bluuebunny/crossref_metadata_2025 huggingface dataset:
Indicators for intervention during the expulsive second‐stage arrest of labour
Authors: Leushuis E , Tromp M , Ravelli ACJ , van Huis AM , Mol BW , Visser GHA , van der Post JAM
Published: October 2009

Objective  To identify antepartum and intrapartum indicators of obstetric interventions during the expulsive second‐stage arrest of labour.

Design  Retrospective cohort study.

Setting  The Netherlands.

Population  A cohort of 389 086 women with singleton, cephalic, term, live‐birth deliveries from 2002 to 2004 who had entered the expulsive second stage of labour. Of all these deliveries, 37 899 (9.7%) were complicated by expulsive second‐stage arrest of labour. Women with a prior Caesarean section or women undergoing an elective Caesarean section were excluded.

Methods  All deliveries in the Netherlands from 2002 to 2004 were registered in the Netherlands Perinatal Registry, which contains the linked and validated data of three databases. Uni‐ and multivariable logistic regression analyses were performed.

Main outcome measures  Ante‐ and intrapartum indicators for interventions during expulsive second‐stage arrest of labour.

Results  Primiparous delivery was the most important antepartum indicator for intervention during expulsive second‐stage arrest. Using multivariable analysis the following antepartum indicators were associated with intervention for expulsive second‐stage arrest of primiparous labour: maternal age, gestational age, diabetes, hypertension and labour induction. Prominent intrapartum indicators for primiparous deliveries were fetal head position and oxytocin augmentation.

Conclusion  Multiple significant antepartum and intrapartum indicators associated with intervention for expulsive second‐stage arrest of labour were identified in this large retrospective study. Prominent were the associations of parity, maternal age and fetal head position with expulsive second‐stage arrest. The identified factors should be further evaluated in prospective studies that aim to develop prediction models.
Metabolic syndrome in young women with the polycystic ovary syndrome: revisiting the threshold for an abnormally decreased high‐density lipoprotein cholesterol serum level
Authors: Dewailly D , Contestin M , Gallo C , Catteau‐Jonard S
Published: October 2009

Please cite this paper as: Dewailly D, Contestin M, Gallo C, Catteau‐Jonard S. Metabolic syndrome in young women with the polycystic ovary syndrome: revisiting the threshold for an abnormally decreased high‐density lipoprotein cholesterol serum level. BJOG 2010;117:175–180.

Objective  To verify whether the adult threshold for an abnormally decreased high‐density lipoprotein cholesterol (HDL‐C) serum level (0.5 g/l) is appropriate in young women with polycystic ovary syndrome (PCOS).

Design  Retrospective analysis of a database.

Setting  Academic Hospital.

Population  A total of 854 women aged 16–40 years having PCOS according to Rotterdam criteria.

Methods  Criteria defining the metabolic syndrome (MetS) (increased waist circumference, systolic and/or diastolic blood pressure, triglycerides, fasting glycaemia and decreased HDL‐C) were separately analysed and compared in three different subgroups (16–20 years, 20–30 years and 30–40 years). The prevalence of the MetS was calculated using two different thresholds (0.5 and 0.4 g/l) for HDL‐C in the 16–20 years group.

Main outcomes measures  Prevalence of MetS.

Results  The prevalence of an abnormal HDL‐C (<0.5 g/l) was higher in the youngest women (60%), whereas frequencies of abnormal waist circumference, systolic and/or diastolic blood pressure, triglycerides and fasting glycaemia were lower than in the two other groups. The prevalence of an abnormal HDL‐C dropped to 27% when using a threshold of 0.4 g/l in the 16–20 years subgroup. The prevalence of the MetS in the 16–20 years subgroup was 11%, whatever the threshold, because HDL‐C was <0.4 g/l in all women once they scored 3 or more.

Conclusions  The adult threshold for HDL‐C overestimates the prevalence of abnormal HDL‐C in young women with PCOS. Until normative data about HDL‐C in adult women under 20 years is available, we suggest using a threshold of 0.4 g/l or ignoring this criterion.
Hippocampal seizures alter the expression of the pannexin and connexin transcriptome
Authors: Mylvaganam Shanthini , Zhang Liang , Wu Chiping , Zhang Zhang Jane , Samoilova Marina , Eubanks James , Carlen Peter L. , Poulter Michael O.
Published: October 2009

J. Neurochem. (2010) 112, 92–102.

Some forms of seizure activity can be stopped by gap junctional (GJ) blockade. Here, we found that GJ blockers attenuate hippocampal seizure activity induced by a novel seizuregenic protocol using Co2+. We hypothesized that this activity may occur because of the altered expression of connexin (Cx) and/or pannexin (Panx) mRNAs and protein. We found a 1.5‐, 1.4‐, and 2‐fold increase in Panx1, Panx2, and Cx43 mRNAs, respectively. Significant post‐translational modifications of the proteins Cx43 and Panx1 were also observed after the Co2+ treatment. No changes were observed in the presence of tetrodotoxin, indicating that seizure activity is required for these alterations in expression, rather than the Co2+ treatment itself. Further analysis of the QPCR data showed that the Cx and Panx transcriptome becomes remarkably re‐organized. Pannexin (Panxs 1 and 2) and glial connexin mRNA became highly correlated to one another; suggesting that these genes formed a transcriptomic network of coordinated gene expression, perhaps facilitating seizure induction. These data show that seizure activity up‐regulates the expression of both glial and neuronal GJ mRNAs and protein while inducing a high degree of coordinate expression of the GJ transcriptome.
The first diplodocid from Asia and its implications for the evolutionary history of sauropod dinosaurs
Authors: UPCHURCH PAUL , MANNION PHILIP D.
Published: October 2009

Abstract:  An isolated anterior caudal vertebra from the Qingshan (= Ch'ing shan) Formation (Early Cretaceous) of Shandong Province, China, is redescribed and shown to be an advanced diplodocid sauropod. This specimen possesses several derived character states that are typically observed in advanced diplodocoids or diplodocids, including the following: a mildly procoelous centrum; a deep pit‐like pneumatic fossa immediately below the caudal rib; wing‐ or fan‐shaped caudal ribs; and complex lamination of the neural spine. The neural spine is apomorphically short and the centrum is short relative to its height compared to those of other diplodocids, which, when coupled with the specimen’s unique geographical location and stratigraphical age, suggests that it probably represents a new taxon. This caudal vertebra provides the first convincing evidence that diplodocids were present in Asia, perhaps as a result of the dispersal of neosauropod lineages from Europe and/or North America during the Early Cretaceous. The discovery of a member of the Diplodocidae in the Early Cretaceous also indicates that this clade did not become extinct at the Jurassic/Cretaceous boundary as previously supposed.
Trends in Hospital Cost and Revenue, 1994–2005: How Are They Related to HMO Penetration, Concentration, and For‐Profit Ownership?
Authors: Shen Yu‐Chu , Wu Vivian Y. , Melnick Glenn
Published: October 2009

Objective. Analyze trends in hospital cost and revenue, as well as price and quantity (1994–2005) as a function of health maintenance organization (HMO) penetration, HMO concentration, and for‐profit (FP) HMO market share.

Data. Medicare hospital cost reports, AHA Annual Surveys, HMO data from Interstudy, and other supplemental data.

Study Design. A retrospective study of all short‐term, general, nonfederal hospitals in metropolitan statistical areas (MSAs) in the United States from 1994 to 2005, using hospital/MSA fixed‐effects translog regression models.

Principal Findings. A 10 percentage point increase in HMO enrollment is associated with 4.1–4.2 percent reduction in costs and revenues in the pre‐2000 period but only a 2.1–2.5 percent reduction in the post‐2000 period. Hospital revenue in HMO‐dominant markets (highly concentrated HMO market and competitive hospital market) is 19–27 percent lower than other types of markets, and the difference is most likely due mainly to lower prices and to a lesser extent lower utilization.

Conclusions. The historical difference of lower spending in high HMO penetration markets compared with low HMO markets narrowed after 2000 and the relative concentration between HMO and hospital markets can substantially influence hospital spending. Additional research is needed to understand how different aspects of these two markets have changed and interacted and how they are causally linked to spending trends.
Does Major Illness Cause Financial Catastrophe?
Authors: Cook Keziah , Dranove David , Sfekas Andrew
Published: October 2009

Objective. We examine the financial impact of major illnesses on the near‐elderly and how this impact is affected by health insurance.

Data Sources. We use RAND Corporation extracts from the Health and Retirement Study from 1992 to 2006.1

Study Design. Our dependent variable is the change in household assets, excluding the value of the primary home. We use triple difference median regressions on a sample of newly ill/uninsured near elderly (under age 65) matched to newly ill/insured near elderly. We also include a matched control group of households whose members are not ill.

Results. Controlling for the effects of insurance status and illness, we find that the median household with a newly ill, uninsured individual suffers a statistically significant decline in household assets of between 30 and 50 percent relative to households with matched insured individuals. Newly ill, insured individuals do not experience a decline in wealth.

Conclusions. Newly ill/uninsured households appear to be one illness away from financial catastrophe. Newly ill insured households who are matched to uninsured households appear to be protected against financial loss, at least in the near term.
The immediate life support course: implementation into an undergraduate nursing programme
Authors: Rice Billiejoan , Gallagher Patrick , Mc Kenna Niall , Traynor Marian , Mc Nulty Trevor
Published: October 2009

Aim: The aim of this paper is to outline how the immediate life support (ILS) course was incorporated into an undergraduate nursing curriculum in a university in Northern Ireland. It also reports on how the students perceived the impact of this course on their clinical practice.

Rationale and Background: The rationale of the course was to develop the student's ability to recognize the acutely ill patient and to determine the relevance of this to clinical practice. Prior to this, the ILS course was only available to qualified nurses, and this paper reports on the first time undergraduate nursing students were provided with an ILS course.

Methods: The ILS course was delivered to 89 third‐year nursing students from the adult branch pathway of the BSc (Hons) programme in Nursing Sciences. Each course was taught to 10–12 students and was completed over eight 7·5 h sessions within a 2‐week period. Recognized advanced life support (ALS) instructors, in keeping with the UK Resuscitation Council guidelines, taught the students.

Results and Conclusion: Student feedback reported that the ILS course helped them understand what constituted the acutely ill patient and the role of the nurse in managing a deteriorating situation. Students also reported that they valued the experience as highlighting gaps in their knowledge.
Dune Restoration Introduces Genetically Distinct American Beachgrass,Ammophila breviligulata, into a Threatened Local Population
Authors: Holmstrom Rebecca M. , Etterson Julie R. , Schimpf David J.
Published: October 2009

There is mounting concern over the source and genetic history of plant propagules used for habitat restoration because introduced genotypes may destabilize remnant local populations through competition and introgression. We examined whether introduced dune grass,Ammophila breviligulata, from Michigan is genetically distinct from a threatened local Minnesota population by comparing local and nonlocal genotypes in well‐established stands in the field and in experimental common gardens. Both observational and experimental studies suggest that Michigan plants differed genetically and had an advantage over local plants in terms of vegetative spread and sexual reproduction. Well‐established restoration populations composed of Michigan plants produced fertile culms that were 1.8 times taller than Minnesota plants and more than twice as fecund. Introgression is unlikely, however, because Minnesota genotypes flowered on average 6.7 weeks earlier than Michigan plants and only 20% of Minnesota pollen remained viable after 4 weeks. In the common gardens, Michigan plants from two sources were larger in size, grew faster, and flowered more frequently than Minnesota plants. Plant surveys across the study area suggest that nonlocal genotypes have spread beyond documented restoration areas and into local stands, particularly in foredunes. Even if gene flow between local and nonlocal plants is limited due to differences in flowering phenology, Michigan genotypes may out‐compete plants in the threatened Minnesota population through greater vegetative and sexual reproduction. The fitness consequences of this change in the genetic composition of the local population have yet to be determined.
Short‐Term and Long‐Term Effects of Soil Ripping, Seeding, and Fertilization on the Restoration of a Tropical Rangeland
Authors: Kinyua David , McGeoch Lauren E. , Georgiadis Nicholas , Young Truman P.
Published: October 2009

Rangeland degradation is a serious problem in semiarid Africa. Extensive areas of bare, compacted, nutrient‐poor soils limit the productivity and biodiversity of many areas. We conducted a set of restoration experiments in which all eight combinations of soil tilling, fertilization, and seeding with native perennial grasses were carried out in replicated plots. After 6 months, little aboveground biomass was produced in plots without tilling, regardless of seeding or fertilization. Tilling alone tripled plant biomass, mostly of herbaceous forbs and annual grasses. Perennial grasses were essentially limited to plots that were both tilled and seeded. The addition of fertilizer had no significant additional effects. After 7 years, vegetation had declined, but there were still large differences among treatments. After 10 years, one tilled (and seeded) plot had reverted to bare ground, but the other tilled plots still had substantial vegetation. Only one seeded grass (Cenchrus ciliaris) was still a contributor to total cover after 10 years. We suggest that restoration efforts on these soils be directed first to breaking up the surface crust, and second to the addition of desirable seed. A simple ripping trial inspired by this experiment showed considerable promise as a low‐cost restoration technique.
Nitrogen Depletion and Redistribution by Free‐Ranging Cattle in the Restoration Process of Mosaic Landscapes: The Role of Foraging Strategy and Habitat Proportion
Authors: Van Uytvanck Jan , Milotic Tanja , Hoffmann Maurice
Published: October 2009

In a mosaic landscape in N‐Belgium (W‐Europe), consisting of forest, grassland, and wooded pasture on former agricultural land, we assessed nitrogen redistribution by free‐ranging cattle (±0.2 animal units ha−1 yr−1). We examined if the spatial redistribution of nitrogen among habitats by cattle could restore nutrient‐poor conditions in preferred foraging habitats, and conversely whether such translocation could lead to extreme eutrophication in preferred resting habitats. We used nitrogen content of different diet classes, habitat use, foraging and defecation behavior, weight gain, and nitrogen losses in the actual situation to explore four different habitat proportion scenarios and two different foraging strategies to calculate a net nitrogen balance per habitat. An atmospheric deposition of 30 kg N ha−1 yr−1 with varying interception factors according to the habitat types was included in an integrated nitrogen balance. All scenarios showed a net nitrogen transport from grassland and wooded pasture to forest habitat. We found that nitrogen redistribution strongly depends on habitat proportion. Nitrogen losses from preferred grassland habitat can be high, given its proportion is small. Depletion is only to be expected at excretion‐free areas and probably is of minor importance to trigger the establishment of woody species. In general, nitrogen transported by cattle was much lower than input by atmospheric deposition, but grazing can compensate for high N inputs in excretion‐free areas and maintain grassland types that support critical loads of 20–25 kg N ha−1 yr−1. In none of the scenarios, N transport by cattle resulted in the exceeding of critical nitrogen loads to vulnerable forest ground vegetation.
Structural Features of the NAD‐Dependent In Situ Retinoic Acid Supply System in Esophageal Mucosa
Authors: Yokoyama Hirokazu , Shiraishi‐Yokoyama Haruko , Hibi Toshifumi
Published: October 2009

Background:  We previously reported that an NAD‐dependent in situ retinoic acid supply system, which comprises some isoforms of alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) and provides retinoic acid from retinol via a 2‐step oxidation process, exists in the rat esophagus. Herein, their isoforms responsible for the pathway and its localization in the rat esophagus was examined.

Methods:  The expressions of mRNAs of various isoforms of ADH and ALDH were examined in the fraction mainly comprising mucosal layer of the rat esophagus by RT‐PCR. Expression levels of Class IV ADH and ALDH 1A1 were compared between the fractions and that mainly comprising muscle layer of the rat esophagus by quantitative PCR. The catalytic activities producing retinoic acid from retinal were compared between the 2 fractions and its optimum pH was also determined.

Results:  Classes I, III, and IV ADHs and ALDHs 1A1 and 3A1 were predominant isoforms in the rat esophageal mucosa. The expression levels of mRNA of Class IV ADH and ALDH 3A1 were significantly higher in the mucosal than in the muscle layer. Consistently, the catalytic activities producing retinoic acid from retinal were significantly higher in the former than the latter. The optimum pH of the process was 9.0.

Conclusions:  Considering the affinities for retinol and retinal of ADHs and ALDHs expressed in the rat esophagus, the NAD‐dependent in situ retinoic acid supply system in the rat esophagus is thought to comprise Class IV ADH and ALDH 1A1. In the rat esophagus, the system exists predominantly in the mucosal layer.
Impact of Right Ventricular Pacing Sites on Exercise Capacity during Ventricular Rate Regularization in Patients with Permanent Atrial Fibrillation
Authors: TSE HUNG‐FAT , SIU CHUNG‐WAH , LAU CHU‐PAK
Published: October 2009

Background:

The deleterious effects of right ventricular apical (RVA) pacing may offset the potential benefit of ventricular rate (VR) regularization and rate adaptation during an exercise in patient's atrial fibrillation (AF).

Methods:

We studied 30 patients with permanent AF and symptomatic bradycardia who receive pacemaker implantation with RVA (n = 15) or right ventricular septal (RVS, n = 15) pacing. All the patients underwent an acute cardiopulmonary exercise testing using VVI‐mode (VVI‐OFF) and VVI‐mode with VR regularization (VRR) algorithm on (VVI‐ON).

Results:

There were no significant differences in the baseline characteristics between the two groups, except pacing QRS duration was significantly shorter during RVS pacing than RVA pacing (138.9 ± 5 vs 158.4 ± 6.1 ms, P = 0.035). Overall, VVI‐ON mode increased the peak exercise VR, exercise time, metabolic equivalents (METs), and peak oxygen consumption (VO2max), and decreased the VR variability compared with VVI‐OFF mode during exercise (P < 0.05), suggesting that VRR pacing improved exercise capacity during exercise. However, further analysis on the impact of VRR pacing with different pacing sites revealed that only patients with RVS pacing but not patients with RVA pacing had significant increased exercise time, METs, and VO2max during VVI‐ON compared with VVI‐OFF, despite similar changes in peaked exercise VR and VR variability.

Conclusion:

In patients with permanent AF, VRR pacing at RVS, but not at RVA, improved exercise capacity during exercise.
Enhanced solute removal with intermittent, in‐center, 8‐hour nocturnal hemodialysis
Authors: TROIDLE Laura , FINKELSTEIN Fredric , HOTCHKISS Mark , LEYPOLDT John Ken
Published: October 2009

Advances in the dialysis technique and increasing urea Kt/V have not improved outcomes for end‐stage renal disease patients maintained on hemodialysis (HD) therapy. Attention has, thus, focused on enhancing solute removal via prolonged HD sessions. A reduction in the serum levels of phosphorus and β‐2‐microglobulin (B2M) with longer HD treatments has been linked to improved patient outcomes. We have shown that serum phosphorus levels are significantly lowered in patients maintained on thrice‐weekly, in‐center, 8‐hour nocturnal HD performed at a blood flow rate of 400 mL/min. The kinetics of this modality were examined. A total of 8 patients participated in the study (age 45±7 years). Serum creatinine levels decreased from 9.2±1.9 to 3.0±1.0 mg/dL at 8 hours while serum phosphorus decreased from 5.7±1.9 to 2.5±0.7 mg/dL at 8 hours. The initial decrease from predialysis values to 1 hour after the start of HD was significant for both creatinine (P<0.0001) and phosphorus (P<0.001). Serum B2M decreased from 26.8±5.5 mg/L predialysis to 14.9±7.0 mg/L at 8 hours (P<0.01). Dialysate‐side clearances of phosphorus and creatinine were 136±13  and 143±27 cm3/min, respectively. Phosphorus clearances were steadily maintained during the 8‐hour session. A total of 904±292 mg of phosphorus was removed during the 8‐hour treatment, with 501±174 mg (55%) removed during the first 4 hours and the remaining 45% continuously removed during the latter one‐half of the session. The overall calculated B2M clearance was 55.1±40.3 cm3/min using the immediate post‐B2M value and 28.4±34.2 mg/L using the 30‐minute postdialysis value for the calculation. Serum levels of phosphorus and B2M decrease dramatically during an 8‐hour session. Future studies are necessary to determine whether the enhanced solute removal with longer HD sessions translates into an improved outcome for HD patients.
Encapsulating peritoneal sclerosis: Importance to the hemodialysis practitioner
Authors: PERL Jeffrey , BARGMAN Joanne M. , CHAN Christopher T.
Published: October 2009

Encapsulating peritoneal sclerosis (EPS) is a rare but devastating complication of long‐term peritoneal dialysis (PD) therapy. Encapsulating peritoneal sclerosis is characterized by peritoneal membrane inflammation, followed by progressive peritoneal membrane fibrosis and intestinal encapsulation. Clinical manifestations include ascites as well as intermittent and recurrent small bowel obstruction. The prognosis of EPS is poor. The exact cause of EPS remains unknown. While the risk factors for EPS are not well elucidated, EPS is seen with increased frequency after an increased duration of PD therapy. In more than half the patients who develop EPS, the diagnosis is made after transfer to hemodialysis (HD). It is important for the HD practitioner to initiate surveillance in any patient at risk for EPS while maintaining a heightened index of suspicion for EPS in an HD patient with gastrointestinal symptoms and a history of previous PD therapy. Early diagnosis and prompt initiation of treatment is essential. Early in the course of EPS, immunosuppressive therapy remains the mainstay of treatment. Ultimately, parenteral nutritional support may be required along with surgical therapy to relieve intestinal obstruction. We report a case of EPS in an HD patient at our center highlighting the incidence, risk factors, and treatment strategies in the context of available evidence.
End‐of‐Life Treatment Preferences Among Older Adults: An Assessment of Psychosocial Influences1
Authors: Carr Deborah , Moorman Sara M.
Published: October 2009

We explore the content and correlates of older adults’ end‐of‐life treatment preferences in two hypothetical terminal illness scenarios: severe physical pain with no cognitive impairment, and severe cognitive impairment with no physical pain. For each scenario, we assess whether participants would reject life‐prolonging treatment, accept treatment, or do not know their preferences. Using data from the 2004 wave of the Wisconsin Longitudinal Study (N = 5,106), we estimate multinomial logistic regression models to evaluate whether treatment preferences are associated with direct experience with end‐of‐life issues, personal beliefs, health, and sociodemographic characteristics. Persons who have made formal end‐of‐life preparations, persons with no religious affiliation, mainline Protestants, and persons who are pessimistic about their own life expectancy are more likely to reject treatment in both scenarios. Women and persons who witnessed the painful death of a loved one are more likely to reject treatment in the cognitive impairment scenario only. Consistent with rational choice perspectives, our results suggest that individuals prefer treatments that they perceive to have highly probable desirable consequences for both self and family.
The Social Dynamics and Durability of Moral Boundaries1
Authors: Brown Keith R.
Published: October 2009

Moral boundaries are often conceptualized as an expression of an individual’s identity or belief system. However, social forces greatly influence how and when consumers activate moral boundaries. Utilizing a dramaturgical perspective, this article shows that the activation of moral boundaries is largely determined by an individual’s position in the market (role), the discourse he or she is expected to perform (scripts), and the individuals with whom he or she is interacting (audience). This article makes four contributions to our understanding of ethical consumption and boundary theory: (1) it provides a counterbalance to theories that imply moral boundaries are an expression of an individual’s belief system; (2) it demonstrates the permeability of moral boundaries; (3) it shows that strong moral boundaries can, but rarely do, lead to the formation of social boundaries; and (4) it reinforces the notion that boundary research needs to include naturalistic data looking at how people activate boundaries in their everyday lives. These findings are based on participant observation and interviews with 102 consumers, activists, store owners, and managers of Fair Trade coffee and handicraft retail stores.
Urban Nightlife, Social Capital, and the Public Life of Cities1
Authors: Grazian David
Published: October 2009

Sociologists and urban scholars emphasize how nightlife establishments contribute to the social capital and public life of cities. In the interests of tempering this line of argument, I suggest three generalizable empirical findings that provide grounds for skepticism on this score: (1) the racial and class barriers to participation imposed by urban nightlife enterprises; (2) the normalization of gender differences and the routine harassment of women within such scenes; and (3) the lack of inclusiveness surrounding local nightlife in urban neighborhood communities. These findings suggest that nightlife scenes may function more efficiently as generators of bonding rather than bridging social capital.
Better to Complicate, Rather than Homogenize, Urban Nightlife: A Response to Grazian
Authors: Anderson Tammy L.
Published: October 2009

Grazian (2009) challenges a prominent narrative that claims urban nightlife is a democratized and social‐capital‐enriching “third space” of social life. For Grazian, urban nightlife is, instead, characterized by (1) race and class divisions, (2) gender inequities and the exploitation of women, and (3) exclusivity rather than inclusiveness or solidarity. Grazian makes a brief and compelling case. It is one I agree with to a certain point. However, in this essay, I present two major concerns with his argument.
Frequency and clinical correlates of adult separation anxiety in a sample of 508 outpatients with mood and anxiety disorders
Authors: Pini S. , Abelli M. , Shear K. M. , Cardini A. , Lari L. , Gesi C. , Muti M. , Calugi S. , Galderisi S. , Troisi A. , Bertolino A. , Cassano G. B.
Published: October 2009

Pini S, Abelli M, Shear KM, Cardini A, Lari L, Gesi C, Muti M, Calugi S, Galderisi S, Troisi A, Bertolino A, Cassano GB. Frequency and clinical correlates of adult separation anxiety in a sample of 508 outpatients with mood and anxiety disorders.

Objective:  To evaluate the frequency and clinical correlates of adult separation anxiety disorder in a large cohort of patients with mood and anxiety disorders.

Method:  Overall, 508 outpatients with anxiety and mood disorders were assessed by the structured clinical interview for diagnostic and statistical manual (IV edition) axis I disorders for principal diagnosis and comorbidity and by other appropriate instruments for separation anxiety into adulthood or childhood.

Results:  Overall, 105 subjects (20.7%) were assessed as having adult separation anxiety disorder without a history of childhood separation anxiety and 110 (21.7%) had adult separation anxiety disorder with a history of childhood separation anxiety. Adult separation anxiety was associated with severe role impairment in work and social relationships after controlling for potential confounding effect of anxiety comorbidity.

Conclusion:  Adult separation anxiety disorder is likely to be much more common in adults than previously recognized. Research is needed to better understand the relationships of this condition with other co‐occurring affective disorders.
Risk factors for incident mild cognitive impairment – results from the German Study on Ageing, Cognition and Dementia in Primary Care Patients (AgeCoDe)
Authors: Luck T. , Riedel‐Heller S. G. , Luppa M. , Wiese B. , Wollny A. , Wagner M. , Bickel H. , Weyerer S. , Pentzek M. , Haller F. , Moesch E. , Werle J. , Eisele M. , Maier W. , Van Den Bussche H. , Kaduszkiewicz H. ,   for the AgeCoDe Study Group
Published: October 2009

Luck T, Riedel‐Heller SG, Luppa M, Wiese B, Wollny A, Wagner M, Bickel H, Weyerer S, Pentzek M, Haller F, Moesch E, Werle J, Eisele M, Maier W, van den Bussche H, Kaduszkiewicz H for the AgeCoDe Study Group. Risk factors for incident mild cognitive impairment – results from the German Study on Ageing, Cognition and Dementia in Primary Care Patients (AgeCoDe).

Objectives:  To provide age‐ and gender‐specific incidence rates of MCI among elderly general practitioner (GP) patients (75+ years) and to identify risk factors for incident MCI.

Method:  Data were derived from the longitudinal German Study on Ageing, Cognition and Dementia in Primary Care Patients (AgeCoDe). Incidence was calculated according to the ‘person‐years‐at‐risk’ method. Risk factors were analysed using multivariate logistic regression models.

Results:  During the 3‐year follow‐up period, 350 (15.0%) of the 2331 patients whose data were included in the calculation of incidence developed MCI [person‐years (PY) = 6198.20]. The overall incidence of MCI was 56.5 (95% confidence interval = 50.7–62.7) per 1000 PY. Older age, vascular diseases, the apoE ε4 allele and subjective memory complaints were identified as significant risk factors for future MCI.

Conclusion:  Mild cognitive impairment is frequent in older GP patients. Subjective memory complaints predict incident MCI. Especially vascular risk factors provide the opportunity of preventive approaches.
Illicit substance use and its correlates in first episode psychosis
Authors: Mazzoncini R. , Donoghue K. , Hart J. , Morgan C. , Doody G. A. , Dazzan P. , Jones P. B. , Morgan K. , Murray R. M. , Fearon P.
Published: October 2009

Mazzoncini R, Donoghue K, Hart J, Morgan C, Doody GA, Dazzan P, Jones PB, Morgan K, Murray RM, Fearon P. Illicit substance use and its correlates in first episode psychosis.

Objective:  To determine if substance use (particularly cannabis) is more frequent among first episode psychosis patients and associated with a more problematic clinical presentation.

Method:  All first episode psychosis (FEP) patients presenting to secondary services were recruited from London and Nottingham, over 2 years, in the Aetiology and Ethnicity of Schizophrenia and Other Psychoses study broad framework. Clinical and sociodemographic variables were assessed using a set of standardized instruments. A schedule was created to retrospectively collate substance use data from patients, relatives and clinicians.

Results:  Five hundred and eleven FEP were identified. They used three to five times more substances than general population. Substance use was associated with poorer social adjustment and a more acute mode of onset. Cannabis use did not affect social adjustment, but was associated with a more acute mode of onset.

Conclusion:  Cannabis has a different impact on FEP than other substances. Large epidemiological studies are needed to disentangle cannabis effect.
Recent time trends in levels of self‐reported anxiety, mental health service use and suicidal behaviour in Stockholm
Authors: Kosidou K. , Magnusson C. , Mittendorfer‐Rutz E. , Hallqvist J. , Hellner Gumpert C. , Idrizbegovic S. , Dal H. , Dalman C.
Published: October 2009

Kosidou K, Magnusson C, Mittendorfer‐Rutz E, Hallqvist J, Gumpert CH, Idrizbegovic S, Dal H, Dalman C. Recent time trends in levels of self‐reported anxiety, mental health service use and suicidal behaviour in Stockholm.

Objective: To investigate recent time trends in several indicators of mental ill‐health and the patterning of these indicators between genders and younger vs. older individuals in Stockholm County.

Method: Several indicators were used; self‐reported anxiety from the Swedish Survey of Living Conditions, information on psychiatric in‐patient and out‐patient care, attempted and completed suicides from national and regional registers. Gender‐ and age‐specific trends were compared for the time period of 1997–2006.

Results: Self‐reported anxiety and psychiatric service use increased among young individuals of both genders, while attempted suicides increased only among young women. By contrast, these indicators decreased or remained stable in the older age group from year 2001 and onwards.

Conclusion: Our data indicate a rising, and highly prevalent, mental ill‐health among the young in Stockholm County, a region representative of urbanized, secular Western societies.
Effects of relaxin on collagen type I released by stretched human periodontal ligament cells
Authors: Takano M , Yamaguchi M , Nakajima R , Fujita S , Kojima T , Kasai K
Published: October 2009

Structured Abstract

Authors –  Takano M, Yamaguchi M, Nakajima R, Fujita S, Kojima T, Kasai K

Objectives –  Relapse of teeth that have moved during orthodontic treatment is a major clinical issue with respect to the goals of successful treatment. Such relapse is a physiologic response of the supporting tissues to application of force, and is mainly attributed to occlusal instability and increased mechanical tension exerted by the periodontal ligament (PDL). Relaxin, a member of the insulin/relaxin family of structurally related hormones, has an influence on many physiologic processes, such as collagen turnover, angiogenesis, and antifibrosis. Therefore, relaxin may also affect orthodontic tooth movement through alterations of the PDL, though little is known regarding the relationship between relaxin and stretched human PDL (hPDL) cells. In the present study, we investigated the effects of relaxin on the expression of collagen type I (Col‐I) and matrix metalloproteinase 1 (MMP‐1) in stretched hPDL cells in vitro.

Materials and Methods –  The release and gene expression of Col‐I, as well as those of MMP‐1 in stretched hPDL cells treated with relaxin were investigated using enzyme‐linked immunosorbent assay and real‐time PCR methods.

Results –  Relaxin decreased the release and gene expression of Col‐I, and increased those of MMP‐1 by stretched hPDL cells in a magnitude‐dependent manner.

Conclusion –  Our results indicate that relaxin modulates collagen metabolism in stretched hPDL cells via the release and expression of Col‐I and MMP‐1. This hormone may be useful to prevent orthodontic relapse following orthodontic treatment.
Low‐energy laser irradiation accelerates the velocity of tooth movement via stimulation of the alveolar bone remodeling
Authors: Yoshida T , Yamaguchi M , Utsunomiya T , Kato M , Arai Y , Kaneda T , Yamamoto H , Kasai K
Published: October 2009

Structured Abstract

Authors –  Yoshida T, Yamaguchi M, Utsunomiya T, Kato M, Arai Y, Kaneda T, Yamamoto H, Kasai K

Introduction –  Previously, the authors have reported the acceleration of tooth movement and osteoclastogenesis on the pressure site in an experimental tooth movement model by low‐energy laser irradiation (LELI), which stimulated the RANK/RANKL system and c‐fms/macrophage colony‐stimulating factor system. However, the effect of LELI on osteogenesis on the tension site is not known clearly. Moreover, the temporal changes in alveolar bone during tooth movement have not been investigated as yet. Therefore, the present study was designed to examine the effects of LELI on alveolar bone remodeling during experimental tooth movement, and observe the temporal bone mineral density (BMD) using micro‐computed tomography (μCT).

Materials and methods –  To induce experimental tooth movement in rats, 10 g force was applied to the upper right first molar with Nickel titanium closed‐coil. Next, a gallium‐aluminum‐arsenide (Ga‐Al‐As) diode laser was used to irradiate the area around the moved tooth, and BMD and the amount of tooth movement were measured by μCT scanning for 21 days. Histopathological examination was also performed.

Results –  The amount of tooth movement in the LELI group was significantly greater than in the non‐irradiation group by the end of the experimental period. Further, compared with the non‐irradiation group, the fall of BMD was less in the LELI group.

Conclusion –  These findings suggest that LELI accelerates the velocity of tooth movement via stimulation of the alveolar bone remodeling.
Comparison of cortical bone thickness and root proximity at maxillary and mandibular interradicular sites for orthodontic mini‐implant placement
Authors: Lim JE , Lee SJ , Kim YJ , Lim WH , Chun YS
Published: October 2009

Structured Abstract

Authors –  Lim JE, Lee SJ, Kim YJ, Lim WH, Chun YS

Objectives –  To compare maxillary and mandibular cortical bone thickness and rootic proximity for optimal mini‐implant placement.

Setting and Sample Population –  CT images from 14 men and 14 women were used to evaluate buccal interradicular cortical bone thickness and root proximity from mesial of the central incisor to the 2nd molar. Cortical bone thickness was measured at 0°, 15°, 30°, and 45° angles relative to the root surface using three‐dimensional images.

Results –  For the cortical bone thickness, there was no statistically significant difference between the maxilla and the mandible in the anterior area; however, there was a significant difference in the posterior area. Cortical bone in the maxilla, mesial and distal to canine interradicular sites, was thickest while thickness in the mandible exhibited a gradual anterior to posterior increase. Cortical bone thickness in the maxilla increased as both level and angle increased, while the cortical bone thickness in the mandible was greatest at 4 mm from the alveolar crest. Root proximity mesial and distal to 2nd premolar interradicular sites was greatest.

Conclusion –  Based on our results, cortical bone thickness depends on the interradicular site rather than sex or individual differences.
Simplified stress analysis on the temporomandibular joint in Class III patients with and without mandibular asymmetry using a rigid body spring model
Authors: Ueki K , Takeuchi N , Nakagawa K , Yamamoto E
Published: October 2009

Structured Abstract

Authors –  Ueki K, Takeuchi N, Nakagawa K, Yamamoto E

Objective –  Aim of this study was to investigate the differences in stress on the temporomandibular joint (TMJ) between Class III patients with and without mandibular asymmetry using a rigid body spring model (RBSM).

Design –  Menton (Me), the centre point of occlusal force on the line that connected the bilateral buccal cusps of the second molars and the most lateral, superior and medial points of the condyle were plotted on frontal cephalograms, and stress on the condyles was calculated with the 2‐dimensional RBSM program of fortran.

Setting and Sample Population –  Eighty Japanese patients with diagnosed mandibular prognathism were divided into two groups, a symmetry group and asymmetry group on the basis of the Mx‐Md midline position.

Outcome measure –  The degree (force partition) of the resultant force, the direction (angulation) and displacement (X, Y) of each condyle were calculated. The horizontal displacement vector (u), the vertical displacement vector (v) and rotation angle (θ) of the mandibular body at Menton were also calculated.

Results –  There were significant differences between the deviated and non‐deviated sides of both groups regarding resultant force (symmetry group: p = 0.0372, asymmetry group: p = 0.0054), X (symmetry group: p < 0.0001, asymmetry group: p = 0.0001) and Y (symmetry group: p = 0.0354, asymmetry group: p = 0.0043). For angulation, there was a significant difference between the deviated and non‐deviated sides in the asymmetry group (p = 0.0095).

Conclusion –  The results of this study suggest that difference in stress angulation on the condyles could be associated with asymmetry in mandibular prognathism.
Cutaneous side effects of inhibition of VEGF signal transduction
Authors: Wozel Gottfried , Sticherling Michael , Schön Michael P.
Published: October 2009

The VEGF signaling pathway (including ligands, surface‐bound receptors and intracellular downstream signaling cascades) is critically involved in angiogenesis under normal and pathological conditions, in particular in malignant tumors. As a consequence, several therapies that target specific components of this pathway have been approved for clinical use or are in various stages of clinical development. Currently, the monoclonal antibodies bevacizumab and ranibizumab, as well as the small‐molecule kinase inhibitors sorafenib and sunitinib, have been approved for cancer therapy. The spectrum of cutaneous side effects elicited by bevacizumab is considerably less pronounced than that seen with EGF inhibitors and includes peripheral sensory neuropathy, stomatitis, skin dryness, skin discoloration and exfoliative dermatitis. In contrast, unwanted cutaneous side effects seen with the less specific small molecule compounds include pruritic exanthems, nail changes, cheilitis and the painful hand‐foot‐syndrome.
Primary mucinous eccrine carcinoma of the skin – a rare clinical tumor with many differential diagnoses
Authors: Scholz Ina M. , Hartschuh Wolfgang
Published: October 2009

Primary mucinous eccrine carcinoma of the skin is an extremely rare tumor most frequently occurring in the face or capillitium. It is felt to be an eccrine carcinoma, characterized by slow progress and unpredictable locally infiltrative growth. Therefore micrographic surgery is important to avoid local recurrence. It can be difficult to differentiate this carcinoma histologically from cutaneous metastases of breast or gastrointestinal tumors. Because of this, a primary staging in affected patients is essential.
Original Research—Women’s Sexual Health: Successful Transcutaneous Electrical Nerve Stimulation in Two Women with Restless Genital Syndrome: The Role of Aδ- and C-Nerve Fibers
Authors: Waldinger Marcel D. , De Lint Govert J. , Venema Pieter L. , Van Gils Ad P.G. , Schweitzer Dave H.
Published: October 2009

Introduction

Currently, efficacious treatment of restless genital syndrome (ReGS) is not available.

Aim

This study aimed to report the results of transcutaneous electrical nerve stimulation (TENS) for ReGS, being a combination of genital dysesthesias, imminent and/or spontaneous orgasms, and/or restless legs, and/or overactive bladder.

Methods

Two women with ReGS were referred to our clinic. In-depth interview, routine and hormonal investigations, electroencephalography, magnetic resonance imaging (MRI) of the brain and pelvis, manual examination of the ramus inferior of the pubic bone, and sensory testing of genital dermatomes were performed. Conventional TENS (frequency: 110 Hz; pulse width: 80 milliseconds) was applied bilaterally at the region of the pudendal dermatome in which immediate reduction of genital sensations occurred. Patients were instructed for self-application of TENS each day for 2 months.

Main Outcome Measures

Oral report, questionnaires on frequency of imminent and/or spontaneous orgasms, combined with questions on intensity of restless genital feelings, restless leg syndrome (RLS), overactive bladder syndrome (OAB), and satisfaction with TENS treatment.

Results

ReGS in a 56-year-old woman manifested as multiple spontaneous orgasms, RLS, and OAB. TENS applied to the sacral region resulted in immediate reduction of complaints and a 90% reduction of spontaneous orgasms, RLS, and OAB in 2 months. ReGS in a 61-year-old woman manifested as a continuous restless genital feeling, imminent orgasms, and OAB. TENS applied to the pubic bone resulted in a complete disappearance of restlessness in the genital area as well as OAB complaints in 2 months. Both women reported to be very satisfied and did not want to stop TENS treatment.

Conclusions

Conventional TENS treatment is a promising therapy for ReGS, but further controlled research is warranted. Preorgasmic and orgasmic genital sensations in ReGS are transmitted by Aδ and C fibers and are inhibited by Aβ fibers. A neurological hypothesis on the pathophysiology of ReGS encompassing its clinical symptomatology, TENS, and drug treatment is put forward.
EFFECT OF METHOD OF PRESERVATION OF PULP ON THE QUALITY OF CARBONATED AND NONCARBONATED BEVERAGES PREPARED FROM PEACH FRUIT
Authors: ARORA SHEETU , AGGARWAL POONAM
Published: October 2009

Peach pulp preserved by different methods, i.e., processing at 100C for 30 min, potassium metabisulphite (KMS; 2,000 ppm), sodium benzoate (750 ppm) and mixture of KMS and sodium benzoate (1,000 and 375 ppm) had no significant effect on total soluble solids (TSS), acidity, TSS : acid ratio, pH of carbonated as well as noncarbonated beverages. Carbonated beverages prepared from pulp with 750 ppm of sodium benzoate retained significantly (P ≤ 0.05) higher carbon dioxide (CO2) content and CO2 gas : volume during storage. Color of the beverages prepared from peach pulp containing KMS was better but the beverages prepared from peach pulp preserved by processing and addition of sodium benzoate were organoleptically more acceptable. Both carbonated and noncarbonated drinks remained organoleptically acceptable throughout storage. Suspension of carbonated beverages was significantly (P ≤ 0.05) higher during storage as compared with noncarbonated beverages.

PRACTICAL APPLICATIONS

Peaches are valued as a table fruit for a short period of time from end of April to end of May. The acceptability and utilization of this fruit can be increased by processing it into delicious carbonated and noncarbonated beverages. This will provide nutritious drink to the consumers and also help in increasing the fruit cultivation resulting in good returns to the growers. This study will also help to give a fillip to the establishment of a peach beverage industry world wide.