bluuebunny/crossref_metadata_2025_split huggingface dataset:
Managing fistula‐in‐ano with ligation of the intersphincteric fistula tract procedure: the Western Hospital experience
Authors: Ooi K. , Skinner I. , Croxford M. , Faragher I. , McLaughlin S. 
Published: August 2011

AbstractAim  To review the preliminary results of the ligation of the intersphincteric fistula tract (LIFT) technique in treating complex anal fistulas at our hospital.Method  Between March and November 2010, patients with cryptoglandular anal fistulas were recruited prospectively from the colorectal clinic and treated using the LIFT procedure. A database was set up to collect information on demographics, past surgical treatments, fistula characteristics, MRI scan results, operative data and follow‐up findings. The primary end‐point measured was cure of the disease. The secondary end‐point was the degree of postoperative continence. Preoperative and postoperative incontinence rates were recorded using Wexner’s Incontinence Scale.Results  Twenty‐five patients (eight women and 17 men; median age, 40 years) underwent the LIFT procedure. Ten patients had recurrent fistulas and previous fistula surgery. The median operating time was 39 min. No intraoperative complications were documented. The median follow‐up duration was 22 (3–43) weeks. Primary healing was observed in 17 (68.0%) patients and the median healing time was 6 weeks; one wound remained incompletely healed. Seven patients (28.0%) had disease recurrence presenting between 7 and 20 weeks postoperatively. No patients reported any incontinence postoperatively.Conclusion  The LIFT procedure has favourable healing rates with little or no risk of incontinence. This operation is safe and easy to learn. The early results from this pilot study show promise and affirm some of the findings of other researchers. These results will suggest opportunities to conduct further controlled studies comparing the LIFT procedure with standard therapies.
J‐pouch vs side‐to‐end coloanal anastomosis after preoperative radiotherapy and total mesorectal excision for rectal cancer: a multicentre randomized trial
Authors: Doeksen A. , Bakx R. , Vincent A. , van Tets W. F. , Sprangers M. A. G. , Gerhards M. F. , Bemelman W. A. , van Lanschot J. J. B. 
Published: August 2011

AbstractAim  Comparison of functional and surgical outcome of the J‐pouch with the side‐to‐end coloanal anastomosis after preoperative radiotherapy and total mesorectal excision in rectal cancer patients.Method  In a multicentre study, patients with a carcinoma of the lower two‐thirds of the rectum were randomized to either a J‐pouch or a side‐to‐end reconstruction. Primary outcome was function of the neorectum 1 year after surgery. A functional outcome [COloREctal Functional Outcome (COREFO)] questionnaire, and two quality of life questionnaires (EORTC‐QLQ‐CR38 and SF‐36) were to be completed by all participants preoperatively, and 4 and 12 months postoperatively. Independent data managers recorded surgical outcome. A group size of 30 patients in each group was calculated based on a 15‐point difference of the COREFO scale.Results  In total, 107 patients were randomized, 55 in the J‐pouch group and 52 in the side‐to‐end anastomosis group. The COREFO incontinence scale at 4 months and the total functional outcome at 4 and 12 months showed better results for the J‐pouch group in comparison with the side‐to‐end anastomosis group. The remaining COREFO scales (frequency, social impact, stool‐related aspects and bowel medication), surgical outcome (complications, reoperations, length of hospital stay, readmissions and mortality) and quality of life did not show significant differences between treatment groups.Conclusion  The overall results of a coloanal J‐pouch and a side‐to‐end anastomosis are comparable, although functional results are slightly better with a J‐pouch. The side‐to‐end anastomosis is technically less demanding and therefore a justified alternative in sphincter‐saving surgery.
Transanal endoscopic microsurgery for rectal carcinoids: the largest reported United States experience
Authors: Kumar A. S. , Sidani S. M. , Kolli K. , Stahl T. J. , Ayscue J. M. , Fitzgerald J. F. , Smith L. E. 
Published: August 2011

AbstractAim  Rectal carcinoids are often inadequately resected by snare excision during colonoscopy. Transanal endoscopic microsurgery is a minimally invasive procedure with low morbidity that offers full‐thickness excision with a low rate of negative margins. It presents an excellent alternative to radical surgery for mid and proximally located lesions. We report the largest United States (US) experience in the use of transanal endoscopic microsurgery for rectal carcinoids.Method  Data of patients who had undergone transanal endoscopic microsurgery for rectal carcinoids were prospectively collected and retrospectively analyzed. Patient and tumour characteristics, operative and perioperative details, as well as oncological outcomes were reviewed.Results  Over a 12‐year period, 24 patients underwent transanal endoscopic microsurgery for rectal carcinoids. Of these, six (25%) were primary surgical resections and 18 (75%) were performed after incomplete snare excisions during colonoscopy. Three (17%) patients who underwent full‐thickness resection after snare excision had residual tumour on histopathological examination. Negative margins were obtained in all cases. No recurrences were noted.Conclusion  Transanal endoscopic microsurgery is effective and safe for the surgical resection of rectal carcinoids < 2 cm in diameter, with typical features and located more than 5 cm from the anal verge. Transanal endoscopic microsurgery can be used for primary resection or for resection after incomplete colonoscopic snare excision.
Deconstructing the native–exotic richness relationship in plants
Authors: Bartomeus Ignasi , Sol Daniel , Pino Joan , Vicente Paloma , Font Xavier 
Published: August 2011

ABSTRACTAim  Classic theory suggests that species‐rich communities should be more resistant to the establishment of exotic species than species‐poor communities. Although this theory predicts that exotic species should be less diverse in regions that contain more native species, macroecological analyses often find that the correlation between exotic and native species richness is positive rather than negative. To reconcile results with theory, we explore to what extent climatic conditions, landscape heterogeneity and anthropogenic disturbance may explain the positive relationship between native and exotic plant richness.Location  Catalonia (western Mediterranean region).Methods  We integrated floristic records and GIS‐based environmental measures to make spatially explicit 10‐km grid cells. We asked whether the observed positive relationship between native and exotic plant richness (R2= 0.11) resulted from the addition of several negative correlations corresponding to different environmental conditions identified with cluster analysis. Moreover, we directly quantified the importance of common causal effects with a structural equation modelling framework.Results  We found no evidence that the relationship between native and exotic plant richness was negative when the comparison was made within environmentally homogeneous groups. Although there were common factors explaining both native and exotic richness, mainly associated with landscape heterogeneity and human pressure, these factors only explained 17.2% of the total correlation. Nevertheless, when the comparison was restricted to native plants associated with human‐disturbed (i.e. ruderal) ecosystems, the relationship was stronger (R2= 0.52) and the fraction explained by common factors increased substantially (58.3%).Main conclusions  While our results confirm that the positive correlation between exotic and native plant richness is in part explained by common extrinsic factors, they also highlight the great importance of anthropic factors that – by reducing biotic resistance – facilitate the establishment and spread of both exotic and native plants that tolerate disturbed environments.
Socialization of Physical and Social Aggression in Early Adolescents' Peer Groups: High‐status Peers, Individual Status, and Gender
Authors: Shi Bing , Xie Hongling 
Published: August 2011

AbstractThe influence of high‐status peers on a target individual's physical and manipulative social aggression in peer groups was examined in a diverse sample of seventh‐grade students. A total of 245 individual members belonging to 65 groups were included in analyses. Aggression was assessed by peer and victim nominations in the fall and spring semesters of seventh grade. High‐status peers rather than low‐status peers in a group had a strong influence on individual members' physical and social aggression. High‐status peers were particularly influential on low‐status individual members' social aggression. A similar pattern was found for physical aggression in boys' groups. These findings imply that high‐status members' aggression rather than the average of all members' may better represent the group norm. Special attention needs to be given to high‐status aggressive adolescents in future intervention and prevention of aggression in schools.
Explaining health marginalisation of the lower educated: the role of cross‐national variations in health expenditure and labour market conditions
Authors: Gesthuizen Maurice , Huijts Tim , Kraaykamp Gerbert 
Published: August 2011

AbstractSeveral studies have shown ample cross‐national variation in the risk that lower educated people run to be in poor health. However, explanations for this cross‐national variation are still scarce. In this article we aim at filling this lacuna by investigating to what extent cross‐national variation in the health gap between the lower and higher educated in Europe is explained by governmental health expenditure, namely, how much governments contribute to a country’s total healthcare costs, and labour market conditions, that is, unemployment rates and modernisation of the labour market. We used information from the European Social Survey (ESS) 2002–2008 on more than 90,000 individuals in 32 European nations, and estimated hierarchical models with cross‐level interactions to test our expectations. Our results show that the relative risk of being in poor health of lower educated individuals is smaller in countries where the government spends much on healthcare and with a highly modernised labour market.
Zinc l‐pyrrolidone carboxylate inhibits the UVA‐induced production of matrix metalloproteinase‐1 by in vitro cultured skin fibroblasts, whereas it enhances their collagen synthesis
Authors: Takino Y. , Okura F. , Kitazawa M. , Iwasaki K. , Tagami H. 
Published: August 2011

SynopsisReduced collagen matrix in the dermis constitutes one of the characteristic features of chronologically aged skin, which is further enhanced on the sun‐exposed portions of the body by chronic ultraviolet light (UV) irradiation, inducing the unique changes associated with skin photoageing. The zinc salt of l‐pyrrolidone carboxylate (Zinc PCA) has long been used as a cosmetic ingredient, because of its astringent and anti‐microbial properties. In the present study, by employing cultured normal human dermal fibroblasts, we found that Zinc PCA suppressed UVA‐induced activation of activator protein‐1 (AP‐1) and reduced matrix metalloproteinase‐1 production in these cells, which is thought to be involved in collagen degradation in photoaged skin. Moreover, Zinc PCA treatment of the cells increased the expression of an ascorbic acid transporter mRNA, SVCT2, but not SVCT1, resulting in the enhanced production of type I collagen. Based on these in vitro findings, we consider Zinc PCA to be a promising candidate for an anti‐skin ageing agent.
Imported leprosy in Italy
Authors: Massone C. , Brunasso A.M.G. , Noto S. , Campbell T.M. , Clapasson A. , Nunzi E. 
Published: August 2011

AbstractBackground  Leprosy is far from being eliminated with more than 200 000 new cases detected (NCD)/year.Objective  Retrospective analysis between 2003 and 2009 to compare the New Case Detected Rate (NCDR) observed in Italy in the immigrant population with the NCDR of the same population in their country of origin to verify if the cases observed are those expected or not.Methods  Leprosy statistics were retrieved from the Italian leprosy register and from official WHO data.Results  The NCD in Italy were lower than expected, from 2003 when the expected number of NCD was 40.5 between the legally resident immigrants, but only one case was diagnosed (98% of lower from the expected), to 2009 when four NCD were diagnosed and 41 were expected (90% lower from expected).Conclusions  This study points out a discrepancy between the observed and the expected cases of leprosy in Italy. Specifically, the number of NCD was less than expected for each studied year. Of course our data do not represent a validation, but only an indication of the leprosy diagnosis in Italy. Difficulty in accessing the health systems, fear of segregation, ignorance and illegal immigrant status with consequent fear of police arrest are possible explaining factors. The critical issue anyhow is the medical expertise. The role of the dermatologist is fundamental. For these reasons, there is still a need for wide spread leprosy teaching programmes. Although with few limitations, this study represents a first approach to validate the accuracy in leprosy diagnosis in Italy.
Methamphetamine exposure during brain development alters the brain acetylcholine system in adolescent mice
Authors: Siegel Jessica A. , Park Byung S. , Raber Jacob 
Published: August 2011

J. Neurochem. (2011) 119, 89–99.AbstractChildren exposed to methamphetamine during brain development as a result of maternal drug use have long‐term hippocampus‐dependent cognitive impairments, but the mechanisms underlying these impairments are not understood. The acetylcholine system plays an important role in cognitive function and potential methamphetamine‐induced acetylcholine alterations may be related to methamphetamine‐induced cognitive impairments. In this study, we investigated the potential long‐term effects of methamphetamine exposure during hippocampal development on the acetylcholine system in adolescence mice on postnatal day 30 and in adult mice on postnatal day 90. Methamphetamine exposure increased the density of acetylcholine neurons in regions of the basal forebrain and the area occupied by acetylcholine axons in the hippocampus in adolescent female mice. In contrast, methamphetamine exposure did not affect the density of GABA cells or total neurons in the basal forebrain. Methamphetamine exposure also increased the number of muscarinic acetylcholine receptors in the hippocampus of adolescent male and female mice. Our results demonstrate for the first time that methamphetamine exposure during hippocampal development affects the acetylcholine system in adolescent mice and that these changes are more profound in females than males.
Anticoagulant management in the cardiovascular setting
Authors: Verheugt Freek W.A. 
Published: August 2011

AbstractVitamin K antagonists have been used as oral anticoagulants (OACs) for over five decades, yet their use in real‐world practice is problematic primarily because of their narrow therapeutic window, exacerbated by extensive food and drug interactions, necessitating regular coagulation monitoring and dose adjustment. Around half of patients receiving warfarin are within the therapeutic range, exposing them to the dangers of under‐anticoagulation (i.e. thrombosis formation) or over‐anticoagulation (i.e. bleeding). A new generation of OACs with improved pharmacology promises to revolutionize antithrombotic management. Rivaroxaban, apixaban (both oral direct Factor Xa inhibitors) and dabigatran (a direct thrombin inhibitor) all exhibit predictable anticoagulant responses and few drug–drug interactions and do not require routine coagulation monitoring.
Is there an underestimation of intima‐media thickness based on M‐mode ultrasound technique in the abdominal aorta?
Authors: Dahlén Elsa M. , Andreasson Thomas , Cinthio Magnus , Nystrom Fredrik H. , Östgren Carl Johan , Länne Toste 
Published: August 2011

SummaryMeasuring intima‐media thickness (IMT) in the common carotid artery (CCA) is a valuable resource for the evaluation of subclinical atherosclerosis. The main objective of this study was to explore whether a B‐mode ultrasound technique, Philips ATL, and an M‐mode ultrasound technique, Wall Track System (WTS), show interchangeable results when measured in CCA and the abdominal aorta (AA). A total of 24 healthy, young subjects were examined. IMT and lumen diameter (LD) of the AA and the CCA were measured twice by two skilled ultrasonographers with two different ultrasound equipment B‐mode: (Philips, ATL and M‐mode: WTS).The intra‐observer variability of IMT in CCA and AA using B‐mode showed a coefficient of variation 8% and 9%, and with M‐mode 11% and 15%, respectively. Interobserver variability of IMT in CCA and AA using B‐mode was 6% and 12%, and with M‐mode 11% and 18%, respectively. CCA IMT was 0·53 ± 0·07 and 0·53 ± 0·09 mm using B‐mode and M‐mode, respectively. However, in AA, IMT was 0·61 ± 0·05 and 0·54 ± 0·10 mm using B‐mode and M‐mode, respectively. Thus, AA IMT was 11·5% thicker using B‐mode (P<0·01). We received adequate IMT readings from the carotid artery as well as the AA using two commonly used B‐mode and M‐mode techniques. B‐mode technique seems to show less variability, especially in the AA. More importantly, the two techniques measured different IMT thickness in the aorta, emphasizing the importance of using similar technique when comparing the impact of absolute values of IMT on cardiovascular disease.
The Accuracy of Present‐on‐Admission Reporting in Administrative Data
Authors: Goldman L. Elizabeth , Chu Philip W. , Osmond Dennis , Bindman Andrew 
Published: August 2011

ObjectiveTo test the accuracy of reporting present‐on‐admission (POA) and to assess whetherPOAreporting accuracy differs by hospital characteristics.Data SourcesWe performed an audit ofPOAreporting of secondary diagnoses in 1,059 medical records from 48California hospitals.Study DesignWe used patient discharge data (PDD) to select records with secondary diagnoses that are powerful predictors of mortality and could potentially represent comorbidities or complications among patients who either had a primary procedure of a percutaneous transluminal coronary angioplasty or a primary diagnosis of acute myocardial infarction, community‐acquired pneumonia, or congestive heart failure. We modeled the relationship between secondary diagnosesPOAreporting accuracy (over‐reporting and under‐reporting) and hospital characteristics.Data CollectionWe created a gold standard from blind reabstraction of the medical records and compared the accuracy of thePDDagainst the gold standard.Principal FindingsThePDDand gold standard agreed onPOAreporting in 74.3 percent of records, with 13.7 percent over‐reporting and 11.9 percent under‐reporting. For‐profit hospitals tended to overcode secondary diagnoses as present on admission (odds ratios [OR] 1.96; 95 percent confidence interval [CI] 1.11, 3.44), whereas teaching hospitals tended to undercode secondary diagnoses as present on admission (OR2.61; 95 percentCI1.36, 5.03).ConclusionsPOA reporting of secondary diagnoses is moderately accurate but varies by hospitals. Steps should be taken to improvePOAreporting accuracy before usingPOAin hospital assessments tied to payments.
Temperature Dependence on Domain Switching Behavior in Lead Zirconate Titanate Under Electrical Load via In Situ Neutron Diffraction
Authors: Pojprapai Soodkhet , Simons Hugh , Studer Andrew J. , Luo Zhenhua , Hoffman Mark 
Published: August 2011

The influence of temperature on the kinetics of domain switching in lead zirconate titanate was investigated by using in situ neutron diffraction. Samples were electrically loaded to 1 kV/mm at 30°C, 125°C, and 175°C, after which the diffracted patterns in the on‐ and off‐state were compared. The results demonstrated that the degree of domain switching increases with increased temperature. Corroboration with hysteresis measurements showed that while the coercive field decreases with increasing temperature, the degree of saturation increased significantly. According to Merz's model, it is therefore apparent that, due to increased switching rate at high temperature, domain switchability increases with temperature.
Mental health‐related learning needs of clinicians working in Australian emergency departments: A national survey of self‐reported confidence and knowledge
Authors: Sivakumar Sharanya , Weiland Tracey J , Gerdtz Marie F , Knott Jonathon , Jelinek George A 
Published: August 2011

AbstractObjective: To identify the mental health‐related learning needs of doctors and nurses working in Australian EDs.Methods: A purpose‐designed survey was developed, and face validity was verified by 12 doctors and nurses. A cross‐sectional survey of a national sample of nurses and senior doctors (registrars and consultants) working in EDs across Australia was then undertaken. The survey consisted of 130 items and required approximately 20 min for completion. The survey was delivered online through email invitation by the College of Emergency Nurses Australasia or the Australasian College for Emergency Medicine. A hardcopy format of the survey was also delivered at a national conference.Results: Mental health presentations that involved a diagnosis of personality disorder, psychosis or behavioural disturbance, and the management of these conditions were patient factors that were considered problematic by up to 46.3% (118/255; 95% CI 40.26–52.40) of doctors and 66.1% (72/109; 95% CI 56.74–74.28) of nurses. Determining care plans, conducting mental status examinations, assessing risk of self‐harm, pharmacology for treatment and for chemical restraint, management of patient aggression or violence, and alcohol or drug intoxication were also found to be areas of knowledge deficit.Conclusion: Doctors and nurses reported deficits in confidence and knowledge in tasks and patient presentations that they might frequently be expected to manage. These data can be used to inform future curricula at both undergraduate and postgraduate levels. Ultimately, this might pave the way for improved care and management of patients with mental health problems presenting to the ED.
Resolving the nuclear dust distribution of the Seyfert 2 galaxy NGC 3081
Authors: Ramos Almeida C. , Sánchez-Portal M. , Pérez García A. M. , Acosta-Pulido J. A. , Castillo M. , Asensio Ramos A. , González-Serrano J. I. , Alonso-Herrero A. , Rodríguez Espinosa J. M. , Hatziminaoglou E. , Coia D. , Valtchanov I. , Pović M. , Esquej P. , Packham C. , Altieri B. 
Published: August 2011

Abstract
We report far-infrared (FIR) imaging of the Seyfert 2 galaxy NGC 3081 in the range 70–500 µm, obtained with an unprecedented angular resolution, using the Herschel Space Observatory instruments PACS and SPIRE. The 11 kpc (∼70 arcsec) diameter star-forming ring of the galaxy appears resolved up to 250 µm. We extracted IR (1.6–500 µm) nuclear fluxes, that is active nucleus-dominated fluxes, and fitted them with clumpy torus models, which successfully reproduce the FIR emission with small torus sizes. Adding the FIR data to the near- and mid-IR spectral energy distribution (SED) results in a torus radial extent of Ro= 4+2− 1 pc, as well as in a flat radial distribution of the clouds (i.e. the q parameter). At wavelengths beyond 200 µm, cold dust emission at T= 28 ± 1 K from the circumnuclear star-forming ring of 2.3 kpc (∼15 arcsec) in diameter starts making a contribution to the nuclear emission. The dust in the outer parts of the galaxy is heated by the interstellar radiation field (19 ± 3 K).