bluuebunny/crossref_metadata_2025 huggingface dataset:
Pyoderma gangrenosum – a review of 24 cases observed over 10 years
Authors: Pereira Neide , Brites Maria Manuel , Gonçalo Margarida , Tellechea Óscar , Figueiredo Amérido
Published: May 2013

Background and objectives  Pyoderma gangrenosum (PG) is a disorder, included in the spectrum of neutrophilic and auto‐inflammatory dermatoses, whose clinical aspects and outcome we intend to characterize.

Materials and methods  In a retrospective study based on files of patients diagnosed during a 10‐year period (2000–2009), we evaluated demographic data, anatomic locations, number of lesions, clinical variants, associated diseases, treatment regimens, healing time, and recurrence.

Results  A total of 24 patients were included, 19 women and five men (F/M = 3.8/1), aged between 17 and 89 years (mean 58.3 ± 24.6 years) with a diagnosis of PG. Lesions, single in 15 patients (62.5%) and multiple in nine (37.5%), were localized in the lower limbs in 19 patients (79.2%), upper limbs (4), abdomen (4), face (2) and genital area (1). Clinical variants observed were ulcerative (17 patients), pustular (4), bullous (2) and superficial granulomatous (1). Associated systemic diseases were observed in 18 patients (75%), gastrointestinal in seven patients (29.2%), hematological in seven (25%), autoimmune inflammatory in three (12%), and solid tumors in two (8.3%). Systemic steroids were used in the treatment, either alone in 10 patients (41.7%) or combined with cyclosporine in eight (33.3%). Complete healing was achieved in 20 patients, on average five months after diagnosis, but lesions recurred one or more times in four patients (16.7%).

Conclusions  As reported in the literature, PG is a rare disorder, more common in females, frequently associated with systemic disease, which compromises the prognosis.
Sebaceous carcinoma in the clinical setting of non‐Hodgkin lymphoma: the Mayo Clinic experience
Authors: Chang Timothy W. , Weaver Amy L. , Brewer Jerry D.
Published: May 2013

Objectives  Non‐Hodgkin lymphoma is a hematologic malignancy associated with the more aggressive behavior of some forms of skin cancer. An association between sebaceous carcinoma and immunosuppression has been identified, but the behavior of sebaceous carcinoma in the setting of non‐Hodgkin lymphoma has not been studied. This study aimed to increase understanding of the behavior of sebaceous carcinoma in patients with concomitant non‐Hodgkin lymphoma.

Methods  Six patients diagnosed with sebaceous carcinoma and non‐Hodgkin lymphoma from 1976 to 2008 were identified at the Mayo Clinic in Rochester, Minnesota. Their charts were reviewed retrospectively.

Results  All six patients were male and White and presented with sebaceous carcinoma on non‐eyelid regions of the head and neck. Two patients had Muir–Torre syndrome; four had secondary cancers that included colon, prostate, transitional cell, and urothelial cancers. Skin cancers other than sebaceous carcinoma included basal cell carcinoma and squamous cell carcinoma. Three patients died of causes unrelated to sebaceous carcinoma; one died of an unknown cause and two were alive at the time of the study.

Conclusions  Sebaceous carcinoma does not appear to behave more aggressively in the setting of non‐Hodgkin lymphoma. Larger studies are needed to definitively understand how sebaceous carcinoma behaves in patients with lymphoma.
Hepatitis C virus genotypes among patients with lichen planus in the Kingdom of Saudi Arabia
Authors: Halawani Mona
Published: May 2013

Objectives  This study aimed to determine the prevalence of anti‐hepatitis C virus (HCV) antibodies and HCV genotypes/subtypes among patients with lichen planus (LP) in Saudi Arabia.

Methods  Fifty patients with LP and 50 healthy blood donors were recruited from dermatology outpatient clinics, and blood samples along with demographic and clinical data were collected. Sera were analyzed for aspartate aminotransferase (AST), alanine aminotransferase (ALT), albumin, bilirubin, hepatitis B virus surface antigen, anti‐HCV antibodies, and HCV‐RNA. Patients with anti‐HCV‐positive LP were genotyped and subtyped.

Results  Clinical examination revealed that 26 (55.3%) of our patients had cutaneous LP, and 10 (21.30%) presented with oral LP. Eleven (23.4%) patients with LP had cutaneous as well as oral infection. Twenty‐eight (59.6%) of our patients with LP were exposed to a variety of HCV risk factors, including history of intramuscular injections (nine of 47; 19%), blood transfusion (seven of 47; 15%), and exposure to family member with HCV infection (five of 47; 10.6%). Of the 47 patients with LP, six (12.76%) tested positive for anti‐HCV antibodies, with two of six (33.33%) being HCV‐RNA positive showing HCV genotypes 1b and 4a, respectively. Mean ± SD serum levels of ALT and AST among patients with anti‐HCV‐positive LP (n = 6) were slightly higher as compared with patients with anti‐HCV‐negative LP. None of the 50 healthy blood donors tested positive for anti‐HCV antibodies, and their liver function test profiles were within normal reference range.

Conclusion  Our findings are in agreement with earlier reports that HCV infection is associated with LP and recommend the screening of patients with LP for ALT, AST, and anti‐HCV antibodies for early diagnosis of HCV infection.
Doses of erythemal ultraviolet radiation observed in Brazil
Authors: de Paula Corrêa Marcelo , C.M. Pires Luciana
Published: May 2013

Non‐melanoma skin cancer represents a quarter of the new cancer cases detected in Brazil. Despite the importance of this issue to public health, there are deficits in knowledge on the local UV radiation levels among physicians. In this work, we evaluate a set of daily erythemal UV doses measured in different Brazilian locations. Very high erythemal UV doses that often exceeded safe amounts were observed over almost the whole year, even during the time interval usually recommended as safe (before 10:00 h and after 16:00 h). These findings will hopefully enable foreign tourists, dermatologists, and decision‐makers to implement new measures for solar protection according to South American standards.
Practical pearls in phototherapy
Authors: Tsui Cindy L. , Levitt Jacob
Published: May 2013

The following tips are suggested for phototherapy: (i) calibrate the unit with a radiometer every 2–4 weeks; (ii) change all bulbs at the same time every 8–10 months for regularly used machines or when the UV meter shows that the power has reached 3 or 4 mW/cm2; (iii) avoid phototherapy sessions on consecutive days to prevent burn on burn; (iv) in the event of a burn, reduce the last PUVA or UVB dose by 50%, reinitiating when erythema has fully disappeared, which might take two days to two weeks; (v) nausea from oral psoralens can be avoided by taking it with a fixed amount of milk or food, taking an antiemetic with this meal prior to dosing, taking five ginger tablets 15 minutes before dosing, or dividing the dosage; (vi) to achieve 0.03% concentration of 8‐methoxypsoralen for hand and foot soak PUVA, dissolve a 10‐mg tablet or 1.0 cc of Oxsoralen® solution 1% in 3 l of water; and (vii) to achieve 0.000075% concentration of 8‐methoxypsoralen for full‐body soak PUVA, dissolve 60 mg 8‐methoxypsoralen in 80 l of water (i.e. a bath tub).
Cognitive Impairment and the Right to Vote: A Strategic Approach
Authors: Barclay Linda
Published: May 2013

Most democratic countries either limit or deny altogether voting rights for people with cognitive impairments or mental health conditions. Against this weight of legal and practical exclusion, disability advocacy and developments in international human rights law increasingly push in the direction of full voting rights for people with cognitive impairments. Particularly influential has been the adoption by the UN of the Convention on the Rights of Persons with Disabilities in 2007. Article 29 declares that states must ‘ensure that persons with disabilities can effectively and fully participate in political and public life on an equal basis with others, directly or through freely chosen representatives, including the right and opportunity for persons with disabilities to vote and be elected’. This article also argues for the right of all people to vote, including people with cognitive impairments, by adopting a uniquely strategic approach. Firstly, some of the strategic limitations of existing arguments in favour of extending the franchise are highlighted. Most such arguments are flawed because they run the risk of inviting disparaging philosophical commentary which compares disabled people to animals, or because they are based on implausible empirical claims, or because they inadvertently tie the case for voting rights for the disabled to other cases unlikely to ever enjoy widespread acceptance. This article, instead, justifies extending voting rights to all people with cognitive impairments based on a simple cost‐benefit analysis that avoids all of these problems.
Peri‐implant versus periodontal wound healing
Authors: Emecen‐Huja Pinar , Eubank Tim D. , Shapiro Vladimir , Yildiz Vedat , Tatakis Dimitris N. , Leblebicioglu Binnaz
Published: May 2013

Aim

Peri‐implant gingival healing following one‐stage implant placement was investigated and compared to periodontal healing.

Methods

Healing at surgical sites [implant (I) and adjacent teeth (T+)] was compared to non‐operated tooth (T−) in non‐smokers receiving one‐stage implant. Periodontal Indices (PI, GI) were recorded at surgery and up to 12 weeks post‐operatively. Peri‐implant (PICF) and gingival crevicular fluids (GCF) were analysed for cytokines, collagenases and inhibitors. Data were analysed by linear mixed model regression analysis and repeated measures anova.

Results

Forty patients (22 females; 21–74 years old) completed the study. Surgical site GI, increased at week 1, decreased significantly during early healing (weeks 1–3; p = 0.0003) and continually decreased during late healing (weeks 6–12) for I (p < 0.01). PICF volume decreased threefold by week 12 (p = 0.0003). IL‐6, IL‐8, MIP‐1β and TIMP‐1 levels significantly increased at surgical sites at week one, significantly decreasing thereafter (p < 0.016). Week one IL‐6, IL‐8 and MIP‐1β levels were ~threefold higher and TIMP‐1 levels 63% higher, at I compared to T+ (p = 0.001).

Conclusion

Peri‐implant gingival healing, as determined by crevicular fluid molecular composition, differs from periodontal healing. The observed differences suggest that peri‐implant tissues, compared to periodontal tissues, represent a higher pro‐inflammatory state.
Twenty‐year trend of increasing obesity in young patients with poorly controlled type 2 diabetes at first diagnosis in urban Japan
Authors: Kushiyama Akifumi , Yoshida Yoko , Kikuchi Takako , Suzawa Naoki , Yamamoto Mayumi , Tanaka Kentaro , Okayasu Mineko , Tahara Tazu , Takao Toshiko , Onishi Yukiko , Kawazu Shoji
Published: May 2013

Aims/Introduction

To investigate trends over the past 20 years for the prevalence of obesity and glycemic control in association with a patient's first hospital visit for type 2 diabetes mellitus.

Materials and Methods

This was a historical, cross‐sectional, time‐series, single‐center study carried out at Marunouchi Hospital. Data from type 2 diabetic patients who were never treated until their first hospital visit were analyzed for the following periods: 1986–1987 (group A, n = 453), 1996–1997 (group B, n = 547) and 2006–2008 (group C, n = 443). Data on each patient's body mass index (BMI), age, untreated duration and glycated hemoglobin levels were also collected.

Results

Obesity in younger patients (below age 40 years and ages 40–49 years in group C) with poor glycemic control increased over time. Patients with a BMI of <21.0 kg/m2 or ≥23.0 kg/m2 showed worse glycemic control than those with a BMI of 21.0–23.0 kg/m2 in group C. Younger patients had worse glycemic control and shorter untreated durations in group C. A BMI ≥23.0 kg/m2 was an independent risk factor for glycated hemoglobin levels ≥8.4% in group C, even after correction for sex, age, untreated duration and symptoms.

Conclusions

In recent years, glycemic control has worsened in young, obese patients in urban Japan. Obesity is rapidly increasing in younger patients, and patients with a BMI ≥23.0 kg/m2 might be candidates for diabetes screening. This trial was registered with the University Medical Information Network Clinical Trials Registry (no. UMIN000005725).
The costs of being dark: the genetic basis of melanism and its association with fitness‐related traits in the sand cricket
Authors: Roff D. A. , Fairbairn D. J.
Published: May 2013

Melanism is an important component of insect cuticle and serves numerous functions that enhance fitness. Despite its importance, there is little information on its genetic basis or its phenotypic and genetic correlation with fitness‐related traits. Here, we examine the heritability of melanism in the wing dimorphic sand cricket and determine its phenotypic and genetic correlation with wing morphology, gonad mass and size of the dorso‐longitudinal muscles (the principle flight muscles). Previously demonstrated trade‐offs among these traits are significant factors in the evolution of life history variation. Using path analysis, we show that melanization is causally related to gonad mass, but not flight muscle mass. Averaged over the sexes, the heritability of melanism was 0.61, the genetic correlation with gonad mass was −0.36 and with wing morph was 0.51. The path model correctly predicted the ranking of melanization score in lines selected for increased ovary mass, increased flight muscle mass, an index that increased both traits and an unselected control. Our results support the general hypothesis that melanization is costly for insects and negatively impacts investment in early reproduction.
Reproductive and post‐reproductive life history of wild‐caughtDrosophila melanogasterunder laboratory conditions
Authors: Klepsatel P. , Gáliková M. , De Maio N. , Ricci S. , Schlötterer C. , Flatt T.
Published: May 2013

The life history of the fruit fly (Drosophila melanogaster) is well understood, but fitness components are rarely measured by following single individuals over their lifetime, thereby limiting insights into lifetime reproductive success, reproductive senescence and post‐reproductive lifespan. Moreover, most studies have examined long‐established laboratory strains rather than freshly caught individuals and may thus be confounded by adaptation to laboratory culture, inbreeding or mutation accumulation. Here, we have followed the life histories of individual females from three recently caught, non‐laboratory‐adapted wild populations ofD. melanogaster. Populations varied in a number of life‐history traits, including ovariole number, fecundity, hatchability and lifespan. To describe individual patterns of age‐specific fecundity, we developed a new model that allowed us to distinguish four phases during a female's life: a phase of reproductive maturation, followed by a period of linear and then exponential decline in fecundity and, finally, a post‐ovipository period. Individual females exhibited clear‐cut fecundity peaks, which contrasts with previous analyses, and post‐peak levels of fecundity declined independently of how long females lived. Notably, females had a pronounced post‐reproductive lifespan, which on average made up 40% of total lifespan. Post‐reproductive lifespan did not differ among populations and was not correlated with reproductive fitness components, supporting the hypothesis that this period is a highly variable, random ‘add‐on’ at the end of reproductive life rather than a correlate of selection on reproductive fitness. Most life‐history traits were positively correlated, a pattern that might be due to genotype by environment interactions when wild flies are brought into a novel laboratory environment but that is unlikely explained by inbreeding or positive mutational covariance caused by mutation accumulation.
How should parents adjust the size of their young in response to local environmental cues?
Authors: Kuijper B. , Johnstone R. A.
Published: May 2013

Models of parental investment typically assume that populations are well mixed and homogeneous and have devoted little attention to the impact of spatial variation in the local environment. Here, in a patch‐structured model with limited dispersal, we assess to what extent resource‐rich and resource‐poor mothers should alter the size of their young in response to the local environment in their patch. We show that limited dispersal leads to a correlation between maternal and offspring environments, which favours plastic adjustment of offspring size in response to local survival risk. Strikingly, however, resource‐poor mothers are predicted to respond more strongly to local survival risk, whereas resource‐rich mothers are predicted to respond less strongly. This lack of sensitivity on the part of resource‐rich mothers is favoured because they accrue much of their fitness through dispersing young. By contrast, resource‐poor mothers accrue a larger fraction of their fitness through philopatric young and should therefore respond more strongly to local risk. Mothers with more resources gain a larger share of their fitness through dispersing young partly because their fitness in the local patch is constrained by the limited number of local breeding spots. In addition, when resource variation occurs at the patch level, the philopatric offspring of resource‐rich mothers face stronger competition from the offspring of other local mothers, who also enjoy abundant resources. The effect of limited local breeding opportunities becomes less pronounced as patch size increases, but the impact of patch‐level variation in resources holds up even with many breeders per patch.
Recent graduate nurse views of nursing, work and leadership
Authors: Cleary Michelle , Horsfall Jan , Jackson Debra , Muthulakshmi Paulpandi , Hunt Glenn E
Published: May 2013

Aims and objectives

To assess recent nurse graduates of a large university and seeks their views of university preparation, requisite nursing skills and qualities, workplace transition, supports received, nurse leadership and role models, and career development and retention.

Background

Concern about attracting and retaining registered nurses is a continuing workforce issue in parts of Asia and throughout the world.

Design

Qualitative interviews with recent nursing graduates.

Methods

Seventeen face‐to‐face interviews took place using a structured schedule of 23 questions. Data were coded and analysed by hand to determine clusters of interest and develop themes.

Results

Four broad topics emerged: (1) skills and qualities graduates consider central to nursing; (2) the support they received during the transition from graduate to novice practitioner and that which continues; (3) elements they value in nursing role models and leaders; and (4) the ward characteristics that will encourage them to remain in nursing and develop a career. Interviewees expressed concerns about retention‐related issues, making suggestions for improvements. Unique findings focus on the blaming culture that many respondents consider they are working in, and the system whereby they are not free to access postgraduate studies until a specific time frame has elapsed, and when they do pursue further studies, they are bonded to the auspicing hospital/health service.

Conclusions

Responses unique to this research are the explicit concerns about a blaming culture, and complaints about rigid rules (bonding system) that virtually prevent an individual from accessing postgraduate studies independent of the hospital system. Interviewees strongly resent the bonding system that indentures them to that place of work.

Relevance to clinical practice

Quality health care is dependent on a well‐educated, sustainable and skilled nursing workforce. Recognition of the concerns of newly graduated nurses in relation to nursing skill acquisition, workplace support issues and career concerns can assist in ensuring these issues are adequately addressed and in turn contribute to a stronger, more stable and competent nursing workforce.
Cumulative survival rate and complication rates of single‐tooth implant; focused on the coronal fracture of fixture in the internal connection implant
Authors: Cha H.‐S. , Kim Y.‐S. , Jeon J.‐H. , Lee J.‐H.
Published: May 2013

This retrospective study evaluated the 5‐year cumulative survival rate and complication rates of a 4·0‐mm internal connection implant (MicroThread™ Osseospeed™, Astra Tech) installed for single‐tooth restoration. The patients who were treated at Asan Medical Center between 2006 and 2007 were included in this study. A life table analysis was used to calculate the 5‐year cumulative survival rate. Comparisons of cumulative survival rates among implant position (anterior, premolar and molar), jawbone (maxilla, mandible), gender and prosthesis type (screw‐retained, cement‐retained) were performed using the log‐rank test. Post‐loading complications were analysed using Fisher's exact test. Twelve of 136 implants (anterior; 22, premolar; 25, molar; 89) were lost during the loading period, and 11 were removed due to coronal fracture of fixture. The 5‐year cumulative survival rate of the whole arch was 91·9%, and that of the molar region was 87·6%. Statistically significant differences were observed in cumulative survival rates among implant position (P = 0·037), whereas no statistically significant differences were observed among gender, jawbone, prosthesis type. Forty‐seven of 114 (41·2%) implants in the posterior region showed post‐loading complications, including coronal fracture of fixture and abutment screw loosening.
SPREAD AND BACKWASH EFFECTS FOR NONMETROPOLITAN COMMUNITIES IN THE U.S.
Authors: Ganning Joanna P. , Baylis Kathy , Lee Bumsoo
Published: May 2013

Few studies empirically estimate the effects of metropolitan growth on nonmetropolitan communities at a national scale. This paper estimates the growth effects of 276 MSAs on population in 1,988 nonmetropolitan communities in the United States from 2000 to 2007. We estimate the distance for growth spillovers from MSAs to nonmetropolitan communities and test the assumption that a single MSA influences growth. We compare three methods of weighting cities’ influence: nearest city only, inverse‐distance, and relative commuting flow to multiple cities. We find the inverse‐distance approach provides slightly more reliable and theoretically supportable results than the traditional nearest city approach.
Effects of dietary β‐(1,3)(1,6)‐D‐glucan supplementation on growth performance, intestinal morphology and haemato‐immunological profile of mirror carp (Cyprinus carpio L.)
Authors: Kühlwein H. , Merrifield D. L. , Rawling M. D. , Foey A. D. , Davies S. J.
Published: May 2013

In recent years, aquaculture research has focused on probiotics, prebiotics, and β‐glucans, in order to improve health status and growth performance. Information regarding the effects of β‐glucan on growth performance and intestinal immunity of mirror carp (Cyprinus carpio L.) is scarce. An experiment was therefore conducted to investigate the effects of a yeast β‐glucan preparation (MacroGard®) on growth performance, intestinal morphology and haemato‐immunological indices of mirror carp. Carp (initial weight 11.1 ± 0.0 g) were fed highly purified diets supplemented with 0% (control), 0.1%, 1% or 2% MacroGard® for 8 weeks. Fish fed diets containing 1% and 2% MacroGard® showed significant improvements in weight gain, specific growth rate and feed conversion ratio compared to fish fed both the control and the 0.1% MacroGard® containing diet. Histological appraisal of the intestine showed a significantly higher infiltration of leucocytes into the epithelial layer of fish fed diets supplemented with 1% and 2% MacroGard® in the anterior intestine compared to fish fed the control and 0.1% MacroGard® diet. This effect was not observed in the posterior intestine. There were no significant differences in the intestinal absorptive surface area and number of goblet cells in either intestinal region. At the end of the experiment, the haematological status of the fish was examined. Compared to control fed fish, the haematocrit value was significantly elevated in fish fed the 2% MacroGard® diet. Furthermore, the blood monocyte fraction was significantly higher in fish fed the 1% and 2% MacroGard® diets. No significant changes were observed in the other blood parameters assessed. The present study shows that high dietary β‐glucan inclusion increases growth performance without detrimental effects on the health indicators assessed. Increased intraepithelial leucocytes in the anterior intestine may indicate a localized immune response; no detrimental effects on intestinal morphology were observed.
Impact of a First Treatment with Phosphodiesterase Inhibitors on Men and Partners’ Quality of Sexual Life: Results of a Prospective Study in Primary Care
Authors: Costa Pierre , Grandmottet Gilles , Mai Hien Duc , Droupy Stéphane
Published: May 2013

Introduction

Phosphodiesterase type 5 inhibitors (PDE5is) as oral treatment for erectile dysfunction (ED) facilitate the management of ED in primary care. Still, compliance is low and general practitioners (GPs) do not always feel confident with this pathology.

Aim

The aim of this paper is to evaluate the impact of a first treatment with PDE5i on the patient and his partner and the management of ED by GPs.

Methods

The Evaluation après traitement de la dyfonction erectile, du bien-êtré émotionnel d'un patient en fonction de la rigidité de son érection survey was a longitudinal, observational French study with prospective collection of data from the GP, the patient, and his partner at baseline and after 3 months of treatment. GPs benefited from a short educational session before starting the survey.

Main Outcome Measures

The main outcome measures are the Erection Hardness Score (EHS), Self-Esteem and Relationship (SEAR) questionnaire, Index of Sexual Life (ISL), and Erectile Dysfunction Inventory of Treatment Satisfaction.

Results

A total of 478 men aged 19–80 years (mean 57 years) were included in the survey by 229 GPs. Before treatment, EHS was mostly grade 1 (28%) or 2 (44%). At the end of the survey, an improvement was reported for 88% of the patients and 58% achieved maximum score EHS 4 (penis completely hard and fully rigid). Mean SEAR scores significantly increased after 3 months for self-esteem, overall and sexual relationship, and more notably with greater improvement in EHS (P < 0.001). Improvement in partners’ ISL scores was significantly higher with greater improvement in EHS (P < 0.001) and in SEAR score for self-esteem. The safety profile of PDE5i was good with few adverse events, mostly headaches. More than 80% of the participating GPs considered that the survey had changed their management of ED.

Conclusion

After 3 months of treatment with PDE5i, a significant improvement in self-esteem was observed in patients with ED, associated with improvement in erection.
Vulvar and Vaginal Atrophy in Postmenopausal Women: Findings from the REVIVE (REal Women's VIews of Treatment Options for Menopausal Vaginal ChangEs) Survey
Authors: Kingsberg Sheryl A. , Wysocki Susan , Magnus Leslie , Krychman Michael L.
Published: May 2013

Introduction

Vulvar and vaginal atrophy (VVA) is a chronic medical condition experienced by many postmenopausal women. Symptoms include dyspareunia (pain with intercourse), vaginal dryness, and irritation and may affect sexual activities, relationships, and activities of daily life.

Aim

The aim of this study is to characterize postmenopausal women's experience with and perception of VVA symptoms, interactions with healthcare professionals (HCPs), and available treatment options.

Methods

An online survey was conducted in the United States in women from KnowledgePanel®, a 56,000-member probability-selected Internet panel projectable to the overall US population. Altogether, 3,046 postmenopausal women with VVA symptoms (the largest US cohort of recent surveys) responded to questions about their knowledge of VVA, impact of symptoms on their activities, communication with HCPs, and use of available treatments.

Main Outcome Measures

Percent is calculated as the ratio of response over total responding for each question for all and stratified participants.

Results

The most common VVA symptoms were dryness (55% of participants), dyspareunia (44%), and irritation (37%). VVA symptoms affected enjoyment of sex in 59% of participants. Additionally, interference with sleep, general enjoyment of life, and temperament were reported by 24%, 23%, and 23% of participants, respectively. Few women attributed symptoms to menopause (24%) or hormonal changes (12%). Of all participants, 56% had ever discussed VVA symptoms with an HCP and 40% currently used VVA-specific topical treatments (vaginal over-the-counter [OTC] products [29%] and vaginal prescription therapies [11%]). Of those who had discussed symptoms with an HCP, 62% used OTC products. Insufficient symptom relief and inconvenience were cited as major limitations of OTC products and concerns about side effects and cancer risk limited use of topical vaginal prescription therapies.

Conclusions

VVA symptoms are common in postmenopausal women. Significant barriers to treatment include lack of knowledge about VVA, reluctance to discuss symptoms with HCPs, safety concerns, inconvenience, and inadequate symptom relief from available treatments.
Psychological Characteristics of BDSM Practitioners
Authors: Wismeijer Andreas A.J. , van Assen Marcel A.L.M.
Published: May 2013

Introduction

It has been generally thought that the practice of bondage-discipline, dominance-submission, sadism-masochism (BDSM) is in some form associated with psychopathology. However, several more recent studies suggest a relative good psychological health of BDSM practitioners.

Aim

The aim of this study was to compare scores of BDSM practitioners and a control group on various fundamental psychological characteristics.

Methods

For this aim, 902 BDSM and 434 control participants completely filled out online questionnaires. Associations were examined using χ2 tests of independence with φ and Cramer's V as effect size measures and eta or Pearson's correlation. Group differences were tested using analysis of covariance, with partial η2 as effect size measure. A priori contrasts were tested using α = 0.01 to correct for multiple testing; for all other tests we used α = 0.05, two tailed.

Main Outcome Measures

The study used Big Five personality dimensions (NEO Five-Factor Inventory), attachment styles (Attachment Styles Questionnaire), rejection sensitivity (Rejection Sensitivity Questionnaire), and subjective well-being (World Health Organization-Five Well-being Index).

Results

The results mostly suggest favorable psychological characteristics of BDSM practitioners compared with the control group; BDSM practitioners were less neurotic, more extraverted, more open to new experiences, more conscientious, less rejection sensitive, had higher subjective well-being, yet were less agreeable. Comparing the four groups, if differences were observed, BDSM scores were generally more favorably for those with a dominant than a submissive role, with least favorable scores for controls.

Conclusion

We conclude that BDSM may be thought of as a recreational leisure, rather than the expression of psychopathological processes.
Sexual Function in Childhood Cancer Survivors: A Report from Project REACH
Authors: Bober Sharon L. , Zhou Eric S. , Chen Bing , Manley Peter E. , Kenney Lisa B. , Recklitis Christopher J.
Published: May 2013

Introduction

Of the approximately 12,000 children and adolescents that will be diagnosed with cancer in 2013, it is expected that over 80% of them will become long-term adult survivors of childhood cancer. Although it has been well established that cancer treatment often has profound negative impact on sexual functioning, sexual functioning in adult survivors of childhood cancer is not well understood.

Aim

The aim of the current study was to examine the report of sexual function in adult survivors of childhood cancer in relationship to both physical and emotional functioning.

Methods

Two hundred ninety-one participants enrolled in Project REACH, a longitudinal study of childhood cancer survivors, completed questionnaires as part of an annual health survey.

Main Outcome Measure

Primary outcome measures included the sexual functioning subscale of the Swedish Health-Related Quality of Life Survey, the SF-12, and the BSI-18.

Results

Results indicate that 29% of young adult survivors reported two or more discrete symptoms of sexual dysfunction. Females were twice as likely to report sexual problems. Sexual problems were not related to specific types of childhood cancer treatments such as type of chemotherapy or radiation. Young adults with sexual dysfunction did report poorer functioning across the range of SF-12 subscales including physical functioning, general health, fatigue, and mental health.

Conclusions

Significant sexual dysfunction is common in adult survivors of childhood cancer. A greater understanding of the particular relationship between sexual dysfunction and both physical and emotional well-being in this relatively young population is needed. Even when long-term cancer survivors are young adults and report generally good health, results underscore the need for clinicians to specifically assess sexual functioning.
Psoriasis and Sexual Behavior in Men: Examination of the National Health and Nutrition Examination Survey (NHANES) in the United States
Authors: Armstrong April W. , Harskamp Caitlin T. , Schupp Clayton W.
Published: May 2013

Introduction

Epidemiologic data on sexual behavior in psoriasis patients are lacking.

Aim

We aim to examine and compare the sexual behaviors between men with and without psoriasis in the United States.

Methods

We analyzed data from the National Health and Nutrition Examination Survey (NHANES) from 2003 to 2006 and 2009 to 2010. Responses from male participants to the dermatology and sexual behavior questionnaires of the NHANES were collated and analyzed.

Main Outcome Measures

Outcome measures included sexual orientation, age of first sexual encounter, number of oral and non-oral sexual partners, and frequency of unprotected sex.

Results

Among 6,444 U.S. men that responded to the psoriasis question, 170 (2.6%) reported a physician-given diagnosis of psoriasis. Heterosexual men accounted for 95.5% and nonheterosexual men 4.5% of the overall study population. On multivariate analysis, psoriasis was not associated with differences in sexual orientation (odds ratio 1.78, 95% confidence interval [CI] 0.75–4.15). Heterosexual men with psoriasis experienced first sexual encounter at an earlier age than those without psoriasis (weighted difference −0.9 years, P = 0.002). Heterosexual men with psoriasis had significantly fewer female oral sexual partners compared with heterosexual men without psoriasis on multivariate analysis (lifetime partner number: rate ratio [RR] 0.65, 95% CI 0.45–0.95; past-year partner number: RR 0.64, 95% CI 0.42–0.97). No significant differences existed between heterosexual men with and without psoriasis regarding frequency of unprotected sex (RR 0.96, 95% CI 0.85–1.09). Among nonheterosexual men with and without psoriasis, no significant differences existed in age first had sex, number of sexual partners, or frequency of unprotected sex.

Conclusion

Heterosexual men with psoriasis have significantly fewer lifetime female oral sexual partners compared with those without psoriasis. Dermatologists and other healthcare providers need to examine the genital region routinely and initiate appropriate therapy to improve patients' sexual health.
A Systematic Review of the Utility of Anticonvulsant Pharmacotherapy in the Treatment of Vulvodynia Pain
Authors: Leo Raphael J.
Published: May 2013

Introduction

Anticonvulsants have increasingly been invoked in the treatment of vulvodynia. However, the evidence supporting this treatment approach has not been systematically assessed.

Aim

The study aims to evaluate the efficacy of anticonvulsant pharmacotherapy in the treatment of vulvodynia.

Methods

A comprehensive search of the available literature was conducted.

Main Outcome Measure

An assessment of the methodological quality of published reports addressing the utility of anticonvulsants in the treatment of vulvodynia was undertaken.

Results

The search yielded nine published reports, i.e., one open-label trial, six nonexperimental studies, and two case reports. A number of methodological shortcomings were identified in several of the reports with respect to study design, including small sample sizes, lack of placebo or other comparison groups, inadequate outcome measures, among others. The vast majority of studies employed gabapentin. Evidence supporting the benefit of anticonvulsants studied to date was limited, i.e., based predominantly upon descriptive/observational reports. There were no systematic investigations into the comparative efficacy of different anticonvulsant agents in the treatment of vulvodynia.

Conclusion

Although some vulvodynia-afflicted patients derive symptom relief from anticonvulsants, there is, as yet, insufficient evidence to support the recommendation of anticonvulsant pharmacotherapy in the treatment of vulvodynia. Additional investigations, employing randomized controlled trials, are warranted.
Sexual Dysfunction in Male Iraq and Afghanistan War Veterans: Association with Posttraumatic Stress Disorder and Other Combat-Related Mental Health Disorders: A Population-Based Cohort Study
Authors: Breyer Benjamin N. , Cohen Beth E. , Bertenthal Daniel , Rosen Raymond C. , Neylan Thomas C. , Seal Karen H.
Published: May 2013

Introduction

Mental health disorders are prevalent in the United States, Iraq, and Afghanistan war veterans. Mental illness, including posttraumatic stress disorder (PTSD) with or without psychiatric medications, can increase the risk for male sexual dysfunction, threatening quality of life.

Aims

We sought to determine the prevalence and correlates of sexual dysfunction among male Iraq and Afghanistan veterans.

Methods

We performed a retrospective cohort study of 405,275 male Iraq and Afghanistan veterans who were new users of U.S. Department of Veterans Affairs healthcare from October 7, 2001 to September 30, 2009 and had 2-year follow-up.

Main Outcome Measures

We determined the independent association of mental health diagnoses and sexual dysfunction after adjusting for sociodemographic and military service characteristics, comorbidities, and medications.

Results

Veterans with PTSD were more likely to have a sexual dysfunction diagnosis, be prescribed medications for sexual dysfunction, or both (10.6%), compared with veterans having a mental diagnosis other than PTSD (7.2%), or no mental health diagnosis (2.3%). In a fully adjusted model, PTSD increased the risk of sexual dysfunction by more than threefold (adjusted risk ratio = 3.61, 95% CI = 3.48–3.75). Veterans with mental health disorders, particularly PTSD, were at the highest risk of sexual dysfunction when prescribed psychiatric medications (adjusted risk ratio = 4.59, 95% CI = 4.41–4.77).

Conclusions

Among U.S. combat veterans, mental health disorders, particularly PTSD, increased the risk of sexual dysfunction independent of the use of psychiatric medications.
The effects of suppressing intrusive thoughts on dream content, dream distress and psychological parameters
Authors: Kröner‐Borowik Tana , Gosch Stefanie , Hansen Kathrin , Borowik Benjamin , Schredl Michael , Steil Regina
Published: May 2013

Suppressing unwanted thoughts can lead to an increased occurrence of the suppressed thought in dreams. This is explainable by the ironic control theory, which theorizes why the suppression of thoughts might make them more persistent. The present study examined the influence of thought suppression on dream rebound, dream distress, general psychiatric symptomatology, depression, sleep quality and perceived stress. Thirty healthy participants (good sleepers) were investigated over a period of 1 week. Half were instructed to suppress an unwanted thought 5 min prior to sleep, whereas the other half were allowed to think of anything at all. Dream content was assessed through a dream diary. Independent raters assessed whether or not the dreams were related to the suppressed target thought. The results demonstrated increased target‐related dreams and a tendency to have more distressing dreams in the suppression condition. Moreover, the data imply that thought suppression may lead to significantly increased general psychiatric symptomatology. No significant effects were found for the other secondary outcomes.
Prognostic Importance of Myocardial Injury in Critically Ill Dogs with Systemic Inflammation
Authors: Langhorn R. , Oyama M.A. , King L.G. , Machen M.C. , Trafny D.J. , Thawley V. , Willesen J.L. , Tarnow I. , Kjelgaard‐Hansen M.
Published: May 2013

Background

In noncardiac critical disease in humans, myocardial injury as detected by cardiac troponin I and T (cTnI and cTnT) has been linked to high intensive care unit (ICU) death independent of prognostic composite scoring.

Hypothesis

Presence of myocardial injury predicts short‐term death in critically ill dogs with systemic inflammation and provides additional prognostic information when combined with established canine prognostic composite scores.

Animals

Forty‐two dogs admitted to the ICU with evidence of systemic inflammation and no primary cardiac disease.

Methods

Prospective cohort study. Blood samples were obtained at ICU admission for the measurement of cTnI and cTnT, C‐reactive protein, and several cytokines. The acute patient physiologic and laboratory evaluation (APPLE) score and the survival prediction index were calculated within the first 24 hours of admission. Receiver operating characteristic (ROC) curves were used to examine the prognostic capacity of each biomarker and severity score. Multiple logistic regression analysis was performed to evaluate whether cardiac markers significantly contributed to severity scores.

Results

Twenty‐eight day case fatality rate was 26% (11/42 dogs). cTnI concentrations were (median [range]) 0.416 [0.004–141.5] ng/mL and cTnT concentrations were 13.5 [<13–3,744] ng/L. cTnI, cTnT, and the APPLE score were all significant prognosticators with areas under the ROC curves [95% CI] of 0.801 [0.649; 0.907], 0.790 [0.637; 0.900], and 0.776 [0.621; 0.889], respectively. cTnI significantly contributed to the APPLE score in providing additional prognostic specificity (P = .025).

Conclusions and Clinical Importance

Markers of myocardial injury predict short‐term death in dogs with systemic inflammation and cTnI significantly contributes to the APPLE score.
Prognostic Value of 24‐Hour AmbulatoryECG(Holter) Monitoring in Boxer Dogs
Authors: Mõtsküla P.F. , Linney C. , Palermo V. , Connolly D.J. , French A. , Dukes McEwan J. , Luis Fuentes V.
Published: May 2013

Background

Boxer dogs are reported to be predisposed to arrhythmogenic right ventricular cardiomyopathy (ARVC), but the natural history has not been well characterized and inconsistent diagnostic criteria have been applied to identify affected dogs. Echocardiographic examination findings are unremarkable in many affected Boxer dogs, and in these dogs, 24‐hour ambulatoryECG(Holter) monitoring often is used for diagnostic and prognostic purposes, despite limited information available relating Holter findings to outcome.

Hypothesis/Objectives

Boxers with complex ventricular arrhythmias at initial presentation will have shorter survival times. The objective was to investigate the prognostic value of Holter monitoring in Boxer dogs.

Animals

One hundred and twenty‐two Boxer dogs seen at 3 university referral hospitals.

Methods

Retrospective study. Survival times were obtained for Boxer dogs evaluated by echocardiography and a 24‐hour HolterECG. Kaplan‐Meier survival analysis was used to estimate the median survival time and Cox proportional hazards analysis was used to identify variables independently associated with cardiac mortality.

Results

Outcome data were obtained for 122/163 dogs meeting the inclusion criteria. Of the 70 dogs that had died, 45 were considered to have suffered cardiac‐related deaths. Median survival was significantly longer in dogs with a left ventricular systolic diameter (LVIDs) ≤ 35 mm compared with those with LVIDs > 35 mm (P < .001). Multivariable analysis in dogs with LVIDs ≤ 35 mm showed that the presence of ventricular tachycardia, age >4.5 years, and male sex were independent predictors of cardiac mortality.

Conclusions and Clinical Importance

Holter monitoring in Boxer dogs provides valuable prognostic information.
You cannot hide your telephone lies: Providing a model statement as an aid to detect deception in insurance telephone calls
Authors: Leal Sharon , Vrij Aldert , Warmelink Lara , Vernham Zarah , Fisher Ronald P.
Published: May 2013

Deception research regarding insurance claims is rare but relevant given the financial loss in terms of fraud. In Study 1, a field study in a large multinational insurance fraud detection company, truth telling mock claimants (N = 19) and lying mock claimants (N = 21) were interviewed by insurance company telephone operators. These operators classified correctly only 50% of these truthful and lying claimants, but their task was particularly challenging: Claimants said little, and truthful and deceptive statements did not differ in quality (measured with Criteria‐Based Content Analysis [CBCA]) or plausibility. In Study 2, a laboratory experiment, participants in the experimental condition (N = 43) were exposed to an audiotaped truthful and detailed account of an event that was unrelated to insurance claims (a day at the motor races). The number of words, quality of the statement (measured with CBCA), and plausibility of the participants' accounts were compared with participants who were not given a model statement (N = 40). The participants who had listened to the model statement provided longer statements than control participants, truth tellers obtained higher CBCA scores than liars, and only in the model statement condition did truth tellers sound more plausible than liars. Providing participants with a model statement is thus an innovative and successful tool to elicit cues to deception. Providing such a model has the potential to enhance performance in insurance call interviews, and, as we argue, in many other interview settings.
Freeway Travel Time Prediction Using Takagi–Sugeno–Kang Fuzzy Neural Network
Authors: Zhang Yunlong , Ge Hancheng
Published: May 2013

This article presents a Takagi–Sugeno–Kang Fuzzy Neural Network (TSKFNN) approach to predict freeway corridor travel time with an online computing algorithm. TSKFNN, a combination of a Takagi–Sugeno–Kang (TSK) type fuzzy logic system and a neural network, produces strong prediction performance because of its high accuracy and quick convergence. Real world data collected from US‐290 in Houston, Texas are used to train and validate the network. The prediction performance of the TSKFNN is investigated with different combinations of traffic count, occupancy, and speed as input options. The comparison between online TSKFNN, offline TSKFNN, the back propagation neural network (BPNN) and the time series model (ARIMA) is made to evaluate the performance of TSKFNN. The results show that using count, speed, and occupancy together as input produces the best TSKFNN predictions. The online TSKFNN outperforms other commonly used models and is a promising tool for reliable travel time prediction on a freeway corridor.