bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of a nematode Meloidogyne incognita and its interaction with above‐ground herbivory on an invasive wetland plant, alligator weed (Alternanthera philoxeroides)
Authors: MAO RUNPING , LU XINMING , DING JIANQING 
Published: December 2010

AbstractInvasive plants may be attacked both above ground and below ground. Few studies have, however, investigated the simultaneous effects of above‐ground and below‐ground herbivory. In the present study, we report the effects of beetle herbivory and nematode infection on alligator weed, Alternanthera philoxeroides, an invasive plant in China. We found that the root‐knot nematode Meloidogyne incognita widely occurred on the plant in south China. To examine its effect on the plant in conjunction with above‐ground herbivory, we conducted a field common garden experiment with a local insect defoliator, Cassida piperata. We also included the native congener Alternanthera sessilis in our experiments for a comparison of the response of invasive and native species. We found no significant effects on plant biomass of the nematode infection in conjunction with the above‐ground herbivory. Further chemical analysis, however, showed that the water‐soluble carbohydrate content in roots of A. philoxeroides was significantly increased in plants attacked by both the nematode and the herbivore compared with the water‐soluble carbohydrate content in plants attacked by only the nematode or herbivore alone. We found no such change in the native congener A. sessilis. Together these results may suggest that A. philoxeroides tolerates joint above‐ground and below‐ground damage by allocating more resources to below‐ground material.
Current state of laparoscopic rectal cancer surgery in Australasia
Authors: Ong Eugene J. S. , Stevenson Andrew R. L. 
Published: December 2010

AbstractBackground:  To establish the current surgical approach to rectal cancer in a group of colorectal surgeons in Australasia and the current opinion regarding laparoscopic rectal cancer surgery.Methods:  An online survey was distributed to the Colorectal Surgical Society of Australia and New Zealand members.Results:  123/177 surgeons responded. During the last year, 94.3% had performed a laparoscopic colorectal case, 77.2% a laparoscopic rectal case and 65% a laparoscopic rectal cancer case. The most common approach to high anterior resection was pure laparoscopic (52.8%). Low anterior resections were most commonly performed with a laparoscopic component (25.2% pure laparoscopic, 33.3% hybrid). Most surgeons (>50%) performed ultra‐low anterior resections or abdomino‐perineal resections via an open technique. In addition, 64.2% intended to perform laparoscopic total mesorectal excision (TME) within 2 years. Most surgeons believe that the quality of laparoscopic TME and oncological outcomes are similar, and surgical access and short‐term outcomes are superior when compared to the open procedure. The major concerns were in performing a low rectal transection, controlling haemorrhage and resource utilization/cost.Conclusion:  Laparoscopic rectal surgery is now widely practiced by Australasian colorectal surgeons and projected to increase in the near future. However, only 10% of surgeons are routinely performing total laparoscopic ultra‐low anterior resections which may have implications for the generalizability of clinical trials in laparoscopic TME and the ability to credential surgeons in this technically challenging field. Quality of TME and oncological outcomes were rated similar to the open operation. Areas of concern included low rectal transection, haemorrhage control and resource utilization/cost.
Operative experience of general surgeons in a rural hospital
Authors: Campbell Nicole A. , Kitchen Graham , Campbell Ian A. 
Published: December 2010

AbstractBackground:  There is a lack of published data on the range of procedures currently carried out by rural general surgeons. The aim of this study is to demonstrate the diversity of conditions encountered and managed by rural general surgeons, in order to determine the scope of training necessary to adequately equip trainees for rural practice.Methods:  An audit of surgical procedures completed by two surgeons over 5 years from June 2004 to June 2009 in a rural Victorian hospital was carried out. Operations were further categorized into specialty groups.Results:  A total of 8336 operations were completed over 5 years, by two surgeons servicing a catchment population of 54 000 people. Traditional general surgical procedures accounted for 44.3% with endoscopies accounting for a further 27.4% of cases. The remainder was accounted for by 11.8% orthopaedics, 4.5% urology, 4.4% vascular (including pacemaker insertion), 3.4% ear, nose and throat, 2.7% neurosurgery, 0.88% obstetrics and 0.42% thoracics. There was a need to be able to perform procedures well outside the field of traditional general surgery, including multisystem trauma, vascular emergencies, caesarean sections and post‐partum hysterectomy.Conclusion:  General surgeons servicing small rural communities are required to carry out a variety of procedures outside the realms of traditional general surgery. Trainees need to acquire a broad skill base, and should be competent managing surgical emergencies across all specialties. A supportive team of medical, nursing and paramedical staff are required for achieving the best outcome for patients.
Parathyroid carcinoma: increasing incidence and changing presentation
Authors: Brown Sebastian , O'Neill Christine , Suliburk James , Sidhu Stan , Sywak Mark , Gill Anthony , Robinson Bruce , Delbridge Leigh 
Published: December 2010

AbstractBackground:  Parathyroid carcinoma has been regarded as an exceedingly rare disease worldwide, responsible for less than 1% of cases of primary hyperparathyroidism. However, there have been anecdotal reports recently of an increasing number of patients presenting with parathyroid carcinoma. The aim of this study was to examine the changing incidence and presentation of parathyroid cancer within a single centre.Patients and methods:  This is a retrospective case series. Data were obtained from the University of Sydney Endocrine Surgical Unit database, as well as a review of hospital records. All pathology was independently reviewed.Results:  Over the 52‐year period of the study from 1958 to 2010, there were 21 cases of confirmed parathyroid cancer. Only three cases were reported in the first 30 years of the study with the majority of cases (n= 11) presenting in the last 5 years. Despite the exponential increase in presentations, no significant differences in demographics or mode of presentation were found.Conclusion:  Possible reasons for the dramatic increase in parathyroid cancer include increased screening, an increase in referrals for parathyroid surgery overall associated with the availability of minimally invasive techniques, changes in diagnostic techniques with immunohistochemistry for parafibromin and protein gene product 9.5 (PGP9.5) or possibly a true increase in the incidence of the disease.
Quantitative lymph node evaluation as an independent marker of long‐term prognosis in stage III rectal cancer
Authors: Vather Ryash , Sammour Tarik , Kahokehr Arman , Connolly Andrew , Hill Andrew 
Published: December 2010

AbstractBackground:  The prognostic significance of lymph node evaluation is not well described for rectal cancer due to a lack of reproducibility in nodal counts and variable use of adjuvant and neoadjuvant therapy. The aim of this study was to examine the role of quantitative lymph node evaluation as an independent marker of prognosis in stage III rectal cancer.Methods:  New Zealand Cancer Registry data were retrieved for consecutive patients with rectal cancer from January 1995 to July 2003. Cases with node‐negative tumours, distant metastases, death within 30 days of surgery and incomplete data fields were excluded. Three nodal stratification systems were investigated – Total Number of Nodes examined (TNN), Absolute number of Positive Nodes (APN) and Lymph Node Ratio (LNR). Univariate and Cox regression analyses were performed with 5‐year all‐cause mortality as the primary end point.Results:  The study identified 895 stage III rectal cancer cases. The mean APN and LNR were significantly higher in patients who died within 5 years. An increasing APN or LNR was associated with a significant increase in 5‐year mortality. The APN and LNR were also powerful predictors of 5‐year mortality after correcting for other factors using Cox regression. The TNN was of no prognostic significance.Conclusions:  Both the APN and LNR are highly effective at independently predicting and stratifying 5‐year mortality in stage III rectal cancer. The significant predictive value of the LNR is likely to be a reflection of the APN rather than one functioning in autonomy, given that the TNN was of no prognostic significance.
Fresh frozen cadavers in surgical teaching: a gelatine arterial infusion technique
Authors: Jansen Shirley , Kirk Darryl , Tuppin Kristie , Cowie Margaret , Bharadwaj Avinash , Hamdorf Jeffrey M. 
Published: December 2010

AbstractBackground:  Fresh frozen human cadavers have been used at the Clinical Training and Evaluation Centre, The University of Western Australia, Perth, WA for years and are an excellent model for surgical dissection thanks to their representative tissue quality. Differentiation between artery and vein can be difficult as both collapse post mortem. A historical technique was therefore refined to increase arterial rigidity using gelatine prior to freezing.Methods:  Two fresh human cadavers were selected after ethical approval. Gelatine was infused into the carotid artery in one, and into the common femoral artery in the second at a more dilute concentration. In both cases, infusion continued until the rate slowed spontaneously indicating filling prior to setting. The cadavers were frozen according to our standard policy and thawed for a teaching course.Results:  These were observational. Examination by palpation and dissection after freezing and subsequent thawing revealed arterial turgor to have developed at the popliteal and brachial levels in the first cadaver, and to the distal vessels in the second. Arterial/venous discrimination was therefore enhanced and confirmed by participant feedback on subsequent courses.Conclusion:  The fresh frozen cadaver is already a superior model for teaching thanks to its near life‐like representation of tissue quality and handling. A successful technique for infusion of gelatine into the arterial tree of fresh human cadavers prior to freezing has been refined resulting in enhancement of arterial/venous discrimination during anatomical, interventional and surgical teaching, further optimizing its use in teaching and this now our standard means of preparation.
Iatrogenic upper limb nerve injuries: a systematic review
Authors: Zhang John , Moore Abigail E. , Stringer Mark D. 
Published: December 2010

AbstractPurpose:  Peripheral nerve injuries are among the most frequent iatrogenic complications and are responsible for considerable morbidity and litigation. Most occur within surgical settings and upper limb nerves are most frequently involved.Methods:  A systematic review of major iatrogenic upper limb nerve injuries was undertaken to evaluate the contemporary spectrum of such injuries. The electronic databases MEDLINE, PubMed, Cochrane Library and Google Scholar were searched for relevant articles listed between January 2000 and May 2010. Iatrogenic injuries to the brachial plexus, radial, axillary, ulnar, median, musculocutaneous and major cutaneous nerves were analysed, focusing on context, mechanisms of injury and incidence.Results:  Iatrogenic upper limb nerve injuries are relatively common and can affect patients in any surgical specialty. Even patients undergoing diagnostic procedures under general anaesthesia are at risk. Orthopaedic surgery and plastic and reconstructive surgery figure prominently in these complications. The spectrum of iatrogenic peripheral nerve injuries has changed in parallel with technological advances in surgery, anaesthesia and medicine.Conclusions:  Some iatrogenic upper limb peripheral nerve injuries may be unavoidable, but most cases are probably preventable by an adequate knowledge of surgical anatomy and an awareness of the types of procedures in which peripheral nerves are particularly vulnerable.
Acceptance of a 5‐mm distal bowel resection margin for rectal cancer: is it safe?
Authors: Rutkowski A. , Nowacki M. P. , Chwalinski M. , Oledzki J. , Bednarczyk M. , Liszka‐Dalecki P. , Gornicki A. , Bujko K. 
Published: December 2010

AbstractAim  Acceptance of a short distal bowel margin results in a higher rate of anterior resection but may compromise oncological safety. This study aimed to evaluate the safety of a 5‐mm distal margin.Method  A retrospective analysis was carried out of 412 consecutive patients with rectal cancer treated with anterior resection with a negative circumferential resection margin. Radiotherapy was given to 63% of patients with an advanced tumour. The median follow up was 75 months.Results  Fewer patients in the group with a distal margin of ≤ 5 mm had a tumour with an advanced pT stage compared to patients in the group with a distal margin of > 5 mm (P = 0.033). Two patients were converted to abdominoperineal resection because of a positive ‘doughnut’, leaving 410 patients, in whom 5.4% (95% CI, 0–11.3%) of the group with a distal margin of ≤ 5 mm had local recurrence at 5 years compared with 4.2% (95% CI, 2.1–6.3%) of the group with a distal margin of > 5 mm (P = 0.726). The corresponding figures for the 5‐year overall survival were 82.4% (95% CI, 72.6–92.2%) vs 76.3% (95% CI, 71.8–80.8%) (P = 0.581). All four anastomotic recurrences occurred in the group with a distal margin of > 5 mm.Conclusion  A distal margin of ≤ 5 mm did not compromise oncological safety in patients undergoing preoperative radiation for an advanced rectal cancer.
Extending the indications and anatomical limits of pelvic lymph node dissection for prostate cancer: improved staging or increased morbidity?
Authors: Touijer Karim , Fuenzalida Rodrigo Pinochet , Rabbani Farhang , Paparel Philippe , Nogueira Lucas , Cronin Angel M. , Fine Samson W. , Guillonneau Bertrand 
Published: December 2010

Study Type – Therapy (case series)Level of Evidence 4OBJECTIVE

To assess, in a risk/benefit analysis, the additional risk for complications and benefits of extending the indications and anatomical limits of pelvic lymph node dissection (PLND).

PATIENTS AND METHODS

In total, 971 consecutive patients with clinically localized prostate cancer underwent laparoscopic radical prostatectomy from 2003–2007.
Before 1 February 2005, patients with a nomogram probability of lymph node invasion (LNI) <2% did not undergo PLND (No PLND group), whereas those with a LNI ≥2% had a PLND limited to the external iliac nodal group (limited PLND group).
After 1 February 2005, all patients underwent a standard PLND including the external iliac, hypogastric and obturator fossa nodal groups (standard PLND group).
The risk parameters were PLND‐related complications and operating time. Complications were graded using a modified Clavien classification. The benefit was the detection of nodal metastases.

RESULTS

In the subgroup of patients with a LNI ≥2%, standard PLND was a superior operation than the limited PLND in detecting nodal metastases (14.3% vs 4.5%, respectively; P = 0.003).
The risk/benefit of standard vs limited PLND would be one additional grade 3 complication per 20 additional patients with nodal metastases. In the subgroup of patients with LNI <2%, three patients (1.0%) had positive nodes after a standard PLND.
The risk/benefit of standard PLND vs no PLND would be one additional grade 3 complication per three or four additional patients with nodal metastasis. The no PLND group was associated with the lowest risk of grade 1, 2 and 3 complications compared to either the limited or standard PLND groups (P < 0.001).

CONCLUSIONS

In patients with LNI ≥2%, standard PLND detects more nodal metastasis. PLND is associated with higher but non‐prohibitive complications rate.
The present study found no evidence that the incidence of complications would be reduced by a limited PLND.
Are men on 5α‐reductase inhibitors appropriately referred to urology? A survey of primary care physicians
Authors: Yafi Faysal A. , Aprikian Armen G. , Tanguay Simon , Kassouf Wassim 
Published: December 2010

Study Type – Therapy (practice pattern survey)Level of Evidence 2bWhat’s known on the subject? and What does the study add?Benign prostatic hyperplasia is one of the most common urologic conditions encountered by general practitioners. 5‐alpha‐reductase inhibitors are newer drugs used for its treatment. Their use, however, can affect PSA kinetics and potentially mask the early detection of prostate cancer.This study further confirms that most general practitioners prefer to use alpha‐blockers over 5‐alpha‐reductase inhibitors in the management of BPH. Furthermore, it clearly shows that there is a lack of awareness of the effect of these medications on PSA kinetics and, as such, further education among GPs is recommended about these drugs in order to optimize their usage at the primary care level and to avoid delays in cancer detection.OBJECTIVE• To investigate among general practitioners (GPs) their level of awareness and indications for urological consultations in patients treated with 5α‐reductase inhibitors (5ARIs).SUBJECTS AND METHODS• We conducted a survey of GPs in Quebec.• Questions covered GPs’ preferred benign prostatic hyperplasia (BPH) management, knowledge of 5ARIs, their role in prostate cancer prevention, and triggers for urology consultation.RESULTS• Of the surveys mailed, 599 were returned (15.7% response rate).• Therapy with 5ARIs was initiated by GPs in 34.3%, with 20% and 12% preferring 5ARIs alone and combined with an α‐blocker as first‐line therapy for BPH, respectively.• Once on therapy, 74% did not refer to a urologist if the PSA level did not decline after 6–12 months.• Finally, 40.7% would not advocate 5ARI chemoprevention for prostate cancer, regardless of risk reduction.• Findings were not associated with GP gender, experience or geographic location of practice (urban versus rural).CONCLUSIONS• There was a preference amongst GP to use α‐blockers over 5ARIs for BPH and hesitancy to use them in prostate cancer chemoprevention.• There is a lack of awareness of 5ARI effects on PSA kinetics and a reluctance to refer to a urologist.• Further education in Quebec is needed about 5ARIs to optimize their usage and avoid delaying cancer detection.
Laparoscopic partial nephrectomy for multiple tumours: feasibility and analysis of peri‐operative outcomes
Authors: Tsivian Alexander , Tsivian Matvey , Benjamin Shalva , Sidi A. Ami 
Published: December 2010

Study Type – Therapy (case series)Level of Evidence 4What’s known on the subject? and What does the study add?Laparoscopic nephron‐sparing procedures have been increasingly utilized. However, in the presence of multiple tumours the procedure choice is usually shifted to radical nephrectomy.In view of favourable perioperative outcomes, the benefits of minimally‐invasive, nephron‐sparing surgery in experienced hands could be safely extended to patients presenting with multiple ipsilateral renal masses.OBJECTIVE
To describe our experience with laparoscopic partial nephrectomy (LPN) for multiple kidney tumours and compare the outcomes with LPN performed for single masses.
PATIENTS AND METHODS
Retrospective analysis of medical records of patients undergoing LPN at our institution between 2005 and 2009 was performed.
The cohort was divided in two groups based on tumour focality: group 1, LPN for a single tumour (n= 99) and group 2, LPN for multiple ipsilateral tumours (n= 12).
The groups were compared with regards to demographic and peri‐operative variables.
RESULTS
Demographic variables were not different between the groups. Median dominant tumour size was 3.1 cm (interquartile range [IQR] 2.4–4.0) and 4.0 cm (2.3–5.9) in groups 1 and 2, respectively.
Median secondary tumour size in group 2 was 1.0 cm (1.0–1.8).
Operative times were longer in group 2 compared with group 1 (220 vs 160 min, P= 0.009).
Warm ischaemia times (WIT) (23 vs 22 min) and estimated blood loss (EBL) (100 vs 85 mL) were similar.
CONCLUSIONS
LPN is a viable option for the treatment of multiple ipsilateral renal tumours.
Peri‐operative outcomes are similar to standard LPN with the exception of longer operative time.
In experienced hands, the advantages of minimally invasive surgery may be extended to select patients with ipsilateral multifocal renal tumours.
Student attitudes towards and use of ICT in course study, work and social activity: A technology acceptance model approach
Authors: Edmunds Rob , Thorpe Mary , Conole Grainne 
Published: December 2010

AbstractThe increasing use of information and communication technology (ICT) in higher education has been explored largely in relation to student experience of coursework and university life. Students' lives and experience beyond the university have been largely unexplored. Research into student experience of ICT used a validated model—the technology acceptance model—to explore the influence of work and social/leisure contexts as well as course study, on attitudes towards and take up of technology. The results suggest that usefulness and ease of use are key dimensions of students' attitudes towards technology in all three contexts but that ICT is perceived most positively in the context of work and technology use at work is an important driver for technology use in other areas.
Pedagogy * technology: A two‐dimensional model for teachers' ICT integration
Authors: Lin Janet Mei‐Chuen , Wang Pei‐Yu , Lin I‐Chun 
Published: December 2010

AbstractThis paper presents a two‐dimensional model for measuring individual teachers' progression in ICT integration and for guiding them toward higher integration levels. There are four levels in the pedagogy dimension: direct teaching, cognitively active learning, constructive learning, and social learning. These levels are defined based on four factors: teacher pedagogical beliefs, instructional strategies used, teacher‐student interactions, and the types of tasks students are expected to carry out. The technology dimension contains eight levels, ranging from Level 0 (nonuse) to Level 7 (implementing sophisticated instructional applications). The eight levels are defined based on three factors: whether a teacher is a passive consumer or an active producer of the ICT‐based resources, sophistication of the ICT tools that a teacher uses, and richness of functionality of an ICT‐based product developed by a teacher. To validate the proposed model in terms of its applicability and practicability, three case studies were conducted. The results showed that this model was able to adapt to individual preferences of the three participating teachers as well as guide their progressions in ICT integration.
Sustainable Rural Tourism: Lessons for Rural Development
Authors: McAreavey Ruth , McDonagh John 
Published: December 2010

AbstractRural areas are recognised for their complex, multifunctional capacities with a range of different interest groups claiming their rights to, and use of, different rural spaces. The current rural development paradigm that is evident across the globe is epitomised by the European LEADER approach. Using evidence from the proposed National Park in Northern Ireland, we ask the question: what is the potential for sustainable rural tourism to contribute to rural development? In our analysis we consider the scope for adaptive tourism to overcome some of the ongoing challenges that have been identified in the LEADER approach. Four themes are revealed from this analysis: institutional (in)capacity, legitimacy of local groups, navigating between stakeholder interests and sustainable tourism in practice. These issues, discussed in turn, have clear implications for the new rural development programme.