bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does the type of hysterectomy affect the prognosis in clinical stage I endometrial cancer?
Authors: Han Chan Hee , Lee Keun Ho , Lee Hae Nam , Kim Chan Joo , Park Tae Chul , Park Jong Sup 
Published: June 2010

AbstractAim:  To determine whether clinical outcomes show a benefit from extended hysterectomy in patients with early endometrial cancer.Methods:  We reviewed the medical records of 101 patients who had endometrial cancer with clinical stage I disease. All the patients were surgically staged, and two types of hysterectomy, simple hysterectomy (SH) or extended hysterectomy (EH), were performed by surgeon's preference. The postoperative pathology findings, recurrence rate and disease‐free survivals (DFS) between the two groups were compared.Results:  Sixty‐six patients and thirty‐five patients underwent SH and EH, respectively. At subsequent surgical staging, seven patients (10.6%) in the SH and four (11.4%) in EH group were upgraded to stage II or III disease. The surgical and pathological features were not different between the groups. Though the recurrence rate was lower in the EH group (9.09% for SH vs 2.86% for EH), it showed no statistical significance (P = 0.241). The 5‐year DFS (88.2% for SH vs 96.0% for EH) showed no statistically significant difference between the groups either (P = 0.242).Conclusion:  Compared to SH, EH did not have any prognostic benefit in clinical stage I endometrial cancer. Until the therapeutic role of the EH is determined by further studies using a larger sample size, SH remains the treatment of choice in patients with early endometrial cancer, and surgeons should not perform extended operation without definite evidence of the disease.
Expression of mucin antigens (MUC1 and MUC16) as a prognostic factor for mucinous adenocarcinoma of the uterine cervix
Authors: Togami Shinichi , Nomoto Mitsuharu , Higashi Michiyo , Goto Masamichi , Yonezawa Suguru , Tsuji Takahiro , Batra Surinder K. , Douchi Tsutomu 
Published: June 2010

AbstractAim:  Only limited data are available regarding mucin antigen expression in adenocarcinoma of the uterine cervix.Methods:  Fifty‐two patients with mucinous adenocarcinoma of the endocervical type were enrolled for making clear implication of the mucin antigens. The expression of mucin antigens in hysterectomized specimens were determined immunohistochemically. Clinicopathological characteristics and prognosis included International Federation of Gynecology and Obstetrics (FIGO) stage, histological grade, nodal and ovarian metastases, overall and disease‐free survivals. The relationships of the expression of mucin antigens to various variables were investigated using uni‐ and multivariate analyses.Results:  The majority of mucinous adenocarcinoma showed overexpression of MUC1 and MUC16. Overexpression of both MUC1 and MUC16 was associated with lower survival rates. Particularly, overexpression of MUC1 was associated with a lower disease‐free survival rate and lymph node metastasis. However, absence of expression of MUC1 and/or MUC16 was associated with longer overall and disease‐free survival. In cases classified as FIGO stage Ib (n = 35), after adjusting for patient age at diagnosis and stratifying by histological grade, MUC1 and/or MUC 16 overexpression was an independent prognostic factor for overall survival (hazard ratio [HR] = 6.16, 95% confidence interval [CI] = 1.01–118.5, P < 0.05). After stratifying by ovarian metastasis, MUC1 and/or MUC 16 overexpression was also an independent prognostic factor for disease‐free survival (HR = 5.50, 95% CI = 0.82–87.4, P < 0.05).Conclusion:  The expressions of MUC1 and/or MUC16 may be available as independent prognostic factors for the endocervical type of mucinous adenocarcinoma.
Bilateral ovarian gonadoblastoma with coexisting dysgerminoma in a girl with 46, XX karyotype
Authors: Yilmaz Bulent , Gungor Tayfun , Bayramoglu Hatice , Soysal Sunullah , Mollamahmutoglu Leyla 
Published: June 2010

AbstractGonadoblastoma is a rare gonadal tumor with tumor cells arranged in nests surrounded by ovarian stroma containing Leydig or lutein‐type cells. In 50% of the cases, there is an overgrowth of germ cells with progression to dysgerminoma. A case of gonadoblastoma with coexisting dysgerminoma developing in both ovaries of a 20‐year‐old girl who had increased abdominal girth is presented here. A pelvic mass measuring 20 × 14 cm was detected by pelvic ultrasonography. Bilateral salphingo‐oophorectomy was performed. The histopathological report revealed bilateral gonadoblastoma with coexisting dysgerminoma. After surgery the patient received radiation and chemotherapy (BEP: bleomycin, etoposide, cisplatin) and was started on hormone replacement therapy. Five years and eight months after treatment, the patient is well and free of recurrence.
Maternal blood and amniotic fluid levels of moxifloxacin, levofloxacin and cefixime
Authors: Özyüncü Özgür , Beksac Mehmet Sinan , Nemutlu Emirhan , Katlan Doruk , Kir Sedef 
Published: June 2010

AbstractAim:  Moxifloxacin and levofloxacin are wide spectrum quinolones and cefixime is a third‐generation cephalosporin with a wider spectrum of activity against gram‐positive and gram‐negative bacteria and anaerobics. Although they are widely used, little is known about the amniotic fluid levels of these antibiotics. The aim of the present investigation was to study and compare the maternal blood and amniotic fluid levels of these antibiotics in second trimester pregnancy.Methods:  To assess the amniotic fluid levels of these antibiotics, 10 pregnant women were given moxifloxacin, 10 were given levofloxacin and 6 were given cefixime orally 2 h before amniocentesis as a single dose for prophylaxis. During amniocentesis, an extra 2 mL amniotic fluid sample and 2 mL maternal venous blood were drawn. The levels of these agents in samples were analyzed using high performance liquid chromatography.Results:  The amniotic fluid levels of moxifloxacin and levofloxacin were 0.27 ± 0.21 µg/mL and 0.60 ± 0.41 µg/mL, respectively. The maternal blood levels were 3.53 ± 0.65 µg/mL and 3.95 ± 0.77 µg/mL in the moxifloxacin and levofloxacin groups, respectively. The maternal blood level of cefixime was 2.59 ± 1.10 µg/mL and the amniotic fluid level was 0.85 ± 0.42 µg/mL. The amniotic fluid passage rates were 7.83% for moxifloxacin, 15.67% for levofloxacin and 37.55% for cefixime.Conclusion:  Of these three antibiotics, cefixime has the highest transplacental passage rate and, therefore, can be used as a therapeutic agent in infectious conditions in which membranes and the placenta are involved. Moxifloxacin and levofloxacin have low passage rates, which should be considered when using as a therapeutic agent.
Fitness costs associated with mounting a social immune response
Authors: Cotter S. C. , Topham E. , Price A. J. P. , Kilner R. M. 
Published: June 2010

Ecology Letters (2010) 13: 1114–1123AbstractSocial immune systems comprise immune defences mounted by individuals for the benefit of others (sensuCotter & Kilner 2010a). Just as with other forms of immunity, mounting a social immune response is expected to be costly but so far these fitness costs are unknown. We measured the costs of social immunity in a sub‐social burying beetle, a species in which two or more adults defend a carrion breeding resource for their young by smearing the flesh with antibacterial anal exudates. Our experiments on widowed females reveal that a bacterial challenge to the breeding resource upregulates the antibacterial activity of a female’s exudates, and this subsequently reduces her lifetime reproductive success. We suggest that the costliness of social immunity is a source of evolutionary conflict between breeding adults on a carcass, and that the phoretic communities that the beetles transport between carrion may assist the beetle by offsetting these costs.
The regulatory logic of m‐xylene biodegradation by Pseudomonas putida mt‐2 exposed by dynamic modelling of the principal node Ps/Pr of the TOL plasmid
Authors: Koutinas Michalis , Lam Ming‐Chi , Kiparissides Alexandros , Silva‐Rocha Rafael , Godinho Miguel , Livingston Andrew G. , Pistikopoulos Efstratios N. , De Lorenzo Victor , Dos Santos Vitor A. P. Martins , Mantalaris Athanasios 
Published: June 2010

SummaryThe structure of the extant transcriptional control network of the TOL plasmid pWW0 born by Pseudomonas putida mt‐2 for biodegradation of m‐xylene is far more complex than one would consider necessary from a mere engineering point of view. In order to penetrate the underlying logic of such a network, which controls a major environmental cleanup bioprocess, we have developed a dynamic model of the key regulatory node formed by the Ps/Pr promoters of pWW0, where the clustering of control elements is maximal. The model layout was validated with batch cultures estimating parameter values and its predictive capability was confirmed with independent sets of experimental data. The model revealed how regulatory outputs originated in the divergent and overlapping Ps/Pr segment, which expresses the transcription factors XylS and XylR respectively, are computed into distinct instructions to the upper and lower catabolic xyl operons for either simultaneous or stepwise consumption of m‐xylene and/or succinate. In this respect, the model reveals that the architecture of the Ps/Pr is poised to discriminate the abundance of alternative and competing C sources, in particular m‐xylene versus succinate. The proposed framework provides a first systemic understanding of the causality and connectivity of the regulatory elements that shape this exemplary regulatory network, facilitating the use of model analysis towards genetic circuit optimization.
Thiazolidinediones induce osteocyte apoptosis and increase sclerostin expression
Authors: Mabilleau G. , Mieczkowska A. , Edmonds M. E. 
Published: June 2010

Diabet. Med. 27, 925–932 (2010)AbstractAims  Thiazolidinediones (TZDs) are associated with a higher risk of bone fracture in women compared with men. The aim of the present study was to investigate whether TZDs could influence osteocyte behaviour and contribute to the skeletal phenotype observed in TZD‐treated patients.Methods  The murine MLO‐Y4 cell line was used as a source of osteocytes. These cells were cultured for 24 h with 0, 10−8 m, 10−7 m, 10−6 m, 10−5 m or 10−4 m of pioglitazone, rosiglitazone or troglitazone in the presence or absence of 17β‐oestradiol. The extent of osteocyte apoptosis was assessed, as was the expression of the bone formation inhibitor sclerostin and receptor activator for nuclear factor κB ligand (RANKL) also.Results  In the absence of 17β‐oestradiol, pioglitazone, rosiglitazone and troglitazone induced osteocyte apoptosis dose‐dependently even at the lowest concentration of 10−8 m. Furthermore, the expression of sclerostin but not RANKL was significantly increased in TZD‐treated cultures compared with untreated cultures. The presence of 17β‐oestradiol significantly reduced TZD‐induced osteocyte apoptosis and also sclerostin up‐regulation.Conclusions  These findings therefore raise the potential concern of using TZDs in post‐menopausal women where the lack of oestrogen would not prevent osteocyte apoptosis and sclerostin up‐regulation and may aggravate the reduction in bone mass in these patients.
The impact of sickle cell trait on glycated haemoglobin in diabetes mellitus
Authors: Bleyer A. J. , Vidya S. , Sujata L. , Russell G. B. , Akinnifesi D. , Hire D. , Shihabi Z. , Knovich M. A. , Daeihagh P. , Calles J. , Freedman B. I. 
Published: June 2010

Diabet. Med. 27, 1012–1016 (2010)AbstractAims  To determine the effect of sickle cell trait on measurement of glycated haemoglobin (HbA1c) in African American patients with diabetes mellitus.Methods  This is a retrospective study including 885 outpatients who underwent HbA1c testing. Medical record review and sickle cell trait determinations based on the HbA1c assay were performed in African American participants. The relationship between HbA1c and serum glucose measurements was analysed.Results  Data were obtained from 385 AA (109 with SCT, 22 with haemoglobin C trait and 254 without haemoglobinopathy) and 500 European American patients. In a model created through multivariate repeated‐effects regression, the relationship between HbA1c and simultaneous serum glucose did not differ between African American subjects with and without the sickle cell trait, but differed between African American subjects without the sickle cell trait and European Americans (P = 0.0002).Conclusions  Sickle cell trait does not impact the relationship between HbA1c and serum glucose concentration. In addition, it does not appear to account for ethnic difference in this relationship between African Americans and whites.
The views of patients with diabetes about nurse prescribing
Authors: Courtenay M. , Stenner K. , Carey N. 
Published: June 2010

Diabet. Med. 27, 1049–1054 (2010)AbstractAims  To explore the views of patients with diabetes about nurse prescribing and the perceived advantages and disadvantages.Methods  Patients were recruited from the case‐loads of seven nurse prescribers in six National Health Service sites in England. Sites reflected the key settings in which nurses typically prescribe for patients with diabetes within primary care. Forty‐one interviews were undertaken by trained qualitative researchers. Interviews addressed opinions and experiences of nurse prescribing; audiotapes were transcribed, coded, and themes identified.Results  Patients were confident in nurse prescribing. Distinctions were made between the role of the nurse and that of the doctor, and views varied with regard to the extent patients felt nurses should work autonomously. Confidence in nurse prescribing was inspired by nurses’ specialist knowledge and experience, a mutual trusting relationship, a thorough consultation, and experience of the benefits of nurse prescribing. Communication between nurses and doctors about patient care, awareness by nurses of their area of competence, training and experience, specialist diabetes knowledge and access to training updates were considered important for safe prescribing. Patterns of attendance had changed in some cases, with patients tending to see doctors less often. Access to medicines was improved for patients during non‐routine/emergency situations.Conclusions  Nurse prescribing is acceptable to patients and can increase the efficiency of diabetes service in primary care. Workforce planners need to include the services of nurse prescribers alongside those of doctors.
THE DEEP CONDITIONS OF SECULARITY
Authors: De VRIES HENT 
Published: June 2010

AbstractIn modern societies and cultures today, religion is widely perceived as basically even if not merely trivially “optional.” This is a contention strongly advocated by Charles Taylor, most notably in his monumental A Secular Age. Throughout his career, Taylor has made the question of religion in modernity the core of his interests. In his most recent work, A Secular Age, Taylor addresses challenging issues of what he calls the “contemporary spiritual experience” and speaks to “the spiritual hungers and tensions of secular modernity.” I critically consider three aspects of this immensely suggestive if not uncontroversial work: (1) I examine whether there is in fact a possible reversibility or revisability to the so‐called ‘optional’ nature of belief that Taylor thinks is characteristic of the secular age; (2) I scrutinize Taylor's notion of “immediacy” of belief in the same milieu; (3) I interrogate his use of the term “fullness” in delineating the temper of the secular age.
WHAT IS THE SELF? IMITATION AND SUBJECTIVITY IN BLAISE PASCAL'S PENSÉES
Authors: WOOD WILLIAM 
Published: June 2010

AbstractI aim to develop a fully theological, yet still Pascalian account of human subjectivity. Exegetically, I argue that the Pensées themselves present two such accounts. The first account is a portrait of fallen subjectivity, selfhood under the reign of sin. The second account is a portrait of authentic subjectivity. This latter account is explicitly Christological and even Trinitarian. Constructively, I argue that Pascal's two accounts show that our subjectivity is performative and imitative: whether under sin or under grace, to be a self is to imitate God.
RETHINKING THE CHRISTOLOGICAL FOUNDATIONS OF REINHOLD NIEBUHR'S CHRISTIAN REALISM
Authors: KOLBET PAUL R. 
Published: June 2010

AbstractWhile Reinhold Niebuhr's realist political philosophy continues to find advocates in many quarters on account of its explanatory power, his Christian ideals have had difficulty gaining purchase in the material world. The tension between particular political interests and universal moral ideals threatens not only to undermine Niebuhr's efforts to preserve the ethical quality of politics but also his grounds for hope. The source of this problem can be traced to a weakness in the Christological foundations of Niebuhr's Christian realism—specifically to his intentional severing of classical Christology from politics in his appropriation of Augustine's realism. After examining the reasons for this rejection of classical reflections about Jesus, this article explains how the Christology of Niebuhr's favorite early Christian realist, Augustine, makes possible a theological reasoning that expands the social imagination, and promotes a deeply principled and hopeful material transformation, while not forfeiting its critical and explanatory capacity.
How often is a low Apgar score the result of substandard care during labour?
Authors: Berglund S , Pettersson H , Cnattingius S , Grunewald C 
Published: June 2010

Please cite this paper as: Berglund S, Pettersson H, Cnattingius S, Grunewald C. How often is a low Apgar score the result of substandard care during labour? BJOG 2010;117:968–978.Objective  To increase our knowledge of the occurrence of substandard care during labour.Design  A population‐based case–control study.Setting  Stockholm County.Population  Infants born in the period 2004–2006 in Stockholm County.Methods  Cases and controls were identified from the Swedish Medical Birth Register, had a gestational age of ≥33 complete weeks, had planned for a vaginal delivery, and had a normal cardiotocographic (CTG) recording on admission. We compared 313 infants with an Apgar score of <7 at 5 minutes of age with 313 randomly selected controls with a full Apgar score, matched for year of birth.Main outcome measure  Substandard care during labour.Results  We found that 62% of cases and 36% of controls were subject to some form of substandard care during labour. In half of the cases and in 12% of the controls, CTG was abnormal for ≥45 minutes before birth. Fetal blood sampling was not performed in 79% of both cases and controls, when indicated. Oxytocin was provided without signs of uterine inertia in 20% of both cases and controls. Uterine contractions were hyperstimulated by oxytocin in 29% of cases and in 9% of controls, and the dose of oxytocin was increased despite abnormal CTG in 19% and 6% of cases and controls, respectively. Assuming that substandard care is a risk factor for low Apgar score, we estimate that up to 42% of the cases could be prevented by avoiding substandard care.Conclusions  There was substandard care during labour of two‐thirds of infants with a low Apgar score. The main reasons for substandard care were related to misinterpretation of CTG, not acting on an abnormal CTG in a timely fashion and incautious use of oxytocin.
Uterine artery embolisation combined with local methotrexate for treatment of caesarean scar pregnancy
Authors: Yang X‐Y , Yu H , Li K‐M , Chu Y‐X , Zheng A 
Published: June 2010

Please cite this paper as: Yang X‐Y, Yu H, Li K‐M, Chu Y‐X, Zheng A. Uterine artery embolisation combined with local methotrexate for treatment of caesarean scar pregnancy. BJOG 2010;117:990–996.Objective  The aim of the study was to determine the efficacy of uterine artery embolisation (UAE) combined with local methotrexate (MTX) for the treatment of caesarean scar pregnancy, compared with other traditional modalities, and to investigate the complications associated with this treatment.Design  A retrospective cohort study.Setting  A large obstetrics and gynaecology unit within a university hospital in China.Sample  Women who were diagnosed with a caesarean scar pregnancy between January 2003 and December 2008, and who had informative case records, were included in the study.Methods  We reviewed the results for all women who received one of three treatments: dilation and curettage (D&C) (11 patients; group A), systemic MTX (17 patients; group B), and UAE and local MTX (38 patients; group C).Main outcome measures  The main outcome measures were success rate, blood loss, time for β human chorionic gonadotrophin (β‐hCG) to decline to normal values, and the duration of hospital stay. Success was defined as a complete recovery with no severe complications and with the preservation of fertility.Results  A total of 66 women diagnosed with caesarean scar pregnancy between January 2003 and December 2008 were identified, and their data were analysed. The success rate in group C was significantly higher than that in groups A and B after adjusting for β‐hCG level (89.5 versus 27.3 and 58.8%, respectively; P < 0.001). The mean blood loss in group C was lower than in the other two groups (240.5 versus 855.5 and 639.4 ml, respectively; P = 0.008 and 0.009, respectively). The average time for β‐hCG to decline to normal values was significantly shorter in group C than in group B (28.1 versus 44.3 days; P = 0.021). A significantly shorter duration of hospital stay was observed in group C compared with group B (12.5 versus 22.0 days; P = 0.024).Conclusions  UAE combined with local MTX is of benefit to women wishing to preserve fertility, and is suitable for use as the primary treatment for caesarean scar pregnancy.
Randomised trial of structured antenatal training sessions to improve the birth process
Authors: Maimburg RD , Væth M , Dürr J , Hvidman L , Olsen J 
Published: June 2010

Please cite this paper as: Maimburg R, Væth M, Dürr J, Hvidman L, Olsen J. Randomised trial of structured antenatal training sessions to improve the birth process. BJOG 2010;117:921–928.Objective  To compare the birth process in nulliparous women enrolled in a structured antenatal training programme, ‘The Ready for Child’ programme, with women allocated to routine care.Design  A randomised controlled trial.Setting  A Danish university hospital.Participants  Thousand hundred and ninety‐three nulliparous women, recruited before week 22 + 0.Methods  Compliance to the protocol was monitored by questionnaires sent to the women by email, and by data from the local birth cohort database. Data were analysed according to the ‘intention‐to‐treat’ principle.Intervention  Women were randomised to receive 9 hours of antenatal training or no formalised training. Of the 1193 women, 603 were randomised to the intervention group and 590 were allocated to the reference group.Main outcome measures  Cervix dilatation on arrival at the maternity ward, use of pain relief and medical interventions during the birth process, and the women’s birth experience.Results  Women who attended the ‘Ready for Child’ programme arrived at the maternity ward in active labour more often than the reference group [relative risk (RR) 1.45, 95% confidence interval (95% CI) 1.26–1.65, P < 0.01], and they used less epidural analgesia during labour (RR 0.84, 95% CI 0.73–0.97, P < 0.01) but not less pain relief overall (RR 0.99, 95% CI 0.94–1.04, P < 0.72). Medical interventions and the women’s self‐reported birth experiences were similar in the two groups. We found no adverse effects of the intervention.Conclusion  Attending the ‘Ready for Child’ programme may help women to cope better with the birth process. Adverse effects are few, if any.