bluuebunny/crossref_metadata_2025 huggingface dataset:
Globalization, Global History and Local Identity in ‘Greater China’
Authors: Edward Wang Q.
Published: April 2010

This article offers a brief contour of the differing interests in, and engagements with, the study of globalization and global history in mainland China, Hong Kong and Taiwan. It argues that in the face of the onrush of globalization, each of these three regions, under the rubric of ‘Greater China’, has developed and adopted distinct strategies to perceive and interpret its multifaceted impact. Scholars, movie makers and journalists in mainland China, Taiwan and Hong Kong have appropriated different meanings of globalization and engaged with its multifarious impacts from their own localized concerns and interests. Globalization has generated more dialogues among the three entities and helped highlight their differences.
Brotherly Intentions? The Egyptian Muslim Brothers and the Politics of a Debate
Authors: Stacher Joshua
Published: April 2010

This article surveys the contemporary debates on the Egyptian Society of Muslim Brothers. It argues that the debate focuses on the unknowable question of the Islamists’ governing intentions or assessing their ‘democratic’ character. This article takes issue with these analytic points of departure and, instead, makes a case for contextualizing the organization’s policies against the backdrop of contemporary Egyptian society. I achieve this by reviewing the group’s philosophical development under the late period of the Mubarak presidency. As such, the Brothers’ recent party platform draft and policies on prominent issues, such as women and minority rights, reveal the Brothers as an organization that appeals to and emerges from national and domestic bases in Egypt as opposed to courting a strictly Islamic constituency.
Researching Electoral Administration in America: Insights from the ‘Post-Florida’ Era
Authors: James Toby S.
Published: April 2010

This article reviews four new additions to the growing literature on electoral administration. It argues that each book adds usefully to the literature, but that there remains an absence of cross-national reflection. The books make important contributions by highlighting the importance of electoral administration, which is often overlooked in democracies; by making important normative contributions to the case for particular procedures; and by developing a number of methodologies that may be of use to researchers and practitioners. They remain, however, based almost exclusively on American elections, reflecting the bias of the broader literature. There is a need for a more comparative approach to the study of electoral administration so that: (a) lessons from ‘overseas’ can be taken to the US; (b) countries other than the US spend more time scrutinising the way in which they run elections; and (c) we can test the existing research findings in new contexts to deepen our understanding of frequently overlooked mechanics of electoral administration.
Long‐term management of vulval lichen sclerosus in adult women
Authors: BRADFORD J. , FISCHER G.
Published: April 2010

Background:  Adult vulval lichen sclerosus (VLS) is usually a lifelong disease with an estimated remission rate after treatment of only 16% [Arch Dermatol 2004; 140 (6): 709]. Although superpotent topical corticosteroid (TCS) is the validated gold standard treatment to induce remission, little data are available on how remission should be maintained.

Aims:  We present a retrospective chart review of 129 adult patients with VLS who have been under surveillance by the authors for a minimum duration of three years.

Methods:  Remission was maintained in most patients with low‐to‐moderate potency TCS. All subjects’ symptoms, signs, treatment regimes and response to treatment including compliance, symptom remission, disease progression with scarring, squamous cell carcinoma and side effects were recorded. Data were compared for the compliant and non‐compliant groups. Fischer’s exact test was used to identify significant differences.

Results:  The mean age at presentation was 53.6 years and mean duration of follow‐up was 6.2 years. Compliance was excellent: 84 (65%) of patients’ self‐reporting as being fully compliant. Symptom remission was achieved in 98% of compliant and 75% of non‐compliant patients (P = 0.001) Progression of disease with scarring was not encountered in any of the compliant patients, but was seen in 35% of non‐compliant patients (P = 0.0001). One patient had squamous cell carcinoma on first presentation. Carcinoma subsequently occurred in none of the compliant patients, and in five partly compliant patients (P = 0.004). Mild, reversible corticosteroid side effects were encountered in 7% of patients.

Conclusions:  Long‐term treatment of adult VLS with individualised regimes using moderate potency TCS is safe and effective. Patients require long‐term follow‐up.
Survey of current management of prolapse in Australia and New Zealand
Authors: VANSPAUWEN Ruben , SEMAN Elvis , DWYER Peter
Published: April 2010

Objective:  To compare current practice in the treatment of pelvic organ prolapse between Australian/New Zealand and United Kingdom (UK) gynaecologists.

Methods:  A postal questionnaire containing questions on four case scenarios, which examined contentious areas of contemporary prolapse management, was sent to 1471 Australian and New Zealand gynaecologists in mid‐2007. The results were compared with those of an identical survey conducted in the UK in 2006.

Results:  The response rate was 13% as only 196 complete responses were received. For primary anterior vaginal prolapse, anterior colporrhaphy was the procedure of choice in 54% followed by vaginal repair with graft in 20%. For recurrence, 75% used a graft. Procedure of choice for uterovaginal prolapse was a vaginal hysterectomy with anterior colporrhaphy (79%) and for vault support, 54% performed uterosacral colpopexy. In women wishing to retain their fertility, 23% would operate and a laparoscopic uterosacral hysteropexy (39%) was preferred. For posterior vaginal prolapse, the procedure of choice was midline plication in 56% and site‐specific repair in 24%. A graft was used in 13% for primary repair and 61% for recurrence, most preferring permanent mesh. Procedure of choice for apical prolapse was sacrospinous fixation with anterior and posterior colporrhaphy (37%), followed by vaginal mesh repair (33%) and abdominal sacrocolpopexy (11%). Few respondents objectively measured prolapse (20%) or followed up patients over one year (12%).

Conclusions:  Australian/New Zealand gynaecologists used fewer traditional transvaginal procedures and more vaginal grafts than their UK colleagues in all compartments. Most respondents favoured permanent mesh (eg mesh kits) and many are missing an opportunity to gather valuable prospective data on these new procedures.
Vitamin D deficiency is common among pregnant women in rural Victoria
Authors: TEALE Glyn R. , CUNNINGHAM Chris E.
Published: April 2010

There is increasing evidence to implicate vitamin D deficiency in a variety of diseases. Previous advice has been to screen high‐risk pregnant women. This study shows that, despite abundant sunshine and latitude consistent with year‐long vitamin D synthesis, 65.5% of a largely low‐risk antenatal population in rural Victoria have insufficient vitamin D. Over 5.0% of women have vitamin D levels that pose a significant neonatal and adult health risk. These findings support routine antenatal testing of vitamin D levels.
Infection and fetal loss in the mid‐second trimester of pregnancy
Authors: ALLANSON Ben , JENNINGS Belinda , JACQUES Angela , CHARLES Adrian K. , KEIL Anthony D. , DICKINSON Jan E.
Published: April 2010

Introduction:  Chorioamnionitis is a common cause of second trimester pregnancy loss, usually due to ascending infection. This study investigates the prevalence and bacteriology of chorioamnionitis in cases of spontaneous pregnancy loss in previable gestations (16–22 weeks).

Methods:  Fetal losses between 16‐ and 22‐week gestation were identified from the institutional database over a three‐year period. Cases with an autopsy were identified, pathology reports reviewed, and maternal features noted (clinical symptoms, blood count and vaginal culture results). Second trimester medical termination for fetal abnormality during the same time period served as controls for the confounding influence of labour.

Results:  A total of 101 cases of spontaneous non‐anomalous non‐macerated fetal losses and 103 control cases of induced loss for fetal anomaly were identified. Median gestation of cases was 19 weeks (interquartile range (IQR) 17, 21) and of controls was 20 weeks (IQR 19, 21). Maternal white cell count was higher in cases (median 13.6 IQR 10.8, 16.6) than in controls (9.9 IQR 7.6, 11.5) (P < 0.01). Seventy‐eight (77.2%) of 101 cases and no controls had histological chorioamnionitis. A fetal reaction was identified in 48.7% of cases with chorioamnionitis, and the frequency of fetal reaction increased as gestation advanced (5.3% at 16‐week gestation vs 33.3% at 22‐week gestation). In cases with chorioamnionitis 36/76 (47.4%) were culture positive, whereas 4/25 (16%) without chorioamnionitis were culture positive.

Conclusion:  In otherwise normal fetuses, chorioamnionitis is a common finding in mid‐trimester pregnancy loss. Routine culture methods have a low sensitivity for isolation of the causative micro‐organisms. This inflammatory process seems to predate the onset of labour and appears a primary mechanism in the aetiology of such losses.
OPTIMIZATION OF DNA EXTRACTION FROM BROWN ALGAE (PHAEOPHYCEAE) BASED ON A COMMERCIAL KIT1
Authors: Snirc Alodie , Silberfeld Thomas , Bonnet Jacques , Tillier Annie , Tuffet Sophie , Sun Jian‐Sheng
Published: April 2010

Large‐scale DNA molecular studies require reliable and efficient tools for DNA extractions. However, for some plant species and brown algae, isolation of high‐quality DNA is difficult. We developed a novel method for isolating high‐quality DNA from the polysaccharide‐rich and polyphenol‐rich brown algae based on a commercial kit and protocol (Qiagen) by optimizing the lysis step and including a chloroform/isoamyl alcohol supplementary purification step. DNAs from 24 brown algal species extracted using the original and the modified Qiagen protocol were compared for yield, quality, and effectiveness in PCR amplification. There was no significant difference in the yields between protocols. However, a statistically significant increase in DNA purity was obtained with the modified protocol, for which the A260/A280 and A260/A230 absorbance ratios averaged 1.66 ± 0.05 and 1.31 ± 0.01, respectively, compared to 1.37 ± 0.04 and 0.52 ± 0.04 with the original protocol. DNAs extracted by the modified procedure were more successfully amplified by PCR (nuclear, mitochondrial, and chloroplastic regions) than DNAs extracted using the original commercial kit and protocol. Importantly, the modified protocol can be applied in a high‐throughput (e.g., 96‐well plate) format, allowing a higher efficiency for downstream molecular analysis. In addition, improved DNA quality could increase its stability for long‐term storage.
REDOX PROPERTIES ARE CONSERVED IN RUBISCOS FROM DIATOMS AND GREEN ALGAE THROUGH A DIFFERENT PATTERN OF CYSTEINES1
Authors: Marín‐Navarro Julia , García‐Murria Maria Jesús , Moreno Joaquín
Published: April 2010

Eukaryotic RUBISCO appears in two sequence‐diverging forms, known as red‐like (present in nongreen algae) and green‐like (of green algae and higher plants) types. Oxidation of cysteines from green‐like RUBISCOs is known to result in conformational changes that inactivate the enzyme and render a relaxed structure more prone to proteolytic attack. These changes may have regulatory value for green algae and higher plants, promoting RUBISCO catabolism under stress conditions. We compare here red‐like RUBISCOs from several diatoms with a representative green‐like RUBISCO from Chlamydomonas reinhardtii, paying special attention to the cysteine‐dependent redox properties. Purified diatom RUBISCO preparations displayed a specific carboxylase activity about one order of magnitude lower than that of the C. reinhardtii P. A. Dang. enzyme. Despite having different patterns of cysteine residues in their primary sequence, the red‐like enzymes from diatoms inactivated also through oxidation of cysteine sulfhydryls to disulfides with a transition midpoint identical to that of the green‐like forms. Cysteine oxidation resulted also in structural modifications of the diatom RUBISCOs, as recognized by a higher sensitivity of the oxidized enzyme to in vitro proteolysis. The coincident redox properties of red‐ and green‐like RUBISCO types suggest that these changes are part of a physiologically significant regulatory mechanism that has been convergently implemented in both groups with a different set of cysteine residues.
Design for Recycling
Authors: Gaustad Gabrielle , Olivetti Elsa , Kirchain Randolph
Published: April 2010

As design for recycling becomes more broadly applied in material and product design, analytical tools to quantify the environmental implications of design choices will become a necessity. Currently, few systematic methods exist to measure and direct the metallurgical alloy design process to create alloys that are most able to be produced from scrap. This is due, in part, to the difficulty in evaluating such a context‐dependent property as recyclability of an alloy, which will depend on the types of scraps available to producers, the compositional characteristics of those scraps, their yield, and the alloy specification itself. This article explores the use of a chance‐constrained based optimization model, similar to models used in operational planning in secondary production today, to (1) characterize the challenge of developing recycling‐friendly alloys due to the contextual sensitivity of recycling, (2) demonstrate how such models can be used to evaluate the potential scrap usage of alloys, and (3) explore the value of sensitivity analysis information to proactively identify effective alloy modifications that can drive increased potential scrap use. These objectives are demonstrated through two cases that involve the production of a broad range of alloys utilizing representative scraps from three classes of industrial end uses.
Long‐Term Retention of Older Adults in the Cardiovascular Health Study: Implications for Studies of the Oldest Old
Authors: Strotmeyer Elsa S. , Arnold Alice M. , Boudreau Robert M. , Ives Diane G. , Cushman Mary , Robbins John A. , Harris Tamara B. , Newman Anne B.
Published: April 2010

OBJECTIVES: To describe retention according to age and visit type (clinic, home, telephone) and to determine characteristics associated with visit types for a longitudinal epidemiological study in older adults.

DESIGN: Longitudinal cohort study.

SETTING: Four U.S. clinical sites.

PARTICIPANTS: Five thousand eight hundred eighty‐eight Cardiovascular Health Study (CHS) participants aged 65 to 100 at 1989/90 or 1992/93 enrollment (58.6% female; 15.7% black). CHS participants were contacted every 6 months, with annual assessments through 1999 and in 2005/06 for the All Stars Study visit of the CHS cohort (aged 77–102; 66.5% female; 16.6% black).

MEASUREMENTS: All annual contacts through 1999 (n=43,772) and for the 2005/06 visit (n=1,942).

RESULTS: CHS had 43,772 total participant contacts from 1989 to 1999: 34,582 clinic visits (79.0%), 2,238 refusals (5.1%), 4,401 telephone visits (10.1%), 1,811 home visits (4.1%), and 740 other types (1.7%). In 2005/06, the All Stars participants of the CHS cohort had 36.6% clinic, 22.3% home, and 41.1% telephone visits. Compared with participants aged 65 to 69, odds ratios of not attending a CHS clinic visit were 1.82 (95% confidence interval (CI)=1.54–2.13), 2.94 (95% CI=2.45–3.57), 4.55 (95% CI=3.70–5.56), and 9.09 (95% CI=7.69–11.11) for those aged 70 to 74, 75 to 79, 80 to 84, and 85 and older, respectively, in sex‐adjusted regression. In multivariable regression, participants with a 2005/06 clinic visit were younger, more likely to be male and in good health, and had had better cognitive and physical function 7 years earlier than participants with other visit types. Participants with home, telephone, and missing visits were similar on characteristics measured 7 years earlier.

CONCLUSION: Offering home, telephone, and proxy visits are essential to optimizing follow‐up of aging cohorts. Home visits increased in‐person retention from 36.5% to 58.8% and diversified the cohort with respect to age, health, and physical functioning.
Interventions to Improve Transitional Care Between Nursing Homes and Hospitals: A Systematic Review
Authors: LaMantia Michael A. , Scheunemann Leslie P. , Viera Anthony J. , Busby‐Whitehead Jan , Hanson Laura C.
Published: April 2010

Transitions between healthcare settings are associated with errors in communication of information and treatment plans for frail older patients, but strategies to improve transitional care are lacking. A systematic review was conducted to identify and evaluate interventions to improve communication of accurate and appropriate medication lists and advance directives for elderly patients who transition between nursing homes and hospitals. MEDLINE, ISI Web, and EBSCO Host (from inception to June 2008) were searched for original, English‐language research articles reporting interventions to improve communication of medication lists and advance directives. Five studies ultimately met all inclusion criteria. Two described interventions that enhanced transmission of advance directives, two described interventions that improved communication of medication lists, and one intervention addressed both goals. One study was a randomized controlled trial, whereas the remaining studies used historical or no controls. Study results indicate that a standardized patient transfer form may assist with the communication of advance directives and medication lists and that pharmacist‐led review of medication lists may help identify omitted or indicated medications on transfer. Although preliminary evidence supports adoption of these methods to improve transitions between nursing home and hospital, further research is needed to define target populations and outcomes measures for high‐quality transitional care.
Unmet Physical Activity Need in Old Age
Authors: Rantakokko Merja , Iwarsson Susanne , Hirvensalo Mirja , Leinonen Raija , Heikkinen Eino , Rantanen Taina
Published: April 2010

OBJECTIVES: To examine which individual and environmental factors correlate with unmet physical activity need in old age and predict development of unmet physical activity need (the feeling that one's level of physical activity is inadequate and thus distinct from the recommended amount of physical activity) over a 2‐year follow‐up.

DESIGN: Observational prospective cohort study and cross‐sectional analyses.

SETTING: Community and research center.

PARTICIPANTS: A total of 643 community‐living ambulatory people aged 75 to 81 took part in face‐to‐face interviews and examinations at baseline and 314 at the 2‐year follow‐up.

MEASUREMENTS: Unmet physical activity need and its potential individual and environmental correlates were assessed at baseline. Development of unmet physical activity need was assessed over the 2‐year follow‐up period.

RESULTS: At baseline, all participants were able to walk at least 500 m outdoors, but 14% perceived unmet physical activity need. Unmet physical activity need was more prevalent in those with musculoskeletal diseases, depressive symptoms, and mobility limitations. Hills in the nearby environment, lack of resting places, and dangerous crossroads correlated with unmet physical activity need at baseline; the association was especially strong in those with walking difficulties. Significant baseline predictors for incident unmet physical activity need (15%) included fear of moving outdoors, hills in the nearby environment, and noisy traffic.

CONCLUSION: Unmet physical activity need is common in ambulatory community‐living older people who have health and mobility problems and report negative environmental features in their neighborhood. Solutions to overcome barriers to physical activity need to be developed to promote equal opportunities for physical activity participation.
Anger and Approach Motivation in Infancy: Relations to Early Childhood Inhibitory Control and Behavior Problems
Authors: He Jie , Degnan Kathryn Amey , McDermott Jennifer Martin , Henderson Heather A. , Hane Amie Ashley , Xu Qinmei , Fox Nathan A.
Published: April 2010

The relations among infant anger reactivity, approach behavior, and frontal electroencephalogram (EEG) asymmetry, and their relations to inhibitory control and behavior problems in early childhood were examined within the context of a longitudinal study of temperament. Two hundred nine infants’ anger expressions to arm restraint were observed at 4 months of age. Infants’ approach behaviors during play with an unpredictable toy and baseline frontal EEG asymmetry were assessed at 9 months of age. Inhibitory control during a Go/No‐Go task and parent report of behavior problems were evaluated at 4 years of age. High anger‐prone infants with left, but not right, frontal EEG asymmetry showed significantly more approach behaviors and less inhibitory control relative to less anger‐prone infants. Although a link between anger proneness in infancy and behavior problems in early childhood was not found, a combination of low approach behaviors and poor inhibitory control was predictive of internalizing behaviors.
Phylogenetic Analysis of Complete rRNA Gene Sequence of Nosema philosamiae Isolated from the Lepidopteran Philosamia cynthia ricini
Authors: ZHU FENG , SHEN ZHONGYUAN , XU XIAOFANG , TAO HENGPING , DONG SHINAN , TANG XUDONG , XU LI
Published: April 2010

ABSTRACT. The microsporidian Nosema philosamiae is a pathogen that infects the eri‐silkworm Philosamia cynthia ricini. The complete sequence of rRNA gene (4,314 bp) was obtained by polymerase chain reaction amplification with specific primers and sequencing. The sequence analysis showed that the organization of the rRNA of N. philosamiae was similar to the pattern of Nosema bombycis. Phylogenetic analysis of rRNA gene sequences revealed that N. philosamiae had a close relationship with other Nosema species, confirming that N. philosamiae is correctly assigned to the genus Nosema.
Sexual Activities, Sexual and Life Satisfaction, and Successful Aging in Women
Authors: Woloski-Wruble Anna C. , Oliel Yulia , Leefsma Miriam , Hochner-Celnikier Drorith
Published: April 2010

Introduction

Sexuality for women at all ages is a vital aspect of life satisfaction and is based upon continuing growth, development, and adaptation. The successful aging model includes physical, mental/emotional, and social well-being. There is no known published literature on the topic of sexual activities of older women and its implications on life and sexual satisfaction.

Aim

To investigate the sexual activities of older women in Israel, their levels of sexual satisfaction and life satisfaction, and to examine the relationship between the level of sexual activities, sexual satisfaction, and life satisfaction.

Main Outcome Measure

Components of the Derogatis Sexual Functioning Inventory, and the Life Satisfaction Index.

Methods

A descriptive, correlational study guided by the theory of “successful aging” by Havighurst (1961) was conducted using a convenience sample of 127 women who attended a menopause clinic for routine and follow up care.

Results

The research findings described older women as being involved in varied, though limited, sexual activities. There was no significant relationship discovered between the number of sexual activities and age. The level of sexual satisfaction of the studied sample was found to be above the mean score. Most of the women reported good sexual/intimate communication with their partners. Women were not satisfied with the limited variety in their sex life. Women reported a high level of life satisfaction. Ultimately, a positive significant correlation was discovered between sexual satisfaction and level of current sexual activity, and between sexual satisfaction and life satisfaction.

Conclusions

Older women are interested in continuing their sexual activities. It is a component of life satisfaction. The desire for sexual variety suggested an important area for patient education. Couple communication was deemed a priority. Health providers should include sexual health issues in their discussions with clients of all ages.
Pentoxifylline Attenuates Transforming Growth Factor-β1-Stimulated Elastogenesis in Human Tunica Albuginea-Derived Fibroblasts Part 2: Interference in a TGF-β1/Smad-Dependent Mechanism and Downregulation of AAT1
Authors: Lin Guiting , Shindel Alan W. , Banie Lia , Ning Hongxiu , Huang Yun-Ching , Liu Gang , Lin Ching-Shwun , Lue Tom F.
Published: April 2010

Introduction

Transforming growth factor-beta1 (TGF-β1) contributes to the pathogenesis of Peyronie’s disease (PD). Pentoxifylline (PTX) antagonizes the effects of TGF-β1 and has been utilized in our clinic for the management of PD although the mechanisms of action are not entirely clear.

Aim

We studied cell-signaling pathways through which TGF-β1 and PTX mediate collagen metabolism, elastin expression, and elastogenesis in tunica albuginea-derived fibroblasts (TADFs).

Methods

TADFs from men with and without PD were cultured and treated with TGF-β1 and PTX as monotherapy at differing concentrations and time points. Combination treatment (TGF-β1 followed by PTX and vice versa) was also investigated.

Main Outcome Measures

Reverse-transcription polymerase chain reaction and Western blotting were utilized to assess differences in elastin metabolism and cellular signaling between groups. Alpha-1 antitrypin (AAT1) expression was assayed.

Results

At doses greater than 0.1 ng/Ml, TGF-β1 increased messenger ribonucleic acid (mRNA) and protein expression of elastin in a time-dependent fashion in TADF. PTX did not interfere with TGF-β1 mediated upregulation of elastin mRNA and protein in TADF. However, pretreatment of TADF with PTX was associated with decreased expression of AAT1, decreased activity of the Smad1/5 pathway, and enhanced phosphorylation of the inhibitory Smad6.

Conclusion

Expression of elastin mRNA and protein is upregulated in TADF by TGF-β1. PTX has no effect on elastin production but attenuates elastogenesis in TADF through an AAT1-related mechanism.
Role for Tyrosine Kinases in Contraction of Rat Penile Small Arteries
Authors: Villalba Nuria , Kun Attila , Stankevicius Edgaras , Simonsen Ulf
Published: April 2010

Introduction

The devasting effect of cancer and treatment thereof contribute to sexual dysfunction. Recently, a series of tyrosine kinase inhibitors have been approved either as add-on or for targeted treatment of cancer. However, tyrosine kinases are not only important for cell growth and proliferation, but also in regulation of vascular tone.

Aim

The present study investigated whether tyrosine kinases contribute to contractility in rat penile arteries, and addressed whether they are involved in calcium entry and/or related to the RhoA/Rho-kinase pathway.

Methods

Segments of the rat dorsal penile artery were mounted in microvascular myographs for simultaneous measurements of intracellular calcium concentration ([Ca2+]i) and tension, and tyrosine kinase activity, and phosphorylation of 20-kDa myosin light chain (MLC20) was measured in dorsal penile artery homogenates.

Main Outcome Measures

In vitro evidence for contractility and changes in intracellular Ca2+ in small penile arteries.

Results

Sodium vanadate (Na3VO4, 1 mM), a tyrosine phosphatase inhibitor, increased [Ca2+]i and tension. A l-type calcium channel blocker, nifedipine (1 µM), markedly reduced Na3VO4-evoked increases in [Ca2+]i and tension. A thromboxane analog, U46619, increased TK activity. In contrast to the inactive analogue, genistein, a general TK inhibitor, concentration-dependently reduced both U46619-evoked contraction, and [Ca2+]i. U46619-induced contraction was markedly inhibited by tyrphostin A23 and bis-tyrphostin, whereas there was no effect of the tyrosine kinase c-Src inhibitor, herbimycin A. Tyrphostin A23 suppressed U46619-mediated phosphorylation of MLC20.

Conclusions

This study suggests that activation of tyrosine kinases is involved in contraction of rat penile smooth muscle probably by regulation of calcium entry through l-type calcium channels. These findings may have implications for the selections of novel add on anticancer treatments, e.g., inhibitors of tyrosine kinases, and for novel approaches to treat erectile dysfunction.
The Impact of Sexual Orientation on Sexuality and Sexual Practices in North American Medical Students
Authors: Breyer Benjamin N. , Smith James F. , Eisenberg Michael L. , Ando Kathryn A. , Rowen Tami S. , Shindel Alan W.
Published: April 2010

Introduction

There has been limited investigation of the sexuality and sexual dysfunction in non-heterosexual subjects by the sexual medicine community. Additional research in these populations is needed.

Aims

To investigate and compare sexuality and sexual function in students of varying sexual orientations.

Methods

An internet-based survey on sexuality was administered to medical students in North American between the months of February and July of 2008.

Main Outcome Measures

All subjects provided information on their ethnodemographic characteristics, sexual orientation, and sexual history. Subjects also completed a series of widely-utilized instruments for the assessment of human sexuality (International Index of Erectile Function [IIEF], Female Sexual Function Index [FSFI], Premature Ejaculation Diagnostic Tool [PEDT], Index of Sex Life [ISL]).

Results

There were 2,276 completed responses to the question on sexual orientation. 13.2% of male respondents and 4.7% of female respondents reported a homosexual orientation; 2.5% of male and 5.7% of female respondents reported a bisexual orientation. Many heterosexual males and females reported same-sex sexual experiences (4% and 10%, respectively). Opposite-sex experiences were very common in the male and female homosexual population (37% and 44%, respectively). The prevalence of premature ejaculation (PEDT > 8) was similar among heterosexual and homosexual men (16% and 17%, P = 0.7, respectively). Erectile dysfunction (IIEF-EF<26) was more common in homosexual men relative to heterosexual men (24% vs. 12%, P = 0.02). High risk for female sexual dysfunction (FSFI<26.55) was more common in heterosexual and bisexual women compared with lesbians (51%, 45%, and 29%, respectively, P = 0.005).

Conclusion

In this survey of highly educated young professionals, numerous similarities and some important differences in sexuality and sexual function were noted based on sexual orientation. It is unclear whether the dissimilarities represent differing relative prevalence of sexual problems or discrepancies in patterns of sex behavior and interpretation of the survey questions.
Efficacy and Safety of Tadalafil for Erectile Dysfunction in Patients with Multiple Sclerosis
Authors: Lombardi Giuseppe , Macchiarella Angelo , Del Popolo Giulio
Published: April 2010

Introduction

Data are sparse concerning the effects of phosphodiesterase type 5 (PDE5) inhibitors for erectile dysfunction (ED) in subjects with multiple sclerosis (MS).

Aim

To evaluate the efficacy and safety of tadalafil use in subjects with ED because of MS.

Methods

Ninety-six MS patients with ED after a 4-week treatment-free period were given tadalafil 10 mg. All patients were re-evaluated after 4 weeks. Those with a score lower than 26 on the International Index of Erectile Function (IIEF-15) and with less than 75% of total successful sexual attempts assessed by the Sexual Encounter Profile Questions 2 and 3 (SEP2-3) had their dosage of tadalafil increased to 20 mg, whereas responding subjects continued with 10 mg. Subsequently, all patients had a final follow-up visit after 8 weeks.

Main Outcome Measures

SEP2-3, IIEF-15 questionnaire. The Life Satisfaction Checklist (LSC) questionnaire composed of eight questions was used prior to starting tadalafil and at the end of the 12-week treatment.

Results

Ninety-two subjects completed the study. Seventy-two responded, 30 of whom used 10 mg. Two subjects discontinued the therapy because of moderate side effects: one suffered from headache and one from tachycardia. Responding patients reached a significant statistical improvement in all follow-ups compared with baseline on the erectile domain and overall sexual satisfaction scores of the IIEF-15 using the Wilcoxon test P <0.01. Furthermore, they showed statistical improvement through the Wilcoxon test P <0.01 on the sexual life, family life, and partner relationship questions of the LSC compared with baseline.

Conclusion

Tadalafil is an effective and safe treatment for males with MS suffering from ED. Further studies are needed on MS patients to evaluate the efficacy and safety of long-term use, and to detect predictable parameters for the success of PDE5 inhibitors.
AMS 700CX/CXM Inflatable Penile Prosthesis Has High Mechanical Reliability at Long-Term Follow-Up
Authors: Kim Dong Suk , Yang Kwang Mo , Chung Hyun Jin , Choi Hyun Min , Choi Young Deuk , Choi Hyung Ki
Published: April 2010

Introduction

AMS 700CX/CXM inflatable penile prosthesis is increasingly applied for the treatment of erectile dysfunction (ED). However, there are a few long-term survival data of the inflatable penile prosthesis (IPP) over 10 years.

Aim

To determine the long-term mechanical reliability of AMS 700CX/CXM inflatable penile prosthesis in patients with ED.

Methods

A total of 438 consecutive patients with ED received implantation of an AMS 700CX/CXM penile prosthesis at our institution from January 1991 to April 2009. In 397 patients (90.7%), the medical records were available and current status of penile prosthesis could be obtained by a direct telephone interview. The overall and mechanical survival rates of penile prosthesis were evaluated using Kaplan–Meier method.

Main Outcome Measures

Assessing the mechanical and overall survival rates of the AMS 700CX/CXM penile prosthesis using Kaplan–Meier analysis, and looking for clinical factors related to survival of the CX/CXM using log-rank test.

Results

Mean age of 397 patients was 63.1 years (range, 24-93) and follow-up duration was 113 months (range 1-219). Eighty-two patients (20.6%) experienced mechanical failure at a median follow-up of 82 months. Mechanical survival rate of the penile prosthesis was 97.6%, 93.2% and 78.2% at 3, 5, and 10 years after implantation, respectively. 12 patients (3.0%) experienced nonmechanical failure including infections, tissue erosion resulting in cylinder protrusion at the meatus and chronic discomfort. Overall survival rate of the penile prosthesis was 95.0%, 91.0% and 75.5% at 3, 5, and 10 years after implantation, respectively. Patients with neurogenic cause for ED showed lower median overall survival of penile prosthesis compared with patients with non-neurogenic cause. Patient age, obesity, and diabetes mellitus had no association with overall survival of penile prosthesis after implantation.

Conclusions

The AMS 700CX/CXM could be accepted and applied in more patients as a reliable treatment alternative of ED.
Exercise prescription and the patient with type 2 diabetes: A clinical approach to optimizing patient outcomes
Authors: Waryasz Gregory R. , McDermott Ann Yelmokas
Published: April 2010

Purpose: To review the current recommendations for physical activity in type 2 diabetes mellitus (T2DM) and propose methods to optimize compliance, reduce the pharmaceutical burden, and improve the general health and well‐being of patients with T2DM.

Data sources: PubMed, SportDiscus, Ovid MEDLINE, Psychinfo, Web of Science, LexisNexis, and EBM reviews.

Conclusions: T2DM is a condition in which physical activity has been documented to improve patient outcomes, yet research has noted that healthcare professionals inadequately address this issue, resulting in physical activity being an underutilized therapy.

Implications for practice: An exercise prescription consists of mode (type), frequency, intensity, duration, and progression. Determining the appropriate mode depends upon patient preference and safety issues regarding the state of T2DM or other conditions. Frequency, intensity, and duration are specific to the type of activity and should be tailored to the patient's abilities to safely perform the activity. Finally, the health professional addresses periodic progression in order to maintain the exercise stimulus needed to promote continued health improvements and prevent “plateauing.” In this article, on the basis of the current scientific research, we propose recommendations that enable healthcare professionals to advocate for their patients with T2DM by offering safe and effective treatment options.
Diagnostic algorithm for the evaluation of hematuria
Authors: Shen Xinying
Published: April 2010

Purpose: To present a logical and cost‐effective diagnostic approach for primary care physicians to a common symptom, hematuria.

Data source: Selected research, review articles, as well as medical textbooks and current government guidelines.

Conclusion: Dipstick test and microscopic urinalysis are two common screening tests for hematuria. Once hematuria is discovered, its etiology should be investigated through a comprehensive history, a focused physical examination, laboratory studies, and radiographic imaging. Microscopic urinalysis is simple yet important in distinguishing glomerular from nonglomerular sources of bleeding. Intravenous urography, renal ultrasonography, or computed tomography may be needed to determine the location and characteristics of lesions. Cytoscopy is important in evaluating lower urinary tract lesions.

Implications for practice: Hematuria is a frequently encountered symptom that has a broad differential diagnosis ranging from insignificant etiology to potentially life‐threatening neoplastic lesions. A systematic method can be useful in efficiently and cost‐effectively managing hematuria. Early and appropriate diagnosis of this common symptom results in improved clinical outcomes.
Cardiovascular risk in minority and underserved women in Appalachian Tennessee: A descriptive study
Authors: Pearson Tamera Lea
Published: April 2010

Purpose: The purposes of this study were to translate current knowledge regarding cardiovascular risk factors, screening, and prevention to a disparate population of women and to ascertain the cardiovascular health status and risk factors in a sample of minority and underserved Appalachian women.

Data sources: Demographic data were collected from a voluntary sample of women from a disparate population living in Appalachian Tennessee. A coronary risk profile recorded family health history, personal health history, and lifestyle habits affecting risk for cardiovascular disease. Physiologic measurements included body mass index, blood pressure, fasting glucose, cholesterol levels, ankle brachial index, and carotid artery stenosis.

Conclusions: Women in Appalachia Tennessee from a disparate population have high risks for heart disease and stroke. This is a critical time to address any modifiable risk factors and aggressively treat underlying cardiovascular diseases such as hypertension and hypercholesterolemia.

Implications for practice: Nurse practitioners (NPs) often provide primary care to women who may not be aware of their cardiovascular risks or actual disease. NPs can ensure that their practice incorporates primary and secondary cardiovascular prevention through screening, individual health education, and aggressive evidence‐based treatment plans for women.
Sensitivity, specificity, positive and negative predictive values: Diagnosing purple mange
Authors: Collier Jill , Huebscher Roxana
Published: April 2010

Purpose: To shed light on several epidemiological terms for better understanding of diagnostic testing measures by using a mythical condition, “purple mange.”

Data sources: Scientific literature related to epidemiology and statistical tests.

Conclusions: Nurse practitioners (NPs) use the concepts of sensitivity (SEN), specificity (SPEC), positive predictive value (PPV), and negative predictive value (NPV) daily in primary care and specialty areas. In addition, PPV and NPV vary with the prevalence of a condition. At times, NPs misunderstand the meaning of these terms.

Implications for practice: In order to develop appropriate treatment plans, an understanding of the concepts of SEN, SPEC, PPV, and NPV is important for interpreting test results. The authors have used this mythical condition purple mange as a teaching tool for NP students.
Improving the Evaluation of Rural Development Policy Pour une meilleure évaluation de la politique de développement rural Die Evaluation der Politik zur Entwicklung des ländlichen Raums verbessern
Authors: Blandford David , Boisvert Richard N. , Hill Berkeley
Published: April 2010

Improving the Evaluation of Rural Development Policy

A previous EuroChoices (Vol. 7, No. 1) compared and contrasted approaches to rural development policy in the EU and US. This Special Issue focuses on the evaluation of these policies, drawing on a workshop held in June 2009 at OECD Conference Center in Paris. Evaluation is an activity that runs parallel with policymaking and is capable of contributing to effectiveness and efficiency at all stages. Evaluators, wherever they work and whatever aspect of rural development is their focus, face some common technical problems. These include multiple (and often ill‐defined) policy objectives, the choice of appropriate indicators (especially the need to distinguish between outputs and outcomes), how to establish baseline values, where to draw boundaries in terms of impact and time, and the identification of additionality and causality. Ensuring that lessons learned from evaluation are actually applied is problematic. Experiences covered in this Issue include the use of macro and case‐study approaches, and various schemes (investment in human and social capital, and agri‐environment and forestry). There is an inherent tension between using a common approach across countries and regions in the interests of comparability and the flexibility needed to capture all the relevant factors in the diverse situations in which rural development actions take place.
Evaluation of Agri‐Environment and Forestry Schemes with Multiple Objectives L’évaluation de programmes agroenvironnementaux et forestiers aux objectifs multiples Die Evaluation von Agrarumwelt‐ und Forstwirtschaftsprogrammen mit multiplen Zielen
Authors: Mortimer Simon , Mauchline Alice , Park Julian , Finn John , Edwards David , Morris Jake
Published: April 2010

Evaluation of Agri‐Environment and Forestry Schemes with Multiple Objectives

The evaluation of EU policy in the area of rural land use management often encounters problems of multiple and poorly articulated objectives. Agri‐environmental policy has a range of aims, including natural resource protection, biodiversity conservation and the protection and enhancement of landscape quality. Forestry policy, in addition to production and environmental objectives, increasingly has social aims, including enhancement of human health and wellbeing, lifelong learning, and the cultural and amenity value of the landscape. Many of these aims are intangible, making them hard to define and quantify. This article describes two approaches for dealing with such situations, both of which rely on substantial participation by stakeholders. The first is the Agri‐Environment Footprint Index, a form of multi‐criteria participatory approach. The other, applied here to forestry, has been the development of ‘multi‐purpose’ approaches to evaluation, which respond to the diverse needs of stakeholders through the use of mixed methods and a broad suite of indicators, selected through a participatory process. Each makes use of case studies and involves stakeholders in the evaluation process, thereby enhancing their commitment to the programmes and increasing their sustainability. Both also demonstrate more ‘holistic’ approaches to evaluation than the formal methods prescribed in the EU Common Monitoring and Evaluation Framework.
View from an Oversight Agency on Evaluation of Rural Development Programmes Point de vue d’une agence de surveillance sur l’évaluation de la politique de développement rural Aus der Sicht einer Aufsichtsbehörde Zur Evaluation von Programmen zur Entwicklung des ländlichen Raums
Authors: Offutt Susan
Published: April 2010

View from an Oversight Agency on Evaluation of Rural Development Programmes

Central government budgets will be highly constrained in the wake of stimulus spending and recession. Fiscal imperatives will increasingly drive the need to reconsider government policy fundamentals. There will be greater scrutiny of public programmes, including those addressing rural development, as decision makers weigh future options for action. Questions will be raised about the efficacy and efficiency of public programmes in meeting their goals, and the results of objective evaluation will be at a premium. Assessment is within the competency of many entities, but national audit agencies offer advantages in performing evaluations to support public deliberation and dialogue. The audit agency perspective is one that is independent from the branch of government that is responsible for programme execution. This independence is necessary but not sufficient for ensuring that evaluations are fair and balanced. An effective audit agency adheres strictly to professional standards of review and referencing and adopts procedures to guarantee that all facts and analyses are thoroughly checked for accuracy. Thus, an audit agency operates with a consistency in approach that may distinguish it from other potential performers of evaluation. This implies that audit agencies may have an increasingly important role to play in evaluating rural development programmes.
Adaptation to Climate Change in Regional Australia: A Decision‐Making Framework for Modelling Policy for Rural Production
Authors: Sposito Victor , Benke Kurt , Pelizaro Claudia , Wyatt Ray
Published: April 2010

A decision‐making framework was developed and applied in regional Australia to identify adaptation issues arising in agricultural systems and rural production as a consequence of climate change. Australian agriculture is very susceptible to the adverse impacts of climate change, with major shifts in temperature and rainfall projected. An advantage of the framework is that it provides a suite of tools to aid in the formulation of strategies for sustainable regional development and adaptation. The decision‐making framework uses a participatory approach that integrates land suitability analysis with uncertainty analysis and spatial optimisation to determine optimal agricultural land use (at a regional scale) for current and possible future climatic conditions. It thus provides a robust analytic approach to (i) recognise regions under threat of productivity declines, (ii) identify alternative cropping systems better adapted to likely future climatic conditions and (iii) investigate policy actions to improve the sub‐optimal situations created by climate change. The decision‐making framework and its methods were applied in a case study of the South West Region of Victoria.