bluuebunny/crossref_metadata_2025 huggingface dataset:
The prevalence of urinary incontinence 20 years after childbirth: a national cohort study in singleton primiparae after vaginal or caesarean delivery
Authors: Gyhagen M , Bullarbo M , Nielsen TF , Milsom I
Published: March 2012

Objective  To investigate the prevalence and risk factors for urinary incontinence (UI) 20 years after one vaginal delivery or one caesarean section.

Design  Registry‐based national cohort study.

Setting  Women who returned postal questionnaires (response rate 65.2%) in 2008.

Population  Singleton primiparae who delivered in the period 1985–1988 with no further births (n = 5236).

Methods  The Swedish Pregnancy, Obesity and Pelvic Floor (SWEPOP) study linked Medical Birth Register (MBR) data to a questionnaire about UI.

Main outcome measures  Prevalence of UI and UI for more than 10 years (UI > 10 years) were assessed 20 years after childbirth.

Results  The prevalence of UI (40.3 versus 28.8%; OR 1.67; 95% CI 1.45–1.92) and UI > 10 years (10.1 versus 3.9%; OR 2.75; 95% CI 2.02–3.75) was higher in women after vaginal delivery than after caesarean section. There was no difference in the prevalence of UI or UI > 10 years after an acute caesarean section or an elective caesarean section. We found an 8% increased risk of UI per current body mass index (BMI) unit, and age at delivery increased the UI risk by 3% annually.

Conclusions  Two decades after one birth, vaginal delivery was associated with a 67% increased risk of UI, and UI > 10 years increased by 275% compared with caesarean section. Our data indicate that it is necessary to perform eight or nine caesarean sections to avoid one case of UI. Weight control is an important prophylactic measure to reduce UI. Current BMI was the most important BMI‐determinant for UI, which is important, as BMI is modifiable.
A simplified method to generate serotonergic neurons from mouse embryonic stem and induced pluripotent stem cells
Authors: Shimada Takeshi , Takai Yoshihiro , Shinohara Kikuko , Yamasaki Atsushi , Tominaga‐Yoshino Keiko , Ogura Akihiko , Toi Akihiro , Asano Kouji , Shintani Norihito , Hayata‐Takano Atsuko , Baba Akemichi , Hashimoto Hitoshi
Published: March 2012

J. Neurochem. (2012) 122, 81–93.

We have developed a new simple method to induce serotonergic neurons from embryonic stem (ES) and induced pluripotent stem cells. When ES or induced pluripotent stem cells were cultured on a thick gel layer of Matrigel, most colonies extended TuJ1‐positive neurites. We found that noggin, a known antagonist of bone morphogenic protein, induces ES cells to express genes involved in serotonergic differentiation, such as Nkx2.2, Pet‐1, Sonic hedgehog, tryptophan hydroxylase 2, and serotonin transporter, as well as increases high potassium‐induced release of serotonin. To concentrate serotonergic neurons, ES cells carrying Pet‐1‐enhancer‐driven enhanced green fluorescent protein were differentiated and sorted into about 80% pure cultures of serotonergic neurons. Whole cell voltage‐clamp recordings showed a voltage‐dependent current in dissociated neurons. This simplified method provides an alternative option for serotonergic differentiation of pluripotent stem cells and will likely contribute a deeper understanding regarding the nature of serotonergic neurons and open new therapeutic perspectives for the treatment of psychiatric disorders.
Innovations in Practice: The impact of the development of a CAMH Intensive Treatment Service and service redesign on psychiatric admissions
Authors: Duffy Fiona , Skeldon Joanne
Published: March 2012

Background

In 2006, the Scottish Government made a commitment to reduce admissions of young people to adult psychiatric wards. This study investigates the impact of a Child and Adolescent Mental Health (CAMH) Intensive Treatment Service (ITS) and service redesign on psychiatric admission rates.

Method

Referral data were obtained for the first year of the ITS, between 23 April 2010 and 1 April 2011. Data on psychiatric admission rates were obtained up until 30 June 2011.

Results

Median length of adolescent inpatient stay reduced from 28 to 15 days and admissions of young people to adult wards significantly reduced by 65%. The number of admissions and readmissions to the adolescent inpatient unit increased.

Conclusions

A CAMH ITS and accompanying service redesign can reduce length of adolescent inpatient stay and significantly reduce the number of young people admitted to adult psychiatric wards.
Ecstasy cannot be assumed to be 3,4‐methylenedioxyamphetamine (MDMA)
Authors: Green AR , King MV , Shortall SE , Fone KCF
Published: March 2012

LINKED ARTICLES

This is a rebuttal by the authors (Green et al., pp. 1523–1536 of this issue) to a commentary by Parrott, pp. 1518–1520 of this issue. To view the article by Green et al. visit http://dx.doi.org/10.1111/j.1476‐5381.2011.01819.x. To view the commentary by Parrott visit http://dx.doi.org/10.1111/j.1476‐5381.2012.01941.x
Allosteric modulation of the group III mGlu4 receptor provides functional neuroprotection in the 6‐hydroxydopamine rat model of Parkinson's disease
Authors: Betts Matthew J , O'Neill Michael J , Duty Susan
Published: March 2012

BACKGROUND AND PURPOSE We recently reported that broad spectrum agonist‐induced activation of presynaptic group III metabotropic glutamate (mGlu) receptors within the substantia nigra pars compacta using L‐2‐amino‐4‐phosphonobutyrate provided functional neuroprotection in the 6‐hydroxydopamine lesion rat model of Parkinson's disease. The aim of this study was to establish whether selective activation of the mGlu4 receptor alone could afford similar functional neuroprotection.

EXPERIMENTAL APPROACH The neuroprotective effects of 8 days of supranigral treatment with a positive allosteric modulator of mGlu4 receptors, (+/−)‐cis‐2‐(3,5‐dichlorphenylcarbamoyl)cyclohexanecarboxylic acid (VU0155041), were investigated in rats with unilateral 6‐hydroxydopamine lesions. The effects of VU0155041 treatment on motor function were assessed using both habitual (cylinder test) and forced (adjusted stepping, amphetamine‐induced rotations) behavioural tests. Nigrostriatal tract integrity was examined by analysis of tyrosine hydroxylase, dopa decarboxylase or dopamine levels in the striatum and tyrosine hydroxylase‐positive cell counts in the substantia nigra pars compacta.

KEY RESULTS VU0155041 provided around 40% histological protection against a unilateral 6‐hydroxydopamine lesion as well as significant preservation of motor function. These effects were inhibited by pre‐treatment with (RS)‐α‐cyclopropyl‐4‐phosphonophenylglycine, confirming a receptor‐mediated response. Reduced levels of inflammatory markers were also evident in the brains of VU0155041‐treated animals.

CONCLUSIONS AND IMPLICATIONS Allosteric potentiation of mGlu4 receptors in the substantia nigra pars compacta provided neuroprotective effects in the 6‐hydroxydopamine rat model A reduced inflammatory response may contribute, in part, to this action. In addition to the reported symptomatic effects, activation of mGlu4 receptors may also offer a novel approach for slowing the progressive degeneration observed in Parkinson's disease.
A dose‐finding study with a novel water‐soluble formulation of paclitaxel for the treatment of malignant high‐grade solid tumours in dogs
Authors: von Euler H. , Rivera P. , Nyman H. , Häggström J. , Borgå O.
Published: March 2012

A new formulation of water‐soluble paclitaxel (Paccal®Vet) has been developed for canine cancer patients, without the need for pre‐medication (traditionally required in non‐water‐soluble paclitaxel formulations). The objective of the study was to determine a clinically safe and efficacious dose ofPaccalVet and to estimate progression‐free and overall survival and to evaluate single‐dose pharmacokinetics in tumour‐bearing dogs. A positive risk:benefit ratio was established forPaccalVet administered at 150 mg m–2intravenous (IV) for three or more treatment cycles. Preliminary efficacy was demonstrated by best objective response rate (86%), median time to response (14 days) and median progression‐free survival (131 days).PaccalVet was associated with expected adverse events (AE) (e.g. myelosuppression), however the majority were transient, clinically silent and manageable. This is the first clinical report of a water‐soluble formulation of paclitaxel suggesting successful administration and being safely used without pre‐medication in dogs.
Complications and risk factors in 2731 diagnostic mini‐laparoscopies in patients with liver disease
Authors: Frenzel Christian , Koch Johannes , Lorenzen Victoria , Werner Tobias , Lohse Ansgar W. , Denzer Ulrike W.
Published: March 2012

Background/Aims

Mini‐laparoscopy (ML) allows macroscopic assessment and biopsy under direct vision and therefore is a valuable technique in the diagnosis of liver disease. Herein we report procedure‐related complications and risk factors.

Methods

A total of 2731 consecutive patients underwent diagnostic ML at two university hospitals (June 1996–December 2007). ML was performed using standard technique with a 1.9mm optical instrument. Coagulation of the liver biopsy site was performed with APC. The following variables were analysed as risk factors for complications: platelet count (<50/nL), international normalized ratio (INR) (>1.5), Cirrhosis, signs of portal hypertension, prior abdominal surgery.

Results

Major complications occurred in 1.0% (n=27) of patients and these were, delayed bleeding from the liver biopsy site or abdominal wall (in 0.7% of patients) and intestinal perforation (in 0.3% of patients). Two patients died after severe haemorrhage (mortality 0.07%); the other patients recovered without sequelae. Bleeding risk was increased in patients with low platelets (OR=6.1), increased INR (OR=8.9), cirrhosis (OR=1.9) and portal hypertension (OR=2.1). Logistic regression showed a significant correlation only for the concurrence of low platelets and increased INR (P = 0.001; OR=14.1); bootstrap analysis identified INR >1.5 as significant predictor (P = 0.0002). Prior abdominal surgery did not carry a significant risk for intestinal perforation (OR=1.1; P = 0.142), unless abdominal adhesions were present (OR=9.5; P = 0.0002). None of the patients required surgery for intestinal perforation.

Conclusion

Mini‐laparoscopy is a diagnostic technique with a low complication rate. However, in patients with increased INR, low platelets or after extensive abdominal surgery, complications may occur in up to 5%.
Major element distribution in Archean banded iron formation (BIF): influence of metamorphic differentiation
Authors: KATSUTA N. , SHIMIZU I. , HELMSTAEDT H. , TAKANO M. , KAWAKAMI S. , KUMAZAWA M.
Published: March 2012

The Archean (2.8 Ga) Banded Iron Formation (BIF) of the Bell Lake region of Yellowknife greenstone belt, Canada is recrystallized to metamorphic assemblages of the amphibolite facies. This BIF is characterized by centimetre‐scale Fe‐rich and Si‐rich mesobands. In the Si‐rich mesobands, thin layers of magnetite microbands are developed in a quartz matrix. The Fe‐rich mesobands are composed mainly of Ca‐amphibole (hornblende), Fe–Mg amphibole (grunerite), and magnetite. The metamorphic foliation locally cuts across the mesoband boundaries, indicating the mesobanding was formed prior to peak metamorphism. Variations in mineral modal proportions between Fe‐rich mesobands and microbands are diagnostic of depositional compositional differences between beds. Micro‐X‐ray fluorescence imaging reveals metamorphic differentiation within Fe‐rich mesobands, with segregation of Fe–Mg amphibole, and the incompatible element Mn is concentrated at the margins of the Fe‐rich mesobands during the amphibole‐forming reactions. Ti was relatively immobile during metamorphic segregation and its distribution provides a record of the original structures in the Fe‐rich mesobands.
Potential Health Effects Related to Pesticide Use on Athletic Fields
Authors: Gilden Robyn , Friedmann Erika , Sattler Barbara , Squibb Katherine , McPhaul Kathleen
Published: March 2012

Objectives

Children come in contact with athletic fields on a daily basis. How these fields are maintained may have an impact on children's potential exposure to pesticides and associated health effects.

Design and Sample

This is a cross‐sectional, descriptive study that utilized a survey to assess playing field maintenance practices regarding the use of pesticides. Athletic fields (N = 101) in Maryland were stratified by population density and randomly selected.

Measures

A survey was administered to field managers (n = 33) to assess maintenance practices, including the use of pesticides. Analysis included descriptive statistics and generalized estimating equations.

Results

Managers of 66 fields (65.3%) reported applying pesticides, mainly herbicides (57.4%). Managers of urban and suburban fields were less likely to apply pesticides than managers of rural fields. Combined cultivation practice was also a significant predictor of increased pesticide use.

Conclusions

The use of pesticides on athletic fields presents many possible health hazards. Results indicate that there is a significant risk of exposure to pesticide for children engaged in sports activities. Given that children are also often concurrently exposed to pesticides as food residues and from home pest management, we need to examine opportunities to reduce their exposures. Both policy and practice questions are raised.
CHARACTERIZATION OF GENETIC MARKERS LINKED TO SEX DETERMINATION IN THE HAPLOID‐DIPLOID RED ALGA GRACILARIA CHILENSIS1
Authors: Guillemin Marie‐Laure , Huanel Oscar R. , Martínez Enrique A.
Published: March 2012

Bulk segregant analysis, random amplified polymorphic DNA (RAPD), and sequence characterized amplified region (SCAR) methods were used to identify sex‐linked molecular markers in the haploid‐diploid rhodophyte Gracilaria chilensis C. J. Bird, McLachlan et E. C. Oliveira. One hundred and eighty 10 bp primers were tested on three bulks of DNA: haploid males, haploid females, and diploid tetrasporophytes. Three RAPD primers (OPD15, OPG16, and OPN20) produced male‐specific bands; and one RAPD primer (OPD12), a female‐specific band. The sequences of the cloned putative sex‐specific PCR fragments were used to design specific primers for the female marker SCAR‐D12‐386 and the male marker SCAR‐G16‐486. Both SCAR markers gave unequivocal band patterns that allowed sex and phase to be determined in G. chilensis. Thus, all the females presented only the female band, and all the males only the male band, while all the tetrasporophytes amplified both male and female bands. Despite this sex‐specific association, we were able to amplify SCAR‐D12‐386 and SCAR‐G16‐486 in both sexes at low melting temperature. The differences between male and female sequences were of 8%–9% nucleotide divergence for SCAR‐D12‐386 and SCAR‐G16‐486, respectively. SCAR‐D12‐386 and SCAR‐G16‐486 could represent degenerated or diverged sequences located in the nonrecombining region of incipient sex chromosomes or heteromorphic sex chromosomes with sequence differences at the DNA level such that PCR primers amplify only one allele and not the other in highly specific PCR conditions. Seven gametic progenies composed of 19 males, 19 females, and the seven parental tetrasporophytes were analyzed. In all of them, the two SCAR markers segregated perfectly with sexual phenotypes.
The Effectiveness of Administrative Reform in New Democracies
Authors: Neshkova Milena I. , Kostadinova Tatiana
Published: March 2012

Practitioners and scholars of postcommunist politics disagree on the accomplishments of administrative reforms in new Eastern European democracies. The transformation of the public sector after 1989 has aimed to consolidate the democratic process and enhance economic development. Skeptics, however, argue that administrative reforms face serious challenges in the context of economic liberalization, insufficient capacity for modernization, and cultural legacies of the past. The authors judge reform effectiveness by testing the impact of civil service reform on government transparency and foreign direct investment. The results of the empirical analysis confirm that once reform is adopted, administrations become more effective at reducing corruption and attracting investment. Despite the delays and difficulties of implementation, the adoption of reform is important in and of itself, and countries can expect positive results sooner than skeptics predict.
Enhancing and Measuring Organizational Capacity: Assessing the Results of the U.S. Department of Justice Rural Pilot Program Evaluation
Authors: Brown Mitchell
Published: March 2012

A significant goal of public administrators in this era of shrinking public funds has been to find ways to enhance and measure organizational capacity and sustainability with minimal outlays of resources. One attempt to address this goal was the Rural Pilot Program, funded by the Office of Violence Against Women in the U.S. Department of Justice. Based on the evaluation of the program, this article (1) describes how capacity was measured, (2) discusses the validation and utility of a self‐administered instrument, and (3) examines whether and to what extent organizational capacity is enhanced by an intermediary funding model. Modest positive changes were found in two areas—organizational staffing and information technology—but no changes were found in other areas. The article concludes with recommendations for designing future programs to enhance capacity and sustainability and for public administrators and grant makers in utilizing self‐administered capacity instruments.
A Billiard Ball in the Left Atrium
Authors: Carrigan Thomas P. , Azam Salman , Sullivan Claire , Hoit Brian D.
Published: March 2012

An 84‐year‐old woman with a history of severe systolic heart failure, a mechanical mitral valve, and atrial fibrillation presented to the hospital with syncope and is found to have a free‐floating intracardiac mass on transthoracic echocardiogram that was absent 5 months earlier. Real time three‐dimensional (3D) transesophageal echocardiography (TEE) images reveal a billiard‐ball‐looking mass thought to be a large left atrial thrombus causing syncope by transiently obstructing the mitral valve orifice. Real time 3D TEE offers several potential advantages for the evaluation of intracardiac masses.
Predictors of Statin‐Induced Regression of Left Anterior Descending Coronary Artery Wall Thickness as Measured by High‐Resolution Transthoracic Echocardiography
Authors: Perry Rebecca , Joseph Majo X. , Chew Derek P. , Aylward Philip E. , De Pasquale Carmine G.
Published: March 2012

Background: Statin therapy has been shown to reduce cardiovascular risk after myocardial infarction (MI). Using a novel technique of high‐resolution transthoracic echocardiography (HRTTE), we sought to assess the statin‐induced changes in left anterior descending coronary artery (LAD) wall thickness in previously statin naive patients over a 12‐month period. Method and Results: Thirty subjects underwent HRTTE assessment of their LAD wall thickness predischarge post‐MI (non‐LAD territory) and at 3, 6, and 12 months. The LAD anterior and posterior wall thickness and vessel luminal diameter were measured. Blood lipid levels were also assessed at each study visit. All subjects were started on moderate lipid‐lowering therapy (40 mg of atorvastatin or simvastatin). There was a sustained decrease in total cholesterol (–23%), triglycerides (–19%), and low‐density lipoprotein (–41%) at the 3‐month visit from the baseline, with no change in high‐density lipoprotein level. Overall, there was no change in the LAD wall thickness and external or vessel lumen diameter over the 12‐month period. Of those that demonstrated regression, the only predictor of percentage change in the LAD wall thickness was the baseline LAD wall thickness. Conclusion: Despite a favorable change in blood lipid profile, no overall change in the LAD wall thickness was detected over a 12‐month period in subjects on moderate statin therapy using HRTTE. However, using case‐based analysis, regression was able to be predicted by the baseline LAD wall thickness. HRTTE may be an instructive noninvasive modality to assess response to statin intervention. (Echocardiography 2012;29:641‐646)
Isolated Noncompaction of Right Ventricle—A Case Report
Authors: Ranganathan Arun , Ganesan Gnanavelu , Sangareddi Venkatesan , Pillai Arunachalam Piramanayagam , Ramasamy Alagesan
Published: March 2012

Isolated noncompaction of ventricular myocardium (INVM) is a genetic cardiomyopathy due to abnormal arrest in endomyocardial embryogenesis between fetal 5th and 8th week. Noncompaction of right ventricle alone is rare. Here we present one such case where a young man presented with progressive right heart failure and atrial fibrillation. Subsequent evaluation by echo and cardiac magnetic resonance imaging confirmed our diagnosis. The cardinal manifestations of INVM are heart failure, arrhythmia, and embolic events and our case presented with former two manifestations. Echocardiographic criteria for diagnosing INVM are discussed.
A Combination of Two Pseudoaneurysms Due to Severe Endocarditis after Cardiac Surgery
Authors: Fu Bo , Dong Li , Yuan Hongsheng , Lin Zhao Shu
Published: March 2012

A 25‐year‐old man who had undergone aortic valve replacement 4 months earlier presented with one episode of syncope. A transthoracic echocardiogram revealed a saccular structure was below the aortic valve annulus and a small vegetation was on the aortic valve prosthesis; blood cultures were positive for Staphylococcus epidermidis. Thoracic computed tomography scan, two‐dimensional transesophageal echocardiogram (TEE), and three‐dimensional TEE demonstrated a combination of two pseudoaneurysms due to severe endocarditis, pseudoaneurysm of the ascending aorta, and pseudoaneurysm of the mitral‐aortic intervalvular fibrosa.
Three‐Dimensional Transesophageal Echocardiography of a Medtronic Hall–Type Tilting Disk Valve
Authors: Bernstein Oren , Haddy Steven
Published: March 2012

We present 3D images of a tilting disk valve (Medtronic Hall) functioning in a total artificial heart.
Inverted McConnell Sign
Authors: de Agustín José Alberto , Marcos‐Alberca Pedro , Fernández‐Golfín Covadonga , Feltes Gisela , Almería Carlos , Macaya Carlos , Zamorano José
Published: March 2012

There is a well‐recognized echocardiographic pattern of the right ventricle (RV) wall motion reported by McConnell which is characterized by normokinesia of the apical segment and akinesia of the mid–free wall with persistence of abnormal wall motion at the base. We describe a case of an 85‐year‐old man with acute massive bilateral pulmonary embolism with opposite regional contraction pattern of the RV free wall than the one referred by McConnell consisting of hyperkinesia of the basal RV free wall and akinesia of the mid‐RV free wall and RV apex, a finding that could be called “inverted McConnell sign.”
Sacrificial Limbs of Sovereignty: Disabled Veterans, Masculinity, and Nationalist Politics in Turkey
Authors: Açıksöz Salih Can
Published: March 2012

Over the last decade, disabled veterans of the Turkish Army who were injured while fighting against the Partiya Karkerên Kurdistan (PKK; Kurdistan Workers’ Party) have become national icons and leading ultranationalist actors. While being valorized as sacrificial heroes in nationalist discourse, they have also confronted socioeconomic marginalization, corporeal otherness, and emasculation anxieties. Against this backdrop, disabled veterans’ organizations have become the locus of an ultranationalist campaign against dissident intellectuals. Building on two years of ethnographic research with disabled veterans in Turkey, this article analyzes these processes through the analytical lens of the body. Locating the disabled veteran body at the intersection of state welfare practices, nationalist discourses on heroism and sacrifice, and cultural norms of masculinity and disability, I illustrate how disabled veterans’ gendered and classed experiences of disability are hardened into a political identity. Consequently, I show how violence generates new modalities of masculinity and political agency through its corporeal effects.[disabled veterans in Turkey, the body, nationalism, masculinity, violence]
Labors of Love: The Transformation of Care in the Non‐Medical Attendant Program at Walter Reed Army Medical Center
Authors: Wool Zoë H. , Messinger Seth D.
Published: March 2012

In this paper, we explore the Non‐Medical Attendant program at Walter Reed Army Medical Center in Washington, DC, which subsidizes the presence of war‐injured soldiers' family members as they live for months or even years at Walter Reed during treatment and rehabilitation. We elaborate the ambiguities of the program and draw on ethnographic research to demonstrate how the program's vagaries combine with the context of an overburdened military medical system and the more familiar strains of family caregiving to place family members in a gray zone of care where the line between labors of love and institutionally compensated work is blurred. [caregiving, military, family, love]
Apoptosis in seborrheic keratoses: an open door to a new dermoscopic score
Authors: Simionescu Olga , Popescu Bogdan Ovidiu , Costache Mariana , Manole Emilia , Spulber Stefan , Gherghiceanu Mihaela , Blum Andreas
Published: March 2012

The aetiology of seborrheic keratoses (SK), the most common benign epithelial tumours, and any relationship with malignancy are not yet known. As a protective anti‐cancer mechanism, apoptosis reflects cellular loss as a reaction to proliferative activity. The objective of this study was to quantify apoptosis in different SK types (acanthotic, hyperkeratotic, reticulated, irritated and clonal) and correlate the dermoscopic picture with apoptosis rate. After a qualitative and quantitative analysis of dermoscopic images, we defined a new quantitative dermoscopic score (C3V2F, crypts, millia cysts, colours, hairpin vessels, irregular vessels, fissures) from 0 to 22, which enabled us to establish cut‐offs correlating with apoptosis rates. All five SK forms were associated with lower apoptosis rates compared with normal skin. A C3V2F score >10 and greater number of crypts and colours reflected a higher apoptosis rate, which implies a benign character of evolution. In contrast, the presence of irregular vessels on more than 50% of the lesion surface implied a lower rate of apoptosis and probably associated with a risk of malignant transformation. On the basis of dermoscopic information, we used multiple regression to establish a model for estimating the rate of apoptosis with a 0.7 prediction interval (approximately 1S.D.). The new C3V2F score could be valuable for the clinical evaluation of possible SK prognosis and decisions regarding excision.
Maternal near‐miss among women with a migrant background in Germany
Authors: REIME BIRGIT , JANSSEN PATRICIA A. , FARRIS LILY , BORDE THEDA , HELLMERS CLAUDIA , MYEZWA HELLEN , WENZLAFF PAUL
Published: March 2012

Objective. To examine the association between region of origin and severe illness bringing a mother close to death (near‐miss). Design. Retrospective cohort study. Setting. Maternity units in Lower Saxony, Germany. Population. 441 199 mothers of singleton newborns in 2001–2007. Methods. Using chi‐squared tests, bivariate and multivariable logistic regression we examined the association between maternal region of origin and near‐miss outcomes with prospectively collected perinatal data up to seven days postpartum. Main outcome measures. Hysterectomy, hemorrhage, eclampsia and sepsis rates. Results. Eclampsia was not associated with region of origin. Compared to women from Germany, women from the Middle East (OR 2.24; 95%CI 1.60–3.12) and Africa/Latin America/other countries (OR 2.17; 95%CI 1.15–4.07) had higher risks of sepsis. Women from Asia (OR 3.37; 95%CI 1.66–6.83) and from Africa/Latin America/other countries had higher risks of hysterectomy (OR 2.65; 95%CI 1.36–5.17). Compared to German women, the risk of hemorrhage was higher among women from Asia (OR 1.55; 95%CI 1.19–2.01) and lower among women from the Middle East (OR 0.66, 95%CI 0.55–0.78). Adjusting for maternal age, parity, occupation, partner status, smoking, obesity, prenatal care, chronic conditions and infertility showed no association between country of origin and risk of sepsis. Conclusion. Region of origin was a strong predictor for near‐miss among women from the Middle East, Asia and Africa/Latin America/other countries. Confounders mostly did not explain the higher risks for maternal near‐miss in these groups of origin. Clinical studies and audits are required to examine the underlying causes for these risks.
Maternal lipids at mid‐pregnancy and the risk of preterm delivery
Authors: MUDD LANAY M. , HOLZMAN CLAUDIA B. , CATOV JANET M. , SENAGORE PATRICIA K. , EVANS RHOBERT W.
Published: March 2012

Objective. This study examined associations between maternal lipid levels at mid‐pregnancy and preterm delivery, medically indicated or spontaneous. Design: Prospective cohort study. Setting. Women were recruited from 52 clinics in five Michigan, USA communities (1998–2004). Population. Pregnant women were enrolled at 15–27 weeks’ gestation and followed to delivery (n=3019). Methods. A single blood sample was obtained at study enrollment. Blood lipids, i.e. total cholesterol (TC), high‐density lipoprotein (HDLc), low‐density lipoprotein (LDLc) cholesterol, and triglycerides (TG), were measured on a sub‐cohort (n=1309). Main outcome measures. There were 221 spontaneous, 100 medically indicated preterm deliveries and 988 term deliveries. Polytomous logistic regression models examined relationships among cholesterol levels (Low: <10th percentile, Referent: 10th–<70th percentile, High: ≥70th percentile), quartiles of TG (Referent: first quartile) and delivery outcome (Referent: term). Results. Odds of medically indicated preterm delivery were increased among women with low TC (adjusted odds ratio (aOR)=2.04, 95% confidence interval (CI): 1.12, 3.72), low HDLc (aOR=1.89, 95%CI: 1.04, 3.42) or low LDLc (aOR=1.96, 95%CI: 1.09, 3.54). Odds of spontaneous preterm delivery were increased among women with high TC (aOR=1.51, 95%CI: 1.06, 2.15), high LDLc (aOR=1.42, 95%CI: 0.99, 2.04) or high TG (aOR=1.90, 95%CI: 1.21, 2.97 and aOR=1.72, 95%CI: 1.06, 2.78 for third and fourth quartiles, respectively). Conclusions. Extremely low TC, HDLc, and LDLc were associated with a modest increase in risk of medically indicated preterm delivery, whereas high TC, LDLc and TG modestly increased the risk of spontaneous preterm delivery. Further research is needed to uncover explanations for these associations and to identify optimal ranges for maternal lipids.
Sexual functioning, quality of life and pelvic pain 12 months after endometriosis surgery including vaginal resection
Authors: SETÄLÄ MARJALEENA , HÄRKKI PÄIVI , MATOMÄKI JAAKKO , MÄKINEN JUHA , KÖSSI JYRKI
Published: March 2012

Objective. To evaluate sexual function, quality of life and pelvic pain after endometriosis surgery including vaginal resection. Design. Prospective observational study with 12 months follow up. Setting. Regional central hospital and university hospital. Population. Twenty‐two patients with deep endometriotic nodules in the posterior fornix of the vagina undergoing complete excision of endometriosis, including vaginal resection. Methods. Sexual functioning was measured with the McCoy Female Sexuality Questionnaire, quality of life with a generic questionnaire (15D) and pain with a 10‐point visual analog scale. Questionnaires were completed before and 12 months after the surgery. Main outcome measures. Changes in sexual function scores, quality‐of‐life scores and pain. Results. Twelve months after surgery, the sexual satisfaction score was higher (p= 0.03) and the sexual problems score lower (p= 0.04) compared with baseline values. Health‐related quality‐of‐life scores for discomfort and symptoms (p= 0.001), distress (p= 0.04), vitality (p= 0.03) and sexual activity (p= 0.001), and the overall 15D score (p < 0.001), were significantly improved. The severity of all studied types of pain was significantly decreased (p < 0.05). Conclusions. Complete excision of endometriosis, including vaginal resection, seems to offer a significant improvement in sexual functioning, quality of life and pelvic pain in symptomatic patients with deeply infiltrating endometriotic nodules in the posterior fornix of the vagina. This surgery may be associated with complications and adverse new‐onset symptoms, and should be performed only after thorough consultation with the patient.
A decision analysis of long‐term lithium treatment and the risk of renal failure
Authors: Werneke U. , Ott M. , Renberg E. Salander , Taylor D. , Stegmayr B.
Published: March 2012

Werneke U, Ott M, Salander Renberg E, Taylor D, Stegmayr B. A decision analysis of long‐term lithium treatment and the risk of renal failure.

Objective:  To establish whether lithium or anticonvulsant should be used for maintenance treatment for bipolar affective disorder (BPAD) if the risks of suicide and relapse were traded off against the risk of end‐stage renal disease (ESRD).

Method:  Decision analysis based on a systematic literature review with two main decisions: (1) use of lithium or at treatment initiation and (2) the potential discontinuation of lithium in patients with chronic kidney disease (CKD) after 20 years of lithium treatment. The final endpoint was 30 years of treatment with five outcomes to consider: death from suicide, alive with stable or unstable BPAD, alive with or without ESRD.

Results:  At the start of treatment, the model identified lithium as the treatment of choice. The risks of developing CKD or ESRD were not relevant at the starting point. Twenty years into treatment, lithium still remained treatment of choice. If CKD had occurred at this point, stopping lithium would only be an option if the likelihood of progression to ESRD exceeded 41.3% or if anticonvulsants always outperformed lithium regarding relapse prevention.

Conclusion:  At the current state of knowledge, lithium initiation and continuation even in the presence of long‐term adverse renal effects should be recommended in most cases.
Traumatic events and suicidal behaviour in the Nigerian Survey of Mental Health and Well‐Being
Authors: Uwakwe R. , Oladeji B. D. , Gureje O.
Published: March 2012

Uwakwe R, Oladeji BD, Gureje O. Traumatic events and suicidal behaviour in the Nigerian Survey of Mental Health and Well‐Being.

Objective:  Not much is known about the role of different traumatic events in predicting suicidal outcomes. We investigated the association of specific traumatic events with different suicidal outcomes.

Method:  Data are from the Nigerian Survey of Mental Health and Well‐Being, a multistage probability household survey of persons aged 18 years and over. Information on traumatic events and suicidal behaviours (ideation, plan and attempts) was collected in face‐to‐face interviews using the Composite International Diagnostic Interview (CIDI.3) from a subsample of the respondents (N = 2143).

Results:  At least one traumatic event was reported by 63% of the sample. Traumatic events were more likely to have been experienced by individuals with different suicidal outcomes, with a dose–response relationship between the number of traumatic events and suicide ideation. The risks of suicidal ideation were elevated among persons with a history of combat experience (OR 6.3 95% CI 1.8–21.8) and those with exposure to war (OR 4.2; 95% CI 1.6–10.6), while that of suicidal attempt was increased among persons with experience of interpersonal violence (OR 4.3; 95% CI 1.4–13.0).

Conclusion:  Traumatic events are common in the general population. This report highlights the role of traumatic events (especially those related to violence) in predicting suicidal behaviour.
Consequences of changing climate and geomorphology for bioenergetics of juvenile sockeye salmon in a shallow Alaskan lake
Authors: Griffiths Jennifer R. , Schindler Daniel E.
Published: March 2012

Abstract –  In high northern latitudes, a wide range of geomorphic processes associated with fluvial, glacial and permafrost activity may interact with climate change to produce unexpected changes in lake thermal regimes with attendant effects on ecological processes. We coupled output from a hydrodynamics model of lake thermal structure to a bioenergetics model to assess how alternative scenarios of climate change, geomorphic evolution and habitat restoration in a shallow Alaskan lake may affect juvenile sockeye salmon bioenergetics and growth. In particular, we evaluated the metabolic costs of different thermal regimes and the potential for changes in consumption to offset those costs. Increased water temperatures associated with future climate increased metabolic costs which were partially offset if fish were able to maintain feeding rates, expressed as a constant proportion of maximum consumption. In this lake, water levels have declined substantially in the last 50 years. Simulated restored lake level had negligible effects on lake temperature and thus on sockeye salmon growth when compared to current conditions. Maintaining lake connectivity to inlet tributaries (cooling lake temperature) was crucial in reducing sockeye salmon metabolic costs particularly with further drops in lake level and climate warming. While considerable research is focused on predicting future thermal and geomorphic conditions in aquatic ecosystems, these processes are rarely considered together, especially for lakes. Understanding the biological responses to geomorphic–climate interactions will be required for developing scenarios for coping with ecosystem responses to global change and evaluating restoration alternatives, especially in high‐latitude systems that support economically and culturally important fisheries.
A Triple Arg Motif Mediates α2B‐Adrenergic Receptor Interaction with Sec24C/D and Export
Authors: Dong Chunmin , Nichols Charles D. , Guo Jianhui , Huang Wei , Lambert Nevin A. , Wu Guangyu
Published: March 2012

Recent studies have demonstrated that cargo exit from the endoplasmic reticulum (ER) may be directed by ER export motifs recognized by components of the coat protein II (COPII) vesicles. However, little is known about ER export motifs and vesicle targeting of the G protein‐coupled receptor (GPCR) superfamily. Here, we have demonstrated that a triple Arg (3R) motif in the third intracellular loop functions as a novel ER export signal for α2B‐adrenergic receptor (α2B‐AR). The 3R motif mediates α2B‐AR interaction with Sec24C/D and modulates ER exit, cell surface transport and function of α2B‐AR. Furthermore, export function of the 3R motif is independent of its position within α2B‐AR and can be conferred to CD8 glycoprotein. These data provide the first evidence implicating that export of GPCRs is controlled by code‐directed interactions with selective components of the COPII transport machinery.
NAD+ biosynthesis and salvage – a phylogenetic perspective
Authors: Gossmann Toni I. , Ziegler Mathias , Puntervoll Pål , de Figueiredo Luis F. , Schuster Stefan , Heiland Ines
Published: March 2012

NAD is best known as an electron carrier and a cosubstrate of various redox reactions. However, over the past 20 years, NAD+ has been shown to be a key signaling molecule that mediates post‐translational protein modifications and serves as precursor of ADP‐ribose‐containing messenger molecules, which are involved in calcium mobilization. In contrast to its role as a redox carrier, NAD+‐dependent signaling processes involve the release of nicotinamide (Nam) and require constant replenishment of cellular NAD+ pools. So far, very little is known about the evolution of NAD(P) synthesis in eukaryotes. In the present study, genes involved in NAD(P) metabolism in 45 species were identified and analyzed with regard to similarities and differences in NAD(P) synthesis. The results show that the Preiss–Handler pathway and NAD+ kinase are present in all organisms investigated, and thus seem to be ancestral routes. Additionally, two pathways exist that convert Nam to NAD+; we identified several species that have apparently functional copies of both biosynthetic routes, which have been thought to be mutually exclusive. Furthermore, our findings suggest the parallel phylogenetic appearance of Nam N‐methyltransferase, Nam phosphoribosyl transferase, and poly‐ADP‐ribosyltransferases.
Evolutionary and physical linkage between calpains and penta‐EF‐hand Ca2+‐binding proteins
Authors: Maki Masatoshi , Maemoto Yuki , Osako Yohei , Shibata Hideki
Published: March 2012

The name calpain was historically given to a protease that is activated by Ca2+ and whose primary structure contains a Ca2+‐binding penta‐EF‐hand (PEF) as well as a calpain cysteine protease (CysPc) domain and a C2‐domain‐like (C2L) domain. In the human genome, CysPc domains are found in 15 genes, but only nine of them encode PEF domains. Fungi and budding yeasts have calpain‐like sequences that lack the PEF domain, and each protein (designated PalB and Rim13, respectively) is orthologous to human calpain‐7, indicating that the calpain‐7 orthologs are evolutionarily more conserved than classical calpains possessing PEF domains. An N‐terminal region of calpain‐7 has a tandem repeat of microtubule‐interacting and transport domains that interact with a subset of endosomal sorting complex required for transport (ESCRT) III proteins. In addition to calpains, PEF domains are found in other Ca2+‐binding proteins including ALG‐2 that associates with ALIX (an ESCRT‐III accessory protein) and TSG101 (an ESCRT‐I subunit). Phylogenetic comparison of dissected domain structures of calpains and experimentally confirmed protein–protein interaction networks imply that there is an evolutionary and physical linkage between mammalian calpains and PEF proteins involving the ESCRT system.
The influence of the HLA‐DRB1 and HLA‐DQB1 allele heterogeneity on disease risk and severity in Iranian patients with multiple sclerosis
Authors: Kollaee A. , Ghaffarpor M. , Ghlichnia H. A. , Ghaffari S. H. , Zamani M.
Published: March 2012

Multiple sclerosis (MS) is a common autoimmune disorder of the central nervous system. Recent studies have shown that the HLA‐DRB1 and DQB1 alleles are associated with MS susceptibility and severity. However, this is controversial in different population studies. In the present study, the roles of HLA‐DRB1 and DQB1 alleles and the amino acids were investigated on disease risk and severity in 120 Iranian patients with MS and 120 controls. Our findings indicate that the DRB1*1501 allele (OR = 3.203 P = 0.001), the DRB1*1501‐DQB1*0602 haplotype (OR = 7.792 P = 0.003) and the DRB1*1501/0701‐ genotype (OR = 3.320 P = 0.006) and amino acid Leu26 (OR = 1.645 P = 0.005) and Phe9 (OR = 1.893 P = 0.009) on the DQβ1 chain are significantly associated with MS susceptibility. DRB1*1001 was the only allele that had a protective effect against MS (P = 0.0004). We also found that the DQB1*0303 allele was significantly associated with disease severity (mean Multiple Sclerosis Severity Score difference = 1.979, P = 0.002). However, protective effect of the DRB1*1001 against MS and also association of DQB1*0303 allele with MS severity need to be confirmed by larger sample size.
Australian Tropical and Subtropical Rain Forest Community Assembly: Phylogeny, Functional Biogeography, and Environmental Gradients
Authors: Kooyman Robert , Rossetto Maurizio , Allen Chris , Cornwell William
Published: March 2012

To compare community assemblage patterns in tropical northeastern and subtropical central eastern Australia across selected gradients and scales, we tested the relationship of species traits with phylogenetic structure, and niche breadth. We considered phylogenetic relationships across current‐day species in assemblages in relation to rain forest species pool sizes, and trait values along gradients including elevation and latitude. Trait values were quantified across scales for seed size, leaf area, wood density and maximum height at maturity for 1137 species and 596 assemblages using trait gradient analysis (TGA). Local assemblages of subtropical species had narrower trait ranges, and higher niche breadth values than corresponding assemblages of tropical species. Leaf size and seed size increased at low latitudes, and community phylogenetic structure was most strongly correlated with seed traits in the subtropics, reflecting dispersal and re‐colonization processes. Elevation accounted for little of the variance in community phylogenetic structure or trait variation across local and regional scales. Stable moist forest areas retained many species from ancestral rain forest lineages across a range of temporally conserved habitats; species within assemblages were less related; and rain forest assemblages had higher functional diversity, but lower niche breadth. This suggests that on average, assemblages of species in stable areas had greater trait variation and narrower distributions. Historic and recent rain forest contraction and re‐expansion can result in recolonized areas that are dominated by species that are more related (phylogenetically) than by chance, have smaller, widely dispersed seeds, and greater niche breadth (broader distributions).
Evolution of sexually transmitted and sexually transmissible human herpesviruses
Authors: Davison Andrew J.
Published: March 2012

Herpesviruses occur in an impressively wide range of animals and are associated with various diseases. The numerous routes taken during hundreds of millions of years of evolution have contributed to their striking adaptability and success as pathogens. Herpesviruses share a distinct virion structure and are classified taxonomically into a single order, the Herpesvirales, which is divided into three families. The phylogenetic relationships among members of the most populous family, the Herpesviridae, which includes all nine human herpesviruses, are generally similar to those among their hosts, supporting the view that there has been a large degree of coevolution between virus and host. Three human herpesviruses (human cytomegalovirus, Kaposi's sarcoma‐‐associated herpesvirus, and herpes simplex virus type 1) are classed as agents capable of sexually transmissible infection (StxI), and one (herpes simplex virus type 2) as an agent capable of sexually transmitted infection (STI). The evolutionary characteristics of these viruses are described.
Scabies in animals and humans: history, evolutionary perspectives, and modern clinical management
Authors: Currier Russell W. , Walton Shelley F. , Currie Bart J.
Published: March 2012

Scabies, a mite infestation frequently sexually transmitted, dates back to antiquity but remains a challenging parasite for study in clinical practice and community settings. Its history is one of centuries of slow progress to recognize the mite and to finally establish its nexus to the clinical syndrome of pruritis with several protean manifestations and different epidemiological patterns. Contemporary methods of management are briefly reviewed, with the future promise of improved evolutionary knowledge associated with the advent of molecular and genetic technology. Current information indicates that humans and earlier protohumans were most likely the source of animal scabies, first of dogs, and later of other species with subsequent spread to wildlife. Morphologically identical variants of Sarcoptes scabiei are nonetheless host specific, as determined by recent DNA studies, and invite future investigations into the dynamics of this troublesome sexually transmissible agent, with the goal of improved recognition and control.