bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of surgery in high‐risk localised prostate cancer
Authors: Gnanapragasam Vincent J. , Mason Malcolm D. , Shaw Greg L. , Neal David E. 
Published: September 2011

The optimal management of high‐risk localised prostate cancer is a major challenge for urologists and oncologists. It is clear that multimodal therapy including radical local treatment is needed in these men to achieve the best outcomes.External beam radiotherapy (EBRT) is an essential component of therapy either as a primary or adjuvant treatment. However, the role of radical prostatectomy (RP) is more controversial. Both methods are currently valid therapy options.There have been many individual studies of EBRT and RP in high‐risk disease, but no good quality large prospective randomized trials.In EBRT, combination with neoadjuvant plus long‐term adjuvant androgen‐deprivation therapy (ADT) has been conclusively shown to improve outcomes and is widely considered the standard of care.However, the role of RP has achieved recent prominence with several important studies. Published data from prospective randomized trials in patients after RP have shown that in men with adverse pathological features at surgery, the addition of adjuvant RT improves biochemical‐free and progression‐free survival.More recently, studies from large‐volume centres comparing EBRT and RP have provided intriguing suggestions of better outcomes with RP as the primary treatment.An important question therefore, is which of the two methods provides the best outcome in men with localised high‐risk disease. Crucially, does the combination of RP and selective adjuvant EBRT provide clinically significant better outcomes compared with EBRT alone?In this review we discuss the current evidence for the role of RP for high‐risk localised prostate cancer and define the parameters and urgent need for a prospective trial to test the role of surgery for this group of patients.
Radiopacity of intracerebral hemorrhage correlates with perihemorrhagic edema
Authors: Wagner I. , Volbers B. , Hilz M. J. , Schwab S. , Doerfler A. , Staykov D. 
Published: September 2011

Background:  Experimental evidence indicates that iron plays a key role in edema formation after intracerebral hemorrhage (ICH). We investigated the relationship between ICH radiopacity on CT as a marker of hematoma iron content and perihemorrhagic edema (PHE) after ICH.Methods:  We retrospectively investigated patients with spontaneous lobar and ganglionic supratentorial ICH who received follow‐up CT scans during the first 7 days after symptom onset (d1, d2–4, d5–7). Measurements of ICH and edema volumes were taken using a semiautomatic threshold‐based volumetric algorithm. Radiopacity of the blood clot was determined using the mean Hounsfield unit (HU) count of the ICH.Results:  A total of 117 patients aged 71.92 ± 11.55 years with spontaneous ICH (34.63 ± 32.44 ml) were included in the analysis. Mean ICH radiopacity was 59.7 ± 3.4 HU. We found significantly larger relative PHE at d2–4 (1.7 ± 0.9 vs. 1.3 ± 0.8; P = 0.032) and d5–7 (2.0 ± 1.3 vs. 1.3 ± 0.9; P = 0.007) and larger peak relative PHE (2.3 ± 1.6 vs. 1.6 ± 1.1; P = 0.006) in patients with ICH radiopacity >60 HU (n = 59), as compared to patients with ICH radiopacity <60 HU (n = 58).Conclusions:  Higher ICH radiopacity, reflecting higher in vivo hematoma iron content, is associated with more PHE after ICH.
A single nucleotide polymorphism rs9468925 of MHC region is associated with clinical features of generalized vitiligo in Chinese Han population
Authors: Liu Jianlan , Tang HuaYang , Zuo XianBo , Liang Bo , Wang PeiGuang , Sun LiangDan , Yang Sen , Zhang XueJun 
Published: September 2011

AbstractBackground  Vitiligo has been found to be associated with different HLA antigens in different ethnic groups. In our previous genome‐wide association study (GWAS), we identified independent association signal of rs9468925 (P = 2.21 × 10−33, OR = 0.74) within HLA‐C‐HLA‐B region.Objectives  To explore the association between rs9468925 polymorphism within MHC and the clinical features of generalized vitiligo.Methods  The study, using 5566 cases and 6462 controls from previous GWA study investigated the single and combined (GA + GG) genotypic distribution of rs9468925 in subsets of vitiligo patients having different clinical features. We performed a QTL analysis (quantitative trait locus) for age of onset with genotype of rs9468925.Results  The GA + GG genotypic distribution of SNP rs9468925 tested with an additive model was found to be significantly different in subgroups of patients of >20 vs. <20 years old (genotypic P = 2.57 × 10−4, combined P = 3.0 × 10−3, OR = 0.77, 95% CI: 0.64–0.92), and in patients with different clinical subtypes of vitiligo (genotypic P = 0.03, combined P = 5.0 × 10−3). However, there was no statistical significance for familial history, halo nevi involvement and autoimmune disease involvement.Conclusions  Allele G of rs9468925 on HLA‐C‐HLA‐B may be associated with a higher risk of vitiligo. Our study showed a significant genotypic variation between patients with age of onset ≤20 years and age of onset >20 years. Obvious clinical differences of generalized vitiligo related to genotypic variation found in the Chinese Han population were confirmed in this study.
Universal and targeted computerised cognitive behavioural therapy (Think, Feel, Do) for emotional health in schools: results from two exploratory studies
Authors: Attwood Megan , Meadows Sara , Stallard Paul , Richardson Thomas 
Published: September 2011

Background:  Computerised Cognitive Behaviour Therapy (cCBT) offers the potential to make evidence based interventions more available and accessible for children and young people. Research is currently limited and proof of concept studies are required to explore the viability and possible therapeutic benefits of cCBT as a universal or targeted intervention in schools.Method:  In Study 1, cCBT was provided as a universal intervention to 13 participants who were assigned to either group cCBT or a matched computer gaming condition. In Study 2, cCBT was provided as a targeted intervention by trained school nurses to 12 participants with mild or moderate emotional problems.Results:  Both studies found cCBT to result in immediate post intervention benefits and feedback about the programme was very positive.Conclusion:  This study provides proof of concept that cCBT provided as a universal or targeted emotional health intervention in schools is viable and may result in immediate therapeutic benefits. These findings are limited by the small sample size and absence of follow‐up but suggest that more methodologically robust evaluations should be pursued.
Activated lymphocytes and high liver expression of IFN‐γ are associated with fulminant hepatic failure in patients
Authors: dos Santos Damião C. M. , Neves Patricia C. C. , Azeredo Elzinandes L. , Pelajo‐Machado Marcelo , Martinho José Manoel S. G. , Pacheco‐Moreira Lúcio F. , Araújo Cristina C. V. , Cruz Oswaldo Gonçalves , de Oliveira Jaqueline Mendes , Pinto Marcelo Alves 
Published: September 2011

AbstractBackground & AimsTo study immunological mechanisms of fulminant hepatic failure (FHF) derived from extensive liver lesions, 14 patients with FHF induced by different aetiologies were investigated by observance of both lymphocyte phenotyping and cytokine levels.MethodsFive patients bearing benign acute hepatitis B (AHB) and seven healthy liver donors (HC) were used as controls. Samples of liver and blood from both FHF patients and HC were obtained during transplantation procedures. Plasma levels of IL‐1β, IL‐4, IL‐6, IL‐8, IL‐10, IFN‐γ, TNF‐α, MCP‐1, RANTES and MIP‐1α were quantified using a multiplex immunoassay. Cell characterization was carried out by flow cytometry. IFN‐γ staining was performed on liver sections using immunofluorescence methods.ResultsAn increase of peripheral frequency of natural killer (NK) cells expressing early activation markers (CD69, HLA‐DR and CD38) and adhesion molecule CD44 was observed in FHF patients. Elevated frequency of T lymphocytes CD4+ and CD8+ expressing CD38 and adhesion molecules CD29 and CD44 was also observed in FHF. Additionally, an increase of natural killer T cells (NKT) was detected in FHF patients. High plasma cytokine levels were not statistically different between FHF and AHB patients. In comparison to HC, a strong liver expression of IFN‐γ was detected in FHF patients. The increased frequency of CD4+CD44+ and IL‐8 cytokine was found in patients with poor prognosis.ConclusionsThese findings indicate the involvement of NK and NKT cells as well as T lymphocytes CD4+ and CD8+ in the inflammatory process inducing FHF, confirmed by the high hepatic expression of IFN‐γ.
The Covariation of Antisocial Behavior and Substance Use in Adolescence: A Behavioral Genetic Perspective
Authors: MAdams Tom , Rowe Richard , Rijsdijk Fruhling , Maughan, Barbara , Eley Thalia C. 
Published: September 2011

Multivariate genetic studies have revealed genetic correlations between antisocial behavior (ASB) and substance use (SU). However, ASB is heterogeneous, and it remains unclear whether all forms are similarly related to SU. The present study examines links between cannabis use, alcohol consumption, and aggressive and delinquent forms of ASB using a behavioral genetic approach. Participants were 1,688 adolescents (482 monozygotic twins, 852 dizygotic twins, and 354 nontwin siblings) aged 15–23 years old (M = 16.91), sampled from the community in the U.K. Multivariate model fitting revealed that the genetic components of alcohol consumption and cannabis use correlated with those of both aggression (.21 and .49, respectively) and delinquency (.35 and .69, respectively). Results suggest that both aggression and delinquency have genetic effects in common with alcohol consumption and cannabis use.
Intraoperative Contamination of the Suction Tip in Clean Orthopedic Surgeries in Dogs and Cats
Authors: Medl Nikola , Guerrero Tomás G. , Hölzle Ludwig , Hässig Michael , Lochbrunner Sebastian , Montavon Pierre M. 
Published: September 2011

ObjectiveTo (1) determine suction tip (intermittent and continuous mode) contamination rate in orthopedic surgery in dogs and cats; (2) examine the effect of surgical time on contamination; and (3) report bacteria isolated.Study DesignClinical study.Sample PopulationClean orthopedic surgeries (n = 50).MethodsSurgical procedures were assigned to 1 of 2 groups: (1) continuous (n = 25) or (2) intermittent suction (n = 25). A control suction was operated in each surgery. Samples for aerobic and anaerobic bacteriologic examination were collected from the surgical suction at 0, 20, 60 minutes, and at the end of surgery, and from the control suction at the end of the surgery only. Comparison of continuous and intermittent suction data, and the effect of surgical time on contamination rate were analyzed using a Kaplan‐Meier survival analysis followed by a Cox proportional hazards model.P< .05 was considered significant.ResultsAerobic contamination occurred in 22 of 50 surgical procedures and there was no anaerobic growth. There was no significant difference between continuous and intermittent suction mode groups (P= .40). Surgical time did not influence the contamination rate (P= .79). Bacterial cultures mainly revealed coagulase‐negativeStaphylococci, however multiresistant bacteria were isolated.ConclusionsWe failed to find superiority of the intermittent operation mode of the suction tip over the continuous mode. A safe time frame before contamination of the suction tip occurs that could not be defined.
Biomechanical Evaluation of Screw‐In Femoral Implant in Cementless Total Hip System
Authors: Kim James Y. , Hayashi Kei , Garcia Tanya C. , Kim Sun‐Young , Entwistle Rachel , Kapatkin Amy S. , Stover Susan M. 
Published: September 2011

ObjectiveTo compare (1) proximal femoral axial strains, (2) femoral head deflection, and (3) failure mechanical properties, betweenHelica head and neck prosthesis implanted femora and normal femora.Study DesignIn vitro study.Sample PopulationCadaveric canine femora (n = 5 pair).MethodsFemoral bone strains and head displacement during in vitro simulation of midstance of the gallop were evaluated using cadaveric femurs cyclically loaded in vitro. Strains and displacements were compared within femurs, before and after, prosthesis implantation; and throughout cycling to seek evidence of movement with cyclic loading. Subsequently, implanted femurs and contralateral, intact femurs were loaded to failure to compare failure mechanical properties and modes of failure.ResultsProximal femoral axial strains were significantly different between intact and implanted femora on all 4 cortical surfaces (P< .05). Compressive strains were lower in the implanted femur on all cortical surfaces, except on the caudal surface which was higher. No difference was noted for femoral head angle under an axial load corresponding to gallop (P> .05). Vertical head displacement was ∼0.1 mm greater for implanted femora than intact femora (P< .05). Yield and failure loads and yield energy of implanted femora were 39–54% lower than those for intact femora (P< .05). Mode of failure for both the intact and implanted femora did not appear to be different.ConclusionHelica femoral prosthesis alters strain distribution in the proximal aspect of the femur and exhibits initial micromotion. Failure load in axial compression of theHelica‐implanted femur is less than that of the normal femur, but greater than that expected in vivo.
Theoretical Analysis of the Effect of Positioning on Hemodynamic Stability During Pregnancy
Authors: Summers Richard L. , Harrison James M. , Thompson James R. , Porter John , Coleman Thomas G. 
Published: September 2011

ACADEMIC EMERGENCY MEDICINE 2011; 18:1094–1098 © 2011 by the Society for Academic Emergency MedicineAbstractObjectives:  A left lateral tilt of 15° has been advocated during trauma resuscitation of near‐term pregnant patients to avoid the potential for hemodynamic compromise caused by aortocaval compression in the supine position. This recommendation is supported by limited objective evidence, and an experimental determination of the optimal tilt required would be very difficult to accomplish logistically. A derivation of the Guyton/Coleman/Summers computer model of cardiovascular physiology was used to analyze the theoretically expected hemodynamic responses to varying degrees of lateral tilt for a normal pregnancy and during a simulated hemorrhagic shock.Methods:  Computer simulation studies were used to predict the degree of left lateral tilt required to restore hemodynamic normalcy during the final 20 weeks of gestation. The analytic procedure involved recreating the clinical conditions for a virtual subject through a simulated reenactment of the clinical transfer of a pregnant patient from a lateral to a supine positioning. An analysis of model validity in the context of this particular clinical condition found the model predictions to be within 5% to 12% of experimental results.Results:  During the simulated lateral to supine position transfer, the virtual patient with Class I hemorrhage had a 7% greater fall in cardiac output and a 17% greater fall in mean arterial pressure (MAP) than the corresponding nonhemorrhagic patient. The model suggests that 15° of tilt will result in hemodynamic normalization only up to 26 weeks of gestation. In addition, 13% greater tilt is required to achieve hemodynamic normalcy in the hemorrhaged term pregnant patient.Conclusions:  Current trauma guidelines suggest that the pregnant trauma patient be placed in a 15° left lateral tilt position to prevent aortocaval compression. A computer simulation study suggests that this tilt may be inadequate to offload the vena cava and normalize the circulation.
Intrapartum epidural analgesia and ST analysis of the fetal electrocardiogram
Authors: BECKER JEROEN H. , SCHAAP TIMME P. , WESTERHUIS MICHELLE E.M.H. , VAN WOLFSWINKEL LEO , VISSER GERARD H.A. , KWEE ANNEKE 
Published: September 2011

AbstractObjective. To evaluate the influence of intrapartum epidural analgesia on the occurrence of ST events of the fetal ECG. Design. Nested case–control study. Setting. Single‐centre academic hospital in the Netherlands. Population. Laboring women with a high‐risk singleton pregnancy in cephalic position beyond 36weeks of gestation. Methods. Data of 72 women who received epidural analgesia using bupivacaine combined with sufentanil and 72 control women were collected and analyzed. The moment of epidural infusion was defined as t0. In the control group, t0 was defined by matching dilatation in centimeters. STAN® registrations from one hour before until two hours after t0 were classified, and the numbers and types of ST events were recorded and judged according to the STAN® clinical guidelines. T/QRS ratios were collected from one hour before t0 until two hours after t0, and differences were compared between the two groups. Main Outcome Measures. Numbers and types of ST events and mean T/QRS ratios before and after t0. Results. There were no significant differences between cases and control women regarding the numbers of ST events, types of ST events and whether they were significant (intervention advised) or not. Correction for outliers (three cases and three control women) did not change the results. Differences of T/QRS ratios before and after t0 were comparable between cases and control women. Conclusions. Epidural analgesia has no effect on the numbers or types of ST events when using ST analysis of the fetal ECG.
Why Financial Institutions Matter: The Case of Energy Infrastructure MLPs
Authors: Ciccotello Conrad S. 
Published: September 2011

Institutional investors entered the Master Limited Partnership (MLP) space in 2001 with the Kinder Morgan offering of I‐share units. In the ten years that have passed since then, the number of MLPs has quadrupled, and their total market capitalization has increased tenfold. When compared to the MLPs of the 1980s, today's MLP are more focused both in terms of operations and distribution policy. After its birth in 1981, the MLP spread to over 30 different industries. But thanks in large part to tax law changes in 1987 that have helped limit MLPs to natural resource sectors, companies adopting the MLP structure since then have been concentrated in energy, and especially in energy infrastructure. And whereas distribution policy varied considerably among the early MLPs, today's MLPs uniformly pay out a large majority of their distributable cash flow.But to maintain or expand existing energy infrastructure while paying out most of their cash from operations, many MLPs require significant amounts of new capital. To help meet this ongoing funding requirement, new kinds of institutional intermediaries such as closed‐end C‐Corporation investment companies have emerged to provide capital to MLPs in the form of direct placements that offer flexibility with regard to offer sizing and timing. Since 2004, the total value of such direct placements of MLP units has exceeded $15 billion.What's more, the rise of this MLP operating/C‐corporation investment company structure has resulted in a novel realignment of incentives and functions. In this innovative arrangement, the pass‐through operating vehicle (i.e., the MLP) avoids double taxation of dividends while effectively committing managers to distribute cash. At the same time, for those MLPs with large maintenance and other requirements for capital, the commitment to pay out cash effectively forces the operating companies to raise capital continuously and stay “close to the capital marketplace.” This unusual combination of operating and investment vehicles also means that C‐Corporation investment companies, unlike their pass‐through counterparts, must manage tax on their own books and disclose to their investors the after‐tax results of their portfolio trading as well as their capital gains “overhang.”
Spatial climate variation pattern and regional prediction of rainfall in Jordan
Authors: Tarawneh Qassem , Şen Zekai 
Published: September 2011

AbstractCurrently Jordan is facing various water problems accompanied by rapid population growth, urbanisation and industrialisation. It is of outmost importance to search for water resources augmentation possibilities leading to decision‐making procedures by addressing the rainfall sources as the main water resources in Jordan, through refined techniques. Point cumulative semivariogram (PCSV) samples are analysed in order to identify the regional dependence of the rainfall phenomena. Amman station is taken as a pivot site because of its location in the centre of the Kingdom, where the samples of the PCSV are calculated for eight systematic directions. Standard regional dependence function (SRDF) is obtained from the sample PCSV and the weighted average procedure is applied with the help of SRDF to predict the rainfall amounts. The radius of rainfall influence is determined for Amman in each direction. The cross‐validation methods are used to predict the rainfall in Amman using different samples representing along each direction. The result of cross‐validation method is acceptable in all samples with relative error not exceeding 10%, except in the desert sides where larger errors indicate weak regional dependence.
Type 2 polarized immune response holds a major position in Epstein–Barr virus‐related idiopathic thrombocytopenic purpura (EBV‐ITP)
Authors: JIN C.‐Q. , LIU F. , DONG H.‐X. , ZHANG J. , ZHOU J.‐W. , SONG L. , XIAO H. , ZHENG B.‐Y. 
Published: September 2011

SummaryIntroduction:  Dysfunctional cellular immunity is considered to be essential to the pathophysiology of Epstein–Barr virus‐related idiopathic thrombocytopenic purpura (EBV‐ITP). Cytokines in peripheral blood and the gene expression of transcription factors in T lymphocytes of patients with were investigated to correlate the polarization of T helper cell type 1 (Th1)/T helper cell type 2 (Th2) with the degree of thrombocytopenia.Methods:  The expression of type 1 (T‐bet) and type 2 (GATA‐3) in T lymphocytes was detected by semiquantitative reverse‐transcription–polymerase chain reaction, and plasma cytokine levels were measured by enzyme‐linked immunoassay in 35 patients and 30 control subjects.Results:  Th1/Th2 [(interleukin‐2 + γ‐interferon)/(interleukin‐10 + interleukin‐13)] cytokine ratios and transcription factor (T‐bet/GATA‐3) mRNA ratios were significantly decreased in patients with EBV‐ITP, and the Th1/Th2 ratio was directly correlated with platelet counts.Conclusion:  Our findings clearly show that type 2 polarization of the autoimmune response accounts for the expression of cytokines and transcription factors in EBV‐ITP.
Fast track program for esophagectomy patients
Authors: Jianjun Qin , Yin Li , Wenqun Xing , Ming Yan , Qingfeng Jiang 
Published: September 2011

AbstractBackground:  A fast track (FT) program for esophagectomy patients is rarely used. We streamlined care using an algorithm for the postoperative care of patients who underwent esophagectomy to try to reduce hospital stays to 7 days while maintaining safety and patient satisfaction.Methods:  A consecutive series of 80 patients with esophageal carcinoma who underwent elective esophageal resection from 2007 to 2008 in our department was taken into the FT program. An algorithm for FT to guide postoperative care was used, featuring avoidance of the intensive care unit, early ambulation, removal of nasogastric tube and oral nutrition starting on postoperative day (POD) 1, with discharge on POD 7.Results:  All patients were operated upon through a left posterolateral thoracotomy with a cervical esophagogastrostomy. Seventy‐eight (97.5%) patients completed the FT program. Discharge home was proposed for POD7. None was readmitted within 30 days of discharge. None suffered from anastomotic leakage. The time to first passage of flatus was 51.7 ± 8.4 h.Conclusion:  The majority of patients with esophageal carcinoma can tolerate FT surgery. Oral nutrition starting on POD1 is safe and FT surgery is feasible for patients scheduled for elective esophageal cancer resections without compromising quality.