bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ureteric stent placement with extraction string: no strings attached?
Authors: Bockholt Nathan A. , Wild Trevor T. , Gupta Amit , Tracy Chad R. 
Published: May 2012

Study Type – Therapy (case series)Level of Evidence 4What's known on the subject? and What does the study add?Of patients treated with an indwelling ureteric stent 80–90% experience lower urinary tract symptoms that are a hindrance to health‐related quality of life. The prevalence of the extraction/retrieval string after ureteroscopy for stone disease and stent placement varies significantly between surgeons and published series, but the benefits of eliminating the need for a secondary procedure such as cystoscopy and stent removal, as well as the decrease in cost to the patient are well established.Published reports have not addressed the prevalence of post‐procedure related events (PREs) in patients who have received an indwelling ureteric stent with the extraction/retrieval string still intact after ureteroscopy for stone disease. By analysing PREs (Emergency Room visits, unscheduled clinic visits, and telephone calls) related to their stent or procedure for patients with and without an extraction/retrieval string, the feasibility of the extraction string can be validated and the misconceptions about their use can be alleviated.OBJECTIVE
To review a retrospective ureteric stent cohort with and without extraction string to compare post‐procedure related events (PRE), as ureteric stent placement after endoscopic management of urolithiasis is common, but data regarding the potential benefits or disadvantages of ureteric stent placement with extraction string are sparse.
PATIENTS AND METHODS
Between June 2009 and June 2010, 293 patients underwent ureteroscopy with or without lithotripsy for stone disease.
In all, 181 patients had a unilateral procedure and underwent stent placement postoperatively.
Records were retrospectively reviewed for operative data and PRE occurring within the first 6 weeks after surgery, defined as unscheduled clinic or Emergency Room visits, or adverse event telephone calls.
RESULTS
Of 181 patients who underwent ureteric stent placement, 43 (23.8%) included an extraction string.
In all, 34.3% of all patients had a PRE, including 37.2% and 33.3% of patients with and without extraction string, respectively (P= 0.64).
PRE occurred in men with or without an extraction string (27.8 vs 32.4%, respectively; P= 0.71) and women with or without an extraction string (44.0 vs 34.3%, respectively, P= 0.39).
PRE occurred with relatively equal frequency between men and women (P= 0.28).
Only two women (4.7%) reported removing their stent prematurely, on postoperative days 2 and 6.
CONCLUSIONS
Ureteric stent placement with extraction string after ureteroscopy for stone disease does not seem to result in more PRE, regardless of gender.
Prospective randomised trials are needed to determine the benefits and disadvantages of ureteric stents with extraction string.
A new prognostic model for cancer‐specific survival after radical cystectomy including pretreatment thrombocytosis and standard pathological risk factors
Authors: Todenhöfer Tilman , Renninger Markus , Schwentner Christian , Stenzl Arnulf , Gakis Georgios 
Published: May 2012

Study Type – Prognosis (cohort series)Level of Evidence 2aWhat's known on the subject? and What does the study add?Preoperative thrombocytosis has been identified as a predictor of poor outcome in various cancer types. However, the prognostic role of platelet count in patients with invasive bladder cancer undergoing radical cystectomy is unknown.The present study demonstrates that preoperative thrombocytosis is an independent risk factor for decreased cancer‐specific survival after radical treatment of invasive bladder cancer. We developed a new prognostic scoring model for cancer‐specific outcomes after radical cystectomy including platelet count and established pathological risk factors. Consideration of platelet count in the final model increased its predictive accuracy significantly. Thrombocytosis may be a useful parameter to include within established international bladder cancer nomograms.OBJECTIVE
To investigate the oncological significance of preoperative thrombocytosis in patients with invasive bladder cancer undergoing radical cystectomy, as it has been reported as a marker for aggressive tumour biology in a variety of solid tumours.
PATIENTS AND METHODS
The series comprised 258 patients undergoing radical cystectomy between 1999 and 2010 in whom different clinical and histopathological parameters were assessed.
Elevated platelet count was defined as >450 × 109/L.
Based on regression estimates of significant parameters in multivariable analysis a new weighted scoring model was developed to predict cancer‐specific outcomes.
RESULTS
The median follow‐up was 30 months (6–116).
Of the 258 patients, 26 (10.1%) had elevated and 232 (89.9%) had normal platelet count. The 3‐year cancer‐specific survival in patients with normal and elevated platelet count was 61.5% and 32.7%, respectively (P < 0.001).
In multivariable analysis, cancer‐specific survival was significantly lower in patients with locally advanced disease (≥pT3a) (relative risk 2.91, 1.54–5.65; P= 0.001), positive soft tissue surgical margins (4.03, 1.99–7.92; P= 0.001) and thrombocytosis (2.68, 1.26–5.14; P= 0.011).
The 3‐year cancer‐specific survival in patients with a score 0 (low risk), 1–2 (intermediate risk) and 3–5 (high risk) was 81.0%, 54.8% and 8.2%, respectively (P < 0.001).
Consideration of preoperative platelet count in the final model increased its predictive accuracy by 1.8% with a concordance index of 0.745 (P= 0.040).
CONCLUSIONS
The presence of thrombocytosis at radical cystectomy portends unfavourable prognosis.
We constructed a simple weighted prognostic model for cancer‐specific outcomes after radical cystectomy based on pretreatment platelet count and established pathological risk factors.
These data warrant external validation and may allow for tailored monitoring and selection of appropriate patients for neoadjuvant and adjuvant trials.
Late recurrence of renal cell carcinoma >5 years after surgery: clinicopathological characteristics and prognosis
Authors: Park Yong Hyun , Baik Kyung Don , Lee Young Ju , Ku Ja Hyeon , Kim Hyeon Hoe , Kwak Cheol 
Published: May 2012

Study Type – Therapy (case series)Level of Evidence 4What's known on the subject? and What does the study add?Late recurrence more than five years after the initial treatment is one of the biological behaviours specific for RCC. In our study, late recurrence was observed in 8.8% of the patients. Also, patients with late recurrence had more favorable clinicopathological features and better prognosis with long cancer‐specific survival after recurrence. Age and preoperative hs‐CRP levels may be independent predictive factors for late recurrence of RCC.OBJECTIVE
To evaluate the clinicopathological features and prognosis of late recurrence of renal cell carcinoma (RCC).
PATIENTS AND METHODS
A total of 747 patients who had undergone curative surgery for RCC with follow‐up of >5 years or recurrence within 5 years were included in the study.
The patients were stratified into four groups based on cancer‐free intervals: no recurrence (no recurrence >5 years after surgery, n= 425), synchronous metastasis (n= 138), early recurrence (recurrence within 5 years, n= 143), and late recurrence (recurrence after 5 years, n= 41).
Multivariate analysis was performed to identify the clinicopathological factors affecting late recurrence and its clinical outcome.
RESULTS
The subgroups were significantly different in clinicopathological variables, including age, preoperative haemoglobin, platelet count, high‐sensitivity C‐reactive protein (hs‐CRP) levels, pT stage and nuclear grade.
In multiple logistic regression analysis, age (odds ratio [OR] 1.085, 95% confidence interval [CI] 1.012–1.163, P= 0.022), and preoperative hs‐CRP levels (OR 6.211, 95% CI 1.590–24.270, P= 0.009) were independent predictive factors for late recurrence.
In patients with synchronous metastasis, early recurrence and late recurrence, 5‐year cancer‐specific survival rates after recurrence were 27.0%, 41.1% and 73.7%, respectively (P < 0.001).
Multivariate Cox analysis indicated that cancer‐free interval, as well as body mass index, initial symptoms, Fuhrman's nuclear grade, sarcomatoid differentiation, lymphovascular invasion and metastasectomy, were independent predictive factors for cancer‐related death.
CONCLUSIONS
Late recurrence of RCC is not a rare event.
Patients with late recurrence had more favourable clinicopathological features and better prognosis with long cancer‐specific survival after recurrence.
Age and preoperative hs‐CRP levels may be independent predictive factors for late recurrence of RCC.
The IGD report ‘Energy density and its role in helping consumers make healthy choices’: a resource for food businesses
Authors: Hackett R. 
Published: May 2012

SummaryEnergy density is the energy (calorie) content per unit weight of a food, meal or diet. It is important in terms of its impact on an individual's energy intake and overall energy balance. With obesity as a major public health issue in the UK and many other countries, encouraging intake of foods that are lower in energy density could help consumers to reduce their energy intake and eat a healthy, balanced diet.The food industry has a role in helping consumers achieve a healthy, balanced diet. Incorporating energy density as an element of the design or development of their products is one way through which food businesses might support this aim.The Institute of Grocery Distribution's (IGD) Industry Nutrition Strategy Group has produced a report for food businesses to help them to consider energy density as part of new product development or product reformulation. ‘The role of energy density in helping consumers make healthy choices’ provides information on energy density and its role in energy balance, techniques to adjust the energy density of foods, with guidance on using this concept in consumer communications.
Financial penalties on foods: the fat tax in Denmark
Authors: Smed S. 
Published: May 2012

SummaryThis paper summarises the recently introduced fat tax in Denmark, which came into force on 1 October 2012, and discusses some of the consequences of introducing the tax. Furthermore, this paper discusses the theoretical background and reasoning for imposing a fat tax as well as some of the problems and concerns stated, especially by the food industry. The fat tax is a tax paid per kilogram of saturated fat in the following foods if the content of saturated fat exceeds 2.3 g/100 g. These include meat, dairy products and animal fats that are rendered or are extracted in other ways, edible oils and fats, margarine and spreadable blended spreads. The declared aim of the tax is to reduce the consumption of saturated fat among the Danish population in order to decrease the prevalence of diet‐related illnesses. The tax is part of a larger reform of the Danish tax system with the general aim of decreasing the income taxation pressure and financing it by, among other things, increased environmental and energy taxes, as well as increased ‘health’ taxes. Pre‐tax simulations predict that the health tax on saturated fat will give rise to a reduction in the consumption of saturated fat of approximately 8%.
Can physical activity improve the health of the overweight without weight loss?
Authors: Gibson‐Moore H. 
Published: May 2012

SummaryThe prevalence of obesity continues to rise, with over one quarter of the UK adult population in 2010 being classified as obese. Obesity has a severe impact on health and is associated with an array of serious health conditions. Physical inactivity is another major contributor to the global burden of disease and is also associated with a range of negative health outcomes. Research suggests that maintaining or improving fitness through physical activity is associated with a lower risk of developing obesity‐related conditions regardless of weight change. Therefore, healthcare professionals should place an emphasis on advising their patients to increase their physical activity levels to meet UK guidelines, as well as on eating a healthy, balanced diet and maintaining a healthy bodyweight.
An overview of the NUTRIMENTHE project
Authors: Horton C. 
Published: May 2012

SummaryThe NUTRIMENTHE project is in receipt of €5.9 million from the European Commission's Seventh Framework Programme to study the effect of diet on the mental performance of children. The project is especially interested in the effect of B‐vitamins, protein (in breast and formula milk), minerals and long‐chain polyunsaturated fatty acids on the six main domains of mental performance. NUTRIMENTHE is also researching consumer perceptions of how diet affects mental performance and the economic consequence of improving mental performance. This article provides an insight into the results and progress made to date by the project.
On the Social Construction of Hellenism Cold War Narratives of Modernity, Development and Democracy for Greece
Authors: LALAKI DESPINA 
Published: May 2012

AbstractHellenism is one of those overarching, ever‐changing narratives always subject to historical circumstances, intellectual fashions and political needs. Conversely, it is fraught with meaning and conditioning powers, enabling and constraining imagination and practical life. In this essay I tease out the hold that the idea of Hellas has had on post‐war Greece and I explore the ways in which the American anti‐communist rhetoric and discussions about political and economic stabilization appropriated and rearticulated Hellenism. Central to this history of transformations are the archaeologists; the archaeologists as intellectuals, as producers of culture who, while stepping in and out of their disciplinary boundaries, rewrote and legitimized the new ideological properties of Hellenism while tapping into the resources of their profession.
Likelihood inference for discriminating between long‐memory and change‐point models
Authors: Yau Chun Yip , Davis Richard A. 
Published: May 2012

We develop a likelihood ratio (LR) test procedure for discriminating between a short‐memory time series with a change‐point (CP) and a long‐memory (LM) time series. Under the null hypothesis, the time series consists of two segments of short‐memory time series with different means and possibly different covariance functions. The location of the shift in the mean is unknown. Under the alternative, the time series has no shift in mean but rather is LM. The LR statistic is defined as the normalized log‐ratio of the Whittle likelihood between the CP model and the LM model, which is asymptotically normally distributed under the null. The LR test provides a parametric alternative to the CUSUM test proposed by Berkes et al. (2006). Moreover, the LR test is more general than the CUSUM test in the sense that it is applicable to changes in other marginal or dependence features other than a change‐in‐mean. We show its good performance in simulations and apply it to two data examples.
Local elections and consumption insurance
Authors: Gan Li , Xu Lixin Colin , Yao Yang 
Published: May 2012

AbstractDuring our sample period from 1987 to 2002, Chinese villages completed the transition from government‐appointed village leaders to elected ones. This article examines if and how much democratic elections of the village leaders affected consumption insurance by Chinese village residents. Exploring a panel dataset of 1,400 households from this period, we find that consumption insurance is around 20 percent more complete with elected village leaders. Furthermore, local elections improve consumption insurance only for the poor and middle‐income farmers, but not for the rich. The results are robust when we allow for pretrending, potential endogeneity of elections, and higher measurement errors for rich residents. We also find that the effects on consumption insurance are stronger when closer to the upcoming election year and when the village committees consist largely of non‐Communist Party members. These findings suggest that the election effects on consumption insurance partly come from increasing accountability to local constituents.
Bank loans vs. trade credit
Authors: Du Julan , Lu Yi , Tao Zhigang 
Published: May 2012

AbstractUsing a World Bank dataset of Chinese firms, we investigate the relative importance of bank loans and trade credit in promoting firm performance. To deal with possible endogeneity issues, we employ distinct and separable instrumental variables for bank loans and trade credit. We find that access to bank loans is central to improving firm performance and growth, while the availability of trade credit is much less important. Our results suggest that trade credit cannot effectively substitute for bank loans. Overall, our findings suggest the need for further development of China's formal financial institutions, which would enable the non‐state sector to grow much faster than it has grown in recent decades.
Consumption smoothing in Russia1
Authors: Notten Geranda , Crombrugghe Denis de 
Published: May 2012

AbstractUsing a panel from the Russian Longitudinal Monitoring Survey (1994–2004), this paper investigates to what extent Russian households have been able to maintain their living standards while suffering income shocks. Consumption smoothing is modelled by means of an equilibrium correction mechanism, which disentangles short‐run dynamics and long‐run equilibrium adjustments. GMM estimation is used to control for individual household effects in the presence of dynamics. Additionally, we differentiate between food and non‐food consumption, positive and negative shocks, rural and urban areas, and several levels of poverty risk. We find that dynamics are important in the consumption equation, and that estimates are sensitive to imputation errors in home food production. No strong claims can be made regarding heterogeneity in smoothing behaviour.
HIV‐2 infection in Providence, Rhode Island from 2002 to 2011
Authors: Hollenbeck BL , Beckwith CG 
Published: May 2012

ObjectivesIn contrast to HIV‐1 infection, little is known about the natural disease course of HIV‐2 and its response to antiretrovirals (ARVs). We describe a cohort of HIV‐2‐infected patients, focusing on the method of diagnosis, ARV treatment and complications.MethodsThrough a retrospective review of medical records at our centre, we identified 12 patients with HIV‐2 infection in our clinic population (1400 active patients) who received care between 2002 and 2011. We summarized clinical characteristics, ARV treatment and outcomes.ResultsSeven of the patients were male and five were female. All patients were born in West African countries. The mode of transmission was heterosexual intercourse in 11 patients, and injecting drug use in one patient. The median CD4 count at the time of diagnosis was 668 cells/μL (range 23 to 1546 cells/μL). HIV‐2 quantitative viral load measurements were not uniformly available to clinicians. Four patients were treated with protease inhibitor‐based regimens, with a mean increase in CD4 count of 183 cells/μL (range 43 to 341 cells/μL). The other eight patients have been observed off ARVs. Two patients experienced complications from HIV, one patient had HIV encephalopathy and molluscom contagiosum, and another had microsporidiosis infection in the setting of AIDS.ConclusionOur results support those of previous studies indicating that HIV‐2 has a more indolent disease course than HIV‐1, with a spectrum of disease ranging from asymptomatic to AIDS. Development of a reliable quantitative HIV‐2 viral load assay to guide management is needed. Further research studies are needed to establish the best time to start ARV treatment in HIV‐2‐infected patients.
Dominance of non‐native species increases over time in a historically invaded strandline community
Authors: Heard Matthew J. , Sax Dov F. , Bruno John F. 
Published: May 2012

AbstractAimWe lack a robust understanding of whether exotic species, in addition to causing changes immediately after establishing, might continue to increase in dominance long after invasion events occur. To address this, we resurveyed strandline plant communities, which are likely to have been invaded for over two centuries.LocationNortheastern USA.MethodsWe resurveyed the richness and cover of native and exotic plants in 2008 and 2009 at 18 sites, which had originally been surveyed in 1998. We examined whether native and exotic dominance had changed, whether native‐rich sites were less likely to be impacted by exotics over time, whether changes in dominance were driven by large changes in a small number of outlier species or by small, incremental changes among many species and whether disturbance mediated any of these relationships.ResultsExotic dominance increased across sites. Initial native diversity was unrelated to patterns of exotic dominance during resurveys. The identity of species that were outliers with respect to changes in distribution or cover varied between resurvey years. Significant changes in exotic‐to‐native richness ratios at sites were detectible with or without the inclusion of outlier species, but changes in abundance ratios were only significant when outlier species were included. Disturbance across sites was not correlated with species richness, cover, or changes in dominance.Main conclusionsIn this historically invaded community, exotics have increased in dominance over the last decade. This change is not due solely to the success of a few hyper‐dominant species, but also to the cumulative effect of small changes in distribution among many species. It remains unclear whether patterns observed are due to invasion processes that are playing out very slowly through time or to some other explanation. Our findings highlight the need for a more robust understanding of the long‐term dynamics of species invasions.
The Impact of the Affordable Care Act on Medicare Advantage Plan Availability and Enrollment
Authors: Afendulis Christopher C. , Landrum Mary Beth , Chernew Michael E. 
Published: May 2012

ObjectiveTo assess the impact of the Patient Protection and Affordable Care Act's (ACA) changes in Medicare Advantage (MA) payment rates on the availability of and enrollment in MA plans.Data SourcesSecondary data on MA plan offerings, contract offerings, and enrollment by state and county, in 2010–2011.Study DesignWe estimated regression models of the change in the number of plans, the number of contracts, and enrollment as a function of quartiles of FFS spending and pre‐ACA MA payment generosity. Counties in the lowest quartile of spending are treated most generously by the ACA.Principal FindingsRelative to counties in the highest quartile of spending, the number of plans in counties in the first, second, and third quartiles rose by 12 percent, 7.6 percent, and 5.4 percent, respectively. Counties with more generous MA payment rates before the ACA lost significantly more plans. We did not find a similar impact on the change in contracts or enrollment.ConclusionsThe ACA‐induced MA payment changes reduced the number of plan choices available for Medicare beneficiaries, but they have yet affected enrollment patterns.