bluuebunny/crossref_metadata_2025_split huggingface dataset:
Meta‐analysis of robot‐assisted versus conventional laparoscopic Nissen fundoplication for gastro‐oesophageal reflux disease
Authors: Wang Zhanhui , Zheng Qi , Jin Zhiming 
Published: January 2012

AbstractBackground:  Conventional laparoscopic Nissen fundoplication (CLF) is generally considered the surgical approach of choice for gastro‐oesophageal reflux disease. Robotic‐assisted laparoscopic fundoplication (RALF) has recently been introduced into laparoscopic clinical practice with the aim of improving surgical performance by eliminating tremors and fatigue. A meta‐analysis of randomized clinical trials (RCTs) was performed to compare RALF and CLF.Methods:  Medline, Embase, ISI Web of Knowledge CPCI‐S and The Cochrane Library were searched and the methodological quality of included trials was evaluated. Outcomes evaluated were intraoperative, dysphagia, flatulence, antisecretory medication, satisfaction with intervention, operation time, hospital stay and total cost. Results were pooled in meta‐analyses as risk ratios and weighted mean differences (WMD).Results:  Of 221 patients in six RCTs, 111 were allocated to CLF and 110 to RALF. RALF prolonged total time necessary to carry out fundoplication (WMD 3.17 (95% confidence interval. 2.33–4.00) min; P < 0.00001, χ2P = 0.25, I2 = 24%). Operation complication, antisecretory medication, satisfaction with intervention, the time needed for hiatal dissection, the time from incision to completion of sutures, the total operation time and total cost were similar in both groups.Conclusion:  Clinical outcomes from RALF were comparable to CLF approach, but RALF prolonged the operation time. Currently, CLF should be routinely used as costs are lower.
Impact of F18‐fluorodeoxyglycose positron emission tomography/computed tomography on the management of resectable pancreatic tumours
Authors: Yao Jinna , Gan Gary , Farlow David , Laurence Jerome M. , Hollands Michael , Richardson Arthur , Pleass Henry C. C. , Lam Vincent W. T. 
Published: January 2012

AbstractBackground:  Positron emission tomography/computed tomography (PET/CT) using F18‐fluorodeoxyglucose has been shown to be valuable in the management of malignant disease. The aim of this study is to investigate the impact of this technique on the management of patients with resectable pancreatic tumours.Methods:  Thirty‐six patients with 37 potentially resectable pancreatic tumours on diagnostic CT imaging underwent PET/CT scans. Operative findings, histological reports and/or clinical follow‐up served as standard of reference. The impact of PET/CT on patient management was estimated by calculating the percentage of patients whose treatment plan was altered due to PET/CT.Results:  Pancreatic adenocarcinoma was diagnosed in 30 patients, neuroendocrine tumours in 3, mass‐forming pancreatitis in 3 and serous cystadenoma in 1. The median standard uptake (max) value was 5.0 (range 2.2–12.0). Sensitivity and specificity of detecting extrapancreatic metastatic disease were 73% and 100%, respectively. Three occult liver metastases were detected at laparotomy following negative PET/CT. PET/CT findings influenced the management of 8 (22%) patients – 3 with liver metastases, 3 with bone metastases, 1 with lymph node metastases and 1 by identifying the benign appearance of the pancreatic tumour.Conclusion:  PET/CT achieves a significant diagnostic impact in detecting extrapancreatic metastatic disease. F18‐fluorodeoxyglucose PET/CT appears to be useful in assessing suspicious pancreatic masses.
Laparoscopic radical prostatectomy: introduction of training during our first 50 cases
Authors: Louie‐Johnsun Mark , Ouyang Rupert , Indrajit Bala , Haque Mohammad 
Published: January 2012

AbstractBackground:  The study aims to assess the initial experience of laparoscopic radical prostatectomy (LRP) in a regional centre in Australia which includes Fellowship training during our first 50 cases.Methods:  Data were collected prospectively from our first 50 consecutive patients who underwent LRP for localized prostate cancer between September 2009 and October 2010. All cases were performed or supervised by the primary surgeon. Patient details, operative details, complications, early oncological and functional outcomes were analysed.Results:  The median age was 65 (45–76) years and median preoperative prostate‐specific antigen was 7.5 (2.5–23) ng/mL, with palpable disease present in 48%. Using D'Amico's risk stratification, 14%, 74% and 12% were in low, intermediate and high‐risk categories, respectively. Forty percent of cases were training cases with a median of 5 (2–8) of 10 operative steps performed by the Fellow. There was one open conversion and no rectal injuries. Mean operative time was 288 (175–440) min and with blood transfusion rate of 6%. Mean length of stay was 2.5 (1–6) days. Positive surgical margin rates for pT2 and pT3 disease were 14% and 52%, respectively, although for the last 25 cases they were 7% and 30%, respectively. Continence rate was 86% at 6 months, and 45% and 33% of preoperatively potent patients were potent after bilateral and unilateral nerve preservation at 6 months.Conclusion:  LRP has been safely introduced in a regional centre with establishment of a Fellowship training programme, with early results comparable with other open, laparoscopic and robotic series.
Appropriate working hours for surgical training according to Australasian trainees
Authors: O'Grady Gregory , Harper Simon , Loveday Benjamin , Adams Brandon , Civil Ian D. , Peters Matthew 
Published: January 2012

AbstractBackground:  The demands of surgical training, learning and service delivery compete with the need to minimize fatigue and maintain an acceptable lifestyle. The optimal balance of working hours is uncertain. This study aimed to define the appropriate hours to meet these requirements according to trainees.Methods:  All Australian and New Zealand surgical trainees were surveyed. Roster structures, weekly working hours and weekly ‘sleep loss hours’ (<8 per night) because of 24‐h calls were defined. These work practices were then correlated with sufficiency of training time, time for study, fatigue and its impacts, and work–life balance preferences. Multivariate and univariate analyses were performed.Results:  The response rate was 55.3% with responders representative of the total trainee body. Trainees who worked median 60 h/week (interquartile range: 55–65) considered their work hours to be appropriate for ‘technical’ and ‘non‐technical’ training needs compared with 55 h/week (interquartile range: 50–60) regarded as appropriate for study/research needs. Working ≥65 h/week, or accruing ≥5.5 weekly ‘sleep loss hours’, was associated with increased fatigue, reduced ability to study, more frequent dozing while driving and impaired concentration at work. Trainees who considered they had an appropriate work–life balance worked median 55 h/week.Conclusions:  Approximately, 60 h/week proved an appropriate balance of working hours for surgical training, although study and lifestyle demands are better met at around 55 h/week. Sleep loss is an important determinant of fatigue and its impacts, and work hours should not be considered in isolation.
Understanding and planning ecological restoration of plant–pollinator networks
Authors: Devoto Mariano , Bailey Sallie , Craze Paul , Memmott Jane 
Published: January 2012

Ecology Letters (2012) 15: 319–328AbstractTheory developed from studying changes in the structure and function of communities during natural or managed succession can guide the restoration of particular communities. We constructed 30 quantitative plant–flower visitor networks along a managed successional gradient to identify the main drivers of change in network structure. We then applied two alternative restoration strategies in silico (restoring for functional complementarity or redundancy) to data from our early successional plots to examine whether different strategies affected the restoration trajectories. Changes in network structure were explained by a combination of age, tree density and variation in tree diameter, even when variance explained by undergrowth structure was accounted for first. A combination of field data, a network approach and numerical simulations helped to identify which species should be given restoration priority in the context of different restoration targets. This combined approach provides a powerful tool for directing management decisions, particularly when management seeks to restore or conserve ecosystem function.
Positive surgical margins are a risk factor for significant biochemical recurrence only in intermediate‐risk disease
Authors: Corcoran Niall M. , Hovens Chris M. , Metcalfe Charles , Hong Matthew K.H. , Pedersen John , Casey Rowan G. , Peters Justin , Harewood Laurence , Goldenberg S. Larry , Costello Anthony J. , Gleave Martin E. 
Published: January 2012

Study Type – Therapy (case series)Level of Evidence 4What's known on the subject? and What does the study add?Positive surgical margins (PSMs) after radical prostatectomy are common, although their impact on the risk of disease recurrence is unknown.We examined the impact of PSMs on the risk of ‘significant’ biochemical recurrence stratified by their risk of occult metastatic disease. We find that only in intermediate‐risk disease does the presence of a PSM have a significant impact on the risk of recurrence, and this represents a failure of technique. By contrast, for high‐ and low‐risk disease, the risk of recurrence is driven by intrinsic tumour biology, and the presence of a PSM has little impact on outcome.OBJECTIVE
To determine the impact of surgical margin status on the risk of significant biochemical recurrence (prostate‐specific antigen [PSA] doubling time <3, <6 or <9 months) after prostatectomy.
MATERIALS AND METHODS
Patients undergoing radical prostatectomy with complete clinical and pathological data and detailed PSA follow‐up were identified from two prospectively recorded databases.
Patients were stratified according to their risk of occult systemic disease (low risk: PSA < 10 ng/dL, pT2 stage and Gleason score ≤6; intermediate risk: PSA 10–20 ng/dL, pT2 stage and/or Gleason score 7; high: PSA > 20 ng/dL or pT3‐4 stage or Gleason score 8–10) and the impact of a positive surgical margin (PSM) within each stratum determined by univariable and multivariable analysis.
RESULTS
Of 1514 patients identified, 276 (18.2%), 761 (50.3%) and 477 (31.5%) were classified as having low‐, intermediate‐ and high‐risk disease respectively.
A total of 370 (24.4%) patients had a PSM and with a median follow‐up of 22.2 months, and 165 (7%) patients had a biochemical recurrence.
Sufficient PSA data was available to calculate PSA doubling times in 151/165 patients (91.5%).
The PSM rate rose significantly, from 11% in low‐risk to 43% in high‐risk disease (P < 0.001), with similar positive associations noted with tumour grade, stage and serum PSA (P < 0.001).
Patients with low‐risk disease had essentially identical risks of significant biochemical recurrence over the study period, regardless of surgical margin status. By contrast, in patients with both intermediate‐ and high‐risk disease, a PSM was a strong predictor of significant biochemical recurrence on univariable analysis. On multivariable analysis, howver, PSM predicted significant disease recurrence in intermediate‐risk disease only.
CONCLUSIONS
PSM is a risk factor for significant biochemical recurrence only in intermediate risk disease.
Suprapubic catheter insertion using an ultrasound‐guided technique and literature review
Authors: Jacob Preman , Rai Bhavan Prasad , Todd Alistair W. 
Published: January 2012

What's known on the subject? and What does the study add?The conventional ‘blind’ technique for suprapubic catheter (SPC) insertion relies on adequate filling of the bladder to displace bowel away from the site of needle puncture. However, in a small percentage of patients this fails to happen, which can occasionally lead to life‐threatening bowel injury. Recently published British Association of Urological Surgeons (BAUS) guidelines have recommended that ultrasonography (US) may be helpful to identify bowel loops and recommends its usage whenever possible.This paper describes the technique of US‐guided needle puncture and SPC insertion to reduce the likelihood of bowel injury. The paper addresses training, equipment and logistical issues associated with this advice. We have reviewed the available publications on the outcomes from this technique and also present our experience.Suprapubic catheter (SPC) insertion is a common method of bladder drainage in contemporary urological practice. The procedure involves insertion of a sharp trocar into the bladder percutaneously, usually by palpation, percussion or cystoscopy for guidance. Although generally considered a safe procedure, the risk of bowel injury is estimated at up to 2.4% with a mortality rate of 1.8%. Recently published British Association of Urological Surgeons (BAUS) guidelines have recommended that ultrasonography (US) may be helpful to identify bowel loops and recommends its usage whenever possible. The present paper describes the use of US for SPC insertion and discusses the implications of this advice. This paper is designed to support and supplement practical techniques learnt on a course and in clinical practice.
Electrophysiological evidence of altered memory processing in children experiencing early deprivation
Authors: Evren Güler O. , Hostinar Camelia E. , Frenn Kristin A. , Nelson Charles A. , Gunnar Megan R. , Thomas Kathleen M. 
Published: January 2012

AbstractAssociations between early deprivation and memory functioning were examined in 9‐ to 11‐year‐old children. Children who had experienced prolonged institutional care prior to adoption were compared to children who were adopted early from foster care and children reared in birth families. Measures included the Paired Associates Learning task from the Cambridge Neuropsychological Test and Automated Battery (CANTAB) and a continuous recognition memory task during which ERPs were also recorded. Children who experienced prolonged institutionalization showed deficits in both behavioral memory measures as well as an attenuated P300 parietal memory effect. Results implicate memory function as one of the domains that may be negatively influenced by early deprivation in the form of institutional care.
Cross‐contextual stability of bullying victimization: A person‐oriented analysis of cyber and traditional bullying experiences among adolescents
Authors: ERENTAITĖ RASA , BERGMAN LARS R. , ŽUKAUSKIENĖ RITA 
Published: January 2012

Erentaitė, R., Bergman, L. R. & Žukauskienė, R. (2012). Cross‐contextual stability of bullying victimization: A person‐oriented analysis of cyber and traditional bullying experiences among adolescents. Scandinavian Journal of Psychology 53, 181–190.Using a person‐oriented approach the study examined whether bullying victimization at school continued into cyberspace victimization in a large sample of high school students in Lithuania (N = 1667, 58% girls), age 15–19 (M = 17.29, SD = 0.95). Three forms of traditional bullying (verbal, physical and relational) and seven forms of cyberbullying victimization through cell phones and computers were included in the analysis. The findings revealed that 35% of traditional bullying victims were also bullied in cyberspace. In particular, adolescents who experienced predominantly verbal and relational bullying at school, showed a higher risk of victimization in cyberspace a year later, while this was not observed for predominantly physical forms of traditional bullying. The findings point to the importance of a cross‐contextual perspective in studies on stability of bullying victimization.
A Framework for Exploring the Policy Implications of UK Medical Tourism and International Patient Flows
Authors: Lunt Neil T. , Mannion Russell , Exworthy Mark 
Published: January 2012

AbstractIt is estimated that over 50,000 individuals from the UK each year elect to fund their own treatment abroad. Such treatments commonly include cosmetic and dental surgery; cardio, orthopaedic and bariatric surgery; IVF treatment; and organ and tissue transplantation. The UK has also experienced inward flows of patients who travel to receive treatment and pay out of pocket, being treated in both private and NHS facilities.The rise of ‘medical tourism’ presents new opportunities and challenges in terms of treatment options for consumers/patients and health policymakers. Such developments denote a commercialization, commodification and internationalization of health care in a way that UK policy has not experienced to date.This article addresses four key issues. We explain the rise of medical‐related travel (applied to the UK), identify key policy considerations for the future, highlight important research gaps and explore conceptual frameworks which might help us understand better the observed patterns of medical tourism. Whilst the context for policy and practice is undoubtedly dynamic, we argue the need for greater clarity in understanding the emergent implications for health policy and health care delivery.
A PASSIONATE BUDDHIST LIFE
Authors: McRae Emily 
Published: January 2012

ABSTRACTThis paper addresses the ways that we can understand and transform our strong emotions and how this project contributes to moral and spiritual development. To this end, I choose to think with two Tibetan Buddhist thinkers, both of whom take up the question of how passionate emotions can fit into spiritual and moral life: the famous, playful yogin Shabkar Tsodruk Rangdrol (1781–1851) and the wandering, charismatic master Patrul Rinpoche (1808–1887). Shabkar's The Autobiography of Shabkar provides excellent examples of using one's own passionate emotions to connect to others and gain insight into the world. Patrul Rinpoche's The Words of My Perfect Teacher (kun bzang bla ma'i zhal lung) focuses on passionate empathy with the emotions of others. Drawing on these texts, I present a (distinctly Buddhist) conception of a passionate life and argue that passionate emotional experience is a central part of moral and spiritual development more broadly construed.
MUSLIM IMAGINARIES AND IMAGINARY MUSLIMS: Placing Islam in Conversation with A Secular Age
Authors: Barre Elizabeth A. 
Published: January 2012

ABSTRACTThis essay begins by exploring the extent to which the narrative of secularization presented in Charles Taylor's A Secular Age might be complicated or otherwise challenged by taking account of parallel processes within Islamic thought and practice. It then considers whether Taylor's argument might nevertheless be applicable to, or illuminative of, contemporary struggles with modernity in the Muslim world.
Antiretroviral therapy prescribing in hospitalized HIV clinic patients
Authors: Rao N , Patel V , Grigoriu A , Kaushik P , Brizuela M 
Published: January 2012

ObjectivesAntiretroviral therapy (ART) medication prescribing errors in hospitalized patients still remain common. This study aimed to examine the initial prescribing of antiretroviral drug regimens for HIV clinic patients admitted to an urban academic teaching hospital.MethodsA retrospective chart review of all patients with a discharge diagnosis of HIV or AIDS was performed. Only patients actively managed by the hospital out‐patient HIV clinic at the time of discharge were included in the final analysis. We compared the ART initially prescribed during hospitalization with the clinic records. Medication errors were separated by type and the prescriber's area of specialty was noted.ResultsFrom 1 January 2009 to 31 December 2009, 90 admissions in 62 patients were included in the final analysis. In 47 of those admissions, the patient had an initial regimen considered to be incorrectly prescribed; in 17 of these 47 admissions, the patient was not prescribed any ART, and in the remainder the errors were related to drug omissions, incorrect frequency/dose, and prescription of the wrong drug. The majority of admissions were by an internal medicine or non‐infectious disease (ID) specialist. Average time to ART initiation was comparable among all prescribers. No statistically significant correlation was found between the number of admissions per patient or the prescriber's area of specialty and the percentage of incorrect regimens ordered.ConclusionHospital HIV medication management still remains an area of focus because of the complexity of regimens, poor medication reconciliation and limited non‐HIV/ID specialist knowledge.
Representativeness: A Tool to Structure Interest Intermediation in the European Union?
Authors: PÉREZ‐SOLÓRZANO BORRAGÁN NIEVES , SMISMANS STIJN 
Published: January 2012

AbstractThis article analyzes how the concept of ‘representativeness/representativity’ has been used by the European Union institutions to structure interest intermediation. It examines how the concept emerged and has been defined, and identifies its scope of application. ‘Representativeness’ is mostly used to refer to organizational features of the interest groups (organizational representativeness), but is occasionally used in relation to representative aspects of the overall system of interest representation (system representativeness). The focus is primarily on aspects of ‘descriptive representativeness’– in particular, territorial and thematic representativeness – rather than on ‘procedural representativeness’ that guarantees authorization and accountability. Originally applied to the social partners only, the White Paper on European Governance proposed to extend the use of representativeness to the wider category of civil society organizations. It will be shown that the application of the concept to these organizations proves more problematic than it does to the social partners. The European Transparency Initiative subsequently abandons representativeness, but it is argued that it contains the seeds for its re‐emergence.
Justifying Enlargement in a Multi‐level Polity: A Discursive Institutionalist Analysis of the Elites–Public Gap over European Union Enlargement*
Authors: HERRANZ‐SURRALLÉS ANNA 
Published: January 2012

AbstractIn view of the decreasing levels of public support for successive European Union enlargements, this article examines how political elites attempt to bridge this growing gap. Drawing insights from discursive institutionalism, the article undertakes a systematic analysis of an aspect that has been widely neglected in the existing literature on enlargement: the relation between the discursive interaction among policy‐makers at the EU level (co‐ordinative discourse) and direct political communication at the national level (communicative discourse). Focusing on the case of Germany, the article argues that debates on enlargement at the EU and national levels have been growing apart since the 1970s, and discusses the implications of this discursive gap for the public legitimization of past and future enlargements.