bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of tumour location and surgical approach on recurrence‐free and cancer‐specific survival analysis in patients with ureteric tumours
Authors: Bin Xu , Roy Ornob P. , Ghiraldi Eric , Manglik Niti , Liang Tang , Vira Manish , Kavoussi Louis R. 
Published: May 2012

Study Type – Therapy (case series)Level of Evidence 4What's known on the subject? and What does the study add?Pathological stage, lymph node metastasis and tumour grade have been established as prognostic factors for upper‐tract urothelial carcinoma, but there are few studies to date assessing location within the ureter as a prognostic factor. There are also few studies comparing surgical approaches to radical nephroureterectomy (NU), partial ureterectomy and endoscopic resection (ENDO) with regard to oncological outcomes.This study did not find any prognostic significance for tumour location or surgical approach with regard to outcomes in patients with ureteric tumours. Although NU is the standard treatment for invasive ureteric tumours, partial ureterectomy and ENDO can safely be performed in selected patients. Despite the risk of a shorter time to recurrence, ENDO can be recommended in low grade, non‐invasive ureteric tumours but only with close, thorough surveillance practices.OBJECTIVE
To assess the impact of tumour location within the ureter and the impact of surgical approach on recurrence‐free survival (RFS) and cancer‐specific survival (CSS) with regard to ureteric tumours.
PATIENTS AND METHODS
Data were retrospectively reviewed from 60 patients with isolated primary ureteric tumours, treated at a single tertiary referral centre.
Patients were treated with radical nephroureterectomy (NU, n= 33), partial ureterectomy (n= 17) or endoscopic resection (ENDO, n= 10).
Kaplan–Meier curves were used for the analysis of RFS and CSS after surgery, stratified by tumour location and surgical approach.
RESULTS
With a median follow‐up of 29 months, tumour location was not associated with disease recurrence (P= 0.423).
The ENDO group had shorter time to disease recurrence.
There were no significant differences in the probability of CSS with regard to either tumour location or surgical approach (P= 0.523 and P= 0.904, respectively).
CONCLUSIONS
Tumour location or surgical approach were not significant predictors of oncological outcomes in patients with ureteric tumours.
Although NU is standard treatment for invasive ureteric tumours, partial ureterectomy and ENDO can safely be performed in selected patients. Despite the risk of a shorter time to recurrence, ENDO can be recommended in low grade, non‐invasive ureteric tumours.
All urothelium‐preserving approaches require thorough surveillance.
Factor XIII Val34Leu polymorphism is associated with increased factor XIII activation and decreased transcutaneous oxygen readings in patients with diabetic foot ulcers
Authors: Küper M. A. , Schüle R. , Mayer P. , Königsrainer A. , Beckert S. 
Published: May 2012

Diabet. Med. 29, 1596–1599 (2012)AbstractAim  To investigate the relationship between the factor XIII Val34Leu polymorphism, plasma factor XIII activation and transcutaneous oxygen readings in patients with diabetic foot ulcers.Methods  Ninety‐two consecutive patients with Type 2 diabetes and active foot ulcers were investigated. Plasma factor XIII activation was assessed by ELISA. Genetic polymorphism was detected using the ABI PRISM® SNaPshotTM Multiplex Kit. Results are expressed as median (minimum–maximum). Differences between groups were calculated by Mann–Whitney U‐test or χ2‐test where appropriate. A P‐value < 0.05 was considered significant.Results  The Val34Leu polymorphism was found in 50 subjects (54%) with 42 being heterozygous (Val/Leu) and eight being homozygous (Leu/Leu). The rate of plasma factor XIII activation was increased in patients with Val/Leu or Leu/Leu [Val/Leu or Leu/Leu 152 (55–283) % vs. Val/Val 103 (33–282) %; P < 0.0001]. Transcutaneous oxygen readings were lower in the Val/Leu or Leu/Leu group [Val/Leu or Leu/Leu 16 (0–58) mmHg vs. Val/Val 35 (1–65) mmHg; P = 0.008]. Similarly, plasma factor XIII activation negatively correlated with transcutaneous oxygen readings (r2 = −0.314; P = 0.014).Conclusions  Val34Leu polymorphism is associated with increased plasma factor XIII activation and seems to be linked with impaired cutaneous microcirculation in patients with diabetic foot ulcers.
Consumer understanding of sugars claims on food and drink products
Authors: Patterson N. J. , Sadler M. J. , Cooper J. M. 
Published: May 2012

SummaryConsumer understanding of nutrition and health claims is a key aspect of current regulations in the European Union (EU). In view of this, qualitative and quantitative research techniques were used to investigate consumer awareness and understanding of product claims in the UK, focusing particularly on nutrition claims relating to sugars. Both research methods identified a good awareness of product claims. No added sugars claims were generally preferred to reduced sugars claims, and there was a general assumption that sweeteners and other ingredients would be added in place of sugars. However, there was little awareness of the level of sugar reduction and the associated calorie reduction in products when reduced sugars claims were made on pack. In focus groups, participants felt deceived if sugar reduction claims were being made without a significant reduction in calories. This was reinforced in the quantitative research which showed that respondents expected a similar and meaningful level of calorie reduction to the level of sugar reduction. The research also identified consumer confusion around the calorie content of different nutrients, including over‐estimation of the calorie content of sugars. This is crucial to consumers' expectations as they clearly link sugar to calories and therefore expect a reduction in sugar content to deliver a reduction in calorie content.
Hypothalamic obesity in children
Authors: Bereket A. , Kiess W. , Lustig R. H. , Muller H. L. , Goldstone A. P. , Weiss R. , Yavuz Y. , Hochberg Z. 
Published: May 2012

SummaryHypothalamic obesity is an intractable form of obesity syndrome that was initially described in patients with hypothalamic tumours and surgical damage. However, this definition is now expanded to include obesity developing after a variety of insults, including intracranial infections, infiltrations, trauma, vascular problems and hydrocephalus, in addition to acquired or congenital functional defects in central energy homeostasis in children with the so‐called common obesity. The pathogenetic mechanisms underlying hypothalamic obesity are complex and multifactorial. Weight gain results from damage to the ventromedial hypothalamus, which leads, variously, to hyperphagia, a low‐resting metabolic rate; autonomic imbalance; growth hormone‐, gonadotropins and thyroid‐stimulating hormone deficiency; hypomobility; and insomnia. Hypothalamic obesity did not receive enough attention, as evidenced by rarity of studies in this group of patients. A satellite symposium was held during the European Congress of Obesity in May 2011, in Istanbul, Turkey, to discuss recent developments and concepts regarding pathophysiology and management of hypothalamic obesity in children. An international group of leading researchers presented certain aspects of the problem. This paper summarizes the highlights of this symposium. Understanding the central role of the hypothalamus in the regulation of feeding and energy metabolism will help us gain insights into the pathogenesis and management of common obesity.
Law and credit constraints in transition economies1
Authors: Skosples Goran 
Published: May 2012

AbstractUsing a survey of over 4,000 firms in 21 transition economies, this paper investigates how legal extensiveness (law on the books) and legal effectiveness (law in practice) affect availability of bank finance. Our findings suggest that both law on the books and law in practice are important, but that they impact firms of different sizes differently. Small firms appear to be the most credit constrained in countries with weak creditor rights and with weak contract enforcement, while large firms are the most credit constrained in countries with weak courts and unclear and inconsistent laws pertaining to firms’ business operations.
Outlay equivalence analysis of child gender bias in household expenditure data
Authors: Parpiev Ziyodullo , Yusupov Kakhramon , Yusupov Nurmukhammad 
Published: May 2012

AbstractThis article reports the results of an empirical analysis of gender‐based discrimination among children based on household consumption data from Uzbekistan. We employ the outlay equivalence methodology to examine whether the entry of a new child leads to different effects in the decrease of adult good consumption for boys and for girls. We use a semi‐parametric estimation method to address the so‐called ‘zero consumption problem’, the statistical problem that arises because some households have zero consumption on a budget line in the period prior to the survey date. The results indicate that alcohol and tobacco reveal the incidence of discrimination against girls, while other groups of adult goods do not.
Diagnosing HIV infection in patients presenting with glandular fever‐like illness in primary care: are we missing primary HIV infection?
Authors: Hsu DTS , Ruf M , O'Shea S , Costelloe S , Peck J , Tong CYW 
Published: May 2012

ObjectivesThe aim of the study was to examine the prevalence of HIV infection in patients presenting in primary care with glandular fever (GF)‐like illness.MethodsSamples from primary care submitted for a GF screen between April 2009 and June 2010 were identified. Samples without an HIV request were anonymized and retrospectively tested using a 4th‐generation HIV antigen/antibody screening test. Reactive samples were further confirmed by an HIV antibody only test, with or without a p24 antigen assay. Antibody avidity testing based on the Recent HIV Infection Testing Algorithm (RITA) was used to identify individuals with evidence of recent acquisition (within 4–5 months).ResultsOf 1046 GF screening requests, concomitant HIV requests were made in 119 patients. Excluding one known positive patient, 2.5% (three of 118) tested HIV positive. Forty‐five (4.3%) had a subsequent HIV test through another consultation within 1 year; of these, 4.4% (two of 45) tested positive. Of the remaining 882 patients, 694 (78.7%) had samples available for unlinked anonymous HIV testing, of which six (0.9%) tested positive. The overall HIV prevalence was 1.3% (11 of 857), with 72.7% (eight of 11) of cases missed at initial primary care presentation. Four of the nine (44.4%) available positive samples had evidence of recent acquisition, with three (75.0%) missed at initial primary care presentation.ConclusionLow levels of HIV testing in patients presenting in primary care with GF‐like illness are resulting in a significant number of missed HIV and seroconversion diagnoses. Local policy should consider adopting an opt‐out strategy to include HIV testing routinely within the GF‐screening investigation panel.
Determinants of epidermal nerve fibre density in antiretroviral‐naïve HIV‐infected individuals
Authors: Shikuma CM , Gerschenson M , Ananworanich J , Valcour VG , Teeratakulpisarn N , Jadwattanakul T , DeGruttola V , Liang C‐Y , McArthur JC , Ebenezer GJ , Chomchey N , Praihirunkit P , Hongchookiath P , Mathajittiphun P , Nakamoto B , Hauer P , Phanuphak P , Phanuphak N ,   the SEARCH 003 protocol team
Published: May 2012

ObjectivesDistal leg epidermal nerve fibre density (ENFD) is a validated predictor of small unmyelinated nerve fibre damage and neuropathy risk in HIV infection. As pre‐existing damage may increase the risk of neuropathy following antiretroviral (ARV) therapy, particularly when the regimen contains stavudine (d4T), we assessed the relationship between ENFD and various parameters including mitochondrial factors in HIV‐infected Thai individuals naïve to ARV therapy.MethodsDistal leg and proximal thigh ENFDs were quantified in HIV‐infected Thai individuals without neuropathy prior to randomization to a HIV clinical trial that focused on mitochondrial toxicity issues. We assessed their association with various clinical and immunovirological parameters as well as with peripheral blood mononuclear cell (PBMC) mitochondrial (mt) DNA copies/cell, oxidative phosphorylation (OXPHOS) complex I (CI) and complex IV (CIV) enzyme activities, and mt 8‐oxo‐deoxyguanine (8‐oxo‐dG) break frequencies.ResultsIn 132 subjects, the median (interquartile range) ENFD (fibres/mm) values were 21.0 (16.2–26.6) for the distal leg and 31.7 (26.2–40.0) for the proximal thigh. By linear regression, lower CD4 count (P < 0.01), older age (P < 0.01), increased body mass index (BMI) (P = 0.04), increased height (P = 0.02), and higher PBMC OXPHOS activity as measured by CIV activity (P = 0.02) were associated with lower distal leg ENFD.ConclusionsOlder age, increased height, higher BMI, poorer immunological status and higher PBMC OXPHOS activity are associated with lower distal leg ENFD in HIV‐infected subjects free of neuropathy prior to initiation of first‐time ARV therapy.
A difficult conversation? The views and experiences of parents and professionals on the consent process for perinatal postmortem after stillbirth
Authors: Heazell AEP , McLaughlin M‐J , Schmidt EB , Cox P , Flenady V , Khong TY , Downe S 
Published: May 2012

Please cite this paper as: Heazell A, McLaughlin M, Schmidt E, Cox P, Flenady V, Khong T, Downe S. A difficult conversation? The views and experiences of parents and professionals on the consent process for perinatal postmortem after stillbirth. BJOG 2012;119:987–997.Objective  To describe the experiences, knowledge and views of both parents and professionals regarding the consent process for perinatal postmortem.Design  Internet‐based survey.Setting  Obstetricians, midwives and perinatal pathologists currently working in the UK. Parents who have experienced a stillbirth in the UK in the previous 10 years.Sample  Obstetricians, midwives and perinatal pathologists registered with their professional bodies. Parents who accessed the Sands website or online forum.Methods  Online self‐completion questionnaire with both fixed‐choice and open‐ended questions.Results  Responses were analysed from 2256 midwives, 354 obstetricians, 21 perinatal pathologists and 460 parents. The most common reason for parents to request postmortem examination was to find a cause for their baby’s death; the prevention of stillbirths in others also ranked highly. Perinatal pathologists possessed greatest knowledge of the procedure and efficacy of postmortem, but were unlikely to meet bereaved parents. The majority of professionals and parents ranked emotional distress and a lengthy wait for results as barriers to consent. The majority of staff ranked workload, negative publicity, religion and cultural issues as important barriers, whereas most parents did not. Almost twice as many parents who declined postmortem examination later regretted their decision compared with those who accepted the offer (34.4 versus 17.4%).Conclusion  Emotional, practical and psychosocial issues can act as real or perceived barriers for staff and bereaved parents. Education is required for midwives and obstetricians, to increase their knowledge to ensure accurate counselling, with due regard for the highly individual responses of bereaved parents. The contribution of perinatal pathologists to staff education and parental decision‐making would be invaluable.
Taxonomy versus phylogeny: evolutionary history of marsh rabbits without hopping to conclusions
Authors: Tursi Rosanna M. , Hughes Phillip T. , Hoffman Eric A. 
Published: May 2012

AbstractAimTo evaluate whether population genetic structure reflects taxonomic recognition of the endangered Lower Keys marsh rabbit (
Sylvilagus palustris hefneri) and the two mainland subspecies.LocationSoutheastern United States.MethodsWe inferred phylogenetic relationships, population structure and genetic diversity within
S. palustris using a mitochondrial gene (cytochrome b) and 10 microsatellite loci.ResultsThe cytochrome b sequence data revealed taxonomy‐phylogeography incongruence, and microsatellite data revealed moderate structure (
F

ST = 0.22) with two genetic clusters recovered: one grouping the western Lower Keys, and the second grouping the eastern Lower Keys together with the mainland. Furthermore, island genetic diversity was not reduced relative to mainland populations (cyt b: π: t = −0.6952, P = 0.5651; h: t = −1.2053, P = 0.4305; microsatellite:
H

E: t = −4.1201, P = 0.1313;
AR
: t = −2.3113, P = 0.2441).Main conclusionsThe taxonomy‐phylogeny disparity reveals unknown aspects of the evolutionary history including an absence of contemporary dispersal barriers between the mainland subspecies and a more recent Lower Keys isolation than originally thought. Moreover, diversity patterns indicate that undocumented man‐mediated transfers may contribute to current genetic structure between eastern Lower Keys and the mainland. Although subspecies designations were not confirmed, these findings support recognition of western Lower Keys populations as a distinct population segment under the Endangered Species Act.
Exceptionally well‐preserved isolated eyes from Cambrian ‘Orsten’ fossil assemblages of Sweden
Authors: CASTELLANI CHRISTOPHER , HAUG JOACHIM T. , HAUG CAROLIN , MAAS ANDREAS , SCHOENEMANN BRIGITTE , WALOSZEK DIETER 
Published: May 2012

Abstract: Eyes other than those of trilobites are rarely preserved in the fossil record. We describe here a set of six tiny, isolated, three‐dimensionally preserved compound eyes. These secondarily phosphatized eyes were etched from ‘Orsten’ limestone nodules dated to theAgnostus pisiformisBiozone from the Cambrian Alum Shale Formation of Sweden. The ovoid eyes arise from an elongated stalk, their surface being covered by a mosaic of regular and hexagonal‐shaped facets representing the surface of ommatidia. Facet size and pattern change within the same specimen from the posterior to the anterior end. With regard to some morphological criteria, we grouped the material in two different morphotypes, type A and B, the first being represented by specimens of two different developmental stages. From stage to stage, mostly growth in overall size and addition of new ommatidia was noticed. Among the meiobenthic ‘Orsten’ arthropods, only the crustaceanHenningsmoenicaris scutulahas been described as possessing stalked eyes, but the eyes of the largest specimen with preserved eyes of this species are much smaller than the new eyes and do not display any kind of ommatidia on their visual surface. However, fragments of larger specimens ofH. scutulaand the co‐occurrence of this species with the new isolated eyes in the sieving residues make it likely that the latter belong to this species but belong to more advanced stages than those described previously ofH. scutula. Ontogenetically, the eye stalks of this fossil crustacean elongate progressively, while the regular hexagonal facets, lacking in early stages, appear later on.
Cost‐Effectiveness of an Electronic Medical Record Based Clinical Decision Support System
Authors: Gilmer Todd P. , O'Connor Patrick J. , Sperl‐Hillen JoAnn M. , Rush William A. , Johnson Paul E. , Amundson Gerald H. , Asche Stephen E. , Ekstrom Heidi L. 
Published: May 2012

Background and ObjectiveMedical groups have invested billions of dollars in electronic medical records (EMRs), but few studies have examined the cost‐effectiveness of EMR‐based clinical decision support (CDS). This study examined the cost‐effectiveness of EMR‐based CDS for adults with diabetes from the perspective of the health care system.Data Sources/SettingClinical outcome and cost data from a randomized clinical trial of EMR‐based CDS were used as inputs into a diabetes simulation model. The simulation cohort included 1,092 patients with diabetes with A1c above goal at baseline.Study DesignThe United Kingdom Prospective Diabetes Study Outcomes Model, a validated simulation model of diabetes, was used to evaluate remaining life years, quality‐adjusted life years (QALYs), and health care costs over patient lifetimes (40‐year time horizon) from the health system perspective.Principal FindingsPatients in the intervention group had significantly lowered A1c (0.26 percent, p = .014) relative to patients in the control arm. Intervention costs were $120 (SE = 45) per patient in the first year and $76 (SE = 45) per patient in the following years. In the base case analysis, EMR‐based CDS increased lifetime QALYs by 0.04 (SE = 0.01) and increased lifetime costs by $112 (SE = 660), resulting in an incremental cost‐effectiveness ratio of $3,017 per QALY. The cost‐effectiveness of EMR‐based CDS persisted in one‐way, two‐way, and probabilistic sensitivity analyses.ConclusionsWidespread adoption of sophisticated EMR‐based CDS has the potential to modestly improve the quality of care for patients with chronic conditions without substantially increasing costs to the health care system.
Function and expression of the proton‐coupled amino acid transporter PAT1 along the rat gastrointestinal tract: implications for intestinal absorption of gaboxadol
Authors: Broberg ML , Holm R , Tønsberg H , Frølund S , Ewon KB , Nielsen AL , Brodin B , Jensen A , Kall MA , Christensen KV , Nielsen CU 
Published: May 2012

BACKGROUND AND PURPOSE Intestinal absorption via membrane transporters may determine the pharmacokinetics of drug compounds. The hypothesis is that oral absorption of gaboxadol (4,5,6,7‐tetrahydroisoxazolo [5,4‐c] pyridine‐3‐ol) in rats occurs via the proton‐coupled amino acid transporter, rPAT1 (encoded by the gene rSlc36a1). Consequently, we aimed to elucidate the in vivo role of rPAT1 in the absorption of gaboxadol from various intestinal segments obtained from Sprague‐Dawley rats.EXPERIMENTAL APPROACH The absorption of gaboxadol was investigated following its administration into four different intestinal segments. The intestinal expression of rSlc36a1 mRNA was measured by quantitative real‐time PCR. Furthermore, the hPAT1‐/rPAT1‐mediated transport of gaboxadol or L‐proline was studied in hPAT1‐expressing Xenopus laevis oocytes, Caco‐2 cell monolayers and excised segments of the rat intestine.KEY RESULTS The absorption fraction of gaboxadol was high (81.3–91.3%) following its administration into the stomach, duodenum and jejunum, but low (4.2%) after administration into the colon. The pharmacokinetics of gaboxadol were modified by the co‐administration of L‐tryptophan (an hPAT1 inhibitor) and L‐proline (an hPAT1 substrate). The in vitro carrier‐mediated uptake rate of L‐proline in the excised intestinal segments was highest in the mid jejunum and lowest in the colon. The in vitro uptake and the in vivo absorption correlated with the expression of rSlc36a1 mRNA along the rat intestine.CONCLUSIONS AND IMPLICATIONS These results suggest that PAT1 mediates the intestinal absorption of gaboxadol and therefore determines its oral bioavailability. This has implications for the in vivo role of PAT1 and may have an influence on the design of pharmaceutical formulations of PAT1 substrates.