bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gestational diabetes mellitus: A risk factor for non‐elective cesarean section
Authors: Gorgal Rosário , Gonçalves Elisabete , Barros Mónica , Namora Gabriela , Magalhães Ângela , Rodrigues Teresa , Montenegro Nuno 
Published: October 2011

AbstractAim:  To assess whether gestational diabetes mellitus (GDM) is associated with non‐elective cesarean section.Material and Methods:  A retrospective cohort study was conducted at the Department of Obstetrics of a level III hospital. Between January 2004 and November 2007, women admitted in labor or with spontaneous rupture of membranes, at term, and with a singleton cephalic presenting fetus were eligible. From these, 220 women with GDM and 660 glucose‐tolerant women, delivered immediately after, were selected. The association between GDM and non‐elective cesarean was estimated using modified Poisson regression analysis. Relative risks were adjusted for age, pre‐pregnancy body mass index, gestational weight gain, previous cesarean, gestational age at delivery and birthweight.Results:  Non‐elective cesarean section rate for women with GDM was 19.5% compared to 13.5% for non‐diabetic women. The crude relative risk of cesarean section was 1.45 (95% CI 1.04–2.02) for women with GDM. After adjustment for confounders, the association between GDM and non‐elective cesarean section remained positive and statistically significant (RR = 1.52; 95% CI 1.06–2.16). No significant differences in cesarean indications were found between the two groups.Conclusion:  GDM was disclosed as a risk factor for non‐elective cesarean section. Knowledge of the condition may have influenced obstetrical practice, favoring cesarean delivery.
Characteristics of patients with subchorionic hematomas in the second trimester
Authors: Yamada Tetsuo , Atsuki Yusuke , Wakasaya Atsushi , Kobayashi Mami , Hirano Yuki , Ohwada Michitaka 
Published: October 2011

AbstractAim:  The aim of this study was to investigate the etiological characteristics of patients diagnosed with subchorionic hematoma.Methods:  A case‐controlled study was performed to compare characteristics of patients and controls. Via ultrasound examination, 47 pregnant patients were found to have subchorionic hematomas and 1075 had no evidence of subchorionic hematomas (controls). In the second trimester, patients were compared with regard to endocervical Chlamydia trachomatis and other vaginal microorganisms.Results:  The overall incidence of subchorionic hematomas in this pregnant population was 4.2%. Maternal clinical characteristics did not differ between cases and controls. Evaluation of the vaginal flora revealed that the positive rates of coagulase‐negative staphylococci (cases: 12.8%; controls: 4.1%; P < 0.01) and Gardnerella vaginalis (cases: 12.8%; controls: 2.5%; P < 0.001) in the cases were significantly higher than those of the controls. The negative rate of Lactobacillus in the cases was significantly higher than that of the controls (cases: 42.6%; controls: 27.6%; P < 0.05).Conclusion:  Pregnant women with subchorionic hematoma in the first trimester showed changes in vaginal flora in the second trimester, which suggests a possible association with subchorionic hematoma and vaginal flora change.
Cervical length predicts placental adherence and massive hemorrhage in placenta previa
Authors: Fukushima Kotaro , Fujiwara Arisa , Anami Ai , Fujita Yasuyuki , Yumoto Yasuo , Sakai Atsuhiko , Morokuma Seiichi , Wake Norio 
Published: October 2011

AbstractAim:  To evaluate the relationship between cervical length (CL) and obstetrical outcome in women with placenta previa.Material and Methods:  Eighty uncomplicated, singleton pregnancies with an antenatally diagnosed previa were categorized based on CL of over 30 mm (n = 60) or 30 mm or less (n = 20). A retrospective chart review was then performed for these cases to investigate the relationship between CL and maternal adverse outcomes.Results:  The mean CL was 38.5 ± 5.4 mm and 26.9 ± 3.2 mm and the mean gestational age at measurement was 29.2 ± 2.7 and 28.5 ± 2.7 weeks of gestation for the longer and shorter CL groups, respectively. The median estimated blood loss at cesarean section (CS) was significantly higher in the shorter CL group (1302 mL vs 2139 mL, P = 0.023) as was the percentage of patients with massive intraoperative hemorrhage (60.0 vs 18.3%, P = 0.001). In the shorter versus longer CL patients, emergent CS before 37 weeks (23.3 vs 50.0%, P = 0.046) and the percentage of patients with placental adherence (6.7 vs 35.0%, P = 0.004) were both significantly more frequent in the shorter CL group. The shorter CL was a risk factor both for massive estimated blood loss (≥2000 mL) (odds ratio 6.34, 95% confidence interval 1.91–21.02, P ≤ 0.01) and placental adherence (odds ratio 6.26, 95% confidence interval 1.23–31.87, P ≤ 0.05) in the multivariate analysis.Conclusion:  CL should be included in the assessment of a placenta previa given its relationship to emergent CS, cesarean hysterectomy, intraoperative blood loss and placental adherence.
Combined perianal‐intrarectal (PI) lidocaine‐prilocaine (LP) cream and lidocaine‐ketorolac gel provide better pain relief than combined PI LP cream and periprostatic nerve block during transrectal prostate biopsy
Authors: Cormio Luigi , Pagliarulo Vincenzo , Lorusso Fabrizio , Selvaggio Oscar , Perrone Antonia , Sanguedolce Francesca , Bufo Pantaleo , Carrieri Giuseppe 
Published: October 2011

What's known on the subject? and What does the study add?Study Type – Harm Reduction RCTLevel of Evidence 1bThe combination of perianal‐intrarectal lidocaine‐prilocaine cream and periprostatic nerve block effectively counteracts probe and sampling related pain during transrectal prostate biopsy, but not pain due to periprostatic infiltration.The novel combination of lidocaine‐prilocaine cream and lidocaine‐ketorolac gel, both administered perianal‐intrarectally, provides the same probe and sampling‐related pain relief than combined perianal‐intrarectal lidocaine‐prilocaine cream and periprostatic nerve block and prevents the non‐negligable pain due to periprostatic infiltration, thus leading to better overall patients' compliance to the procedure.OBJECTIVE
To compare the efficacy and safety of combined perianal‐intrarectal (PI) lidocaine‐prilocaine (LP) cream and lidocaine‐ketorolac (LK) gel with combined PI LP cream and periprostatic nerve block (PPNB) in relieving pain during transrectal ultrasonography guided prostate biopsy (TPB).
PATIENTS AND METHODS
In all, 200 patients were randomized to receive combined PI LP cream and LK gel (group 1) or combined PI LP cream and PPNB (group 2) before TPB.
The 0–10‐point visual analogue scale (VAS) was used for assessing pain at probe insertion and movements (VAS‐1), periprostatic infiltration (VAS‐2) when applied, and prostate sampling (VAS‐3), as well as maximal procedural pain (MPP).
Complications occurring ≤20 days after the TPB were recorded.
RESULTS
The groups were comparable for patients' age, serum PSA level, prostate volume, and cancer detection rate.
All patients tolerated the procedure well. The two anaesthetic regimens provided almost equal mean VAS‐1 (0.33 vs 0.37; P= 0.701) and VAS‐3 (0.52 vs 0.51; P= 0.954) scores, but patients in group 2 reported significantly greater MPP scores (0.68 vs 1.53; P < 0.001) as periprostatic infiltration was the most painful part of the procedure (mean VAS‐2: 1.33).
Complications rate was similar in the two groups (1% vs 2%; P= 0.38).
CONCLUSIONS
The novel combination of PI LP cream and LK gel provided the same probe‐ and sampling‐ related pain relief as combined PI LP and PPNB; moreover, by preventing the non‐negligible periprostatic infiltration pain, it provided significantly better overall patients' compliance to the procedure.
Being safe and easy to administer, this novel non‐infiltrative regimen has the potential to replace infiltrative anaesthesia in relieving pain during TPB.
Risk of multiple primary cancers following melanoma and non‐melanoma skin cancer
Authors: Stracci F. , Fabrizi V. , D’Alò D. , La Rosa F. , Papini M. 
Published: October 2011

AbstractBackground  The relationship between cutaneous malignancies and successive primary cancers has been studied since several years, but it still remains controversial.Objective  The aim of this study was to evaluate the excess risk of multiple primary cancer among the population of Umbria, Italy, that survived a skin cancer.Methods  The data registered in the Umbrian Population Cancer Registry from 1994 to 2006 were collected, recorded, and analysed in accordance to the standard methods recommended for cancer registries. Among skin cancer patients, those with multiple cutaneous and non‐cutaneous cancers were selected. Only sites with a frequency of more than five cases were considered. The expected number of cases was obtained from indirect standardization with regional incidence rates in several sites that incurred in the overall period. The significance of the observed/expected ratios and the corresponding 95% CI were based on the Poisson distribution.Results  In men, a significant standardized incidence ratio (SIR) was found for melanoma (2.21), non‐melanoma skin cancers (1.86), Hodgkin’s (4.95) and non‐Hodgkin lymphoma (1.82), and tongue/mouth cancer (2.47). In women, melanoma, non‐melanoma skin and breast cancer showed a significant high SIRs (4.13, 1.55 and 1.28 respectively). All other cancers showed a non‐significant SIR. Considering all sites combined and all sites except skin cancers, the analysis showed a significant excess in men, whereas a significant risk was observed in women only when also skin cancers were considered.Conclusions  Data from the whole of Umbrian population revealed that skin cancer patients experience marked excess risk of further primary cancers. The main risk in both genders is skin melanoma and other skin cancers. The excess of lymphomas and tongue/mouth cancers is also significant in men, and breast cancer in women. These observations prompt us to include a screening for these cancers in the follow‐up of our patients surviving a skin malignancy.
Prevalence, frequency and problem rating of hot flushes persist in older postmenopausal women: impact of age, body mass index, hysterectomy, hormone therapy use, lifestyle and mood in a cross‐sectional cohort study of 10 418 British women aged 54–65
Authors: Hunter MS , Gentry‐Maharaj A , Ryan A , Burnell M , Lanceley A , Fraser L , Jacobs I , Menon U 
Published: October 2011

Please cite this paper as: Hunter M, Gentry‐Maharaj A, Ryan A, Burnell M, Lanceley A, Fraser L, Jacobs I, Menon U. Prevalence, frequency and problem rating of hot flushes persist in older postmenopausal women: impact of age, body mass index, hysterectomy, hormone therapy use, lifestyle and mood in a cross‐sectional cohort study of 10 418 British women aged 54–65. BJOG 2012;119:40–50.Objective  Hot flushes and night sweats (HFs/NSs) are the main menopausal symptoms, but few studies have been adequately powered to examine the dimensions or predictors of experiencing HFs/NSs. We report on these variables in a large UK cohort of postmenopausal women.Design  Cross‐sectional cohort study.Setting  UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) cohort.Population  A cohort of 202 638 postmenopausal women, aged 50–74 years, without oophorectomy, recruited to UKCTOCS between 2001 and 2005.Methods  Women completed a follow‐up questionnaire, and those aged 54–65 years were mailed a survey in July 2008.Main outcome measures  Hot flush prevalence and hot flush rating scale.Results  Of the 15 000 women mailed, 10 418 returned completed questionnaires; 90% had previously had HFs/NSs. Despite being on average 10 years postmenopausal, 54% experienced HFs/NSs (frequency of 33 per week with mean problem rating 4/10) that persisted across the age range. Past hysterectomy (OR 1.50, 95% CI 1.19–1.86), ever having smoked (OR 1.27, 95% CI 1.11–1.46) and alcohol consumption (current units) (OR 1.05, 95% CI 1.01–1.09) predicted ever having had HFs/NSs. Anxiety (OR 3.09, 95% CI 2.57–3.72), hysterectomy (OR 2.74, 95% CI 2.32–3.25), depressed mood (OR 1.57, 95% CI 1.24–1.99), years since last menstrual period (OR 0.95, 95% CI 0.94–0.96) and education (above and below 18 years) (OR 0.98, 95% CI 0.97–0.99) predicted the current prevalence of HFs/NSs. Few predictors of frequency were identified, but problem rating was associated with depressed mood, hysterectomy, skirt size increase and frequency of HFs/NSs. Past hormone therapy users who had discontinued treatment were more likely to have HFs/NSs that were more frequent and problematic.Conclusions  To date, this is the largest UK study of the experience of HFs/NSs amongst older postmenopausal women. HFs/NSs are more prevalent in this age band than has previously been assumed. These findings and the associations of smoking, hysterectomy, anxiety, depressed mood and hormone therapy use with the experience of HFs/NSs have implications for prevention and symptom management.
Reconstructing range dynamics and range fragmentation of European bison for the last 8000 years
Authors: Kuemmerle Tobias , Hickler Thomas , Olofsson Jörgen , Schurgers Guy , Radeloff Volker C. 
Published: October 2011

AbstractAim  Understanding what constituted species’ ranges prior to large‐scale human influence, and how past climate and land use change have affected range dynamics, provides conservation planners with important insights into how species may respond to future environmental change. Our aim here was to reconstruct the Holocene range of European bison (Bison bonasus) by combining a time‐calibrated species distribution models (SDM) with a dynamic vegetation model.Location  Europe.Method  We used European bison occurrences from the Holocene in a maximum entropy model to assess bison range dynamics during the last 8000 years. As predictors, we used bioclimatic variables and vegetation reconstructions from the generalized dynamic vegetation model LPJ‐GUESS. We compared our range maps with maps of farmland and human population expansion to identify the main species range constraints.Results  The Holocene distribution of European bison was mainly determined by vegetation patterns, with bison thriving in both broadleaved and coniferous forests, as well as by mean winter temperature. The heartland of European bison was in Central and Eastern Europe, whereas suitable habitat in Western Europe was scarce. While environmentally suitable regions were overall stable, the expansion of settlements and farming severely diminished available habitat.Main conclusions  European bison habitat preferences may be wider than previously assumed, and our results suggest that the species had a more eastern and northern distribution than previously reported. Vegetation and climate transformation during the Holocene did not affect the bison’s range substantially. Conversely, human population growth and the spread of farming resulted in drastic bison habitat loss and fragmentation, likely reaching a tipping point during the last 1000 years. Combining SDM and dynamic vegetation models can improve range reconstructions and projections, and thus help to identify resilient conservation strategies for endangered species.
Inhalation of LPS induces inflammatory airway responses mimicking characteristics of chronic obstructive pulmonary disease
Authors: Korsgren Magnus , Linden Margareta , Entwistle Neil , Cook Jason , Wollmer Per , Andersson Morgan , Larsson Bengt , Greiff Lennart 
Published: October 2011

SummaryAim:  Inhalation of lipopolysaccharide (LPS) produces both systemic and pulmonary inflammatory responses. The aim of this study was to further characterize the response to LPS in order to develop a human model suitable for early testing of drug candidates developed for the treatment for chronic obstructive pulmonary disease (COPD).Materials:  Blood and induced sputum were obtained 4, 24 and 48 h following inhalation of saline and LPS (5 and 50 μg). Blood was analysed for C‐reactive protein (CRP), α1‐antitrypsin and neutrophils/leucocytes, and sputum was analysed for biomarkers of neutrophil inflammation and remodelling activities, i.e. neutrophil elastase (NE) protein/activity and α1‐antitrypsin. Levels of tumour necrosis factor‐α (TNFα) were measured in both blood and sputum. Urine was collected 0–24 and 24–48 h postchallenge, and desmosine, a biomarker of elastin degradation, was measured.Results:  Lipopolysaccharide inhalation induced dose‐dependent flu‐like symptoms and increases in plasma CRP and α1‐antitrypsin as well as increases in blood neutrophil/leucocyte numbers. Furthermore, LPS produced increases in sputum TNFα and sputum NE activity. Urine levels of desmosine were unaffected by the LPS challenge. All subjects recovered 48 h postchallenge, and indices of inflammatory activity were significantly lower at this observation point cf 24 h postchallenge.Conclusion:  Inhalation of LPS in healthy volunteers can be used as a safe and stable model of neutrophil inflammation. Blood/plasma and sputum indices can be employed to monitor the response to LPS. We suggest that this model may be used for initial human studies of novel COPD‐active drugs.
Illiberis (Primilliberis) rotundata Jordan (Lepidoptera: Zygaenidae: Procridinae) male sex attractant: Optimization and use for seasonal monitoring
Authors: SUBCHEV Mitko A. , KOSHIO Chiharu , TOSHOVA Teodora B. , EFETOV Konstantin A. 
Published: October 2011

AbstractIlliberis (Primilliberis) rotundata Jordan, 1907 (Lepidoptera: Zygaenidae) is an orchard pest distributed in Honshu, Shikoku and Kyushu in Japan and also in China, Korea, Mongolia and Russia (south‐eastern Siberia and Far East). For optimizing a known sex attractant lure containing sex pheromone components of the species (2R)‐butyl (7Z)‐dodecenoate and (2R)‐butyl (9Z)‐tetradecenoate, field work was organized in three cherry tree plots in Naruto, Tokushima in 2009 and 2010. As a result, the mixture of (2R)‐butyl (7Z)‐dodecenoate and (2R)‐butyl (9Z)‐tetradecenoate in a ratio of 30:100–50:100 (130–150 µg, respectively) was found to be the most attractive for the males of this pest. The seasonal flight of I. rotundata in Naruto, Japan as estimated by pheromone traps started at the end of May and lasted up to the end of June with a mass flight at the very end of May to first week of June.
Emergency Medicine Directors’ Perceptions on Professionalism: A Council of Emergency Medicine Residency Directors Survey
Authors: Sullivan Christine , Murano Tiffany , Comes Jim , Smith Jessica L. , Katz Eric D. 
Published: October 2011

ACADEMIC EMERGENCY MEDICINE 2011; 18:S97–S103 © 2011 by the Society for Academic Emergency MedicineAbstractObjectives:  The Accreditation Council for Graduate Medical Education requires residency training programs to teach and assess professionalism in residents; however, programs may struggle to successfully remediate residents not meeting professionalism standards. To assist programs with this complex issue, a Professionalism Remediation Task Force was formed by the Council of Emergency Medicine Residency Directors (CORD‐EM), which surveyed program directors (PDs) concerning their experiences. The purpose of this study is to report survey results regarding the identification and rating of unprofessional behaviors and challenges in the evaluation and remediation of professionalism.Methods:  In June 2010, the task force sent an anonymous survey via the CORD‐EM listserv to PDs with active EM programs.Results:  Fifty percent (77/154) of eligible PDs responded to the survey. Most PDs rated the unprofessional behaviors of interpersonal/communication conflicts, lack of responsibility during patient care, lack of respect of coworkers, and reports of impairment as “critical”; repeated tardiness, incomplete work, poor ability to accept feedback, poor attitude, and repetitive unresponsiveness to aid colleagues were rated as “very serious”; frequent missed deadlines were “serious”; and repetitive failure to complete medical records was rated as “mildly serious.” A resident with “less serious” professionalism issues was also felt to be likely to have “serious” or “critical” issues “often” (33.8% of respondents) or “always” (6.5%). The most common methods of assessment were clinical/advisor evaluations. However, existing assessment methods were described as inadequate in identifying serious professionalism issues by 50.7% of responding PDs. Unprofessionalism was most commonly discovered by unofficial faculty complaint (54.5%). Eighty percent report that professionalism is more difficult to remediate than other core competencies. Resident ownership of the problem was reported as most critical to remediation success (84.4%). PDs perceived the greatest challenges in residency remediation to be lack of resident insight or responsibility for the problem (45.2%) and personality/behavioral issues (32.9%).Conclusions:  Identification and remediation of professionalism in EM residents is challenging. A future goal is to create a system by which PDs can use standardized pathways as a guide to identify and remediate unprofessional conduct.
Education Research: A Primer for Educators in Emergency Medicine
Authors: Yarris Lalena M. , Deiorio Nicole M. 
Published: October 2011

ACADEMIC EMERGENCY MEDICINE 2011; 18:S27–S35 © 2011 by the Society for Academic Emergency MedicineAbstractAs medical educators strive to adopt an evidence‐based, outcomes‐driven approach to teaching, education research in emergency medicine (EM) is burgeoning. Many educational challenges prompt specific research questions that are well suited to investigative study, but educators face numerous barriers to translating exciting ideas into research publications. This primer, intended for educators in EM, provides a brief overview of the current scope and essential elements of education research. We present an approach to identifying research problems and conceptual frameworks and defining specific research questions. A common approach to curricular development is reviewed, as well as a fundamental overview of qualitative and quantitative methods that can be applied to educational research questions. Finally, suggestions for disseminating results and overcoming common barriers to conducting research are discussed.