bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of age, body mass index, and parity on Pelvic Organ Prolapse Quantification system measurements in women with symptomatic pelvic organ prolapse
Authors: Shalom Dara F. , Lin Stephanie N. , St Louis Sarah , Winkler Harvey A.
Published: January 2012

Aim:  To evaluate the effect of age, body mass index (BMI), and parity on Pelvic Organ Prolapse Quantification (POP‐Q) system measurements in women with symptomatic prolapse.

Material and Methods:  The charts of 603 women with symptomatic prolapse were reviewed. Patients with prior prolapse surgery or hysterectomy were excluded. POP‐Q measurements were recorded by a single examiner. Data were analyzed using descriptive statistics, the Pearson's product‐moment correlation, and Wilcoxon signed rank test.

Results:  Three hundred and eleven patients met inclusion criteria. Mean age was 63.4 years, mean parity was 2.6, and mean body mass index (BMI) was 26.6 kg/m2. Increasing age was correlated with worsening scores on Ba (r = 0.33, P < 0.0001), C (r = 0.14, P < 0.02), D (r = 0.14, P = 0.02) and Bp (r = 0.13, P = 0.02), while parity was only correlated with worsening scores on Aa (r = 0.12, P = 0.04). There was no correlation between BMI and any POP‐Q data point.

Conclusion:  The effect of increasing parity was seen solely on point Aa in women with symptomatic prolapse. Age affected all vaginal compartments, while BMI had no impact on POP‐Q data points.
Meperidine for uterine dystocia and its effect on duration of labor and neonatal acid‐base status: A randomized clinical trial
Authors: El‐Refaie Tamer A. , El‐Said Mourad M. , Shoukry Aktham A. , Khafagy Soha M. , El‐Din Adel S. , Badawy Montaha M.
Published: January 2012

Aim:  The aim of this study was to evaluate the effectiveness of meperidine, administered during the first stage of labor in patients with uterine dystocia, on the duration of labor and neonatal acid‐base status at birth.

Material and Methods:  We randomly assigned 240 nulliparous women with a singleton pregnancy at term who were diagnosed with uterine dystocia in labor at 4–6‐cm cervical dilatation to receive either a single dose of 50 mg meperidine in 10 mL of saline (slow intravenous injection over 2 min) or 10 mL of isotonic saline (control group). The primary outcome measures were duration of labor (from the time of beginning of the intervention to the time of the expulsion of the fetal head) and umbilical cord arterial acid‐base status.

Results:  The evidence revealed no statistically significant difference between the two groups in length of labor (188.2 ± 92.3 min in the meperidine group compared to 205.4 ± 96.1 min in the placebo group, P = 0.159). The pH of the umbilical cord arterial samples was lower in the meperidine group than in the control group, although the difference was not statistically significant (P = 0.089).

Conclusion:  Because of the absence of any beneficial effect of meperidine on uterine dystocia, its use in labor should be limited to pain relief in the absence of epidural analgesia.
Role of Hayman technique and its modification in recurrent puerperal uterine inversion
Authors: Mondal Prabhat Chandra , Ghosh Debdutta , Santra Debjyoti , Majhi Arup Kumar , Mondal Anirban , Dasgupta Subhendu
Published: January 2012

Acute puerperal uterine inversion is a rare and fatal complication after delivery. The first priority is its rapid management and prevention of postpartum hemorrhage. On rare occasions, there may be recurrence of inversion after reduction. We applied Hayman technique to two cases of recurrent uterine inversion.
Diagnosis and management of leiomyosarcoma arising from ovarian vein: Case report and literature review
Authors: Tsuyoshi Hideaki , Yoshida Yoshio , Kurokawa Tetsuji , Kotsuji Fumikazu
Published: January 2012

Primary leiomyosarcomas arising from the ovarian vein are extremely rare and are associated with high morbidity. A 49‐year‐old nulliparous woman presented with a left lower abdominal mass. Although extremely rare, the radiological appearance is able to preoperatively identify malignant retroperitoneal masses, such as leiomyosarcomas originating from the ovarian vein; thus, the patient underwent a simple total excision of the mass‐adjacent organs, as well as complete resection of the uterus, bilateral adnexae and the left ovarian vein. Adjuvant postoperative combination chemotherapy with gemcitabine and docetaxel was administered. At 22 months, she had no recurrence or metastasis. Delayed diagnosis and high metastatic potentiality are associated with the high morbidity of vascular leiomyosarcomas. The preoperative radiological appearance is useful for early diagnosis, and radical treatment with adjuvant chemotherapy consisting of gemcitabine and docetaxel may improve the poor prognosis of patients with leiomyosarcoma arising from the ovarian vein.
Re‐consideration of lymphadenectomy for stage Ib1 cervical cancer
Authors: Kato Hidenori , Todo Yukiharu , Suzuki Yoshihiro , Ohba Youko , Minobe Shin‐ichiro , Okamoto Kazuhira , Yamashiro Katsusige , Sakuragi Noriaki
Published: January 2012

Aim:  Because of less frequent lymph node metastasis and parametrial involvement, patients with stage Ib1 cervical cancer may benefit from a curtailment of surgery. We retrospectively investigated the distribution of lymph node metastasis in stage Ib1 patients. After comparing the data with that of higher stages and sentinel lymph node navigation (SLNN), the appropriate extent of lymphadenectomy (LA) in stage Ib1 disease was newly suggested.

Method:  A total of 303 patients underwent a radical hysterectomy with LA and the region‐specific rate of node metastasis was obtained. SLNN was performed for 50 patients using 99mTc phytate injection into the cervix and intra‐operative detection by a gamma‐probe.

Results:  The rate of node metastasis and the average number of nodes removed, respectively, were: 23/189 (12.2%), 65.2 in stage Ib1; 14/47 (29.8%), 70.1 in stage Ib2; 7/20 (35.0%), 78.2 in stage IIa; and 26/47 (55.3%), 69.1 in stage IIb. Lymph node metastasis in stage Ib1 was prevalent in the obturator (Ob) (9.5%), inter‐iliac (Ii) (4.9%), superficial common iliac (Sc) (2.3%), cardinal (Cd) (2.2%) and external iliac (Ei) (1.7%) nodes. In patients with upper stage disease, lymph node metastasis could occur in all lymph nodes. In stage Ib1 patients, the sentinel nodes were assigned only to the Ob, Ii, Sc and Ei nodes, being identical with frequent metastatic sites in stage Ib1 (excluding Cd).

Conclusion:  The extent of LA can be routinely completed with the removal of Ob, Ii, Ei, Sc and Cd nodes, which may provide a higher quality of life, including the reduction of lymphedema by preventing the removal of the inguinal nodes.
Relearning in the Elderly: Age‐Related Effects on the Size of Savings
Authors: van der Hoeven Nienke , de Bot Kees
Published: January 2012

This article reports on a study on learning new and relearning forgotten words of French as a foreign language in young (mean age 22.4), middle‐aged (mean age 50.3), and elderly speakers (mean age 76.0). The three age groups performed similarly on relearning old words, but the younger learners were significantly better at learning new words. Data from a questionnaire on contact with French and a working‐memory test showed that neither diminished language contact nor age‐related decline in working memory can be seen as single factors explaining differences between learning and relearning. The decline in older adults’ ability to learn new lexical information is discussed in terms of theories explaining age‐related memory deficits and conceived of as an age‐related deficiency to form associations between unrelated concepts.
How subjective are subjective language complaints
Authors: Martins I. P. , Mares I. , Stilwell P. A.
Published: January 2012

Background and purpose:  Subjective language complaints (SLC) are common during ageing but have not been investigated in detail. We aim to determine their association with demographic and clinical variables and objective cognitive performance.

Methods:  A sample of 479 individuals aged 50 years or above (average 66 ± 9.1 years), followed in primary care, with no history of brain disorder were asked two questions concerning SLC, fulfilled a depression scale and undertook a battery of cognitive tests. Response to questions regarding proper name retrieval (PNR) and word finding difficulties (WFD) was studied and their contribution to each measure of the battery calculated by repeated linear regression analysis, adjusting for age, sex, education, living alone and depressive symptoms.

Results:  Word finding difficulties (47.6%) were more frequently reported than problematic PNR (10.9%). Both were more common in women, in subjects with depressive symptoms and in those living alone, but were unrelated with age or education. Both symptoms contributed significantly to the variance in tests of semantic fluency and episodic memory. PNR was also associated with immediate phonological memory.

Conclusions:  Subjective language complaints are especially common amongst individuals living alone and/or with depressive symptoms. They are associated with a worse cognitive performance in some memory and language‐executive tests. Further studies are needed to understand their predictive value for cognitive decline.
Health‐related quality of life and depressive symptoms in significant others of people with multiple sclerosis: a community study
Authors: Giordano A. , Ferrari G. , Radice D. , Randi G. , Bisanti L. , Solari A. ,   on behalf of the POSMOS study
Published: January 2012

Background and purpose:  Uncertain prognosis and modest treatment efficacy make multiple sclerosis (MS) a particularly difficult disease to adjust to for both patients and their significant others (SOs). Few studies have assessed health‐related quality of life (HRQOL) and depressive symptoms in SOs of people with MS in the community. We assessed, and identified predictors of, HRQOL and depression in SOs of adults with MS.

Methods:  POSMOS (postal survey of self‐assessed health in MS adults and SOs) is a longitudinal survey on a random sample of 251 people with MS in the Milan area. In 2010, SOs and contemporaneous controls completed the SF‐36 and Chicago Multiscale Depression Inventory (CMDI).

Results:  Overall, 142 SOs (mean age 53.1 years; 50% women, 65% partners) and 120 controls (similar to SOs for sex and education, but older) participated. By multivariable modeling of the SO plus control population, SF‐36 vitality was lower in SOs (proportional odds ratio 0.45; 95% confidence interval 0.28–0.70), women (0.41; 0.27–0.64), and older subjects (0.98; 0.97–0.99). SF‐36 mental health was also lower in SOs (0.62; 0.40–0.96) and women (0.43; 0.28–0.67). Regarding MS characteristics associated with HRQOL and depression in SOs, severe disability [Expanded Disability Status Scale (EDSS > 6.5)] had no effect, whilst depressive symptoms (pathologic CMDI) negatively influenced most SF‐36 and all CMDI scores in SOs.

Conclusions:  SOs had significantly lower vitality and psychological well‐being than controls, identifying a burden in being the companion of a person with MS. This burden was unrelated to physical compromise but associated with depressive symptoms in MS.
A role for the sensory neuropeptide calcitonin gene‐related peptide in endothelial cell proliferation in vivo
Authors: Mapp Paul I , McWilliams Daniel F , Turley Matthew J , Hargin Edward , Walsh David A
Published: January 2012

BACKGROUND AND PURPOSE We have tested the hypothesis that calcitonin gene‐related peptide (CGRP) is a mediator of capsaicin‐induced angiogenesis in vivo.

EXPERIMENTAL APPROACH In a series of experiments, the knee joints of rats were injected with CGRP, capsaicin or vehicle control. Groups of animals (n = 6) were treated with the CGRP receptor antagonist BIBN4096BS and/or the NK1 receptor antagonist SR140333. Endothelium, proliferating endothelial cell nuclei and macrophages were identified 24 h later in the synovium by immunohistochemistry and quantified by image analysis. mRNA for the receptors for CGRP and adrenomedullin were sought in normal and inflamed rat and human synovia using RT‐PCR.

KEY RESULTS Intra‐articular CGRP injection increased the endothelial cell proliferation index, whereas macrophage infiltration and knee joint diameters were similar to saline‐injected controls. CGRP‐induced endothelial cell proliferation was dose‐dependently inhibited by BIBN4096BS. mRNA for adrenomedullin and the CGRP receptor subunits were detected in normal and inflamed human and rat synovia. In capsaicin‐induced synovitis, the increased endothelial cell proliferation index was partially blocked by administration of NK1 or CGRP antagonists individually and was reduced to the level of saline controls by coadministration of both receptor antagonists.

CONCLUSIONS AND IMPLICATIONS These data support the hypothesis that CGRP stimulates angiogenesis in vivo directly by activating CGRP receptors. Capsaicin‐induced endothelial cell proliferation was completely blocked by coadministration of CGRP and NK1 receptor antagonists, indicating that both CGRP and substance P may contribute to angiogenesis in this model of synovitis.
Inhibition of T‐type Ca2+ channels by endostatin attenuates human glioblastoma cell proliferation and migration
Authors: Zhang Yuan , Zhang Junhong , Jiang Dongsheng , Zhang Dong , Qian Zhiyuan , Liu Chunfeng , Tao Jin
Published: January 2012

BACKGROUND AND PURPOSE Endostatin (ES) is a c‐terminal proteolytic fragment of collagen XVIII with promising antitumour properties in several tumour models, including human glioblastoma. We hypothesized that this peptide could interact with plasma membrane ion channels and modulate their functions.

EXPERIMENTAL APPROACH Using cell proliferation and migration assays, patch clamp and Western blot analysis, we studied the effects of ES on the proliferation and migration of human glioblastoma U87 cells, mediated by T‐type Ca2+ channels.

KEY RESULTS Extracellular application of ES reversibly inhibited T‐type Ca2+ channel currents (T‐currents) in U87 cells, whereas L‐type Ca2+ currents were not affected. This inhibitory effect was associated with a hyperpolarizing shift in the voltage‐dependence of inactivation but was independent of G‐protein and protein tyrosine kinase‐mediated pathways. All three α1 subunits of T‐type Ca2+ channels (CaV3), α1G (CaV3.1), α1H (CaV3.2) and α1I (CaV3.3), were endogenously expressed in U87 cells. Using transfected HEK293 or CHO cells, we showed that only CaV3.1 and CaV3.2, but not CaV3.3 or CaV1.2 (L‐type), channel currents were significantly inhibited. More interestingly, ES inhibited the proliferation and migration of U87 cells in a dose‐dependent manner. Pretreatment of the cells with the specific T‐type Ca2+ channel blocker mibefradil occluded these inhibitory effects of ES.

CONCLUSION AND IMPLICATIONS This study provides the first evidence that the antitumour effects of ES on glioblastoma cells is through direct inhibition of T‐type Ca2+ channels and gives new insights into the future development of a new class of antiglioblastoma agents that target the proliferation and migration of these cells.

LINKED ARTICLE This article is commented on by Santoni et al., pp. 1244–1246 of this issue. To view this commentary visit http://dx.doi.org/10.1111/j.1476‐5381.2012.01908.x
Determinants of Health Costs due to Farmers’ Exposure to Pesticides: An Empirical Analysis
Authors: Athukorala Wasantha , Wilson Clevo , Robinson Tim
Published: January 2012

Pesticide spraying by farmers has an adverse impact on their health. However, in studies to date examining farmers’ exposure to pesticides, the costs of ill health and their determinants have been based on information provided by farmers themselves. Some doubt has therefore been cast on the reliability of these estimates. In this study, we address this by conducting surveys among two groups of farmers who use pesticides on a regular basis. The first group is made up of farmers who perceive that their ill health is due to exposure to pesticides and have obtained at least some form of treatment (described in this article as the ‘general farmer group’). The second group is composed of farmers whose ill health has been diagnosed by doctors and who have been treated in hospital for exposure to pesticides (described here as the ‘hospitalised farmer group’). Cost comparisons are made between the two groups of farmers. Regression analysis of the determinants of health costs show that the most important determinants of medical costs for both samples are the defensive expenditure, the quantity of pesticides used per acre per month, frequency of pesticide use and number of pesticides used per hour per day. The results have important policy implications.
War Legacies, Welfare and Livelihoods in Rural Areas: The Case of Kosovo
Authors: Douarin Elodie , Litchfield Julie , Sabates‐Wheeler Rachel
Published: January 2012

This article examines the effects of war on livelihood choices and welfare outcomes of rural households in Kosovo using the 2000 Kosovo Living Standards Measurement Survey. We analyse the extent of the legacy of war on livelihood activities and welfare. We first identify livelihood portfolio clusters of households pursuing similar combinations of activities. These clusters are comparable to those described in more qualitative studies in the immediate post‐conflict period. We then examine the determinants of livelihood portfolio choice and the consequences of these for welfare outcomes. Our results provide evidence of a relationship between a household’s experience of war and livelihood choice. We also identify significant selection effects on welfare for three out of four livelihood clusters, highlighting the fact that selecting into a specific livelihood portfolio changes welfare relative to expected levels. Our results show that war not only affects livelihood choices but also changes the returns to these activities.
A NEW METHOD FOR OBTAINING NUCLEAR GENE SEQUENCES FROM FIELD SAMPLES AND TAXONOMIC REVISIONS OF THE PHOTOSYNTHETIC EUGLENOIDS LEPOCINCLIS (EUGLENA) HELICOIDEUS AND LEPOCINCLIS (PHACUS) HORRIDUS (EUGLENOPHYTA)1
Authors: Bennett Matthew S. , Triemer Richard E.
Published: January 2012

One of the foremost issues in the field of algal taxonomy is the inability to acquire, grow, and sequence new taxa. This problem is particularly true in the study of photosynthetic euglenoids where most of the distinct taxa in culture collections have been sequenced, and many other taxa of interest have been resistant to culturing, and thus, sequencing. In an effort to address this problem, we have utilized a new technique, novel to the field of taxonomy, which allows for the sequencing of nuclear genes from a very small number of cells. Through this procedure, a DNA extraction followed by a multiple displacement amplification (MDA), taxa obtained by field collection had their genomic DNA (gDNA) amplified many fold to microgram quantities. The DNA was then used as template DNA for PCR reactions, and multiple nuclear genes were amplified successfully from several different taxa. By applying this procedure, we were able to shed new light on taxa that have been historically difficult to classify, resulting in the assignment of Euglena helicoideus (C. Bernard) M. S. Benn. et Triemer and Phacus horridus (Pochm.) M. S. Benn. et Triemer to the genus Lepocinclis.
PROROCENTRUM BIMACULATUM SP. NOV. (DINOPHYCEAE, PROROCENTRALES), A NEW BENTHIC DINOFLAGELLATE SPECIES FROM KUWAIT (ARABIAN GULF)1
Authors: Chomérat Nicolas , Saburova Maria , Bilien Gwenaël , Al‐Yamani Faiza
Published: January 2012

A new benthic dinoflagellate species, Prorocentrum bimaculatum sp. nov., is studied from Kuwait’s marine sediments, based on detailed morphological and molecular data. Cells are large, oblong oval in shape. They are 49.9–55.3 μm long and 38.4–43.2 μm wide. The ornamentation of this new species is peculiar, and characterized by smooth valves with large pores (0.32–0.50 μm) scattered on their surface, except in two circular patches of ∼15 μm in diameter, devoid of ornamentation and located on both sides of the valve centers. The periflagellar area is widely triangular, located in a moderate excavation of the right valve, and comprises nine platelets. The intercalary band of P. bimaculatum is smooth. The molecular phylogenetic position of this new taxon was inferred from SSU and LSU rDNA genes. In both phylogenetic analyses, P. bimaculatum branched with high support with Prorocentrum consutum and formed a clade sister to the one including P. lima and related species such as P. arenarium, P. belizeanum, P. hoffmannianum, and P. maculosum. From the phylogenetic study, since most species related to P. bimaculatum are known for their toxic effects and production of okadaic acid, this new species can be considered as a potential toxin producer, but this has to be analyzed.
Processing Optimization of Lead Magnesium Niobate‐Lead Titanate  Thin Films for Piezoelectric MEMS Application
Authors: Bastani Yaser , Bassiri‐Gharb Nazanin
Published: January 2012

We report processing conditions and electromechanical properties of highly textured, 0.7Pb(Mg1/3Nb2/3)O3–0.3PbTiO3 (PMN–PT) films, processed via chemical solution deposition on platinized silicon substrates. Textured perovskite seed layers, optimization of heat treatment conditions and Pb content control were studied to obtain pure perovskite PMN–PT films with dense, columnar grains. Highly (100)‐ and (111)‐oriented films, with Lotgering factors between 91% and 97%, and average grain size up to ~430 nm were synthesized on thin PbTiO3 and Pb(Zr,Ti)O3 seed layers. Overall, (100)‐textured films showed higher dielectric permittivity and saturated d33,f piezoelectric coefficients. Dense, submicron‐thick, (100)‐oriented films showed low‐field, relative dielectric permittivity of up to ~2850 (tan δ = 0.02) at 1 kHz, and remnant polarization values up to 17.5 μC/cm2. The films showed saturated d33,f piezoelectric coefficients as high as 210 pm/V.
Structures and Microwave Dielectric Properties of Ba[Ti1−x(Co0.5W0.5)x]O3 (x = 0.40–0.90) Perovskite Ceramics
Authors: Tian Cailan , Yue Zhenxing , Meng Siqin , Zhou Yuanyuan
Published: January 2012

Perovskite ceramics of Ba[Ti1−x(Co0.5W0.5)x]O3 (x = 0.40–0.90) were synthesized by a conventional solid‐state reaction method. Crystal phase, microstructure, and microwave dielectric property of the ceramics were investigated. A phase transition from simple cubic (x = 0.40–0.55) to hexagonal and then to cubic double pervoskite (x = 0.75–0.90) was detected. A single hexagonal perovskite structure (P63/mmc) was obtained at 1425°C and stabilized at room temperature only at x = 0.61. For ceramics x = 0.55–0.60 and x = 0.62–0.75, they are mixtures that consisted of cubic and hexagonal perovskites. With increasing x, Qxf increased from 2800 to 20 700 GHz, whereas dielectric constant (εr) decreased from 65 to 18, and temperature coefficient of resonant frequency (τƒ) decreased from 44 to −17 ppm/°C. Hexagonal perovskite (εr = 18, Qxf = 7700 GHz, τƒ = −14 ppm/°C) had decreased εr, τƒ and increased Qxf values, compared with the cubic perovskite phases. The phase formation and the relationship between structures and microwave dielectric properties were discussed.
Study of Phase Transformation of Rapid‐Thermal‐Annealed TiOx Films and Their Photo‐Induced Hydrophilicity
Authors: Chung Chen‐Kuei , Liao Ming‐Wei
Published: January 2012

Crystalline structure and bonding behavior of promising titanium oxide material strongly influenced the performance of photocatalysis or photovoltaics devices in application. A novel method to control phase formation of sputtered TiOx films was investigated by various as‐sputtered nonstoichiometry x of TiOx and followed by rapid thermal annealing (RTA) at 550°C–750°C for 2 min in air. The as‐deposited TiOx films were amorphous with no X‐ray diffraction peak whereas the significant crystalline peaks of anatase or rutile phases were detected after RTA at 550°C–750°C. The nonstoichiometry x of TiOx films greatly influenced formation of crystalline TiO2 phase structures as annealed at 750°C. Pure anatase was detected in nonstoichiometry x > 1.97 specimens whereas pure rutile phase was detected in x < 1.61 specimens, respectively. An anatase‐rutile mixture obtained at 1.61 < x < 1.97 showed highly photo‐enhanced hydrophilic property after UV irradiation. Different crystalline phase structures of TiO2 films including the rutile, anatase, and mixture can be prepared by reactive sputtering and post RTA for enhancing performance of films. The relationship between process and phase transformation mechanism was also correlated and discussed.
Are CT Angiography Source Images Accurate for Evaluating Infarct Volume?
Authors: Watanabe Masaki , Qureshi Adnan I.
Published: January 2012

Noncontrast computed tomography (NCCT) has been considered the standard test for determining eligibility for thrombolysis from the beginning of the thrombolytic era. CT angiography (CTA) reveals the cranio‐cervical vessel and the occlusion site. Furthermore, the source image (SI) of the CTA (CTA‐SI) reflects cerebral blood volume and can detect the infarct core as hypoattenuated areas with higher sensitivity than ischemic changes on NCCT. However, it was recently reported that the CTA‐SI using fast acquisition protocol significantly overestimated the infarct core mostly on the basis of the poor collaterals. On the other hand, CTA‐SI using standardized protocol was reported to be good predictor for final infarct extension. Imaging used in the setting of acute stroke should accurately address the presence and size of an irreversible ischemic core. Further studies are required to confirm whether another measure or adjustment in CTA‐SI values can be more reliable for evaluating the infarct core.
Antenatal exercise to improve outcomes in overweight or obese women: A systematic review
Authors: SUI ZHIXIAN , GRIVELL ROSALIE M. , DODD JODIE M.
Published: January 2012

Background. Women who are overweight or obese during pregnancy are at increased risk of a number of adverse pregnancy outcomes. Objective. To review the literature systematically to assess the benefits and harms of an exercise intervention for pregnant women who are overweight or obese. Search strategy. A literature search of PUBMED, SCOPUS, the Cochrane Controlled Trials Register (CENTRAL) and the Australian and International Clinical Trials Registers was performed, as well as an additional hand search through bibliographies of various publications. There were no date or language restrictions. Selection criteria. Studies included were randomized controlled trials comparing supervised antenatal exercise intervention with routine standard antenatal care in women who were overweight or obese during pregnancy. The primary outcome was maternal gestational weight gain. The quality of each study was assessed utilizing standard Cochrane systematic review methodology. Data collection and analysis. Six randomized controlled trials and one quasi‐randomized trial were identified and included, involving a total of 276 women who were overweight or obese during pregnancy. Results. Provision of a supervised antenatal exercise intervention was associated with lower gestational weight gain (five trials, 216 participants, mean difference of −0.36 kg, 95% confidence interval −0.64 to −0.09 kg) when compared with standard antenatal care. Conclusions. A monitored physical activity intervention appears to be successful in limiting gestational weight gain; however, the effect on maternal and infant health is less certain.
The influence of fetal head circumference on labor outcome: a population‐based register study
Authors: ELVANDER CHARLOTTE , HÖGBERG ULF , EKÉUS CECILIA
Published: January 2012

Objective. To investigate the association between postnatal head circumference and the occurrence of the three main indications for instrumental delivery, namely prolonged labor, signs of fetal distress and maternal distress. We also studied the association between postnatal fetal head circumference and the use of vacuum extraction and emergency cesarean section. Design. Population‐based register study. Setting. Nationwide study in Sweden. Population. A total of 265 456 singleton neonates born to nulliparous women at term between 1999 and 2008 in Sweden. Methods. Register study with data from the Swedish Medical Birth Register. Main outcome measures. Prolonged labor, signs of fetal distress, maternal distress, use of vacuum extraction and emergency cesarean section. Results. The prevalence of each outcome increased gradually as the head circumference increased. Compared with women giving birth to a neonate with average size head circumference (35 cm), women giving birth to an infant with a very large head circumference (39–41 cm) had significantly higher odds of being diagnosed with prolonged labor [odds ratio (OR) 1.49, 95% confidence interval (CI) 1.33–1.67], signs of fetal distress (OR 1.73, 95% CI 1.49–2.03) and maternal distress (OR 2.40, 95% CI 1.96–2.95). The odds ratios for vacuum extraction and cesarean section were thereby elevated to 3.47 (95% CI 3.10–3.88) and 1.22 (95% CI 1.04–1.42), respectively. The attributable risk proportion percentages associated with vacuum extraction and cesarean section were 46 and 39%, respectively among the cases exposed to a head circumference of 37–41 cm. Conclusions. Large fetal head circumference is associated with complicated labor and is etiological to a considerable proportion of assisted vaginal births and emergency cesarean sections.
Risk of malignancy index used as a diagnostic tool in a tertiary centre for patients with a pelvic mass
Authors: HÅKANSSON FANNY , HØGDALL ESTRID V.S. , NEDERGAARD LOTTE , LUNDVALL LENE , ENGELHOLM SVEND A. , PEDERSEN ANETTE T. , HARTWELL DORTHE , HØGDALL CLAUS ,   FROM THE DANISH ‘PELVIC MASS’ OVARIAN CANCER STUDY
Published: January 2012

Abstract  Objective. Risk of malignancy index (RMI), based on a serum cancer antigen 125 level, ultrasound findings and menopausal status, is used to discriminate ovarian cancer from benign pelvic mass. In Denmark, patients with pelvic mass and RMI ≥200 are referred to tertiary gynecologic oncology centers according to the national guidelines for ovarian cancer treatment. The guidelines include recalculation of RMI at the tertiary center and, if indicated, positron emission tomography/computed tomography and fast‐track surgery by specialists in cancer surgery. The aim of this study was to validate the use of RMI ≥200 as a tool for preoperative identification of ovarian cancer at a tertiary center. Design. Prospective observational study. Setting. A tertiary center in Copenhagen, Denmark. Population. One thousand one hundred and fifty‐nine women with pelvic mass. Methods. The RMI was calculated after ultrasound examination and blood sampling for serum cancer antigen 125 analysis within two weeks before surgery. Main outcome measures. Sensitivity, specificity, positive and negative predictive values were calculated to evaluate the ability of RMI to distinguish between ovarian cancer and benign pelvic mass. Results. There were 778 women diagnosed with benign pelvic mass, while 251 had ovarian cancer and 74 had borderline ovarian tumor. Fifty‐six women were diagnosed with other forms of cancer. Sensitivity and specificity for ovarian cancer vs. benign pelvic mass for RMI ≥200 were 92 and 82%, respectively. Corresponding positive and negative predictive values were 62 and 97%. Conclusions. Risk of malignancy index ≥200 is a reliable tool for identifying patients with ovarian cancer pelvic masses at a tertiary centre to select patients for further preoperative examinations.
Psoriasiform pemphigus foliaceus: a report of two cases
Authors: Grekin Sarah J. , Fox Matthew C. , Gudjonsson Johann E. , Fullen Douglas R.
Published: January 2012

Pemphigus foliaceus (PF) represents an autoimmune blistering disease characterized by the disruption of epidermal intercellular adhesion proteins. Clinical findings include superficial crusted erosions in a seborrheic distribution; however, the disease can rarely present as an exfoliative erythroderma. Histopathologic findings include acantholysis with cleavage within the granular layer. Direct immunofluorescence studies show intercellular IgG and complement deposition. We present two patients, to our dermatology department, with a previous diagnosis of psoriasis, with an exfoliative erythroderma, which ultimately proved to be because of PF based on histopathological features, direct immunofluorescence results and levels of antibodies against desmoglein 1. Both patients responded well to oral prednisone and rituximab. This variant of PF should be entertained in both the clinical differential diagnosis of psoriasiform erythroderma and in the microscopic differential diagnosis of psoriasiform epidermal hyperplasia with focal acantholysis, particularly in patients for whom the clinical history is not classic for psoriasis or for whom conventional psoriasis therapies have not proven beneficial.

Grekin SJ, Fox MC, Gudjonsson JE, Fullen DR. Psoriasiform pemphigus foliaceus: a report of two cases.
Use of an expanded immunohistochemical panel to distinguish cutaneous Hodgkin lymphoma from histopathologic imitators
Authors: Cho Raymond J. , McCalmont Timothy H. , Ai Weiyun Z. , Fox Lindy P. , Treseler Patrick , Pincus Laura B.
Published: January 2012

In lymph nodes, classical Hodgkin lymphoma can typically be distinguished from non‐Hodgkin lymphoma (NHL) by the presence of Hodgkin and Reed‐Sternberg cells that co‐express CD30 and CD15. However, anaplastic large cell lymphoma (ALCL) and diffuse large B‐cell lymphoma (DLBCL) can show identical features, and some cases of classical Hodgkin lymphoma lack CD15 expression, rendering them difficult to differentiate from CD30‐positive NHL. The differential diagnosis of cutaneous Hodgkin lymphoma similarly includes ALCL and DLBCL, and, additionally, tumors of mycosis fungoides. Recent studies have shown that classical Hodgkin lymphoma is of B‐cell origin in virtually all cases, and shows at least focal weak expression of the B‐cell marker PAX5 and often focal weak expression and no expression of the B‐cell markers Oct‐2 and BOB.1, respectively. All three of these markers are almost invariably absent in T‐cell lymphomas and are strongly expressed in B‐cell lymphomas. We report a 40‐year‐old man with classical Hodgkin lymphoma who developed cutaneous nodules. A biopsy from one revealed Hodgkin/Reed‐Sternberg cells with a similar immunophenotype to the diagnostic lymph node biopsy, namely CD30+/CD15+, diffusely but weakly PAX5+, focally weakly Oct‐2+ and lacking BOB.1 expression, thereby confirming a diagnosis of cutaneous Hodgkin lymphoma. To our knowledge, this is the first report of the expression pattern of the combination of PAX5, Oct‐2 and BOB.1 in the context of cutaneous involvement by Hodgkin lymphoma.

Cho RJ, McCalmont TH, Ai WZ, Fox LP, Treseler P, Pincus LB. Case report demonstrating use of an expanded immunohistochemical panel to distinguish cutaneous Hodgkin lymphoma from histopathologic imitators.
The effects of heparan sulphate mimetic RGTA‐OTR4120 on irradiated murine salivary glands
Authors: Spiegelberg Linda , Djasim Urville M. , van Neck Johan W. , Wolvius Eppo B. , van der Wal Karel G.H.
Published: January 2012

J Oral Pathol Med (2012) 41: 477–483

Background:  This study focuses on the potential of ReGeneraTing Agent OTR4120 (RGTA‐OTR4120) to treat radiation‐induced damage of salivary glands. RGTAs are biopolymers designed to mimic the effects of heparan sulphate, thereby stimulation tissue repair and regeneration.

Methods:  C3H mice were irradiated with a single dose of 15 Gy in the head and neck region. RGTA‐OTR4120 was injected 24 h after radiotherapy, followed by weekly injections. At 2, 6 and 10 weeks after radiotherapy, salivary flow rates were measured and animals were sacrificed to obtain parotid and submandibular glands for histology. Periodic acid Schiff stain was performed to visualize mucins that are produced by acinar cells. Amylase and total protein content were measured in saliva samples.

Results:  Salivary flow rates were increased at 2 weeks, but not at 6 and 10 weeks after radiotherapy with RGTA‐OTR4120 administration, compared to irradiated controls. Two and 10 weeks after radiotherapy, the mucin production activity of acinar cells was increased under influence of RGTA administration. RGTA‐OTR4120 did not influence amylase or total protein secretion.

Conclusion:  RGTA‐OTR4120 administration has a positive effect on salivary flow rates in irradiated mice on the short term. The effect was absent 10 weeks after radiotherapy, while at that time point, mucin producing activity of acinar cells was elevated by RGTA‐OTR4120 administration. Given these results and the advantages of RGTA use in irradiated patients, further investigation on the potential of this drug to treat radiation‐induced salivary gland damage, alone or in combination with other drugs, such as amifostine, is suggested.
Discussions on oral health care among elderly Chinese immigrants in Melbourne and Vancouver
Authors: MacEntee Michael I , Mariño Rodrigo , Wong Sabrina , Kiyak Asuman , Minichiello Victor , Chi Iris , Lo Edward CM , Huancai Lin
Published: January 2012

doi: 10.1111/j.1741‐2358.2011.00568.x

Discussions on oral health care among elderly Chinese immigrants in Melbourne and Vancouver

Background:  This study explored how elderly Chinese immigrants value and relate to how acculturation influences oral health and subsequent service use.

Methods:  Elders who had immigrated to Melbourne and Vancouver within the previous 15 years were recruited from local community centres and assigned to focus groups of 5–7 participants in Vancouver (4 groups) or Melbourne (5 groups).

Results:  Following an iterative process of thematic analysis, the discussions revealed that immigrants care about the comfort and appearance of their teeth, and they value Western dentistry as a supplement to traditional remedies, but they have difficulty getting culturally sensitive information about oral health care. Accessing dentistry, they explained, is distressing because of language problems and financial costs that impose on their children. Consequently, many immigrants obtain dental treatment in China when they return for occasional visits. They felt that separation of dentistry from national health care programmes in Canada and Australia disregards natural links between oral health and general health.

Conclusions:  The similarity of concerns in both cities suggests that dissemination of information and availability of services are the important themes influencing oral health, and that, beliefs developed over a lifetime play an important role in interpreting oral health in the host country.
IPARZINE‐SKR study: randomized, double‐blind clinical trial of a new topical product versus placebo to prevent pressure ulcers
Authors: Verdú José , Soldevilla Javier
Published: January 2012

This study compared the efficacy of a new topical agent (IPARZINE‐4A‐SKR) on preventing category I pressure ulcers (PUs) over a 2‐week period, compared with a placebo. A double‐blind, randomised, multi‐centre, placebo‐controlled clinical trial in two parallel groups was conducted. The primary objective was to compare PU incidence between groups. Hospital and socio‐sanitary centre patients (n = 194) at risk of developing a PU (Braden scale) were randomised into two groups. The intervention group included 99 patients, and the placebo group comprised 95 patients. Patients were comparable in terms of age, sex and PU risk. In both groups, patients had a high risk of developing PUs. The product was applied on the sacrum, trochanters and heels. Six PUs (incidence = 6·1%) were detected in the intervention group versus seven (incidence = 7·4%) in the placebo group. Differences were not statistically significant (z = 0·08; P = 0·94), relative risk = 0·82 (95% confidence interval = 0·29–2·36). The main limitation of the study was the sample size and, therefore, the main difficulty encountered was in determining whether the product is ineffective or simply has not been used with sufficient patients. In conclusion, it is not possible to confirm that there are any differences between the studied and the placebo treatments in the prevention of PUs. The results obtained were similar to those obtained in studies of PU prevention using products based on topical fatty acids.
Conflict accompanying the choice of initial treatment in breast cancer patients
Authors: KOKUFU Hiroko
Published: January 2012

Aim:  The purpose of this study is to reveal the state of conflict accompanied by the choice of initial treatment in breast cancer patients, and to clarify the factors affecting conflict.

Methods:  The subjects were female breast cancer patients, to whom options for initial treatment were presented by a physician. The data were collected using questionnaires based on the following scales: Psychological Resilience Scale, Japanese Decisional Conflict Scale, satisfaction with decision‐making, and Mental Adjustment to Cancer Scale Japanese version.

Results:  The mean factor score of decisional conflict was 2.36, indicating moderate conflict. A subscale of the Psychological Resilience Scale “positive future orientation” was weakly related to subscales of the Decisional Conflict Scale, “feeling unsupported by others” (rs = −0.31, P < 0.05) and “lack of advice about the decision” (rs = −0.27, P < 0.05). “Lack of advice about the decision”, “feeling unsupported by others” and “perception of the quality of decision made” were strongly related to satisfaction and “fighting spirit”.

Conclusion:  It was speculated that only the fact of information acquisition and clarification of values are not sufficient and that patients need to be sure that they are receiving actual advice and support.
Prospects of Transcript Profiling for mRNAs and MicroRNAs Using Formalin‐Fixed and Paraffin‐Embedded Dissected Autoptic Multiple Sclerosis Lesions
Authors: Eisele Sylvia , Krumbholz Markus , Fischer Marie‐Therese , Mohan Hema , Junker Andreas , Arzberger Thomas , Hohlfeld Reinhard , Bradl Monika , Lassmann Hans , Meinl Edgar
Published: January 2012

The elaboration of novel pathogenic aspects of multiple sclerosis (MS) requires the analysis of well‐defined stages of lesion development. However, specimens of certain stages and lesion types are either present in small brain biopsies, insufficient in size for further molecular studies or available as formalin‐fixed and paraffin‐embedded (FFPE) material only. Therefore, application of current molecular biology techniques to FFPE tissue is warranted. We compared FFPE and frozen tissue by using quantitative polymerase chain reaction and report: (1) FFPE material is highly heterogeneous regarding the utility for transcript profiling of mRNAs; well‐preserved FFPE samples had about a 100‐fold reduced sensitivity compared with frozen tissue, but gave similar results for genes of sufficient abundance; (2) FFPE samples not suitable for mRNA analysis are still highly valuable for miRNA quantification; (3) the length of tissue fixation greatly affects utility for mRNA but not for miRNA analysis; (4) FFPE samples can be processed via a hot water bath for dissection of defined lesion areas; and (5) in situ hybridization for proteolipid protein (PLP) helps to identify samples not suitable for mRNA amplification. In summary, we present a detailed protocol how to use autoptic FFPE tissue for transcript profiling in dissected tissue areas.
The Ideal Spectral Profile of Topical Sunscreens
Authors: Diffey Brian L. , Brown Michael W.
Published: January 2012

Sunscreens were originally designed to prevent sunburn and incorporated active ingredients that absorbed principally in the UVB region. However, over the past 20 years or so new ingredients have been developed that extend absorption across a much wider range of the solar ultraviolet spectrum in the belief that sunscreens should provide balanced spectral absorption. This article develops the rationale for spectral uniformity by showing that this requirement is aligned to more natural forms of photoprotection. It is shown that a modern sunscreen can provide a spectrally balanced absorption profile in line with shade and many types of clothing fabric. Finally, a new metric is introduced that measures how well the spectral absorption profile of topical sunscreens performs against this ideal.
Hypericin‐mediated Photodynamic Antimicrobial Effect on Clinically Isolated Pathogens†
Authors: Yow Christine M. N. , Tang Hi M. , Chu Ellie S. M. , Huang Zheng
Published: January 2012

The aim of this study was to determine the photodynamic antimicrobial effect of hypericin on clinically isolated Staphylococcus aureus and Escherichia coli cells. Bacterial cells (108 cells per mL) were incubated with hypericin (0–40 μm) for 30 min and followed by light irradiation of 600–800 nm at 5–30 J cm−2. Cell survival was determined by colony counting, cellular hypericin uptake examined by flow cytometer, and cell membrane damage examined by scanning electron microscopy and leakage assay. The effectiveness of hypericin‐mediated photodynamic killing was strongly affected by cellular structure and photosensitizer uptake. The combination of hypericin and light irradiation could induce significant killing of Gram positive methicillin‐sensitive and ‐resistant S. aureus cells (>6 log reduction), but was not effective on Gram negative E. coli cells (<0.2 log reduction). The difference was caused by different cell wall/membrane structures that directly affected cellular uptake of hypericin.
Questions, questions: Can the contradictions between the petrologic, isotopic, thermodynamic, and astrophysical constraints on chondrule formation be resolved?
Authors: ALEXANDER Conel M. O’D. , EBEL Denton S.
Published: January 2012

Abstract– Here, we show that several geochemical indicators point to number densities during chondrule formation that were far higher than can be accounted for by known nebula processes. The number densities implied by compound chondrules and nonspherical chondrules are shown to be significantly higher than estimated in previous studies. At the implied chondrule number densities, if a chondrule formation region survived a formation event it would have been gravitationally bound and would have collapsed quite rapidly to form an asteroidal‐sized body. The diversity of chondrule compositions and textures in a chondrite group could have formed in a single event in subvolumes of a formation region that were chemically isolated from one another because of slow diffusion in the gas. Within these subvolumes, equilibration between chondrules with different compositions would have been fairly rapid, although small isotopic mass fractionations in elements like Fe, Si, Mg, and O may persist. This could explain the existence of the small isotopic mass fractionations in these elements that have been observed in chondrules. However, the evidence for recycling of chondrules requires that there was more than one chondrule formation event prior to formation of a parent asteroid. Finally, we argue that OC and CO chondrule Mg‐Al systematics are both consistent with single ages or narrow ranges of ages, and that the CO, and possibly the OC, ages date parent body alteration. This would resolve the conundrum of needing to preserve in a turbulent nebula physically and chemically distinct CO and OC chondrule populations for 1–2 Myr.