bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of clinical models for predicting erectile function after localized prostate cancer treatment
Authors: Haskins Amy E , Han Paul KJ , Lucas Frances L , Bristol Ian , Hansen Moritz
Published: July 2014

Objectives

To develop clinical prediction models estimating the probability of maintaining erections adequate for intercourse 2 years after prostate cancer treatment, based on pretreatment characteristics.

Methods

Study participants consisted of prostate cancer patients with localized disease and functional erections before undergoing surgery (n = 536) or radiation therapy (n = 240) at a single USA institution. Baseline patient‐ and treatment‐related data were collected from a clinical database and through chart review. Erectile function at 2 years post‐treatment was prospectively assessed through a self‐administered single‐item measure. Multivariate logistic regression using backward selection was used to derive clinical prediction models to predict erectile function at 2 years for surgery and radiation therapy patients; the models were internally validated using bootstrapping methods.

Results

The final prediction model for surgery patients included the predictor variables of age, body mass index, smoking, diabetes, hypertension and nerve‐sparing procedures, whereas the model for radiation therapy patients included hypertension, risk category and radiation technique. The new models showed acceptable calibration and discrimination: c‐statistic = 0.71 (95% confidence interval 0.68–0.76) for surgery and 0.66 (95% confidence interval 0.61–0.74) for radiation therapy models.

Conclusions

New clinical prediction models based on patient and treatment characteristics show promising accuracy in predicting erectile function at 2 years in patients treated with surgery and radiation for localized prostate cancer. More work is required to confirm and validate these models in different patient populations.
Infectious diseases consultations at an Australian Tertiary Hospital: a review of 11 511 inpatient consultations
Authors: Bursle E. C. , Playford E. G. , Looke D. F. M.
Published: July 2014

Background

Infectious diseases (ID) clinicians provide an important service within tertiary hospitals. However, as a largely consultation‐based service, their value can be difficult to evaluate.

Aims

A review of 13.5 years of consultations was undertaken to define the scope of the service and any changes over time.

Methods

ID consultations at the Princess Alexandra Hospital are tracked on a database, recording information including the requesting team, indication for and outcome of the consult. Incident formal inpatient consultations between July 1999 and December 2012 were reviewed retrospectively. Phone consultations, repeat consultations and ID admissions were excluded.

Results

Eleven thousand five hundred and eleven consultations were identified, with annual consultations increasing significantly during this period. Overall, formal consultations were performed on 1.3% of admissions. Consultations were most commonly requested by orthopaedics (14.3%) and general medicine (11.4%). The two most common syndromes triggering a consult were bloodstream infection (13.9%) and complicated soft tissue infection (7.8%). The final diagnosis was most frequently osteomyelitis (7.9%). Staphylococcus aureus (19.4%) and Pseudomonas aeruginosa (8.3%) were the most commonly identified pathogens.

Conclusion

The demand for ID consultations has increased over time and there are likely to be many drivers of this increase. Information derived from this audit can enhance the ID service by guiding service delivery, trainee education and informing funding or accreditation applications.
Sovereign Ratings and Oil‐Exporting Countries: The Effect of High Oil Prices on Ratings
Authors: Breunig Robert V. , Chia Tse Chern
Published: July 2014

We investigate how high and rising oil prices in the 2003–2008 period affected the sovereign ratings of oil‐exporting countries, after controlling for fundamentals. Based on a large dataset of countries from Standard and Poor's and Moody's, we find strong statistical evidence of a large ratings premium – nearly two notches – for those oil‐exporting countries with a large share of net oil revenue to gross domestic product, relative to countries with similar economic fundamentals. We have some limited forecast information from the rating agencies and the effect increases when we include this information, providing further evidence that this ratings premium is not driven by expected improvements in fundamentals. This finding has implications for asset prices in oil‐exporting countries and highlights the risk that in the event of a sharp unanticipated drop in oil prices, sovereign rating downgrades of oil‐exporting countries could be sharper than the deterioration in their economic fundamentals.
Art School Building: the Old/New Chelsea
Authors: Howarth Lucy
Published: July 2014

In the wake of the recent demolition of the 1965 Chelsea School of Art building on Manresa Road in London, this article seeks to explore the relationship between art school architecture and art school pedagogy. Research on art school buildings, both national and international, and British art school education of the 1960s, is brought to bear, on the former ‘New School of Art in Chelsea’ building. In addition to an account of how this building came about, drawn from archival records and interviews with architects and former Chelsea students and staff, the correlation of utopianist values in post‐war British society, modernist architecture and higher education in art is examined. The reports of the National Advisory Council on Art Education (NACAE), which, in the 1960s, ushered in fundamental changes to British art education, are touched upon, and an account of the building design developed between art educationalists (including Chelsea Principal Lawrence Gowing and Chairman of the NACAE William Coldstream) and architects of the London County Council, is given. Photographs of the building, in the 1960s and during its demolition in 2010, are included. In addition to a historical account and case‐study, and despite the difficulties inherent, art school building is approached as an imaginative and socio‐political gesture, as a utopian act; ‘art school building’ in both senses (‘building’ as a verb and as a noun).
Fishing in Puddles: Place and Space in Performance Research
Authors: Piasecka Shelley
Published: July 2014

This article examines the significance of place and space from a Performance Studies and Social Studies perspective. In terms of the social sciences, I draw upon the formal, symbolic and marginal articulation of place. Hetherington suggests that certain places act as focal point for the establishment of social identities, citing city‐centre landmarks and shopping malls. Similarly, children attach all kinds of values to the formal spaces they occupy. As one example of this point, I examine the child's relationship to the school hall. From the perspective of performance, I examine a project under taken at a junior school in Stoke‐on‐Trent, inspired by the site work of Wrights & Sites. As a critical lens, I adopt Boal's understanding of the oneiric dimension. The oneiric dimension is particularly relevant in performance work as these are the moments when we (as performers and spectators) are pulled into the action. In these instances, the physical space simply disappears, imagination replaces actuality and the desire to believe outweighs the reality of the present.
Brokers Beyond Clientelism: A New Perspective Through the Argentine Case
Authors: Zarazaga Rodrigo
Published: July 2014

Party machines and brokers have been widely researched in political science since 1950, yet a full description of brokers' roles is still missing. This article contributes by describing in detail the many roles brokers perform for their parties and explaining why each broker performs all these roles. In particular, it shows that besides fulfilling clientelistic strategies, brokers perform important executive governability functions once their party is in power. Brokers multitask because they have the neighborhood knowledge required to successfully perform political activities at the local level. Moreover, performing nonclientelistic roles prepares brokers to perform clientelistic strategies. The article also presents a novel theoretical account for why voters abide by the clientelistic deal. Based on interviews with 120 brokers, it analyzes the complete set of brokers' strategies, and detailed narrative accounts show the clientelistic machine at work.
Indigenous Autonomy and the Contradictions of Plurinationalism in Bolivia
Authors: Tockman Jason , Cameron John
Published: July 2014

The government of Bolivia led by President Evo Morales and the Movement Toward Socialism (MAS) party claims to be constructing a new postliberal or plurinational state. However, this alleged experiment in plurinationalism conflicts with two central elements of government and MAS party strategy: the expansion of the economic development model based on the extraction of non-renewable natural resources, and the MAS's efforts to control political space, including indigenous territories. This article analyzes these contradictions by examining how Bolivia's constitution and legal framework appear to support indigenous autonomy while simultaneously constraining it. Specifically, it explores how political and bureaucratic processes have seriously limited opportunities to exercise indigenous rights to autonomy. The article makes a comparative analysis of the implications of Bolivia's experience for indigenous autonomy and plurinationalism for other resource extraction–dependent states.
The Role of Professionals in Policy Reform: Cases from the City Level, São Paulo
Authors: Dowbor Monika , Houtzager Peter P.
Published: July 2014

A new generation of social policies in Brazil and elsewhere in Latin America are being read by scholars as first and foremost the result of top-down initiatives by state elites and technocrats. This article explores what role, if any, middle-class professionals have played and how this role might be framed in analytical terms. The article examines the trajectory of two of the most important new social programs that target the poor in the city of São Paulo, Brazil: the family health program PSF and Renda Mínima. It compares the city-level reform dynamics that have shaped the trajectory of the programs over 18 years. It finds that networks of reformist middle-class professionals that traverse public and private institutions played a substantial role in the creation and evolution of the new programs.
Outsiders and Executive-Legislative Conflict in Latin America
Authors: Carreras Miguel
Published: July 2014

One of the most significant developments in Latin American democracies since the beginning of the Third Wave of democratization is the rise to power of political outsiders. However, the study of the political consequences of this phenomenon has been neglected. This article begins to fill that gap by examining whether the rise of outsiders in the region increases the level of executive-legislative confrontation. Using an original database of political outsiders in Latin America, it reports a series of logistic regressions showing that the risk of executive-legislative conflict significantly increases when the president is an outsider. The likelihood of institutional paralysis increases when an independent gets elected, due to the legislative body's lack of support for the president and the outsider's lack of political skills. The risk of an executive's attempted dissolution of Congress is also much higher when the president is an outsider.
Loyalty and Disloyalty in the Mexican Party System
Authors: Kerevel Yann P.
Published: July 2014

Why do politicians in Mexico switch parties? The party-switching literature suggests that politicians generally switch parties for office-seeking or policy-seeking motives, whereas literature on the Mexican party system suggests that switching may be related to party system realignment during the democratic transition. Using data on party switching across the political careers of politicians who served as federal deputies between 1997 and 2009, this study argues that party switching in Mexico can primarily be explained by the office-seeking behavior of ambitious politicians. Only in rare instances do politicians switch parties because of policy disagreements, and party system realignment fails to explain a large number of party switches. This article also suggests that the ban on consecutive re-election encourages party switching; after every term in office, Mexican politicians have the opportunity to re-evaluate their party affiliation to continue their careers.
Expression of the oestrogen receptor GPER by testicular peritubular cells is linked to sexual maturation and male fertility
Authors: Sandner F. , Welter H. , Schwarzer J. U. , Köhn F. M. , Urbanski H. F. , Mayerhofer A.
Published: July 2014

Besides the two nuclear oestrogen receptors (ESR1/ESR2), the G protein‐coupled oestrogen receptor (GPER) was described in the human testis but little is known about testicular GPER during development or male infertility. We performed an immunohistochemical analysis using human and rhesus monkey testicular samples. The results obtained in adult primate testes showed GPER in interstitial and vascular cells as well as in smooth muscle‐like peritubular cells, which build the wall of seminiferous tubules. Expression of GPER was also found in cultured human testicular peritubular cells (HPTCs) by Western blotting and RT‐PCR/sequencing. Furthermore, as seen in time‐lapse videos of cultured cells, addition of a specific GPER agonist (G1) significantly reduced the numbers of HTPCs within 24 h. A GPER antagonist (G15) prevented this action, implying a role for GPER related to the control of cell proliferation or cell death of peritubular cells. Peritubular cell functions and their phenotype change, for example, during post‐natal development and in the cases of male infertility. The study of non‐human primate samples revealed that GPER in peritubular cells was detectable only from the time of puberty onwards, while in samples from infantile and prepubertal monkeys only interstitial cells showed immunopositive staining. In testicular biopsies of men with mixed atrophy, a reduction or loss of immunoreactive GPER was found in peritubular cells surrounding those tubules, in which spermatogenesis was impaired. In other cases of impaired spermatogenesis, namely when the tubular wall was fibrotically remodelled, a complete loss of GPER was seen. Thus, the observed inverse relation between the state of fertility and GPER expression by peritubular cells implies that the regulation of primate testicular peritubular cells by oestrogens is mediated by GPER in both, health and disease.
The role of diversity practices and inclusion in promoting trust and employee engagement
Authors: Downey Stephanie N. , van der Werff Lisa , Thomas Kecia M. , Plaut Victoria C.
Published: July 2014

This paper investigates the association of diversity practices with an important aspect of workplace well‐being, engagement. It was hypothesized that this association would be mediated by trust climate, and that this mediation relationship would be stronger when employees experienced feelings of inclusion in the workplace. Using a sample of 4,597 health sector employees, results indicated that diversity practices are associated with a trusting climate that, in turn, is positively related to employee engagement. Furthermore, the relationship between diversity practices and trust climate was moderated by inclusion. Theoretical and practical implications of the study are discussed along with recommendations for future research.
Evaluations of a bullying case involving a victim with autism spectrum disorder
Authors: Gentry Rachel H. , Pickel Kerri L. , Johnson Meghan C.
Published: July 2014

We investigated how people determine whether a specific occurrence of aggression between students constitutes bullying and how they think perpetrators should be treated. In two experiments, we examined perceptions of relational bullying at a university involving a victim who admits to engaging in socially inappropriate behavior. Participants were assigned to one of three victim disability conditions: autism spectrum disorder (ASD), dyslexia, or no disability. They listened to a recording of a disciplinary hearing and made several evaluations (e.g., verdict). Participants' judgments were more likely to favor the victim if they learned that he had ASD rather than dyslexia or no disability. Observers may view an ASD diagnosis as a reasonable explanation for behaving inappropriately and therefore excuse the victim's conduct.
Can music with prosocial lyrics heal the working world? A field intervention in a call center
Authors: Niven Karen
Published: July 2014

Music with lyrics about helping is shown to reduce aggression in the laboratory. This paper tests whether the prosocial lyric effect generalizes to reducing customer aggression in the workplace. A field experiment involved changing the hold music played to customers of a call center. The results of a 3 week study suggested that music significantly affected customers, but not in the way suggested by previous laboratory experiments; compared with days when instrumental background music was played, caller anger and employee exhaustion were lower on days when callers were played popular music with neutral, but not prosocial, lyrics. The findings suggest that music influences customer aggression, but that the prosocial lyric effect may not generalize from the laboratory to the call center.
Turnover of breeding bird communities on islands in an inundated lake
Authors: Si Xingfeng , Pimm Stuart L. , Russell Gareth J. , Ding Ping
Published: July 2014

Aim

MacArthur and Wilson's theory of island biogeography proposes that the rate at which species colonize an island depends on the island's isolation (distance effect), whereas the local extinction rate depends on its area (area effect). Alternative hypotheses recognize that area can affect the colonization rate (target effect) and that isolation can affect the extinction rate (rescue effect) and, moreover, that these relationships may dominate. We quantify these relationships and associated turnover rates and incidence using long‐term counts of breeding bird communities on islands in an inundated lake.

Location

Thousand Island Lake, China.

Methods

We assessed the occupancy and behaviour of breeding birds on 37 islands from 2007 to 2012. We estimated the effects of area, isolation and other biogeographical parameters on the frequencies of colonization and extinction events using multivariate logistic regression. We then extended these results to derived properties such as species turnover rates and incidence.

Results

Extinction rates decreased and colonization rates increased on larger islands. Isolation had no significant effect on colonization or extinction rates. Islands had high species turnover overall, and turnover rates followed the same pattern as extinction rates with different areas and isolations. Pool turnover, which controls for the number of species in the pool, was higher on large islands. Species richness also increased with area. Our study of bird communities supported area and target effects, but not distance and rescue effects.

Main conclusions

Island area was a better predictor of colonization and extinction than isolation, probably because of the relatively small scale (c. 580 km2) and homogeneous vegetation structure of our research system, and the strong dispersal ability of birds. We conclude that the differences between our observations and theoretical predictions, or results from other studies that measured colonization and extinction directly, are consistent with the particular biogeography of these islands.
Cognitive benefits of last night's sleep: daily variations in children's sleep behavior are related to working memory fluctuations
Authors: Könen Tanja , Dirk Judith , Schmiedek Florian
Published: July 2014

Background

Recent studies have suggested substantial fluctuations of cognitive performance in adults both across and within days, but very little is known about such fluctuations in children. Children's sleep behavior might have an important influence on their daily cognitive resources, but so far this has not been investigated in terms of naturally occurring within‐person variations in children's everyday lives.

Methods

In an ambulatory assessment study, 110 elementary school children (8–11 years old) completed sleep items and working memory tasks on smartphones several times per day in school and at home for 4 weeks. Parents provided general information about the children and their sleep habits.

Results

We identified substantial fluctuations in the children's daily cognitive performance, self‐reported nightly sleep quality, time in bed, and daytime tiredness. All three facets were predictive of performance fluctuations in children's school and daily life. Sleep quality and time in bed were predictive of performance in the morning, and afternoon performance was related to current tiredness. The children with a lower average performance level showed a higher within‐person coupling between morning performance and sleep quality.

Conclusions

Our findings contribute important insights regarding a potential source of performance fluctuations in children. The effect of varying cognitive resources should be investigated further because it might impact children's daily social, emotional, and learning‐related functioning. Theories about children's cognitive and educational development should consider fluctuations on micro‐longitudinal scales (e.g., day‐to‐day) to identify possible mechanisms behind long‐term changes.
Commentary: Attachment is a biological concept – a reflection on Fearon et al. (2014)
Authors: Rutter Michael
Published: July 2014

This article is a commentary on Fearon et al. (2014, Genetic and environmental influences on adolescent attachment) published in this issue.
Commentary: Genetic influences on adolescent attachment security: an empirical reminder of biology and the complexities of development – a reply to Rutter (2014)
Authors: Fearon Pasco , Shmueli‐Goetz Yael , Viding Essi , Fonagy Peter , Plomin Robert
Published: July 2014

We were delighted to learn that Michael Rutter had written a commentary (Rutter, 2014) on our article (Fearon, Shmueli‐Goetz, Viding, Fonagy, & Plomin, 2014).
3D geometry analysis of the medial meniscus – a statistical shape modeling approach
Authors: Vrancken A. C. T. , Crijns S. P. M. , Ploegmakers M. J. M. , O'Kane C. , van Tienen T. G. , Janssen D. , Buma P. , Verdonschot N.
Published: July 2014

The geometry‐dependent functioning of the meniscus indicates that detailed knowledge on 3D meniscus geometry and its inter‐subject variation is essential to design well functioning anatomically shaped meniscus replacements. Therefore, the aim of this study was to quantify 3D meniscus geometry and to determine whether variation in medial meniscus geometry is size‐ or shape‐driven. Also we performed a cluster analysis to identify distinct morphological groups of medial menisci and assessed whether meniscal geometry is gender‐dependent. A statistical shape model was created, containing the meniscus geometries of 35 subjects (20 females, 15 males) that were obtained from MR images. A principal component analysis was performed to determine the most important modes of geometry variation and the characteristic changes per principal component were evaluated. Each meniscus from the original dataset was then reconstructed as a linear combination of principal components. This allowed the comparison of male and female menisci, and a cluster analysis to determine distinct morphological meniscus groups. Of the variation in medial meniscus geometry, 53.8% was found to be due to primarily size‐related differences and 29.6% due to shape differences. Shape changes were most prominent in the cross‐sectional plane, rather than in the transverse plane. Significant differences between male and female menisci were only found for principal component 1, which predominantly reflected size differences. The cluster analysis resulted in four clusters, yet these clusters represented two statistically different meniscal shapes, as differences between cluster 1, 2 and 4 were only present for principal component 1. This study illustrates that differences in meniscal geometry cannot be explained by scaling only, but that different meniscal shapes can be distinguished. Functional analysis, e.g. through finite element modeling, is required to assess whether these distinct shapes actually influence the biomechanical performance of the meniscus.
Self‐control study on reduced‐dose depot versus daily administration of gonadotrophin‐releasing hormone agonists for pituitary desensitization in in vitro fertilization cycles
Authors: Gao Jun , Xu Yan‐Wen , Miao Ben‐Yu , Zhou Can‐Quan
Published: July 2014

Aim

Our aim was to analyze the effect of reducing the dose of depot gonadotrophin‐regulating hormone‐agonist (GnRH‐a) to 1.0 mg on pituitary desensitization and clinical outcome of in vitro fertilization and embryo transfer cycles.

Material and Methods

This retrospective self‐control study was conducted on 143 patients who underwent repeated long‐protocol treatment from 1 January 2011 to 31 May 2012 at our hospital. Of the 143 patients, 64 received reduced‐dose depot (1.0 mg diphereline depot) GnRH‐a for the first cycle and short‐acting GnRH‐a (0.05 mg diphereline) for the second cycle, while 79 patients received short‐acting GnRH‐a for the first cycle and reduced‐dose depot GnRH‐a for the second cycle.

Results

The serum follicle‐stimulating hormone, luteinizing hormone and estradiol levels on the day of gonadotrophin initiation were significantly higher in the short‐acting group compared with the long‐acting group. Both number of days of gonadotrophin stimulation and gonadotrophin doses were significantly higher in the short‐acting group. On the day of human chorionic gonadotrophin administration, the serum estradiol level was significantly higher while the progesterone level was significantly lower in the short‐acting group. There were no significant differences with regard to the number of retrieved oocytes, fertilization rate, number of transferred embryos, clinical pregnancy rate, implantation rate, and early pregnancy loss rate between the two groups. However, the oocyte maturation rate was significantly higher in the long‐acting group.

Conclusion

Reduced‐dose depot GnRH‐a can be successfully used for pituitary desensitization in in vitro fertilization and embryo transfer. Deeper downregulation with reduced‐dose depot GnRH‐a indicates that the optimal dose of GnRH‐a warrants future study.
Extracorporeal membrane oxygenation saved a mother and her son from fulminant peripartum cardiomyopathy
Authors: Park Sang Hyun , Chin Jung Yeon , Choi Min Suk , Choi Jin Ho , Choi Yu Jeong , Jung Kyung Tae
Published: July 2014

A 34‐year‐old full‐term pregnant woman presented with abruptly aggravating dyspnea. A chest X‐ray showed pulmonary edema, and an echocardiogram revealed a left ventricular ejection fraction of 39%. Despite conventional medical treatment for acute heart failure and mechanical ventilation, hypoxia and metabolic acidosis were aggravated, and the fetal heart rate decreased to 90 b.p.m., suggestive of fetal distress. We decided to initiate extracorporeal membrane oxygenation (ECMO) and perform a cesarean section. The infant was successfully delivered without hypoxic brain damage. The patient was weaned from ECMO 6 days after delivery and was extubated 1 day after discontinuation of ECMO. Left ventricular systolic function had completely recovered at this time. This is the first report of a patient with peripartum cardiomyopathy who had a successful delivery with the support of ECMO, demonstrating that ECMO can serve as a rescue therapy, not only treating peripartum cardiomyopathy but also permitting a safe delivery.
Novel reversible permanent contraception: An animal experiment of embedding contraceptive surgery in the fimbriated extremity of the fallopian
Authors: Xin Gang , Du Juan , Zhang Jun , Xu YongPing
Published: July 2014

Aim

According to female pelvic anatomical characteristics, we designed a novel reversible permanent contraception: embedding contraceptive surgery in the fimbriated extremity of the fallopian. This study involves embedding the oviduct of New Zealand rabbits into the peritoneum, and assesses contraceptive effect, morphological changes and recoverability.

Methods

Thirty New Zealand rabbits were divided into three groups: embedding in the fimbriated extremity of the fallopian group (A group); polyethylene film in the fimbriated extremity of the fallopian group (B group); and control (C group). Surgery was performed in each group, respectively. Contraceptive efficacy, morphological changes and recoverability were noted.

Results

As for contraceptive effect, mating experiences were successful. After 3 months, there were no pregnant rabbits in group A and B, while in group C all samples were pregnant. Regarding recoverability, after belly operation, 10 rabbits in group A showed dropsy in the bilateral oviducts. Tissue adhesion could be found in the fimbriated extremity of the fallopian with a large range of damage. All samples in group B also had dropsy, but only two of them had unilateral slight adhesions in the fimbriated extremity of the fallopian, while others had no pathological changes. After being released from the oviduct embedding, five rabbits in group A became pregnant and nine in group B.

Conclusion

Embedding contraceptive surgery in the fimbriated extremity of the fallopian after being covered by polyethylene film is reliable and safe. Releasing the embedding may cause minor injury. Although there is a problem of hydrosalpinx, the pregnancy rate is high.
Comparison between two incision angles of mediolateral episiotomy in primiparous women: A randomized controlled trial
Authors: El‐Din Adel S. S. , Kamal Magdy M. , Amin Malaka A.
Published: July 2014

Aim

To compare two incision angles (60° vs 40°) of mediolateral episiotomy in primiparous Egyptian women, regarding the incidence of anal sphincter injury as well as episiotomy‐related pain and dyspareunia.

Methods

The current prospective randomized controlled trial (ClinicalTrials.gov, NCT01930721) was conducted at Ain Shams University Maternity Hospital. Eligible women were randomized into two groups: group 1 included women who had the episiotomy incision made at an angle of 60° to the midline; and group 2 included women who had the episiotomy incision made at an angle of 40° to the midline. Primary outcome measures were differences in short‐term related pain and rate of third/fourth degree perineal tears.

Results

A total of 330 primiparous women were recruited. The shortest distance to the outer edge of the anal epithelium was significantly shorter in women of group 2 when compared to that in women of group 1. Out of the included 330 women, 13 (4%) had third/fourth‐degree perineal tears (4 [2.4%] in group 1 in contrast to nine [5.5%] in group 2). This difference was not significant A 60°‐angled mediolateral episiotomy was associated with significantly higher rates of moderate/severe episiotomy‐related pain post‐partum. The rates of moderate/severe episiotomy‐related pain and dyspareunia assessed 6 months post‐partum were also higher among women of group 1, when compared to group 2; the latter two differences did not reach statistical significance, however.

Conclusion

When compared to the 40°‐angled mediolateral episiotomies, 60°‐angled ones were associated with significantly higher short‐term‐related pain. Although they were also associated with lower rate of third/fourth‐degree perineal tears and higher rate of long‐term related pain and dyspareunia, these differences did not reach a statistically significant level.
Obstetric and neonatal outcomes of delayed interval delivery in cerclage and non‐cerclage cases: An analysis of 20 multiple pregnancies
Authors: Doger Emek , Cakiroglu Yigit , Ceylan Yasin , Kole Emre , Ozkan Sebiha , Caliskan Eray
Published: July 2014

Aim

The aim of study is to compare maternal and fetal outcomes of pregnancies in which cerclage was placed following the loss of first fetus with those without cerclage placement in multiple pregnancies for delayed interval delivery.

Methods

Records of pregnancies in which the first fetus was lost between 13–26 weeks and delayed delivery experienced for retained fetus(es), were collected retrospectively. A total of 20 patients including 11 twins, seven triplets and two quadruplets were evaluated. Cases with cervical cerclage placed after the first delivery were evaluated as the cerclage group (n = 11) and the cases without cerclage placement were evaluated as the non‐cerclage group (n = 9).

Results

Median duration of delay was 22 days (range, 3–121) for both groups; 40 days (range, 5–121) in cerclage group and 12 days (range, 3–46) in the non‐cerclage group (P = 0.003). Average birthweight of retained fetus(es) in the cerclage group was 850 ± 153.6 g (mean ± standard error [SE]) and 549.5 ± 149.1 g (mean ± SE) in the non‐cerclage group (P = 0.04). Delivery week of retained fetus(es), live birth rate, take‐home baby rate and chorioamnionitis ratio were not different in between the groups.

Conclusion

Cervical cerclage after the first delivery is associated with a longer delivery interval and higher birthweight of retained fetus.
Different subsets of Langerhans cells in human uterine tubes and uterus
Authors: Rabi Suganthy , Jacob Tripti Meriel , Lionel Jessie , Indrasingh Inbam
Published: July 2014

Aim

Langerhans cells (LC) are antigen‐presenting cells present in tissues with high antigenic exposure. Their role in the upper female reproductive tract is not fully understood. This study aims to determine the distribution and morphology of LC in the normal and post‐partum human uterine tubes and uterus by staining with the specific LC markers, CD1a and zinc iodide‐osmium (ZIO), and to determine their association with helper and cytotoxic T cells.

Material and Methods

Normal and post‐partum uterine tube and uterine specimens were stained with CD1a and ZIO and their morphology and distribution noted. Double immune staining with CD1a‐CD4 and CD1a‐CD8 in post‐partum uterine tube were also done.

Results

It was noted that CD1a‐positive cells were significantly fewer and smaller in diameter than ZIO‐positive cells in the uterine tube and both types of cells were significantly more prevalent in post‐partum tubes. Perivascular clusters of ZIO‐positive cells were seen in the post‐partum tubes. Close association of CD1a‐positive cells with CD4‐ and CD8‐positive T cells was noted in the post‐partum uterine tube. In the uterus, scanty CD1a‐positive cells were present in the surface and glandular epithelium and endometrial stroma. ZIO‐positive cells were absent.

Conclusion

This study suggests that CD1a‐positive and ZIO‐positive cells may be different subsets of LC that are needed for presentation of antigen to immunocompetent cells. Their respective functions are yet to be determined.
Expression of glucose transporter protein 1 and p63 in serous ovarian tumor
Authors: Cai Yu , Zhai Jian‐jun , Feng Bi‐bo , Duan Xian‐zhi , He Xiao‐jin
Published: July 2014

Aim

It has been shown that glycolytic metabolism is increased in malignant cells. Cancer cell growth is an energy‐related process supported by an increased glucose metabolism. In addition, p63, a known homolog of p53, is expressed predominantly in basal cell and squamous cell carcinomas. The purpose of this study was to evaluate the expression of glucose transporter protein 1 (GLUT1) and p63 in patients with serous ovarian tumor (benign, borderline and malignant) and study their close relationship with the malignant transformation of serous ovarian tumors.

Methods

Two hundred formalin‐fixed, paraffin‐embedded sections were immunostained with rabbit anti‐GLUT1 polyclonal antibody and mouse anti‐p63 monoclonal antibody using the streptavidin‐biotin method. The samples were as follows: 40 normal ovarian tissues, 40 serous cystadenomas, 40 borderline serous cystadenomas and 80 serous cystadenocarcinomas were stained.

Result

Normal ovarian tissues showed completely negative staining for GLUT1 and p63. However, from benign serious cystadenomas, borderline cystadenomas to cystadenocarcinomas, the expression of GLUT1 and p63 grew stronger (P < 0.05). Moreover, the intensity staining of GLUT1 maintained a significant association with the expression of p63 (P < 0.05). In χ2‐test analysis, expression of borderline cystadenomas and cystadenocarcinomas, intraperitoneal implants, ascites, lymph node status and International Federation of Gynecology and Obstetrics (FIGO) stage and GLUT1 expression levels have an appalling significance (P < 0.05), while FIGO stage, intraperitoneal implants and lymph node status except patient age and ascites have a statistical significance with the expression of p63 levels (P < 0.05).

Conclusion

Our findings show a progressive increase in the expression of GLUT1 and p63 from the benign serous cystadenomas, borderline cystadenomas to cystadenocarcinomas. Overexpression of GLUT1 and p63 are associated with the histology FIGO stage and metastasis of the tumors. These data suggested that the expression of GLUT1 and p63 may be closely related to the malignant transformation of serous ovarian tumors. However, the relative importance of GLUT1 and p63 in ovarian serous tumor development and tumorigenesis remains mostly unclear and awaits further investigation.
Coring‐type laparoscopic resection of a cavitated non‐communicating rudimentary horn under hysteroscopic assistance
Authors: Akdemir Ali , Ergenoglu Ahmet Mete , Yeniel Ahmet Özgür , Sendag Fatih , Karadadaş Nedim
Published: July 2014

Non‐communicating accessory uterine horns with an endometrial cavity are the most common and clinically significant unicornuate subtype of Müllerian duct abnormality. They are generally associated with symptoms of dysmenorrhea, dyspareunia, infertility, endometriosis, adhesions, and life‐threatening cornual pregnancy. Treatment options include surgical resection of the rudimentary horn, hysteroscopic recanalization, and endometrial ablation. Currently, laparoscopic resection is the recommended treatment choice. Dissection of the rudimentary horn from the unicornuate uterus is the most challenging part of this procedure and may compromise the remaining unicornuate uterus wall. Here we describe a case of laparoscopic coring‐type resection of a non‐communicating functional rudimentary horn firmly attached to the unicornuate uterus, by using hysteroscopic assistance. The use of hysteroscopy, adjunct to laparoscopy, facilitates the coring‐type resection and may strengthen the remaining myometrial scar.
Assessment of sub‐endometrial blood flow parameters following dydrogesterone and micronized vaginal progesterone administration in women with idiopathic recurrent miscarriage: A pilot study
Authors: Ghosh Sanghamitra , Chattopadhyay Ratna , Goswami Sourendrakanta , Chaudhury Koel , Chakravarty Baidyanath , Ganesh Ashalatha
Published: July 2014

Aim

To evaluate differences in uteroplacental blood flow and pregnancy outcome in women with idiopathic recurrent spontaneous miscarriage (IRSM) following administration of micronized vaginal progesterone and oral dydrogesterone.

Methods

One hundred and thirty‐three women (aged 23–40 years) who had had early miscarriages and spontaneous conception participated. Oral dydrogesterone (group A, n = 51) and micronized vaginal progesterone (group B, n = 50) were administrated for luteal support and compared. Pregnant women without history of recurrent miscarriage served as controls (group C, n = 32). The outcome measures consisted of endometrial blood flow parameters by Doppler indices and ongoing pregnancy rate.

Results

Before progesterone supplementation, resistivity index (RI) and pulsatility index (PI) were found to be significantly higher in groups A and B as compared to controls. Although statistically not significant, end diastolic velocity (EDV) and systolic/diastolic (S/D) ratio was found to be superior in controls than IRSM women. Peak systolic velocity (PSV) was comparable between IRSM and non‐IRSM groups. Following progesterone supplementation, groups A and B showed a highly significant reduction in RI, PI and an increase in EDV. A relative increase in the value of PSV was observed in group A as compared to group B. There was remarkable difference in S/D in both groups. Although not statistically significant, group C showed reduction in RI, PI, PSV, EDV and S/D ratio. Pregnancy salvage rates were higher in group A (92.0%) as compared to group B (82.3%).

Conclusion

Progesterone supplementation appears to lower vascular resistance in women with IRSM. Oral dydrogesterone appears to be equally effective in improving endometrial blood flow as compared with micronized progesterone.
Bilateral Optic Neuropathy with Bilateral Putaminal Lesions: A Case Report
Authors: Togawa Jumpei , Ohi Takekazu
Published: July 2014

Bilateral optic neuropathy with bilateral putaminal lesions may be caused by methanol or cyanide poisoning or mitochondrial disorders including Leber hereditary optic neuropathy and Leigh syndrome. We report the case of a 34‐year‐old Japanese man who developed bilateral visual loss 5 days after the development of gastrointestinal symptoms. Magnetic resonance imaging of the brain on admission revealed high‐intensity signal areas in the bilateral putamina on diffusion‐weighted and T2‐weighted images as well as a high‐intensity signal area in the left middle cerebellar peduncle that had been identified 3 years previously. We diagnosed bilateral optic neuropathy with bilateral putaminal lesions caused by preceding infection‐triggered demyelination. We administered methylprednisolone, but his vision did not recover.
What Makes a Family Firm Innovative? CEO Risk‐Taking Propensity and the Organizational Context of Family Firms
Authors: Kraiczy Nils D. , Hack Andreas , Kellermanns Franz W.
Published: July 2014

Investigating the new product portfolio innovativeness of family firms connects two important topics that have recently received considerable attention in innovation and family firm research. First, new product portfolio innovativeness has been identified as a critical determinant of firm performance. Second, research on family firms has focused on the questions of if and why family firms are more or less innovative than other organizational forms. Research investigating the innovativeness of family firms has often applied a risk‐oriented perspective by identifying socioemotional wealth (SEW) as the main reference that determines firm behavior. Thus, prior research has mainly focused on the organizational context to predict innovation‐related family firm behavior and neglected the impact of preferences and the behavior of the chief executive officer (CEO), which have both been shown to affect firm outcomes. Hence, this study aims to extend the previous research by introducing the CEO's disposition to organizational context variables to explain the new product portfolio innovativeness of small and medium‐sized family firms. Specifically, this study explores how the organizational context (i.e., ownership by top management team [TMT] family members and generation in charge of the family firm) of family firms interacts with CEO risk‐taking propensity to affect new product portfolio innovativeness. Using a sample of 114 German CEOs of small and medium‐sized family firms operating in manufacturing industries, the results show that CEO risk‐taking propensity has a positive effect on new product portfolio innovativeness. Moreover, the analyses show that the organizational context of family firms impacts the relationship between CEO risk‐taking propensity and new product portfolio innovativeness. Specifically, the relationship between CEO risk‐taking propensity and new product portfolio innovativeness is weaker if levels of ownership by TMT family members are high (high SEW). Additionally, the effect of CEO risk‐taking propensity on new product portfolio innovativeness is stronger in family firms at earlier generational stages (high SEW). This result suggests that if SEW is a strong reference, family firm‐specific characteristics can affect individual dispositions and, in turn, the behaviors of executives. Therefore, this study helps extend the knowledge on the determinants of new product portfolio innovativeness of family firms by considering an individual CEO preference and the organizational context variables of family firms simultaneously.
Further Definition on the Multiple Partner Choice Arena: A Potential Animal Model for the Study of Premature Ejaculation
Authors: Olayo-Lortia Jesús , Ferreira-Nuño Armando , Velázquez-Moctezuma Javier , Morales-Otal Adriana
Published: July 2014

Introduction

The multiple partner choice arena (MPCA) is an experimental setup in which male rats display a significant shortening of ejaculation latency, which is the main characteristic of premature ejaculation (PE) in men. Thus, the MPCA is a potential animal model for PE.

Aim

In this study, we further analyze whether the features of the MPCA satisfy the validity criteria for it to be considered an animal model as well as the possible participation of the serotoninergic system in the faster ejaculation exhibited by male rats in the MPCA.

Methods

In Experiment 1, male rats were tested in a standard arena to assess their sexual behavior, then were assessed 1 week later in the MPCA. Another group was first tested in the MPCA, then in a standard arena. In Experiment 2, male rats divided into two groups were treated daily with WAY-100635 (5-HT1A antagonist) or vehicle for 15 days. In each group, half of the subjects were tested in a standard arena and half were tested in the MPCA on days 1, 8, and 15 of treatment.

Main Outcome Measures

Number of intromissions and intromission and ejaculation latencies were the main outcome measures.

Results

In Experiment 1, males tested in the MPCA ejaculated significantly faster, regardless of the order in which they were evaluated in both arenas. In Experiment 2, the administration of WAY-100635 increased intromission and ejaculation latencies, and the number of intromissions in the MPCA.

Conclusions

The results obtained in the MPCA support its use as an animal model for PE evaluation.
Association of Quantity and Duration of Smoking with Erectile Dysfunction: A Dose–Response Meta-Analysis
Authors: Cao Shiyi , Gan Yong , Dong Xiaoxin , Liu Junan , Lu Zuxun
Published: July 2014

Introduction

Some original studies and a recent meta-analysis suggested that smoking could be associated with the risk of erectile dysfunction (ED), but the dose–response relationship between them was unclear.

Aim

The aim of this study was to investigate the potential association between quantity and duration of smoking and the risk of ED.

Methods

We conducted a literature search of PubMed, Embase, Web of Science, and Scopus from these databases' inception through March 2014 for observational epidemiological studies examining the association between smoking and risk of ED. Random-effects meta-analyses were used to combine the results of included studies.

Main Outcome Measure

Quantitative review of published observational epidemiological studies on the association between smoking and risk of ED was the main outcome measure.

Results

One cohort study and nine cross-sectional studies were eligible for inclusion in the meta-analysis (50,360 participants and 12,218 cases with ED). No evidence of a curve linear association was observed between smoking and risk of ED. The summary odds ratio of ED for an increase of 10 cigarettes smoked per day was 1.14 (95% confidence interval 1.09 to 1.18), with moderate heterogeneity (P = 0.061, I  2 = 44.7%). For an increment of 10 years of smoking, the combined odds ratios of ED was 1.15 (95% confidence interval 1.10 to 1.19), without substantial heterogeneity (P = 0.522, I  2 = 0.0%).

Conclusions

Evidence from observational studies suggests that there is a positive dose–response association between quantity and duration of smoking and risk of ED.