bluuebunny/crossref_metadata_2025_split huggingface dataset:
Population pharmacokinetics of intravenous bolus etomidate in children over 6 months of age
Authors: Lin Lin , Zhang Jian‐Wei , Huang Yue , Bai Jie , Cai Mei‐Hua , Zhang Ma‐Zhong 
Published: September 2011

SummaryBackground:  Information has been very limited on the population pharmacokinetics (PK) of etomidate in pediatric patients. The purpose of this study was to characterize the PK of etomidate in children.Methods:  Forty‐nine children aged over 6 months undergoing elective surgery received etomidate 0.3 mg·kg−1 bolus i.v. within 15 s for anesthesia induction. Arterial blood samples were collected for 2 h after injection. A population nonlinear mixed effects modeling approach was used to characterize etomidate PK. Estimates were standardized to a 70‐kg adult using allometric size models.Results:  Children had a median age of 4 years (0.53–13.21 years) and weight 15.7 kg (7.5–52 kg). PK of etomidate was best estimated using a three‐compartment model with weight on systemic (Cl1) and inter‐compartmental clearances (Cl2, Cl3), central (V1), and peripheral compartment volumes (V2, V3). The most significant PK covariate was age, with increasing age having reduced size‐adjusted Cl1, V1, and V3 (all P < 0.01). The estimates of PK parameter (standardized to 70‐kg adult) for a typical 4‐year‐old children were Cl1 = 1.50 l·min−1, Cl2 = 1.95 l·min−1, Cl3 = 1.23 l·min−1, V1 = 9.51 l, V2 = 11.0 l, and V3 = 79.2 l, respectively.Conclusions:  Owing to enhanced clearance and increased central compartment volume of etomidate, smaller (younger) children will require higher etomidate bolus dose than larger (older) children to achieve equivalent plasma concentrations. The dependence of Cl1 and V1 on age does not support weight‐based etomidate dosing in smaller children.
Peri‐ and postoperative outcomes of robot‐assisted radical cystectomy (RARC)
Authors: Smith Angela B. , Raynor Mathew C. , Pruthi Raj S. 
Published: September 2011

What's known on the subject? and What does the study add?Robot‐assisted radical cystectomy is an increasingly used method for surgical extirpation for clinically localized, muscle‐invasive urothelial cartinoma. This study reviews its technique and associated preoperative and oncological outcomes.OBJECTIVE
To assess peri‐and postoperative outcomes of robot‐assisted radical cystectomy (RARC) with pelvic lymph node dissection (PLND) and urinary diversion for the treatment of bladder cancer.
MATERIALS AND METHODS
We review our previously described surgical technique for RARC and its development over recent years, with an accompanied video illustration.
We also focus on peri‐ and postoperative outcomes of RARC and compare this with the ‘gold standard’ of open RC.
RESULTS
RARC has been steadily growing since 2003, with acceptable peri‐and postoperative outcomes.
Most studies report decreased blood loss, return of bowel function, and shorter length of hospital stay. Furthermore, complication rates have been shown to be similar to that of open series.
Most importantly, oncological outcomes appear to be favourable in terms of margin status, LND and disease‐specific survival, although data may be affected by the lack of long‐term results and a randomized clinical trial assessing overall survival.
CONCLUSIONS
RARC with PLND and urinary diversion is an increasingly used strategy in the treatment armamentarium for bladder cancer.
Perioperative and oncological outcomes from existing data have been favourable thus far, but are limited by relatively short follow‐up.
Randomized clinical trials with extended patient follow‐up are needed to fully assess outcomes related to RARC.
Animal models in urinary diversion
Authors: Roosen Alexander , Woodhouse Christopher R.J. , Wood Daniel N. , Stief Christian G. , McDougal W. Scott , Gerharz Elmar W. 
Published: September 2011

What's known on the subject? and What does the study add?For more than 150 years animal models have been used in the study of various aspects of urinary diversion using bowel segments.For the first time this review provides a comprehensive analysis and synopsis of all animal models used in urinary diversion as a structured database for further research.
We set out to critically assess the value of animal experimentation in urinary diversion through intestinal segments, as some authors question the effectiveness of animal research, criticising the methodological quality, lack of standardization, inadequate reporting and the few systematic reviews in this field.
Based on a comprehensive MEDLINE literature search (MeSH database; search terms: urinary diversion, urinary reservoirs, continent, rat, dog, animal models) we retrieved and evaluated all full‐length papers published in English, German, French, and Spanish languages from 1966 to 2011 reporting the use of animal models in the setting of urinary diversion.
Studies were stratified according to the addressed research question. Within each category species, gender, number of animals, age at procedure, type of diversion, mortality, length of follow‐up, experimental procedure and outcome were recorded and tabulated.
In all, 159 articles were judged to be relevant and while there are numerous animal models only a few have been used in more than one study.
Animals were used for the systematic study of new surgical techniques (93 articles) or metabolic and functional consequences of urinary reconstruction (66 articles). For the latter purpose, the most often used animal is the rat, whereas the dog model is preferred for technical experimentation.
In many studies, the validity of the model is at least questionable. Animal experiments have repeatedly been conducted addressing the same question, often with striking discrepancies in outcome. Animal studies were even performed after a surgical technique had been pioneered in humans.
The use of animal models in urinary diversion is far from standardized rendering the results less than ideal for comparison across studies.
Due to differences in anatomy and physiology, the applicability of findings in animal experiments to clinical urology is limited. Continued effort is needed to optimise the use of animal models in experimental urology.
Is robotics the future of laparoendoscopic single‐site surgery (LESS)?
Authors: Spana Gregory , Rane Abhay , Kaouk Jihad H. 
Published: September 2011

What's known on the subject? and What does the study add?LESS is a surgical technique that is utilized in many urological surgeries. The recent fusion of robotics and conventional LESS has significant implications for the future direction of LESS.This study is a review of LESS surgery, with a discussion about emerging technologies and the future directions of LESS surgery.
Laparoendoscopic single‐site surgery (LESS) is a term that covers a spectrum of surgical techniques that perform laparoscopic surgery by consolidating all ports into one surgical incision.
In recent years, there has been an expansion of LESS surgical techniques with a wide spectrum of urological procedures being performed using LESS surgery.
Paralleling the clinical expansion of LESS are efforts to improve the instrumentation and access devices as well as incorporation of robotic platforms to the LESS arena.
This expansion in technology has generated the essential question: is robotics the future of LESS?
Balancing continence function and oncological outcomes during robot‐assisted radical prostatectomy (RARP)
Authors: Mottrie Alexander , Gallina Andrea , De Wil Peter , Thüer David , Novara Giacomo , Ficarra Vincenzo 
Published: September 2011

What's known on the subject? and What does the study add?In the last decade, the desire to reduce the invasiveness of traditional open and laparoscopic surgery and, above all, the attempt of achieving better functional results, produced the increased interest in and the popularity of robotic techniques both in Europe and the USA.In the present study we reported on our original surgical technique, and our perioperative, functional and oncological results, as well as on data from the most important published studies.
A critical point in the evaluation of the radical prostatectomy (RP) outcomes is whether patients who obtain good cancer control also obtain good functional results.
Specifically, urinary continence recovery seems to have a more relevant impact on the patient's health‐related quality of life in comparison with potency recovery. Moreover, this functional outcome is relevant for all patients who underwent RP regardless of the execution of a nerve‐sparing approach to preserve potency.
Data coming from robot‐assisted RP (RARP) series show excellent results for early and definitive urinary continence recovery and for negative surgical margins. Unfortunately, no data are available about the combination of these two relevant outcomes after RARP.
In this review article, we describe our surgical technique to minimize the risk of urinary incontinence and positive surgical margins and summarize data concerning continence recovery and early oncological outcomes after RARP.
Robotic cystectomy: surgical technique
Authors: Hosseini Abolfazl , Adding Christofer , Nilsson Andreas , Jonsson Martin N. , Wiklund N. Peter 
Published: September 2011

What's known on the subject? and What does the study add?Robotic‐assisted radical cystectomy and pelvic lymphadenectomy have previously been described with an extracorporeal urinary diversion.In this study we describe the technique with totally intracorporeal RARC and orthotopic neobladder.OBJECTIVE
The aim of this report is to describe our surgical technique of robotic assisted radical cystectomy (RARC) with totally intracorporeal urinary diversion in patients with urinary bladder cancer.
PATIENTS AND METHODS
A total of 45 patients (7 women and 38 men) with high‐grade and/or muscle‐invasive urothelial cancer of the bladder underwent RARC and intracorporeal urinary diversion at our department.
Orthotopic ileal neobladder was performed in 36 patients and ileal conduit was performed in 9 patients.
RESULT
Except in two patients that operation was converted to open surgery during the reconstruction of the orthotopic neobladder, the procedure was performed totally intracorporeal.
The operations time, estimated blood loss and length for hospital stay were decreased over the time.
CONCLUSION
RARC with totally intracorporeal urinary diversion is feasible.
Skin autofluorescence is associated with severity of vascular complications in Japanese patients with Type 2 diabetes
Authors: Tanaka K. , Tani Y. , Asai J. , Nemoto F. , Kusano Y. , Suzuki H. , Hayashi Y. , Asahi K. , Nakayama M. , Miyata T. , Watanabe T. 
Published: September 2011

Diabet. Med. 29, 492–500 (2012)AbstractAims  Skin autofluorescence, a non‐invasive measure of the accumulation for advanced glycation end products, has been reported to be a useful marker for diabetic vascular risks in the Caucasian population. The aim of this study was to evaluate associations between skin autofluorescence and vascular complications in non‐Caucasian patients with Type 2 diabetes.Methods  Subjects in this cross‐sectional study comprised 130 Japanese patients with Type 2 diabetes. Skin advanced glycation end products were assessed by skin autofluorescence using an autofluorescence reader. Association between skin autofluorescence and severity of vascular complications was evaluated.Results  Of the 130 patients, 60 (46.2%) had microvascular complications such as diabetic retinopathy, neuropathy and nephropathy, 10 (7.7%) had macrovascular complications and 63 (48.5%) had micro‐ and/or macrovascular complications. Skin autofluorescence increased with severity of vascular complications. Independent determinants of skin autofluorescence were age (β = 0.24, P < 0.01), mean HbA1c in previous year (β = 0.17, P = 0.03), microvascular complications (β = 0.44, P < 0.01) and macrovascular complications (β = 0.27, P < 0.01). Multiple logistic regression analysis revealed that diabetes duration (odds ratio 1.15, P < 0.01), systolic blood pressure (odds ratio 1.04, P = 0.01), skin autofluorescence (odds ratio 3.62, P = 0.01) and serum albumin (odds ratio 0.84, P < 0.01) were independent factors for the presence of vascular complications in these patients.Conclusions  Skin autofluorescence had independent effects on vascular complications in Japanese patients with Type 2 diabetes. This indicates that skin advanced glycation end products are a surrogate marker for vascular risk and a non‐invasive autofluorescence reader may be a useful tool to detect high‐risk cases in non‐Caucasian patients with diabetes.
Alcohol consumption and risk of pre‐diabetes and type 2 diabetes development in a Swedish population
Authors: Cullmann M. , Hilding A. , Östenson C.‐G. 
Published: September 2011

Diabet. Med. 29, 441–452 (2012)AbstractAims  Alcohol is a potential risk factor of Type 2 diabetes. However, more detailed information on effects of alcohol types and early phases of Type 2 diabetes development seems warranted. The aim of this study was to investigate the influence of alcohol consumption and specific alcoholic beverages on the risk of developing pre‐diabetes and Type 2 diabetes in middle‐aged Swedish men and women.Methods  Subjects, who at baseline had normal glucose tolerance (2070 men and 3058 women) or pre‐diabetes (70 men and 41 women), aged 35–56 years, were evaluated in this cohort study. Logistic regression was performed to estimate the risk [odds ratio (OR) and 95% confidence interval (CI)] to develop pre‐diabetes and Type 2 diabetes at 8–10 years follow‐up, in relation to self‐reported alcohol intake at baseline. Adjustment was performed for several risk factors.Results  Total alcohol consumption and binge drinking increased the risk of pre‐diabetes and Type 2 diabetes in men (OR 1.42, 95% CI 1.00–2.03 and OR 1.67, 95% CI 1.11–2.50, respectively), while low consumption decreased diabetes risk in women (OR 0.41, 95% CI 0.22–0.79). Men showed higher risk of pre‐diabetes with high beer consumption (OR 1.84, 95% CI 1.13–3.01) and of Type 2 diabetes with high consumption of spirits (OR 2.03, 95% CI 1.27–3.24). Women showed a reduced risk of pre‐diabetes with high wine intake (OR 0.66, 95% CI 0.43–0.99) and of Type 2 diabetes with medium intake of both wine and spirits (OR 0.46, 95% CI 0.24–0.88 and OR 0.55, 95% CI 0.31–0.97, respectively), whereas high consumption of spirits increased the pre‐diabetes risk(OR 2.41, 95% CI 1.47–3.96).Conclusion  High alcohol consumption increases the risk of abnormal glucose regulation in men. In women the associations are more complex: decreased risk with low or medium intake and increased risk with high alcohol intake.
Metabolic regulation during constant moderate physical exertion in extreme conditions in Type 1 diabetes
Authors: Valletta J. J. , Chipperfield A. J. , Clough G. F. , Byrne C. D. 
Published: September 2011

Diabet. Med. 29, 822–826 (2012)SummaryBackground  Constant moderate intensity physical exertion in humid environments at altitude poses a considerable challenge to maintaining euglycaemia with Type 1 diabetes. Blood glucose concentrations and energy expenditure were continuously recorded in a person trekking at altitude in a tropical climate to quantify changes in glucose concentrations in relation to energy expenditure.Case report  Blood glucose concentrations and energy expenditure were continuously monitored with a Guardian® real‐time continuous glucose monitoring system (CGMS) and a SenseWear® Pro3 armband (BodyMedia Inc., USA), in a 27‐year‐old woman with Type 1 diabetes, during her climb up Mount Kinabalu in Borneo (c. 4095 m). Comparative control data from the same person was collected in the UK (temperate climate at sea level) and Singapore (tropical climate at sea level). Maximum physical effort during the climb was < 60% VO2MAX (maximal oxygen consumption). Mean daily calorific intakes were 2300 kcal (UK), 2370 kcal (Singapore) and 2274 kcal (Mount Kinabalu), and mean daily insulin doses were 54 U (UK), 40 U (Singapore) and 47 U (Mount Kinabalu). Despite markedly increased energy expenditure during the climb [4202 kcal (Mount Kinabalu) vs. 2948 kcal (UK) and 2662 kcal (Singapore)], mean blood glucose was considerably higher during the trek up Mount Kinabalu [13.2 ± 5.9 mmol/l, vs. 7.9 ± 3.8 mmol/l (UK) and 8.6 ± 4.0 mmol/l (Singapore)].Conclusion  Marked unexpected hyperglycaemia occurred while trekking on Mount Kinabalu, despite similar calorie consumption and insulin doses to control conditions. Because of the risk of unexpected hyperglycaemia in these conditions, we recommend that patients embarking on similar activity holidays undertake frequent blood glucose monitoring.
Fictionalism and Incompleteness
Authors: Woodward Richard 
Published: September 2011

AbstractThe modal fictionalist faces a problem due to the fact that her chosen story seems to be incomplete—certain things are neither fictionally true nor fictionally false. The significance of this problem is not localized to modal fictionalism, however, since many fictionalists will face it too. By examining how the fictionalist should analyze the notion of truth according to her story, and, in particular, the role that conditionals play for the fictionalist, I develop a novel and elegant solution to the incompleteness problem.
The effects of cover crops and conventional tillage on soil and runoff loss in vineyards and olive groves in several Mediterranean countries
Authors: Gómez J. A. , Llewellyn C. , Basch G. , Sutton P. B. , Dyson J. S. , Jones C. A. 
Published: September 2011

AbstractCover crops (CC) in vineyards and olive groves provide an alternative to conventional tillage (CT) for land management. Runoff, sediment and nutrient loss from six sites in France, Spain and Portugal were compared over 3–4 yr. In general, runoff loss was not significantly reduced by the CC alternatives: average annual runoff coefficients ranged from 4.9 to 22.8% in CT compared with 1.9–25% in the CC alternatives. However, at two sites, reductions in average annual runoff coefficients were greater for CC: 17.2 and 10.4% in CT, 6.1 and 1.9% in CC. Nutrient loss in runoff followed a similar pattern to runoff, as did pesticide loss on the one site; reductions occurred when runoff losses were significantly reduced by CC. The lack of differences at the other sites is thought to be due to a combination of soil conditions at the surface (compaction and capping) and sub‐surface (low‐permeability horizons close to the surface). In contrast, CC always resulted in reductions in soil erosion loss, plus similar reductions in nutrients and organic matter (OM) associated with sediment. Soil erosion loss ranged from 1.4 to 90 t/ha/yr in CT compared with 0.04–42.7 t/ha/yr in CC. Overall, reductions in runoff and associated nutrient and pesticide loss from vineyards and olives occurred with the introduction of CCs only when soil permeability was sufficiently high to reduce runoff. In contrast, reduction in soil erosion and associated nutrients and OM occurred even when the amount of runoff was not reduced. In the most extreme encountered situations (highly erodible soils in vulnerable landscape positions and subject to highly erosive rainfall), additional conservation measures are needed to prevent unsustainable soil loss.
Revision of the disparid Stylocrinus (Crinoidea) from the Devonian of Europe, Asia and Australia
Authors: BOHATÝ JAN 
Published: September 2011

Abstract:  The discovery of new specimens and the restudy of known collections result in revision of the diagnosis and the stratigraphic distribution of the disparid crinoid genus Stylocrinus, from the Middle and Upper Devonian of Europe, Asia and Australia. The consistent development of three basal plates, the atomous arms with internally inclined edges adjoining laterally with adjacent brachials in an interlocking network and an apparently rudimentary pinnulation is recognised. The high ecophenotypic plasticity of the common species S. tabulatus negates the validity of several former subspecies and demonstrates the general morphologic variability of the aboral cup proportions. This contrasts with the low morphological spectrum of rarer stylocrinid species. With exclusion of ‘S. elimatus’ (Silurian) from Stylocrinus, the genus is limited to the Devonian. A neotype is proposed for the lost holotype of S. tabulatus. Stylocrinus prescheri sp. nov. is described from the Eifelian to Givetian of Europe and Asia. The first evidence of the gastropod grazing trace fossil Radulichnus on a crinoid aboral cup (S. tabulatus), the post‐mortem incurred ossicular‐boring of radial and basal plates as well as the post‐mortem encrusting by a rugose coral are further observations on Stylocrinus aboral cups.
Late Emsian Rutoceratoidea (Nautiloidea) from the Prague Basin, Czech Republic: morphology, diversity and palaeoecology
Authors: MANDA ŠTĚPÁN , TUREK VOJTĚCH 
Published: September 2011

Abstract:  Nautiloids of the superfamily Rutoceratoidea from the late Emsian (late Early Devonian) of the Prague Basin (Czech Republic) are commented upon. Species recognized include the hercoceratids Hercoceras mirum, H.? transiens, Ptenoceras proximum, P. nudum, P. minusculum and Anomaloceras anomalum, as well as the rutoceratids Adelphoceras bohemicum, Homoadelphoceras devonicans, Pseudorutoceras bolli and Goldringia? devonicans. In addition, four new species are described: Parauloceras regulare sp. nov., Roussanoffoceras chlupaci sp. nov., Otomaroceras sp. nov. and Goldringia sp. nov. Morphology and distribution patterns of Pragian and late Emsian rutoceratoid faunas from the Prague Basin are compared. They show that an increased diversity was accompanied by a higher level of specialization of rutoceratoids, which manifested itself in low abundance, increased facies dependence and greater variation in shell size during the Early Devonian. The evolution of sculpture and a contracted aperture, both regarded as protective adaptive features, was also examined, but no adaptive trend towards more pronounced sculpture and constriction of the aperture was found to have occurred in the Early Devonian. A more distinctive sculpture was, however, observed in shallow‐water assemblages of P. proximum in comparison with deeper‐water faunules, and two additional cephalopod species were examined in order to obtain comparative data. The presence of distinct sculpture patterns in coeval shallow‐ and deeper‐water assemblages suggests limited migration between them and consequently reflects some degree of territoriality in Devonian nautiloids. New data on early shell development in P. proximum are presented. During the Choteč Event, rutoceratoid generic diversity dropped dramatically, one family became extinct and the Early Devonian diversification of the group came to an end. The recovery of nautiloid faunas was slower than that of other cephalopods and associated, unrelated invertebrates. The absence of change in abundance patterns between Pragian and late Emsian rutoceratoid faunas, i.e. prior to and subsequent to ammonoid radiation, suggests that the appearance and radiation of the latter group in the early Emsian did not affect the structure of nautiloid assemblages, i.e. these two clades did not occupy the same niches.