bluuebunny/crossref_metadata_2025 huggingface dataset:
Deterioration in biomechanical properties of the vagina following implantation of a high‐stiffness prolapse mesh
Authors: Feola A , Abramowitch S , Jallah Z , Stein S , Barone W , Palcsey S , Moalli P
Published: December 2012

Objective

To define the impact of prolapse mesh on the biomechanical properties of the vagina by comparing the prototype Gynemesh PS (Ethicon) to two new‐generation lower stiffness meshes, SmartMesh (Coloplast) and UltraPro (Ethicon).

Design

A study employing a nonhuman primate model.

Setting

University of Pittsburgh, PA, USA.

Population

Forty‐five parous rhesus macaques.

Methods

Meshes were implanted via sacrocolpopexy after hysterectomy and compared with sham. Because its stiffness is highly directional, UltraPro was implanted in two directions: UltraPro Perpendicular (less stiff) and UltraPro Parallel (more stiff), with the indicated direction referring to the position of the blue orientation lines relative to the longitudinal axis of the vagina. The mesh–vaginal complex (MVC) was excised in toto after 3 months.

Main outcome measures

Active mechanical properties were quantified as the contractile force generated in the presence of 120 mmol/l KCl. Passive mechanical properties (a tissue's ability to resist an applied force) were measured using a multiaxial protocol.

Results

Vaginal contractility decreased by 80% following implantation with the Gynemesh PS (P = 0.001), 48% after SmartMesh (P = 0.001), 68% after UltraPro Parallel (P = 0.001) and was highly variable after UltraPro Perpendicular (P = 0.16). The tissue contribution to the passive mechanical behaviour of the MVC was drastically reduced for Gynemesh PS (P = 0.003), but not for SmartMesh (P = 0.9) or UltraPro independent of the direction of implantation (P = 0.68 and P = 0.66, respectively).

Conclusions

Deterioration of the mechanical properties of the vagina was highest following implantation with the stiffest mesh, Gynemesh PS. Such a decrease associated with implantation of a device of increased stiffness is consistent with findings from other systems employing prostheses for support.
Prolapse and sexual function in women with benign joint hypermobility syndrome
Authors: Mastoroudes H , Giarenis I , Cardozo L , Srikrishna S , Vella M , Robinson D , Kazkaz H , Grahame R
Published: December 2012

Objective

To determine whether pelvic organ prolapse (POP) and sexual dysfunction are more severe in women with benign joint hypermobility syndrome (BJHS) than in the normal population.

Design

Case–control study.

Setting

King's College Hospital NHS Foundation Trust, London, UK and University College Hospital, London, UK.

Population

Women diagnosed with BJHS (n = 60) at University College Hospital. Control participants (n = 60) recruited from King's College Hospital NHS Foundation Trust.

Methods

Objective assessment of POP was undertaken using the Pelvic Organ Prolapse Quantification System (POP‐Q). Both groups were asked to complete the Prolapse quality of life (P‐QOL) and pelvic organ prolapse/urinary incontinence sexual (PISQ‐12) questionnaires.

Main outcome measures

Comparison of vaginal anatomy using POP‐Q between the two groups. Comparison of P‐QOL and PISQ‐12 quality of life scores between the two groups.

Results

In all, 120 women (60 in Study group, 60 in Control group) were recruited. All women in the study group were matched with healthy control women according to age, parity and ethnicity. There was a statistically significant difference between points Aa, Ba, Ap, Bp and C in study and control groups showing that prolapse is objectively more severe in those with BJHS. Significantly more women with BJHS felt that POP interfered with sex and defecation compared with the control group. The impact of prolapse symptoms on quality of life was statistically different in almost all nine P‐QOL domains.

Conclusions

A large number of women with BJHS have prolapse symptoms, which significantly affect their quality of life. POP is more severe in women with BJHS.
A comparison of genital sensory and motor innervation in women with pelvic organ prolapse and normal controls including a pilot study on the effect of vaginal prolapse surgery on genital sensation: a prospective study
Authors: North CE , Creighton SM , Smith ARB
Published: December 2012

Objective

To study genital sensory and motor innervation in women with pelvic organ prolapse and to determine the effect of vaginal prolapse surgery on genital sensation.

Design

A prospective observational study.

Setting

A tertiary referral unit in northwest England.

Population

Twenty women complaining of prolapse symptoms (including seven undergoing vaginal prolapse repair) and a control group of ten healthy women.

Methods

Women attended a research clinic where genital sensory thresholds were determined by quantitative sensory testing and motor innervation was assessed by concentric needle electromyography (EMG) of the pelvic floor muscles. Women undergoing surgery were assessed preoperatively and postoperatively at 6 months.

Main outcome measures

Primary outcome measure was change in genital vibration threshold and the percentage of polyphasic potentials on EMG.

Results

Healthy control women had normal vibration detection thresholds at the vagina and clitoris. Thresholds in the majority of women with prolapse were abnormal and in all women with prolapse over the age of 50 years. Women with prolapse had a significantly larger percentage of polyphasic potentials of the left pubococcygeus but not the right. There was no significant change in genital sensory thresholds at 6 months postoperatively following vaginal repair.

Conclusions

The majority of women with prolapse have abnormal genital vibration detection, which is particularly evident after the age of 50 years. Impaired sensory function does not correlate with EMG markers of partial motor denervation. In women with abnormal sensory thresholds, no additional effect was detected following vaginal prolapse repair.
DNA barcoding of the genus Lepidion (Gadiformes: Moridae) with recognition of Lepidion eques as a junior synonym of Lepidion lepidion
Authors: Bañón R. , Arronte J. C. , Vázquez‐Dorado S. , Del Río J. L. , de Carlos A.
Published: December 2012

DNA sequences of cytochrome c oxidase I gene (COI) from Lepidion spp. were employed to test the efficiency of species identification. A sample of 32 individuals from five Lepidion species was sequenced and combined with 26 sequences from other BOLD projects. As a result, 58 Lepidion DNA sequences of the COI gene belonging to eight of the nine recognized Lepidion species were analysed. Sequences were aligned and formed seven clades in a Bayesian phylogenetic tree, where Lepidion lepidion and Lepidion eques grouped jointly. The Kimura 2‐parameter genetic distances, among congeners were, on average, 4.28%, 16 times greater than among conspecifics (0.27%). The main diagnostic meristic data of Lepidion spp. were compiled and a detailed morphological revision of the congeneric species L. eques and L. lepidion was made. The eye diameter was significantly different between L. eques and L. lepidion (P < 0.001). The number of anal fin rays ranged from 45 to 51 in L. lepidion and from 47 to 54 in L. eques, but no significant differences were obtained in the mean values of this variable (P = 0.07). According to the morphological and genetic analyses, the results strongly suggest that the Mediterranean codling L. lepidion and the North Atlantic codling L. eques are conspecific, making L. eques a junior synonym of L. lepidion.
Effects of dexmedetomidine on inflammatory responses in patients undergoing laparoscopic cholecystectomy
Authors: KANG S.‐H. , KIM Y.‐S. , HONG T.‐H. , CHAE M.‐S. , CHO M.‐L. , HER Y.‐M. , LEE J.
Published: December 2012

Background

Dexmedetomidine has been shown to reduce pro‐inflammatory cytokine levels in rats with sepsis and in severely ill patients. The aim of this study was to document the effects of dexmedetomidine on inflammatory responses during and after surgery.

Materials and Methods

Patients undergoing laparoscopic cholecystectomy were enrolled. After induction of anaesthesia, patients in the dexmedetomidine group (n = 24, group D) received a loading dose of dexmedetomidine (1.0 μg/kg), followed by infusion of dexmedetomidine at 0.5 μg/kg/h. A saline‐treated group (n = 23, group S) served as a control. Intraoperative mean arterial pressure (MAP), heart rate (HR), and amount of rescue analgesic administered as post‐anaesthetic care were compared between the groups. The pro‐inflammatory cytokines tumour necrosis factor (TNF)‐α, interleukin (IL)‐1β, and IL‐6, and anti‐inflammatory cytokines IL‐4 and IL‐10 were quantified by sandwich enzyme‐linked immunoassay at three times: after anaesthesia induction (T0), at the end of peritoneal closure (T1), and 60 min after surgery (T2). The C‐reactive protein (CRP) level and leukocyte count were measured on post‐operative day 1.

Results

At time points T1 and T2, the IL‐1β, TNF‐α, and IL‐10 levels were lower in group D than in group S (P < 0.05). The CRP level and leukocyte count on post‐operative day 1 were also lower in group D (P < 0.05), as were intraoperative MAP, HR, and amount of rescue analgesic administered after surgery.

Conclusions

Dexmedetomidine administration during surgery reduced intraoperative and post‐operative secretion of cytokines, as well as post‐operative leukocyte count and CRP level.
An Update of Research Examining College Student Alcohol‐Related Consequences: New Perspectives and Implications for Interventions
Authors: Mallett Kimberly A. , Varvil‐Weld Lindsey , Borsari Brian , Read Jennifer P. , Neighbors Clayton , White Helene R.
Published: December 2012

The objective of this review is to provide an update on existing research examining alcohol‐related consequences among college students with relevance for individual‐based interventions. While alcohol‐related consequences have been a focus of study for several decades, the literature has evolved into an increasingly nuanced understanding of individual and environmental circumstances that contribute to risk of experiencing consequences. A number of risk factors for experiencing alcohol‐related consequences have been identified, including belonging to specific student subgroups (e.g., Greek organizations) or drinking during high‐risk periods, such as spring break. In addition, the relationship between students' evaluations of both negative and positive consequences and their future drinking behavior has become a focus of research. The current review provides an overview of high‐risk student subpopulations, high‐risk windows and activities, and college students' subjective evaluations of alcohol‐related consequences. Future directions for research are discussed and include determining how students' orientations toward consequences change over time, identifying predictors of membership in high‐risk consequence subgroups and refining existing measures of consequences to address evolving research questions.
Imbalanced Synaptic Plasticity Induced Spatial Cognition Impairment in Male Offspring Rats Treated with Chronic Prenatal Ethanol Exposure
Authors: An Lei , Yang Zhuo , Zhang Tao
Published: December 2012

Background

As chronic prenatal ethanol (EtOH) exposure (CPEE) may cause deficiencies in a variety of behavioral and cognitive functions, the aim of present study is to investigate the effects of CPEE on spatial learning and memory and examine the action of CPEE on synaptic plasticity balance in the hippocampus of adolescent male rats.

Methods

The animal model was produced by EtOH exposure throughout gestational period with 4 g/kg bodyweight, while the male offspring rats were used in the study. Morris water maze (MWM) test was performed, and then, long‐term potentiation (LTP) and depotentiation were recorded from Schaffer collaterals to CA1 region in the hippocampus.

Results

It was shown that escape latencies in learning period and re‐acquisition period were prolonged in CPEE‐treated group compared with that in control group. Furthermore, LTP was drastically inhibited, and depotentiation was distinctly enhanced in CPEE‐treated group compared with that in control group.

Conclusions

It is suggested that the balance between cognitive stability and flexibility was broken by the bidirectional effects of long‐term synaptic plasticity. In addition, the spatial cognition was attenuated by the alteration of synaptic plasticity balance in CPEE‐treated male adolescent rats.
Longitudinal Associations Between Smoking Cessation Medications and Alcohol Consumption Among Smokers in the International Tobacco Control Four Country Survey
Authors: McKee Sherry A. , Young‐Wolff Kelly C. , Harrison Emily L. R. , Cummings K. Michael , Borland Ron , Kahler Christopher W. , Fong Geoffrey T. , Hyland Andrew
Published: December 2012

Background

Available evidence suggests that quitting smoking does not alter alcohol consumption. However, smoking cessation medications may have a direct impact on alcohol consumption independent of any effects on smoking cessation. Using an international longitudinal epidemiological sample of smokers, we evaluated whether smoking cessation medications altered alcohol consumption independent of quitting smoking.

Methods

Longitudinal data were analyzed from the International Tobacco Control Four Country (ITC‐4) Survey between 2007 and 2008, a telephone survey of nationally representative samples of smokers from the United Kingdom, Australia, Canada, and the United States (n = 4,995). Quantity and frequency of alcohol consumption, use of smoking cessation medications (varenicline, nicotine replacement [NRT], and no medications), and smoking behavior were assessed across 2 yearly waves. Controlling for baseline drinking and changes in smoking status, we evaluated whether smoking cessation medications were associated with reduced alcohol consumption.

Results

Varenicline was associated with a reduced likelihood of any drinking compared with nicotine replacement (OR = 0.56; 95% CI = 0.34 to 0.94), and consuming alcohol once a month or more compared to nicotine replacement (OR = 0.43; 95% CI = 0.27 to 0.69) or no medication (OR = 0.63; 95% CI = 0.41 to 0.99). Nicotine replacement was associated with an increased likelihood of consuming alcohol once a month or more compared to no medication (OR = 1.14; 95% CI = 1.03 to 1.25). Smoking cessation medications were not associated with more frequent drinking (once a week or more) or typical quantity consumed per episode. Medication effects on drinking frequency were independent of smoking cessation.

Conclusions

This epidemiological investigation demonstrated that varenicline was associated with a reduced frequency of alcohol consumption. Continued work should clarify under what conditions nicotine replacement therapies may increase or decrease patterns of alcohol consumption.
A naturalistic evaluation and audit database of agomelatine: clinical outcome at 12 weeks
Authors: Sparshatt A. , McAllister Williams R. H. , Baldwin D. S. , Haddad P. M. , Bazire S. , Weston E. , Taylor P. , Taylor D.
Published: December 2012

Objective

To determine the effectiveness of agomelatine in routine clinical practice and explore factors associated with response and continuation.

Method

Consecutive patients prescribed agomelatine in participating psychiatric services were included. Patient demographic and outcome data were collected at treatment initiation and then at weeks 4, 8 and 12. Outcomes were analysed with respect to clinical and demographic factors.

Results

A total of 110 patients from nine NHS trusts were followed through 12 weeks of treatment. Agomelatine was largely used in difficult‐to‐treat or refractory patients: 83 (75%) had failed to respond to, or relapsed on, prior antidepressants. There were high rates of physical (54.5%) and psychiatric (50.0%) comorbidity. At 12 weeks of treatment, 68 (62%) continued agomelatine treatment. Overall, 69 subjects (62.7%) improved by at least one point of the Clinical Global Impression (severity) scale. Of 42 who discontinued, 23 (56%) discontinued because of lack of efficacy and 10 (24%) due to an adverse event. Of all variables examined, only a history of more than five episodes of depression significantly predicted discontinuation of treatment (OR continuation – 0.36, 95% CI 0.14, 0.95).

Conclusion

Agomelatine was effective and generally well tolerated in a cohort of difficult‐to‐treat patients in clinical practice.
A non‐rewarding, non‐aversive buprenorphine/naltrexone combination attenuates drug‐primed reinstatement to cocaine and morphine in rats in a conditioned place preference paradigm
Authors: Cordery Sarah F. , Taverner Alistair , Ridzwan Irna E. , Guy Richard H. , Delgado‐Charro M. Begoña , Husbands Stephen M. , Bailey Christopher P.
Published: December 2012

Concurrent use of cocaine and heroin is a major public health issue with no effective relapse prevention treatment currently available. To this purpose, a combination of buprenorphine and naltrexone, a mixed very‐low efficacy mu‐opioid receptor agonist/kappa‐opioid receptor antagonist/nociceptin receptor agonist, was investigated. The tail‐withdrawal and the conditioned place preference (CPP) assays in adult Sprague Dawley rats were used to show that naltrexone dose‐dependently blocked the mu‐opioid receptor agonism of buprenorphine. Furthermore, in the CPP assay, a combination of 0.3 mg/kg buprenorphine and 3.0 mg/kg naltrexone was aversive. A combination of 0.3 mg/kg buprenorphine and 1.0 mg/kg naltrexone was neither rewarding nor aversive, but still possessed mu‐opioid receptor antagonist properties. In the CPP extinction and reinstatement method, a combination of 0.3 mg/kg buprenorphine and 1.0 mg/kg naltrexone completely blocked drug‐primed reinstatement in cocaine‐conditioned rats (conditioned with 3 mg/kg cocaine, drug prime was 3 mg/kg cocaine) and attenuated drug‐primed reinstatement in morphine‐conditioned rats (conditioned with 5 mg/kg morphine, drug prime was 1.25 mg/kg morphine). These data add to the growing evidence that a buprenorphine/naltrexone combination may be protective against relapse in a polydrug abuse situation.
Nicotine vapor inhalation escalates nicotine self‐administration
Authors: Gilpin Nicholas W. , Whitaker Annie M. , Baynes Brittni , Abdel Abdelrahim Y. , Weil Madelyn T. , George Olivier
Published: December 2012

Humans escalate their cigarette smoking over time, and a major obstacle in the field of pre‐clinical nicotine addiction research has been the inability to produce escalated nicotine self‐administration in rats. In experiment 1, male Wistar rats were trained to respond for nicotine in 2‐hour operant sessions, then exposed to chronic intermittent (12 hours/day) nicotine vapor and repeatedly tested for nicotine self‐administration at 8–12 hours of withdrawal. Rats were tested intermittently on days 1, 3 and 5 of the vapor exposure procedure, then tested with nicotine vapor exposure on 6–15 consecutive days. Rats exhibited transient increases in operant nicotine responding during intermittent testing, regardless of vapor condition, and this responding returned to baseline levels upon resumption of consecutive‐days testing (i.e. nicotine deprivation effect). Nicotine vapor‐exposed rats then escalated nicotine self‐administration relative to both their own baseline (∼200% increase) and non‐dependent controls (∼3× higher). In experiment 2, rats were exposed or not exposed to chronic intermittent nicotine vapor, then tested for spontaneous and precipitated somatic signs of nicotine withdrawal. Eight hours following removal from nicotine vapor, rats exhibited robust mecamylamine‐precipitated somatic signs of withdrawal. There was a strong correlation between nicotine flow rate and air–nicotine concentration, and the air–nicotine concentrations used in experiments 1 and 2 resemble concentrations experienced by human smokers. Collectively, these results suggest that chronic intermittent nicotine vapor inhalation produces somatic and motivational signs of nicotine dependence, the latter of which is evidenced by escalation of nicotine self‐administration.
From the Laboratory to Clinical Trials and Back Again: Lessons Learned from HIV Prevention Trials
Authors: Sibeko Sengeziwe , Makvandi‐Nejad Shokouh
Published: December 2012

Problem

Inadequate, irrelevant, or inappropriate timing of biological specimen collection during clinical trials is a cause for delay in understanding and explaining correlates of protection and/or effectiveness, particularly at the portal of entry in the context of sexual HIV transmission and its prevention.

Methods

We present examples of HIV prevention trials to illustrate the impact of preplanned versus unplanned laboratory science program on the interpretation of trial results and advancement of the field.

Results

Of the five completed pre‐exposure prophylaxis trials, only two announced main outcome results simultaneously with data on correlates of drug‐related effectiveness. In four of the vaccine trials completed, the only one that showed a protective effect presented data on protection correlates significantly later.

Conclusion

Clinical trials must preplan collaborative immunophysiological research and prioritize biological specimen collection and storage for enhancement of research on correlates of protection. Similarly appropriate specimens should be prioritized for pathogenesis research.
Study of the Technique and of the Materials of a 19th‐Century Polychrome Wood Mask fromPapuaNewGuinea
Authors: Baraldi P. , Lo Monaco A. , Ortenzi F. , Pelosi C. , Quarato F. , Rossi L.
Published: December 2012

This paper presents the results of the analysis carried out on a polychrome wood mask fromPapuaNewGuinea during conservation work at Pigorini Museum's restoration laboratory. The significance of this study is that no prior work has characterized the painting materials ofPapuaNewGuinea masks both with spectroscopic and internal microstratigraphic analysis. In fact, these objects were studied especially from an anthropological or conservative point of view and the wood was wrongly defined by its visual appearance. Microstratigraphic and spectroscopic investigations discovered a refined execution technique that up to now has not been demonstrated. The stratigraphy of the painted layers demonstrates a deep knowledge of the materials and of the application techniques on the part of thePapuaNewGuinea people, together with the ability to foresee the aesthetic result for the artefact. The analysis of the constitutive materials and of the stylistic features supplied valid results in favour of provenance of the mask fromPapuaNewGuinea.
Metacognitive beliefs, beliefs about voices and affective symptoms in patients with severe auditory verbal hallucinations
Authors: van Oosterhout Bas , Krabbendam Lydia , Smeets Guus , van der Gaag Mark
Published: December 2012

Objectives

This study explores associations between metacognitive beliefs and beliefs about voices in patients with severe auditory verbal hallucinations, and their hypothesized relationship with levels of depression and anxiety. Furthermore, it was hypothesized that metacognitive beliefs are better able to explain differences in levels of depression and anxiety, than beliefs about voices.

Design

Cross‐sectional data were obtained from baseline measurements of a randomized controlled trial. All patients (N = 77) met the criteria for a DSM‐IV diagnosis within the schizophrenia spectrum. A correlation analysis was conducted to explore the associations between metacognitive beliefs and beliefs about voices. Regression analysis was performed to test the second hypothesis.

Method

Metacognitive beliefs were measured using the MCQ‐30. Beliefs about voices were measured using the BAVQ‐R. Furthermore, the Beck Depression Inventory‐II and the Beck Anxiety Inventory were applied to measure depression and anxiety. All analyses were a priori controlled for gender and level of education.

Results

Significant associations were found between negative beliefs about voices and negative metacognitive beliefs. One of the metacognitive beliefs, that is, perceived uncontrollability and danger of thinking, proved to be a key variable in explaining differences in levels of depression and anxiety and seemed to have greater explanatory value than all of the beliefs about voices when analysed simultaneously.

Conclusions

The results offer modest support to models emphasizing the fact that metacognitive beliefs are a core feature in the development and maintenance of depression and anxiety in patients with severe auditory verbal hallucinations.

Practitioner points

Positive clinical implications:

Further evidence for the importance of metacognitive beliefs.

Specific emphasis on anxiety and depression in patients with severe hallucinations.

Limitations

Small sample size.

Cross‐sectional data only.
Identification of dysfunctional cooperative learning teams and troubled individuals
Authors: Hsiung Chin‐Min , Lou Shi‐Jer , Lin Chi‐Chang , Wang Pei‐Ling
Published: December 2012

In cooperative learning, students work together as a team to maximize the academic success of all the team members. The failure of even a single member can compromise the success of the entire team. Thus, to evaluate the functioning of the team reliably, it is necessary to consider both the performance of the individual team members and the interactions among them. In this study, a method was developed for identifying dysfunctional teams and troubled individuals by examining the correlation between the team scores obtained in sequential tests and the correlation between the scores obtained by the different team members. The effectiveness of the proposed method was evaluated via field experiments. Forty‐eight students were randomly assigned to cooperative learning teams and their learning performance assessed by four‐unit tests. The results indicated that the proposed method can identify the most troubled individuals in a team even when the team performance/grouping information is not taken explicitly into account. Furthermore, when the team information is considered, the method can identify both the dysfunctional teams and the troubled individuals within the teams. Therefore, the proposed method provides a useful basis for the development of computer‐assisted solutions for assessing the performance of cooperative learning teams.
Genetic profiling in acute myeloid leukaemia ─ where are we and what is its role in patient management
Authors: Ofran Yishai , Rowe Jacob M.
Published: December 2012

Genetic profiling in acute myeloid leukaemia (AML) is a moving target. Only 4 years ago, AML was re‐classified, based on karyotypic abnormalities. However, numerous important new mutations and other genetic abnormalities that were not considered in this classification have been identified. Current cytogenetic‐based classification is limited by the substantial number of intermediate‐risk patients in whom the preferred therapy is debatable. In addition, the majority of AML patients co‐express multiple mutations and cannot be easily categorized into predefined homogenous groups. The tremendous progress in mass sequencing allows parallel identification of multiple genetic aberrations in large cohorts. Thus, a new concept of genetic profiling has arisen. Genes and proteins biologically interact with each other; therefore, it should not be surprising that mutations in different genes interact. Prognosis is determined by the composition of mutations and aberrations in leukaemic stem cells. As a consequence, clinical decisions no longer rely on scant genetic data and require comprehensive genetic evaluation. Some non‐genetic parameters are also important and should be incorporated into the clinical decision algorithm. Genetic interaction‐based profiles are challenging and recent studies demonstrate an improvement in prognostic predictions with this model. Thus, genetic profiling is likely to have a major therapeutic impact, at least for intermediate‐risk cytogenetics.
Child and parent engagement in the mental health intervention process: a motivational framework
Authors: King Gillian , Currie Melissa , Petersen Patricia
Published: December 2012

Background

This article proposes a conceptual model of child and parent engagement in the mental health intervention process.

Method

A scoping review was performed of articles on predictors of engagement in mental health interventions, the effectiveness of engagement interventions, and interpersonal aspects of care. A comprehensive search of PsycINFO and PsycARTICLES was performed for literature published in English from 2000 to 2012.

Results

Based on the review, a motivational framework is proposed in which engagement is defined as a state comprised of a hopeful stance, conviction, and confidence, brought about when therapists optimize engagement processes of receptiveness, willingness, and self‐efficacy.

Conclusions

Implications concern the need to help clients understand what to expect from the therapy process, and to educate therapists about engagement strategies.
Factors influencing the adoption and implementation of teledentistry in the UK, with a focus on orthodontics
Authors: Patel Reena N. , Antonarakis Gregory S.
Published: December 2012

Objectives

Utilizing Rogers' diffusion of innovation theory, this study aims to develop a better understanding of the challenges faced in teledental projects, and outline the factors that impact upon the adoption and implementation of teledental projects, with a focus on orthodontics, thus attempting to provide an explanation for the low uptake in the UK, as well as to suggest factors to encourage success.

Methods

A literature search was carried out to obtain information concerning teledentistry (and telemedicine) from both primary and secondary research sources. Using the relevant information obtained, Rogers' diffusion of innovation theory was used as a framework, which was subsequently applied to the key stakeholder groups of a healthcare organization.

Results

The model describes five characteristics of an innovation: relative advantage, compatibility, complexity, trialability and observability. These attributes are discussed in the context of key stakeholder groups within a healthcare organization: clinicians, patients, hospital managers, and healthcare decision‐makers and funders. Each stakeholder group is motivated by different values and experiences, which in turn influence their decision to adopt a new technology.

Conclusions

Implementing teledental applications necessitates full comprehension and consideration of the healthcare environment and also a commitment to completely integrate teledentistry within that environment. This is a process that demands strategic alignment with clinical and organizational goals, clinical engagement and strong political support. The challenges within each stakeholder group must be specifically targeted.
Advising mothers about breastfeeding and weaning reduced pacifier use in the first year of life: a randomized trial
Authors: Feldens Carlos Alberto , Ardenghi Thiago Machado , Cruz Luciane Nascimento , Cunha Scalco Giovana Pereira da , Vítolo Márcia Regina
Published: December 2012

Objective

To assess the effectiveness of home visits for advising mothers about breastfeeding and weaning on pacifier use in the first year of life.

Method

A randomized field trial was conducted on mothers who gave birth within the public health system in the Brazilian city of Sao Leopoldo (intervention group = 200; controls = 300). The intervention group received the advice 10 days after the child's birth, monthly up to 6 months, at 8, 10, and 12 months, based on the ‘Ten Steps for Healthy Feeding’, a Brazilian national health policy for primary care, which follows WHO guidelines. Relative risk (RR) was used to estimate the effects of the intervention on the risk of using a pacifier.

Results

55.4% of the children in the intervention group and 66.1% of the controls used a pacifier in the first year of life. The risk of using a pacifier was 16% lower for the intervention group (RR = 0.84; 95% CI, 0.71–0.99). A multivariable Poisson regression model showed higher adjusted risk of using a pacifier for children who had breastfeeding interrupted in the first month of life (RR = 1.43; 95% CI, 1.21–1.69) and whose mothers presented higher level of depression (RR = 1.40; 95% CI, 1.17–1.66).

Conclusions

Pacifier use is highly prevalent in the population studied. The home visits for dietary advice appear to help in reducing pacifier use in infants. These findings suggest the need for public health strategies that address early advice on pacifier use to promote child oral and general health.
Prolactin rescues and primes autoreactive B cells directly and indirectly through dendritic cells in B6.Sle3mice
Authors: Gonzalez J , Saha S , Peeva E
Published: December 2012

The lupus susceptibility interval Sle3/5 confers responsiveness to prolactin in C57BL/6 (B6) mice and hyperprolactinaemia induces a lupus-like phenotype in B6.Sel3/5 mice. In this study, the immunostimulatory effects of prolactin in B6 mice containing the Sle3 portion of the Sel3/5 interval (B6.Sle3 mice) were dissected. Because of the Sle3 interval's involvement in activation of myeloid cells, the effect of dendritic cells (DCs) from prolactin-treated B6.Sle3 mice on the phenotype of B6 mice was also evaluated. B cells from prolactin-treated B6 and B6.Sle3 mice and from B6 recipients of prolactin-modulated DCs from B6.Sle3 mice were tested for DNA-reactivity and resistance to B cell receptor (BCR)-mediated apoptosis. The expression of co-stimulatory molecules on lymphocytes and myeloid cells was also evaluated. In prolactin-treated B6.Sle3 mice, transitional type 2 B cells increased while type 1 B cells decreased as a consequence of prolactin-induced resistance to BCR-mediated apoptosis leading to the survival of DNA-reactive B cells. Follicular B cells from prolactin-treated mice expressed increased levels of CD40, B7·2 and IAb, and DCs and monocytes had higher levels of CD44 and B7·2 than placebo-treated mice. Adoptive transfer of DCs from prolactin-treated B6.Sle3 mice to B6 recipients demonstrated the intrinsic ability of prolactin-modulated DCs to induce a development of lupus-like characteristics in B6 mice. Based on these results, prolactin accelerates the breakdown of immune tolerance in B6.Sle3 mice by promoting the survival, maturation and activation of autoreactive B cells, DCs and macrophages.
Origins and rationale of centres for parents and young children together
Authors: Hoshi‐Watanabe Miwako , Musatti Tullia , Rayna Sylvie , Vandenbroeck Michel
Published: December 2012

The range of centres where parents and children come together has mushroomed in different parts of the world, as new social work practices address the emerging non‐material needs of parents in changing demographic contexts. In this paper, we explore the origins and modi operandi of these centres in Belgium, France, Italy and Japan. Analysis of previous studies and policy documents reveal diverse political rationales, including addressing declining birth rates, preventing psychosocial problems and social isolation of mothers and promoting social cohesion and equality of educational opportunities. Remarkably, despite the diverse cultural and socio‐political contexts and rationales, these centres also share very similar ways of functioning and provide an informal type of social support to parents with young children. As these recently emerged centres are seldom studied, further research is welcomed to explore parents' and professionals' perspectives.
PTEN mosaicism with features of Cowden syndrome
Authors: Gammon A , Jasperson K , Pilarski R , Prior TW , Kuwada S
Published: December 2012

We present the first known case of somatic PTEN mosaicism causing features of Cowden syndrome (CS) and inheritance in the subsequent generation. A 20‐year‐old woman presented for genetics evaluation with multiple ganglioneuromas of the colon. On examination, she was found to have a thyroid goiter, macrocephaly, and tongue papules, all suggestive of CS. However, her reported family history was not suspicious for CS. A deleterious PTEN mutation was identified in blood lymphocytes, 966A>G, 967delA. Genetic testing was recommended for her parents. Her 48‐year‐old father was referred for evaluation and was found to have macrocephaly and a history of Hashimoto's thyroiditis, but no other features of CS. Site‐specific genetic testing carried out on blood lymphocytes showed mosaicism for the same PTEN mutation identified in his daughter. Identifying PTEN mosaicism in the proband's father had significant implications for the risk assessment/genetic testing plan for the rest of his family. His result also provides impetus for somatic mosaicism in a parent to be considered when a de novo PTEN mutation is suspected.
Abrupt evolution of Philadelphia chromosome‐positive acute myeloid leukemia in myelodysplastic syndrome
Authors: Fukunaga Akiko , Sakoda Hiroto , Iwamoto Yoshihiro , Inano Shojiro , Sueki Yuki , Yanagida Soshi , Arima Nobuyoshi
Published: December 2012

Myelodysplastic syndrome (MDS) is a clonal disorder arising from an alteration in multipotent stem cells, which lose the ability of normal proliferation and differentiation. Disease progression occurs in approximately 30% MDS cases. Specific chromosomal alterations seem responsible for each step in the evolution of acute myeloid leukemia (AML). Multiple genetic aberrations occur during the clonal evolution of MDS; however, few studies report the presence of the Philadelphia (Ph) chromosome. We report a rare case of Ph‐positive AML, which evolved during the course of low‐risk MDS. The patient, a 76‐year‐old man with mild leukocytopenia, was diagnosed with MDS, refractory neutropenia (RN). After 1.5 yr, his peripheral blood and bone marrow were suddenly occupied by immature basophils and myeloblasts, indicating the onset of AML. A bone marrow smear showed multilineage dysplasia, consistent with MDS evolution. Chromosomal analysis showed an additional t(9;22)(q34;q11) translocation. Because progression occurred concurrently with emergence of the Ph chromosome, we diagnosed this case as Ph‐positive AML with basophilia arising from the clonal evolution of MDS. The patient was initially treated with nilotinib. A hematological response was soon achieved with disappearance of the Ph chromosome in the bone marrow. Emergence of Ph‐positive AML in the course of low‐risk MDS has rarely been reported. We report this case as a rare clinical course of MDS.
Vacuolar protein sorting mechanisms in plants
Authors: Xiang Li , Etxeberria Ed , Van den Ende Wim
Published: December 2012

Plant vacuoles are unique, multifunctional organelles among eukaryotes. Considerable new insights in plant vacuolar protein sorting have been obtained recently. The basic machinery of protein export from the endoplasmic reticulum to the Golgi and the classical route to the lytic vacuole and the protein storage vacuole shows many similarities to vacuolar/lysosomal sorting in other eukaryotes. However, as a result of its unique functions in plant defence and as a storage compartment, some plant‐specific entities and sorting determinants appear to exist. The alternative post‐Golgi route, as found in animals and yeast, probably exists in plants as well. Likely, adaptor protein complex 3 fulfils a central role in this route. A Golgi‐independent route involving plant‐specific endoplasmic reticulum bodies appears to provide sedentary organisms such as plants with extra flexibility to cope with changing environmental conditions.
Net Recharge vs. Depth to Groundwater Relationship in the Platte River Valley of Nebraska, United States
Authors: Szilagyi Jozsef , Zlotnik Vitaly A. , Jozsa Janos
Published: December 2012

One‐km resolution MODIS‐based mean annual evapotranspiration (ET) estimates in combination with PRISM precipitation rates were correlated with depth to groundwater (d) values in the wide alluvial valley of the Platte River in Nebraska for obtaining a net recharge (Rn) vs. d relationship. MODIS cells with irrigation were excluded, yielding a mixture of predominantly range, pasture, grass, and riparian forest covers on sandy soils with a shallow groundwater table. The transition depth (dt) between negative and positive values of the net groundwater recharge was found to be at about 2 (±1) m. Within 1 (±1) m of the surface and at a depth larger than about 7 to 8 (±1) m, the mean annual net recharge became independent of d at a level of about −4 (±12)% and 13 (±10)%, respectively, of the mean annual precipitation rate. The obtained Rn(d) relationship is based on a calibration‐free ET estimation method and may help in obtaining the net recharge in shallow groundwater areas of negligible surface runoff where sufficient groundwater‐depth data exist.
Basic haemoglobinopathy diagnostics in Dutch laboratories; providing an informative test result
Authors: Kaufmann J. O. , Smit J. W. , Huisman W. , Idema R. N. , Bakker E. , Giordano P. C.
Published: December 2012

Introduction

After a first survey in 2001, the Dutch Association of Hematological Laboratory Research (VHL) advised its members to adopt a basic protocol for haemoglobinopathy carrier detection and to provide genetic information with all positive results to allow health‐care professionals to inform carriers about potential genetic risks. This article reports on the compliance with these recommendations and their consequences.

Methods

Clinical chemists of all 106 Dutch laboratories were invited to answer a survey on patient population, diagnostic techniques used, (self‐reported) knowledge, use and effect of the additional information.

Results

The average increase in diagnostic output was over 60% and the recommended basic protocol was applied by 65% of the laboratories. Over 84% of the laboratories reported to be aware of the additional recommendations and 77% to be using them. Most laboratories with limited diagnostic requests were still sending their cases to other laboratories and included the genetic information received from these laboratories in their diagnostic reports. The effect of information on subsequent ‘family analysis’ was estimated to be between 26 and 50%.

Conclusions

The present study shows an increase in diagnostic potential for haemoglobinopathy over the last decade, especially in the larger cities. Low ‘family testing’ rates were mostly found in areas with lower carrier prevalence or associated with local reluctance to pass the information to carriers. In spite of a dramatic improvement, too many carriers are still not informed because of lack of awareness among health‐care providers and more education is needed.
A novel filtration method for cord blood processing using a polyester fabric filter
Authors: Shima T. , Forraz N. , Sato N. , Yamauchi T. , Iwasaki H. , Takenaka K. , Akashi K. , McGuckin C. , Teshima T.
Published: December 2012

Introduction

Cord blood (CB) is being increasingly used as a source of hematopoietic stem cells for transplantation to treat diseases of the blood and immune systems, and there is an urgent need to expand CB banking worldwide. CB processing requires costly machinery or a clean room that hampers wider application of CBT particularly in the developing countries.

Methods

We developed a novel filtration system using a nonchemical‐coated and nonwoven polyester fabric filter, which traps cells through affinity and does not require centrifugation or potentially toxic chemicals.

Results

Cell processing with the device resulted in minimum cell loss of total cells and CD34+ cells, without impairing the ability of CD34+ cells to engraft and differentiate both in vivo and in vitro.

Conclusion

CB processing with this device is simple, cost‐effective, and nontoxic without requiring costly equipment will thus facilitate international CB banking, which helps in meeting the increasing worldwide demand for CB for allogeneic hematopoietic stem cell transplantation.
Targeting gene expression to the female larval fat body of transgenic Aedes aegypti mosquitoes
Authors: Totten D. C. , Vuong M. , Litvinova O. V. , Jinwal U. K. , Gulia‐Nuss M. , Harrell R. A. , Beneš H.
Published: December 2012

As the fat body is a critical tissue for mosquito development, metamorphosis, immune and reproductive system function, the characterization of regulatory modules targeting gene expression to the female mosquito fat body at distinct life stages is much needed for multiple, varied strategies for controlling vector‐borne diseases such as dengue and malaria. The hexameric storage protein, Hexamerin‐1.2, of the mosquito Aedes atropalpus is female‐specific and uniquely expressed in the fat body of fourth instar larvae and young adults. We have identified in the Hex‐1.2 gene, a short regulatory module that directs female‐, tissue‐, and stage‐specific lacZ reporter gene expression using a heterologous promoter in transgenic lines of the dengue vector Aedes aegypti. Male transgenic larvae and pupae of one line expressed no Escherichia coli β‐galactosidase or transgene product; in two other lines reporter gene activity was highly female‐biased. All transgenic lines expressed the reporter only in the fat body; however, lacZ mRNA levels were no different in males and females at any stage examined, suggesting that the gene regulatory module drives female‐specific expression by post‐transcriptional regulation in the heterologous mosquito. This regulatory element from the Hex‐1.2 gene thus provides a new molecular tool for transgenic mosquito control as well as functional genetic analysis in aedine mosquitoes.
Radionucleide tests for the assessment of intestinal permeability
Authors: BEHRENS R. H. , SZAZ K. F. , NORTHROP C. , ELIA M. , NEALE G.
Published: December 2012

Abstract. 14C labelled‐D‐mannitol and aquo (ethylenediaminetriacetoacetic acid)51 chromium (III) (51Cr EDTA) have been evaluated as markers of intestinal permeability in twenty‐four healthy control subjects, sixteen patients with recently diagnosed coeliac disease and twenty subjects with coeliac disease in remission on a gluten‐free diet. The percentage excretion of 14C mannitol in urine collected for 6 h was significantly less in patients with coeliac disease (mean 6·7%) than controls (mean 13·5%). Conversely the excretion of 51Cr EDTA was significantly greater in patients with coeliac disease (mean 1·23%) compared with controls (mean 0·28%). The mean ratio of the percentage excretion of 51Cr to the percentage excretion of 14C was 0·29 in patients with untreated coeliac disease compared with 0023 for healthy control subjects (P < 0001). Patients with untreated coeliac disease were clearly separated from control subjects by use of the 51Cr EDTA: 14C mannitol ratio but not by the excretion of independent markers.
Altered interaction between triiodothyronine and its nuclear receptors in absence of Cortisol: a proposed mechanism for increased thyrotropin secretion in corticosteroid deficiency states
Authors: DE NAYER PH. , DOZIN B. , VANDEPUT Y. , BOTTAZZO F. C. , CRABBE J.
Published: December 2012

Abstract. Thyroid hormones occasionally appear less effective when administered alone to patients with panhypopituitarism, and manifestations suggestive of hypothyroidism have been reported in patients suffering from untreated Addison's disease. In the latter condition, thyrotropin secretion is increased: this occurs already after as little as 2 days of temporary withdrawal of therapy with substitution doses of corticosteroids while circulating levels of thyroid hormones remain within normal limits. Therefore, a possible role of Cortisol in interaction between triiodothyronine and its nuclear receptors was examined at the level of circulating lymphocytes obtained from patients with primary or secondary adrenocortical failure. The affinity of these receptors was found to be decreased, by more than 50% on average, in the absence of Cortisol treatments. This change was promptly corrected upon resumption of therapy. The number of binding sites was not significantly modified. The influence of Cortisol on thyroid hormone receptors discussed here might account for the clinical observations mentioned above.