bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of combining simvastatin with rosiglitazone on inflammation, oxidant stress and ambulatory blood pressure in patients with the metabolic syndrome: the SIROCO study
Authors: Lazich I. , Sarafidis P. , de Guzman E. , Patel A. , Oliva R. , Bakris G. 
Published: September 2011

Aim: Individually, statins and thiazolidinediones (TZDs) show positive effects on atherosclerosis progression in cellular and animal models as well as patients with diabetes; however, their combined effects have not been studied. This study examines the effects of simvastatin combined with rosiglitazone on vascular inflammation, oxidant stress, ambulatory blood pressure (BP) and other atherosclerotic factors in patients with the metabolic syndrome.Methods: This is a randomized, double blind, placebo‐controlled study in 53 subjects with the metabolic syndrome. Participants were randomized to simvastatin 40 mg/day plus placebo vs. simvastatin 40 mg/day plus rosiglitazone 4 mg/day for 6 months. The primary endpoint was the between‐group difference in high‐sensitivity C‐reactive protein (hs‐CRP) and secondary variables including urinary isoprostanes, serum malondialdehyde (MDA), ambulatory BP, adiponectin, and lipid and glycaemic profiles.Results: At study end, the group randomized to the simvastatin/rosiglitazone combination had a greater reduction in hs‐CRP of 1.33 mg/dl, (p = 0.029) and showed a trend for a greater reduction in urinary isoprostane (−39%), (p = 0.056) compared to simvastatin/placebo group. Changes in MDA levels did not differed between groups (p = 0.81). 24‐h systolic blood pressure (SBP) also showed a 4.5 mmHg reduction at 6 months (p = 0.06). Adiponectin levels increased by 3.91 µg/ml in the combination group over placebo, (p = 0.03) and blood glucose decreased in combination group vs. placebo.Conclusion: Our data show that patients with the metabolic syndrome given a statin/TZD combination manifest greater reductions in markers of vascular inflammation and oxidant stress, 24‐h ambulatory BP and increases in adiponectin as well as improved glycaemic indices.
From Leonardo to da Vinci: the history of robot‐assisted surgery in urology
Authors: Yates David R. , Vaessen Christophe , Roupret Morgan 
Published: September 2011

What's known on the subject? and What does the study add?Numerous urological procedures can now be performed with robotic assistance. Though not definitely proven to be superior to conventional laparoscopy or traditional open surgery in the setting of a randomised trial, in experienced centres robot‐assisted surgery allows for excellent surgical outcomes and is a valuable tool to augment modern surgical practice.Our review highlights the depth of history that underpins the robotic surgical platform we utilise today, whilst also detailing the current place of robot‐assisted surgery in urology in 2011.The evolution of robots in general and as platforms to augment surgical practice is an intriguing story that spans cultures, continents and centuries. A timeline from Yan Shi (1023–957 bc), Archytas of Tarentum (400 bc), Aristotle (322 bc), Heron of Alexandria (10–70 ad), Leonardo da Vinci (1495), the Industrial Revolution (1790), ‘telepresence’ (1950) and to the da Vinci® Surgical System (1999), shows the incredible depth of history and development that underpins the modern surgical robot we use to treat our patients. Robot‐assisted surgery is now well‐established in Urology and although not currently regarded as a ‘gold standard’ approach for any urological procedure, it is being increasingly used for index operations of the prostate, kidney and bladder. We perceive that robotic evolution will continue infinitely, securing the place of robots in the history of Urological surgery. Herein, we detail the history of robots in general, in surgery and in Urology, highlighting the current place of robot‐assisted surgery in radical prostatectomy, partial nephrectomy, pyeloplasty and radical cystectomy.
Assessment of complication and functional outcome reporting in the minimally invasive prostatectomy literature from 2006 to the present
Authors: Hakimi A. Ari , Faleck David M. , Sobey Steven , Ioffe Edward , Rabbani Farhang , Donat Sherri M. , Ghavamian Reza 
Published: September 2011

What's known on the subject? and What does the study add?Minimally invasive approaches to radical prostatectomy have been touted to lead to superior surgical and functional outcomes with less potential complications despite scant and often conflicting reports in the peer reviewed literature.This review provides evidence that the minimally invasive prostatectomy literature still fails to meet the standards and critical benchmarks necessary for adequate complications reporting. Given our current release on observational studies. Increased effects should be made to standardize all complications and functional outcomes reporting for minimally invasive prostate cancer surgery.To query the minimally invasive urological literature from 2006 to the middle of 2010, focusing on complications and functional outcome reporting in laparoscopic radical prostatectomy (LRP) and robot‐assisted LRP (RALP), to see if there has been an improvement in the overall reporting of complications. We performed a Medline search using the Medical Subject Heading terms ‘prostatectomy’, ‘laparoscopy’, ‘robotics’, and ‘minimally invasive’. We then applied the Martin criteria for complications reporting to the selected articles. We identified 51 studies for a total of 32 680 patients. When excluding functional outcomes the outpatient complications reporting was 20/51 (39.2%). In all, 35% and 43% of papers did not list any method for recording continence and potency, respectively. A complication grading system was only used in 30 studies (58.8%). Of the 16 papers using a grading scale in 2006–2007, only 31.3% used the Clavien system, compared with 69% from 2008 to the first half of 2010. In all, 27% of papers used some form of risk‐factor analysis for complications. Multivariate analysis was used in 43% of papers, 29% looked at body mass index, while one looked at prostate weight, and another age. There has been an overall improvement in complications reporting in the minimally invasive RP literature since 2005. However, most studies still do not fulfil many of the criteria necessary for standardised complication reporting. Functional outcome reporting remains poor and unstandardised. Given our current reliance on observational studies, increased efforts should be made to standardise all complication outcomes reporting.
Commonly used antihypertensives and lower urinary tract symptoms: results from the Boston Area Community Health (BACH) Survey
Authors: Hall Susan A. , Chiu Gretchen R. , Kaufman David W. , Wittert Gary A. , Link Carol L. , McKinlay John B. 
Published: September 2011

Study Type – Prevalence (inception cohort)Level of Evidence 1bWhat's known on the subject? and What does the study add?Certain antihypertensives, particularly diuretics and calcium channel blockers, are known to be associated with increased risk of LUTS including nocturia, but little is known about gender‐specific effects.This is the first epidemiological study, to our knowledge, to compare the prevalence of several urological symptoms (storage, voiding and nocturia) among male and female users of a wide variety of common antihypertensives using a community‐based sample.OBJECTIVE
To examine differences in the prevalence of lower urinary tract symptom (LUTS) among users of five common AHT classes compared with non‐users, adjusted for LUTS risk factors in a large, representative sample.
SUBJECTS AND METHODS
Data were from the Boston Area Community Health Survey, a population‐based study of community‐dwelling male and female (30–79 years) residents of Boston, MA, USA for whom prescription drug information was collected between 2002 and 2005.
The urological symptoms of storage, voiding, and nocturia were assessed using interviewer‐administered questionnaires and the American Urological Association Symptom Index. This analysis was conducted among 1865 participants with an AHT indication.
Associations of angiotensin‐converting enzyme inhibitors, beta blockers, calcium channel blockers (CCBs) and loop and thiazide diuretics with the three groups of LUTS were estimated using odds ratios (ORs) and 95% confidence intervals (CIs) from multivariate logistic regression (referent group: untreated hypertension). Overlap in use was accounted for using monotherapy and combination therapy exposure categories.
RESULTS
Among women, monotherapy with CCBs was associated with increased prevalence of nocturia (OR = 2.65, 95% CI: 1.04–6.74) and voiding symptoms (OR = 3.84, 95% CI: 1.24–11.87); these results were confined to women aged <55 years.
Among men of all ages, positive associations were observed for thiazides and voiding symptoms (monotherapy OR = 2.90, 95% CI: 1.17–7.19), and loop diuretics and nocturia (combination therapy OR = 2.55, 95% CI: 1.26–5.14).
CONCLUSION
Results are consistent with the hypothesis that certain AHTs may aggravate LUTS. The presence of new or worsening LUTS among AHT users suggests medications should be reviewed and a change in AHT class considered.
What explains landscape patterns of tree mortality caused by bark beetle outbreaks in Greater Yellowstone?
Authors: Simard Martin , Powell Erinn N. , Raffa Kenneth F. , Turner Monica G. 
Published: September 2011

ABSTRACTAim Bark beetle outbreaks have recently affected extensive areas of western North American forests, and factors explaining landscape patterns of tree mortality are poorly understood. The objective of this study was to determine the relative importance of stand structure, topography, soil characteristics, landscape context (the characteristics of the landscape surrounding the focal stand) and beetle pressure (the abundance of local beetle population eruptions around the focal stand a few years before the outbreak) to explain landscape patterns of tree mortality during outbreaks of three species: the mountain pine beetle, which attacks lodgepole pine and whitebark pine; the spruce beetle, which feeds on Engelmann spruce; and the Douglas‐fir beetle, which attacks Douglas‐fir. A second objective was to identify common variables that explain tree mortality among beetle–tree host pairings during outbreaks.Location Greater Yellowstone ecosystem, Wyoming, USA.Methods We used field surveys to quantify stand structure, soil characteristics and topography at the plot level in susceptible stands of each forest type showing different severities of infestation (0–98% mortality;n= 129 plots). We then used forest cover and beetle infestation maps derived from remote sensing to develop landscape context and beetle pressure metrics at different spatial scales. Plot‐level and landscape‐level variables were used to explain outbreak severity.Results Engelmann spruce and Douglas‐fir mortality were best predicted using landscape‐level variables alone. Lodgepole pine mortality was best predicted by both landscape‐level and plot‐level variables. Whitebark pine mortality was best – although poorly – predicted by plot‐level variables. Models including landscape context and beetle pressure were much better at predicting outbreak severity than models that only included plot‐level measures, except for whitebark pine.Main conclusions Landscape‐level variables, particularly beetle pressure, were the most consistent predictors of subsequent outbreak severity within susceptible stands of all four host species. These results may help forest managers identify vulnerable locations during ongoing outbreaks.
Toward a conceptual synthesis for climate change responses
Authors: O'Connor Mary I. , Selig Elizabeth R. , Pinsky Malin L. , Altermatt Florian 
Published: September 2011

ABSTRACTAim  To identify hypotheses for how climate change affects long‐term population persistence that can be used as a framework for future syntheses of ecological responses to climate change.Location  Global.Methods  We surveyed ecological and evolutionary concepts related to how a changing climate might alter population persistence. We organized established concepts into a two‐stage framework that relates abiotic change to population persistence via changes in the rates or outcomes of ecological and evolutionary processes. We surveyed reviews of climate change responses, and evaluated patterns in light of our conceptual framework.Results  We classified hypotheses for population responses to climate change as one of two types: (1) hypotheses that relate rates of ecological and evolutionary processes (plasticity, dispersal, population growth and evolution) to abiotic change, and (2) hypotheses that relate changes in these processes to four fundamental population‐level responses (colonization, acclimatization, adaptation or extinction). We found that a disproportionate emphasis on response in the climate change literature is difficult to reconcile with ecological and evolutionary theories that emphasize processes. We discuss a set of 24 hypotheses that represent gaps in the literature that limit our ability determine whether observed climate change responses are sufficient to facilitate persistence through future climate change.Main conclusions  Though theory relates environmental change to fundamental ecological and evolutionary processes and population‐level responses, clear hypotheses based on theory have not been systematically formulated and tested in the context of climate change. Stronger links between basic theory and observed impacts of climate change are required to assess which responses are common, likely or able to facilitate population persistence despite ongoing environmental change. We anticipate that a hypothesis‐testing framework will reveal that indirect effects of climate change responses are more pervasive than previously thought and related to a few general processes, even though the patterns they create are incredibly diverse.
Beyond Individual Transferrable Quotas: methodologies for integrating ecosystem impacts of fishing into fisheries catch rights
Authors: Gibbs Mark T , Thébaud Olivier 
Published: September 2011

AbstractWhile there has been a growing concern for the adverse ecological impacts of fishing, progress on incorporating these into operational fisheries management has been slow. Many fisheries management organizations have addressed the problem of overharvesting and over‐capitalization first. In this domain, the question of access regulation has gained growing recognition as a key dimension of fisheries sustainability, leading to recommendation and progressive implementation of rights‐based systems, in particular Individual Transferrable Quotas (ITQs). While adjustments in fishing capacity resulting from the implementation of these systems may entail a reduction in some unwanted ecosystem impacts of fishing, it is also recognized that they will not be sufficient to achieve the ecological outcomes increasingly demanded by the global community. There is thus a need to examine the possibilities for a common management framework for dealing with both over‐capitalization of fisheries and adverse ecological effects of fishing. In this paper, we examine the feasibility of incorporating greater ecosystem goods and services into ITQ policy instruments initially designed with a narrow focus on commercial target species. We consider the advantages and limitations of alternative approaches in this respect and identify some of the practical issues associated with the different alternatives, in particular the underpinning knowledge requirements. We argue that given the need for increasingly streamlined management processes, further investigation into practical ways forward in this domain is crucial if management of fisheries is to achieve economic efficiency while fully encompassing the ecologically sustainable development objectives of ecosystem‐based fisheries management.
No increase in headache after previous intracranial infections: a historical cohort study (HUNT)
Authors: Linde M. , Langnes H. A. , Hagen K. , Bergh K. , Stovner L. J. 
Published: September 2011

Background and purpose:  Despite the absence of robust scientific evidence, it is today generally accepted that the acute headache typical for intracranial infections can develop into permanent headache complaints. This widespread concept was explored in the first, large, longitudinal, population‐based study.Methods:  Data on confirmed exposure to intracranial infections amongst all adult inhabitants in a geographical area during a 20‐year period were assembled from hospital records. Surviving individuals were later invited to the third Nord‐Trøndelag Health Survey (HUNT 3), where 39 690 (42%) of 94 194 invited inhabitants aged ≥20 years responded to a validated headache questionnaire. Using logistic regression, the 1‐year prevalence of headache and its subtypes according to the diagnostic criteria of the International Headache Society was assessed and compared between those with and without previous confirmed intracranial infection. Age and sex were used as covariates.Results:  Overall, 43 participants were identified with earlier intracranial infection, whereof three had more than one infection: bacterial meningitis (n = 19), lymphocytic meningitis (n = 18), encephalitis (n = 9), and brain abscess (n = 1).The mean interval from infection to participation in HUNT 3 was 11.2 (range 1.5–19.7) years. There was no significant increase in the prevalence of headache (OR 1.10, 95% CI 0.58–2.07), its subtypes (migraine, or tension‐type headache), or chronic daily headache (OR 1.85, 95% CI 0.45–7.68) amongst participants with previous intracranial infection compared with the surrounding population.Conclusions:  This study challenges the existence of chronic post‐bacterial meningitis headache and does not indicate the presence of other long‐term headaches induced by intracranial infection.
Expression of stromal‐cell‐derived factor‐1 (SDF‐1): a predictor of ischaemic stroke?
Authors: Wurster T. , Stellos K. , Geisler T. , Seizer P. , Andia M. E. , Schuster A. , May A. E. , Melms A. , Gawaz M. , Bigalke B. 
Published: September 2011

Background and purpose:  Platelet stromal‐cell‐derived factor‐1 (SDF‐1) plays a pivotal role in angiogenesis and the regeneration of ischaemic tissue through the regulation of haematopoietic progenitor cells and is upregulated at the sites of vascular injury and platelet activation. Thus, SDF‐1 has recently been discussed as a predictor in ischaemic diseases such as acute myocardial infarction. However, no clinical data pertinent to the investigation of the platelet SDF‐1 expression in patients with stroke are available.Methods:  We consecutively evaluated 196 patients who were admitted to the stroke unit with symptoms suspected for stroke. Surface expression of the platelet activation markers (P‐selectin and GPIb) and the expression of platelet‐bound SDF‐1 were determined by two‐colour whole blood flow cytometry.Results:  Patients with transient ischaemic attack (TIA) as well as with ischaemic stroke showed similar levels of SDF‐1 expression on hospital admission compared with patients with non‐ischaemic (NI) events and with 30 healthy controls (TIA (mean fluorescence intensity ± SD): 31.5 ± 18.2 vs. NI: 26.4 ± 15.7; P = 0.361; stroke: 28.7 ± 19.8 vs. NI; P = 0.943; control: 26.1 ± 11.3; P > 0.05 compared with all). Platelet SDF‐1 expression showed a trend with the severity of stroke according to National Institute of Health Stroke Scale score (r = 0.125; P = 0.085), but significantly correlated with the peak levels of C‐reactive protein (r = 0.218; P = 0.002) and with the levels of platelet activation (P‐selectin: r = 0.389; P = 0.001). Multifactorial analysis of covariance revealed a significant influence on platelet SDF‐1 expression by smoking (P = 0.019).Conclusions:  Platelet SDF‐1 surface expression did not show any significant difference in patients with TIA and ischaemic stroke compared with patients with NI events. Thus, single biomarker evaluation of platelet SDF‐1 surface expression is not helpful to predict ischaemic stroke.
Use of a handheld, computerized device as a decision support tool for stroke classification
Authors: Nam H. S. , Cha M.‐J. , Kim Y. D. , Kim E. H. , Park E. , Lee H. S. , Nam C. M. , Heo J. H. 
Published: September 2011

Background:  The Trial of ORG 10172 in Acute Stroke Treatment (TOAST) classification has been widely used to determine etiology of ischemic stroke. However, interrater reliability is known to be modest. The complexity of abstraction and the interpretation of various clinical and laboratory data might limit the accuracy of the TOAST classification. In this study, we developed a computerized clinical decision support system for stroke classification that can be used in a handheld device and tested whether this system can improve diagnostic accuracy and reliability.Methods:  Based on the TOAST classification, a logical algorithm was developed and implemented on a handheld device, named iTOAST. After answering six questions using the touch interface, the stroke subtype result is displayed on the screen. Four neurology residents were randomly assigned to classify stroke subtypes using iTOAST or the conventional method (cTOAST). Using a crossover design, they classified the stroke subtypes of 70 patients. The standard subtypes were determined by three stroke experts. Correlated kappa coefficients using iTOAST compared with cTOAST were determined.Results:  The kappa (SE) value of iTOAST [0.790 (0.041), 95% CI: 0.707–0.870] was higher than that of cTOAST [0.692 (0.046), 95% CI: 0.600–0.782] (P < 0.001). Neither sequence (P = 0.857) nor period effect (P = 0.999) was observed.Conclusions:  The stroke classification tool using a handheld, computerized device was easy, accurate, and reliable over the conventional method. It may have additional benefit because a handheld, computerized device is accessible anytime and anywhere.
Surviving underground: Irregular migrants, Italian families, invisible welfare
Authors: Ambrosini Maurizio 
Published: September 2011

Ambrosini M. Surviving underground: irregular migrants, Italian families, invisible welfareThe aim of this article, which focuses on the Italian case and its domestic and care sector, is to highlight two aspects. The first concerns the interaction among unauthorised migrants, the demand of their labour on the one hand and the other social actors they meet during their settling process on the other hand. The second concerns the nature of the irregularity of their condition, which is dynamic and often transient. Despite the increasingly fierce declarations, the reality does not correspond to the claims regarding control of the migration flows. Recognised or disguised forms of tolerance with only occasional implementation of severe measures – such as deportation – and regularisation processes of different kinds and with different purposes seem to be more the rule than the exception in Italy, as in other developed countries.