bluuebunny/crossref_metadata_2025_split huggingface dataset:
Why are some patients admitted to psychiatric hospital while others are not? A study assessing risk during the admission interview and relationship to outcome
Authors: Hunt Glenn E. , O'Hara‐Aarons Maureen , O'Connor Nick , Cleary Michelle 
Published: November 2011

ABSTRACTThe aim of this study was to determine what patient characteristics are used to decide whether a patient is or is not admitted to a psychiatric hospital, and what happens to those not admitted. A further aim was to determine if high levels of risk on admission predict seclusions, length of stay, or readmission within 28 days. Data were collected prospectively on consecutive presentations to an admission office via case notes and electronic databases. Eighty percent (100/127) of the adults presenting to the admission office over a typical month were admitted to hospital. Patients were more likely to be admitted if they were experiencing psychosis or exacerbation of schizophrenia, referred by other doctors or mental health teams, had a legal reason for referral, or if they were homeless. There was no association between risk for violence or suicide and seclusion rates, length of stay, or being readmitted within 28 days. It was reassuring to find that 85% of those not admitted were referred to other mental health providers, and none required admission over the following month. This study found high rates of seclusion and readmissions within 1 year, which requires further study to find strategies to reduce these rates.
Methanogenic toluene metabolism: community structure and intermediates
Authors: Fowler S. Jane , Dong Xiaoli , Sensen Christoph W. , Suflita Joseph M. , Gieg Lisa M. 
Published: November 2011

SummaryToluene is a model compound used to study the anaerobic biotransformation of aromatic hydrocarbons. Reports indicate that toluene is transformed via fumarate addition to form benzylsuccinate or by unknown mechanisms to form hydroxylated intermediates under methanogenic conditions. We investigated the mechanism(s) of syntrophic toluene metabolism by a newly described methanogenic enrichment from a gas condensate‐contaminated aquifer. Pyrosequencing of 16S rDNA revealed that the culture was comprised mainly of Clostridiales. The predominant methanogens affiliated with the Methanomicrobiales. Methane production from toluene ranged from 72% to 79% of that stoichiometrically predicted. Isotope studies using 13C7 toluene showed that benzylsuccinate and benzoate transiently accumulated revealing that members of this consortium can catalyse fumarate addition and subsequent reactions. Detection of a BssA gene fragment in this culture further supported fumarate addition as a mechanism of toluene activation. Transient formation of cresols, benzylalcohol, hydroquinone and methylhydroquinone suggested alternative mechanism(s) for toluene metabolism. However, incubations of the consortium with 18O‐H2O showed that the hydroxyl group in these metabolites did not originate from water and abiotic control experiments revealed abiotic formation of hydroxylated species due to reactions of toluene with sulfide and oxygen. Our results suggest that toluene is activated by fumarate addition, presumably by the dominant Clostridiales.
Unveiling microbial life in the new deep‐sea hypersaline Lake Thetis. Part II: a metagenomic study
Authors: Ferrer Manuel , Werner Johannes , Chernikova Tatyana N. , Bargiela Rafael , Fernández Lucía , La Cono Violetta , Waldmann Jost , Teeling Hanno , Golyshina Olga V. , Glöckner Frank Oliver , Yakimov Michail M. , Golyshin Peter N. ,   The MAMBA Scientific Consortium
Published: November 2011

SummarySo far only little is known about the microbial ecology of Mediterranean deep‐sea hypersaline anoxic lakes (DHALs). These brine lakes were formed by evaporite dissolution/brine seeps and are important model environments to provide insights into possible metabolisms and distributions of microorganisms on the early Earth. Our study on the Lake Thetis, a new thalassohaline DHAL located South‐East of the Medriff Corridor, has revealed microbial communities of contrasting compositions with a high number of novel prokaryotic candidate divisions. The major finding of our present work is co‐occurrence of at least three autotrophic carbon dioxide fixation pathways in the brine–seawater interface that are likely fuelled by an active ramified sulphur cycle. Genes for the reductive acetyl‐CoA and reductive TCA pathways were also found in the brine suggesting that these pathways are operational even at extremely elevated salinities and that autotrophy is more important in hypersaline environments than previously assumed. Surprisingly, genes coding for RuBisCo were found in the highly reduced brine. Three types of sulphide oxidation pathways were found in the interface. The first involves a multienzyme Sox complex catalysing the complete oxidation of reduced sulphur compounds to sulphate, the second type recruits SQR sulphide:quinone reductase for oxidation of sulphide to elemental sulphur, which, in the presence of sulphide, could further be reduced by polysulphide reductases in the third pathway. The presence of the latter two allows a maximal energy yield from the oxidation of sulphide and at the same time prevents the acidification and the accumulation of S0 deposits. Amino acid composition analysis of deduced proteins revealed a significant overrepresentation of acidic residues in the brine compared with the interface. This trait is typical for halophilic organisms as an adaptation to the brine's extreme hypersalinity. This work presents the first metagenomic survey of the microbial communities of the recently discovered Lake Thetis whose brine constitutes one of saltiest water bodies ever reported.
Good quality white‐light transurethral resection of bladder tumours (GQ‐WLTURBT) with experienced surgeons performing complete resections and obtaining detrusor muscle reduces early recurrence in new non‐muscle‐invasive bladder cancer: validation across time and place and recommendation for benchmarking
Authors: Mariappan Paramananthan , Finney Steven M. , Head Elizabeth , Somani Bhaskar K. , Zachou Alexandra , Smith Gordon , Mishriki Said F. , N'Dow James , Grigor Kenneth M. ,   for members of the Edinburgh Urological Cancer Group
Published: November 2011

Study Type – Therapy (cohort)Level of Evidence 2bWhat's known on the subject? and What does the study add?Apart from bladder tumour multiplicity, size, stage, grade and presence of cis, early recurrence following white light TURBT for new bladder tumours is also determined by surgeon experience, completeness of resection and presence or absence of detrusor muscle in the specimen.This study aims to validate surgeon experience and detrusor muscle as independent predictors of early recurrence following apparently complete white light TURBT in new bladder tumours.OBJECTIVE
To validate in patients undergoing first transurethral resection of bladder tumour (TURBT) for non‐muscle‐invasive bladder cancer (NMIBC), the presence/absence of detrusor muscle (DM) in the specimen and surgeon experience as independent predictors of the quality of TURBT.
PATIENTS AND METHODS
Patients with new NMIBC, who had undergone complete first resections were recruited from a prospectively maintained cohort from the 1980s at the Western General Hospital, Edinburgh, UK and a contemporary cohort from the Aberdeen Royal Infirmary, UK.
Tumour size, multiplicity, surgeon category, presence or absence of DM in the specimen, grade, stage, findings at first check cystoscopy and early re‐TURBT were evaluated.
Surgeons were stratified into a senior group (consultant and trainees in year five or six) and a junior group (trainees below year five).
Early recurrence, or recurrence rate at the first follow up cystoscopy (RRFFC), was used to measure quality and was defined as finding pathologically confirmed tumour at early re‐TURBT or the first check cystoscopy.
RESULTS
From a total of 566 patients evaluated from both cohorts, 473 NMIBC specimens were suitable for analysis.
Logistic regression multivariate analysis revealed that the absence of DM was associated with a higher RRFFC (odds ratio [OR]= 3.6, 95% CI = 1.7–7.5, P < 0.001).
Senior surgeons were more likely to resect DM (OR = 4.9, 95% CI = 2.3–10.7, P < 0.001)
Senior surgeons were independently associated with a lower RRFFC (OR = 5.3, 95% CI = 2.1–12.9, P < 0.001).
CONCLUSIONS
Detrusor muscle status at the first, apparently complete, TURBT and surgeon's experience independently predict the quality of TURBT.
Documented complete resection by experienced surgeons with DM presence (good quality white‐light TURBT) should be considered a benchmark for white‐light TURBT in NMIBC.
Type of transrectal ultrasonography probe influences prostate cancer detection rates on repeat prostate biopsy
Authors: Ching Christina B. , Zaytoun Osama , Moussa Ayman S. , Li Jianbo , Avallone Anthony , Jones J. Stephen 
Published: November 2011

Study Type – Diagnostic (case series)Level of Evidence 4What's known on the subject? and What does the study add?It is known that the end‐fire probe detects more prostate cancer on initial prostate biopsy, but there is no literature looking at the influence of type of probe on repeat biopsy.Given that the literature on the influence of ultrasonography probe on repeat prostate biopsy is non‐existent, the present study adds information which may help urologists improve their chances of detecting prostate cancer on prostate biopsy. Determining which type of probe to use on a prostate biopsy is a simple external factor that may help improve patient management.OBJECTIVE
To determine if the type of transrectal ultrasonography (TRUS) probe used during repeat prostate biopsy influences prostate cancer detection rates.
PATIENTS AND METHODS
We conducted a retrospective chart review of 680 men undergoing repeat prostate biopsy at our institution between 2000 and 2010.
Patient mean (range) age was 64.2 (39–95) years.
The median (range) prostate‐specific antigen (PSA) level was 5.5 (0.37–33.8) ng/mL and median (range) free PSA was 17 (5–45) %.
Patient age, PSA, prostate volume, number of biopsy cores, time interval between initial and repeat biopsy, digital rectal examination and pathological findings were all included in a multivariate logistic regression analysis.
RESULTS
The use of an end‐fire probe on repeat biopsy significantly increased prostate cancer detection (odds ratio [OR] 1.59, 95% confidence interval [CI]: 1.03–2.46).
The time interval between 1st and 2nd biopsy was also significant (OR 1.46, 95% CI: 1.11–1.09).
On univariate analysis, white race (OR 0.66, 95% CI: 0.44–0.99), increasing prostate volume (OR 0.70, 95% CI: 0.55–0.89), and higher free PSA (OR 0.54, 95% CI: 0.34–0.84) were associated with a decreased risk of cancer.
When evaluating the different permutations of using an end‐fire or side‐fire probe on initial or repeat biopsy, there was no difference in prostate cancer detection regardless of order of use of an end‐fire or side‐fire probe.
CONCLUSIONS
An end‐fire probe is associated with improved prostate cancer detection rates on both initial and repeat biopsy.
The order of probe use does not appear to matter.
Global robotic experience and the type of surgical system impact the types of robotic malfunctions and their clinical consequences: an FDA MAUDE review
Authors: Lucas Steven M. , Pattison Erik A. , Sundaram Chandru P. 
Published: November 2011

Study Type – Therapy (case series)Level of Evidence 4What's known on the subject? and What does the study add?Malfunctions of the robotic surgical system have been reported, and the critical failure rate leading to converting or aborting the case occurs in less than 1% of cases. However, little is known about how global robotic experience with time and the advent of newer robotic surgical systems impact robot malfunctions. In this study, we characterize the changes in type and consequences of robot malfunctions over time and by type of robotic system used (da Vinci or da Vinci S).OBJECTIVES
To assess annual rates of robotic system malfunctions and compare the da Vinci S® system (dVS) and da Vinci® surgical system (dV).
To assess the types of malfunctions and associated outcomes for robotic cases and determine the extent to which experience and technological improvements impact these.
PATIENTS AND METHODS
This study is a retrospective review of the US Food and Drug Administration (FDA) MAUDE (Manufacturer and User Facility Device Experience) database, a publicly available, voluntary reporting system (http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfmaude/search.cfm).
The database was searched using the two phrases ‘da Vinci’ and ‘Intuitive Surgical’ from 2003 to 2009.
Malfunctions of the instruments, console, patient‐side cart, camera and cannula were recorded.
Data on intraoperative injuries, case delays and conversions were also collected.
RESULTS
In all, 1914 reports were reviewed (991 dVS and 878 dV, 45 unclassified) with peak years for reports of 2008 for dVS (571) and 2007 for dV (211), P < 0.001.
With respect to time, the proportion of console and patient‐side cart malfunctions declined from 2007 onward compared with the proportions prior to 2007 (5.1% vs 9.4% and 6.6% vs 10.9%).
Patient injury did not change with year of surgery (0.5–5.4% of malfunctions, P= 0.358), open conversions declined (21.3% of malfunctions before 2007 vs 9.9% from 2007 onward, P < 0.001) and patient deaths increased (0.0013% of cases before 2007 vs 0.0061% of cases from 2007 onward, P < 0.001).
With regard to robotic system, console and patient‐side cart malfunctions were more frequent with the dV than the dVS: 82/878 vs 39/991 and 100/878 vs 48/991, P < 0.001.
Open conversion was more frequent with dV than dVS (19.3% vs 7.7% of reported malfunctions, P < 0.001), while patient injury was less with dV than dVS (3.5% vs 5.9%, P= 0.021).
CONCLUSIONS
The dVS decreased console and patient‐side cart errors relative to total malfunctions, which were also influenced by surgical year.
Open conversions were reduced by increased robotic experience and newer surgical system.
Differences in patient injury may reflect changes in reporting or case complexity.
Which patients are at the highest risk of dying from competing causes ≤10 years after radical prostatectomy?
Authors: Froehner Michael , Koch Rainer , Litz Rainer J. , Hakenberg Oliver W. , Wirth Manfred P. 
Published: November 2011

Study Type – Outcomes (cohort)Level of Evidence 2bWhat's known on the subject? and What does the study add?Several comorbidity classifications have been investigated for their suitability to assist treatment decision‐making in men with early prostate cancer. In unselected patients, some serious comorbidities have been shown to be associated with a 10‐year competing mortality rate clearly superseding the 50% level.The present study shows that it is hardly possible to discern meaningful subsets of patients with a 10‐year risk of competing mortality of >50% by using comorbidity classifications. This finding suggests that the selecting clinicians did well in estimating the medium‐term survival probability in men referred for radical prostatectomy.OBJECTIVE
To identify subsets of patients who are most likely to die from competing causes ≤10 years after radical prostatectomy (RP).
PATIENTS AND METHODS
In all, 2205 consecutive patients who underwent RP for clinically localized prostate cancer between 1992 and 2005 were studied. The 10‐year cumulative competing mortality rates were determined in several worst‐case scenarios formed by using comorbidity classifications and combinations of them.
RESULTS
In this sample of men selected for RP, even those with the most severe comorbidity level had a competing mortality risk of <50% ≤10 years after RP.
Depending on the comorbidity classification used, the 10‐year cumulative competing mortality rates differed between 16 and 39% in the whole sample and between 18 and 48% in men aged ≥65 years.
CONCLUSION
Clinicians do well in estimating the further life span in candidates for RP. Comorbidity classifications may assist treatment choice in this population but are not able to discern meaningful subsets to be excluded from curative treatment because of a life expectancy falling below a limit of 10 years.
Survival after treatment for carcinoma invading bladder muscle: a Dutch population‐based study on the impact of hospital volume
Authors: Goossens‐Laan Catharina A. , Visser Otto , Hulshof Maarten C.C.M. , Wouters Michel W. , Bosch J. L. H. Ruud , Coebergh Jan‐Willem W. , Kil Paul J.M. 
Published: November 2011

Study Type – Prognosis (cohort)Level of Evidence 2aWhat's known on the subject? and What does the study add?The subject of mortality and survival rates after radical cystectomies in high‐volume hospitals in comparison to low‐volume hospitals has been extensively studied. Postoperative mortality is known to be significantly lower with high‐volume providers, but for survival rates there was only a trend forwards this finding. For this reason, we performed this Dutch population‐based study on survival rates, to see if we had enough power to support this trend with significant findings. To our knowledge, this is the first study of good quality showing a significant beneficial effect for survival in high‐volume hospitals.OBJECTIVE
To examine the volume–outcome relationship for carcinoma invading bladder muscle (MIBC) with respect to differences in survival rates among all hospitals in the Netherlands as a guide for regionalization initiatives.
MATERIALS AND METHODS
This population‐based retrospective study included all patients (n= 13 033) newly diagnosed with MIBC during the period 1999–2008 in the Netherlands, selected from the Netherlands Cancer Registry.
Data were collected on demographics, morphology, stage at diagnosis and after surgery, primary treatment, vital status and date of follow‐up or death.
The relative survival rate (RSR) per treatment was analysed for age, stage and hospital surgical volume.
RESULTS
Overall 5 and 10‐year RSR for all treatments of MIBC was 32% and 25%, respectively.
Although 71.7% of the patients featured stages II and III, radical cystectomy was only performed in only 42% and 44% of these patients, respectively.
Relative survival for MIBC remained unchanged in the two consecutive time periods (1999–2003 and 2004–2008).
In all, 34% of patients diagnosed in low‐volume hospitals (<10 cystectomies/year) underwent cystectomy vs 42% of those diagnosed in high‐volume hospitals (P= 0.000).
In a multivariate analysis long‐term survival (>30 days after surgery) was significantly lower in patients after cystectomy for stage II/III in low‐volume hospitals (hazard ratio [HR] 1.17, P= 0.036). A high lymph node count (>20) was associated with a lower risk of death (HR 0.52, P= 0.000).
CONCLUSIONS
The 10‐year RSR for patients with MIBC in the Netherlands was modest (25%) and has remained unchanged in the last decade.
The chance of undergoing cystectomy is significantly higher in high‐volume hospitals. Long‐term survival after cystectomy is higher in high‐volume hospitals.
Regionalization of bladder cancer treatments could improve overall outcomes.
Motion Retrieval Using Low‐Rank Subspace Decomposition of Motion Volume
Authors: Sun Chuan , Junejo Imran , Foroosh Hassan 
Published: November 2011

AbstractThis paper proposes a novel framework that allows for a flexible and an efficient retrieval of motion capture data in huge databases. The method first converts an action sequence into a novel representation, i.e. the Self‐Similarity Matrix (SSM), which is based on the notion of self‐similarity. This conversion of the motion sequences into compact and low‐rank subspace representations greatly reduces the spatiotemporal dimensionality of the sequences. The SSMs are then used to construct order‐3 tensors, and we propose a low‐rank decomposition scheme that allows for converting the motion sequence volumes into compact lower dimensional representations, without losing the nonlinear dynamics of the motion manifold. Thus, unlike existing linear dimensionality reduction methods that distort the motion manifold and lose very critical and discriminative components, the proposed method performs well even when inter‐class differences are small or intra‐class differences are large. In addition, the method allows for an efficient retrieval and does not require the time‐alignment of the motion sequences. We evaluate the performance of our retrieval framework on the CMU mocap dataset under two experimental settings, both demonstrating promising retrieval rates.
Risk‐Averse Mitigation Decisions in an Unpredictable Climate System*
Authors: Lontzek Thomas S. , Narita Daiju 
Published: November 2011

AbstractRisk aversion plays a central role in the decisions made in the face of uncertainties, and climate‐change mitigation should be no exception. However, the interlinkage of risk aversion and climate‐change uncertainties has hardly been investigated numerically, in part because of the computational difficulties of stochastic optimization. In this paper, we apply the numerical techniques of stochastic optimization to the economic modeling of climate change, with the aim of modeling the decision preferences of a risk‐conscious agent in the face of unpredictable climate change. The model underlines the critical role played by the risk‐aversion parameter in determining the effects of uncertainties on mitigation, not only in level but also in sign.
Supremacy or Primacy of EU Law—(Why) Does it Matter?
Authors: Avbelj Matej 
Published: November 2011

AbstractEven 50 years on the principle of supremacy or primacy is still surrounded with ambiguity, which is apparent already on the level of semantics. The principle has not carried a single name, but three. This paper argues that a disparity in the denomination of the principle amounts to much more than semantics. It exhibits conceptual differences. Different conceptualisations of the principle of primacy or supremacy entail different models of structural principles of EU law: the hierarchical, the conditionally hierarchical and the heterarchical model. These are no mere theoretical constructions; rather they have influenced concrete practices of EU law, including the most recent Kücükdeveci case as well as the Lisbon decision of the German Constitutional Court. While none of the three models has yet found an unequivocal and conclusive endorsement in the EU practice, there are compelling theoretical and practical reasons for which one of them should be preferred over the others. Whether EU law has supremacy or primacy therefore matters.