bluuebunny/crossref_metadata_2025_split huggingface dataset:
Superficial bladder cancer: the response of a marker tumour to a single intravesical instillation of epirubicin
Authors: POPERT R. J. M. , GOODALL J. , COPTCOAT M. J. , THOMPSON P. M. , PARMAR M. K. B. , MASTERS J. R. W. 
Published: November 2008

Objective To determine the response of a marker tumour to a single instillation of intravesical epirubicin.Patients and methods Eighty‐one patients (54 men, 27 women) with a mean age of 69.3 years (range 36–92) with superficial bladder cancer were randomized to receive a single instillation of intravesical epirubicin. At the initial cystoscopy all but one papillary marker tumour was resected. Subsequently the patients were a randomized to receive either intravesical epirubicin at a concentration of 1 mg/ml (n=40) or 2 mg/ml (n=41) in 50 ml of saline for 1h. THe response of the marker tumour was determined at 3 months (first check cystoscopy). The toxicity associated with both treatments was also recorded.Results A complete response (no visible or microscopic bladder carcinoma) was observed in 46% (95% confidence interval (CI) 35–57%) of a patients. No patient experienced systemic side‐effects. Chemical cystitis and bladder irritability were the most frequent local sideeffects, occurring in 15% (95% CI 8 ‐ 24%) of the patients.Conclusions A single instillation of intravesical epirubicin has a demonstrable effect in superficial bladder cancer. The results compare farvourably with more onerous regimes. Side‐effects were minimal at 1 mg/ml and acceptable at 2 mg/ml.
Procoagulant properties of benign and malignant prostatic tissue
Authors: ADAMSON A. S. , FRANCIS J. L. , WITHEROW R. O'N. , SNELL M. E. 
Published: November 2008

Objective To determine the factor‐X activating procoagulant activity (FXAA) of prostatic tissue removed at transurethral resection in a specific chromogenic assay.Patients and methods FXAA was extracted from transurethrally resected prostatic tissue using a cryofragmentation technique. Tissue from 50 patients with prostate cancer was analysed and compared with that from 36 control patients with benign prostatic‐hypertrophy. Enzyme activities were assayed in a two stage chromogenic assay and correlated with conventional markers of tumour aggressiveness.Results FXAA was found to be significantly lower (P <0.001) in tissue from malignant prostates compared with benign prostatic hypertrophy tissue. Loss Of FXAA was also related to Gleason grade (P <0.03), percentage of chips involved by tumour (P <0.04) and bone scan status (P <0.02). Using antibody inhibition tests this procoagulant was characterized as being a factor VII/tissue factor complex.Conclusions Malignant change in the prostate is associated with a reduction in FXAA and this may be an important factor in prostatic tumour growth anddissemination.
Percentage area density of epithelial and mesenchymal components in benign prostatic hyperplasia: comparison of results between single biopsy, multiple biopsies and multiple tissue specimens
Authors: Robert M. , Costa P. , Bressollef F. , Mottet N. , Navratil H. 
Published: November 2008

Objective To determine whether histological analysis of six multiple random biopsies of the gland or analysis of only one biopsy provides a good estimate of the different components of the hyperplastic gland compared with the results obtained from tissue specimens {reference values). Materials and methods The various components of prostate tissue obtained from 30 men undergoing suprapu‐bic adenomectomy were investigated. The histological analysis was performed on multiple tissue specimens reflecting adenoma (reference values) and on one and six biopsies performed at random on the enucleated material of the hyperplastic gland. Immunohisto chemistry using anti‐actin as a label of smooth muscle and specific histological staining coupled with computer‐assisted quantitative morphometric analysis was used to ascertain the histological composition of the prostate. Results The mean (±SD) area densities obtained from tissue specimens were 34.1 ±5%, 32.4 ± 6.9%, 17.6 ±4.5% and 15.9 ±5.5% of smooth muscular and fibrous tissue, and epithelium and glandular lumen, respectively. The mean ratio of stromal to epithelial hyperplasia averaged 4.05 ± 1.73. Both one and six biopsies gave a good estimate of fibrous tissue and glandular epithelium, but the percentage of smooth muscle was overestimated and the percentage of glandular lumen was underestimated. There was a significant relation between the prostate area densities of glandular epithelium (r=‐0.41, P<0.05), the percentage area density of prostate smooth muscle (r=0.43, P<0.05), and the weight of enucleated adenoma. No correlation was found with prostate‐specific antigen (PSA). Conclusion It seems feasible to propose medical treatment of benign prostatic hyperplasia (BPH) based on the histological composition of the prostate gland. One biopsy, reflecting in good proportions the nature of the adenoma, would be used to provide insight into the pathogenesis and therapy of BPH.
Treatment of penile curvature — a retrospective study of 175 patients operated with plication of the tunica albuginea or with the Nesbit procedure
Authors: Poulsen J. , Kirkeby H.J. 
Published: November 2008

Objective To evaluate the outcome and complications after operative correction of sexually disabling penile angulation. Patients and methods Between January 1 1987 and December 31 1991,175 patients underwent operative correction of penile angulation due to Peyronie's disease (57 patients) or congenital curvature (118 patients). Thirty two patients were treated by plication of the tunica albuginea and 143 by the Nesbit procedure. Post‐operatively 91% of the patients were seen in the out‐patient clinic after 3–5 months. A questionnaire sent to all patients 6–60 months after surgery was returned by 74% of the patients, and the present Results are based on the most recent information obtained. Results In the plication group good or acceptable results were obtained in 12 of 32 patients (38%) after the first operation, and in a further nine patients (22%) after a second operation. In the Nesbit group 126 of 143 patients (88%) obtained good or acceptable Results after the first operation and a further seven patients (5%) reported success after a second operation. The failures in the Nesbit group were due mainly to post‐operative erectile dysfunction in patients with Peyronie's disease, in contrast to the plication group where failures were primarily due to recurrence of angulation. Conclusion Operative correction of penile curvature is a reasonably safe procedure, but should not be performed solely for cosmetic reasons. In the present retrospective study the results were better after the Nesbit procedure compared with plication of the tunica albuginea. However, a review of the literature does not give support to one operative technique over the other. This can only be clarified by performing a prospective randomized trial.
The role of tobacco in penile carcinoma
Authors: Harish K. , Ravi R. 
Published: November 2008

Objective To study the role of tobacco in squamous cell carcinoma of the penis. Subjects and methods The use of tobacco in the form of cigarettes, chewing tobacco and snuff was studied in a total of 503 patients and age‐matched controls. Results By multivariate analysis, a significant association was found between smoking (P= 0.002) or chewing tobacco (P< 0.001) and the use of snuff (P= 0.004) in patients with penile carcinoma as compared with controls. A dose‐response relationship was observed for both smoking and chewing. Conclusions The use of tobacco is a significant risk factor for penile carcinoma, and the use of more than one form of tobacco increases this risk.
Local Access to Care Programs (LACPs): New Developments in the Access to Care for the Uninsured
Authors: BLEWETT LYNN A. , ZIEGENFUSS JEANETTE , DAVERN MICHAEL E. 
Published: November 2008

Context: New, locally based health care access programs are emerging in response to the growing number of uninsured, providing an alternative to health insurance and traditional safety net providers. Although these programs have been largely overlooked in health services research and health policy, they are becoming an important local supplement to the historically overburdened safety net. Methods: This article is based on a literature review, Internet search, and key actor interviews to document programs in the United States, using a typology to classify the programs and document key characteristics. Findings: Local access to care programs (LACPs) fall outside traditional private and publicly subsidized insurance programs. They have a formal enrollment process, eligibility determination, and enrollment fees that give enrollees access to a network of providers that have agreed to offer free or reduced‐price health care services. The forty‐seven LACPs documented in this article were categorized into four general models: three‐share programs, national‐provider networks, county‐based indigent care, and local provider–based programs. Conclusions: New, locally based health access programs are being developed to meet the health care needs of the growing number of uninsured adults. These programs offer an alternative to traditional health insurance and build on the tradition of county‐based care for the indigent. It is important that these locally based, alternative paths to health care services be documented and monitored, as the number of uninsured adults is continuing to grow and these programs are becoming a larger component of the U.S. health care safety net.
What Ever Happened to N‐of‐1 Trials? Insiders' Perspectives and a Look to the Future
Authors: KRAVITZ RICHARD L. , DUAN NAIHUA , NIEDZINSKI EDMUND J. , HAY M. CAMERON , SUBRAMANIAN SASKIA K. , WEISNER THOMAS S. 
Published: November 2008

Context:When feasible, randomized, blinded single‐patient (n‐of‐1) trials are uniquely capable of establishing the best treatment in an individual patient. Despite early enthusiasm, by the turn of the twenty‐first century, few academic centers were conducting n‐of‐1 trials on a regular basis.Methods:The authors reviewed the literature and conducted in‐depth telephone interviews with leaders in the n‐of‐1 trial movement.Findings:N‐of‐1 trials can improve care by increasing therapeutic precision. However, they have not been widely adopted, in part because physicians do not sufficiently value the reduction in uncertainty they yield weighed against the inconvenience they impose. Limited evidence suggests that patients may be receptive to n‐of‐1 trials once they understand the benefits.Conclusions:N‐of‐1 trials offer a unique opportunity to individualize clinical care and enrich clinical research. While ongoing changes in drug discovery, manufacture, and marketing may ultimately spur pharmaceutical makers and health care payers to support n‐of‐1 trials, at present the most promising resuscitation strategy is stripping n‐of‐1 trials to their essentials and marketing them directly to patients. In order to optimize statistical inference from these trials, empirical Bayes methods can be used to combine individual patient data with aggregate data from comparable patients.
The Relative Merits of Population‐Based and Targeted Prevention Strategies
Authors: ZULMAN DONNA M. , VIJAN SANDEEP , OMENN GILBERT S. , HAYWARD RODNEY A. 
Published: November 2008

Context: Preventive medicine has historically favored reducing a risk factor by a small amount in the entire population rather than by a large amount in high‐risk individuals. The use of multivariable risk prediction tools, however, may affect the relative merits of this strategy. Methods: This study uses risk factor data from the National Health and Nutrition Examination Survey III to simulate a population of more than 100 million Americans aged thirty or older with no history of CV disease. Three strategies that could affect CV events, CV mortality, and quality‐adjusted life years were examined: (1) a population‐based strategy that treats all individuals with a low‐ or moderate‐intensity intervention (in which the low‐intensity intervention represents a public health campaign with no demonstrable adverse effects), (2) a targeted strategy that treats individuals in the top 25 percent based on a single risk factor (LDL), and (3) a risk‐targeted strategy that treats individuals in the top 25 percent based on overall CV risk (as predicted by a multivariable prediction tool). The efficiency of each strategy was compared while varying the intervention's intensity and associated adverse effects, and the accuracy of the risk prediction tool. Findings: The LDL‐targeted strategy and the low‐intensity population‐based strategy were comparable for CV events prevented over five years (0.79 million and 0.75 million, respectively), as were the risk‐targeted strategy and moderate‐intensity population‐based strategy (1.56 million and 1.87 million, respectively). The risk‐targeted strategy, however, was more efficient than the moderate‐intensity population‐based strategy (number needed to treat [NNT] 19 vs. 62). Incorporating a small degree of treatment‐related adverse effects greatly magnified the relative advantages of the risk‐targeted approach over other strategies. Reducing the accuracy of the prediction tool only modestly decreased this greater efficiency. Conclusions: A population‐based prevention strategy can be an excellent option if an intervention has almost no adverse effects. But if the intervention has even a small degree of disutility, a targeted approach using multivariable risk prediction can prevent more morbidity and mortality while treating many fewer people.
Algorithm for determining optimum sequestration depth of CO2 trapped by residual gas and solubility trapping mechanisms in a deep saline formation
Authors: LIN C. K. 
Published: November 2008

AbstractAn algorithm is proposed here for determining the optimum sequestration depth (in terms of depth corresponding to maximum net income per unit rock volume) in a saline formation for CO2 trapped by residual gas and solubility trapping mechanisms. The Peng–Robinson equation of state was used to determine the density and fugacity of sequestered CO2 and the compression energy required for CO2 injection. Geochemist’s Workbench®, a commercial geochemical software package, was used to estimate CO2 solubility in groundwater. Operational costs and CO2 emissions due to compression energy consumption were estimated. A hypothetical reference case was constructed to illustrate the proposed algorithm, assuming constant values of geothermal gradient, hydrostatic pressure gradient, sweep efficiency and initial groundwater chemistry, with a depth‐dependent porosity and porosity‐dependent saturation of residual gas. In general, the algorithm was illustrated successfully for the hypothetical reference case and produced the following results. The depth corresponding to maximum trapping capacity was approximately 3000 m, but the depth representing maximum net income was approximately 1300 m. CO2 emissions due to compression energy consumption per unit mass of CO2 sequestration cannot be ignored, but may be <0.15, even down to a depth of 7000 m. Both the trapping capacity and net income of CO2 sequestration decreased with geothermal gradient, but the corresponding optimum depths increased with geothermal gradient.
Effects of changes in reservoir thermodynamic conditions on 222Rn composition of discharged fluids: study for two wells at Los Azufres geothermal field (Mexico)
Authors: BARRAGÁN R. M. , ARELLANO V. M. , PORTUGAL E. , SEGOVIA N. 
Published: November 2008

Abstract 222Rn anomalies that occurred at the time of the 19 September 1985 M8.1 Michoacan, Mexico, earthquake in fluids from two wells of Los Azufres, geothermal field were studied considering (i) the changes in well‐bottom thermodynamic conditions (pressure, enthalpy and steam/water ratio) and (ii) the discharged mass flow rates. In the studied steam well the anomalously high 222Rn concentration (as compared with background data) was observed on 11 September and was due to an important compressive process, which formed two‐phase fluids at reservoir, where usually single steam occurred. This caused the increase in 222Rn, as it remained in the steam. The compressive process was partially induced by changes in the production conditions at wellhead (because a well test was being developed) when sampling, but it was also seismic‐induced, as similar 222Rn anomalies were observed in other steam wells for which stable conditions at sampling were maintained. Another case is given for a two‐phase well where anomalously low 222Rn values (compared to background data) were recorded in September–October 1985. As stable conditions were maintained during sampling (1983–1986), 222Rn data were correlated to ?twb> the total mass flow rates produced by the well. Results suggested that the well produced two types of liquid–steam mixtures with a common end‐member regarding the liquid, but implying two ‘end‐member’ fluids with different 222Rn contents. The most 222Rn enriched end‐member was regarded as the original reservoir steam while that with relatively lower 222Rn concentration was stated as likely constituted by a mixture of reservoir and reinjection fluids. From the linear correlations, 222Rn contents for both end‐members were estimated while the 222Rn composition of the reservoir liquid feeding the studied well was estimated to be negligible compared to steam from the intersection of both curves. As one anomalously low 222Rn value was measured for a sample collected on the 12 September 1985, it seemed that a seismic‐induced process increased the reservoir permeability just before the earthquake allowing the liquid to reach the production zones of some two‐phase wells. This interpretation was supported by the behaviour of gas species (CO2 and N2) and δD in the two‐phase well studied and injection mass flow rates in one probably‐related reinjection well.
Genetic Structure of Threatened Native Populations and Propagules Used for Restoration in a Clonal Species, American Beachgrass (Ammophila breviligulataFern.)
Authors: Fant Jeremie B. , Holmstrom Rebecca M. , Sirkin Eileen , Etterson Julie R. , Masi Susanne 
Published: November 2008

AbstractAn important goal of native plant restorations was to reconstitute populations that are genetically similar to native ones, thereby increasing the probably of successful establishment and persistence. We examined the extent to which this goal has been accomplished in Great Lakes restorations ofAmmophila breviligulataFern., a beachgrass species that is widely used for habitat restoration and is considered threatened in the study areas. In parallel studies on Lake Michigan and Lake Superior, we used polymorphic Intersimple Sequence Repeat markers to assess genetic similarity between well‐established and new native populations, restored populations, and restoration propagules obtained from two commercial suppliers. Native populations were generally more diverse than expected for a clonal species, whereas the commercially cultivated releases were monotypic. One of the commercial releases used in Minnesota was exclusively found in restored populations and did not occur in any other native population at this site. The propagules used in the newly planted restoration in Illinois were derived from a release that commercial suppliers maintain was derived from a native Michigan population, as opposed to a selected release. Diversity in this restoration was equivalent to that native Illinois’ populations; however, many of the genotypes were not of local origin. Overall, study underscores the importance of obtaining baseline genetic surveys of remnant native populations and restoration propagules before restoration efforts are initiated, especially when the populations are threatened or endangered.
Differences in Belowground Heterogeneity Within a Restoration of a Dewatered Reservoir in Southwestern Wisconsin
Authors: Wells Ana J. , Balster Nick J. , VanWychen Stefanie , Harrington John 
Published: November 2008

Abstract Integrating belowground properties into ecological restoration is critical for understanding aboveground response. We investigated a recently dewatered basin in southwestern Wisconsin to test hypotheses related to the magnitude, heterogeneity, and spatial dependence of physicochemical properties between sediments and buried soils. A spatial grid was established in a 2.4‐ha basin to sample 7 physical and 13 chemical properties. Sediment depth (Sd) averaged 43 cm (std dev = 15) across the study area. The mean bulk density (BD) of the buried soils (1.41 g/cm3) was significantly greater than the sediments (0.97 g/cm3), which corresponded with a significantly higher soil moisture content (SMC) and hydraulic conductivity (Ks) of the sediments. Relative to one another, buried soils had significantly higher concentrations of Bray P, Cu, and Mn, whereas sediments had higher concentrations of Bray K, K, total phosphorus, Na, S, Al, and Ca and thus had a higher pH; Fe and B concentrations were similar between the sediments and the buried soil. Sediments were consistently less spatially heterogeneous than the buried soils. Using geostatistics, sediment BD and SMC displayed both small‐scale spatial structures and large‐scale trends, whereas Sd and the buried soil SMC displayed only small‐scale variability. Distance from the former dam was positively related to nine physicochemical properties and negatively related to only S, SMC, and the percentage of clay; no trends were found in the buried soils. These results demonstrate that damming, inundation, and dewatering due to dam removal yielded a spatially distinct and homogenized substrate relative to the soils that were buried.
Prairie Wolf Slough Wetlands Demonstration Project: A Case Study Illustrating the Need for Incorporating Soil and Water Quality Assessment in Wetland Restoration Planning, Design and Monitoring
Authors: Montgomery James A. , Eames J. Marshall 
Published: November 2008

Abstract In northeastern Illinois, restored wetlands are used to improve water quality in streams degraded by agriculture and urban development. Using freshwater wetlands to reduce nitrogen loading to lakes and rivers is well documented; however, there are fewer studies addressing their use to remove phosphorous. In 1998, a systematic water quality monitoring project was begun at Prairie Wolf Slough Wetland Demonstration Project, a restored palustrine emergent marsh wetland located on an abandoned farm field north of Chicago. The wetland drains 98 ha of mixed land uses into the Chicago River. Our objectives were to assess spatial and temporal variations in total suspended solids, soluble reactive and total phosphorous concentrations, and mass loadings and compute a mass balance and retention efficiency for these constituents. Water sampling was conducted from 1998 to 2003. In 2004, soil samples were collected from the marsh and an adjacent abandoned farm site and analyzed for soil test (Bray) phosphorus. The marsh effectively traps suspended solids but acts as a source of soluble reactive and total phosphorous to the river both during the growing and nongrowing seasons. Net export of phosphorous from the wetland was likely due to mobilization of orthophosphate as a result of anoxic conditions produced during inundation events. Often little consideration is given to the link between soil and water quality when locating restoration sites. Our study adds to a growing body of literature that clearly demonstrates the need for both soil and water quality assessments in wetland restoration planning, design, and monitoring.