bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pleural controversy: Closed needle pleural biopsy or thoracoscopy—Which first?
Authors: KOEGELENBERG COENRAAD F.N. , DIACON ANDREAS H. 
Published: March 2011

ABSTRACTThe most efficient and cost‐effective approach to the diagnosis of pleural exudates remains controversial. Important considerations include the respective diagnostic yields of thoracocentesis, closed pleural biopsy and thoracoscopy; the incremental gain in diagnostic yield when sequentially combining these investigations; and the role of various image modalities. The diagnostic yield of thoracocentesis is in the order of 60% for malignancy and >90% for tuberculosis. A second aspiration may increase the yield for malignancy, but a third is generally superfluous. Many authorities consider thoracoscopy the investigation of choice in exudative pleural effusions where a thoracocentesis was nondiagnostic and particularly when malignancy is suspected. It allows for the direct inspection of the pleura and for talc poudrage. Thoracoscopy has a diagnostic yield of 91–95% for malignant disease and as high as 100% for pleural tuberculosis. Access to thoracoscopy is, however, limited in many parts of the world, as significant resources and expertise are required. Blind closed pleural biopsy has a yield of 80% for tuberculosis and <60% for pleural malignancy. Recent studies suggest that CT and/or ultrasound guidance may improve the yield, particularly for malignancy, where it may be as high as 88% and 83%, respectively. A second thoracocentesis combined with an image‐assisted pleural biopsy with either an Abrams needle or cutting needle, depending on the setting, may therefore be an acceptable alternative to thoracoscopy. With such an approach, thoracoscopy may potentially be reserved for cases not diagnosed by means of closed pleural biopsy.
Tension‐free vaginal tape retropubic sling for recurrent stress urinary incontinence after Burch colposuspension failure
Authors: Shao Yuan , He Hong‐chao , Shen Zhou‐jun , Zhou Wen‐long 
Published: March 2011

Objectives:  To verify the efficacy and to clarify the mechanism of the tension‐free vaginal tape retropubic sling for recurrent stress urinary incontinence after Burch colposuspension failure.Methods:  A total of 24 women having tension‐free vaginal tape retropubic sling placement for recurrent stress urinary incontinence after a previous failed Burch urethropexy were enrolled in the present study. Median follow up was 57 months (range 12–96). Pre‐ and postoperative urethral mobility and urodynamics were evaluated.Results:  Preoperatively, all 24 patients had intrinsic sphincter deficiency and 14 had urethral hypermobility. Postoperatively, 15 patients were completely dry and two had a leakage of urine less than 5 g/h. The overall success rate was 70.8%. There was a significant postoperative increase of maximum urethral closure pressure (P < 0.001), and a decrease of average flow rate (P = 0.001) and urethral hypermobility (P < 0.001). When comparing successful with failure cases, only elevated maximum urethral closure pressure (P = 0.002) was significantly different. Multivariate logistic regression showed the change of maximum urethral closure pressure (P = 0.011) was the only independent parameter significantly correlated with the outcome of sling placement.Conclusions:  Recurrent stress urinary incontinence with intrinsic sphincter deficiency after Burch colposuspension might be well treated with the tension‐free vaginal tape retropubic sling by effectively elevating the maximum urethral closure pressure.
Predicting microbial nitrogen pathways from basic principles
Authors: van de Leemput Ingrid A. , Veraart Annelies J. , Dakos Vasilis , de Klein Jeroen J. M. , Strous Marc , Scheffer Marten 
Published: March 2011

SummaryNitrogen compounds are transformed by a complicated network of competing geochemical processes or microbial pathways, each performed by a different ecological guild of microorganisms. Complete experimental unravelling of this network requires a prohibitive experimental effort. Here we present a simple model that predicts relative rates of hypothetical nitrogen pathways, based only on the stoichiometry and energy yield of the performed redox reaction, assuming competition for resources between alternative pathways. Simulating competing pathways in hypothetical freshwater and marine sediment situations, we surprisingly found that much of the variation observed in nature can simply be predicted from these basic principles. Investigating discrepancies between observations and predictions led to two important biochemical factors that may create barriers for the viability of pathways: enzymatic costs for long pathways and high ammonium activation energy. We hypothesize that some discrepancies can be explained by non‐equilibrium dynamics. The model predicted a pathway that has not been discovered in nature yet: the dismutation of nitrite to the level of nitrate and dinitrogen gas.
Varicocele as a risk factor for androgen deficiency and effect of repair
Authors: Tanrikut Cigdem , Goldstein Marc , Rosoff James S. , Lee Richard K. , Nelson Christian J. , Mulhall John P. 
Published: March 2011

Study Type – Therapy (case control)Level of Evidence 2bOBJECTIVE• To determine whether men with varicoceles have lower testosterone levels than those without and to ascertain if testosterone levels increase after varicocelectomy.PATIENTS AND METHODS• We measured preoperative testosterone levels in 325 men with palpable varicoceles and in 510 men with vasectomy reversal without varicoceles who served as a comparison group.• The testosterone levels between groups were compared by age. Of the men with varicoceles, 200 had data on both pre‐ and postoperative testosterone levels, which were compared to assess postoperative changes.RESULTS• Men with varicocele had significantly lower testosterone levels than the comparison group, with mean (sd) levels of 416 (156) vs 469 (192) ng/dL (P < 0.001). This difference persisted when analysed by age.• The testosterone levels significantly increased after repair from 358 (126) to 454 (168) ng/dL (P < 0.001).• Of the 70% of patients with postoperative improvement in testosterone levels, the mean (sd) increase in testosterone was 178 (142) ng/dL. The percentage change in testosterone levels was: 30% had no increase, 41% increased by ≤50%, 19% increased between by 51–100%, and 10% increased by >100%.• There was no association between change in testosterone level and age, laterality of varicocele, or varicocele grade.CONCLUSIONS• Men with varicoceles had significantly lower testosterone levels than the comparison group of men with vasectomy reversal.• Microsurgical varicocele ligation resulted in a significant increase in serum testosterone levels in more than two‐thirds of men.• These findings suggest that varicocele is a significant risk factor for androgen deficiency and that repair may increase testosterone levels in men with varicocele and low testosterone levels.
Feasibility and safety of retroperitoneoscopic laparoendoscopic single‐site nephrectomy: technique and early outcomes
Authors: Chueh Shih‐Chieh Jeff , Sankari Bashir R. , Chung Shiu‐Dong , Jones J. Stephen 
Published: March 2011

What’s known on the subject? and What does the study add?Laparoendoscopic single‐site (LESS) nephrectomy is feasible to remove diseased kidneys. Most of such procedures previously reported were performed through a transperitoneal (trans‐abdominal) approach.We report the feasibility, safety, and techniques of performing such operations without disturbing the bowels (a retroperitoneal LESS approach). This approach provides acceptable operative outcomes, and is especially valuable for patients who need to have an intact peritoneal envelope, or those with potentially abnormal or obliterated peritoneal space.Study Type – Therapy (case series)Level of Evidence 4OBJECTIVES• To retrospectively review our experience with respect to evaluating the feasibility and safety of retroperitoneoscopic laparoendoscopic single‐site surgery (LESS) nephrectomy.• To present the technical details of such a procedure.PATIENTS AND METHODS• In total, eight retroperitoneoscopic LESS nephrectomies (in seven patients) were completed for a variety of indications in a single centre.• The GelPOINT apparatus (Applied Medical, Rancho Santa Margarita, CA, USA) was used as an access platform through a flank incision (3–5 cm).• Except for a bendable grasper and flexible vascular staplers, all instruments used were conventional straight laparoscopic instruments.• Perioperative data were retrospectively obtained for all patients, including demographic data, operative indications, operative records, length of stay, complications, and pathological analysis.RESULTS• All retroperitoneoscopic LESS nephrectomy procedures attempted were completed successfully without complications. No extra working port was required for any case.• Median (range) operating time was 164 (87–198) min and median (range) estimated blood loss was 50 (10–200) cm3. Median (range) length of hospital stay was 2 (1–3) days.• The median narcotic used was 34 mg of parental morphine sulphate equivalent. The median (range) visual analogue pain scale score at discharge was 2 (0–3) out of 10.• The present single arm observation study is limited by the small patient number and the absence of a control cohort.CONCLUSIONS• Retroperitoneoscopic LESS nephrectomy using the GelPOINT apparatus as an access platform is feasible and safe.• It provides adequate flexibility and spacing of port placements as well as acceptable operative outcomes.• It is especially valuable for those patients who need to maintain peritoneal integrity or those with an abnormal or obliterated peritoneal space.
Coordinate expression of multiple proteins in plant cells by exploiting endogenous kex2p‐like protease activity
Authors: Zhang Bei , Rapolu Madhusudhan , Huang Leyang , Su Wei Wen 
Published: March 2011

SummarySimultaneous expression of multiple proteins in plants finds ample applications. Here, we examined the biotechnological application of native kex2p‐like protease activity in plants for coordinate expression of multiple secretory proteins from a single transgene encoding a cleavable polyprotein precursor. We expressed a secretory red fluorescent protein (DsRed) or human cytokine (GMCSF), fused to a downstream green fluorescent protein (GFP) by a linker containing putative recognition sites of the kex2p‐like protease in tobacco cells and referred to them as RKG and GKG cells, respectively. Our analyses showed that GFP is cleaved off the fusion proteins and secreted into the media by both RKG and GKG cells. The cleaved GFP product displayed the expected fluorescence characteristics. Using GFP immunoprecipitation and fluorescence analysis, the cleaved DsRed product in the RKG cells was found to be functional as well. However, DsRed was not detected in the RKG culture medium, possibly due to its tetramer formation. Cleaved and biologically active GMCSF could also be detected in GKG cell extracts, but secreted GMCSF was found to be only at a low level, likely because of instability of GMCSF protein in the medium. Processing of polyprotein precursors was observed to be similarly effective in tobacco leaf, stem and root tissues. Importantly, we also demonstrated that, via agroinfiltration, polyprotein precursors can be efficiently processed in plant species other than tobacco. Collectively, our results demonstrate the utility of native kex2p‐like protease activity for the expression of multiple secretory proteins in plant cells using cleavable polyprotein precursors containing kex2p linker(s).
Kindergarten children’s sensitivity to geometry in maps
Authors: Spelke Elizabeth S. , Gilmore Camilla K. , McCarthy Shannon 
Published: March 2011

AbstractGeometrical concepts are critical to a host of human cognitive achievements, from maps to measurement to mathematics, and both the development of these concepts, and their variation by gender, have long been studied. Most studies of geometrical reasoning, however, present children with materials containing both geometric and non‐geometric information, and with tasks that are open to multiple solution strategies. Here we present kindergarten children with a task requiring a focus on geometry: navigation in a small‐scale space by a purely geometric map. Children spontaneously extracted and used relationships of both distance and angle in the maps, without prior demonstration, instruction, or feedback, but they failed to use the sense information that distinguishes an array from its mirror image. Children of both genders showed a common profile of performance, with boys showing no advantage on this task. These findings provide evidence that some map‐reading abilities arise prior to formal instruction, are common to both genders, and are used spontaneously to guide children’s spatial behavior.
Ethnic Discrimination in Germany’s Labour Market: A Field Experiment
Authors: Kaas Leo , Manger Christian 
Published: March 2011

Abstract
This paper studies ethnic discrimination in Germany’s labour market with a correspondence test. We send two similar applications to each of 528 advertisements for student internships, one with a Turkish-sounding and one with a German-sounding name. A German name raises the average probability of a callback by about 14%. Differential treatment is particularly strong and significant in smaller firms at which the applicant with the German name receives 24% more callbacks. Discrimination disappears when we restrict our sample to applications including reference letters which contain favourable information about the candidate’s personality. We interpret this finding as evidence for statistical discrimination.
Familial and sporadic melanoma: different clinical and histopathological features in the Italian population – a multicentre epidemiological study – by GIPMe (Italian Multidisciplinary Group on Melanoma)
Authors: Chiarugi A. , Nardini P. , Crocetti E. , Carli P. , De Giorgi V. , Borgognoni L. , Brandani P. , Pimpinelli N. , Manganoni A.M. , Quaglino P. ,   GIPMe Participants Centres
Published: March 2011

AbstractBackground  Having a familial member affected by cutaneous melanoma is a risk factor for this neoplasm. Only a few epidemiological case–control studies have been carried out to investigate whether familial and sporadic melanomas show different clinical and histopathological features.Objective  The aim of this study was to evaluate eventual different features and risk factors in subjects affected by familial and sporadic cutaneous melanoma.Methods  A case–control multicentre study interesting 1407 familial (n = 92) and sporadic (n = 1315) melanomas in the Italian population. The analysis was made using t‐test for continuous variables and chi‐squared test for categorized ones. The variables which have shown statistically significant differences in the two groups in the univariate analysis were included in a multivariate model.Results  The results showed some main significantly clinical differences between the two groups investigated: earlier age at diagnosis, a greater proportion of sunburns and a higher number of naevi were observed for the familial cases compared with sporadic ones. Nevertheless, we did not find a diagnostic anticipation in familial melanomas, in fact the invasion level and the thickness of melanomas was similar in the two groups.Conclusion  Some relevant clinical differences are observed between the two groups examined. The familial melanoma members, although carriers of constitutional risk factors, are not careful enough to primary and secondary prevention.
Differential expression of connective tissue growth factor and extracellular matrix proteins in lichen sclerosus
Authors: Gambichler T. , Skrygan M. , Czempiel V. , Tigges C. , Kobus S. , Meier J.J. , Köhler C.U. , Scola N. , Stücker M. , Altmeyer P. , Kreuter A. 
Published: March 2011

AbstractBackground  The histopathology of lichen sclerosus (LS) suggests abnormalities in extracellular matrix (ECM) composition.Objectives  We aimed to investigate the expression pattern of ECM proteins and related growths factors and Smad signal transducers in LS as compared with healthy skin.Methods  To assess the expression of decorin, biglycan, versican, perlecan, fibronectin, dermatopontin, extracellular matrix protein 1 (ECM‐1), matrix metalloproteinase 1, tissue inhibitor of metalloproteinase 1, connective tissue growth factor (CTGF), transforming growth factor β1, and Smad‐3 protein, real‐time RT‐PCR and immunohistochemistry were performed on skin specimens obtained from the genital region of healthy subjects (n = 10) as well as LS patients (n = 26).Results  Median mRNA as well as mean protein expression of biglycan, versican, fibronectin, and ECM‐1 was significantly higher in LS when compared with healthy controls. Both mRNA and protein CTGF expression observed in LS was significantly higher than in controls. CTGF mRNA expression significantly correlated with mRNA expression of biglycan, versican and fibronectin.Conclusions  Expression of ECM proteins (e.g. proteoglycans, ECM‐1) and CTGF is altered in LS. TGF‐ß/Smad‐3 independent up‐regulation of CTGF may induce accumulation of ECM proteins and maintain fibrosis in chronic LS.
Spirituality, illness and personal responsibility: the experience of Jordanian Muslim men with coronary artery disease
Authors: Nabolsi Manar M. , Carson Alexander M. 
Published: March 2011

Scand J Caring Sci; 2011; 25; 716–724

Spirituality, illness and personal responsibility: the experience of Jordanian Muslim men with coronary artery diseaseSpiritual care is an aspect of nursing in many parts of the world; however, there is very little evidence of this in an Arab Muslim country. This qualitative study explores the meaning of spirituality as experienced by Jordanian Muslim men living with coronary artery disease. A hermeneutical phenomenological orientation was used to explore the experience of spirituality as lived by Arab Muslim men with coronary artery disease. A purposive sample of 19 men was selected from the Coronary care Unit (CCU) in a teaching hospital in Jordan. Data were collected using semi‐structured interviews. Data were analyzed using Colaizzi’s steps of phenomenological analysis. Four themes emerged from the data. The participants explained that faith facilitated their acceptance of illness and enhanced their coping strategies, that seeking medical treatment did not conflict with their belief in fate, that spirituality enhanced their inner strength, hope and acceptance of self‐responsibility and it helped to them to find meaning and purpose in their life. In this study, Parse’s theory of human becoming served as the foundation for understanding the paradoxical rhythmical pattern of the human experience of spirituality in illness. The findings suggest that patients’ faith plays a central role in the choices they make either healthy or unhealthy, or accepting or rejecting their personal responsibility in promoting their future health and well‐being. In addition, it provide nurses with the basis for providing spiritual care and developing a culturally sensitive healthcare plans in this population.
Translational neuropharmacology and the appropriate and effective use of animal models
Authors: Green AR , Gabrielsson J , Fone KCF 
Published: March 2011

This issue of the British Journal of Pharmacology is dedicated to reviews of the major animal models used in neuropharmacology to examine drugs for both neurological and psychiatric conditions. Almost all major conditions are reviewed. In general, regulatory authorities require evidence for the efficacy of novel compounds in appropriate animal models. However, the failure of many compounds in clinical trials following clear demonstration of efficacy in animal models has called into question both the value of the models and the discovery process in general. These matters are expertly reviewed in this issue and proposals for better models outlined. In this editorial, we further suggest that more attention be made to incorporate pharmacokinetic knowledge into the studies (quantitative pharmacology). We also suggest that more attention be made to ensure that full methodological details are published and recommend that journals should be more amenable to publishing negative data. Finally, we propose that new approaches must be used in drug discovery so that preclinical studies become more reflective of the clinical situation, and studies using animal models mimic the anticipated design of studies to be performed in humans, as closely as possible.LINKED ARTICLES This article is part of a themed issue on Translational Neuropharmacology. To view the other articles in this issue visit http://dx.doi.org/10.1111/bph.2011.164.issue‐4
Endocannabinoid tone versus constitutive activity of cannabinoid receptors
Authors: Howlett Allyn C. , Reggio Patricia H. , Childers Steven R. , Hampson Robert E. , Ulloa Nadine M. , Deutsch Dale G. 
Published: March 2011

This review evaluates the cellular mechanisms of constitutive activity of the cannabinoid (CB) receptors, its reversal by inverse agonists, and discusses the pitfalls and problems in the interpretation of the research data. The notion is presented that endogenously produced anandamide (AEA) and 2‐arachidonoylglycerol (2‐AG) serve as autocrine or paracrine stimulators of the CB receptors, giving the appearance of constitutive activity. It is proposed that one cannot interpret inverse agonist studies without inference to the receptors' environment vis‐à‐vis the endocannabinoid agonists which themselves are highly lipophilic compounds with a preference for membranes. The endocannabinoid tone is governed by a combination of synthetic pathways and inactivation involving transport and degradation. The synthesis and degradation of 2‐AG is well characterized, and 2‐AG has been strongly implicated in retrograde signalling in neurons. Data implicating endocannabinoids in paracrine regulation have been described. Endocannabinoid ligands can traverse the cell's interior and potentially be stored on fatty acid‐binding proteins (FABPs). Molecular modelling predicts that the endocannabinoids derived from membrane phospholipids can laterally diffuse to enter the CB receptor from the lipid bilayer. Considering that endocannabinoid signalling to CB receptors is a much more likely scenario than is receptor activation in the absence of agonist ligands, researchers are advised to refrain from assuming constitutive activity except for experimental models known to be devoid of endocannabinoid ligands.LINKED ARTICLES This article is part of a themed issue on Cannabinoids in Biology and Medicine. To view the other articles in this issue visit http://dx.doi.org/10.1111/bph.2011.163.issue‐7