bluuebunny/crossref_metadata_2025_split huggingface dataset:
Utility of the Surgical Apgar Score in a District General Hospital
Authors: Thorn Christopher C. , Chan Melanie , Sinha Nihal , Harrison Richard A. 
Published: March 2012

AbstractBackgroundThe Surgical Apgar Score (SAS) is a simple tool for intraoperative risk stratification. The aim of this prospective observational study was to assess its performance in predicting outcome after general/vascular and orthopedic surgery and its utility in a U.K. district general hospital.MethodA prospective cohort of 223 consecutive general, vascular, and orthopedic surgical cases was studied. The SAS was calculated for all patients, and its relationship to 30 day mortality and major complication assessed with reference to the mode of surgery (elective or emergent). Statistical analysis of categorical data was performed with Fisher’s exact test and the AUC (area under the curve) on receiver operating characteristic (ROC) analysis. Selected cases were reviewed to assess the potential of the SAS to modify postoperative management.ResultsThe proportion of patients who died or experienced major complications increased monotonically with Surgical Apgar Score category in general and vascular but not orthopedic cases. The relative risks of mortality or major complication between SAS categories were less marked than in previous publications. The SAS performed variably on ROC curve analysis, with an AUC of 0.62–0.73. Discrimination achieved significance in general and vascular cases (p = 0.0002) but not in orthopedic cases (p = 0.15). Subgroup analysis of high (SAS < 7) and low risk (SAS ≥ 7) groups demonstrated utility of the score in general surgery and vascular cases overall (p < 0.0001), and in the emergency (p = 0.004) but not elective (p = 0.12) subgroups. Case note review of those patients who died indicated that despite their identification by the SAS, there would have been limited scope to modify outcome.ConclusionThis study provides further evidence that the SAS is a simple and effective predictive tool in the emergency general and vascular surgical setting. It appears to have a limited role in the management of individual patients after orthopedic surgery and elective general/vascular surgery. The SAS has been proven to reliably stratify risk in larger populations and might be applied most usefully as a marker of quality. Further studies are required to determine whether its application can influence outcome.
A Novel Definition of Extrathyroidal Invasion for Patients with Papillary Thyroid Carcinoma for Predicting Prognosis
Authors: Hotomi Muneki , Sugitani Iwao , Toda Kazuhisa , Kawabata Kazuyoshi , Fujimoto Yoshihide 
Published: March 2012

AbstractObjectivesExtrathyroidal invasion is one of the most significant risk factors for patients with papillary thyroid carcinoma (PTC). The purpose of this study was to evaluate a novel definition of extrathyroidal invasion for patients with PTC as a method for predicting a patient’s prognosis.MethodsThe prospective study was conducted for consecutive 930 patients with primary PTC who received surgery during 1993–2009. We defined only patients who had preoperative recurrent laryngeal nerve palsy or patients in whom the tumor had invaded to the mucosa of the trachea and/or esophagus as Ex3. Patients with minimal invasion were classified as Ex1, and patients with massive invasion, when we could shave off the tumors, were classified as Ex2. Patients without extrathyroidal invasion were classified as Ex0.ResultsPatients classified Ex3 showed significantly shorter disease‐free survival (p = 0.03) and disease‐specific survival (p = 0.007) than patients classified Ex2. The time to recurrence at resection sites was shorter in patients classified Ex3 than in patients classified Ex2 (p = 0.02). The time to death due to distant metastasis of patients classified Ex3 was significantly shorter than that of patients classified Ex2 (p = 0.02). Within the patients classified Ex3, disease‐specific survival of patients with invasion to other nearby structures was shorter than that of patients with invasion to only recurrent laryngeal nerve (p = 0.008).ConclusionsThe degree and site of invasion is an important prognostic factor for PTC. Our novel classification of extrathyroidal invasion is valuable in predicting the prognosis of PTC.
Adenosine, dopamine and serotonin receptors imbalance in lymphocytes of Lesch‐Nyhan patients
Authors: García Marta G. , Puig Juan G. , Torres Rosa J. 
Published: March 2012

AbstractLesch‐Nyhan disease (LND) is caused by complete deficiency of the hypoxanthine‐guanine phosphoribosyltransferase enzyme. It is characterized by overproduction of uric acid, jointly with severe motor disability and self‐injurious behaviour which physiopathology is unknown. These neurological manifestations suggest a dysfunction in the basal ganglia, and three neurotransmitters have been implicated in the pathogenesis of the disease: dopamine, adenosine and serotonin. All of them are implicated in motor function and behaviour, and act by binding to specific G‐protein coupled receptors in the synaptic membrane where they seem to be integrated through receptor–receptor interactions. In this work we have confirmed at protein level the previously reported increased expression of DRD5 and the variably aberrant expression of ADORA2A, in LND PBL respect to control PBL. We have also described, for the first time, a decreased expression and protein level of 5‐HTR1A in LND PBL respect to control PBL. If these results were confirmed in the Lesch‐Nyhan patients basal ganglia cells, this would support the hypothesis that pathogenesis of neurological manifestations of Lesch‐Nyhan patients may be related to an imbalance of neurotransmitters, rather than to the isolated disturbance of one of the neurotransmitters, and this fact should be taken into account in the design of pharmacologic treatment for their motor and behavioural disturbances.
Intraindividual cognitive decline using a brief computerized cognitive screening test
Authors: Darby David G. , Pietrzak Robert H. , Fredrickson Julia , Woodward Michael , Moore Lynette , Fredrickson Amy , Sach Jack , Maruff Paul 
Published: March 2012

AbstractBackgroundProgressive intraindividual decline in memory and cognition is characteristic of dementia and may be useful in detecting very early Alzheimer's disease pathology.MethodsThis study evaluated the slopes of cognitive performance over a 12‐month period in 263 healthy, community‐dwelling, adult volunteers aged ≥50 years. Participants completed a brief computerized battery of cognitive tests (CogState) at baseline and during 3‐, 6‐, 9‐, and 12‐month follow‐up assessments. Linear mixed models were used to estimate age‐adjusted mean slopes and 95% confidence intervals of change for each of the cognitive measures.ResultsBy defining age‐adjusted mean slopes, and 95% confidence intervals for a measure of episodic memory, individuals with greater than expected decline (equal to or lower than the fifth percentile level of decline) were identified. From these, four individuals completed a full medical, neurologic, and neuropsychological evaluation, with none of them fulfilling criteria for mild cognitive impairment, but three (75%) having positive amyloid‐positron emission tomographic scans.ConclusionsIntraindividual decline in cognitive performance can be detected in otherwise healthy, community‐dwelling, older persons, and this may deserve further study as a potential indicator of early Alzheimer's disease pathology.
Islamic investing
Authors: Walkshäusl Christian , Lobe Sebastian 
Published: March 2012

AbstractUsing a large international sample of 35 developed and emerging markets, we analyze whether Islamic indices exhibit a different performance to conventional benchmarks. While there is no compelling evidence of performance differences in robust Sharpe ratio tests and after controlling for market risk, we find a significantly positive four‐factor alpha for the aggregate developed markets region. This outperformance stems, however, mainly from the U.S. and is largely attributable to the exclusion of financial stocks in Sharia‐screened portfolios. As the extensive downturn of financials is related to the recent financial crisis, we do not argue that this outperformance will continue over time. The style analysis reveals that Islamic indices invest mainly in growth stocks and positive momentum stocks. This, for a passive portfolio intriguing result can, however, be explained by the strong sector allocation towards energy firms and their strong momentum characteristic during the sample period.
Review Article: Understanding the Regulatory State
Authors: MORAN MICHAEL 
Published: March 2012

misunderstanding the regulatory state?In the last quarter of the twentieth century something transformed government across the advanced capitalist world, and a large amount of comparative political enquiry is now concerned with pinning a convincing label on that transformation. Of the many candidates the subject of this review article has proved especially popular. As I will show, a regulatory state is now commonly said to exist in a wide range of geographical and institutional settings: writers speak of a regulatory state in the United States and in Britain; of the European regulatory state; and even of refinements like ‘a regulatory state inside the state’.
Chilling curves for Piaractus mesopotamicus (Holmberg, 1887) embryos stored at −8°C
Authors: Lopes Taís da S. , Streit Danilo Pedro , Fornari Darci Carlos , de Oliveira Diego , Ribeiro Ricardo Pereira , Romagosa Elizabeth 
Published: March 2012

SummaryThe present study investigates the effect of different slow chilling curves on the storage of pacu (Piaractus mesopotamicus) embryos submitted to chilling at −8°C. Embryos at the blastopore closure stage were divided into two groups: G1 – embryos exposed to cryoprotectant solution containing methanol (10%) and sucrose (0.5 M), treated as follows: (T1) taken directly from room temperature to the refrigerator without being submitted to the curve; (T2) chilling curve of 0.5°C/min; and (T3) chilling curve of 1°C/min; and G2 – the cryoprotectant solution alone was submitted to these same temperatures, receiving the embryos only after temperature had decreased, corresponding to treatments T4, T5 and T6, respectively. Treatments were kept at −8°C for a period of 6 h. Embryo development was evaluated for each treatment, with six replicates in an entirely randomized design. Survival among embryos not submitted to refrigeration was 94.3 ± 8.05%. Percentage of total larvae (TL) and addled eggs (AE) did not differ statistically between the groups, although percentage of swimming larvae (SL) exhibited higher values in G1 for the 1°C/min curve. Furthermore, when comparing the three chilling curves, a decrease of 1°C/min resulted in the highest TL percentage (90.85%), followed by the 0.5°C/min curve (78.52%). Thus, the use of 1°C/min chilling curves is recommended for P. mesopotamicus embryos stored for 6 h at −8°C.
Effects of cryostorage on human sperm chromatin integrity
Authors: Fortunato Adriana , Leo Rita , Liguori Francesca 
Published: March 2012

SummaryThe integrity of sperm chromatin structure has proven to be of great importance for human fertility. In this study, we investigated whether sperm cryopreservation has an effect on nuclear DNA tertiary structure, (i.e. condensation), measured by aniline blue staining, in 103 male patients who required consultation for hypo-fertility. Sperm DNA damage was significantly higher in patients showing oligospermia and severe morphological abnormalities than in native sperm populations. Furthermore we observed that chromatin decondensation was related to the cryostorage technique and to the duration of storage. This increase in decondensation was highly significant (P< 0.01) immediately after cryopreservation and from 90 days of cryostorage onwards. The possible mechanisms involved in sperm chromatin cryoinjury and the need to incorporate new methods for testing sperm nuclear structure alteration into the routine spermiogram are discussed.
Does congenital heart disease severely jeopardise family life and pregnancies? Obstetrical history of women with congenital heart disease in a single tertiary centre
Authors: Morissens Marielle , Viart Pierre , Tecco Laura , Wauthy Pierre , Michiels Simone , Dessy Hugues , Malekzadeh Milani Sophie , Verbeet Thierry , Castro Rodriguez Jose 
Published: March 2012

AbstractAimWomen with congenital heart disease are often considered to be restricted in their obstetrical life and even their marital life. Our single-centre study aimed to determine the real-life situation of these women with regard to successful family life and any pregnancy complications they may experience.MethodsFrom our database of adults with congenital heart disease, 160 of 178 women completed a questionnaire and had their files reviewed. They were classified into three groups according to their pregnancy risk – “good condition” group, no pregnancy restriction; “at-risk” group, pregnancy allowed with close follow-up at a tertiary centre; and “contraindicated” group, pregnancy inadvisable.ResultsThe proportion of women in a relationship was 46% with no difference between the three groups. In the groups where pregnancy was allowed, 55% of women conceived a child. The total incidence of spontaneous abortion was 21%. The rate of caesarean section was 15%. The incidence of cardiac failure was 4.7%, arrhythmia 1.2%, endocarditis 1.2%, hypertension 2.4%, and preeclampsia 1.2%. Foetal complications included prematurity and/or low birth weight (9.5%) and one foetal malformation (0.82%).ConclusionWomen with severe congenital heart disease are willing to start a family and are successful in this enterprise. Although the complication rate during pregnancy in congenital heart disease remains high, with good monitoring these pregnancies occur without severe complications and a low rate of medical abortion or caesarean section.
Stenting across head and neck vessels using covered stents for persisting aortic arch obstruction
Authors: Bentham James R. , Oswal Nilesh , Yates Robert 
Published: March 2012

AbstractObjectiveTo describe endovascular stent placement using partially covered stents to preserve flow in head and neck vessels.BackgroundEndovascular stent placement has become established as a first-line therapy for native coarctation of the aorta or re-coarctation in older children and adults. Increasingly covered stents are becoming the preferred option over bare-metal stents because of the perceived lower risk of aneurysm formation. Open-cell bare-metal stents are chosen when there is a high likelihood of jailing a head and neck vessel. Here we describe partial uncovering of a covered stent before implantation to allow flow through the uncovered portion of the stent to the branch vessel but preserve the covering over the majority of the remaining stent.MethodsWe describe two cases with aortic arch hypoplasia and re-coarctation, both of which required two partially uncovered stents for a satisfactory result.ConclusionsEndovascular stent placement is becoming the preferred option in the management of coarctation of the aorta in older children and adults. Strategies to deal with transverse arch hypoplasia and multiple levels of aortic arch obstruction frequently involving branch vessels or aneurysms need to be considered before these procedures are embarked upon. Partially uncovering stents may afford more protection than using bare-metal stents in the transverse and distal arch while preserving flow in head and neck branches, and is a technically straightforward procedure.
Hemiazygos vein “steal hypoxic-syndrome” after hemi-Fontan operation: comprehensive four-dimensional flow magnetic resonance visualisation
Authors: Valverde Israel , Razishankar Aarthi , Miller Owen , Razavi Reza 
Published: March 2012

AbstractA 2-year-old boy with hypoplastic left heart syndrome and previous hemi-Fontan palliation surgery was referred for cardiovascular magnetic resonance evaluation because of progressive cyanosis. This case report illustrates the advantages of non-invasive four-dimensional magnetic resonance imaging for comprehensive identification and quantification of venovenous collaterals in patients with palliated hemi-Fontan staged surgery.
Assessment of cavopulmonary connections by advanced imaging: value of flat-detector computed tomography
Authors: Glöckler Martin , Koch Andreas , Halbfaß Julia , Greim Verena , Rüffer Andrè , Cesnjevar Robert , Achenbach Stephan , Dittrich Sven 
Published: March 2012

AbstractObjectivesTo investigate the impact of flat-detector computed tomography on the clinical assessment of patients with cavopulmonary connections, and to evaluate the obtained diagnostic accuracy and supplementary information, as well as the value of overlaid three-dimensional reconstructions on fluoroscopic images during catheter-based interventions.MethodsWe analysed 31 consecutive patients retrospectively in whom flat-detector computed tomography was used to visualise the cavopulmonary connection. We investigated patients with cavopulmonary connections either early post-operatively (first group), before converting to a total cavopulmonary connection (second group), and patients with failing total cavopulmonary connection (third group). Flat-detector computed tomography based on a single rotational angiography was used to create a three-dimensional vascular model. The clinical value of flat-detector computed tomography was evaluated using standard categories of diagnostic utility. Used contrast volume and radiation exposure were quantified.ResultsWithin 18 months, flat-detector computed tomography was performed in 31 cases with cavopulmonary connections. The median age was 1.9 years (range 0.3–43 years). In the first group, we found anomalies in 4 out of 8 cases, which led to therapeutic or prophylactic procedures; in the second and third groups, we performed interventions in 14 out of 23 cases. The overall clinical value was always rated superior to conventional biplane angiography. The median dose area product was 91.8 microgray square metres (range 33.0–679.3 microgray square metres). The required contrast medium was 2.08 millilitres per kilogram (range 0.66–4.7 millilitres per kilogram).ConclusionFlat-detector computed tomography improves the diagnostic accuracy in cavopulmonary connections and provides additional diagnostic information, which may lead to therapeutic or prophylactic procedures. Overlaid three-dimensional images on fluoroscopy facilitate and provide security for interventions.
Outsourcing Business and I.T. Services: the Evidence of Success, Robust Practices and Contractual Challenges
Authors: Lacity Mary , Willcocks Leslie 
Published: March 2012

AbstractIn this article, Mary Lacity and Leslie Willcocks review the practice of outsourcing business and information technology services. Research finds that outsourcing can deliver value to client organisations, but that it takes a tremendous amount of detailed management by clients and providers to realise expected benefits. The proven practices that contribute to positive outsourcing outcomes can be summarised as contractual governance, relational governance, client retained capabilities, and provider capabilities. Despite outsourcing's maturity, some enduring contractual challenges remain, particularly in the areas of incentive pricing and contract adaptability.
Evaluating and Promoting an In-House Information Team
Authors: Speight Dunstan 
Published: March 2012

AbstractMuch has been written and discussed about the outsourcing of library staff. In the following article, Dunstan Speight, Library Manager at Berwin Leighton Paisner LLP, looks at the role of in-house information teams. Although written from the perspective of the manager of a team of researchers in a City law firm, the author hopes that elements of his experience will have a relevance to other sectors and team structures.
Knowledge Management in Law: a Look at Cultural Resistance
Authors: Zeide Elana , Liebowitz Jay 
Published: March 2012

AbstractKnowledge management is still a difficult issue within law firms. One of the potential barriers to widespread adoption of knowledge management in law firms has been cited as cultural resistance. In order to better understand this obstacle, a Delphi survey was conducted with key knowledge management experts in US and UK law firms. There were six factors that focused on elements of cultural resistance. This article, written by Elana Zeide and Jay Liebowitz, highlights the findings.
Information Overload: When Information Becomes Hazardous to Your Health
Authors: Woolfson Beverley 
Published: March 2012

AbstractBeverley Woolfson analyses the concept of information overload: how it has evolved, and its relevance to the information professional in the commercial law firm. Using data gathered during her MSc dissertation research and combining it with current theories on the topic, the writer concludes that while the information intermediary is often vulnerable to the dangers of overload, a number of strategies can be implemented to ensure that its effects are minimised.
Boris and the Pandas: a Blue Print for a Brilliant Intranet
Authors: Fishleigh Jackie 
Published: March 2012

AbstractJackie Fishleigh summarises some tried and tested methods that can turn an intranet into an invaluable business tool. This article provides a number of top tips for engaging users and maintaining their interest and attention for the benefit of their working community. The article, which draws heavily on recently published material by Martin White and Interact Intranet, aims to be informative and entertaining!
Coseismic and postseismic deformation of the 2011 Tohoku‐Oki earthquake constrained by GRACE gravimetry
Authors: Wang Lei , Shum C. K. , Simons Frederik J. , Tapley Byron , Dai Chunli 
Published: March 2012

Spaceborne gravimetry data from the Gravity Recovery And Climate Experiment (GRACE) are processed using spatio‐spectral Slepian localization analysis enabling the high‐resolution detection of permanent gravity change associated with both coseismic and postseismic deformation resulting from the great 11 March 2011 Mw 9.0 Tohoku‐Oki earthquake. The GRACE observations are then used in a geophysical inversion to estimate a new slip model containing both coseismic slip and after‐slip. The GRACE estimated moment for the total slip, up to the end of July 2011 is estimated as (4.59 ± 0.49) × 1022 N m, equivalent to a composite Mw of 9.07 ± 0.65. If the moment for the Tohoku‐Oki main shock is assumed to be 3.8 × 1022 N m, the contribution from the after‐slip is estimated to be 3.0 × 1021–12.8 × 1021 N m, in good agreement with a postseismic slip model inverted from GPS data. We conclude that GRACE data provide an independent constraint to quantify co‐ and post‐seismic deformation for the Tohoku‐Oki event.
Evidence for the direct oxidation of organic nitrogen to N2 gas in the Arabian Sea
Authors: Trimmer Mark , Purdy Kevin J 
Published: March 2012

Abstract
We performed a suite of 15N incubations (15NO2−, 15NO3− and 15NH4+) with and without the organic-nitrogen (N) compound allylthiourea (ATU), in the suboxic waters of the Arabian Sea. Production of 29N2 in control (-ATU) incubations with either 15NH4++14NO2−, or their analogues, 15NO2−+14NH4+, though small, confirmed the presence of anammox. In contrast, when we added ATU, along with 15NO2− and 14NH4+, there was a much greater production of 29N2, with 92% of the 15N-label being recovered as 29N2 on average. Such stimulated production of 29N2 could not be due to anammox, as the addition of ATU, along with 15NH4++14NO2−, only produced 29N2 equivalent to that in the controls. The ratios of 29N2 to 30N2 produced also precluded stimulation of denitrification. We present this as evidence for a hitherto uncharacterised metabolism potentially capable of oxidising organic-N (e.g. NH2 groups) directly to N2 gas at the expense of NO2−.