bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hypospadias: risk factor patterns and different phenotypes
Authors: Brouwers Marijn M. , Van Der Zanden Loes F.M. , De Gier Robert P.E. , Barten Evert J. , Zielhuis Gerhard A. , Feitz Wouter F.J. , Roeleveld Nel 
Published: September 2009

Study Type – Aetiologic (case‐referent) Level of Evidence 2aOBJECTIVETo obtain more insight into the origin of hypospadias by exploring a wide range of potential risk factors in a case‐referent study in which a distinction was made between different phenotypes.PATIENTS AND METHODSCases and referents were 305 boys with hypospadias and 629 boys with middle ear effusion whose parents completed postal questionnaires. Hypospadias phenotype was classified as distal (195 boys), middle (67), and proximal (43). Adjusted odds ratios (OR) with 95% confidence intervals (CI) were estimated using logistic regression.RESULTSLow birth weight, being a twin or triplet, mother being a diethylstilbestrol‐daughter, fertility treatments, paternal subfertility, obesity, prescriptive drug use, and familial occurrence of hypospadias or testicular cancer were associated with hypospadias in general. For familial occurrence of hypospadias, there were high risk estimates for the distal and middle phenotypes with an OR (95%CI) of 10.4 (4.5–24.1) and 9.0 (3.1–26.0), but not for the proximal type at 1.8 (0.2–14.9). By contrast, the association with low birth weight (a proxy for placental dysfunction) seemed much stronger for proximal hypospadias with an OR (95%CI) of 9.1 (3.4–24.2) compared with distal and middle hypospadias at 2.6 (1.4–5.0) and 2.3 (0.8–6.5). There were similar estimates for pre‐eclampsia.CONCLUSIONThese findings indicate aetiological heterogeneity of hypospadias and provide indications for the possible mechanisms through which specific risk factors may interfere with penile development.
The West Midlands Bladder Cancer Prognosis Programme: rationale and design
Authors: Zeegers Maurice P. , Bryan Richard T. , Langford Carolyn , Billingham Lucinda , Murray Paul , Deshmukh Neeta S. , Hussain Syed , James Nick , Wallace D. Michael A. , Cheng K.K. 
Published: September 2009

Study Type – Prognosis (inception cohort) Level of Evidence 1bOBJECTIVETo describe the rationale and design of the Bladder Cancer Prognosis Programme (BCPP), and to demonstrate the capability of this design.METHODSThere is a need to understand the determinants of bladder cancer to help reduce recurrence, progression, morbidity, mortality and related costs. We previously showed that lifestyle factors are important for determining the risk of bladder cancer, but little is known about their importance in determining the risk of recurrence or progression after diagnosis. Also, histopathological factors alone provide only crude prognostication; the analysis of molecular markers represents a method for refinement but research in this area has not been useful in informing therapeutic decisions or prognostication. The BCPP is a prospective longitudinal cohort study of all patients with newly diagnosed bladder cancer within the West Midlands (UK), investigating the influence of lifestyle factors on recurrence and progression, health‐related quality of life, the predictive effect of a panel of molecular markers on recurrence or progression, and the establishment of Europe’s largest comprehensive bladder cancer bio‐repository. It also incorporates the first randomized clinical trial on the efficacy of selenium and vitamin E on bladder cancer. The numbers and proportions of eligible patients recruited, questionnaires completed and specimens obtained were all recorded.RESULTSSince December 2005, 771 patients have been recruited (68% of eligible patients) and of these, 331 are currently being followed up by questionnaires. We have obtained blood, urine and tumour tissues from 92%, 80% and 80% of patients, respectively.CONCLUSIONSThe design of the BCPP has allowed this study to be incorporated into routine clinical work throughout the West Midlands, achieving high levels of recruitment, and data and specimen collection. This might represent a model for the future investigation of urological and other malignancies.
Abnormal protein expression in the corpus cavernosum impairs erectile function in type 2 diabetes
Authors: Chiou Wen‐Fei , Liu Hui‐Kang , Juan Chi‐Wen 
Published: September 2009

Study Type – Aetiology (case control) Level of Evidence 3bOBJECTIVETo investigate the changes in corporal relaxation, intracavernous pressure (ICP) and associated protein expression that control normal erectile function in rats with type 2 diabetes (T2D), as this disease is part of the ‘metabolic syndrome’ associated with a high rate of erectile dysfunction (ED) in men, resulting from failure of corpus cavernosum‐mediated processes.MATERIALS AND METHODST2D was induced in rats by feeding them with a high‐fat diet (HFD) followed by an injection with low‐dose streptozotocin (STZ); they were then compared with rats that received a normal diet (ND).RESULTSHyperglycaemia and dyslipidaemia were induced in HFD + STZ rats, suggesting that T2D was established. The rats with T2D had associated ED, as both nonadrenergic noncholinergic‐mediated corporal relaxation and increased ICP by cavernous nerve stimulation were significantly attenuated compared to the ND group. Western blot analysis revealed diabetes‐associated lower expression of endothelial and neuronal nitric oxide synthase (e and nNOS), and cGMP‐dependent protein kinase (PKG)‐1α/β expression in penile tissue than in the ND group. Contrary to the proteins that regulate corporal relaxation, there were relatively high levels of RhoA/Rho kinase receptor 1 (ROCK1) and ET‐A receptor (ETAR) in T2D rats. However, the expressed level of phosphodiesterase‐5 and insulin‐like growth factor binding protein 3 was not altered significantly in response to T2D.CONCLUSIONDecreased expression of certain proteins that mediate the relaxant mechanism, associated with increased expression of certain proteins that mediate contractile mechanisms, might be important in the development of T2D‐associated ED. In particular, down‐regulated eNOS/nNOS/PKG1 as well as up‐regulated ETAR/RhoA/ROCK1 might participate in the aetiology of ED in T2D.
Serum testosterone is associated with aggressive prostate cancer in older men: results from the Baltimore Longitudinal Study of Aging
Authors: Pierorazio Phillip M. , Ferrucci Luigi , Kettermann Anna , Longo Dan L. , Metter E. Jeffrey , Carter H. Ballentine 
Published: September 2009

Study Type – Prognosis (inception cohort) Level of Evidence 1bOBJECTIVETo evaluate the relationship between testosterone levels and the development of high‐risk prostate cancer, by prospectively examining serum androgen concentrations in a well‐studied cohort, as the role of testosterone in prostate cancer progression is debated.PATIENTS AND METHODSThe study comprised 781 men in the Baltimore Longitudinal Study of Aging who had sex steroid measurements before a diagnosis of prostate cancer, or at their last visit for those without cancer (no cancer, 636; cancer, not high risk, 109; cancer, high risk, 36). High‐risk cancer was defined as death from prostate cancer, a prostate specific antigen (PSA) level of ≥20 ng/mL at diagnosis, or a Gleason score of ≥8. The hazard ratio (HR) of high‐risk disease was determined using a Cox proportional hazards regression model with simple updating, and risk rates were stratified by age and tercile for androgens of interest based on the proportional hazards analyses.RESULTSThe likelihood of high‐risk prostate cancer doubled per unit (0.1) increase in the free testosterone index (FTI) for patients aged >65 years (HR 2.07, 95% confidence interval, CI, 1.01–4.23; P = 0.047); the likelihood for men aged ≤65 years was inversely related to the FTI (HR 0.96, 95% CI 0.35–2.6; P = 0.9). The risk rate per person‐years increased from lowest to highest tercile of FTI for the oldest men (age >70 years) but this trend was not apparent among younger men.CONCLUSIONHigher levels of serum free testosterone are associated with an increased risk of aggressive prostate cancer among older men. These data highlight the importance of prospective trials to insure the safety of testosterone‐replacement therapy.
Structural analysis of the corpora cavernosa in patients with ischaemic priapism
Authors: Costa Waldemar S. , Felix Bruno , Cavalcanti Andre G. , Medeiros Jr Jorge , Sampaio Francisco J. 
Published: September 2009

Study Type – Therapy (case series) Level of Evidence 4OBJECTIVETo evaluate, using quantitative and qualitative methods, the changes in the corpora cavernosa of patients with ischaemic priapism.PATIENTS AND METHODSWe obtained samples of corpora cavernosa from seven patients with ischaemic priapism (mean age 38 years, range 28–44) who had a cavernous‐glandular shunt. The control tissues were fragments of corpora cavernosa obtained from autopsies of seven age‐matched men who died from causes unrelated to the urogenital tract. Histochemical and immunohistochemical techniques were used to assess and quantify the extracellular matrix and smooth muscle fibres. The volumetric density of smooth muscle, elastic fibres and collagen were determined in corpora cavernosa.RESULTSFrom the stereological analysis the mean (sd) values of volumetric density were: for collagen, control 34.76 (4.64), priapism 39.64 (2.91) (P = 0.002); elastic system fibres, controls 28.10 (2.85), priapism 36.10 (3.06) (P = 0.001); smooth muscle fibres, controls 43.37 (4.96), priapism 26.48 (5.00) (P < 0.001). There were significantly more fibrous elements of the connective tissue and significantly fewer smooth muscle fibres in the corpora cavernosa of patients with ischaemic priapism than in controls.CONCLUSIONIschaemic priapism is associated with early and significant changes in the components of the extracellular matrix and smooth muscle fibres of the corpora cavernosa. This could explain the frequent occurrence of erectile dysfunction found in patients with ischaemic priapism.
Retroperitoneoscopic partial adrenalectomy for small adrenal tumours (≤1 cm): the Ruijin clinical experience in 88 patients
Authors: Wang Xiao‐jing , Shen Zhou‐jun , Zhu Yu , Zhang Rong‐ming , Shun Fu‐kang , Shao Yuan , Rui Wen‐bin , He Wei 
Published: September 2009

Study Type – Therapy (case series) Level of Evidence 4OBJECTIVETo present our experience of retroperitoneoscopic partial adrenalectomy (RPA) for small adrenal tumours, as with modern imaging methods small adrenal lesions are being diagnosed more commonly, and retroperitoneoscopic adrenal surgery for small adrenal tumours (≤1 cm) can be challenging.PATIENTS AND METHODSWe retrospectively reviewed the records of 389 consecutive retroperitoneoscopic adrenalectomies from September 2005 to December 2008, 88 of which were small adrenal tumours and treated by RPA. Ultrasonography and computed tomography (CT) were used in all patients before RPA, and magnetic resonance imaging or positron emission tomography/CT in some patients. We used RPA for adrenal tumours and total adrenalectomy for adrenal cancer. During the surgery, the internal part of the adrenal gland close to the retroperitoneum was freed first, and the whole adrenal tissue was dissected completely. The preoperative imaging was important in these procedures.RESULTSThere were no deaths; conversions to open surgery were necessary in four patients (4.5%), the reasons being a missing target in two, massive haemorrhage caused by central adrenal vein injury in one, and severe adhesion in one. The mean (range) size of the adrenal tumours was 0.7 (0.5–1.0) cm, including 69 aldosterone‐producing adenomas, 11 nonfunctional adrenal adenomas, three Cushing syndrome, two phaeochromocytomas, two myelolipomas and one melanoma. The operative duration in the initial 38 cases was significantly longer than that in the subsequent 50 (P < 0.01). However, there was no significant correlation between estimated blood loss and the number of procedures. Tumour size did not correlate with estimated blood loss and operative duration. There was no significant correlation between body mass index and operative duration.CONCLUSIONRPA is a safe, effective and minimally invasive therapeutic option for patients with small adrenal tumours. With improved operative technique the RPA has been completed in more quickly. Freeing the internal part of the adrenal gland close to the retroperitoneum first, and exploring the whole adrenal tissue during surgery are the key points of RPA. The location of the small adrenal tumour can be different from that shown on imaging before surgery, and the abnormality of the adrenal gland should be considered.
Renal cell carcinoma with retro‐aortic renal vein thrombus: a case series
Authors: Marsh Howard , Cranston David , Sullivan Mark 
Published: September 2009

Study Type – Therapy (case series) Level of Evidence 4OBJECTIVETo present three cases of tumour thrombus in the retro‐aortic renal vein (RARV) arising from left renal cell carcinomas (RCCs), a very rare event (<1:1000–2000 per case) and to discuss the embryological, radiological and surgical aspects of this anomaly.PATIENTS AND METHODSThree cases of RCC with RARV thrombus presented in a 1‐month period at one institution.RESULTSAll three cases were identified before surgery by computed tomography (CT) urograms and had a successful nephrectomy.CONCLUSIONRCC in the presence of RARVs is rare but can be identified on CT urogram. At nephrectomy, a midline laparotomy or full ‘rooftop incision’ is recommended, and any attempt to mobilize the kidney before dealing with the renal pedicle should be avoided.
The Informational Value of Incumbency
Authors: BEVIÁ CARMEN , LLAVADOR HUMBERTO 
Published: September 2009

AbstractThis paper exploits the informational value of incumbency: incumbency confers voters information about governing politicians not available from challengers. We propose a measure of incumbency advantage that improves the use of pure reelection success. We also study the relationship between incumbency advantage, ideological bias, and terms in office. Our argument emphasizes that incumbency affects candidates' chances of winning even if they had no opportunity to strategically utilize policies.
Tournaments of Weakly Heterogeneous Players
Authors: RYVKIN DMITRY 
Published: September 2009

AbstractWe consider three prominent tournament formats—contests, binary elimination tournaments, and round‐robin tournaments—in the case when players are heterogeneous in their abilities but the heterogeneity is, in a well‐defined sense, weak. Using linear approximation, we characterize equilibrium strategies and payoffs in the three tournament games and compare them to the benchmark symmetric case of identical players. We describe small deviations from the symmetric equilibria by elasticities of a player's equilibrium effort with respect to her own ability and the abilities of her rivals. Our results only require general symmetry and smoothness assumptions but not specific functional forms for the probabilities of winning in tournaments. We show that, in equilibrium: (i) a player's effort and payoff depend on her rivals' abilities in a model‐independent way, either through the average ability of the field (for static games), or through the properly discounted average ability of the field (for dynamic elimination tournaments); (ii) players respond stronger to changes in their own relative abilities than to changes in their rivals' relative abilities; (iii) aggregate effort (dissipated rent) does not change compared to the benchmark case; (iv) it is not possible to manipulate aggregate effort through seeding in binary elimination tournaments, although optimal seeding schemes for other purposes can be identified; and (v) balanced seeding and a uniform distribution of relative abilities cancel out the dependence of a player's effort on her rivals' abilities in binary elimination tournaments.
Towards a combined prognostic index for survival in HIV infection: the role of ‘non‐HIV’ biomarkers
Authors: Justice AC , McGinnis KA , Skanderson M , Chang CC , Gibert CL , Goetz MB , Rimland D , Rodriguez‐Barradas MC , Oursler KK , Brown ST , Braithwaite RS , May M , Covinsky KE , Roberts MS , Fultz SL , Bryant KJ ,   for the VACS Project Team
Published: September 2009

BackgroundAs those with HIV infection live longer, ‘non‐AIDS’ condition associated with immunodeficiency and chronic inflammation are more common. We ask whether ‘non‐HIV’ biomarkers improve differentiation of mortality risk among individuals initiating combination antiretroviral therapy (cART).MethodsUsing Poisson models, we analysed data from the Veterans Aging Cohort Study (VACS) on HIV‐infected veterans initiating cART between 1 January 1997 and 1 August 2002. Measurements included: HIV biomarkers (CD4 cell count, HIV RNA and AIDS‐defining conditions); ‘non‐HIV’ biomarkers (haemoglobin, transaminases, platelets, creatinine, and hepatitis B and C serology); substance abuse or dependence (alcohol or drug); and age. Outcome was all cause mortality. We tested the discrimination (C statistics) of each biomarker group alone and in combination in development and validation data sets, over a range of survival intervals, and adjusting for missing data.ResultsOf veterans initiating cART, 9784 (72%) had complete data. Of these, 2566 died. Subjects were middle‐aged (median age 45 years), mainly male (98%) and predominantly black (51%). HIV and ‘non‐HIV’ markers were associated with each other (P<0.0001) and discriminated mortality (C statistics 0.68–0.73); when combined, discrimination improved (P<0.0001). Discrimination for the VACS Index was greater for shorter survival intervals [30‐day C statistic 0.86, 95% confidence interval (CI) 0.80–0.91], but good for intervals of up to 8 years (C statistic 0.73, 95% CI 0.72–0.74). Results were robust to adjustment for missing data.ConclusionsWhen added to HIV biomarkers, ‘non‐HIV’ biomarkers improve differentiation of mortality. When evaluated over similar intervals, the VACS Index discriminates as well as other established indices. After further validation, the VACS Index may provide a useful, integrated risk assessment for management and research.
The State and Marginality: Reflections on Urban Outcasts from China's Urban Transition
Authors: WU FULONG 
Published: September 2009

AbstractThis essay reflects on four structural logics of poverty generation, developed in Urban Outcasts. These are the logics of macro‐social, economic, political and spatial dynamics. Considering the Chinese context, the essay suggests that, rather than being isolated from mainstream production, the Chinese urban poor are engaged in global commodity production. While no obvious ghettos have been so far identified in Chinese cities, there are spatial concentrations of the poor in particular neighbourhoods. This spatial concentration is related to state institutions before and after economic reform. Throughout the process of poverty generation, the role of the state is prominent, as highlighted in Wacquant's research on American and French cities. I argue that the role of the state is complex, not just penal. One significant contribution of Wacquant's book is that it reveals important differences between French banlieues and American ghettoes, thus highlighting the need to examine place‐specific regimes of marginality. As for ‘advanced’ marginality, Wacquant emphasizes its structural causes, which are particularly relevant to China's urban transition. In China, we can also identify the ‘advanced’ stage of suppressing the poor in the process of urban change.Résumé Cet essai s'intéresse à quatre logiques structurelles de génération de la pauvreté, présentées dans Urban Outcasts (Parias urbains): les logiques des dynamiques macro‐sociale, économique, politique et spatiale. S'attachant au contexte chinois, l'essai suggère que, loin d'être isolés de l'activité de production dominante, les pauvres des villes chinoises participent à la production de biens mondiale. Jusqu'à présent, aucun cas manifeste de ghetto urbain n'a été identifié en Chine, même s'il existe des concentrations spatiales de pauvres dans certains quartiers. Cette concentration spatiale est liée aux institutions étatiques, avant et après la réforme économique. Au cours du processus générateur de pauvreté, le rôle de l'État est déterminant, comme l'ont souligné les travaux de Wacquant sur des villes américaines et françaises. À mon avis, le rôle de l'État est complexe, pas seulement pénal. L'un des apports appréciables du livre de Wacquant tient à ce qu'il révèle les différences notables entre les ‘banlieues’ françaises et les ghettos américains, mettant ainsi en avant la nécessité d'examiner les systèmes de marginalité en fonction du lieu. Quant à la marginalité‘avancée’, l'auteur insiste sur ses causes structurelles, lesquelles sont particulièrement pertinentes pour la période de transition urbaine chinoise. En Chine, on peut aussi identifier le stade ‘avancé’ d'élimination des pauvres dans le processus de transformation des villes.
Space Matters — Marginalization and Its Places
Authors: DANGSCHAT JENS S. 
Published: September 2009

AbstractAnalysing the social situation of hyperghettos in Chicago and the banlieues in Paris, Loïc Wacquant goes far beyond the empirical comparison by detecting the underlying logics of social polarization. Thus, he contends that each society produces its own social inequalities through its respective power relations and that place matters for social exclusion processes. This fact, however, should not be analysed simply by structural factors. Therefore, a theory of space is needed by which it is possible to explain the inner logics of socio‐spatial exclusion. Following the theory of the self‐recruiting of the upper classes by Pierre Bourdieu (the structure–habitus–practise reproduction formula) this theory has to connect the macro level (market economy, neoliberal regulation, the production of images, goals and attitudes towards social justice, etc.) which explains the logics of regulation and class composition, the meso level (territories and places with their own logics, social structures and social relations in networks — bridging or bonding) and the micro level (with its subjective constructions of realities and everyday behaviour). The commentary concludes with the question why critical books like Urban Outcasts are so rare and argues that the ‘economy of awareness’ is negatively impacting on the scientific community.Résumé Dans Urban Outcasts (Parias urbains), analyser la situation sociale des hyperghettos de Chicago et des ‘banlieues’ de Paris conduit Loïc Wacquant au‐delà de la comparaison empirique en détectant la logique sous‐jacente de la polarisation sociale. En conséquence, il affirme que chaque société produit ses propres inégalités sociales au travers des relations de pouvoir en place, et que le lieu joue un rôle dans les processus d'exclusion sociale. Néanmoins, ce fait ne devrait pas être analysé uniquement selon des facteurs structuraux. Il faut donc une théorie de l'espace permettant d'expliquer la logique interne de l'exclusion socio‐spatiale. Partant de la théorie de Pierre Bourdieu sur l'auto‐recrutement des classes supérieures (formule de reproduction: structure, habitus, pratique), cette théorie doit relier trois niveaux: le niveau macro (économie de marché, régulation néolibérale, production d'images, objectifs et attitudes en faveur de la justice sociale, etc.) qui explique la logique de la régulation et de la composition des classes; le niveau méso (territoires et lieux ayant chacun leur logique, leurs structures sociales et leurs réseaux de relations sociales, qu'ils soient bonding ou bridging); le niveau micro (avec ses interprétations subjectives des réalités et du comportement au quotidien). En conclusion, le commentaire se demande pourquoi les livres critiques comme Urban Outcasts sont aussi rares et préconise que ‘l'économie de l'attention’ a un impact négatif sur la communauté scientifique.