niels , Ögren Mattias , Vach Werner , Høilund‐Carlsen Poul F. , Geertsen Ulla , Walter Steen 
Published: January 2010

Study Type – Diagnostic (case series) Level of Evidence 4OBJECTIVESTo evaluate prospectively [18F]‐fluorocholine positron‐emission/computed tomography (FCH PET/CT) for lymph node staging of prostate cancer before intended curative therapy, and to determine whether imaging 15 or 60 min after radiotracer injection is preferable.PATIENTS AND METHODSIn all, 25 consecutive patients with newly diagnosed prostate cancer (Gleason score >6, and/or a prostate‐specific antigen level of >10 ng/mL, and/or T3 cancer) were scanned before lymphadenectomy. Each patient was assessed twice with imaging, at 15 and 60 min after the injection with FCH. Images were compared with the results of histopathological examination of the surgically removed lymph nodes. Maximum standardized uptake values (SUVmax) at 15 and 60 min were also compared.RESULTSHistopathologically, metastases were present in removed lymph nodes from three patients. FCH PET/CT showed a high radiotracer uptake in four patients, the former three and a fourth. The sensitivity, specificity, positive and negative predictive value of FCH PET/CT for patient based lymph node staging of prostate cancer were 100%, 95%, 75% and 100%, respectively; the corresponding 95% confidence intervals were 29.2–100%, 77.2–99.9%, 19.4–99.4% and 83.9–100%, respectively. Values of SUVmax at early and late imaging were not significantly different.CONCLUSIONSThis small series supports the use of FCH PET/CT as a tool for lymph node staging of patients with prostate cancer. Values of SUVmax at early and late imaging did not differ. However, larger prospective studies are needed to validate these findings.
Targeting expression of a fungal ferulic acid esterase to the apoplast, endoplasmic reticulum or golgi can disrupt feruloylation of the growing cell wall and increase the biodegradability of tall fescue (Festuca arundinacea)
Authors: Buanafina Marcia M. de O. , Langdon Tim , Hauck Barbara , Dalton Sue , Timms‐Taravella Emma , Morris Phillip 
Published: January 2010

SummaryIn the cell walls of grasses, ferulic acid is esterified to arabinoxylans and undergoes oxidative reactions to form ferulates dimers, trimers and oligomers. Feruloylation of arabinoxylan is considered important not only because it leads to cross‐linked xylans but also because ferulates may act as a nucleating site for the formation of lignin and hence link arabinoxylans to lignin by forming a lignin–ferulate–arabinoxylan complex. Such cross‐linking is among the main factors inhibiting the release of fermentable carbohydrates from grasses either for ruminant nutrition or for biofuel production. We have found that significant reductions in the levels of monomeric and dimeric phenolics can be achieved in the growing cell walls during plant development in leaves of Festuca arundinacea by constitutive intracellular targeted expression of Aspergillus niger ferulic acid esterase (FAEA). We propose that this occurred by directly disrupting ester bonds linking phenolics to cell wall polysaccharides by apoplast targeting or by preventing excessive feruloylation of cell wall carbohydrates prior to their incorporation into the cell wall, by targeting to the Golgi membrane system. Plants with lower cell wall ferulate levels, which showed increased digestibility and increased rates of cellulase‐mediated release of fermentable sugars, were identified. Targeting FAE to the Golgi was found to be more effective than targeting to the ER, which supports the current theories of the Golgi as the site of feruloylation of arabinoxylans. It is concluded that targeting FAEA expression to the Golgi or apoplast is likely to be an effective strategy for improving wall digestibility in grass species used for fodder or cellulosic ethanol production.
In Vivo Assessment of a New Method of Pulsatile Perfusion Based on a Centrifugal Pump
Authors: Herreros Jesús , Ubilla Matías , Berjano Enrique J. , Vila–Nuñez Juan E. , Páramo José A. , Sola Josu , Mercé Salvador 
Published: January 2010

AbstractThe aim of this study was to assess platelet dysfunction and damage to organs after extracorporeal circulation using a pump based on a new method that adds a pulsatile flow to the continuous flow provided by a centrifugal pump. The continuous component of the total flow (2–3 L/min) is created by a Bio‐Pump centrifugal pump, while the pulsatile component is created by the pulsating of an inner membrane pneumatically controlled by an intra‐aortic counterpulsation balloon console (systolic volume of 37.5 mL in an asynchronous way with a frequency of 60 bpm). Six pigs were subjected to a partial cardiopulmonary bypass lasting 180 min and were sacrificed 60 min after extracorporeal circulation was suspended. The hematological study included the measurement of hematocrit, hemoglobin, leukocytes, and platelet function. The new pump did not significantly alter either platelet count or platelet function. In contrast, hematocrit and hemoglobin were significantly reduced during extracorporeal circulation (approximately 5% P = 0.011, and 2 g/dL P = 0.01, respectively). The leukocyte count during extracorporeal circulation showed a tendency to decrease, but this was not significant. In general, the short‐term use of the new pump (4 h) did not cause any serious morphological damage to the heart, lung, kidney, or liver. The results suggest that the hemodynamic performance of the new pump is similar to a conventional centrifugal pump and could therefore be appropriate for use in extracorporeal circulation.
Genetic testing in the epilepsies—Report of the ILAE Genetics Commission
Authors: Ottman Ruth , Hirose Shinichi , Jain Satish , Lerche Holger , Lopes‐Cendes Iscia , Noebels Jeffrey L. , Serratosa José , Zara Federico , Scheffer Ingrid E. 
Published: January 2010

SummaryIn this report, the International League Against Epilepsy (ILAE) Genetics Commission discusses essential issues to be considered with regard to clinical genetic testing in the epilepsies. Genetic research on the epilepsies has led to the identification of more than 20 genes with a major effect on susceptibility to idiopathic epilepsies. The most important potential clinical application of these discoveries is genetic testing: the use of genetic information, either to clarify the diagnosis in people already known or suspected to have epilepsy (diagnostic testing), or to predict onset of epilepsy in people at risk because of a family history (predictive testing). Although genetic testing has many potential benefits, it also has potential harms, and assessment of these potential benefits and harms in particular situations is complex. Moreover, many treating clinicians are unfamiliar with the types of tests available, how to access them, how to decide whether they should be offered, and what measures should be used to maximize benefit and minimize harm to their patients. Because the field is moving rapidly, with new information emerging practically every day, we present a framework for considering the clinical utility of genetic testing that can be applied to many different syndromes and clinical contexts. Given the current state of knowledge, genetic testing has high clinical utility in few clinical contexts, but in some of these it carries implications for daily clinical practice.