bluuebunny/crossref_metadata_2025_split huggingface dataset:
Versatility of the capsular genes during biofilm formation by Streptococcus pneumoniae
Authors: Domenech Mirian , García Ernesto , Moscoso Miriam 
Published: June 2009

Summary Streptococcus pneumoniae forms part of the natural microbiota of the nasopharynx. For the pneumococcus to cause infection, colonization needs to occur and this process is mediated by adherence of bacteria to the respiratory epithelium. Although the capsular polysaccharide (CPS) of S. pneumoniae is known to be important for infection to occur, its role in colonization is controversial. Biofilm models are starting to emerge as a promising tool to investigate the role of CPS during nasopharyngeal carriage, which is the first step in the dissemination and initiation of a pneumococcal infection. Using a well‐defined model system to analyse in vitro biofilm formation in pneumococcus, here we explore the molecular changes underlying the appearance of capsular mutants using type 3 S. pneumoniae cells. Spontaneous colony phase variants show promoter mutations, as well as duplications, deletions and point mutations in the cap3A gene, which codes for a UDP‐glucose dehydrogenase (UDP‐GlcDH). Increased biofilm‐forming capacity could usually be correlated with a reduction both in colony size and in the relative amount of CPS present on the cell surface of each colony variant. However, a mutation in Cap3A Thr83Ile (a strictly conserved residue in bacterial UDP‐GlcDHs) that resulted in very low CPS production also led to impaired biofilm formation. We propose that non‐encapsulated mutants of pneumococcal type 3 strains are essentially involved in the initial stages (the attachment stage) of biofilm formation during colonization/pathogenesis.
Immunostimulation to reduce recurrence after surgery for anal condyloma acuminata: a prospective randomized controlled trial
Authors: Mistrangelo M. , Cornaglia S. , Pizzio M. , Rimonda R. , Gavello G. , Dal Conte I. , Mussa A. 
Published: June 2009

AbstractAim  Human papillomavirus is the most common cause of sexually transmitted disease. It is associated with immunosuppression and shows a marked tendency to recur. We investigated a natural immunostimulant aimed to reduce recurrence.Method  A randomized controlled study was carried out including 261 patients allocated to surgical excision alone (control group; n = 122) and surgical excision plus postoperative immunostimulation for 30 days with a natural product (STET; study group; n = 139). Patients with HIV positivity were excluded. All patients gave fully informed consent.Results  The patients were followed for 6 months after surgery. Recurrence occurred in 7.2% (10/139) in the study group and in 27.1% (33/122) in the control group (P < 0.0001). There were no significant differences in the sex, sexual orientation, number of lesions, time to diagnosis and treatment or localization of lesions in the two groups.Conclusions  Immunostimulation using a natural product significantly reduced the incidence of recurrence of anal condylomata in patients undergoing surgical excision.
Hypersensitivity to Social Rejection and Perceived Stress as Mediators between Attachment Anxiety and Future Burnout: A Prospective Analysis
Authors: Ronen Sigalit , Baldwin Mark W. 
Published: June 2009

Drawing on Sociometer Theory, the current study examined whether the tendency to focus on and worry about social rejection at the workplace can predict stress and burnout. Data were collected at two time points from 231 hotel employees. Prospective‐longitudinal design, structural equation modeling analyses revealed that participants' hypersensitivity to social rejection at the workplace predicted an increase in stress and in burnout across the 1 month of participation. Furthermore, the findings revealed that hypersensitivity to social rejection fully mediated the link between attachment anxiety and future stress and that hypersensitivity to social rejection and stress fully mediated the link between attachment anxiety and future burnout. Approximately 64 per cent of the variance in future burnout was explained by these variables. The results demonstrate the significant role social evaluative stressors play in the development of stress responses at the workplace.S’appuyant sur la sociometer theory, la présente étude examine si la tendance à se préoccuper et s’inquiéter du rejet social sur le lieu de travail peut prédire le stress et l’épuisement. Les données ont été collectées par deux fois auprès de 231 employés d’hôtellerie. Le traitement des études longitudinales par des analyses de modélisation par équations structurelles révèle que l’hypersensibilité des sujets au rejet sur le lieu de travail contribue à une augmentation du stress et de l’épuisement au cours du mois de participation. Les conclusions soulignent que l’hypersensibilité au rejet social est totalement influencée par le lien entre anxiété, attachement et stress futur et que l’hypersensibilité au rejet social et au stress est totalement influencée par le lien entre anxiété, attachement et épuisement à venir. Approximativement 64% de la variance de l’épuisement à venir est expliqué par ces variables. Les résultats montrent le rôle significatif joué par des sources de stress liées au jugement social d’autrui dans le développement des réponses de stress sur le lieu de travail.
Professional Basketball's Unsportsmanlike Fouls in the Eyes of the Beholders
Authors: Bar‐Eli Michael , Shimkin Tali , Wolf Yuval 
Published: June 2009

A series of three experiments, based on the method of Functional Measurement, has explored the importance assigned by professional basketball players to relevant dispositions of defense and offense players, as determinants of unsportsmanlike fouls. The 106 participants were leading male players in the premier basketball league in Israel. Experiment 1 was based on a 16 (24)‐cell model. In an individual meeting, each participant estimated the likelihood that a defense player would commit an unsportsmanlike foul on an offense player. In each of the 16 to‐be‐judged incidents, specific information on a specific combination of aggressiveness and susceptibility to victimisation of two imaginary protagonists in an offense–defense on‐the‐court incident was given to the participant. Experiment 2 was a replication of Experiment 1. There, however, names of 16 well‐known players were mentioned, the aggressiveness and susceptibility to victimisation of each fitting the model requirements. In Experiment 3, a partial replication of Experiment 2, likelihood estimations were made from two perspectives—potential perpetrator and potential victim. Overall, meaningful importance was assigned especially to the dispositions of the perpetrator, not the victim. The findings are conceived as reflections of players' cognitive schemata of on‐the‐court violence.Basée sur la méthode de la mesure fonctionnelle, une série de 3 expérimentations a exploré l’importance que des joueurs de basket professionnels attribuent aux dispositions de joueurs attaquant ou défenseur à commettre des fautes anti sportives. Les 106 sujets sont des joueurs de sexe masculin de la ligue 1 de basket israélienne. L'expérience 1 est basée sur un modèle à 16 (24) cases. Lors de passation individuelle, chaque participant estime la probabilité qu'un joueur arrière commette une faute anti sportive sur un joueur avant. Pour chacun des 16 incidents à juger, une information spécifique a été donnée aux participants. Il s'agissait d'une combinaison particulière de l'agressivité et de la propension à la victimisation des deux protagonistes imaginaires dans une situation d'incident soit offensif soit défensif sur le terrain. L'expérimentation 2 est une réplique de la première. Cependant, les noms de 16 joueurs connus sont mentionnés, l'agressivité et la propension à la victimisation étaient appropriées aux exigences du modèle. Dans l'expérience 3, réplique partielle de la deuxième, la probabilité des estimations a été faite selon deux perspectives: auteur potentiel et victime potentielle. Globalement, une importance significative a été assignée aux dispositions de l'auteur et non de la victime. Les résultats sont conçus comme reflétant le schéma cognitif des joueurs lors de violence sur le terrain.
Provision of radical pelvic urological surgery in England, and compliance with improving outcomes guidance
Authors: Mayer Erik K. , Bottle Alex , Darzi Ara W. , Athanasiou Thanos , Vale Justin A. 
Published: June 2009

OBJECTIVETo investigate compliance with Improving Outcomes Guidance (IOG) for radical pelvic surgery in England, and explore the pattern of service provision for radical cystectomy (RC) and radical prostatectomy (RP) before and after the introduction of IOG.METHODSFor the period 2000/01–2006/07, all admissions for RC and RP were extracted from Hospital Episode Statistics (HES). At the institutional level, the numbers of RC and RP cases were combined to assess adherence to IOG. The IOG catchment populations for each institution were calculated by linking HES data to census ward population data. The pattern of service provision for RC and RP was independently assessed by assigning institutions into low‐, medium‐ and high‐volume groups of roughly equal volumes a priori, based on the ascending order of annual RC or RP rate, respectively. For RC it was also possible to explore the between‐institution referral activity for RC by identifying the ‘final endoscopic bladder procedure’ that occurred immediately before the RC for each patient. This gave an indication of where the diagnosis and decision for RC had been made.RESULTSThe percentage of institutions achieving the recommended IOG minimal case volume of 50 per year increased significantly between 2000/01 and 2006/07 (36% in odds per year, P < 0.001; odds ratio 1.36, 95% confidence interval 1.24–1.50), although absolute numbers remained relatively low (34% in 2006/07). Only one institution had a catchment population greater than the recommended 1 million. The total number of institutions performing RC decreased significantly over the years (P = 0.03), whereas for RP the decrease was not significant (P = 0.6). The decrease reflected a decline in the number of low‐volume institutions, both for RC and RP, although this decline was not more than expected by chance. There had been a significant increase in the percentage of patients referred to another provider for their RC, from 5.5% in 2000/01 to 19.6% in 2006/07 (28% rise in odds per year, P < 0.001: odds ratio 1.28, 95% confidence interval 1.23–1.33).CONCLUSIONThere was evidence of centralization of radical pelvic urological surgery, although it is only relatively recently that this seems to have taken place with any certainty. The absolute numbers of providers achieving the IOG minimum caseload standard was relatively low. What impact this has had, if any, on the quality of patient care is yet to be fully determined.
The aggressiveness of urinary tract urothelial carcinoma increases with the severity of chronic kidney disease
Authors: Hung Peir‐Haur , Shen Cheng‐Huang , Chiu Yen‐Ling , Jong Ing‐Ching , Chiang Pei‐Chun , Lin Chang‐Te , Hung Kuan‐Yu , Tsai Tun‐Jun 
Published: June 2009

OBJECTIVETo assess, in a retrospective cohort, urinary tract urothelial carcinoma (UT‐UC) in patients with various stages of chronic kidney disease (CKD) and their clinicopathological features, as patients with end‐stage renal disease (ESRD) have a higher incidence of UT‐UC, but the relationship between early stages of CKD and characteristics of UT‐UC are less well known.PATIENTS AND METHODSThe study included 267 patients with pathologically confirmed UT‐UC from January 1994 to December 2006; all had a physical examination (blood pressure), and measurements of laboratory data (serum creatinine, serum haemoglobin) and pathological data. The glomerular filtration rate (GFR) was calculated using the Modification of Diet in Renal Disease equation. Patients were divided into three groups by individual GFR (mL/min), i.e. >60 (no/mild CKD), 30–60 (CKD stage 3) and <30 (CKD stage 4/5).RESULTSThe CKD stages included 81 (30.3%) patients with none/mild CKD, 121 (45.3%) with CKD stage 3 and 65 (24.3%) with CKD stage 4/5. There was a significant and parallel increase in the frequency of UT‐UC as CKD severity increased from none/mild CKD to stage 3 (11% vs 55%), and from CKD stage 3 to 4/5 (55% vs 71%; P < 0.05). Pathologically, the frequency of high‐grade and high T stage UT‐UC in patients with CKD stage 3 (90% and 35%, respectively) and CKD stage 4/5 (91% and 29%, respectively) were significantly greater than in the group with none/mild CKD (P < 0.001). Advanced age and more distant metastasis were independent risk factors for patient survival.CONCLUSIONThe aggressiveness of UT‐UC increased with the severity of CKD, and this might have important clinical consequences.
In idiopathic calcium oxalate stone‐formers, unattached stones show evidence of having originated as attached stones on Randall’s plaque
Authors: Miller Nicole L. , Williams Jr James C. , Evan Andrew P. , Bledsoe Sharon B. , Coe Fredric L. , Worcester Elaine M. , Munch Larry C. , Handa Shelly E. , Lingeman James E. 
Published: June 2009

Study Type – Diagnostic (exploratory cohort) Level of Evidence 2bOBJECTIVETo analyse the structure and composition of unattached stones in idiopathic calcium oxalate (CaOx) stone‐formers (ICSF) and compare them to attached stones from the same cohort, to investigate whether there is more than one pathogenic mechanism for stone formation in ICSF.PATIENTS AND METHODSICSF undergoing percutaneous nephrolithotomy or ureteroscopy for the treatment of nephrolithiasis gave consent to participate in this study. All accessible renal papillae were endoscopically imaged using a digital endoscope. All stones were removed and determined by the operating surgeon to be attached or unattached to the underlying papilla. Micro‐computed tomography (micro‐CT), which provides three‐dimensional analysis of entire stones, was used to compare the structure and composition of attached and unattached stones.RESULTSOf 115 stones collected from nine patients (12 renal units), only 25 stones were found not to be attached to renal papillae. Of these 25 stones, four were lost and 12 showed definite morphological evidence of having been attached to tissue, probably having been displaced from papillae during access. For the remaining nine stones, micro‐CT analysis showed at least one internal region of calcium phosphate within each of these unattached CaOx stones, i.e. the internal structure of the unattached stones is consistent with their having originated attached to Randall’s plaque, and then having become detached but retained in the kidney, with new layers of CaOx eventually covering the original attachment site.CONCLUSIONSMicro‐CT analysis supports the hypothesis that in ICSF, both attached and unattached stones occur as a result of a common pathogenic mechanism, i.e. in this type of stone former, CaOx stones, even those not showing morphology that betrays attachment, all originate attached to interstitial plaque on the renal papilla.
Does early prostate‐specific antigen doubling time (ePSADT) after radical prostatectomy, calculated using PSA values from the first detectable until the first recurrence value, correlate with standard PSADT? A report from the Shared Equal Access Regional Cancer Hospital Database Group
Authors: Teeter Anna E. , Presti Jr Joseph C. , Aronson William J. , Terris Martha K. , Kane Christopher J. , Amling Christopher L. , Freedland Stephen J. 
Published: June 2009

OBJECTIVETo determine if prostate‐specific antigen doubling time (PSADT), calculated from the first detectable PSA level after radical prostatectomy (RP) to the first PSA level of ≥0.2 ng/mL (early PSADT or ePSADT), correlated with ‘standard’ PSADT (henceforth PSADT) calculated using values ≥0.2 ng/mL, as a short PSADT following biochemical recurrence (BCR) after RP portends a poor prognosis and poor response to salvage treatment but this is based upon PSADT calculated using PSA values of ≥0.2 ng/mL.PATIENTS AND METHODSWe used Spearman’s correlation to determine the correlation between ePSADT and PSADT among 157 men in the Shared Equal Access Regional Cancer Hospital database who underwent RP between 1988 and 2005 and had a calculable ePSADT and PSADT. We systematically examined ePSADT thresholds and their positive and negative predictive values (PPV and NPV, respectively), to predict aggressive recurrences (PSADT of <9 months).RESULTSePSADT was significantly, though poorly, correlated with PSADT (r = 0.30, P < 0.001). ePSADT more accurately predicted PSADT among men with a long ePSADT. Of men with an ePSADT of ≥20 or ≥15 months, the NPV for an aggressive recurrence was 98% and 93%, respectively. However, among men with an ePSADT of <3 months, the PPV for aggressive recurrence was only 39%.CONCLUSIONSAlthough ePSADT and PSADT were significantly related, the overall correlation was poor. This was highlighted by the finding that only 39% of men with the shortest ePSADT (<3 months) had a PSADT of <9 months. However, a long ePSADT correlated well with a long PSADT and is thus useful in identifying men at low risk for prostate cancer‐specific mortality very early in their BCR.
Site of positive surgical margins influences biochemical recurrence after radical prostatectomy
Authors: Godoy Guilherme , Tareen Basir U. , Lepor Herbert 
Published: June 2009

OBJECTIVETo determine whether the number and location of positive surgical margins (PSMs) in radical prostatectomy (RP) surgical specimens affect biochemical recurrence (BCR) rates.PATIENTS AND METHODSThe locations of PSMs were recorded for 1308 consecutive men who underwent RP between October 2000 and December 2006. BCR was defined as three consecutive prostate‐specific antigen (PSA) level rises with the peak level ≥0.15 ng/mL. Multivariate regression analyses were used to identify preoperative predictors of PSMs and BCR. The estimated 5‐year risk of BCR was calculated using the Kaplan–Meier method.RESULTSIn all, 128 (9.8%) men had one or more PSMs. The mean body mass index, mean preoperative serum PSA level, the distributions of clinical stage and biopsy Gleason scores, and the presence or absence of biopsy perineural invasion were significantly different between men with or with no PSMs. In multivariate analysis, baseline serum PSA level, Gleason score and perineural invasion were independent preoperative predictors of PSMs. The 5‐year actuarial BCR rates were dependent on the site of the PSM (P = 0.035) and not the number of PSMs (P = 0.18). The rank order of estimated 5‐year BCR rates according to the site of PSMs were base > anterior > posterolateral > apex ≈ posterior.CONCLUSIONSAbout half of the men with PSMs in the RP surgical specimen in our prospective series did not develop BCR. The risk of BCR was dependent on the site and not the number of PSMs. Adjuvant therapy should be considered in cases with anterior and basilar PSMs due to the very high risk of BCR.
Narrow band imaging for detecting residual/recurrent cancerous tissue during second transurethral resection of newly diagnosed non‐muscle‐invasive high‐grade bladder cancer
Authors: Naselli Angelo , Introini Carlo , Bertolotto Franco , Spina Bruno , Puppo Paolo 
Published: June 2009

Study Type – Diagnostic (case series) Level of Evidence 4OBJECTIVETo determine if narrow‐band imaging (NBI) can be used to detect high‐grade cancerous lesions missed with the white light at the time of a second transurethral resection (TUR) of high‐grade non‐muscle‐invasive bladder cancer (NMIBC).PATIENTS AND METHODSConsecutive patients with newly diagnosed high‐grade NMIBC were enrolled in a prospective observational study. Patients with incomplete resection or absence of muscle tissue in the specimen were excluded. About 1 month after the first TUR, NBI cold‐cup biopsies were taken from areas suspicious for urothelial cancer at the end of an extensive white‐light second TUR protocol including: (i) resection of the scar of the primary tumour; (ii) resection of any overt or suspected urothelial lesions; and (iii) six random cold‐cup biopsies of healthy mucosa.RESULTSIn 2008, 47 consecutive patients were recruited after giving written consent (median age 62 years, range 49–83, 39 men and eight women). Nine patients (19%) had macroscopic or microscopic high‐grade NMI urothelial cancer, whereas one was reassessed as having muscle‐invasive disease at the white‐light second TUR plus the six random biopsies. NBI biopsies were taken in 40 of the 47 patients and detected six more patients with high‐grade cancerous tissue (13%). In all 16 of the 47 patients (34%) were found to have residual/recurrent cancer using our extensive protocol of second TUR followed by NBI biopsies.CONCLUSIONSAdding NBI biopsies at the end of an extensive second TUR protocol in patients with newly diagnosed high‐grade NMIBC can lead to the identification of patients with otherwise missed high‐grade residual/recurrent urothelial carcinoma.
The number of negative pelvic lymph nodes removed does not affect the risk of biochemical failure after radical prostatectomy
Authors: Murphy Alana M. , Berkman Douglas S. , Desai Manisha , Benson Mitchell C. , McKiernan James M. , Badani Ketan K. 
Published: June 2009

Study Type – Therapy (case series) Level of Evidence 4OBJECTIVESTo assess patients who had radical prostatectomy (RP) and pelvic lymph node dissection (PLND) for pT2–4 N0M0 prostate cancer, to determine if LN yield affects the risk of biochemical failure (BCF), as the extent of PLND at the time of RP has become increasingly uncertain with the decreasing trend in tumour stage.PATIENTS AND METHODSWe reviewed the Columbia University Urologic Oncology Database for patients with pT2–4 N0M0 prostate cancer treated with RP from 1990 to 2005. Exclusion criteria included <12 months of follow‐up, incomplete clinical and pathological data, and neoadjuvant androgen‐deprivation therapy (ADT) or immediate adjuvant ADT or external beam radiotherapy. Unadjusted and adjusted models were used to determine the ability of clinical and pathological variables to predict BCF.RESULTSThe final dataset included 964 patients, with a mean age of 60.5 years and median preoperative prostate‐specific antigen (PSA) level of 6.2 ng/mL. The median (range) LN yield was 7 (1–42) and the median follow‐up 59 (12–190) months. In the unadjusted and adjusted models, preoperative PSA, pathological Gleason score, pathological stage, surgical margin status and year of surgery were significant predictors of BCF. The LN group was not a significant predictor of BCF in both the unadjusted and adjusted model (P = 0.759 and 0.408, respectively). When patients were stratified into high‐ and low‐risk groups, LN yield remained an insignificant predictor of BCF.CONCLUSIONA higher LN yield at the time of RP does not increase the chance of cure for patients with pT2–4N0M0 prostate cancer. This lack of a survival advantage holds true for patients with high‐risk disease.