bluuebunny/crossref_metadata_2025_split huggingface dataset:
Extra‐adrenal paraganglioma of the equine orbit: six cases
Authors: Miesner Tracy , Wilkie David , Gemensky‐Metzler Anne , Weisbrode Steven , Colitz Carmen 
Published: July 2009

AbstractAt The Ohio State University from 1994–2006 six of seven horses evaluated for primary orbital disease were diagnosed with extra‐adrenal paraganglioma (EAPG). The horses ranged in age from 14 to 24 years, with a mean of 16.8 years. Duration of clinical signs was 1.5 years to 5 years, with a mean of 2.8 years. Clinical signs varied, but all six had non‐painful exophthalmus of the right eye. Five horses had complete ocular exams reported; three of five had decreased to absent vision, two of five had pale optic nerves, and in three of five, difficulty of retropulsion of the globe was noted. Diagnostic tests performed included complete blood count, serum profile, radiography, ultrasound, computed tomography, true‐cut biopsy, ocular examination, guttural pouch endoscopy, oral examination, and physical examination. Expulsive hemorrhage during orbital exenteration occurred in all horses. In five of six cases, tumor extension through the orbital foramen was apparent intra‐operatively. Histopathologic appearance of all surgically removed tissues consisted of sheets of polygonal cells with abundant lightly granular cytoplasm, round nuclei with vesicular chromatin, and rare mitoses. Neoplastic cells were arranged into small groups separated by a fine fibrovascular stroma. All six cases were chromagranin positive on immunohistochemical staining. Follow‐up ranged from six months to six years, with a mean of two years. Four of the five horses that recovered from surgery had no apparent tumor recurrence in 6–48 months.
Low‐hemorrhage‐risk surgical approach to expose the optic nerve in rabbits without bony removal and rectus resection
Authors: Li Xiaoliang , Cai Changsi , Li Liming , Chai Xinyu , Ren Qiushi 
Published: July 2009

AbstractObjective A low‐hemorrhage‐risk surgical approach to expose the optic nerve (ON) in rabbits through the orbital process of the frontal bone without removal of the bony orbit and resection of the rectus muscle was explored and assessed in this study. This approach will be used to investigate a new visual prosthesis that requires intraorbital ON stimulation with penetrating electrodes.Animals Chinese Albino rabbits (n = 10).Methods Rabbits were classified into a surgery and a control group (five in each). In the surgery group, the ON exposure was explored by the newly proposed surgical approach. Surgical time, blood loss, visually evoked potentials (VEP) at four different scheduled time points, and H&E‐stained histology of the ON at one month after surgery were recorded and analyzed to assess the ease and safety of the approach.Results The average surgical time for the ON exposure was 16.40 ± 1.14 min with average blood loss of 0.52 ± 0.08 mL. Within the one‐month follow‐up, the ON exhibited a naturally reversible conduction change in terms of VEP amplitude. Histological examination of the ON was unremarkable. A postoperative mild ptosis of the surgical eye resolved within one month after surgery.Conclusion The ease and safety of this new surgical approach allowed it to be easily used by non‐expert operators and widely applied in rabbit experiments for various research purposes requiring exposure of the ON.
The cornea of Guinea pig: structural and functional studies
Authors: Cafaro Thamara A. , Ortiz Susana G. , Maldonado Cristina , Espósito Fernando A. , Croxatto Juan O. , Berra Alejandro , Ale Omar L. , Torrealday Juan I. , Urrets‐Zavalía Enrique A. , Urrets‐Zavalía Julio A. , Serra Horacio M. 
Published: July 2009

AbstractObjective  To describe the functional and structural characteristics of the cornea in healthy Guinea pigs.Animals studied  Healthy male and female pigmented and albino Guinea pigs (Caviaporcellus) aged 3–5 months old were used.Procedures  The animals’ corneas underwent different in vivo studies including: slit‐lamp biomicroscopy, fluorescein staining (FS), break‐up time test (BUT), confocal microscopy and pachymetry. The corneas were also studied histopathologically with light microscopy, immunohistochemistry and transmission electron microscopy.Results  No significant differences were found between pigmented and albino animals, male and female, OD and OS in any study performed. The differences on corneal thickness values were not significant among central (227.85 ± 14.09 µm) and upper and temporal peripheral regions (226.60 ± 12.50 and 225.70 ± 14.40 µm, respectively). All histological studies performed permitted identification and precise description of the different corneal structures in Guinea pigs: the stratified epithelium (45.52 ± 5.26 µm), Bowman's layer (2.23 ± 0.38 µm), stroma (163.69 ± 4.90 µm), Descemet's membrane (3.96 ± 0.46 µm) and the endothelium (5.09 ± 0.71 µm). Combining results from all eyes mean and SD from corneal BUT values was 4.98 ± 1.67 s. Corneas often showed discrete superficial erosions being the FS positive in both eyes from all the animals.Conclusion  This study provides a detailed in vivo and postfixed histological description of the Guinea pig's cornea and information about the physiological tests.
Expression of vascular endothelial growth factor and angiopoietins in human corpus cavernosum
Authors: Tomada Nuno , Tomada Inês , Vendeira Pedro , Neves Delminda 
Published: July 2009

OBJECTIVETo evaluate the expression of the angiogenic factors vascular endothelial growth factor (VEGF) and angiopoietins (Ang) 1 and 2, in normal human penile erectile tissue.MATERIALS AND METHODSPenile fragments were removed from four young healthy organ donors (aged 17–28 years), and processed for immunohistochemical studies for VEGF, Ang1 and Ang2, and their specific receptors (VEGFR1 and 2, and Tie2, respectively). Molecular analysis was used to confirm the expression of VEGF and Angs in erectile tissue.RESULTSVEGF and VEGFR1 expression was restricted to smooth muscle cells (SMCs). VEGFR2 was detected mainly in the endothelium lining and to a lesser extent in the SMC. Ang1 had a scattered distribution mostly in the perivascular SM layer, showing co‐localization with VEGF. Tie2 was faintly detected in the endothelial cells. Ang2 was not detected by immunohistochemical studies, but the use of the same antibody in molecular analysis confirmed Ang2 expression in human corpus cavernosum.CONCLUSIONSWe show for the first time the co‐localization of VEGF and Ang1 in the SMC, suggesting an interaction for vessel stabilization. Ang2 seems to be available for neoangiogenesis, if challenged. Studies of endothelial markers, growth factors and specific receptors are useful for understanding vascular organization and angiogenesis in normal human erectile tissue. This knowledge will be fundamental for developing newer therapeutic approaches to prevent or even cure erectile dysfunction.
Obesity is associated with a higher risk of clear‐cell renal cell carcinoma than with other histologies
Authors: Lowrance William T. , Thompson R. Houston , Yee David S. , Kaag Matthew , Donat S. Machele , Russo Paul 
Published: July 2009

Study Type – Prognosis (cohort)  Level of Evidence 2aOBJECTIVETo investigate the association between body mass index (BMI) and histology of renal cell carcinoma (RCC) in a contemporary cohort, as obesity is increasingly prevalent in the USA and might be contributing to the increasing incidence of RCC, but little is known about the relationship of obesity with the different histological subtypes of RCC.PATIENTS AND METHODSFrom January 2000 to December 2007 we identified 1640 patients with renal cortical tumours undergoing surgical extirpation at our institution, and who had their BMI recorded. Multivariable logistic regression models were used to test the association of BMI with RCC histology.RESULTSThe median (interquartile range) BMI was 28 (25–32) kg/m2 and 38% of patients were classified as obese (BMI >30 kg/m2). After adjusting for tumour size, age, gender, American Society of Anesthesiologists score, estimated glomerular filtration rate, hypertension, diabetes mellitus and smoking, the BMI was significantly associated with clear‐cell histology; the odds ratios were 1.04 for each unit of BMI (95% confidence interval, CI, 1.02–1.06; P < 0.001) and 1.48 when comparing obese vs non‐obese patients (95% CI 1.19–1.84; P < 0.001). In the subgroup of patients with RCC (excluding benign renal cortical tumours), BMI was still an independent predictor of clear‐cell histology (odds ratio 1.04, 95% CI 1.02–1.06, P = 0.001).CONCLUSIONSThese results suggest that BMI is an independent predictor of clear‐cell histology in patients with a renal cortical tumour. While the aetiology of this phenomenon requires further study, these findings might have implications in determining a patient’s risk of harbouring a clear‐cell RCC and in subsequent treatment recommendations.
Acquisition of flexible cystoscopy skills on a virtual reality simulator by experts and novices
Authors: Schout Barbara M.A. , Muijtjens Arno M.M. , Hendrikx Ad J.M. , Ananias Hildo J.K. , Dolmans Valérie E.M.G. , Scherpbier Albert J.J.A. , Bemelmans Bart L.H. 
Published: July 2009

Study Type – Therapy (case control) Level of Evidence 3bOBJECTIVETo assess the construct validity of the URO MentorTM (Simbionix Corp., Cleveland, OH, USA) virtual reality training model for several variables of skills training in cysto‐urethroscopy, addressing two research questions: (i) Does training on the URO Mentor significantly improve novices’ performance in terms of time, trauma, areas inspected and Global Rating Scale (GRS) score?; (ii) is discrimination between different levels of expertise possible using the URO Mentor?METHODSThirty experts and 50 novices performed seven tasks on the URO Mentor during one training session. The first, fourth and seventh tasks were ‘test tasks’ to evaluate participants’ performance. The simulator recorded procedure time and trauma; a supervisor scored which areas were inspected and gave scores on the GRS. A two‐way analysis of variance with repeated‐measures test was used to analyse experts’ and novices’ performances, with P < 0.05 considered to indicate statistical significance. Effect sizes (ES) were calculated to quantify the practical significance of the results; ES of 0.10, 0.30, and 0.50 were considered small, medium and large, respectively.RESULTSNovices’ performances showed a significant improvement with large ES in time (linear trend of learning curve P < 0.001, ES 0.66) and mean GRS score (linear trend P < 0.001, ES 0.84, quadratic trend P = 0.018, ES 0.24). There was a medium improvement for trauma (linear trend P < 0.001, ES 0.40) and a small improvement in areas inspected (linear trend P = 0.032, ES 0.21). That the 95% confidence intervals of the measures on the first task of experts and novices did not coincide indicates that differentiation between experts and novices on the four variables measured can be achieved using the URO Mentor.CONCLUSIONSTraining on the URO Mentor appears to result in a medium to large improvement of novices’ performances for time, trauma, areas inspected and GRS scores. Moreover, discrimination between different levels of expertise is possible using this simulator.
Ultrasonographic bladder measurements can replace urodynamic study for the diagnosis of non‐monosymptomatic nocturnal enuresis
Authors: Tafuro Lucia , Montaldo Paolo , Iervolino Luigia Rita , Cioce Fabrizio , Del Gado Roberto 
Published: July 2009

Study Type – Diagnostic (exploratory cohort)  Level of Evidence 2bOBJECTIVETo compare urodynamic (UD) and ultrasonography (US)‐based measurements for the diagnosis and follow‐up of patients with non‐monosymptomatic primary nocturnal enuresis (NMPNE).PATIENTS AND METHODSThe study included 455 enuretic children (282 boys and 173 girls, mean age 9.58 years) with daytime voiding symptoms and with more than one void per night. In healthy children the upper limits for US‐measured bladder wall thickness are 3 and 5 mm for a full or empty bladder, respectively. In 419 children the results showed urodynamic signs of an overactive bladder (OAB) and the US‐measured bladder wall was thickened. After 6 months of antimuscarinic treatment, we re‐assessed the children with US and UD; the relation between UD and US measurements was confirmed. After analysing these data, we considered the use of a new diagnostic assessment for patients with NMPNE. In children with a significant US measurement, i.e. a bladder wall with a thickness of >3 mm (full bladder) and >5 mm (empty bladder), the diagnostic assessment was concluded and therapy was started. We restricted the UD examination exclusively to those patients who either had severe intractable symptoms or did not respond to treatment. This new management was applied to 453 patients with NMPNE. After the first 6 months of therapy all the patients were assessed with a new US study.RESULTSIn all, 343 patients (75.7%) were full‐responders, with a normal bladder wall thickness; 82 (18.1%) were partial responders but with no normalization of bladder wall thickness; only 28 (6.2%) were classified as nonresponders with a persistent thickened bladder wall.CONCLUSIONSWe favour a more conservative management: the UD study should be limited to the very few patients who either have severe intractable symptoms or do not respond to treatment. In our experience, the US study, which is not invasive, is useful for the diagnosis and follow‐up of NMPNE and it is preferable to the UD study, which is invasive and often traumatic for children.
Fragmentation of prostatic needle biopsy cores containing adenocarcinoma: the role of specimen submission
Authors: Fajardo Daniel A. , Epstein Jonathan I. 
Published: July 2009

Study Type – Diagnostic (case series) Level of Evidence 4OBJECTIVETo determine the factors contributing to the fragmentation of prostatic core biopsies containing prostatic carcinoma, which might complicate the quantification of the number cores with cancer and/or the amount of tumour in a core.MATERIALS AND METHODSProstate biopsy cases containing fragmented cores with cancer and cancer cases present only in unfragmented cores were sought in records from the consultant service of one of the authors. A ‘part’ corresponded to the site‐specific jar submitted by the urologist (i.e. left or right; left apex, left mid, etc.). Cases of prostatic adenocarcinoma with fragmented cores containing cancer (463) and cases with cancer lacking fragmented cores (200) were compared.RESULTSThe mean number of parts per case was 8.1 and 7.5 in the unfragmented and fragmented cases, respectively (not significant). The mean number of cores per part was significantly higher in the fragmented group than the unfragmented group (2.6 vs 2.1, P = 0.004). The number of parts containing cancer was higher in cases with fragmented cores than in cases with unfragmented cores (2.8 vs 1.6, P < 0.001). A higher mean Gleason score was associated with the cancer in fragmented cores than in unfragmented cores (6.6 vs 6.2, P < 0.001). Multivariate regression analysis showed that fragmentation was associated with the number of parts with cancer (P < 0.001), cores per part (P < 0.001) and Gleason score (P < 0.04).CONCLUSIONSThe number of parts per case with cancer, number of cores submitted per part, and Gleason score contribute to the likelihood of fragmentation of cores containing prostatic adenocarcinoma.
The Practice and Process of Delivering Integration through Strategic Planning
Authors: Jarzabkowski Paula , Balogun Julia 
Published: July 2009

abstractThis paper explains how strategic planning is able to deliver strategic integration within organizations. While communication and participation within planning processes are perceived to have an integrative effect, we argue that these effects are unlikely to arise simply from bringing people together. Rather, we suggest that, given the varying interests of actors in different business units, integration will only arise from active negotiations and compromises between these actors. The paper is based upon a case of strategic planning in a multinational that was attempting to develop greater strategic integration across Europe. Drawing upon an activity theory framework, we examine how a common strategy emerges over time through modifications to the planning process and to different actors' roles within it. The findings are used to develop a process model that shows how different business unit characteristics of planning experience and relative power shape different experiences of communication and participation activities and different processes for achieving integration. The paper concludes with a discussion of how this process model contributes to the literature on strategic planning, political processes of strategy‐making, and strategy‐as‐practice.
Deferred modification of antiretroviral regimen following documented treatment failure in Asia: results from the TREAT Asia HIV Observational Database (TAHOD)
Authors: Zhou J , Li PCK , Kumarasamy N , Boyd M , Chen YMA , Sirisanthana T , Sungkanuparph S , Oka S , Tau G , Phanuphak P , Saphonn V , Zhang FJ , Omar SFS , Lee CKC , Ditangco R , Merati TP , Lim PL , Choi JY , Law MG , Pujari S ,   on behalf of the TREAT Asia HIV Observational Database
Published: July 2009

Objective
The aim of the study was to examine the rates and predictors of treatment modification following combination antiretroviral therapy (cART) failure in Asian patients with HIV enrolled in the TREAT Asia HIV Observational Database (TAHOD).Methods
Treatment failure (immunological, virological and clinical) was defined by World Health Organization criteria. Countries were categorized as high or low income by World Bank criteria.Results
Among 2446 patients who initiated cART, 447 were documented to have developed treatment failure over 5697 person‐years (7.8 per 100 person‐years). A total of 253 patients changed at least one drug after failure (51.6 per 100 person‐years). There was no difference between patients from high‐ and low‐income countries [adjusted hazard ratio (HR) 1.02; P=0.891]. Advanced disease stage [Centers for Disease Control and Prevention (CDC) category C vs. A; adjusted HR 1.38, P=0.040], a lower CD4 count (≥51 cells/μL vs. ≤50 cells/μL; adjusted HR 0.61, P=0.022) and a higher HIV viral load (≥400 HIV‐1 RNA copies/mL vs. <400 copies/mL; adjusted HR 2.69, P<0.001) were associated with a higher rate of treatment modification after failure. Compared with patients from low‐income countries, patients from high‐income countries were more likely to change two or more drugs (67%vs. 49%; P=0.009) and to change to a protease‐inhibitor‐containing regimen (48%vs. 16%; P<0.001).Conclusions
In a cohort of Asian patients with HIV infection, nearly half remained on the failing regimen in the first year following documented treatment failure. This deferred modification is likely to have negative implications for accumulation of drug resistance and response to second‐line treatment. There is a need to scale up the availability of second‐line regimens and virological monitoring in this region.
Promoting Leisure Physical Activity Participation among Adults with Intellectual Disabilities: Validation of Self‐Efficacy and Social Support Scales
Authors: Peterson Jana J. , Andrew Peterson N. , Lowe John B. , Nothwehr Faryle K. 
Published: July 2009

Background  Many individuals with intellectual disabilities are not sufficiently active for availing health benefits. Little is known about correlates of physical activity among this population on which to build health promotion interventions.Materials and Methods  We developed scales for measurement of self‐efficacy and social support for leisure physical activity among adults with intellectual disabilities. Study participants were 152 adults with mild to moderate intellectual disabilities.Results  The scales demonstrated good internal consistency and fair to excellent test–re‐test reliability. Confirmatory factor analyses revealed good fit for each of the scales, supporting the hypothesized structure of each. Scales also correlated with self‐reported leisure physical activity, providing evidence of construct validity.Conclusions  Studies of physical activity correlates are needed to formulate evidence‐based programmes to promote physical activity participation. This measure demonstrated good psychometric properties, and will be useful for examining social support and self‐efficacy for physical activity by adults with intellectual disabilities.
Obstetric interventions for babies born before 28 weeks of gestation in Europe: results of the MOSAIC study
Authors: Kollée LAA , Cuttini M , Delmas D , Papiernik E , den Ouden AL , Agostino R , Boerch K , Bréart G , Chabernaud J‐L , Draper ES , Gortner L , Künzel W , Maier RF , Mazela J , Milligan D , Van Reempts P , Weber T , Zeitlin J ,   the MOSAIC Research group
Published: July 2009

Objective  To describe obstetric intervention for extremely preterm births in ten European regions and assess its impact on mortality and short term morbidity.Design  Prospective observational cohort study.Setting  Ten regions from nine countries participating in the ‘Models of Organising Access to Intensive Care for Very Preterm Babies in Europe’ (MOSAIC) project.Population  All births from 22 to 29 weeks of gestation (n = 4146) in 2003, excluding terminations of pregnancy.Methods  Comparison of three obstetric interventions (antenatal corticosteroids, antenatal transfer and caesarean section for fetal indication) rates at 22–23, 24–25 and 26–27 weeks to that at 28–29 weeks and the association of the level of intervention with pregnancy outcome.Main outcome measures  Use of antenatal corticosteroids, antenatal transfer and caesarean section by two‐week gestational age groups as well as a composite score of these three interventions. Outcomes included stillbirth, in‐hospital mortality and intraventricular haemorrhage (IVH) grades III and IV and/or periventricular leucomalacia (PVL) and bronchopulmonary dysplasia (BPD).Results  There were large differences between regions in interventions for births at 22–23 and 24–25 weeks. Differences were most pronounced at 24–25 weeks; in some regions these babies received the same care as babies of 28–29 weeks, whereas elsewhere levels of intervention were distinctly lower. Before 26 weeks and especially at 24–25 weeks, there was an association between the composite intervention score and mortality. No association was observed at 26–27 weeks. For survivors at 24–25 weeks, the intervention score was associated with higher rates of BPD, but not with IVH or PVL.Conclusions  There are large differences between European regions in obstetric practices at the lower limit of viability and these are related to outcome, especially at 24–25 weeks.