bluuebunny/crossref_metadata_2025 huggingface dataset:
Families and health‐care professionals' perspectives and expectations of family‐centred care: hidden expectations and unclear roles
Authors: Coyne Imelda
Published: June 2013

Background and objective

Family‐centred care (FCC) is viewed as a pivotal concept in the provision of high‐quality nursing care for children and their families, yet implementation continues to be problematic worldwide. This research investigated how FCC was enacted from families and nurses' perspectives.

Design

Descriptive qualitative approach using elements of analysis from grounded theory method. Data were collected though individual interviews with 18 children aged 7–16 years, their parents (n = 18) and 18 nurses from two children's hospital and one children's unit in a large general hospital in Ireland.

Results

Four key themes were identified: expectations; relying on parents' help; working out roles; and barriers to FCC. Nurses wholeheartedly endorsed FCC because of the benefits for families and their reliance on parents' contribution to the workload. There was minimal evidence of collaboration or negotiation of roles which resulted in parents feeling stressed or abandoned. Nurses cited busy workload, under‐staffing and inappropriate documentation as key factors which resulted in over‐reliance on parents and hindered their efforts to negotiate and work alongside parents.

Conclusions

Families are willing to help in their child's care but they require clear guidance, information and support from nurses. Hidden expectations and unclear roles are stressful for families. Nurses need skills training, adequate resources and managerial support to meet families' needs appropriately, to establish true collaboration and to deliver optimal family‐centred care.
Quit intention as a predictor of quit attempts over time in adolescents with psychiatric disorders
Authors: Tzilos Golfo K. , Strong David R. , Abrantes Ana M. , Ramsey Susan E. , Brown Richard A.
Published: June 2013

Background

Rates of smoking among adolescents with psychiatric comorbidity are high, despite the well‐known health risks. The current longitudinal study examined patterns of quitting behavior in adolescent smokers with psychiatric comorbidity.

Methods

The study evaluated 191 inpatient adolescents who had been enrolled in a randomized controlled trial of motivational interviewing versus brief advice for smoking cessation, and assessed their intentions to quit smoking.

Results

Rates of quit attempts at post‐hospital, 1‐month, and 6‐month assessments were 23%, 17%, and 17%, respectively. Adolescents who reported an intention to quit smoking (43%) were significantly more likely to report a quit attempt, regardless of psychiatric symptoms, cognitive factors, or substance use.

Conclusions

Intention to quit smoking appears to translate to substantial quit behavior, even in a high‐risk adolescent population that may otherwise be viewed as uninterested in quitting, suggesting the need to proactively connect this population with adequate services and follow‐up support. (Am J Addict 2014;23:84–89)
Perineural Invasion by Squamous‐Cell Carcinoma
Authors: COTTEL WILLIS I.
Published: June 2013

Perineural invasion by squamous‐cell carcinoma is an ominous sign when discovered by either the pathologist or the chemosurgeon. This report details our experience with seventeen cases of perineural invasion and their successful outcome, using a multidisciplinary approach, including Mohs' surgery.
Metastatic Basal‐Cell Carcinoma
Authors: KORD JOHN P. , COTTEL WILLIS I. , PROPER STEVEN
Published: June 2013

Three cases of metastatic basal‐cell carcinoma are reported. All of the cases were relatively small when compared with other lesions reported in the literature. With early chemosurgical treatment of small recurrent carcinomas, metastasizing basal‐cell cacinoma will be a condition of the past.
The Midline Forehead Island Flap
Authors: FIELD LAWRENCE M.
Published: June 2013

Abstract. The midline forehead island flap exemplifies pedicled island flaps based on random circulation. The use of this flap for medial canthal reconstruction is set forth by photographs, diagrams, and appropriate commentary.
Multiple Eruptive Melius Hair Cysts Treated with Carbon Dioxide Laser Vaporization
Authors: HUERTER CHRISTOPHER J. , WHEELAND RONALD G.
Published: June 2013

Abstract. The use of carbon dioxide laser to treat multiple facial, eruptive vellus hair cysts is described. An excellent cosmetic result without scarring or recurrence of lesions was obtained.
Trichloroacetic Acid Peel of Molluscum Contagiosum in Immunocompromised Patients
Authors: GARRETT STEVEN J. , ROBINSON JUNE K. , ROENIGK HENRY H.
Published: June 2013

Seven human immunodeficiency virus‐(HIV) positive patients with biopsy proved extensive facial molluscum contagiosum were treated with trichloroacetic acid peels. Peels were performed with 25 to 50% trichloroacetic acid (average 35%) and were repeated every 2 weeks as needed. A total of 15 peels were performed with an average reduction in lesion counts of 40.5% (range 0 to 90%). No spread of molluscum lesions, scarring, or secondary infection developed at 2 months' follow‐up. Trichloroacetic acid peeling in concentrations of 35% or less appears to be a safe, effective, adjuvant therapy in the treatment of extensive molluscum contagiosum in immunocompromised patients.
EMLA
Authors: LYCKA BARRY A. S.
Published: June 2013

A eutectic mixture of local anesthetics (EMLA) contains 2.5% lidocaine and 2.5% prilocaine in an oil and water emulsion and has been found to give effective, safe analgesia on normal and diseased skin, making it useful for numerous medical and surgical procedures, such as anesthesia for superficial surgery, split‐thickness skin grafts, venipuncture, argon laser treatment, epilation, and debridement of infected ulcers. Other indications have included use in postherpetic neuralgia, hyperhidrosis, painful ulcers, and inhibition of itching and burning. To be effective, EMLA should ideally be applied to the desired area for at least 1 hour under an occlusive dressing. The medication has been approved since May 1991 in Canada for use on intact skin and has been available in Europe for many years. This study discusses the background, efficacy, and current and potential uses for EMLA
Efficacy of Double Gloving as a Protection Against Blood Exposure in Dermatologic Surgery
Authors: COHEN MICHAEL S. , DO JACQUELINE T. , TAHERY DAN P. , MOY RONALD L.
Published: June 2013

Double gloving has been widely suggested as a means of decreasing exposure to blood and other body fluids. However, most dermatologists do not routinely follow this practice when performing surgical procedures because it reduces manual dexterity and increases costs. To determine whether double gloving should be routinely practiced in dermatologic surgery, pairs of sterile surgical gloves worn during weekly UCLA dermatologic surgery clinics were collected over a period of 3 months and examined for perforations. The procedures gloves were used for ranged from excision of benign lesions, lasting 15 minutes, to hair trans‐plants, lasting 3 hours. Upon completion of the procedures, 8 (5.5%) of 144 pairs of single gloves, 2 (3.7%) of 54 pairs of double inner gloves, and 3 (5.5%) of 54 pairs of double outer gloves were found to have perforations. There were no instances of both the double outer and the double inner gloves having perforations when worn on the same hand. This suggests that double gloving offers a protective advantage by providing extra protection for both the surgeon and the patient during dermatologic surgery.
Recurrent Varicose Veins
Authors: THIBAULT PAUL KENNETH , LEWIS WARREN ANTHONY
Published: June 2013

Treatment options following duplex evaluation of recurrent varicose veins are discussed and a method of injecting incompetent perforating veins using ultrasound guidance is described. The results of duplex evaluation 6 months postinjection using this technique are presented. These early results indicate that sclerosant injection employing ultrasound guidance is an effective and safe method of treating incompetent perforating veins.
OUTCOMES OF BUTTONHOLE AND ROPE‐LADDER CANNULATION TECHNIQUES IN A TROPICAL RENAL SERVICE
Authors: Smyth Wendy , Hartig Vicki , Manickam Valli
Published: June 2013

Background

Buttonhole cannulation was introduced into this Queensland Renal Service in 2005. Contrary to published literature, a local review of cannulation outcomes found no greater likelihood of infections with the buttonhole technique.

Objectives

To compare the outcomes of buttonhole and rope‐ladder cannulation techniques.

Design

Prospective cohort.

Participants

Consenting patients attending for haemodialysis via an existing arteriovenous fistula (n = 104).

Measurements

Cannulation sites were assessed at every dialysis session for 12 weeks; fear and pain were scored by participants weekly.

Results

No statistically significant differences in infection, haematoma formation, pain or fear between the techniques. Occurrence of aneurysm was higher (p < 0.05) in the rope‐ladder group. More patients in buttonhole group required multiple cannulation attempts (p < 0.05). More of the rope‐ladder group failed to attend their scheduled dialysis sessions (p < 0.05).

Conclusions and applications to practice

This study confirms that in this setting there are few negative outcomes of either technique of fistula cannulation. Specifically, buttonhole cannulation appears to be a safe alternative means of fistula access to the gold‐standard cannulation technique. The Service is examining strategies to improve attendance.
Somatization as a Predictor of Outcomes Following Functional Restoration of Chronic Disabling Occupational Musculoskeletal Pain Disorder Patients
Authors: Hartzell Meredith M. , Choi Yunhee , Neblett Randy , Williams Mark , Mayer Tom G. , Gatchel Robert J.
Published: June 2013

Chronic disabling occupational musculoskeletal pain disorder (CDOMPD) patients often have high levels of somatization, a phenomenon in which somatic symptoms are medically unexplainable. Examination of 1,458 CDOMPD patients, who completed the patient health questionnaire (PHQ) somatization module from 2003 to 2010 and underwent functional restoration treatment, were divided into low, moderate, and high somatization at pretreatment. Somatization was highly responsive to treatment, and those with high somatization reported the highest depressive symptoms, disability, and pain intensity, and the lowest health‐related quality of life at pre‐ and post‐treatment. Somatization levels significantly predicted 1‐year socioeconomic outcomes of work return, work retention, and healthcare utilization. High somatization may act as a “red flag” for clinicians, indicating patients may be at risk for poor treatment outcomes.
Systematic Review of Oral Treatments for Seborrheic Dermatitis
Authors: Gupta A.K. , Richardson M. , Paquet M.
Published: June 2013

Seborrheic dermatitis (SD) is normally treated with topical corticosteroids and antifungals. Oral therapies can be prescribed in severe or unresponsive cases. This review aims to assess the quantity and quality of published reports on oral therapies for SD. MEDLINE and Embase databases and the reference listings of publications were searched for any publication using oral treatment for SD. The quality of the included publications was assessed using a modified 27 item checklist by Downs and Black. Twenty‐one publications (randomized controlled trials, open trials and case reports) covering eight oral therapies (itraconazole, terbinafine, fluconazole, ketoconazole, pramiconazole, prednisone, isotretinoin and homeopathic mineral therapy) were identified. Most of the publications investigated oral antifungals and the quality of the evidence was generally low. The clinical efficacy outcome reported varied considerably between the studies, preventing statistical analysis and direct comparison between treatments. However, ketoconazole therapy was associated with more relapses compared with other treatments. Itraconazole dosing regimen for SD was generally 200 mg/day for the first week of the month followed by 200 mg/day for the first 2 days for 2–11 months. Terbinafine was prescribed at 250 mg/day either as a continuous (4–6 weeks) or as an intermittent regimen (12 days per month) for 3 months. Fluconazole has administered daily (50 mg/day for 2 weeks) or weekly (200–300 mg) for 2–4 weeks. Ketoconazole dosing regimen was 200 mg daily for 4 weeks. Finally, a single 200 mg dose of pramiconazole was administered to patients. This review also highlights key areas for consideration when designing future studies.
Novel single‐step multiplex real‐time polymerase chain reaction assay for simultaneous quantification of hepatitis virus A, B, C, and E in serum
Authors: Irshad Mohammad , Ansari Mohammad Ahmad , Irshad Khushboo , Lingaiah Raghavendra
Published: June 2013

Background and Aim

Viral hepatitis needs an earliest diagnosis for its proper and timely treatment. Although serodiagnosis of viral hepatitis is in regular practice, however, it has certain limitations and points to alternate procedures of diagnosis. Present study was designed to develop a single‐step multiplex real‐time polymerase chain reaction (PCR) assay for detection of hepatitis A virus (HAV), hepatitis B virus (HBV), hepatitis C virus (HCV) and hepatitis E virus (HEV) related nucleic acids in sera from infected patients.

Methods

The PCR was standardized to detect HAV, HBV, HCV and HEV in serum using variables including annealing temperature, extension temperature, MgCl2, and primer concentrations. The conserved regions of all viral genomes were used as targets for amplification.

Results

This novel assay was found to be a fast, sensitive, specific, and reproducible system for detection of HAV, HBV, HCV, and HEV in serum. The detection limit for different viral genomes at 100% level was found to be 280 copies/mL for HAV, 290 copies/mL for HBV, 30 copies/mL for HCV, and 300 copies/mL for HEV in a single‐tube assay system.

Conclusion

Present multiplex real‐time PCR is the first report on single‐step nucleic acid detection of HAV, HBV, HCV, and HEV in sera samples. It is an alternate diagnostic assay for common use in laboratories analyzing viral hepatitis cases.
Serum hepatitis B surface antigen quantification as a useful assessment for significant fibrosis in hepatitis B e antigen‐positive hepatitis B virus carriers
Authors: Xun Yun‐hao , Zang Guo‐qing , Guo Jian‐chun , Yu Xiu‐li , Liu Hong , Xiang Jing , Liu Jing , Shi Jun‐ping
Published: June 2013

Background and Aims

The role of serum quantitative hepatitis B surface antigen (qHBsAg) in identifying hepatitis B virus (HBV) carriers with significant fibrosis is unknown. This study aims to evaluate the diagnostic value of qHBsAg for hepatic fibrosis in hepatitis B e antigen (HBeAg)‐positive HBV carriers.

Methods

Consecutive biopsy‐proven HBeAg‐positive HBV carriers were prospectively recruited in our center from 2009 to 2011 and were randomly divided into training and validation set. Area under receiver‐operator curve (AUC) was used to determine the diagnostic accuracy of simple tests for significant fibrosis (Scheuer stage, F ≥ 2).

Results

Overall, a total of 197 eligible patients (median age 31 years; 149 males) were enrolled. The median qHBsAg was 4.20 (log10 IU/mL). Significant fibrosis was confirmed in 112 (56.9%) patients. By logistical regression analysis, qHBsAg and γ‐glutamyl transpeptidase were identified as predictors for significant fibrosis in training set (n = 124). Thus, qHBsAg index and γ‐glutamyl transpeptidase to qHBsAg ratio (GqHBsR) were selected for the subsequent analysis. In the training set, an AUC of 0.762, 0.826, 0.749, and 0.771 was observed for qHBsAg index, GqHBsR, FIB‐4, and aspartate aminotransferase to platelet ratio index, respectively (all P < 0.05). GqHBsR yielded a higher AUC than aspartate aminotransferase to platelet ratio index and FIB‐4 (both P < 0.05). Using the optimal cut‐off of 7.78, GqHBsR showed a sensitivity of 78.9% and a specificity of 73.6%. About 80% of liver biopsy could be avoided in the entire cohort.

Conclusions

Serum qHBsAg‐based simple tests, especially GqHBsR, can accurately and specifically identify significant fibrosis in treatment‐naïve HBeAg‐positive HBV carriers.
CSF levels of the neuronal injury biomarker visinin‐like protein‐1 in Alzheimer's disease and dementia with Lewy bodies
Authors: Luo Xinni , Hou Le , Shi Haishan , Zhong Xiaomei , Zhang Yufeng , Zheng Dong , Tan Yan , Hu Guoyan , Mu Nan , Chan Jianping , Chen Xinru , Fang Yaxiu , Wu Fengchun , He Hongbo , Ning Yuping
Published: June 2013

The overlapping clinical features of Alzheimer's disease (AD) and Dementia with Lewy bodies (DLB) make differentiation difficult in the clinical environment. Evaluating the CSF levels of biomarkers in AD and DLB patients could facilitate clinical diagnosis. CSF Visinin‐like protein‐1 (VILIP‐1), a calcium‐mediated neuronal injury biomarker, has been described as a novel biomarker for AD. The aim of this study was to investigate the diagnostic utility of CSF VILIP‐1 and VILIP‐1/Aβ1–42 ratio to distinguish AD from DLB. Levels of CSF VILIP‐1, t‐tau, p‐tau181P, Aβ1–42, and α‐synuclein were measured in 61 AD patients, 32 DLB patients, and 40 normal controls using commercial ELISA kits. The results showed that the CSF VILIP‐1 level had significantly increased in AD patients compared with both normal controls and DLB patients. The CSF VILIP‐1 and VILIP‐1/Aβ1–42 levels had enough diagnostic accuracy to allow the detection and differential diagnosis of AD. Additionally, CSF VILIP‐1 levels were positively correlated with t‐tau and p‐tau181P within each group and with α‐synuclein in the AD and control groups. We conclude that CSF VILIP‐1 could be a diagnostic marker for AD, differentiating it from DLB. The analysis of biomarkers, representing different neuropathologies, is an important approach reflecting the heterogeneous features of AD and DLB.

image

Neuronal Ca2+‐sensor protein VILIP‐1 has been implicated in the calcium‐mediated neuronal injury and pathological change of AD. The CSF VILIP‐1 and VILIP‐1/Aβ1‐42 levels had enough diagnostic accuracy to allow the detection and differential diagnosis of AD. CSF VILIP‐1 is a useful biomarker for AD. Evaluating the CSF levels of VILIP‐1 in AD and DLB patients could facilitate clinical diagnosis.
Prospective study of prevalence of overactive bladder symptoms and child‐bearing in women of reproductive age
Authors: Palma Thais , Raimondi Marina , Souto Sophia , Fozzatti Celina , Palma Paulo , Riccetto Cássio
Published: June 2013

Aim

The aim of the study was to verify the presence of overactive bladder syndrome (OAB) symptoms in premenopausal women and relate them with child‐bearing data.

Material and Methods

We interviewed 1050 women aged 20–45 years in the area of Campinas, Brazil, to investigate the prevalence of OAB symptoms. In this study we used the International Consultation on Incontinence Questionnaire – Overactive Bladder (ICIQ‐OAB) questionnaire (International Continence Society standard), in its validated Portuguese version and a specific questionnaire for the demographics.

Results

Overall, multiparous and primiparous women showed significantly higher scores in the ICIQ‐OAB questionnaire than nulliparous women. Multiparous women also presented more frequency than nulliparous women (P < 0.0001). Nulliparous women presented less nocturia than primiparous or multiparous women (P < 0.0001). No significant differences were found in urgency (P = 0.0682), and multiparous women presented more urgency incontinence than nulliparous ones (P = 0.0313).

Conclusions

Nulliparous women presented fewer OAB symptoms than primiparous women. Multiparous women presented more symptoms than the other two groups. There were no significant differences between cesarean and vaginal delivery, but the scores of women who had vaginal delivery were higher than those who had cesareans. Both types of delivery were related to higher ICIQ‐OAB scores (more severe symptoms) than those of nulliparous women.
New findings and concepts about the G‐spot in normal and absent vagina: Precautions possibly needed for preservation of the G‐spot and sexuality during surgery
Authors: Thabet Saeed Mohamad Ahmad
Published: June 2013

Aim

The aim of this study was to extend the clinicohistological study to involve the whole normal and absent vagina for confirming the presence of the G‐spot and its relation to the surrounding organs and sexuality and to identify certain precautions for its preservation during surgery.

Material and Methods

This study was a descriptive randomized prospective study conducted at Kasr El Aini School of Medicine, Cairo University, Egypt. The G‐spot was examined in 1500 women, 500 of them having vaginal and vulval surgery done for gynecological reasons. The G‐spot was examined for its clinical and histological features and for determining the effect of surgery on its state and function.

Results

The G‐spot was found to be present in all women. It was a localized spot in 58% and diffuse in 42% of cases. Associated ejaculation was reported in all cases of the localized type and in 24.5% of the diffuse types. Clinical examination was found to be associated with certain local response in 52.7% of the local types. The G‐spot was also found to be connected to the hymen in 100%, the urethra in 52.7%, the vulva in 82.2% and the cervix in 10.8% of cases. The mean of the sex scores and sexuality were significantly decreased in surgery involving the G‐spot area. Recorded figures were 93.6 ± 3.4 and 88.2 ± 3.3 before and after surgery, respectively. The corresponding figures in the cases having a general spot were 86.4 ± 4.4 and 84.5 ± 2.4, respectively. The G‐spot was found in cases of absent vagina to be localized in 59%, generalized in 28.2% and absent in 12.8% of cases.

Conclusions

The G‐spot is actually present in all women. It is originally related to the lower urinary tract and it is connected to different parts of the genital tract. It may be localized or generalized. Its integrity is essential for obtaining normal physiological sexuality. Surgery may affect the integrity of the G‐spot, so surgical precautions must be carried out to maintain the integrity of this spot and the patient's sexuality.
Should System Firms Develop Complementary Products? A Dynamic Model and an Empirical Test
Authors: van den Ende Jan , Jaspers Ferdinand , Rijsdijk Serge A.
Published: June 2013

While Nintendo develops many video games internally, Apple is only marginally involved in the development of iPhone applications. This paper addresses the question: to what extent and how should system firms be involved in the development of complementary products for their “core products”? These core products may include video consoles, electronic book readers, etc. This is a highly relevant question, because the success of core products depends strongly on their complementary products, e.g., video games and electronic books. This study proposes a dynamic model for the degree that system firms should be involved in complementary product development by considering, as contingency factors, the novelty of the core, and the novelty of the complementary products. Both novelties influence the degree to which system firms should be involved in the development of complementary products. In terms of a system firm's involvement, this study makes a distinction between the degree of integration and the degree of ownership. The degree of integration reflects the extent to which the system firm is actively involved in the coordination of the complementary product, e.g., to ensure that the complementary product is optimally aligned with its core product and that the full potential of the core product is achieved. The degree of ownership reflects the extent to which the system firm finances the development of the complementary product and therefore, the degree of formal control authority over the complementary product. This model was tested using data from a survey of 99 development projects for mobile telecommunications applications. The results reveal that integration by the system firm contributes to the performance of complementary products for new core products but has a negative effect if a new complement is developed for a mature core product. In addition, ownership contributes to performance if both the core and complementary products are new. In other circumstances, a clear effect of ownership by the system firm on performance is not found. The implications of our findings are that system firms should be strongly involved in complementary product development when they introduce a new core product, and even more so if the complementary products are new. However, they should decrease their degree of involvement over time as the core product matures and, again, even more so if the complementary product is new. The paper concludes by providing practical implications for system firms in the mobile telecommunications industry and beyond.
Clinical, Sociodemographic, and Service Provider Determinants of Guideline Concordant Colorectal Cancer Care for Appalachian Residents
Authors: Fleming Steven T. , Mackley Heath B. , Camacho Fabian , Seiber Eric E. , Gusani Niraj J. , Matthews Stephen A. , Liao Jason , Yang Tse‐Chuan , Hwang Wenke , Yao Nengliang
Published: June 2013

Background

Colorectal cancer represents a significant cause of morbidity and mortality, particularly in Appalachia where high mortality from colorectal cancer is more prevalent. Adherence to treatment guidelines leads to improved survival. This paper examines determinants of guideline concordance for colorectal cancer.

Methods

Colorectal cancer patients diagnosed in 2006‐2008 from 4 cancer registries (Kentucky, Ohio, Pennsylvania, and North Carolina) were linked to Medicare claims (2005‐2009). Final sample size after exclusions was 2,932 stage I‐III colon, and 184 stage III rectal cancer patients. The 3 measures of guideline concordance include adjuvant chemotherapy (stage III colon cancer, <80 years), ≥12 lymph nodes assessed (resected stage I‐III colon cancer), and radiation therapy (stage III rectal cancer, <80 years). Bivariate and multivariate analyses with clinical, sociodemographic, and service provider covariates were estimated for each of the measures.

Results

Rates of chemotherapy, lymph node assessment, and radiation were 62.9%, 66.3%, and 56.0%, respectively. Older patients had lower rates of chemotherapy and radiation. Five comorbidities were significantly associated with lower concordance in the bivariate analyses: myocardial infarction, congestive heart failure, respiratory diseases, dementia with chemotherapy, and diabetes with adequate lymph node assessment. Patients treated by hospitals with no Commission on Cancer (COC) designation or lower surgical volumes had lower odds of adequate lymph node assessment.

Conclusions

Clinical, sociodemographic, and service provider characteristics are significant determinants of the variation in guideline concordance rates of 3 colorectal cancer measures.
Characterization of Orgasmic Difficulties by Women: Focus Group Evaluation
Authors: Kingsberg Sheryl A. , Tkachenko Natalia , Lucas Johna , Burbrink Amy , Kreppner Wayne , Dickstein Jodi B.
Published: June 2013

Introduction

Female orgasmic disorder (FOD) is the second most prevalent sexual disorder in women. According to the most recent revision of the Diagnostic and Statistical Manual of Mental Disorders, Fourth edition (DSM-IV-TR), the term “marked distress” is central to the diagnosis of FOD. In practice, the term “distress” for use as a criterion for a clinical diagnosis is a medical construct and may not correlate with the language used by women with FOD to describe what they are experiencing.

Aim

The objective of this study was to explore the terminology used by women to describe their feeling associated with difficulties in achieving orgasm.

Methods

Women experiencing difficulties in achieving orgasm were invited to participate in a focus group. The focus groups included a characterization, picture sort and language exploration exercise and completing the Female Sexual Distress Scale-Desire, Arousal, Orgasm (FSDS-DAO) to determine the impact and emotional associations of decreased/lack of orgasms.

Main Outcome Measures

Patient reported terminology for characterization of their FOD, and validity of question 15 of FSDS-DAO.

Results

Sixty-seven percent (44/66) of the women used the word “frustrated” when asked, “What one word would you use to describe your orgasm difficulties?” In the language exploration exercise, the most common term used to describe emotions associated with decreased orgasm was “frustration.” Responses (0=never to 4=always) to question 15 (frustrated by problems with orgasm) of the FSDS-DAO, ranged from 1 to 4 (mean 3.0) indicating that women were very frustrated.

Conclusions

The term “frustrated” was the most relevant and common emotion women feel when they have difficulties in achieving orgasm. Additionally, the women consistently supported the content validity of question 15 of the FSDS-DAO. Despite the use of the term “distress” in the DSM-IV-TR criteria for FOD, the term reflects the medical construct required to become a sexual dysfunction and does not appear to be an accurate representation of most women's feelings of orgasm difficulties.
The number of markers and samples needed for detecting bottlenecks under realistic scenarios, with and without recovery: a simulation‐based study
Authors: Hoban Sean M. , Gaggiotti Oscar E. , Bertorelle Giorgio
Published: June 2013

Detecting bottlenecks is a common task in molecular ecology. While several bottleneck detection methods exist, evaluations of their power have focused only on severe bottlenecks (e.g. to Ne ~10). As a component of a recent review, Peery et al. () analysed the power of two approaches, the M‐ratio and heterozygote excess tests, to detect moderate bottlenecks (e.g. to Ne ~100), which is realistic for many conservation situations. In this Comment, we address three important points relevant to but not considered in Peery et al. Under moderate bottleneck scenarios, we test the (i) relative advantage of sampling more markers vs. more individuals, (ii) potential power to detect the bottleneck when utilizing dozens of microsatellites (a realistic possibility for contemporary studies) and (iii) reduction in power when postbottleneck recovery has occurred. For the realistic situations examined, we show that (i) doubling the number of loci shows equal or better power than tripling the number of individuals, (ii) increasing the number of markers (up to 100) results in continued additive gains in power, and (iii) recovery after a moderate amount of time or gradual change in size reduces power, by up to one‐half. Our results provide a practical supplement to Peery et al. and encourage the continued use of bottleneck detection methods in the genomic age, but also emphasize that the power under different sampling schemes should be estimated, using simulation modelling, as a routine component of molecular ecology studies.
Competence and natural transformation in vibrios
Authors: Sun Yan , Bernardy Eryn E. , Hammer Brian K. , Miyashiro Tim
Published: June 2013

Natural transformation is a major mechanism of horizontal gene transfer in bacteria. By incorporating exogenous DNA elements into chromosomes, bacteria are able to acquire new traits that can enhance their fitness in different environments. Within the past decade, numerous studies have revealed that natural transformation is prevalent among members of the Vibrionaceae, including the pathogen Vibrio cholerae. Four environmental factors: (i) nutrient limitation, (ii) availability of extracellular nucleosides, (iii) high cell density and (iv) the presence of chitin, promote genetic competence and natural transformation in Vibrio cholerae by co‐ordinating expression of the regulators CRP, CytR, HapR and TfoX respectively. Studies of other Vibrionaceae members highlight the general importance of natural transformation within this bacterial family.
Sclerotherapy for the mucoceles of the anterior lingual salivary glands with pingyangmycin
Authors: Cai Y , Wang R , Yang S‐F , Zhao Y‐F , Zhao J‐H
Published: June 2013

Recurrence is very common if the mucoceles of the anterior lingual salivary glands (ALSGs) are treated by surgery due to its anatomic characteristics. Therefore, more effective and less invasive treatment methods are urgently required to be applied instead of surgery. In this study, 40 patients with the mucocele of the ALSGs received the intralesional injections of pingyangmycin, and the median number of injections per patient was 2.075 (range, 1–3). All cases completely recovered with no recurrence after follow‐up of more than 16 months. The complications included the local swelling, pain, and ulceration following injection, and all these symptoms resolved 7–10 days after the injection. Taken together, sclerotherapy with pingyangmycin is an effective and safe treatment method for the mucocele of the ALSGs and may be the primary treatment modality.
Visualizing Carbene Equilibria
Authors: Moss Robert A. , Wang Lei , Hoijemberg Pablo A. , Krogh‐Jespersen Karsten
Published: June 2013

Reviewed herein are equilibria between halocarbenes and halocarbanions, carbenes and carbene complexes and carbenes and O‐ylides. The transient species were visualized by laser flash photolysis coupled with UV–Visible spectroscopy. This methodology enabled the determination of equilibrium constants and the extraction of associated thermodynamic parameters. Parallel computational studies provided anticipated structures and energies for the transient species, as well as electronic absorption wavelengths and oscillator strengths.
Effects of Boundary-Layer Ingestion on the Aero-Acoustics of Transonic Fan Rotors
Authors: Defoe Jeffrey J. , Spakovszky Zoltán S.
Published: June 2013

The use of boundary-layer-ingesting, embedded propulsion systems can result in inlet flow distortions where the interaction of the boundary-layer vorticity and the inlet lip causes horseshoe vortex formation and the ingestion of streamwise vortices into the inlet. A previously-developed body-force-based fan modeling approach was used to assess the change in fan rotor shock noise generation and propagation in a boundary-layer-ingesting, serpentine inlet. This approach is employed here in a parametric study to assess the effects of inlet geometry parameters (offset-to-diameter ratio and downstream-to-upstream area ratio) on flow distortion and rotor shock noise. Mechanisms related to the vortical inlet structures were found to govern changes in the rotor shock noise generation and propagation. The vortex whose circulation is in the opposite direction to the fan rotation (counter-swirling vortex) increases incidence angles on the fan blades near the tip, enhancing noise generation. The vortex with circulation in the direction of fan rotation (co-swirling vortex) creates a region of subsonic relative flow near the blade tip radius that decreases the sound power propagated to the far-field. The parametric study revealed that the overall sound power level at the fan leading edge is set by the ingested streamwise circulation, and that for inlet designs in which the streamwise vortices are displaced away from the duct wall, the sound power at the upstream inlet plane increased by as much as 9 dB. By comparing the far-field noise results obtained to those for a conventional inlet, it is deduced that the changes in rotor shock noise are predominantly due to the ingestion of streamwise vorticity.
Sequentially reweighted TV minimization for CT metal artifact reduction
Authors: Zhang Xiaomeng , Xing Lei
Published: June 2013

Purpose:

Metal artifact reduction has long been an important topic in x‐ray CT image reconstruction. In this work, the authors propose an iterative method that sequentially minimizes a reweighted total variation (TV) of the image and produces substantially artifact‐reduced reconstructions.

Methods:

A sequentially reweighted TV minimization algorithm is proposed to fully exploit the sparseness of image gradients (IG). The authors first formulate a constrained optimization model that minimizes a weighted TV of the image, subject to the constraint that the estimated projection data are within a specified tolerance of the available projection measurements, with image non‐negativity enforced. The authors then solve a sequence of weighted TV minimization problems where weights used for the next iteration are computed from the current solution. Using the complete projection data, the algorithm first reconstructs an image from which a binary metal image can be extracted. Forward projection of the binary image identifies metal traces in the projection space. The metal‐free background image is then reconstructed from the metal‐trace‐excluded projection data by employing a different set of weights. Each minimization problem is solved using a gradient method that alternates projection‐onto‐convex‐sets and steepest descent. A series of simulation and experimental studies are performed to evaluate the proposed approach.

Results:

Our study shows that the sequentially reweighted scheme, by altering a single parameter in the weighting function, flexibly controls the sparsity of the IG and reconstructs artifacts‐free images in a two‐stage process. It successfully produces images with significantly reduced streak artifacts, suppressed noise and well‐preserved contrast and edge properties.

Conclusions:

The sequentially reweighed TV minimization provides a systematic approach for suppressing CT metal artifacts. The technique can also be generalized to other “missing data” problems in CT image reconstruction.
Coinfection: Doing the Math
Authors: Lello Joanne
Published: June 2013

A transmission model clarifies the effects of influenza on pneumococcal pneumonia and bridges the gap between individual animal experiments and human epidemiological data.
Banking on Carbon
Authors: Chow Edward Kai-Hua
Published: June 2013

Carbon nanotubes can improve ex vivo expansion of stem cells from cord blood.
Outpatient Treatment of Severe Acute Malnutrition
Authors: Mahfuz Mustafa
Published: June 2013

A study of an outpatient therapeutic feeding program explores patient outcomes and factors contributing to recovery from severe acute malnutrition (SAM).
High-Throughput Nano-Biofilm Microarray for Antifungal Drug Discovery
Authors: Srinivasan Anand , Leung Kai P. , Lopez-Ribot Jose L. , Ramasubramanian Anand K.
Published: June 2013

Micro- and nanoscale technologies have radically transformed biological research from genomics to tissue engineering, with the relative exception of microbial cell culture, which is still largely performed in microtiter plates and petri dishes. Here, we present nanoscale culture of the opportunistic fungal pathogen
Candida albicans
on a microarray platform. The microarray consists of 1,200 individual cultures of 30 nl of
C. albicans
biofilms (“nano-biofilms”) encapsulated in an inert alginate matrix. We demonstrate that these nano-biofilms are similar to conventional macroscopic biofilms in their morphological, architectural, growth, and phenotypic characteristics. We also demonstrate that the nano-biofilm microarray is a robust and efficient tool for accelerating the drug discovery process: (i) combinatorial screening against a collection of 28 antifungal compounds in the presence of immunosuppressant FK506 (tacrolimus) identified six drugs that showed synergistic antifungal activity, and (ii) screening against the NCI challenge set small-molecule library identified three heretofore-unknown hits. This cell-based microarray platform allows for miniaturization of microbial cell culture and is fully compatible with other high-throughput screening technologies.

IMPORTANCE
Microorganisms are typically still grown in petri dishes, test tubes, and Erlenmeyer flasks in spite of the latest advances in miniaturization that have benefitted other allied research fields, including genomics and proteomics. Culturing microorganisms in small scale can be particularly valuable in cutting down time, cost, and reagent usage. This paper describes the development, characterization, and application of nanoscale culture of an opportunistic fungal pathogen,
Candida albicans
. Despite a more than 2,000-fold reduction in volume, the growth characteristics and drug response profiles obtained from the nanoscale cultures were comparable to the industry standards. The platform also enabled rapid identification of new drug candidates that were effective against
C. albicans
biofilms, which are a major cause of mortality in hospital-acquired infections.
Is the Nickel-Dependent Urease Complex of
Cryptococcus
the Pathogen’s Achilles’ Heel?
Authors: Morrow Carl A. , Fraser James A.
Published: June 2013

The nitrogen-scavenging enzyme urease has been coopted in a variety of pathogenic organisms as a virulence factor, most notoriously to neutralize stomach acid and establish infection by the gastric pathogen
Helicobacter pylori
. The opportunistic fungal pathogen
Cryptococcus neoformans
also utilizes urease as a virulence factor, only in this case to invade the central nervous system (CNS) via the blood-brain barrier and cause life-threatening meningoencephalitis. A recent study [A. Singh, R. Panting, A. Varma, T. Saijo, K. Waldron, A. Jong, P. Ngamskulrungroj, Y. Chan, J. Rutherford, K. Kwon-Chung, mBio 4(3):e00220-13] genetically and biochemically characterizes the accessory proteins required for successful activation of the urease protein complex, including the essential nickel cofactor. The accessory proteins Ure4, Ure6, and Ure7 are all essential for urease function. Ure7 appears to combine the roles of two bacterial accessory proteins: it incorporates both the GTPase activity and nickel chaperone properties of UreE, a bacterial protein whose homolog is missing in the fungi. An accompanying nickel transporter, Nic1, is responsible for most, but not all, nickel uptake into the fungal cell. Mutants of the core urease protein Ure1, accessory protein Ure7, and transporter Nic1 are all attenuated for invasion of the CNS of mice, and urease activity may directly affect integrity of the tight junction of the endothelial cells of the blood-brain barrier, the network of proteins that limits paracellular permeability. This work highlights the potential of urease, its accessory proteins, and nickel transport as potential chemotherapeutic targets.
Investigating community ownership of a text message programme to improve adherence to antiretroviral therapy and provider-client communication: a mixed methods research protocol
Authors: Mbuagbaw Lawrence , Ongolo-Zogo Pierre , Thabane Lehana
Published: June 2013

Introduction

Mobile phone ownership and use are growing fastest in sub-Saharan Africa, and there is evidence that mobile phone text messages can be used successfully to significantly improve adherence to antiretroviral therapy and reduce treatment interruptions. However, the effects of many mobile health interventions are often reduced by human resource shortages within health facilities. Also, research projects generating evidence for health interventions in developing countries are most often conducted using external funding sources, with limited sustainability and adoption by local governments following completion of the projects. Strong community participation driven by active outreach programmes and mobilisation of community resources are the key to successful adoption and long-term sustainability of effective interventions. Our aim was to develop a framework for community ownership of a text messaging programme to improve adherence to antiretroviral therapy; improve communication between patients and doctors and act as a reminder for appointments.

Methods and analysis

We will use the exploratory sequential mixed methods approach. The first qualitative phase will entail focus group discussions with people living with HIV at the Yaoundé Central Hospital in Yaoundé, Cameroon (6–10 participants/group). The second quantitative phase will involve a cross-sectional survey (n=402). In this study, binary logistic regression techniques will be used to determine the factors associated with community readiness and acceptability of ownership. Data from both phases will be merged.

Ethics and dissemination

This study has been approved by the Yaoundé Central Hospital Institutional Review Board. The results of this paper will be disseminated as peer-reviewed publications at conferences and as part of a doctoral thesis.
Alfalfa dodder (Cuscuta campestris) toxicity in horses: clinical, haematological and serum biochemical findings
Authors: Abutarbush S. M.
Published: June 2013

The objective of this observational study is to describe clinical, haematological and serum biochemical findings of horses affected with alfalfa dodder (Cuscuta campestris) toxicity. Twenty horses naturally exposed to alfalfa dodder toxicity were examined and information was collected on history and clinical signs. Physical examination was done on horses in the premises (n=20), and venous blood samples of 12 horses were submitted for haematology and serum biochemical examination for each horse. Abnormal clinical signs started around 36 hours after horses were fed the contaminated alfalfa. Abnormal signs were seen in 11 horses and those included diarrhoea (n=8), decreased appetite (n=7), neurological signs (n=4) and abdominal pain (n=1). Some horses had multiple clinical signs of the above. The results of complete blood cell count revealed leukocytopenia, neutropenia and thrombocytopenia. Serum biochemical analysis revealed decreased ALP, AST and CPK levels and increased direct bilirubin level. The used alfalfa was stopped immediately and a different alfalfa from a new container that did not contain any weeds was fed. Horses on the premises were observed closely, and the abnormal clinical signs resolved within three days. No treatment was implemented. Knowledge about toxicity of horses by Cuscuta species is scarce in the English veterinary literature and very limited.
The reliability of running economy expressed as oxygen cost and energy cost in trained distance runners
Authors: Shaw Andrew J. , Ingham Stephen A. , Fudge Barry W. , Folland Jonathan P.
Published: June 2013

This study assessed the between-test reliability of oxygen cost (OC) and energy cost (EC) in distance runners, and contrasted it with the smallest worthwhile change (SWC) of these measures. OC and EC displayed similar levels of within-subject variation (typical error < 3.85%). However, the typical error (2.75% vs 2.74%) was greater than the SWC (1.38% vs 1.71%) for both OC and EC, respectively, indicating insufficient sensitivity to confidently detect small, but meaningful, changes in OC and EC.
Field monitoring of earth pressures on integral bridge abutments
Authors: Huntley Shelley A. , Valsangkar Arun J.
Published: June 2013

Integral abutment bridges have become a successful alternative to the traditional design procedure of using expansion joints to balance the thermal movements of bridge structures. However, there are many design and detailing variations, and uncertainties exist about the soil–structure interaction of the integral abutments. Therefore, field data from pressure cells installed behind the abutments of a 76 m long, two-span, pile-supported integral abutment bridge are the focus of this paper. The data on external displacements of the abutments are also reported. The applicability of using common theoretical passive earth pressure coefficients is assessed and it appears that the traditional methods of Coulomb and Rankine are not the best approach for predicting the earth pressure envelope. Additionally, over the monitoring period of three years, it was found that a definite conclusion regarding the ratcheting of lateral earth pressure could not be established for this bridge site. Finally, comparisons to earth pressures measured at other field studies indicate variability in the earth pressure distribution, magnitude, and behaviour over time, as these are dependent on several factors distinctive to each bridge site.