bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of conjugated estrogen versus conjugated estrogen associated with medroxyprogesterone acetate in postmenopausal women on internal carotid artery pulsatility index: A randomized pilot study
Authors: Wender Maria C. O. , Vigo Francieli , Oliveira Patricia P. , Bittellbrun Fernando , Furtado Alvaro P. A. , Schvartzman Luiza , Capp Edison , de Freitas Fernando Monteiro 
Published: March 2011

AbstractAim:  To compare the effect of conjugated estrogen (CEE) versus conjugated estrogen and medroxyprogesterone acetate (MPA) therapy on internal carotid artery pulsatility index (PI) in postmenopausal women.Material & Methods:  In the prospective, randomized, single‐blinded comparative study, postmenopausal women meeting the inclusion criteria were randomized into one of two groups: CEE group (CEE 0.625 mg/day), or CEE + MPA group (CEE 0.625 mg/day plus MPA 2.5 mg/day). Patients were submitted to blood tests (total cholesterol, high‐density lipoprotein cholesterol, triglycerides and total glucose) and to color Doppler ultrasound of the internal carotid artery to assess PI at the beginning of the study. Ultrasound was repeated after 16 weeks of treatment. Statistical analysis was performed using Student's t‐test or two‐way analysis of variance for repeated measures. Data were considered to be significant at P < 0.05.Results:  Seventy‐five postmenopausal women (age 53.3 ± 5.5 years) were included in the study. There was a statistically significant reduction in PI in both groups after 16 weeks of hormonal treatment. However, there was no difference between the two groups (group 1: 0.8960 to 0.8450; group 2: 0.9048 to 0.8426).Conclusion:  The use of CEE and CEE associated with MPA during 16 weeks led to an improvement in internal carotid flow as measured by PI, with no difference between the treatments.
Fetal scalp stimulation test: An adjunct to intermittent auscultation in non‐reassuring fetal status during labor
Authors: Rathore Asmita M. , Ramji Siddarth , Devi Chabungbam Bijayalakshmi , Saini Sushila , Manaktala Usha , Batra Swaraj 
Published: March 2011

AbstractAims:  To evaluate fetal scalp stimulation test (FSST) as an adjunct to intermittent auscultation in diagnosis of intrapartum fetal acidosis and associate result of FSST with cord blood pH and immediate neonatal outcome.Material & Methods:  This study was conducted at a tertiary hospital in India. Digital FSST was performed in seven hundred and fifty women in labor with singleton gestation ≥37 weeks, cephalic presentation and fetal heart abnormalities and/or thick meconium stained amniotic fluid. Intermittent auscultation was used for fetal monitoring during labor. The outcome measure was cord blood pH < 7.20 and neonatal morbidity.Results:  The non‐reactive FSST is associated with lower umbilical cord blood pH, lower Apgar scores and higher asphyxia related neonatal morbidity (P‐value < 0.001). The non‐reactive FSST had 41% sensitivity and 84% specificity to detect pH < 7.20. The positive predictive value of FSST for fetal acidosis is 44% and negative predictive value is 83%. The likelihood ratio for acidosis with noncreative FSST is 2.57.Conclusions:  Non‐reactive FSST is associated with adverse neonatal outcomes. The positive and negative predictive values of FSST to diagnose fetal cord blood pH < 7.20 during labor are 44% & 83%, respectively.
Embryonal rhabdomyosarcoma of the uterine cervix in a 47‐year‐old woman
Authors: Baiocchi Glauco , Faloppa Carlos Chaves , de Toledo Osório Cynthia Aparecida Bueno , Kumagai Lillian Yuri , Fukazawa Elza Mieko , Cunha Isabela Werneck 
Published: March 2011

AbstractEmbryonal rhabdomyosarcoma (RMS) of the female genital tract usually occurs in the vagina during childhood. The uterine cervix as a primary site is rare, but is more frequent until the second decade of life. It usually has a good prognosis and the treatment is based on multidrug chemotherapy, radiotherapy and surgery. RMS accounts for <5% of all adult soft tissue sarcomas. Previous reports that included all primary sites showed a poorer five‐year disease specific survival for adults with RMS when compared to the pediatric population. This difference has been attributed to a higher proportion of adverse prognostic clinical and pathological factors, and to inadequate treatment given to adults with RMS. A total of 115 patients with cervical embryonal RMS have previously been described; however, only 10 cases were reported in women older than 40 years. We present a 47‐year‐old woman treated with radical hysterectomy followed by adjuvant chemotherapy and review the current literature.
Neonatal small‐for‐gestational age status as a favorable factor for the complete vaginal delivery of both fetuses in Japanese dichorionic twins
Authors: Inde Yusuke , Satomi Misao , Miyake Hidehiko , Suzuki Shunji 
Published: March 2011

AbstractAim:  In singletons, neonatal small‐for‐gestational age (SGA) status is an unfavorable postpartum outcome leading to cesarean section (CS) and increasing the possibility of maternal operative complications. Perinatal characteristics of SGA newborns in dichorionic (DC) twins were investigated for the prognostic impact on their mothers.Methods:  A retrospective study was performed from 2004 to 2009 on 329 DC twins with two live births. Neonates were classified as SGA if they weighed less than the 10th percentile at birth according to Japanese singleton norms. Statistical differences between DC twins delivering appropriate‐for‐gestational age (AGA)/AGA pairs (control group) and AGA/SGA, SGA/AGA or SGA/SGA pairs (the first/second twins) were analyzed.Results:  The median (range) of the gestational ages at delivery for AGA/AGA, AGA/SGA, SGA/AGA and SGA/SGA pairs were 37.1 (27.1–40.3), 37.2 (29.0–40.9), 37.1 (28.1–40.7) and 37.3 (33.3–40.4) weeks, and the complete vaginal delivery rates of both fetuses were 66.2% (43/65), 84.8% (28/33), 82.4% (14/17) and 70.0% (7/10), respectively. Compared with AGA/AGA pairs, AGA/SGA pairs showed a higher incidence of spontaneous vaginal births of both fetuses (31.3% [26/83] vs 19.9% [37/186], OR 1.84, 95% CI 1.45–4.73) and a lower incidence of emergent CS (25.3% [21/83] vs 38.7% [72/186], OR 0.53, 95% CI 0.30–0.95).Conclusion:  The relatively small size of SGA fetuses allows both fetuses to remain inside the uterus for a longer time and to easily pass through the maternal parturient canal for complete vaginal delivery. Neonatal SGA status is a favorable factor for avoiding operative complications of CS and optimizing maternal perinatal outcomes.
Survey of early preterm singleton live births in Iwate Prefecture as a provincial model of the medical situation in Japan
Authors: Nishigori Hidekazu , Tanno Kozo , Fukushima Akimune , Kanasugi Tomonobu , Haba Gen , Fujiwara Jun , Ogasawara Toshihiro , Imai Toshihiko , Sugiyama Toru , Kobayashi Takashi , Yoshizumi Noboru 
Published: March 2011

AbstractAim:  The aim of this study was to survey early preterm (prior to 32 weeks' gestation) singleton live births in Iwate Prefecture as a provincial model of the medical situation in Japan.Materials and Methods:  Data from 177 early preterm singleton live births, and 31 445 total live births (January 2005–December 2007) in Iwate Prefecture Japan were used to analyze the incidence of early preterm singleton live birth in each medical service area.Results:  The incidence of spontaneous early preterm singleton live birth did not differ between the coastal and inland medical service areas (3.35 vs 3.57 per 1000 live births). In the Morioka medical service area (radius about 40 km), the incidence of spontaneous early preterm singleton live birth in municipalities without obstetric care facilities was significantly higher than that in municipalities with obstetric care facilities (6.62 vs 2.65 per 1000 live births, P < 0.005). The incidence of early preterm singleton live birth due to pregnancy‐induced hypertension in the coastal medical service areas was higher than that in the inland areas (1.67 vs 0.71 per 1000 live births, P < 0.05).Conclusions:  In Iwate Prefecture, Japan, the incidence of singleton preterm live birth before 32 weeks of pregnancy varies among its constituent medical service areas according to geographic factors as well as the availability of obstetric care facilities.
Experimental model of laryngotracheal stenosis in infants: effects of different high‐frequency jet ventilation patterns on pulmonary parameters
Authors: Mausser Gerlinde , Schellauf Angelika , Scherübl Michael , Arrer Andreas , Schwarz Gerhard 
Published: March 2011

SummaryBackground:  Supraglottic high‐frequency jet ventilation (HFJV) in laryngotracheal surgery in infants with modified jet laryngoscopes offers the surgeon an unimpaired operating field. However, supraglottic HFJV is associated with the development of high airway pressures, inadvertent positive end‐expiratory pressure (PEEP) levels, and barotrauma.Methods:  We investigated the total lung volumes (TLV) and tidal volume variations at peak inspiratory pressure levels (PIP) and at PEEP levels along with the pulmonary pressures (PIP and PEEP) during two conventional methods of supraglottic HFJV in an infant trachea–lung model without stenosis and with different degrees of stenosis.Results:  With augmentation of the driving pressure in the experiment without stenosis, the TLV plus the pulmonary pressures increased. With narrowing of the stenosis, TLV reduced at PIP level and increased at PEEP level. Volume shifts were significantly higher during superimposed HFJV compared with monofrequent HFJV at equivalent stenosis diameter (P < 0.05) except for the setting with 0.3 bar driving pressure (P > 0.05). The pulmonary PIP was in none of the test series higher than 20 mbar, and the pulmonary PEEP did not exceed 14 mbar.Conclusions:  The results from our experimental model support the safe and effective clinical use of supraglottic HFJV in infants with tracheal stenosis. Moderate driving pressures provide acceptable pulmonary pressures in normal compliant lungs.
Colorectal cancer in nonagenarians
Authors: Arenal J. J. , Tinoco C. , Labarga F. , Martínez R. , Gonzalo M. 
Published: March 2011

AbstractAim  The aim of the study was to analyze the short‐term and long‐term outcomes of nonagenarians treated for colorectal cancer.Method  A retrospective analysis was performed of 74 patients, ≥ 90 years of age, diagnosed with colorectal cancer during the period 1986–2009. Comorbidity, American Society of Anesthesiology (ASA) grade, symptoms, diagnosis, treatment, mortality, morbidity and survival were analyzed.Results  Of the 74 patients, 48 (65%) were women. Twenty‐two patients were classified as ASA grade I–II, 26 as ASA grade III and 26 as ASA grade IV–V. Thirty‐one (42%) had intestinal obstruction at the time of diagnosis. Twenty‐two (30%) patients were diagnosed during the period 1986–2000 and 52 (70%) were diagnosed between 2001 and 2009. Forty‐four (59%) patients underwent surgery, of whom 19 (49%) were treated as an emergency. Eleven (25%) patients died postoperatively, with mortality rates of 12% (3/25) for elective surgery and 42% (8/19) for emergency surgery. Surgical mortality for ASA grade I and grade II patients was 5% (1/20) and their 5‐year survival rate (postoperative mortality excluded) was 44%, whereas 5‐year survival for ASA grade III patients who underwent surgery was 12.5% and surgical mortality was 25% (4/16). There were no survivors beyond 36 months among patients who did not receive surgery.Conclusion  Our results indicate that elective and emergency colorectal surgery can be performed with acceptable rates of mortality and morbidity on nonagenarian patients in good general condition with low perioperative risk. The 5‐year survival rate was related to ASA grade and to the use of surgery.
Patient and surgeon factors are associated with the use of laparoscopy in appendicitis
Authors: McCartan D. P. , Fleming F. J. , Hill A. D. K. 
Published: March 2011

AbstractAim  The use of a minimally invasive approach to treat appendicitis has yet to be universally accepted. The objective of this study was to examine recent trends in Ireland in the surgical management of acute appendicitis.Method  Data were obtained from the Irish Hospital In‐Patient Enquiry system for patients discharged with a diagnosis of appendicitis between 1999 and 2007. An anonymous postal survey was sent to all general surgeons of consultant and registrar level in Ireland to assess current attitudes to the use of laparoscopic appendectomy.Results  The use of laparoscopic appendectomy increased throughout the study and was the most common approach for appendectomy in 2007. Multivariate analysis revealed age under 50 years (OR = 1.51), female sex (OR = 2.84) and residence in high‐density population areas (OR = 4.15) as predictive factors for undergoing laparoscopic appendectomy in the most recent year of the study. While 97% of surgeons reported current use of laparoscopy in patients with acute right iliac fossa pain, in most cases it was selective. Surgeons in university teaching hospitals (42 of 77; 55%) were more likely to report using laparoscopic appendectomy for all cases of appendicitis than those in regional (six of 23; 26%) or general (13 of 53; 25%) hospitals (P = 0.048).Conclusion  This study has demonstrated a significant increase in laparoscopic appendectomy, yet a variety of patient and surgeon factors contribute to the choice of procedure. Differences in the perception of benefit of the laparoscopic approach amongst surgeons appears to be an important factor in determining the operative approach for appendectomy.
Underlying functional bowel disorder may explain patient dissatisfaction after haemorrhoidal surgery
Authors: Favreau C. , Siproudhis L. , Eleouet M. , Bouguen G. , Bretagne J.‐F. 
Published: March 2011

AbstractAim  The aim of this study was to assess patient dissatisfaction and functional symptoms following haemorrhoid surgery, aspects of which are seldom covered in other published series.Method  A self‐administered questionnaire was mailed to 359 consecutive patients (prospective database; 198 men, 161 women; median follow up, 59 [1–120] months) who underwent either Milligan‐Morgan haemorrhoidectomy (n = 205) or stapled haemorrhoidopexy (n = 154).Results  The response rate was 72%; 2.4% of patients had no opinion, 13.6% were dissatisfied, 33.0% were satisfied, and 51.0% were very satisfied with the treatment. Dissatisfied patients were more likely to be women and more likely to have a long history of constipation and irritable bowel syndrome. The duration of surgery and the rates of pre‐ and postoperative complications did not differ between groups. Residual bleeding (49%vs 32%), prolapse (67%vs 31%) and pain (91%vs 55%) occurred more frequently in the dissatisfied group compared with the satisfied group (P < 0.001). Incontinence (4 [0–16] vs 1 [0–15]; P = 0.0003) and constipation (19 [1–34] vs 8 [0–31]; P < 0.0001) scores were significantly higher in the dissatisfied group compared with satisfied patients. Anal pain was the predominant symptom associated with dissatisfaction in a logistic regression model.Conclusion  Persistent pain remains the major long‐term factor associated with dissatisfaction after surgery for haemorrhoids.
Making it real: a hands‐on approach to teaching research
Authors: Birks M. 
Published: March 2011

BIRKS M. (2011) Making it real: a hands‐on approach to teaching research. International Nursing Review58, 270–272Aim:  The purpose of this paper was to report on the delivery of a series of seminars in Sarawak, East Malaysia using a unique hands‐on approach to the teaching of skills in research and evidence‐based health care. These seminars proved to be a meaningful and memorable experience for both the facilitators and participants.Background:  The international push for the delivery of evidence‐based health care has resulted in a growing need for the teaching of skills in the conduct and application of research. Nurses and other health‐care professionals recognize that they have a responsibility to contribute to and maintain an evidence base for practice, yet are often stymied by a lack of professional development opportunities.Conclusion:  The knowledge necessary to understand research, along with skills in the conduct of research, can be made accessible to health‐care professionals in diverse locations. The experience reported in this paper demonstrates that opportunities exist to provide education about research and evidence‐based practice in an engaging, active and meaningful way.
A hybrid approach to university subject learning activities
Authors: Osorio Gómez Luz Adriana , Duart Josep M. 
Published: March 2011

AbstractIn order to get a better understanding of subject design and delivery using a hybrid approach, we have studied a hybrid learning postgraduate programme offered by the University of the Andes, Bogotá, Colombia. The study analyses students' perceptions of subject design and delivery, with particular reference to learning activities and the roles of lecturers and students during moments of interaction. Elements of socio‐cultural activity theory were taken as a reference for subject analysis. It is a qualitative research project containing some quantitative data. For the purposes of the study, the following instruments were designed and applied: a student survey, student interviews (by subject), lecturer interviews, and a subject design and planning observation guide. The study's conclusions present the characteristics of learning activities and of student–lecturer and student–student interaction that fostered the attainment of subject learning objectives. These characteristics can make a positive contribution to the process of subject design and delivery using a hybrid approach, meaning integration between face‐to‐face and e‐learning actions in the delivery of learning activities.
Analysis of failure time using threshold regression with semi‐parametric varying coefficients
Authors: Li Jialiang , Lee Mei‐Ling Ting 
Published: March 2011

Many new statistical models may enjoy better interpretability and numerical stability than traditional models in survival data analysis. Specifically, the threshold regression (TR) technique based on the inverse Gaussian distribution is a useful alternative to the Cox proportional hazards model to analyse lifetime data. In this article we consider a semi‐parametric modelling approach for TR and contribute implementational and theoretical details for model fitting and statistical inferences. Extensive simulations are carried out to examine the finite sample performance of the parametric and non‐parametric estimates. A real example is analysed to illustrate our methods, along with a careful diagnosis of model assumptions.
Agency and Institutional Investment
Authors: Brennan Michael J. , Cheng Xiaolong , Li Feifei 
Published: March 2011

AbstractIn this paper we summarise and extend the agency‐based model of asset pricing of Brennan (1993) to show that the implied agency effects on asset pricing are too small to be empirically detectable: empirical tests confirm this and we show that the positive findings of Gomez and Zapatero (2003) are due to their choice of sample. We also derive new empirical implications for the composition of institutional investment portfolios and empirically confirm the major result, that institutional portfolios will be short the minimum variance portfolio.
Indoctrinated, but not Incurable? Klaus Mann's Interrogation of German Prisoners of War in 1944
Authors: Von Lindeiner‐Stráský Karina 
Published: March 2011

ABSTRACTIt has been stated that ‘die persönlichen Erfahrungen […] mit deutschen Kriegsgefangenen zu Ende des Krieges’ led to disillusion and disappointment among the German exiles who fought in the war against Hitler.1 This disappointment manifested itself in the many conflicts between former exiles on the one hand and representatives of the governments of their host nations as well as fellow Germans on the other.Like Stefan Heym, Hans Habe and others, the writer in exile Klaus Mann felt obliged to devote himself to the war against National Socialism, not only in his works, but also as a man of action. As a member of the Psychological Warfare Branch of the Fifth Army he worked in a propaganda unit on the Italian front in 1944. This article deals with Mann's interrogations of German prisoners of war, whom he questioned about their morale, their attitude towards the war, towards propaganda and towards Germany's future. The hitherto unpublished reports of his interrogations, some of which can be found in Mann's estate, provide a fascinating insight into the mind and attitudes of German soldiers shortly before the end of World War II. Furthermore, they help us to understand the nature of the gap that had opened between the exiles and their fellow‐Germans and hence to explain the exiles’ side of the growing separation between the two groups towards the end of the war and in the immediate post‐war years.Es ist schon häufiger diskutiert worden, dass ‘die persönlichen Erfahrungen […] mit deutschen Kriegsgefangenen zu Ende des Krieges’ zu Desillusionierung und Enttäuschungen unter den deutschen Exilanten führten, die sich dem Krieg gegen Hitler angeschlossen hatten.2 Diese Enttäuschung manifestierte sich in den vielen Konflikten nicht nur zwischen den Exilanten und den Repräsentanten ihrer Gastländer, sondern auch zwischen den Exilanten und den ‘daheimgebliebenen’ Deutschen.Wie Stefan Heym, Hans Habe und andere fühlte sich der Exilschriftsteller Klaus Mann dem Kampf gegen den Nationalsozialismus verpflichtet, den er mit fortschreitendem Krieg nicht nur mit der Feder, sondern auch durch direkte Aktion führen wollte. Als Mitglied der Psychological Warfare Branch der Fifth Army wurde er 1944 an der italienischen Front in einer Propagandaeinheit eingesetzt. Diese Studie untersucht Manns Verhöre mit deutschen Kriegsgefangenen aus dieser Zeit, die er zu ihrer Moral, ihrer Einstellung zum Krieg, zur Propaganda und zu Deutschlands Zukunft befragte. Die Mitschriften seiner Verhöre, die in Manns Nachlass zu finden sind, sind bisher zum größten Teil unveröffentlicht. Sie gewähren einen faszinierenden Einblick in die Denkweise und die Ansichten deutscher Soldaten kurz vor Ende des zweiten Weltkriegs. Darüber hinaus tragen sie auch dazu bei, die Ursachen des Grabens zu verstehen, der sich zwischen den Exilanten und ihren ehemaligen Landsmännern aufgetan hatte und die wachsende Fremdheit der beiden Gruppen gegen Ende des zweiten Weltkriegs und unmittelbar danach nachzuvollziehen.
Strategic Migrant Network Building and Information Sharing: Understanding ‘Migrant Pioneers’ in Canada
Authors: Somerville Kara 
Published: March 2011

AbstractThis article explores the migrant networks that develop between migrants, non‐migrants and the larger Indian diaspora. Specifically, it examines the decision to migrate to Toronto, Canada and how this decision is shaped by, and in turn shapes the migrant network. Based on 35 interviews with migrants from Karnataka, South India, two main findings are presented. First, migrants are deliberately choosing settlement countries in which their families are not yet located, thereby becoming “migrant pioneers” in their country of settlement, which is an attempt to expand their migrant networks globally. Second, the narratives these migrants receive and subsequently impart to others are often inaccurate, which can lead to miscommunication flows among these migrant networks. These findings are considered in light of the large body of research on migrant networks and the ways they develop and transmit information. This paper argues that existing understanding of migrant networks is somewhat static. Findings indicate that these “migrant pioneers” may be engaging in global risk‐diversification strategies for subsequent generations, but may themselves suffer from the more immediate consequences of misinformed networks.