bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient advocacy and patient centredness in participant recruitment to randomized‐controlled trials: implications for informed consent
Authors: Tomlin Zelda , deSalis Isabel , Toerien Merran , Donovan Jenny L. 
Published: June 2012

AbstractContext  With the routinization of evidence‐based medicine and of the randomized‐controlled trial (RCT), more patients are becoming ‘sites of evidence production’ yet, little is known about how they are recruited as participants; there is some evidence that ‘substantively valid consent’ is difficult to achieve.Objective  To explore the views and experiences of nurses recruiting patients to randomized‐controlled trials and to examine the extent to which their recruitment practices were patient‐centred and patient empowering.Design  Semi‐structured in‐depth interviews; audio recording of recruitment appointments; thematic interactional analysis (drawing on discourse and conversation analysis).Setting and participants  Nurses recruiting patients to five publicly funded RCTs and patients consenting to the recording of their recruitment sessions.Main outcome measures  The views of recruiting nurses about their recruitment role; the extent to which nurse–patient interactions were patient‐centred; the nature of the nurses’ interactional strategies and the nature and extent of patient participation in the discussion.Results  The nurses had a keen sense of themselves as clinicians and patient advocates and their perceptions of the trial and its interventions were inextricably linked to those of the patients. However, many of their recruitment practices made it difficult for patients to play an active and informed part in the discussion about trial participation, raising questions over the quality of consent decisions.Conclusion  Nurses working in patient recruitment to RCTs need to reconcile two different worlds with different demands and ethics. Evidence production, a central task in evidence‐based medicine, poses a challenge to patient‐centred practice and more research and relevant training are needed.
Evaluation of Genetic Traits for Improving Productivity and Adaptation of Groundnut to Climate Change in India
Authors: Singh P. , Boote K. J. , Kumar U. , Srinivas K. , Nigam S. N. , Jones J. W. 
Published: June 2012

AbstractAnticipated climate change will alter the temperature and rainfall characteristics of crop growing seasons. This will require genetic improvement of crops for adapting to future climates for higher yields. The CROPGRO model for groundnut was used to evaluate genetic traits of Virginia and Spanish types of groundnut for various climate scenarios of India. The analysis revealed that productivity of groundnut can be increased in current and future climates by adjusting the duration of various life‐cycle phases, especially the seed‐filling to physiological maturity (SD‐PM). Increased maximum leaf photosynthesis rate (AMAX), increased partitioning to reproductive organs (XFRT) and increased individual seed‐fill duration (SFDUR) all contributed to the increase in pod yield in all climates. More determinate pod set (shorter PODUR) was beneficial only in the water deficit environments. The positive effect of increasing specific leaf area (SLA) and leaf size (SIZLF) on pod yield was greater in environments more favourable for plant growth. Increasing reproductive tolerance to high temperature by 2 °C increased pod yield of groundnut in warmer environments, especially where the crop often suffers from drought. Increased adaptive partitioning to roots (ATOP) increased drought resistance of groundnut on high water‐holding capacity soils. Combination of traits had additive effects and pod yield increased substantially. These results indicate that the CROPGRO model can be used to assess the potential of individual or combination of plant traits for guiding breeding of improved groundnut varieties for current and future climates.
Trabeculectomy: the limitations for registrar training
Authors: Sun Lisa L , Lee Graham A 
Published: June 2012

AbstractBackground:  Trainee exposure to glaucoma surgery was analysed and outcomes compared with those of consultant cases.Design:  Retrospective review was carried out at Princess Alexandra Hospital and Royal Brisbane and Women's Hospital, two major tertiary teaching hospitals in Brisbane, Queensland, Australia.Participants:  Two hundred and forty‐eight consecutive public patients undergoing primary trabeculectomy surgery between 2003 and 2010.Methods:  The rate of trabeculectomy performed by trainees, the success and complication rates were examined and compared with those of consultant ophthalmologists.Main Outcome Measures:  Intraocular pressure was divided into two groups of ≤21 mmHg and ≤15 mmHg and visual field progression.Results:  Two hundred and forty‐eight primary trabeculectomy cases were performed between 2003 and 2010. Trainees carried out 145 cases (59%), making the rate of trabeculectomy operations 1.1 per trainee per year (16–17 trainees) as compared with 1.6 per trainee per year from 1996 to 2002 at the same institutions. Complications rates in the first postoperative week were similar between consultants and trainees, the most common being wound leak and hyphaema. An intraocular pressure of ≤15 mmHg without the use of topical medications was achieved in 25 out of 50 (50%) glaucoma‐interest consultant, 24 out of 53 (45.3%) general consultant and 68 out of 145 (46.9%) trainee cases (P = 0.951). The rate of visual field progression was also statistically similar between trainees and consultants (19.5% and 21.3%), respectively.Conclusion:  With increasing trainee numbers, the rate of trabeculectomy surgery is declining compared with previous years, with less trainee exposure to trabeculectomy surgery and inability to achieve surgical competency levels.
Hyaluronidase toxicity: a possible cause of postoperative periorbital inflammation
Authors: Zamora‐Alejo Katherine , Moore Sacha , Leatherbarrow Brian , Norris Jonathan H , Lake Damien B , Malhotra Raman , Selva Dinesh , Goggin Michael 
Published: June 2012

AbstractBackground:  Periorbital inflammation following regional anaesthesia is commonly attributed to hyaluronidase allergy. This case series suggests an alternative explanation in some patients.Design:  Retrospective case series.Participants:  Seven patients presenting with postoperative non‐infectious periorbital inflammation following peribulbar or sub‐tenons anaesthesia, presenting at four different institutions, are described.Methods:  Data on patient demographics, operative data, clinical presentation, treatment and allergy testing were collected among the four institutions.Main Outcome Measures:  Response to treatment and allergy testing were noted among the patients included in this study.Results:  Seven patients (five female) underwent uneventful phacoemulsification under a peribulbar or sub‐tenon's block, all including hyaluronidase with concentrations ranging 50–250 IU/mL. The onset of inflammatory symptoms and signs varied from 12 h to 3 days after the surgery. The most common form of presentation was lid swelling and chemosis. Patients were treated with oral corticosteroids, with good clinical response. Four patients underwent skin prick and intradermal testing to the local anaesthetic used, and to the suspect and a control hyaluronidase batch. The results were all negative, excluding allergy as the aetiology of this toxic periorbital syndrome, in at least these four patients.Conclusion:  Hyaluronidase toxicity, potentially related to concentration of hyaluronidase, may be a cause of postoperative periorbital inflammation after cataract surgery, rather than hypersensitivity.
No histological evidence of orbicularis oculi muscle hypertrophy in congenital epiblepharon
Authors: Kakizaki Hirohiko , Takahashi Yasuhiro , Kang Hyera , Ikeda Hiroshi , Iwaki Masayoshi , Selva Dinesh , Leibovitch Igal 
Published: June 2012

AbstractBackground:  To analyse the microscopic anatomy of the orbicularis oculi muscle in patients with congenital epiblepharon and to determine whether hypertrophy of the orbicularis oculi muscle, which is considered as a possible cause of this eyelid malposition, exists.Methods:  Sixty‐seven eyelids with congenital epiblepharon of 41 Japanese patients, as well as 30 control eyelids of 24 Japanese patients with other eyelid pathologies (upper eyelid: fourteen blepharoptosis, one trichiasis and two retractions; lower eyelid: five involutional entropions, one trichiasis and seven retractions) were analysed. These controls contained no orbicularis pathology such as cicatrization or orbitopathy. The muscle specimens were obtained from the central part of the pretarsal orbicularis oculi muscle during surgery. The specimens were stained with haematoxylin & eosin. Only specimens with cross‐sectional areas that included large muscle fibres were selected. In each section, 10 muscle fibres were measured across their smallest diameter, thereby avoiding inaccurate measurements of muscle kinking occurring during the processing or by any obliquity of the plane of section. Measurements of the muscle fibre diameter were made with a digital measure.Results:  There were no significant differences in the average diameter of the muscle fibres between the patients with congenital epiblepharon and the control group.Conclusions:  There was no evidence of orbicularis oculi muscle hypertrophy in congenital epiblepharon.
Intravitreal ranibizumab as an adjunct for Ahmed valve surgery in open‐angle glaucoma: a pilot study
Authors: Desai Rajen U , Singh Kuldev , Lin Shan C 
Published: June 2012

AbstractBackground:  To determine the safety and efficacy of intravitreal ranibizumab therapy before and after Ahmed tube insertion for open‐angle glaucoma as a means of optimizing postoperative intraocular pressure control.Design:  Randomized, controlled trial.Participants:  Open‐angle glaucoma patients scheduled for Ahmed tube insertion, randomized to ranibizumab or control groups.Methods:  Ranibizumab (0.5 mg in 0.05 mL) was administered intravitreally at three time points: 9 days prior to surgery, 1 month post‐surgery and 2 months post‐surgery. Control patients underwent the same procedure without ranibizumab.Main Outcome Measure:  Success at 6 months postoperatively was defined as intraocular pressure <18 mmHg with no adjunctive medications or intraocular pressure <15 mmHg with one adjunctive medication.Results:  The study and control arms included six and five subjects, respectively, with four in each arm undergoing combined cataract surgery. In the ranibizumab arm, the preoperative and postoperative intraocular pressure/medication usage was 21.0 ± 6.7 mmHg on 3.2 ± 1.5 medications and 14.7 ± 1.9 mmHg on 0.5 ± 0.8 medications, respectively. In the control arm, preoperative and postoperative intraocular pressure/medication usage was 18.8 ± 3.8 mmHg on 2.8 ± 1.3 medications and 16.2 ± 3.6 mmHg with 1.8 ± 1.6 medications, respectively. Success was achieved in 83% of subjects in the ranibizumab group compared with 40% in the control group (two‐tailed Fisher's exact test, P = 0.24).Conclusion:  The findings from this small pilot comparative study suggest that intravitreal ranibizumab use may be a safe and potentially effective adjunctive treatment modality in improving success after Ahmed tube placement.
Indigenous access to cataract surgery: an assessment of the barriers and solutions within the Australian health system
Authors: Boudville Andrea I , Anjou Mitchell D , Taylor Hugh R 
Published: June 2012

AbstractBackground:  To identify barriers in the health systems that limit access to cataract surgery for Indigenous Australians and present strategies to overcome these barriers.Design:  Interview and focus group‐based qualitative study.Participants:  Five hundred thirty participants were consulted in semi‐structured interviews, focus group discussions and stakeholder workshops.Methods:  Semi‐structured interviews with a cross‐section of health‐care professionals, eye care practitioners, primary health‐care workers, hospital staff and health department staff were conducted in 21 site locations. Focus group discussions with clients from seven Aboriginal Health Services in Victoria were conducted. Stakeholder workshops included Aboriginal Community Controlled Health sector, eye care sector, government departments and non‐government organizations. A total of 279 semi‐structured interviews were conducted in the Northern Territory, New South Wales, Queensland, South Australia, Victoria and Western Australia. Three stakeholder workshops were held.Main Outcome Measures:  Barriers and solutions to increase access to cataract surgery for Indigenous Australians.Results:  Analysis of the participant responses identified health system barriers at primary care, specialist care and hospital levels. These included: long waiting times, cost of surgery, complexity of the steps involved in treatment, lack of surgical capacity and low awareness of regional eye health needs. Strategies to overcome these barriers involve a system‐wide approach to increase provision and utilization of services.Conclusion:  The need for surgery is real and services need to expand beyond current levels. The solutions for overcoming barriers to cataract surgery could be used as a model for other health interventions which rely on close interaction between primary and specialist care services.
Improving bioregional frameworks for conservation by including mammal distributions
Authors: BINO GILAD , RAMP DANIEL , KINGSFORD RICHARD T. 
Published: June 2012

AbstractLarge identifiable landscape units, such as ecoregions, are used to prioritize global and continental conservation efforts, particularly where biodiversity knowledge is inadequate. Setting biodiversity representation targets using coarse large‐scale biogeographic boundaries, can be inefficient and under‐representative. Even when using fine‐scale biodiversity data, representation deficiencies can occur through misalignment of target distributions with such prioritization frameworks. While this pattern has been recognized, quantitative approaches highlighting misalignments have been lacking, particularly for assemblages of mammal species. We tested the efficacy of Australia's bioregions as a spatial prioritization framework for representing mammal species, within protected areas, in New South Wales. We produced an approach based on mammal assemblages and assessed its performance in representing mammal distributions. Substantial spatial misalignment between New South Wales's bioregions and mammal assemblages was revealed, reflecting deficiencies in the representation of more than half of identified mammal assemblages. Using a systematic approach driven by fine‐scale mammalian data, we compared the efficacy of these two frameworks in securing mammalian representation within protected areas. Of the 61 species, 38 were better represented by the mammalian framework, with remaining species only marginally better represented when guided by bioregions. Overall, the rate at which mammal species were incorporated into the protected area network was higher (5.1% ± 0.6 sd) when guided by mammal assemblages. Guided by bioregions, systematic conservation planning of protected areas may be constrained in realizing its full potential in securing representation for all of Australia's biodiversity. Adapting the boundaries of prioritization frameworks by incorporating amassed information from a broad range of taxa should be of conservation significance.
RNA‐binding proteins involved in RNA localization and their implications in neuronal diseases
Authors: Tolino Marco , Köhrmann Martin , Kiebler Michael A. 
Published: June 2012

AbstractVery often, developmental abnormalities or subtle disturbances of neuronal function may yield brain diseases even if they become obvious only late in life. It is therefore our intention to highlight fundamental mechanisms of neuronal cell biology with a special emphasis on dendritic mRNA localization including local protein synthesis at the activated synapse. Furthermore, we would like to point out possible links to neuronal or synaptic dysfunction. In particular, we will focus on a series of well‐known RNA‐binding proteins that are involved in these processes and outline how their dysfunction might yield neurodevelopmental, neurodegenerative or neuropsychiatric disorders. We are convinced that increasing our understanding of RNA biology in general and the mechanisms underlying mRNA transport and subsequent translation at the synapse will ultimately generate important novel RNA‐based tools in the near future that will allow us to hopefully treat some of these devastating diseases.
Urologists and oncologists: adapting to a new treatment paradigm in castration‐resistant prostate cancer (CRPC)
Authors: Sartor A. Oliver , Fitzpatrick John M. 
Published: June 2012

What's known on the subject? and What does the study add?The interplay between urologists and oncologists in the treatment of prostate cancer has been long standing. Recent paradigm shifts in treatment are reviewed with an emphasis on how these treatments may eventually alter the dynamic equilibrium between urology and oncology specialists.The treatment landscape for men with castration‐resistant prostate cancer (CRPC) is undergoing significant changes; a redefinition of the respective roles of oncologists and urologists will probably occur. In addition, the advent of the multidisciplinary team or coordinated‐care approach, which has been gathering momentum over the last decade, will become not simply a preference but a clear necessity. In the present review, we explore the current wave of new treatments and describe the possibility of more complex approaches to combined therapy. New treatment options include abiraterone acetate, cabazitaxel, MDV3100 (in development), radium‐223 (in development) and sipuleucel‐T. We also present the traditional roles of the urologist and oncologist in caring for patients with CRPC and discuss how these may change. Compounding the new potential for treatment success, as well as the complexity of therapeutic strategies, is the emergence of novel biomarkers to evaluate treatment efficacy and to assist in patient prognosis. The prospects for successful treatment of patients with CRPC have developed considerably so that these patients may soon have a reasonable expectation of therapeutic efficacy and meaningful extension of their lives.
Expression of epithelial–mesenchymal transition markers in renal cell carcinoma: impact on prognostic outcomes in patients undergoing radical nephrectomy
Authors: Harada Ken‐ichi , Miyake Hideaki , Kusuda Yuji , Fujisawa Masato 
Published: June 2012

What's known on the subject? and What does the study add?There have been few studies evaluating the prognostic value of epithelial‐mesenchymal transition markers in renal cell carcinoma (RCC); therefore, the significance of these markers in the prognosis of patients with RCC, particularly that in those with localized disease, remains largely unknown.Consideration of the expression levels of potential epithelial‐mesenchymal transition markers, particularly clusterin and Twist in addition to conventional prognostic parameters, would contribute to the prediction of disease recurrence after radical nephrectomy for localized renal cell carcinoma.OBJECTIVE
To evaluate the expression of multiple molecular markers involved in the process of epithelial–mesenchymal transition (EMT) in renal cell carcinoma (RCC) with the aim of clarifying the prognostic significance of these markers in patients undergoing radical nephrectomy.
PATIENTS AND METHODS
The expression levels of 11 EMT markers, including E‐cadherin, N‐cadherin, β‐catenin, γ‐catenin, clusterin, Slug, Snail, Twist, vimentin, ZEB1 and ZEB2, in radical nephrectomy specimens from 122 patients with clinically localized RCC were measured by immunohistochemical staining.
RESULTS
In this series, disease recurrence occurred in 39 (32.0%) patients, with a 5‐year recurrence‐free survival rate of 64.4%.
Univariate analysis identified expression levels of E‐cadherin, clusterin, Twist and vimentin, in addition to C‐reactive protein (CRP) level, pathological stage and microvascular invasion, as significant predictors for disease recurrence.
Of these, expression levels of clusterin and Twist, CRP levels and microvascular invasion appeared to be independently related to disease recurrence on multivariate analysis.
There were significant differences in recurrence‐free survival according to positive numbers of these four independent factors: disease recurrence occurred in two of 26 patients negative for any risk factor (7.7%), 23 of 73 pateints positive for one or two risk factors (31.5%) and 14 of 23 patients positive for three or four risk factors (60.9%).
CONCLUSION
Consideration of the expression levels of potential EMT markers, particularly clusterin and Twist, in RCC specimens, in addition to conventional prognostic parameters, contributes to the accurate prediction of disease recurrence after radical nephrectomy for localized RCC.
Cumulative impacts of fisheries in the California Current
Authors: Kaplan Isaac C , Gray Iris A , Levin Phillip S. 
Published: June 2012

AbstractEcosystem‐based fisheries management calls for the consideration of the indirect and cumulative effects of fishing, in addition to estimating direct fishing mortality. Here, we quantify such effects of fishing fleets, and their interactions, using a spatially explicit Atlantis simulation model of the food web and fisheries in the California Current. Simulations testing the effects of single fleets suggested that bottom trawl, fixed gear, and hake (Merluccius productus) trawl primarily have direct impacts on their target and bycatch species. Few indirect effects from these three fleets extended through predator–prey links to other parts of the food web. In contrast, effects of the purse seine fleet extended beyond the three groups it harvested, strongly altering the abundance of predators, planktonic prey, and benthos. In terms of nine ecosystem attributes, our experiments involving single fleets identified six fleets that caused the bulk of negative impacts. Specific fleets impacted different aspects of the ecosystem, for instance with groundfish gears causing reductions in piscivore abundance, and hake trawl and purse seine increasing krill through reducing abundance of planktivores. In terms of interactions among fleets' effects, the vast majority of effects were simply additive – the combined effect of two fleets was simply the sum of the individual fleets' effects. The analyses offer one way to sharpen the focus of ecosystem‐based fisheries management in the California Current, emphasizing impacts and interactions of particular stressors.
Child Trafficking: ‘Worst Form’ of Child Labour, or Worst Approach to Young Migrants?
Authors: Huijsmans Roy , Baker Simon 
Published: June 2012

ABSTRACTThis article presents a critique to the human trafficking discourse in relation to child migration, based on data obtained from the anti‐trafficking community in the Greater Mekong Sub‐region combined with an analysis of secondary material. It also presents a set of qualitative accounts of migration at a young age from Lao PDR and Thailand. On this basis a more theorized, grounded and nuanced perspective on child labour migration is developed. This situates child labour migration historically, embeds it within overarching processes of rural transformation and accounts for young migrants’ agency in the social process of migration, the latter shedding light on the social production of exploitation in relation to young migrants.