bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence and risk factors for third‐ and fourth‐degree perineal lacerations during vaginal delivery: a multi‐country study
Authors: Hirayama F , Koyanagi A , Mori R , Zhang J , Souza JP , Gülmezoglu AM
Published: January 2012

Please cite this paper as: Hirayama F, Koyanagi A, Mori R, Zhang J, Souza J, Gülmezoglu A. Prevalence and risk factors for third‐ and fourth‐degree perineal lacerations during vaginal delivery: a multi‐country study. BJOG 2012;119:340–347.

Objective  To investigate the prevalence and risk factors of third‐ and fourth‐degree perineal lacerations in 24, mainly developing, countries.

Design  Analysis using cross‐sectional data from the WHO Global Survey on Maternal and Perinatal Health.

Setting  Seven African, nine Asian and eight Latin American countries.

Population  Women at admission to hospital for delivery in 373 facilities between 2004 and 2008.

Methods  We estimated the country‐wise prevalence of third‐ and fourth‐degree perineal lacerations, and conducted region‐wise multivariate logistic regression analyses to identify its risk factors.

Main outcome measures  Prevalence and risk factors of third‐ and fourth‐degree perineal lacerations.

Results  A total of 214 599 women who underwent vaginal delivery were analysed. The prevalence of third‐ and fourth‐degree perineal lacerations ranged widely across countries [from 0.1% (China, Cambodia, India) to 15.0% (Philippines)] and facilities (from null to 76.3%). After the deletion of facilities reporting no third‐ or fourth‐degree perineal lacerations, and also highly outlying facilities, the range in prevalence was 0.1% (Uganda) to 1.4% (Japan). Forceps‐assisted delivery, nulliparity and high birthweight were significant risk factors in all three regions. Vacuum‐assisted delivery was also a significant risk factor in Africa and Asia.

Conclusions  Misdiagnosis of third‐ and fourth‐degree perineal lacerations in developing countries may be common. Correct recognition and diagnosis may lead to timely treatment and fewer sequelae. Risk factors of third‐ and fourth‐degree perineal lacerations in developing countries were similar to those previously reported from developed countries.
Significance of close relationships after the tsunami disaster in connection with existential health – a qualitative interpretive study
Authors: Rehnsfeldt Arne , Arman Maria
Published: January 2012

Scand J Caring Sci; 2012; 26; 537–544

Significance of close relationships after the tsunami disaster in connection with existential health – a qualitative interpretive study

Background:  In an existential health perspective, the potential for recovery and development through natural life circumstances provides a factor to be taken into account. Earlier research on disaster‐stricken people indicates that people create their own ways of recovering and that natural caring encounters (with family or friends) imply important health factors.

Aim:  The aim of the study is to acquire an in‐depth understanding of the significance of natural close relationships for survivors of the tsunami disaster in Southeast Asia in connection with the development of existential health and understanding of life in a long‐term perspective. The sample consists of 19 persons afflicted by the 2004 tsunami in Southeast Asia, both Swedish tourists and relatives at home. Data were collected from interviews recurring five times during 2006.

Findings:  What is evidently seen is how the ontological aspects are expressed in data in relation to the existential and relational aspects. In concrete terms, this is understood when survivors say that their lives are completely changed (an ontological turn in their understanding of life). A change also occurs in the way they relate to others (a concrete existential turn), for example, in their families. When the findings on communion as an utterance of interdependence were read comprehensively, it was seen that human encounters in the aftermath of a disaster are not only about relationships but inherently affect people’s entire understanding of life both ontologically and existentially. Relationships with others and communion become a way of understanding or defining life. To conclude, in line with the aim of the study, the data suggest that relationships and communion with other people helped the survivors of the tsunami to discover a new understanding of life. It is also clear that natural encounters have had great importance for progress in existential health.
AN ANALYSIS OF THE GEM‐BLUE GLAZE OF YE WANG'S KOJI POTTERY*
Authors: TSENG YUNG‐KUAN , XU BI‐YAN
Published: January 2012

Koji pottery is a glazed ceramic art used widely for figurines. In early Taiwan, it was employed in temple construction for decorative purposes. Ye Wang (1826–87) is the first historically documented Koji artist of Taiwan and also the most prominent Koji pottery artist, noted for his modelling and glazing skills. Unfortunately, his unique technique was lost following his death in 1887. In order to provide vital information for ongoing conservation work on Koji pottery, this study analysed the physical and chemical characteristics of Ye Wang's gem‐blue glaze, to discover the glaze formula. DSC combined with the two‐thirds rule revealed that the firing temperature of Ye Wang's works of art was most probably around 878–923°C. EPMA revealed that the gem‐blue glaze has high alkali levels, and belongs to the PbO–K2O–B2O3–Na2O–SiO2 system, deriving its unique colour from copper, iron, manganese and cobalt. This study found high potassium levels in the gem‐blue glaze, which are generally a characteristic of traditional Chinese glazes. In addition, a unique discovery of boron, commonly used in famille rose, was also identified in the glaze. By comparing spectra of historical and reconstructed glazes and adjusting the proportion of chromophoric elements, this study found a glazing formula with colours close to those of Ye Wang's gem‐blue glaze.
NON‐DESTRUCTIVE SOURCING OF BRONZE AGE NEAR EASTERN OBSIDIAN ARTEFACTS: REDEVELOPING AND REASSESSING ELECTRON MICROPROBE ANALYSIS FOR OBSIDIAN SOURCING*
Authors: FRAHM E.
Published: January 2012

Despite predictions in the 1980s that electron microprobe analysis (EMPA) would become a popular technique for obsidian sourcing, few studies have used it with this goal, and most of them are now outdated and unrepresentative of modern EMPA. For example, Merrick and Brown (1984) recorded their data on punch cards. Furthermore, these studies destructively prepared artefacts for analysis. The research at hand endeavoured: (1) to establish the modern capabilities of EMPA for obsidian sourcing; and (2) to develop and evaluate procedures for non‐destructive artefact analysis. Issues such as diagenetic effects and compatibility with NAA and XRF data were also investigated.
Blockade of the Nuclear Factor Kappa B Pathway Prolonged Islet Allograft Survival
Authors: Ding Xiaoming , Wang Xiaohong , Xue Wujun , Tian Xiaohui , Li Yang , Jiao Fengmei , Feng Xinshun , Zheng Jin
Published: January 2012

Nuclear factor kappa B (NF‐κB) pathway is known for its important role in the upregulation of various inflammatory mediators and its “switch regulator” functionality for transcription factor gene networks which control cytokine‐induced β‐cell dysfunction and death. In this study, the islets were divided into the control group, Ad‐green fluorescent protein, and the adenovirus transfected with inhibitor kappa B group. The proliferation index of peripheral blood mononuclear cells and the islets apoptosis index were examined after mixed lymphocyte‐islet reaction with inverted fluorescence microscopy. Moreover, mRNA expression of inflammatory cytokines was measured by reverse transcription polymerase chain reaction. The islet graft survival time in diabetic rats, insulin in grafts, and cytokine concentrations in the supernatant were determined by immunohistochemistry and enzyme‐linked immunosorbent assay. We found that blocking of NF‐κB activation in β‐cells significantly downregulated inflammatory chemokine production by islets cells in vitro and in vivo, inhibited T‐cell recruitment into the pancreatic islets, inhibited β‐cell dysfunction, and effectively prolonged the survival time of islet grafts. The results presented in this work highlight a novel mechanism of blocking NF‐κB activation in β‐cells for the treatment of islet cell transplantation.
Management of Single‐Ventricle Patients With Berlin Heart EXCOR Ventricular Assist Device: Single‐Center Experience
Authors: Mackling Tracey , Shah Tejas , Dimas Vivian , Guleserian Kristine , Sharma Mahesh , Forbess Joseph , Ardura Monica , Gross‐Toalson Jami , Lee Ying , Journeycake Janna , Barnes Aliessa
Published: January 2012

There are minimal data regarding chronic management of single‐ventricle ventricular assist device (VAD) patients. This study aims to describe our center's multidisciplinary team management of single‐ventricle patients supported long term with the Berlin Heart EXCOR Pediatric VAD. Patient #1 was a 4‐year‐old with double‐outlet right ventricle with aortic atresia, L‐looped ventricles, and heart block who developed heart failure 1 year after Fontan. She initially required extracorporeal membrane oxygenation support and was transitioned to Berlin Heart systemic VAD. She was supported for 363 days (cardiac intensive care unit [CICU] 335 days, floor 28 days). The postoperative course was complicated by intermittent infection including methicillin‐resistant Staphylococcus aureus, intermittent hepatic and renal insufficiencies, and transient antithrombin, protein C, and protein S deficiencies resulting in multiple thrombi. She had a total of five pump changes over 10 months. Long‐term medical management included anticoagulation with enoxaparin, platelet inhibition with aspirin and dipyridamole, and antibiotic prophylaxis using trimethoprim/sulfamethoxazole. She developed sepsis of unknown etiology and subsequently died from multiorgan failure. Patient #2 was a 4‐year‐old with hypoplastic left heart syndrome who developed heart failure 2 years after bidirectional Glenn shunt. At systemic VAD implantation, he was intubated with renal insufficiency. Post‐VAD implantation, his renal insufficiency resolved, and he was successfully extubated to daytime nasal cannula and biphasic positive airway pressure at night. He was supported for 270 days (CICU 143 days, floor 127 days). The pump was upsized to a 50‐mL pump in May 2011 for increased central venous pressures (29 mm Hg). Long‐term medical management included anticoagulation with warfarin and single‐agent platelet inhibition using dipyridamole due to aspirin resistance. He developed increased work of breathing requiring intubation, significant anasarca, and bleeding from the endotracheal tube. The family elected to withdraw support. Although both patients died prior to heart transplantation, a consistent specialized multidisciplinary team approach to the medical care of our VAD patients, consisting of cardiothoracic surgeons, heart transplant team, hematologists, pharmacists, infectious disease physicians, psychiatrists, specialty trained bedside nursing, and nurse practitioners, allowed us to manage these patients long term while awaiting heart transplantation.
Should Care Managers for Older Adults Be Located in Primary Care? A Randomized Controlled Trial
Authors: Parsons Matthew , Senior Hugh , Kerse Ngaire , Chen Mei‐hua , Jacobs Stephen , Vanderhoorn Stephen , Anderson Craig
Published: January 2012

Objectives

To determine the effect of a primary care‐based care management initiative on residential care placement and death in a population of frail older adults referred for needs assessment in New Zealand.

Design

Randomized controlled trial with follow‐up at 3, 6, 12, 18, and 24 months for residential care placement and mortality.

Setting

Fifty‐five family physician practices in New Zealand that established a care management initiative for older adults assessed as being at high risk of residential care placement in 2004 to 2006.

Participants

Three hundred fifty‐one individuals (243 female, 108 male) aged 65 and older (mean 81) who were assessed as being at risk of permanent residential care placement.

Interventions

The care management program (Coordinator of Services for Elderly) consisted of a nominated health professional care manager geographically aligned to family physicians housed with the family physician or located nearby.

Measurements

Rates of permanent residential care placement and mortality.

Results

The risk of permanent residential care placement or death was 0.36 for usual care (control group) and 0.26 for the care management initiative, a 10.2% absolute risk reduction, with the majority of the risk reduction seen in residential care placement (control group 0.25, intervention group 0.16).

Conclusion

A family physician‐aligned community care management approach reduces frail older adults’ risk of mortality and permanent residential care placement.
Comparison of Safety and Efficacy of Insulin Glargine and Neutral Protamine Hagedorn Insulin in Older Adults with Type 2 Diabetes Mellitus: Results from a Pooled Analysis
Authors: Lee Pearl , Chang Annette , Blaum Caroline , Vlajnic Aleksandra , Gao Ling , Halter Jeffrey
Published: January 2012

Objectives

To compare the safety and efficacy of adding insulin glargine or neutral protamine Hagedorn (NPH) insulin to existing oral antidiabetic drug (OAD) regimens in adults with type 2 diabetes mellitus.

Design

Pooled analysis of data from five randomized controlled trials with similar designs.

Setting

Three hundred forty‐two centers in more than 30 countries worldwide.

Participants

Randomly selected individuals aged ≤ 80 with a body mass index ≤ 40 kg/m2 and a glycosylated hemoglobin (HbA1c) level of 7.5% to 12.0%.

Measurements

Fixed‐ and random‐effects models were used to compare outcomes after 24 or 28 weeks of treatment (insulin glargine, n = 1,441; NPH insulin, n = 1,254) according to age (≥65, n = 604 vs < 65, n = 2,091) and age based on treatment (e.g., ≥65 receiving insulin glargine vs NPH insulin). Outcomes included change in HbA1c, fasting blood glucose (FBG), insulin dose, and hypoglycemia incidence and event rates.

Results

At end point, participants aged 65 and older receiving insulin glargine had greater reductions in HbA1c and FBG than those receiving similar doses of NPH insulin. In contrast, for participants younger than 65, there were no statistically significant differences in reductions in HbA1c or FBG between insulin glargine and NPH insulin. Daytime hypoglycemia rates were similar in all groups, although the rates of nocturnal symptomatic and severe hypoglycemia were lower with insulin glargine than NPH insulin.

Conclusion

Addition of insulin glargine to oral antidiabetic drugs in older adults with poor glycemic control may have modestly better glycemic benefits than adding NPH insulin, with low risk of hypoglycemia.
The Quadriceps Angle: Reliability and Accuracy in a Fox (Vulpes vulpes) Pelvic Limb Model
Authors: Miles James E. , Frederiksen Jane V. , Jensen Bente , Kirpensteijn Jolle , Svalastoga Eiliv L. , Eriksen Thomas
Published: January 2012

Objectives

To evaluate the effect of measurement technique and limb positioning on quadriceps (Q) angle measurement, intra‐ and interobserver reliability, potential sources of error, and the effect of Q angle variation.

Study Design

Cadaveric radiographic study and computer modeling.

Animals

Pelvic limbs from red foxes (Vulpes vulpes).

Methods

Q angles were measured on hip dysplasia (HD) and whole limb (WL) view radiographs of each limb between the acetabular rim, mid‐point (Q1: patellar center, Q2: femoral trochlea), and tibial tuberosity. Errors of 0.5–2.0 mm at measurement landmarks alone and in combination were modeled to identify the effect on Q angle. The effect of measured Q angles on the medial force exerted on the patella (FMEDIAL) was calculated.

Results

The HD position yielded significantly (P < .001) more medial Q angles than the WL position. No significant difference was observed between Q1 and Q2, but Bland–Altman plots indicated they were not equivalent. Intra‐ and interobserver agreement was substantial. Q2 errors were inherently greater than Q1: the mid‐point and tibial tuberosity are the most important sources of Q angle variability. Increasing Q angles significantly increased the exerted FMEDIAL (P < .0001, gradient 1.7%).

Conclusions

Measurements are reliable, but Q2 is more prone to error than Q1, and the 2 measurement techniques are not interchangeable. Positional errors must be kept below 1.3 mm (Q1) or 0.8 mm (Q2).
Biodegradable Sleeves for Metal Implants to Prevent Implant‐Associated Infection: An Experimental In Vivo Study in Sheep
Authors: von Plocki Stephanie C. , Armbruster David , Klein Karina , Kämpf Käthi , Zlinszky Katalin , Hilbe Monika , Kronen Peter , Gruskin Elliott , von Rechenberg Brigitte
Published: January 2012

Objective

To evaluate biocompatibility of biodegradable sleeves containing antimicrobial agents, designed for local drug delivery to prevent implant‐related infection.

Study Design

Synthetic polyester sleeves (a copolymer of glycolide, caprolactone, trimethylene carbonate, lactide) were cast as thin films. The antimicrobial agents incorporated in the sleeves included gentamicin sulfate, triclosan, or a combination of these drugs.

Animals

Adult sheep (n = 15).

Methods

Two limited contact dynamic compression plates (LC‐DCP) with or without sleeves were implanted on tibiae (bilateral) of 15 sheep. Sleeves were placed over the plates before implantation. Beneath half of the plates, 5‐mm drill hole defects were made in the near cortex. Samples were harvested 4 weeks later for histology and microradiography.

Results

Macroscopically, no irritation of bone or adjacent tissue was seen. Small remnants of sleeves were visible on histology, and positively correlated with the presence of macrophages and foreign body cells. Thick sections showed no difference between the test samples and controls in terms of fibrous capsule formation, periosteal remodeling, and defect remodeling. Inflammatory cells, macrophages, and foreign body cells were more prominent in sections with sleeves, but were not statistically significantly different from controls. Cell numbers were within normal physiologic limits normally seen as cellular response to foreign bodies consisting of polymers.

Conclusion

The normal healing response indicated that the biodegradable sleeves demonstrate tissue biocompatibility.
Strategic Alliance Poker: Demonstrating the Importance of Complementary Resources and Trust in Strategic Alliance Management
Authors: Reutzel Christopher R. , Worthington and Jamie D. Collins William J.
Published: January 2012

Strategic Alliance Poker (SAP) provides instructors with an opportunity to integrate the resource based view with their discussion of strategic alliances in undergraduate Strategic Management courses. Specifically, SAP provides Strategic Management instructors with an experiential exercise that can be used to illustrate the value creation potential of complementary resources and the role of trust in fostering resource sharing in strategic alliances. A discussion of the theoretical background, implementation, implications, and results of SAP is provided in this paper.
Valuing Access to U.S. Public Lands: A Pricing Experiment to Inform Federal Policy*
Authors: Aadland David , Anatchkova Bistra , Grandjean Burke D. , Shogren Jason F. , Simon Benjamin , Taylor Patricia A.
Published: January 2012

Objectives

We report on a nation‐wide study conducted for federal land‐management agencies. Congress mandated a new annual pass for recreational access to U.S. public lands.

Methods

To assist policymakers in setting a price for the new pass, we administered a national telephone survey with more than 2,000 respondents. Using “contingent valuation” methods, we model willingness to pay for the pass at different prices. Our research design lets us estimate and adjust for hypothetical bias.

Results

We show that survey respondents (especially those least familiar with the hypothetical good) tend to overstate their true willingness to pay.

Conclusions

We present the results and describe how our conclusions were used by policymakers to set the price of the new pass at $80. We also demonstrate the external validity of our findings by comparing the projected pass sales from our model to subsequent actual sales.
Exile Politics and Republican Party Affiliation: The Case of Cuban Americans in Miami*
Authors: Girard Chris , Grenier Guillermo J. , Gladwin Hugh
Published: January 2012

Objectives

We test the hypothesis that exile politics—measured by support for anti‐Castro policies—contribute to the overwhelming preference for the Republican Party among South Florida's Cuban Americans.

Methods

Logistic regression is used to analyze six surveys conducted in South Florida between 1995 and December 2008.

Results

Among Cuban Americans in Miami‐Dade County, measures of exile politics account for a recent downward shift in Republican registration, as well as for much of the variation in Republican registration by race and age. Also, measures of exile politics partly explain differences between Cubans and non‐Cubans with regard to partisan preference.

Conclusion

Although some scholars argue that domestic issues have taken a back seat in guiding party preferences for Miami's Cubans, a decline in support for anti‐Castro policies appears to have created a greater opening for domestic concerns in the 2008 election cycle.
Genetic Diversity and Variance of Stentor coeruleus (Ciliophora: Heterotrichea) Inferred from Inter‐Simple Sequence Repeat (ISSR) Fingerprinting
Authors: Zhang Wen‐Jing , Lin Yuan‐Shao , Cao Wen‐Qing , Yang Jun
Published: January 2012

We used inter‐simple sequence repeat fingerprinting to analyze the genetic structure of 16 populations of Stentor coeruleus from three lakes and three ponds in China. Using 14 polymorphic primers, a total of 99 discernible DNA fragments were detected, among which 76 (76.77%) were polymorphic, indicating median genetic diversity in these populations. Further, both Nei's gene diversity (h) and Shannon's information index (I) between the different populations revealed a median genetic diversity. At the same time, gene flow was interpreted to be low. The main factors responsible for the median level of diversity and low gene flow within populations are probably due to a low frequency of sexual recombinations. Analysis of molecular variance showed that there was high genetic differentiation among the five water bodies. Both cluster analysis and a nonmetric multidimensional scaling analysis suggested that genotypes isolated from the same locations displayed a higher genetic similarity than those from different ones, separating populations into subgroups according to their geographical locations. However, there is a weak positive correlation between the genetic distance and geographical distance.
Supervisors' Instrumental and Emotional Influences on Subordinate Help‐Seeking Behavior: An Exploratory Study
Authors: THACKER REBECCA A. , STONER JASON
Published: January 2012

Research on subordinate help‐seeking in the workplace is limited. In the present research, we hypothesize that subordinates' help‐seeking behaviors will be influenced by 3 supervisor influences that are instrumentally and emotionally related to the subordinate: providing direct job‐related assistance and emotional support, and socializing with the supervisor outside of work. The results indicate that providing job‐related assistance and socializing are significant predictors of subordinates' help‐seeking behaviors. Dominance analysis reveals that socializing outside of work is the dominant factor influencing subordinates' help‐seeking behaviors. Implications from the findings and suggestions for future research are presented.
Can Outcome Expectancies Help Explain Sex Differences in Direct and Indirect Aggression?
Authors: MARKS ANTHONY D. G. , HINE DONALD W. , MANTON GARY C. , THORSTEINSSON EINAR B.
Published: January 2012

This study examined the role of outcome expectancies in explaining sex differences in adolescents' inclination to engage in acts of aggression. Using a sample of Australian adolescents, 2 scales were developed to measure outcome expectancies of direct and indirect aggression. The data were used in subsequent mediation analyses. Sex differences in direct aggression were partially mediated by 2 types of aggression expectancies. Relative to females, males anticipated more overall benefits associated with acting aggressively and less fear of reprisals from authority figures. This pattern of expectancy beliefs predicted higher levels of self‐reported direct aggression. Sex differences in indirect aggression were fully mediated by anticipation of personal benefits, with males expecting greater personal benefits for engaging in this type of aggression.
Menstrual exacerbation of schizophrenia symptoms
Authors: Seeman M. V.
Published: January 2012

Seeman MV. Menstrual exacerbation of schizophrenia symptoms.

Objective:  To better understand premenstrual exacerbations of schizophrenia in women and weigh treatment options.

Method:  A PubMed literature search was conducted, using the search terms ‘schizophrenia’, ‘psychosis’, ‘menstrual exacerbation’, ‘hormones’ and assessing relevance to premenstrual exacerbation of schizophrenia symptoms.

Results:  Exacerbations are usually distinguishable from periodic or menstrual psychosis, a relatively rare condition. Controversy continues about whether low estrogen periods of the month lead to an increase in schizophrenia symptoms among women of reproductive age or whether some women suffer from both schizophrenia and premenstrual dysphoric disorder (PMDD). No treatment trials of specific interventions have been conducted so that physicians must decide on a case‐by‐case basis whether to raise antipsychotic doses premenstrually, try estrogens or estrogen/progesterone combinations or selective estrogen receptor modulators, or target PMDD symptoms.

Conclusion:  Clinicians need to be aware of premenstrual symptom aggravation in a large minority of women with schizophrenia. Treatment strategies will depend on the nature of the symptoms that are exacerbated. Optimal treatment needs to be adjusted to the individual woman.
Genital seborrheic keratoses are human papillomavirus‐related lesions. A linear array genotyping test study
Authors: TARDÍO JUAN C. , BANCALARI EUGENIA , MORENO AMALIA , MARTÍN‐FRAGUEIRO LUZ M.
Published: January 2012

Tardío JC, Bancalari E, Moreno A, Martín‐Fragueiro LM. Genital seborrheic keratoses are human papillomavirus‐related lesions. A linear array genotyping test study. APMIS 2012; 120: 477–83.

Controversy exists about the meaning of human papillomavirus (HPV) detection in seborrheic keratosis (SK). To clarify the pathogenic contributing role of HPV in the development of genital SK, we have studied 40 genital SKs, 20 extragenital SKs, and 20 non‐SK genital lesions by polymerase chain reaction for HPV, using a Linear Array Genotyping test that detects 37 genital HPV types. Twenty‐eight of the 40 genital SK specimens (70%) were positive for HPV. Twenty‐seven of the 28 positive cases (96%) contained HPV6, one of them associated to HPV18 and HPV35 (4%), and the remaining lesion (4%) harbored HPV55. However, HPV was detected in only 2/20 extragenital SK samples (10%) and in 1/20 non‐SK genital lesions (5%). Our results support a pathogenic relationship between HPV and genital SK by showing: 1) a high rate of virus detection in these lesions, with a strong predilection for HPV6, and 2) scarcity of genital HPV types in most of the remaining non‐SK cutaneous genital lesions and in the extragenital SKs. HPV cannot be found in a minority of genital SKs using highly sensitive techniques, and therefore, other presently unknown factors may also be implied in the pathogenesis of these lesions.
Demand for and utilization of dental services according to household income in the adult population in Norway
Authors: Grytten Jostein , Holst Dorthe , Skau Irene
Published: January 2012

Abstract –   Objectives:  The aim of this study was to describe the effect of income on demand and utilization of dental services according to household income in the adult population.

Methods:  The data were collected using a questionnaire, which was sent to a random sample of Norwegians aged 20 years or older living at home, 1861 persons in total. Demand was measured according to whether the person had been to the dentist during the last year. Utilization was measured as expenditure for dental treatment for those who had been to the dentist during the last year. The independent variables were the respondents’ household income, age, gender, education, dental status and the mean fee for a dental consultation in the municipality. In the first stage, we carried out a logistic regression analysis of the log odds of having demanded dental services during the last year. In the second stage, we carried out a multiple regression analysis of expenditure for dental treatment for those who had been to the dentist during the last year.

Results:  Altogether, 80% of the respondents had been to the dentist during the last year. Demand during the last year varied most according to dental status. There was little difference between men and women. The results of the logistic regression showed that the probability of having been to the dentist was 0.82 for those with a household income of €25 000 and 0.85 for those with a household income of €100 000. Mean expenditure for dental treatment was €355. There was no statistically significant relationship between household income and expenditure for dental treatment.

Conclusions:  Differences in demand for dental services according to household income are small, and there are no differences in utilization according to income. The findings are interesting, because in a population in which people have to pay almost all the costs for dental treatment themselves, one would expect the income differences in demand and utilization to be greater.
Toll‐Like Receptor Expression and Function in the COV434 Granulosa Cell Line
Authors: Price Jennifer Claire , Cronin James , Sheldon Iain Martin
Published: January 2012

Problem

Bacterial infections perturb ovarian follicle function, despite the lack of immune cells such as macrophages within healthy ovarian follicles. This study examined whether the granulosa cells that line ovarian follicles could, like macrophages, use Toll‐like receptors (TLRs) to detect pathogen‐associated molecular patterns (PAMPs) and initiate inflammation.

Method of study

The COV434 human granulosa and THP‐1 macrophage cell lines were used to determine the expression of TLRs and measure the production of cytokines, chemokines and estradiol in response to the PAMPs lipopolysaccharide, peptidoglycan, lipoteichoic acid and flagellin from bacteria.

Results

The THP‐1 and granulosa cells expressed mRNA for TLR1‐10 and TLR4‐10, respectively. The supernatants of THP‐1 cells accumulated IL‐1β, IL‐6, IL‐8 and CCL5 in response to PAMPs. Treatment of granulosa cells with PAMPs increased expression of IL1B mRNA after 3 hr, but did not change the accumulation of IL‐1β, IL‐6, IL‐8, CCL5 or estradiol. Granulosa cells produced IL‐8 constitutively, and this was reduced using chemical inhibitors for p38 and JNK mitogen‐activated protein kinases.

Conclusion

The COV434 human granulosa cell line expresses TLRs and constitutively secretes IL‐8 but only mounts an inflammatory response to PAMPs at the transcriptional level.
MRI CHARACTERISTICS OF CEREBRAL MICROBLEEDS IN FOUR DOGS
Authors: Fulkerson Caroline V. , Young Benjamin D. , Jackson Nicolette D. , Porter Brian , Levine Jonathan M.
Published: January 2012

Cerebral microbleeds in people are small foci of hemosiderin‐containing macrophages in normal brain parenchyma. They are the remnant of previous hemorrhage and occur with greater frequency in older individuals. Our purpose was to describe the magnetic resonance (MR) appearance of cerebral microbleeds in four dogs. These lesions appeared as round, hypointense foci measuring ≤4 mm on T2*‐gradient‐recalled echo images. They were less conspicuous or absent on T2‐weighting, being iso‐ or hypointense, and uniformly invisible on T1‐weighted images. No contrast enhancement was seen in any of the cerebral microbleeds. Necropsy‐derived histopathologic analysis of one brain confirmed these lesions to be chronic cerebrocortical infarcts containing hemosiderin. The MR changes seen in dogs were analogous to what has been described in people and will be helpful in distinguishing cerebral microbleeds from other brain lesions.
Post‐natal anaemia and iron deficiency in HIV‐infected women and the health and survival of their children
Authors: Isanaka Sheila , Spiegelman Donna , Aboud Said , Manji Karim P. , Msamanga Gernard I. , Willet Walter C. , Duggan Christopher , Fawzi Wafaie W.
Published: January 2012

Prenatal iron supplementation may improve pregnancy outcomes and decrease the risk of child mortality. However, little is known about the importance of post‐natal maternal iron status for child health and survival, particularly in the context of HIV infection. We examined the association of maternal anaemia and hypochromic microcytosis, an erythrocyte morphology consistent with iron deficiency, with child health and survival in the first two to five years of life. Repeated measures of maternal anaemia and hypochromic microcytosis from 840 HIV‐positive women enrolled in a clinical trial of vitamin supplementation were prospectively related to child mortality, HIV infection and CD4 T‐cell count. Median duration of follow‐up for the endpoints of child mortality, HIV infection and CD4 cell count was 58, 17 and 23 months, respectively. Maternal anaemia and hypochromic microcytosis were associated with greater risk of child mortality [hazard ratio (HR) for severe anaemia = 2.58, 95% confidence interval (CI): 1.66–4.01, P trend < 0.0001; HR for severe hypochromic microcytosis = 2.36, 95% CI: 1.27–4.38, P trend = 0.001]. Maternal anaemia was not significantly associated with greater risk of child HIV infection (HR for severe anaemia = 1.46, 95% CI: 0.91, 2.33, P trend = 0.08) but predicted lower CD4 T‐cell counts among HIV‐uninfected children (difference in CD4 T‐cell count/µL for severe anaemia: −93, 95% CI: −204–17, P trend = 0.02). The potential child health risks associated with maternal anaemia and iron deficiency may not be limited to the prenatal period. Efforts to reduce maternal anaemia and iron deficiency during pregnancy may need to be expanded to include the post‐partum period.
Anencephaly Does Not Cause Structural Alterations in the Fetal Penis
Authors: de Carvalho João P.M. , Costa Waldemar S. , Sampaio Francisco J.B. , Favorito Luciano Alves
Published: January 2012

Introduction

Anencephaly is the most severe neural tube defect in human fetuses. There is an increasing need for tissue replacement in chronic diseases and reconstructive surgeries. Fetal tissues have been used as a substitute for native organs.

Aim

The aim of this article was to compare the structure and morphology of the corpora cavernosa (CC) and spongiosum (SP) of penises from anencephalic and normal human fetuses.

Main Outcome Measures

The main outcome measures of this study were the proposition of a new model for biological studies and tissue transplantation.

Methods

We studied 11 penises from normal human fetuses, aged 14–23 weeks postconception (WPC), and five penises from anencephalic fetuses, aged 18–22 WPC. The organs were removed and processed by routine histological and immunolabeling techniques. Analysis of connective tissue (Cot), smooth muscle (SMC), and elastic fiber (EF) were performed in sections. Data were expressed as area density (Ad) using digital processing and software. Means were statistically compared using the unpaired t-test and linear regression was performed. Statistical significance was considered if P < 0.05.

Results

The intracavernosal septum was present in all samples. We did not observe differences in the Ad of Cot and SMC in the penises of anencephalic fetuses when compared with normal ones. The simple linear regression suggested that during human development, there is a gradual increase in Cot (R2 = +0.45) and a decrease of SMC (R2 = −0.62) in the CC in both groups studied. Elastin was observed only in fetuses from 20th WPC.

Conclusions

There was no difference in the structure of the CC and corpus SP of anencephalic fetuses compared with normal ones. Elastin was documented from 20th WPC, which suggests the maintenance of erectile function. Histochemistry and immunolabeling suggested that penile shaft development is maintained and unaltered in anencephalic fetuses. Further studies should be performed to analyze anencephalic fetuses as a potential tissue-donating group and a model for biological studies.
Penile Arterial Waveform Analyzing System for Early Identification of Young Adults with High Risk of Erectile Dysfunction
Authors: Wu Hsien-Tsai , Lee Chun-Ho , Chen Chin-Jung , Sun Cheuk-Kwan
Published: January 2012

Introduction

High prevalence of erectile dysfunction in young adults has raised much concern regarding early identification of risk factors for timely intervention.

Aim

This study aimed at identifying young males at risk through a novel penile arterial waveform analyzing system.

Methods

Between July 2009 and December 2010, 30 young adult volunteers of age 18 to 29 without known history of vascular diseases or erectile dysfunction were recruited.

Main Outcome Measures

Basic demographic and anthropometric characteristics (i.e., age, body weight, body height, body mass index, waist circumference) were recorded. Blood samples were obtained for determining levels of testosterone, glycosylated hemoglobin, triglyceride, fasting sugar, low- and high-density lipoproteins (HDL). Data obtained from visual sexual stimulation (VSS) RigiScan and the penile arterial waveform amplitude (PAWA) ratios were compared in terms of their correlations with anthropometric and serum biochemical parameters using Pearson’s correlation analysis.

Results

PAWA ratios were found to correlate with Rigidity (tip and base) (r = 0.425, P = 0.019 and r = 0.664, P < 0.001, respectively). Significant associations of PAWA ratios were noted not only with serum testosterone level but also with risk factors for metabolic and cardiovascular diseases including total triglyceride, HDL, age, waist circumference, body mass index, and diastolic blood pressure. However, VSS RigiScan failed in identifying significant correlations with HDL, age, and diastolic blood pressure.

Conclusions

Not only could the penile waveform analyzing system assess penile endothelial function in young adults, but the results also showed significant associations with their serum testosterone levels and metabolic parameters. The findings suggest that PAWA ratio may serve as an indicator for early identification and treatment of young adults at risk of erectile dysfunction.
A Study of Possible Associations Between Single Nucleotide Polymorphisms in the Serotonin Receptor 1A, 1B, and 2C Genes and Self-Reported Ejaculation Latency Time
Authors: Jern Patrick , Westberg Lars , Johansson Ada , Gunst Annika , Eriksson Elias , Sandnabba Kenneth , Santtila Pekka
Published: January 2012

Introduction

Previous research has indicated that serotonergic genes may influence ejaculatory function. Attempts to investigate effects of polymorphisms in serotonergic genes have been carried out, but so far, no study has conducted exploratory genotype analyses regarding the serotonin receptor 1A, 1B, and 2C subtypes, which have been hypothesized to mediate the inhibitory effects of serotonin on ejaculation in rodents.

Aim

The aim of the present study was to investigate effects of a total of six single nucleotide polymorphisms (SNPs) located in genes encoding serotonin receptor subtypes 1A, 1B, and 2C on self-reported ejaculation latency time.

Methods

A retrospective self-report measure of ejaculation latency time was used to investigate ejaculatory function in a population-based sample of 1,399 male twins. DNA was collected using self-administered saliva sampling.

Main Outcome Measure

Calculations of allelic effects were conducted using the Generalized Estimating Equations module of PASW 18.0, which appropriately controls for between-subjects dependence.

Results

Out of six investigated polymorphisms, two SNPs (both serotonin receptor 5-HT1B linked) had a significant main effect on ejaculation latency time. Of these, one (rs11568817) remained significant after Bonferroni correction for multiple testing, indicating that individuals homozygous for the G allele had significantly shorter ejaculation latencies.

Conclusions

The results of this study support the hypothesis that serotonergic genes play a role in ejaculatory function in the general population. Replication of the results of the present study is warranted.
The Effects of Fibromyalgia Syndrome on Female Sexuality: A Controlled Study
Authors: Yilmaz Halim , Yilmaz Sema Dereli , Polat Halime Almula Demir , Salli Ali , Erkin Gulten , Ugurlu Hatice
Published: January 2012

Introduction

Fibromyalgia may have negative effects on sexual function in women.

Aims

To evaluate the sexuality of women with fibromyalgia and healthy control subjects, and to investigate the relation between sexuality and clinical parameters of fibromyalgia.

Main Outcome Measures

Female Sexual Function Index (FSFI), Tender Points Count (TPC), Beck Depression Inventory (BDI), Fibromyalgia Impact Questionnaire (FIQ), and Visual Analog Scale (VAS).

Methods

Clinical evaluation and surveys were done with 126 women with fibromyalgia and 132 healthy women.

Results

Patients with fibromyalgia had higher BDI scores and lower frequency of sexual intercourse than control subjects. The mean FSFI scores (total and all domains) were significantly lower in patients with fibromyalgia than control subjects. Mean FSFI scores (total and most domains) were significantly lower in patients with fibromyalgia who had BDI score ≥ 17 than those who had BDI score < 17. In women with fibromyalgia, a significant negative correlation was noted between total FSFI score, and both FIQ and BDI scores.

Conclusions

Fibromyalgia has negative effects on female sexual function that are aggravated by depression.
The Effect of Gepirone-ER in the Treatment of Sexual Dysfunction in Depressed Men
Authors: Fabre Louis F. , Clayton Anita H. , Smith Louis C. , Goldstein Irwin , Derogatis Leonard R.
Published: January 2012

Introduction

Sexual dysfunction is common in patients with major depressive disorder (MDD). Antidepressant medications especially the selective serotonin reuptake inhibitors (SSRIs) may improve depressive symptoms but further decrease sexual function. Gepirone extended release (gepirone-ER) differs from the SSRIs in only affecting the 5-HT1A receptor and has demonstrated efficacy in treatment of depression and sexual dysfunction in depressed women. This report describes the effect of gepirone-ER on sexual function in depressed men.

Aim

The aims of this article were to study the effects of gepirone-ER on sexual function in men with MDD and to determine if positive effects are independent of antidepressant or anxiolytic activity.

Main Outcome Measures

The main outcome measures of this article were Hamilton depression rating scale (HAMD-17), and changes in sexual functioning questionnaire (CSFQ).

Methods

In an 8-week study, gepirone-ER, placebo, or fluoxetine were administered in a double-blind fashion to 181 depressed men. The CSFQ results were used to determine quality of sexual function. To test for an antidepressant or anxiolytic effect, a 50% reduction in HAMD-17 score separated antidepressant responders from nonresponders, and item 12 of the HAMD scale (psychic anxiety) scores of 0 or 1 separated anxiolytic responders from nonresponders.

Results

Gepirone-ER treatment improved total sexual function compared with placebo measured by the CSFQ at weeks 4 (P = 0.012) and 8 (P = 0.046). At 4 weeks, almost every CSFQ domain is improved. The orgasm domain was especially improved, 67% by week 4. Gepirone-ER antidepressant and anxiolytic nonresponders showed significant improvement in sexual function. Fluoxetine treatment did not produce improvement. In fact, fluoxetine-treated subjects had lower scores on the total CSFQ, less than placebo, and significantly less than gepirone-ER.

Conclusion

Gepirone-ER improves sexual dysfunction in depressed men. All domains of sexual function improved. Gepirone-ER has a pro-sexual effect independent of antidepressant or anxiolytic activity.
Operating in an Intellectual Property World: Knowledge Sharing among Plant Breeders in Canada
Authors: Galushko Viktoriya , Gray Richard , Oikonomou Emmanouil
Published: January 2012

This paper examines the incentives for knowledge sharing in an industry where a public institution and a private firm develop new differentiated crop varieties and sell them to heterogeneous farmers. The decision of the public institution to either share their knowledge, or protect and cross‐license their IP with the rival firm, is a strategic choice. While the profit‐maximizing private research firms have an incentive to protect and secure their intellectual property (IP), under some conditions they choose to cross‐license their technology rather than forgo access to the public IP. The budget constrained public firm, with an objective of maximizing farmers’ welfare, can have an incentive to share its IP but under certain conditions has an incentive to incur transaction costs to protect and cross‐license its technology to obtain access to the private technology. The theoretical model shows that public incentives to protect IP are likely to be stronger in a research industry with significant corporate presence. A survey of Canadian wheat and canola breeders reveals that public breeders are far more secretive in the canola sector than in the wheat sector, a dichotomy that is consistent with the theoretical results.

Le présent article examine les avantages du partage de connaissances dans un secteur d’activité où une institution publique et une firme privée mettent au point de nouvelles variétés végétales différenciées et les vendent à des agriculteurs hétérogènes. La décision de l’institution publique de partager ses connaissances ou de protéger sa propriété intellectuelle (PI) et de procéder à la concession de licences réciproques avec la firme rivale constitue un choix stratégique. Bien que les firmes de recherche privées axées sur la maximisation des bénéfices aient intérêt à protéger leur PI, dans certaines conditions, elles choisissent de procéder à la concession de licences réciproques plutôt que de renoncer à l’accès de la PI du secteur public. L’institution publique à budget restreint, qui vise entre autres à maximiser le bien‐être des agriculteurs, peut tirer profit du partage de sa PI mais, dans certaines conditions, elle a intérêt à assumer les coûts de transaction pour protéger sa technologie et procéder à une concession de licences réciproques afin d’obtenir l’accès à la technologie du secteur privé. Le modèle théorique montre que les avantages publics liés à la protection de la PI risquent d’être plus importants dans un secteur de la recherche où la présence des entreprises est forte. Un sondage mené auprès de sélectionneurs de blé et de canola canadiens révèle que, dans le secteur public, les sélectionneurs de canola sont beaucoup plus enclins à conserver le secret que les sélectionneurs de blé, une dichotomie qui concorde avec les résultats théoriques.