bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence and Prevention of Postoperative Venous Thromboembolism: Are They Meaningful Quality Indicators in Japanese Health Care Settings?
Authors: Kunisawa Susumu , Ikai Hiroshi , Imanaka Yuichi 
Published: August 2011

AbstractBackgroundVenous thromboembolism (VTE) epidemiology varies widely across surgical procedures. At present, there are few epidemiologic reports regarding VTE in Japan. Japanese VTE prophylaxis guidelines recommend a risk‐based approach based on previous epidemiologic statistics. VTE includes deep vein thrombosis (DVT) and pulmonary embolism (PE). PE prevention is the main goal, although the relation between PE and DVT is still controversial.MethodsWe collected administrative data for 1,016,496 surgical patients from 260 hospitals. We analyzed DVT and PE incidence and selected two subgroups for further analysis: gastroenterologic surgery and specific orthopedic surgery (high‐frequency group).ResultsOverall DVT incidence was 1947 (0.19%); and the PE incidence was 538 (0.05%). DVT case fatality rate was 3.44% (67/1947); that for PE was 22.86% (123/538). Both overall and subgroup incidences were comparable to those in previous reports. Subgroup analyses in the high‐frequency group did not show a relation between DVT and PE. VTE prophylaxis did not show a relation between DVT and PE despite 99% adherence.ConclusionsOur results are consistent with established data regarding DVT and PE incidence. Administrative data available in Japan provides a powerful epidemiologic tool to characterize rare diseases such as DVT and PE. DVT is not a suitable quality indicator in Japan. However, PE is too rare to be considered a rate‐based outcome indicator, and VTE prophylaxis is too widely applied to be used as a process indicator. VTE measurement is not a useful quality indicator in Japan to compare hospitals but provides a longitudinal self‐survey.
The Surgical Treatment of Graves’ Disease in Children and Adolescents
Authors: Chiapponi C. , Stocker U. , Mussack Th. , Gallwas J. , Hallfeldt K. , Ladurner R. 
Published: August 2011

AbstractBackgroundSurgery as definitive treatment of pediatric Graves’ disease is recommended for children and adolescents experiencing adverse effects of thionamides or disease relapse after at least 2 years of medical treatment. In addition, it is indicated in patients with a large goiter or with suspicious nodules. Total or near‐total thyroidectomy should be performed, since subtotal thyroidectomy is associated with a high risk of relapse in this group. Patients should be referred to surgeons experienced in thyroid surgery because studies show that children and adolescents have a higher complication rate than adults.MethodsThis is a retrospective matched case–control study. To analyze postoperative morbidity of children and adolescents (mean age = 15 ± 3 years) with Graves’ disease who underwent total thyroidectomy between 2000 and 2010 in our department, a statistically identical group of adults (mean age = 46 ± 3) who also underwent total thyroidectomy for Graves’ disease was matched as a control. End points were surgical complications like postoperative bleeding, transient and permanent recurrent laryngeal nerve palsy, and transient and permanent hypoparathyroidism.ResultsThere was no significant difference in the mean operation time (137 ± 33 min), the rate of intraoperative parathyroid gland autotransplantation (9.5%), postoperative bleeding (4.8%), transient and permanent recurrent laryngeal nerve palsy (4.8 and 0%), and transient and permanent hypocalcemia (28.6 and 0%).ConclusionTotal thyroidectomy in children and adolescents with Graves’ disease performed in a department that specializes in endocrine surgery is a safe procedure with no higher complication rates than total thyroidectomy in adults with Graves’ disease.
Staging of Peripheral‐Type Intrahepatic Cholangiocarcinoma: Appraisal of the New TNM Classification and its Modifications
Authors: Igami Tsuyoshi , Ebata Tomoki , Yokoyama Yukihiro , Sugawara Gen , Takahashi Yu , Nagino Masato 
Published: August 2011

AbstractBackgroundIn the seventh edition, the TNM classification for intrahepatic cholangiocarcinoma (IHC) is separated from that for hepatocellular carcinoma. Because it is the first independent classification for IHC, the validity of the new classification needs to be evaluated.MethodsThe medical records of 93 patients with peripheral‐type IHC who underwent treatment (61 resected and 32 unresectable tumors) were retrospectively reviewed focusing on the new TNM classification for IHC.ResultsThe 5‐year survival rate and the median survival time for the 61 patients with resected tumors were 33.9% and 2.05 years, respectively. The survival of the patients with periductal invasion was similar to that of the patients without. The survival of the patients with metastasis to the gastrohepatic lymph nodes (G‐LN) was dismal without any 2‐year survivors and similar to that of the patients with unresectable tumors (P = 0.247). On multivariate analysis, histologic differentiation (P = 0.034), multiple tumors (P = 0.014), lymph node metastasis (P < 0.001), and distant metastasis other than lymph node metastasis (P = 0.007) were identified as independent prognostic factors. According to the above results, we modified the new TNM classification as follows: IHC with multiple tumors was classified as pT4 disease; periductal invasion was excluded from determinant of the T‐categories; and metastasis to G‐LN was treated as distant metastasis. The survival curves based on our modifications were better stratified than those based on the new TNM classification.ConclusionsThe TNM classification for IHC included some clinical inconsistencies; therefore, we proposed some modifications of the new TNM classification for IHC and demonstrated that these modifications offer better stratification of the survival data. Further revisions are necessary for its improvement.
Improved Lymph Node Harvest from Resected Colon Cancer Specimens Did Not Cause Upstaging from TNM Stage II to III
Authors: Storli Kristian , Søndenaa Karl , Furnes Bjørg , Leh Sabine , Nesvik Idunn , Bru Tore , Gudlaugsson Einar , Bukholm Ida , Norheim‐Andersen Solveig , Eide Geir 
Published: August 2011

AbstractBackgroundThe number of lymph nodes retrieved and examined from a resected colon cancer specimen may be crucial for correct staging. We examined if efforts to increase the lymph node harvest to more than 12 lymph nodes per specimen would upstage some patients from TNM stage II to III.MethodsThree hospitals compared results from 2000 with those of 2007 in 421 resected patients with stage II and III colon cancer. Hospital A endeavored to improve the surgical procedure while the pathologists enhanced the quality of lymph node sampling. Hospital B did not make any marked changes, while hospital C introduced the GEWF lymph node solvent (glacial acetic acid, ethanol, distilled water, and formaldehyde) in their pathology method.ResultsIn 2000, 12 or more lymph nodes were harvested in 39.6, 45.0, and 21.1% of the specimens from the three hospitals, while the figures for 2007 were 85.7, 42.0, and 90.3%, respectively. The significant increase in lymph node harvest in two of the hospitals in 2007 compared to 2000 (p < 0.001) did not affect the share of patients with stage III in 2007 (38.7%) compared to 2000 (44.1%) (p = 0.260). The number of positive lymph nodes and the lymph node ratio (LNR) decreased from 2000 to 2007. A lymph node yield of 12 or more was not associated with an increased probability of positive lymph nodes in a multivariable logistic regression analysis.ConclusionMore radical surgery and dedicated pathologists and the use of the GEWF solvent significantly increased the lymph node yield but did not upstage patients from TNM stage II to III.
Encapsulation of R. planticola Rs-2 from alginate-starch-bentonite and its controlled release and swelling behavior under simulated soil conditions
Authors: Wu Zhansheng , Guo Lina , Qin Shaohua , Li Chun 
Published: August 2011

Abstract
The plant growth-promoting bacteria (PGPR) Raoultella planticola Rs-2 was encapsulated with the various blends of alginate, starch, and bentonite for development of controlled-release formulations. The stability and release characteristics of these different capsule formulations were evaluated. The entrapment efficiency of Rs-2 in the beads (capsules) was more than 99%. The diameter of dry beads ranged from 0.98 to 1.41 mm. The bacteria release efficiency, swelling ratio, and biodegradability of the different bead formulations were enhanced by increasing the starch or alginate contents, but were impeded by higher bentonite content. The release kinetics of viable cells from capsules and the swelling ratio of capsules were studied in simulated soil media of varying temperature, moisture, pH, and salt content. The release of loaded Rs-2 cells and swelling of capsules are greatly affected by moisture, temperature, pH and salt content of the release medium. The release of viable Rs-2 cells from capsules was positively associated with the swelling properties of the capsules. The release of Rs-2 cells occurred through a Case II diffusion mechanism. In summary, this work indicates that alginate-starch-bentonite blends are a viable option for the development of efficient controlled-release formulations of Rs-2 biofertilizer, and which could have a promising application in natural field conditions.
Scale-down assessment of the sensitivity of Yarrowia lipolytica to oxygen transfer and foam management in bioreactors: investigation of the underlying physiological mechanisms
Authors: Kar Tambi , Destain Jacqueline , Thonart Philippe , Delvigne Frank 
Published: August 2011

Abstract
A scale-down investigation of the impact of local dissolved oxygen limitation on lipase production by Y. lipolytica has been performed. One of the major issues encountered during this kind of process is foam formation, requiring a reduction of the overall oxygen transfer efficiency of the system in order to keep antifoam consumption to a reasonable level. A regulation strategy involving oxygen enrichment of the air flow through the reactor has allowed this issue to be partly overcome. For a second time, the scale dependency of the process operated with air enrichment has been investigated by a combination of scale-down and pilot-scale cultivation tests. The scale-down apparatus considered in this work comprised a well-mixed part connected to a plug-flow part subjected to dissolved oxygen limitation. Surprisingly, foaming intensity was greatly reduced in the case of the test performed in scale-down reactors (SDRs) while maintaining the same stirring and aeration intensities in the stirred part of the reactor. For mean residence time of 100 s in the recycle loop of the reactor, foam formation was significantly reduced while cell growth and lipase production were both unaltered. When the residence time in the recycle loop was raised to 200 s, the foam phenomena was also reduced, but the lipase yield was altered as well as lip2 gene transcription and translation as shown by real-time quantitative polymerase chain reaction (RT-qPCR) and reporter gene activity, respectively. Our results clearly show the importance of primarily taking into account cell physiology for the scaling-up procedure.
RETRACTED ARTICLE: Optimization of Biodiesel Production Using a Magnetically Stabilized Fluidized Bed Reactor
Authors: Guo Pingmei , Huang Fenghong , Huang Qingde , Zheng Chang 
Published: August 2011

AbstractA biodiesel production process using magnetically stabilized fluidized bed reactor (MSFBR) has been developed based on the refined cottonseed oil. The reactant flow rate and magnetic field intensity effects on the nanometer magnetic catalyst behavior in the column were investigated. Orthogonal experiments (L4(2)3) were applied to optimize the best transesterification reaction conditions. Reaction temperature, methanol to oil molar ratio, and reactant flow rate were the main factors to influence transesterification conversion efficiency. These three factors chosen for the present investigation were based on the results of single‐factor tests. The optimum transesterification reaction conditions of cottonseed oil were determined in MSFBR as follows: methanol to oil molar ratio 8:1, 40 cm3 min−1 reactant flow rate, 225 Oe magnetic field intensity and reaction temperature of 65 °C, the conversion efficiency reached 97% in 100 min. The cold filter plugging point and kinematic viscosity of cottonseed oil biodiesel were higher than that described by Chinese specifications of biodiesel because of the special fatty acid profiles of cottonseed oil. The activity stability of the nanometer magnetic solid catalyst in MSFBR was much better than that in the autoclave stirred reactor (ASR).
Visceral adiposity after tibolone use
Authors: Carranza‐Lira Sebastián , Bárcena‐Jacobo Tomás D. , Sandoval‐Barragán Martha P. , Ramos‐León Julio C. 
Published: August 2011

AbstractObjectiveTo evaluate the differences in visceral fat between women using tibolone and those not using tibolone.MethodsSixty‐five healthy postmenopausal women were included in the study: 26 who were taking tibolone (2.5 mg/day); and 39 who were not receiving tibolone treatment. Anthropometric measurements were performed, with subcutaneous and visceral fat measured via ultrasound. Differences between the groups were determined via Student t test.ResultsThere were no significant differences in age (P = 0.796), weight (P = 0.256), height (P = 0.456), body mass index (P = 0.08), waist circumference (P = 0.420), or waist–hip ratio (P = 0.1) between the groups. Hip circumference was significantly lower in the study group than in the control group (97.7 ± 12.2 cm vs 103 ± 8.1 cm; P < 0.04). There were no significant differences between the groups in subcutaneous fat measurements (P = 0.56). There were significantly lower visceral fat measurements (2.8 ± 1.1 cm vs 3.9 ± 1.6 cm; P < 0.004) and a significantly lower visceral fat–subcutaneous fat ratio (1.1 ± 0.3 vs 1.5 ± 0.7; P < 0.005) in the study group than in the control group.ConclusionPostmenopausal women who use tibolone have lower visceral fat measurements than do woman of similar age who do not use tibolone.
Factors contributing to failure of vacuum delivery and associated maternal/neonatal morbidity
Authors: Wanyonyi Sikolia Z. , Achila Bob , Gudu Naomi 
Published: August 2011

AbstractObjectiveTo determine factors contributing to the failure of vacuum delivery and to compare the neonatal and maternal morbidity associated with failed and successful procedures.MethodsA retrospective case–control study was undertaken at Aga Khan University Hospital, Nairobi, Kenya, by review of medical charts from the period of January 2007 to December 2010. In total, 31 cases of failed vacuum delivery were compared with 124 controls where extraction was successful. The primary outcome measure was fetal malposition. Secondary outcome measures included a composite score of maternal complications, a 5‐minute Apgar score below 7, an umbilical arterial pH below 7.1, and a base excess below − 12. Multiple logistic regression analysis was undertaken to identify factors associated with failure of vacuum delivery.ResultsDemographic and labor characteristics were similar in both groups. Fetal malposition significantly contributed to the failure of vacuum delivery (odds ratio 12.7, 95% confidence interval 1.5–14.8). Failure of vacuum delivery was not associated with clinically important neonatal or maternal morbidity.ConclusionsVacuum extraction is a safe mode of delivery where indicated, with minimal maternal and neonatal morbidity even in the event of procedural failure.
Rapid initiation of quetiapine well tolerated as compared with the conventional initiation regimen in patients with schizophrenia or schizoaffective disorders
Authors: Hsiao Cheng‐Cheng , Chen Kun‐Po , Tsai Chang‐Jer , Wang Liang‐Jen , Chen Chih‐Ken , Lin Shih‐Ku 
Published: August 2011

AbstractA 2‐week, randomized, parallel‐group open trial was designed to evaluate the safety and tolerability of a rapid initiation regimen with a higher dose of quetiapine (up to 800 mg/d by Day 4) than that used in the conventional initiation regimen of quetiapine (up to 400 mg/d by Day 5) in patients with schizophrenia or schizoaffective disorders. Forty patients were recruited and randomly (3:1) assigned to either the group with rapid initiation of quetiapine or the group with conventional initiation. At the end of the investigation, the difference between the groups in the incidence of adverse events was not significant; a significant drop in the Barnes Akathisia Rating Scale and Simpson‐Angus Scale scores was observed only in the group with the rapid initiation regimen. The groups did not differ in terms of improvement on the Clinical Global Impression—Severity of Illness and Positive and Negative Syndrome Scale at the end of the study. The results of our 2‐week study suggest that rapid initiation with a higher dose of quetiapine (up to 800 mg/d by Day 4) is well tolerated in patients with schizophrenia or schizoaffective disorders and does not compromise efficacy relative to the conventional initiation.
Treatment of Chronic Tendinopathy with Ultrasound‐Guided Needle Tenotomy and Platelet‐Rich Plasma Injection
Authors: Finnoff Jonathan T. , Fowler Steven P. , Lai Jim K. , Santrach Paula J. , Willis Elaine A. , Sayeed Yusef A. , Smith Jay 
Published: August 2011

ObjectiveTo determine whether ultrasound (US)‐guided percutaneous needle tenotomy followed by a platelet‐rich plasma (PRP) injection would result in pain reduction, functional improvement, or structural alterations in patients with chronic, recalcitrant tendinopathy.DesignPart A was a retrospective observational study. Part B was a prospective observational study.SettingOutpatient academic sports medicine center.ParticipantsPatients were required to have chronic (>3 months), recalcitrant tendinopathy treated with US‐guided percutaneous tenotomy and PRP injection between January 2007 and October 2009. Fifty‐one subjects met the inclusion criteria. Forty‐one (80%) participated in part A of the study, whereas 34 subjects (67%) participated in part B.MethodsIn part A, subjects completed a survey obtaining anthropomorphic, demographic, pain, and functional data. Subjects' platelet, hemoglobin, and white blood cell concentrations from their whole‐blood and PRP samples were also obtained. In part B, subjects returned to the clinic after US‐guided percutaneous needle tenotomy and PRP injection for a diagnostic US, which was compared with their preprocedure diagnostic US.Main Outcome MeasuresThe main outcome measures included changes in pain, function, and tendon characteristics.ResultsThe tendinopathy location was in the upper extremity in 10 subjects (24.4%), was in the lower extremity in 31 subjects (75.6%), and had been present for a mean of 40 months. The mean postprocedure follow‐up was 14 months, and the maximum benefits occurred 4 months postprocedure. There were mean functional and worst‐pain improvements of 68% and 58%, respectively. Eighty‐three percent of subjects were satisfied with their outcomes and would recommend the procedure to a friend. Although no tendons demonstrated a normal sonographic appearance after the procedure, 84% of subjects had an improvement in echotexture, 64% had a resolution of intratendinous calcifications, and 82% had a decrease in intratendinous neovascularity. None of the variables analyzed in this study demonstrated a significant correlation with pain or functional outcome measures.ConclusionsIn this case series, we found US‐guided percutaneous needle tenotomy followed by PRP injection to be a safe and effective treatment for chronic, recalcitrant tendinopathy, and this treatment was associated with sonographically apparent improvements in tendon morphology. However, because of the intrinsic limitations of the study design and the heterogeneity of treated tendons, further research is required to corroborate our findings.
Dense suspensions in rotating-rod flows: normal stresses and particle migration
Authors: Boyer François , Pouliquen Olivier , Guazzelli Élisabeth 
Published: August 2011

AbstractNormal stress differences are measured in dense suspensions of neutrally buoyant non-Brownian spheres dispersed in a Newtonian fluid. Rotating-rod rheometry is used to characterize the suspension normal stresses which are responsible for a rod-dipping phenomenon. These normal stress differences are seen to strongly increase above a volume fraction of approximately 22 %. During the course of the experiments, a new time-dependent behaviour is also observed: the dip is filled with increasing times. This time evolution is found to be related to particle migration from regions of high shear rate to regions of low shear rate. The behaviour is compared with the predictions of a suspension balance model in which the particle migration flux is related to the normal stresses of the suspension.
Numerical investigation of a jet from a blunt body opposing a supersonic flow
Authors: Chen Li-Wei , Wang Guo-Lei , Lu Xi-Yun 
Published: August 2011

AbstractNumerical investigation of a sonic jet from a blunt body opposing a supersonic flow with a free stream Mach number ${M}_{\infty } = 2. 5$ was carried out using large-eddy simulation for two total pressure ratios of the jet to the free stream, i.e. $\mathscr{P}= 0. 816$ and 1.633. Results have been validated carefully against experimental data. Various fundamental mechanisms dictating the flow phenomena, including shock/jet interaction, shock/shear-layer interaction, turbulent shear-layer evolution and coherent structures, have been studied systematically. Based on the analysis of the flow structures and features, two typical flow states, i.e. unstable and stable states corresponding to the two values of $\mathscr{P}$, are identified and the behaviours relevant to the flow states are discussed. Small-scale vortical structures mainly occur in the jet column, and large-scale vortices develop gradually in a recirculation region when the jet terminates through a Mach disk and reverses its orientation as a conical free shear layer. The turbulent fluctuations are enhanced by the rapid deviation of the shear layer and the interaction with shock waves. Moreover, the coherent structures of the flow motion are analysed using the proper orthogonal decomposition technique. It is found that the dominant mode in the cross-section plane exhibits an antisymmetric character for the unstable state and an axisymmetric one for the stable state, while statistical analysis of unsteady loads indicates that the side loads can be seen as a rotating vector uniformly distributed in the azimuthal direction. Further, we clarify a feedback mechanism whereby the unsteady motion is sustained by the upstream-propagating disturbance to the Mach disk through the recirculation subsonic region and downstream propagation in the conical shear layer. Feedback models are then proposed which can reasonably well predict the dominant frequencies of the two flow states. The results obtained in this study provide physical insight into the understanding of the mechanisms relevant to the opposing jet/supersonic flow interaction.