bluuebunny/crossref_metadata_2025 huggingface dataset:
Serum and urinary neutrophil gelatinase‐associated lipocalin levels in children with chronic renal diseases
Authors: Nishida Masashi , Kawakatsu Hidekazu , Okumura Yasuko , Hamaoka Kenji
Published: January 2010

Background:  Recent studies showed that serum and urinary neutrophil gelatinase‐associated lipocalin (NGAL) represents a novel, sensitive, specific biomarker for early detection of acute kidney injury. However, the clinical significance of measuring serum and urinary NGAL on chronic renal diseases remains unclear.

Methods:  In this study, we measured serum and urinary NGAL levels in patients with several common pediatric renal diseases such as renal dysfunction (estimated glomerular filtration rate < 90 mL/min/1.73 m2), proliferative glomerulonephritis, steroid‐resistant and steroid‐sensitive nephrotic syndrome, and tubular dysfunction.

Results:  Urinary NGAL level was significantly increased compared with the control in all of these disease groups except in patients with a remission stage of steroid‐sensitive nephrotic syndrome, although a significant increase in serum NGAL level was observed in the renal dysfunction group only. Both serum and urinary NGAL levels showed significant inverse correlations with an estimated glomerular filtration rate in the analysis with total subjects, and also in the analysis with the renal dysfunction group in urinary NGAL. In proteinuric patients, the extent of proteinuria significantly correlated with urinary NGAL level. In patients with tubular dysfunction, the increase of urinary NGAL level was remarkable compared with the other disease groups.

Conclusion:  These results indicated that urinary NGAL level is a better biomarker for chronic renal diseases in children than serum NGAL level, although multiple pathological mechanisms should be considered in evaluating these NGAL values.
The Pedagogy of Slowing Down: Teaching Talmud in a Summer Kollel
Authors: Kanarek Jane
Published: January 2010

This article explores a set of practices in the teaching of Talmud called “the pedagogy of slowing down.” Through the author's analysis of her own teaching in an intensive Talmud class, “the pedagogy of slowing down” emerges as a pedagogical and cultural model in which the students learn to read more closely and to investigate the multiplicity of meanings inherent in the Talmudic text, thus bridging the gap between an ancient text and its contemporary students. This article describes the specific techniques in the pedagogy of slowing down, and the ways in which this teaching practice contributes both to students' becoming more attentive readers and to the ongoing development of their religious voices.
Three Reviews of For Life Abundant: Practical Theology, Theological Education, and Christian Ministry, edited by Dorothy C. Bass and Craig Dykstra, 2008
Authors: Slough Rebecca , Stortz Martha E. , Kwok Pui‐lan
Published: January 2010

For Life Abundant, the fruit of sustained reflection among systematic theologians, practical theologians, and pastors, is an important new work that deserves attention. The volume provokes creative and critical thinking about practical theology. Its contributors conceptualize the field as a disciplined practice of imagination and skill residing at the confluence of Christian tradition and living ecclesial communities, and ask what such a construal of practical theology might mean for theological education.

Given the significance of For Life Abundant, Teaching Theology and Religion asked three theological educators who are located in different regions, types of institutions, and fields, to review and respond to it. Rebecca Slough describes the volume's central questions and organization, and considers how it might contribute to the deliberations of a seminary faculty regarding a school's curriculum. Martha Stortz shows how the process and structure of For Life Abundant are in themselves illustrative of the conceptualization of practical theology for which it argues. Kwok Pui‐lan notes the volumes strengths and goes on to probe its lacunae, particularly with regard to global, gender, and multi‐cultural considerations relevant to a robust construal of pastoral theology in our time.

While the authors of these three reviews and responses to the volume did not interact as they wrote them, together they comprise a conversation that should be on‐going. TTR invites further responses to the volume.
God's Stuff: The Constructive Powers of Chaos For Teaching Religion
Authors: Willhauck Susan
Published: January 2010

Order and organization are valued in the classroom, and there is a prevailing understanding that chaos should be avoided. Yet chaos can also be potent space or a source from which new things spring forth. This article investigates biblical, scientific, and cultural understandings of chaos to discover how these contribute to a revelatory metaphor for teaching. It examines Catherine Keller's engagement with chaos theory in creation theology for pedagogical implications. Using a framework suggested in the work of Mary Elizabeth Moore, the author interprets powers and practices of chaos teaching and provides examples of how the metaphor plays out in the teaching of religion and theology.
Risks for methicillin‐resistant Staphylococcus aureus colonization or infection among patients with HIV infection*
Authors: Ramsetty SK , Stuart LL , Blake RT , Parsons CH , Salgado CD
Published: January 2010

Background

Risks for methicillin‐resistant Staphylococcus aureus (MRSA) among those with HIV infection have been found to vary, and the epidemiology of USA‐300 community‐acquired (CA) MRSA has not been adequately described.

Methods

We conducted a retrospective review of HIV‐infected out‐patients from January 2002 to December 2007 and employed multivariate logistic regression (MLR) to identify risks for MRSA colonization or infection. Pulsed‐field gel electrophoresis (PFGE) was used to identify USA‐300 strains.

Results Seventy‐two (8%) of 900 HIV‐infected patients were colonized or infected with MRSA. MLR identified antibiotic exposure within the past year [odds ratio (OR) 3.4; 95% confidence interval (CI) 1.5–7.7] and nadir CD4 count <200 cells/μL (OR 2.5; 95% CI 1.2–5.3) as risks for MRSA colonization or infection. Receipt of antiretroviral therapy (ART) within the past year was associated with decreased risk (OR 0.16; 95% CI 0.07–0.4). Eighty‐nine percent of available strains were USA‐300. MLR identified skin or soft tissue infection (SSTI) as the only predictor for infection with USA‐300 (OR 5.9; 95% CI 1.4–24.3).

Conclusion Significant risks for MRSA among HIV‐infected patients were CD4 count nadir <200 cells/μL and antibiotic exposure. Only the presence of an SSTI was associated with having USA‐300, and thus the use of patient characteristics to predict those with USA‐300 was limited. In addition, ART within the previous year significantly reduced the risk of MRSA colonization or infection.
Enabling self‐directed computer use for individuals with cerebral palsy: a systematic review of assistive devices and technologies
Authors: DAVIES T CLAIRE , MUDGE SUZIE , AMERATUNGA SHANTHI , STOTT N SUSAN
Published: January 2010

Aim  The purpose of this study was to systematically review published evidence on the development, use, and effectiveness of devices and technologies that enable or enhance self‐directed computer access by individuals with cerebral palsy (CP).

Methods  Nine electronic databases were searched using keywords ‘computer’, ‘software’, ‘spastic’, ‘athetoid’, and ‘cerebral palsy’; the reference lists of articles thus identified were also searched. Thirty articles were selected for review, with 23 reports of development and usability testing of devices and seven evaluations of algorithms to increase computer recognition of input and cursor movements.

Results  Twenty‐four studies had fewer than 10 participants with CP, with a wide age range of 5 to 77 years. Computer task performance was usually tested, but only three groups sought participant feedback on ease and comfort of use. International standards exist to evaluate effectiveness of non‐keyboard devices, but only one group undertook this testing. None of the study designs were higher than American Academy for Cerebral Palsy and Developmental Medicine level IV.

Interpretation  Access solutions for individuals with CP are in the early stages of development. Future work should include assessment of end‐user comfort, effort, and performance as well as design features. Engaging users and therapists when designing and evaluating technologies to enhance computer access may increase acceptance and improve performance.
Social Capital, Migration and Development in the Valles Centrales of Oaxaca, Mexico: Non‐Migrants and Communities of Origin Matter
Authors: GABBAROT MARIANA , CLARKE COLIN
Published: January 2010

This article investigates the importance of place‐of‐origin communities to an understanding of the impact of migrant remittances on local development, employing the concept of social capital. Two aspects of social capital (each present prior to migration) are shown to be of significance–family relationships and community organisation. Drawing on recent research in two peasant communities in Oaxaca, Mexico, social capital is used to examine the relevance of non‐migrants in shaping the outcomes of migration in communities of origin. Evaluation of migrant remittances and home‐town associations demonstrates the developmental significance of non‐migrants and communities of origin.
Mortality of Tuberculosis in Very Old People
Authors: Salvadó Meritxell , Garcia‐Vidal Carolina , Vázquez Pilar , Riera Montserrat , Rodríguez‐Carballeira Mónica , Martínez‐Lacasa Javier , Cuchi Eva , Garau Javier
Published: January 2010

OBJECTIVES: To describe the clinical characteristics and outcomes of tuberculosis (TB) in elderly people.

DESIGN: Observational analysis of a prospective cohort of adults with TB (1995–2004). A case–control study to determine attributable mortality to TB in very old people was done.

RESULTS: Of 319 patients with TB, 109 (34.2%) were aged 65 and older. The older group was more likely to have comorbidities (1.4% vs 0.4%; P<.001), extrapulmonary and disseminated TB (50.4% vs 26.1%; P<.001), toxicity (22% vs 9.8%; P=.006), and 30‐day mortality (18.3% vs 1.6%; P<.001). When patients aged 65 to 79 were compared with those aged 80 and older, only differences in TB‐related mortality were detected (9.8% vs 44.4%; P=.01). In the attributable mortality analysis, 30‐day and 6‐month mortality were higher in very old patients with TB than in controls without TB (41.7% vs 11.1%, P=.005; 45.8% and 19.4%, P=.01, respectively). No differences in mortality were shown when excluding patients with postmortem TB diagnosis or those who died within the first 72 hours of diagnosis.

CONCLUSION: Older people with TB had a higher frequency of atypical features, more adverse drug reactions, and greater TB‐related mortality than younger people. Data suggest that very old patients with TB have higher mortality, but if diagnosed early and adequately treated, very old patients with TB do not have greater mortality than those without.
Disparity in Use of Psychotherapy Offered in Primary Care Between Older African‐American and White Adults: Results from a Practice‐Based Depression Intervention Trial
Authors: Joo Jin Hui , Morales Knashawn H. , de Vries Heather F. , Gallo Joseph J.
Published: January 2010

The purpose of this study was to assess ethnic differences in use of psychotherapy (having met at least once with a psychotherapist) for late‐life depression in primary care. Participants were identified through a two‐stage, age‐stratified (60–74, ≥75) depression screening of randomly sampled patients from 20 practices in New York City, Philadelphia, and Pittsburgh in a practice‐randomized trial. Practices were randomly assigned to usual care or to an intervention with a depression care manager who worked with primary care physicians to provide algorithm‐based care. Depression status based on clinical interview and any use of psychotherapy within the 2‐year follow‐up interval were the primary dependent variables under study. The focus was on 582 persons with complete data. Participants were sorted into major depression (n=385, 112 African American and 273 white) and clinically significant minor depression (n=197, 51 African American and 146 white) based on clinical diagnostic assessment. Persons who self‐identified as African American were less likely than whites to use interpersonal therapy (IPT) if they had minor depression, even after adjusting for potentially influential variables including age, cognitive functioning, and whether the dose of antidepressant was adequate (adjusted odds ratio (AOR)=0.22, 95% confidence interval (CI)=0.06–0.80). Ethnicity was not significantly associated with IPT use in persons with major depression (AOR=0.71, 95% CI=0.37–1.37). Older African Americans with minor depression were less likely than whites to use psychotherapy. Targeted strategies are needed to mitigate the disparity in use of psychotherapy.
Designing a Learner‐Centered Geriatrics Curriculum for Multilevel Medical Learners
Authors: McCrystle Sindy W. , Murray Louise M. , Pinheiro Sandro O.
Published: January 2010

This article describes the development of a learner‐centered, needs‐based geriatrics curriculum for medical trainees, specifically, a geriatric block rotation for family medicine and internal medicine residents with the incorporation of a new group of learners: medical students. The objectives were to develop a curriculum that meets the needs of learners with diverse levels of geriatric experience and learning needs. The process used to accomplish these objectives is outlined. In an effort to design a learner‐centered, competence‐based curriculum, two instruments were developed. These instruments served to identify the learning needs of the varied levels of learners and to develop the specific goals and objectives of this 4‐week geriatric rotation. The Geriatric Self‐Competency Checklist (GSCC) and a Geriatric Knowledge Test were administered before and after the rotation. On average, learners identified eight priority learning needs using the GSCC. Evaluation and feedback from faculty and preceptors was also important in the identification of learning needs and during the learning process. Faculty development was initiated, focusing on the identification of competence in specific curricular areas. Examples of application of adult learning principles in curriculum design and implementation are also shared. No additional costs or faculty were required for this project, which is important if scarce academic geriatrics resources are to be used to reach the many more medical students and residents. This is essential for quality care needs of the rapidly aging population.
Fatal Trichosporon fungemia in patients with hematologic malignancies
Authors: Suzuki Kei , Nakase Kazunori , Kyo Taiichi , Kohara Tadahiro , Sugawara Yumiko , Shibazaki Tetsunori , Oka Kouji , Tsukada Tetsuya , Katayama Naoyuki
Published: January 2010

Objective: Invasive Trichosporon infection has been increasingly recognized in patients with hematologic malignancies. Our study aims to clarify the clinical characteristics of this disease and factors influencing patient prognosis. Patients and methods: We retrospectively analyzed 33 cases of Trichosporon fungemia (TF) in patients with hematologic malignancies treated at our collaborating five hospitals in Japan between 1992 and 2007. Results: The majority of these patients had acute leukemia (82%), neutropenia (85%), and a history of intensive chemotherapy (91%). TF occurred as a breakthrough infection during antifungal therapy in 30 patients (91%), 18 of whom were receiving micafungin. The surveillance cultures of most patients were negative for Trichosporon. Only a few patients exhibited elevated levels of 1,3‐β‐d‐glucan before positive blood culture. Twenty‐five patients (76%) died of this infection. The resolution of infection was associated with neutrophil recovery (P = 0.0001), absence of hyperglycemia (P = 0.023), and azole inclusive therapy (P = 0.031). Survival was significantly longer in patients receiving antifungal therapies containing azole than in those who did not receive azole (P = 0.0034). Conclusions: At present, the diagnosis of invasive trichosporonosis depends on blood culture studies, and the mortality of this disease is high; however, azole therapy and control of blood glucose level, together with hematopoietic recovery could help in improving the clinical outcome. When we use antifungals lacking anti‐Trichosporon activity, sufficient care should be taken to prevent the development of breakthrough trichosporonosis.
THP‐COP regimen for the treatment of peripheral T‐cell lymphoma and adult T‐cell leukemia/lymphoma: a multicenter phase II study
Authors: Takamatsu Yasushi , Suzumiya Junji , Utsunomiya Atae , Maeda Koichi , Matsuoka Hitoshi , Suzushima Hitoshi , Tsukada Junichi , Shibata Keisuke , Tamura Kazuo ,   the Kyushu Hematology Organization for Treatment Study Group (K‐HOT)
Published: January 2010

Objective: The efficacy of pirarubicin (THP)‐COP was previously compared with cyclophophamide + doxorubicin + vincristine + prednisolone (CHOP) in elderly patients with lymphoma. The subset analysis showed that T‐cell lymphoma had a significantly better response with THP‐COP, whereas no such difference was observed in B‐cell lymphoma. The aim of this study is to confirm the efficacy of THP‐COP in the treatment of T‐cell lymphoma. Methods: We underwent a multicenter phase II study of THP‐COP as a first‐line treatment for T‐cell lymphoma. The overall response rate, survival period, and toxicity were analyzed. Results: Fifty‐three patients were enrolled in this study. Seventeen patients had peripheral T‐cell lymphoma (PTCL), including nine of PTCL not otherwise specified (PTCL‐NOS) and eight of angioimmunoblastic T‐cell lymphoma (AITL). Thirty‐six patients had adult T‐cell leukemia/lymphoma (ATLL), including 20 of acute type and 16 of lymphoma type. A treatment response was obtained in 35 (66%) patients, including 17 (32%) complete responses. Median overall survival (OS) and progression‐free survival (PFS) times were 14.3 months and 5.2 months, respectively. Patients with ATLL showed a tendency to obtain low response rate (61% vs. 77%, P = 0.27) and had a significantly inferior OS (13.3 vs. 28.6 months, P = 0.04) and PFS (4.6 vs. 8.1 months, P = 0.01) in comparison with PTCL. Grade 3 to 4 neutropenia, anemia, and thrombocytopenia occurred in 72%, 34%, and 58% of the patients, respectively. Febrile neutropenia was observed in 51% and grade 3 non‐hematological toxicities in 2–9% of the patients. Conclusion: The efficacy of THP‐COP is equivalent to that of CHOP for the first‐line therapy in T‐cell lymphoma.
Thrombocytopenia as an adverse effect of complementary and alternative medicines, herbal remedies, nutritional supplements, foods, and beverages*
Authors: Royer Derek J. , George James N. , Terrell Deirdra R.
Published: January 2010

Background:  Thrombocytopenia is a well‐recognized adverse effect of many drugs. However, the association of thrombocytopenia with complementary/alternative medicines, herbal remedies, nutritional supplements, foods, and beverages has been rarely described, except for reports of thrombocytopenia caused by quinine‐containing beverages.

Objectives:  To systematically identify all published reports of thrombocytopenia associated with these substances and to assess the evidence supporting their causal association with thrombocytopenia.

Methods:  Eleven databases were searched to identify relevant published reports. A priori criteria were defined for article selection and assessment. Each selected article was independently assessed by the three authors to document the presence of the criteria and determine the level of evidence for a causal association of the reported substance with thrombocytopenia.

Results:  Twenty‐seven articles were identified that reported the occurrence of thrombocytopenia with 25 substances (other than quinine). However, only six articles describing five substances (cow’s milk, cranberry juice, Jui [Chinese herbal tea], Lupinus termis bean, and tahini [pulped sesame seeds]) reported clinical data supporting definite evidence of a causal association with thrombocytopenia. Four articles provided probable evidence for four additional substances, and five articles provided possible evidence for five additional substances. In the remaining articles, the association with thrombocytopenia was unlikely or the articles were excluded from review.

Conclusions:  Reports of thrombocytopenia describing definite or probable evidence for an association of a complementary/alternative medicines, herbal remedies, nutritional supplements, foods, and beverages are rare. Whether the occurrence of thrombocytopenia with these substances is uncommon or unrecognized is unknown.
The role of NCAM in auditory fear conditioning and its modulation by stress: a focus on the amygdala
Authors: Bisaz R. , Sandi C.
Published: January 2010

Chronic stress in rodents was shown to induce structural shrinkage and functional alterations in the hippocampus that were linked to spatial memory impairments. Effects of chronic stress on the amygdala have been linked to a facilitation of fear conditioning. Although the underlying molecular mechanisms are still poorly understood, increasing evidence highlights the neural cell adhesion molecule (NCAM) as an important molecular mediator of stress‐induced structural and functional alterations. In this study, we investigated whether altered NCAM expression levels in the amygdala might be related to stress‐induced enhancement of auditory fear conditioning and anxiety‐like behavior. In adult C57BL/6J wild‐type mice, chronic unpredictable stress resulted in an isoform‐specific increase of NCAM expression (NCAM‐140 and NCAM‐180) in the amygdala, as well as enhanced auditory fear conditioning and anxiety‐like behavior. Strikingly, forebrain‐specific conditional NCAM‐deficient mice (NCAM‐floxed mice that express the cre‐recombinase under the control of the promoter of the α‐subunit of the calcium‐calmodulin‐dependent protein kinase II), whose amygdala NCAM expression levels are reduced, displayed impaired auditory fear conditioning which was not altered following chronic stress exposure. Likewise, chronic stress in these conditional NCAM‐deficient mice did not modify NCAM expression levels in the amygdala or hippocampus, while they showed enhanced anxiety‐like behavior, questioning the involvement of NCAM in this type of behavior. Together, our results strongly support the involvement of NCAM in the amygdala in the consolidation of auditory fear conditioning and highlight increased NCAM expression in the amygdala among the mechanisms whereby stress facilitates fear conditioning processes.
MAGNETIC RESONANCE SIGNAL CHANGES DURING TIME IN EQUINE LIMBS REFRIGERATED AT 4°C
Authors: BOLEN GÉRALDINE , HAYE DIMITRI , DONDELINGER ROBERT , BUSONI VALERIA
Published: January 2010

When ex vivo magnetic resonance (MR) imaging studies are undertaken, specimen conservation should be taken into account when interpreting MR imaging results. The purpose of this study was to assess MR changes during time in the anatomic structures of the equine digit on eight cadaver limbs stored at 4°C. The digits were imaged within 12 h after death and then after 1, 2, 7, and 14 days of refrigeration. After the last examination, four feet were warmed at room temperature for 24 h and reimaged. Sequences used were turbo spin echo (TSE) T1, TSE T2, short tau inversion recovery (STIR), and double‐echo steady state (DESS). Images obtained were compared subjectively side by side for image quality and signal changes. Signal‐to‐noise ratio (SNR) was measured and compared between examinations. There were no subjective changes in image quality. A mild size reduction of the synovial recesses was detected subjectively. No signal change was seen subjectively except for bone marrow that appeared slightly hyperintense in STIR and slightly hypointense in TSE T2 sequence after refrigeration compared with day 0. Using quantitative analysis, significant SNR changes in bone marrow of refrigerated limbs compared with day 0 were detected in STIR and TSE T2 sequences. Warming at room temperature for 24 h produced a reverse effect on SNR compared with refrigeration with a significant increase in SNR in TSE T2 images. After 14 days of refrigeration a statistically significant decrease of SNR was found in bone marrow in TSE T2 and DESS sequences. The SNR in the deep digital flexor tendon was not characterized by significant change in SNR.
COMPARISON OF GASTROGRAFIN TO BARIUM SULFATE AS A GASTROINTESTINAL CONTRAST AGENT IN RED‐EARED SLIDER TURTLES (TRACHEMYS SCRIPTA ELEGANS)
Authors: LONG CHARLES TYLER , PAGE RICHARD B. , HOWARD ANTWAIN M. , MCKEON GABRIEL P. , FELT STEPHEN A.
Published: January 2010

Red‐eared slider turtles (Trachemys scripta elegans) commonly develop intestinal obstruction. The gastrointestinal transit time in turtles tends to be longer than in other animals, making a rapid diagnosis of obstruction difficult. Fifteen red‐eared sliders were given either Gastrografin® or 30% w/v barium sulfate orally to compare ease of administration, transit time, and image quality. Each contrast medium was easy to administer but barium sulfate had to be administered more slowly (mean=40 s) than Gastrografin® (mean=20 s) to prevent regurgitation. The mean transit and emptying time of Gastrografin® was at least 9 h faster than barium sulfate at all time points except gastric transit. Both contrast media had a smooth, uniform appearance that outlined the mucosa with well‐defined margins within the stomach and proximal small intestine. Dilution of Gastrografin® occurred as it progressed through the intestines, resulting in decreased opacity in the distal small intestine and colon. Pre‐administration packed cell volume and total serum protein levels of four turtles receiving Gastrografin® were compared with levels at 24‐, 96‐, and 168‐hours postadministration as well as to four control turtles not receiving contrast medium. Packed cell volume and total serum protein levels did not significantly differ among the Gastrografin® and control group. From a clinical perspective, administration of Gastrografin® allows for quicker results with only minor hematologic changes in red‐eared sliders, but visualization of this contrast medium in the lower gastrointestinal tract may be insufficient for an accurate diagnosis.
NORMAL CANINE PEDIATRIC GASTROINTESTINAL ULTRASONOGRAPHY
Authors: STANDER NERISSA , WAGNER WENCKE M. , GODDARD AMELIA , KIRBERGER ROBERT M.
Published: January 2010

The normal sonographic appearance of the adult canine gastrointestinal tract has been described. Interpretation of abdominal ultrasonographic findings in puppies is difficult due to the lack of information on normal ultrasonographic findings. The gastrointestinal tract, jejunal lymph node size and the presence and appearance of abdominal fluid were investigated in 23 normal, 7–12‐week‐old Beagle puppies. The duodenal wall thickness was greater than in other parts of the gastrointestinal tract (mean 3.8 ± standard deviation [SD] 5 mm, range 3.2–4.8 mm). The mean stomach wall thickness was 2.7 ± SD 0.4 mm (range 2.2–3.7 mm), the mean jejunal wall thickness was 2.5 ± SD 0.5 mm (range 1.2–3.4 mm), and the mean colonic wall thickness was 1.3 ± SD 0.3 mm (range 0.7–2.0 mm). In addition, mean duodenal and jejunal mucosal layer thicknesses measured 2.7 ± SD 0.5 mm (range 2.0–3.8 mm) and 1.5 ± SD 0.4 mm (range 0.6–2.5 mm), respectively. Homogenous, hypoechoic jejunal lymph nodes were easily found and the mean thickness was 7.1 ± SD 2.2 mm (range 1.5–12.5 mm). A mild amount of anechoic free peritoneal fluid was present in all puppies.
What’s New in Sex Therapy (CME)
Authors: Althof Stanley E.
Published: January 2010

Introduction

“Is there anything new in sex therapy?” Has the field of sex therapy been stagnating and failing to develop new treatments? Clearly, the important pharmaceutical advances of the past 11 years have overshadowed the developments in the field of sex therapy.

Aim

The goal of this manuscript is to call attention to the recent innovations in the field of sex therapy.

Method

Review of the literature.

Results

There are four candidates to consider: (i) combination medical and psychological therapy; (ii) the technique of mindfulness for women with complaints of arousal disorder and low sexual desire; (iii) Internet sexual therapy and; and (iv) reconceptualization of genital pain and psychological interventions for women with these complaints. This article reviews the literature in these areas and offers commentary regarding the benefits and limitations of the research. Finally, future directions for research in these four areas are discussed.

Conclusions

Psychological innovation and intervention remains a vital aspect in the field of sexual medicine. New methods continue to be developed and appraised and the methodology, design, and sophistication of sex therapy outcome research have significantly advanced.
Priapism: Pathogenesis, Epidemiology, and Management
Authors: Broderick Gregory A. , Kadioglu Ates , Bivalacqua Trinity J. , Ghanem Hussein , Nehra Ajay , Shamloul Rany
Published: January 2010

Introduction

Priapism describes a persistent erection arising from dysfunction of mechanisms regulating penile tumescence, rigidity, and flaccidity. A correct diagnosis of priapism is a matter of urgency requiring identification of underlying hemodynamics.

Aims

To define the types of priapism, address its pathogenesis and epidemiology, and develop an evidence-based guideline for effective management.

Methods

Six experts from four countries developed a consensus document on priapism; this document was presented for peer review and debate in a public forum and revisions were made based on recommendations of chairpersons to the International Consultation on Sexual Medicine. This report focuses on guidelines written over the past decade and reviews the priapism literature from 2003 to 2009. Although the literature is predominantly case series, recent reports have more detailed methodology including duration of priapism, etiology of priapism, and erectile function outcomes.

Main Outcome Measures

Consensus recommendations were based on evidence-based literature, best medical practices, and bench research.

Results

Basic science supporting current concepts in the pathophysiology of priapism, and clinical research supporting the most effective treatment strategies are summarized in this review.

Conclusions

Prompt diagnosis and appropriate management of priapism are necessary to spare patients ineffective interventions and maximize erectile function outcomes. Future research is needed to understand corporal smooth muscle pathology associated with genetic and acquired conditions resulting in ischemic priapism. Better understanding of molecular mechanisms involved in the pathogenesis of stuttering ischemic priapism will offer new avenues for medical intervention. Documenting erectile function outcomes based on duration of ischemic priapism, time to interventions, and types of interventions is needed to establish evidence-based guidance. In contrast, pathogenesis of nonischemic priapism is understood, and largely attributable to trauma. Better documentation of onset of high-flow priapism in relation to time of injury, and response to conservative management vs. angiogroaphic or surgical interventions is needed to establish evidence-based guidance.
Implants, Mechanical Devices, and Vascular Surgery for Erectile Dysfunction
Authors: Hellstrom Wayne J.G. , Montague Drogo K. , Moncada Ignacio , Carson Culley , Minhas Suks , Faria Geraldo , Krishnamurti Sudhakar
Published: January 2010

Introduction

The field of erectile dysfunction (ED) is evolving and there is a need for state-of-the-art information in the area of treatment.

Aim

To develop an evidence-based, state-of-the-art consensus report on the treatment of erectile dysfunction by implants, mechanical devices, and vascular surgery.

Methods

To provide state-of-the-art knowledge concerning treatment of erectile dysfunction by implant, mechanical device, and vascular surgery, representing the opinions of 7 experts from 5 countries developed in a consensus process over a 2-year period.

Main Outcome Measure

Expert opinion was based on the grading of evidence-based medical literature, widespread internal committee discussion, public presentation, and debate.

Results

The inflatable penile prosthesis (IPP) is indicated for the treatment of organic erectile dysfunction after failure or rejection of other treatment options. Comparisons between the IPP and other forms of ED therapy generally reveal a higher satisfaction rate in men with ED who chose the prosthesis. Organic ED responds well to vacuum erection device (VED) therapy, especially among men with a suboptimal response to intracavernosal pharmacotherapy. After radical prostatectomy, VED therapy combined with phosphodiesterase type 5 therapy improved sexual satisfaction in patients dissatisfied with VED alone. Penile revascularization surgery seems most successful in young men with absence of venous leakage and isolated stenosis of the internal pudendal artery following perineal or pelvic trauma. Currently, surgery to limit venous leakage is not recommended.

Conclusions

It is important for the future of the field that patients be made aware of all treatment options for erectile dysfunction in order to make an informed decision. The treating physician should be aware of the patient’s medical and sexual history in helping to guide the decision. More research is needed in the area of revascularization surgery, in particular, venous outflow surgery.
Standards for Clinical Trials in Sexual Dysfunction in Women: Research Designs and Outcomes Assessment
Authors: Clayton Anita H. , Dennerstein Lorraine , Fisher William A. , Kingsberg Sheryl A. , Perelman Michael A. , Pyke Robert E.
Published: January 2010

Introduction

Clinical trial design in female sexual dysfunction (FSD) is an evolving science, with some areas of controversy.

Aim

To develop an evidence-based, expert consensus-report on design of FSD clinical research.

Methods

Literature review including the Food and Drug Administration (FDA) clinical trial guidelines with critique by six experts from three countries, modified after public presentation and debate.

Main Outcome Measure

Expert opinion and recommendations were based on grading of evidence based literature, internal committee dialogue, open presentation, and debate.

Results

Design of clinical research for regulatory approval is driven by FDA guidelines. Diagnostic and Statistical Manual-IV definitions and consideration of comorbidity of sexual disorders may complicate patient selection and outcomes. Measures for study end points include satisfying sexual events utilizing a daily diary, sexual distress, and patient-reported outcomes measures of the construct under study. Currently, trial duration is recommended to be 6 months for efficacy trials to allow for modification of behavioral adaptations to changes in desire. Important issues include safety assessments, generalizability, having a representative study population, stratification by reproductive status, partner assessment, contextual and interpersonal factors, symptom duration and severity, management of placebo response, and drug dosing. Statistical analysis should include assessment of change from baseline to end point between study drug and placebo, determination of statistically significant change vs. clinically meaningful effects, linear mapping of all measures of the same construct, and determination of responders and remitters.

Conclusions

Future trials should include clear population definitions, direct and indirect measures of the specific FSD construct, and procedures to allow generalizability of diagnosis and treatment to the target population.
Plasma protein electrophoresis ofTrachemys scriptaandIguana iguana
Authors: Giménez Mercè , Saco Yolanda , Pato Raquel , Busquets Alex , Martorell Jaime M. , Bassols Anna
Published: January 2010

Background:Protein electrophoresis is widely applied in veterinary medicine, but is not used often in reptiles, in part because of lack of reference values.

Objective:The goals of this study were to compare plasma protein profiles obtained by cellulose acetate electrophoresis (CAE) and agarose gel electrophoresis (AGE), measure precision and examine interference by sample hemolysis, and establish preliminary reference intervals for 2 reptile species.

Methods:Heparinized plasma samples from healthy and diseased adult femaleIguana iguana(n=40) andTrachemys scripta(n=60) were analyzed by CAE and AGE. Total protein concentration was measured by the biuret method. Electrophoresis results were compared using Bland–Altman plots and Passing–Bablok regression analysis. Precision and the effects of sample hemolysis were determined. Results from clinically healthy animals were used to determine reference intervals.

Results:Five protein fractions were identified in both species, with bisalbuminemia observed in 23/40 iguanas. High correlation was observed between the 2 methods for all fractions, with few proportional and systematic errors. Coefficients of variation were lower using AGE vs CAE and forI. iguanavsT. scripta. Two additional bands were observed in hemolyzed samples fromT. scripta; 1 additional band was observed forI. iguana. Minimum and maximum values were reported for healthyI. iguana(n=14) andT. scripta(n=22).

Conclusions:Although both methods are acceptable, the performance of AGE was slightly better than that of CAE for analysis of plasma from reptiles. Furthermore, reptile electrophoretic patterns should be interpreted based on the method used, the species analyzed, and the quality of the plasma sample.
Serum IgG Concentrations after Intravenous Serum Transfusion in a Randomized Clinical Trial in Dairy Calves with Inadequate Transfer of Colostral Immunoglobulins
Authors: Chigerwe M. , Tyler J.W.
Published: January 2010

Background:Plasma transfusions have been used clinically in the management of neonates with failure of passive transfer. No studies have evaluated the effect of IV serum transfusions on serum IgG concentrations in dairy calves with inadequate transfer of passive immunity.

Hypothesis:A commercially available serum product will increase serum immunoglobulin concentration in calves with inadequate transfer of colostral immunoglobulins.

Animals:Thirty‐two Jersey and Jersey‐Holstein cross calves with inadequate colostral transfer of immunoglobulins (serum total protein <5.0 g/L).

Methods:Thirty‐two calves were randomly assigned to either control (n = 15) or treated (n = 17) groups. Treated calves received 0.5 L of a pooled serum product IV. Serum IgG concentrations before and after serum transfusion were determined by radial immunodiffusion.

Results:Serum protein concentrations increased from time 0 to 72 hours in both control and transfused calves and the difference was significant between the control and treatment groups (P< .001). Mean pre‐ and posttreatment serum IgG concentrations in control and transfused calves did not differ significantly. Median serum IgG concentrations decreased from 0 to 72 hours by 70 mg/dL in control calves and increased over the same time interval in transfused calves by 210 mg/dL. The difference was significant between groups (P< .001). The percentage of calves that had failure of immunoglobulin transfer 72 hours after serum transfusion was 82.4%.

Conclusions and Clinical Importance:Serum administration at the dosage reported did not provide adequate serum IgG concentrations in neonatal calves with inadequate transfer of colostral immunoglobulins.
Improvement of Ohmic contacts to In0.65Ga0.35Sb using Mo refractory metal and surface preparation for 6.3 Å heterojunction bipolar transistors
Authors: Mairiaux E. , Desplanque L. , Wallart X. , Zaknoune M.
Published: January 2010

This article describes a comparative study of Ti/Au, Ti/Pd/Au, Ti/Pt/Au, Mo/Au, Mo/Pt/Au, and Pd/Mo/Pt/Au Ohmic contacts to both n- and p-In0.65Ga0.35Sb. For In0.65Ga0.35Sb:Te doped to 2×1018 cm−3, specific contact resistivities ρc below 2×10−6 Ω cm2 were demonstrated. Lower ρc in the 10−7 Ω cm2 range were also achieved for In0.65Ga0.35Sb:C doped to 4.5×1019 cm−3. The influence of surface preparation has been investigated on unannealed Mo/Pt/Au contacts and further improvements of the specific contact resistivities to as low as (8.7±0.7)×10−7 and (2.9±1.7)×10−8 Ω cm2 have been achieved for n- and p-InGaSb, respectively.
Low-dimensional oxide nanostructures on metals: Hybrid systems with novel properties
Authors: Netzer Falko P. , Allegretti Francesco , Surnev Svetlozar
Published: January 2010

Oxide nanostructures in low dimensions on well-defined metal surfaces form novel hybrid systems with tremendous potential and impact in fundamental research and for the emerging nanotechnologies. In contrast to bulk materials low-dimensional oxide nanostructures not only involve a large number of undercoordinated atoms but their interaction with the metal substrate also provides constraints on their structure and morphology and often yields elastic strain and/or uncompensated charge. These factors modify significantly the physical and chemical properties of the nanophases as compared to bulk oxides. In this review the authors will examine critically the available data with respect to structure-property relationships of metal-supported oxide nanostructures in reduced dimensions. The connection between structure, elastic strain, and charge transfer on the one hand, and electronic and magnetic behavior on the other one, will be discussed. The novel chemical properties of the oxide-metal nanostructure systems will provide another focus of this review.
Step-width adjustment in fabrication of staircase structures
Authors: Li P. , Lee S.-Y. , Jeon S. C. , Kim J. S. , Kim K. N. , Hyun M. S. , Yoo J. J. , Kim J. W.
Published: January 2010

Three-dimensional structures increasingly find applications in various devices such as diffractive optical elements, photonic element, microelectromechanical systems, etc., and are often fabricated by e-beam lithography. Their performance is known to be highly sensitive to their dimensions. Therefore, it is critical to achieve high dimensional accuracy for the desired characteristics. However, as the feature size in three-dimensional structures decreases down to nanoscale, the lateral development of the resist and the proximity effect due to electron scattering can make dimensions of the written features in a device substantially different from the target dimensions. In this study, this issue is addressed for staircase structures; specifically, minimizing the difference between the target and the actual widths of each step. Through computer simulation and experiments, it has been shown that significant improvement in dimensional accuracy, especially the step widths of the staircase structures, can be achieved by the proposed practical width-adjustment scheme.
New Ligands for Neurexins
Authors: Gough Nancy R.
Published: January 2010

By interacting with a particular set of neurexin splice variants, leucine-rich repeat transmembrane protein 2 contributes to the formation of excitatory synapses.
New Endogenous Regulators of Class I Histone Deacetylases
Authors: Riccio Antonella
Published: January 2010

Extracellular stimuli can elicit alterations in gene transcription through regulation of histone deacetylases by sphingosine-1-phosphate.
GacA-Controlled Activation of Promoters for Small RNA Genes in
Pseudomonas fluorescens
Authors: Humair Bérénice , Wackwitz Birgit , Haas Dieter
Published: January 2010

The Gac/Rsm signal transduction pathway positively regulates secondary metabolism, production of extracellular enzymes, and biocontrol properties of
Pseudomonas fluorescens
CHA0 via the expression of three noncoding small RNAs, termed RsmX, RsmY, and RsmZ. The architecture and function of the
rsmY
and
rsmZ
promoters were studied
in vivo
. A conserved palindromic upstream activating sequence (UAS) was found to be necessary but not sufficient for
rsmY
and
rsmZ
expression and for activation by the response regulator GacA. A poorly conserved linker region located between the UAS and the −10 promoter sequence was also essential for GacA-dependent
rsmY
and
rsmZ
expression, suggesting a need for auxiliary transcription factors. One such factor involved in the activation of the
rsmZ
promoter was identified as the PsrA protein, previously recognized as an activator of the
rpoS
gene and a repressor of fatty acid degradation. Furthermore, the integration host factor (IHF) protein was found to bind with high affinity to the
rsmZ
promoter region
in vitro
, suggesting that DNA bending contributes to the regulated expression of
rsmZ
. In an
rsmXYZ
triple mutant, the expression of
rsmY
and
rsmZ
was elevated above that found in the wild type. This negative feedback loop appears to involve the translational regulators RsmA and RsmE, whose activity is antagonized by RsmXYZ, and several hypothetical DNA-binding proteins. This highly complex network controls the expression of the three small RNAs in response to cell physiology and cell population densities.
Automated Quantification and Sizing of Unbranched Filamentous Cyanobacteria by Model-Based Object-Oriented Image Analysis
Authors: Zeder Michael , Van den Wyngaert Silke , Köster Oliver , Felder Kathrin M. , Pernthaler Jakob
Published: January 2010

Quantification and sizing of filamentous cyanobacteria in environmental samples or cultures are time-consuming and are often performed by using manual or semiautomated microscopic analysis. Automation of conventional image analysis is difficult because filaments may exhibit great variations in length and patchy autofluorescence. Moreover, individual filaments frequently cross each other in microscopic preparations, as deduced by modeling. This paper describes a novel approach based on object-oriented image analysis to simultaneously determine (i) filament number, (ii) individual filament lengths, and (iii) the cumulative filament length of unbranched cyanobacterial morphotypes in fluorescent microscope images in a fully automated high-throughput manner. Special emphasis was placed on correct detection of overlapping objects by image analysis and on appropriate coverage of filament length distribution by using large composite images. The method was validated with a data set for
Planktothrix rubescens
from field samples and was compared with manual filament tracing, the line intercept method, and the Utermöhl counting approach. The computer program described allows batch processing of large images from any appropriate source and annotation of detected filaments. It requires no user interaction, is available free, and thus might be a useful tool for basic research and drinking water quality control.