bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of varicocele on sperm function and semen oxidative stress
Authors: Blumer Camile Garcia , Restelli Adriana Ester , Giudice Paula Toni Del , Soler Thiesa Butterby , Fraietta Renato , Nichi Marcilio , Bertolla Ricardo Pimenta , Cedenho Agnaldo Pereira
Published: May 2011

Study Type – Aetiology (case control)

Level of Evidence 3b

What’s known on the subject? and What does the study add?

Varicocele leads to alterations in sperm DNA integrity even when alterations in semen quality are not yet observed in adolescents. In adults, alterations to sperm DNA are associated to altered sperm morphology, indicating that altered spermatogenesis may be an important cause for the increased sperm DNA fragmentation observed in these men. One other important cause of increased DNA fragmentation is oxidative stress, and we wished to verify if this was the case.

The study adds the information that, in the adult varicocele, it is most likely that an altered testicular environment is leading to increased DNA fragmentation and decreased mitochondrial activity and acrosome integrity, because no increase in oxidative stress was observed.

OBJECTIVE

• To assess the effect of varicocele on sperm DNA integrity, mitochondrial activity, lipid peroxidation and acrosome integrity.

PATIENTS AND METHODS

• In all, 30 patients with a clinically diagnosed varicocele of grade II or III and 32 men without a varicocele were evaluated for sperm DNA fragmentation (comet assay), mitochondrial activity (3,3′‐diaminobenzidine assay), lipid peroxidation (malondialdehyde) and acrosome integrity (fluorescent probe labelled peanut agglutinin).

RESULTS

• The varicocele group showed fewer spermatozoa with intact DNA (grade II,P= 0.040), more cells with inactive mitochondria (class III,P= 0.001), fewer cells with active mitochondria (class I,P= 0.005) and fewer spermatozoa with intact acrosomes (P< 0.001). Finally, no significant differences were observed in lipid peroxidation levels.

CONCLUSION

• Men with varicocele showed an increase in sperm DNA fragmentation and a reduction in mitochondrial activity and acrosome integrity. However, lipid peroxidation levels remained unchanged.
Near‐infrared tissue oximetry and digital image analysis: quantification of renal ischaemia in real time during partial nephrectomy
Authors: Caire Arthur A. , Alvarez Xavier , Conley Sarah , Sartor Alton , Lee Benjamin R.
Published: May 2011

What’s known on the subject? and What does the study add?

There is little known on how to objectively measure renal ischemia during partial nephrectomy. This study clemonstrates two potentially useful methods to measure renal ischemia during partial nephrectomy.

OBJECTIVE

• To determine the feasibility of using near‐infrared tissue oximetry (TO) and digital image analysis for assessing renal function and to quantify local renal ischaemia in a porcine model.

MATERIALS AND METHODS

• Tissue oximetry was performed and red/blue (R/B) colour ratios were determined on renal units of Yorkshire swine.

• Interval measurements were taken before clamping the renal hilum, during warm ischaemia, and after unclamping using a ViOptix T.OxTM Tissue Oximeter and Matlab® digital image analysis.

• Matlab software analysed images from the laparoscopic camera and determined an R/B ratio to track renal ischaemia.

• The tissue oximeter used direct infrared light and was placed adjacent to the kidney parenchymal surface.

• The data were divided into preclamp, clamp and post‐clamp, and compared between methodologies.

RESULTS

• The R/B ratio showed a higher rate of change compared with TO during clamp time in both the 15‐min experiment (R/B = 96.0 vs. TO = 52.1 unit/reference) and the 30‐min experiment (R/B = 97.6 vs. TO = 45.9).

• The R/B ratio showed a higher rate of change compared with TO at 1 min after clamping in the 15‐min experiment (R/B = 80.1 vs. TO = 12.4).

• Both detection devices showed similar changes in pre‐ and post‐clamp measurements in the 15‐ min experiment (R/B = 1.6 vs. TO = 3.8) and the 30‐min experiment (R/B = 4.7 vs. TO =−4.5).

• In the 30‐min experiment the R/B ratio showed a significant difference between preclamp, clamp, and post‐clamp states (P= 0.026).

CONCLUSIONS

• Both TO and digital image analysis were able to calculate an ischaemic drop in tissue oxygen saturation during periods of acute renal ischaemia.

• The findings suggest that the R/B ratio observed during histogram analysis shows a greater sensitivity compared with TO in quantifying renal ischaemia.
Occupational exposure to HIV: a conflict situation for health workers
Authors: Kumakech E. , Achora S. , Berggren V. , Bajunirwe F.
Published: May 2011

KUMAKECH E., ACHORA S., BERGGREN V. & BAJUNIRWE F. (2011) Occupational exposure to HIV: a conflict situation for health workers. International Nursing Review58, 454–462

Aim:  To determine the frequency of occupational exposure to human immunodeficiency virus (HIV), the circumstances and predisposing factors, the high‐risk groups, the extent to which exposures are reported and the post‐exposure prophylaxis (PEP) utilized by health‐care workers (HCWs) and students in a Ugandan hospital.

Background:  Occupational exposure to HIV is a low but potential risk of HIV infection to health workers.

Method:  Self‐administered questionnaire was given to 224 participants (including 98 HCWs and 126 students) in Mbarara Hospital, Uganda. Data were analysed with descriptive statistics using the Statistical Package for the Social Sciences version 15.0 (SPSS Inc, Chicago, IL, USA).

Findings:  Of the 224 participants surveyed, 19.2% reported having sustained injection needle stick injuries in the previous year, of which 4.46% occurred with HIV‐infected blood. Other reported injuries were cannula needle stick injury (0.89%), suture needle stick injuries (3.13%), scalpel cut injuries (0.45%) and muco‐cutaneous contamination (10.27%). The most affected groups were nurses–midwives for scalpel injuries and students for stick injuries. The predisposing factors reported included lack of protective devices and recapping of needles. Exposures were under‐reported. Uptake of PEP was also low.

Conclusion:  Occupational exposure to HIV presents a conflict situation for HCWs. It remains a frequent occurrence particularly among student nurses–midwives, despite being avoidable. Its prophylactic treatment is hampered by poor reporting and investigation of exposures, and poor access to PEP. Strict adherence to universal precaution and proper handling of occupational exposure to HIV should be encouraged.
The nursing profession in Saudi Arabia: an overview
Authors: Almalki M. , FitzGerald G. , Clark M.
Published: May 2011

ALMALKI M., FITZGERALD G. & CLARK M. (2011) The nursing profession in Saudi Arabia: an overview. International Nursing Review58, 304–311

Aim:  The study aims to provide an overview of the nursing profession in Saudi Arabia, including its history, educational development, workforce and professional practice.

Background:  Saudi Arabia is faced with a chronic shortage of Saudi nurses, accompanied by high rates of turnover. Expatriate nurses form a large proportion of the nursing workforce in Saudi healthcare facilities, with Saudis comprising only 29.1% of the total nursing workforce. Despite the fact that the proportion of Saudi nurses is very low in general, this rate is lower in the private health sector where local nurses comprise only 4.1% of the total.

Methods:  Data relating to the nursing profession in Saudi Arabia were extracted from published literature identified through search of a range of publically available databases such as Medline, CINAHL, Google Scholar, Saudi health databases, Saudi health journals, government reports and relevant texts. Obtained information was evaluated for relevance and grouped on a thematic basis.

Conclusion:  The status of nursing in Saudi Arabia should be enhanced in order to make it a worthwhile career. The media should engage in helping to promote a positive image of the nursing profession. The education sector should reconsider the length of nursing training (5 years compared with 3 years in many developed countries) while maintaining competent and safe practice. Reducing the financial burden on the nursing student through provision of additional financial support would encourage more students. In particular, nurses should be paid a full salary during the intern year as currently occurs with medical students.
Deliberate self‐harm and psychological problems in young adolescents: Evidence of a bidirectional relationship in girls
Authors: LUNDH LARS‐GUNNAR , WÅNGBY‐LUNDH MARGIT , BJÄREHED JONAS
Published: May 2011

Lundh, L. G., Wångby‐Lundh, M. & Bjärehed, J. (2011). Deliberate self‐harm and psychological problems in young adolescents: Evidence of a bidirectional relationship in girls. Scandinavian Journal of Psychology 52, 476–483.

The purpose of this study was to test the hypotheses that there is a bidirectional prospective relationship between mental health and deliberate self‐harm, in the sense that (1) psychological problems are a risk factor for the development of self‐harm; (2) self‐harm is a risk factor for the development of psychological problems; and (3) the relative absence of psychological problems is a protective factor against the continued use of self‐harm in adolescents who have started to harm themselves. This was studied in a community sample of 879 young adolescents by means of a 2‐wave longitudinal design with a one‐year interval, with self‐harm measured by a nine‐item version of the Deliberate Self‐Harm Inventory (DSHI‐9r) and psychological problems by the self‐report version of the Strengths and Difficulties Questionnaire (SDQ). The hypothesis of bidirectional relationship between psychological problems and self‐harm was supported among girls, but not among boys – although there was evidence of psychological problems as a risk factor of self‐harm in boys, the converse was not the case. The relative absence of psychological problems was found to be a protective factor against self‐harm only among boys, but not among girls. The results are discussed in terms of self‐harm having a different role in the development of psychopathology among girls than among boys.
Emotional difficulties in seventh grade children in Denmark
Authors: REINHOLDT‐DUNNE M. L. , ESBJØRN B. H. , HØYER M. , DAHL S. , BOESEN A. J. , HANSEN S. G. , LETH I.
Published: May 2011

Reinholdt‐Dunne, M. L., Esbjørn, B. H., Høyer, M., Dahl, S., Boesen, A. J., Hansen, S. G. & Leth, I. (2011). Emotional difficulties in seventh grade children in Denmark. Scandinavian Journal of Psychology 52, 433–439.

The present study investigates the prevalence of emotional difficulties and quality of life in a sample of 834 children from 56 seventh grade (aged 12–14 years) classes. Data was derived from a study of mental well‐being developed by the National Council for Children, Denmark. The sample selection ensured that the children were nationally representative. Data was collected using the Strength and Difficulties Questionnaire (SDQ) and the Health Behaviour in School‐aged Children (HBSC). Results indicated that 10.8% of children had concerns regarding emotional difficulties (6.6% definite concern; 4.2% some concern), and that significantly more girls than boys (44 girls and 10 boys) reported this concern. A novel finding was that emotional difficulties were related to children’s perception of having low quality of life. Findings furthermore suggested that children’s perception of a low home economy, less time spent on leisure activities, and female gender were all associated with emotional difficulties.
Self‐directed and interpersonal male violence in adolescence and young adulthood: a 30‐year follow up of a Stockholm cohort
Authors: Rojas Yerko
Published: May 2011

In line with Wilkinson’s theory on inequality and health, this study simultaneously analyses self‐directed and interpersonal violence among men in a Stockholm birth cohort born in 1953 with respect to their early life experiences of stress, their lack of social connectedness and their relative deprivation. Multinomial logistic regressions with cluster‐robust variance estimates were used. Self‐directed violence was found to be related to self‐rated loneliness and non‐membership of voluntary associations but not to a lack of friendship in school at the age of 12–13, while the opposite was shown to be true for interpersonal violence. Growing up in a family that received means‐tested social assistance at least once during the period 1953–1965 was taken as an objective indicator of relative deprivation and proved to be correlated with both self‐directed and interpersonal violence. Disadvantaged social comparison at the age of 12–13, taken as a subjective indicator of relative deprivation, was only statistically related to a subsequent risk of interpersonal violence. It is suggested that different types of social connectedness and relative deprivation, respectively, explain these different patterns of violence. Furthermore, the study speculates on the possibility of frequent social comparison itself being a factor to consider when trying understanding violence in general.
On the Integrability of the Poisson Driven Stochastic Nonlinear Schrödinger Equations
Authors: Villarroel Javier , Montero Miquel
Published: May 2011

We consider the Cauchy problem for the dissipative nonlinear Schrödinger equations driven by a Poisson noise, namely

image

where γn > 0 and 0 < t1 < ⋯ < tn < ⋯ are certain sequences of random numbers and  is the deterministic loss coefficient. This perturbation incorporates the possibility of sudden changes in the field that occur randomly. If Γ= 0, we prove that the resulting equation can be piece‐wise related to the unperturbed NLS equation and show how to solve the initial value problem. We also determine a complete set of conserved quantities. When Γ≠ 0 the equation is nonintegrable. Nevertheless, we determine the random evolution of physically relevant quantities like the field’s Energy E(t) ≡∫dx|u|2(t, x) and momentum. By considering a joint z‐Laplace transform we obtain the mean Energy decay. A naturally related quantity is the “half‐life”, or the time before the Energy degrades below a given value E1. We show that the mean of this random quantity satisfies an integral equation and solve it by Laplace transformation. In particular cases we also determine the complete probability distribution of Energy and half life.
LETTING REALITY BECOME REAL: On Mystery and Reality in Dietrich Bonhoeffer's Ethics
Authors: Nissen Ulrik Becker
Published: May 2011

In Dietrich Bonhoeffer's Ethics the notion of reality plays a central role. The present article focuses on the ethical implications of the Chalcedonian Christology underlying this concept. This approach is tied to the debate on the relationship between the universal and specific identity of Christian social ethics in public discourse. In the opening section the article outlines the pertinence of this debate with regard to Bonhoeffer's Christological ethic. In the following section the article analyzes Bonhoeffer's concept of reality and the implied Chalcedonian traits. With this foundation established the article raises the question about its social ethical implications. The final part of the article argues that Bonhoeffer's ethics and ecclesiology cannot be separated from each other, explaining why Bonhoeffer's notion of reality leads to an assertion of the church's role in letting reality become real. In the light of Bonhoeffer's notion of reality the last section argues for the reconciliation of Christian witness and participation in public discourse.
Reviewing evidence‐based practice for pupils with dyslexia and literacy difficulties
Authors: Griffiths Yvonne , Stuart Morag
Published: May 2011

There is now a strong evidence base from theory and research providing a ‘template’ to inform practice at Wave 2, guiding the design and implementation of time‐limited effective early intervention programmes for pupils identified as ‘at risk’ of reading difficulties following initial literacy instruction (Rose, 2009). In contrast, there is currently an absence of evidence to guide the more fine‐grained selection and design of specific interventions (Wave 3) for those nonresponders to otherwise effective reading intervention. In this paper, we first outline our current understanding of the characteristics of effective early intervention programmes, and of the pupils who do not respond. Three theoretically motivated single‐case studies from developmental theory and processing models of skilled performance are then considered as a source of evidence providing useful insights into the type of assessment needed to inform the planning of highly individualised intervention programmes for pupils with severe and persisting literacy difficulties.
Association of haplotype combination of serotonin transporter gene polymorphisms with monthly headache days in MOH patients
Authors: Terrazzino S. , Tassorelli C. , Sances G. , Allena M. , Viana M. , Monaco F. , Bellomo G. , Nappi G. , Canonico P. L. , Genazzani A. A.
Published: May 2011

Objectives:  To evaluate the role of 5‐HTTLPR, STin2 VNTR, and rs1042173T>G polymorphisms of the serotonin transporter gene (SLC6A4) as susceptibility factors for medication overuse headache (MOH) and to assess their value as predictors of the number of headache days per month, a potential marker of disease severity.

Methods:  Genotyping was performed by PCR and PCR‐RFLP on genomic DNA extracted from peripheral blood of 227 MOH patients and 312 control subjects. Logistic regression analysis was used to evaluate the association between the SL6A4 gene polymorphisms and MOH risk. The association between polymorphic variants and monthly headache days was evaluated by linear regression analysis.

Results:  Logistic regression analysis, adjusted for age and gender, revealed a nominal association between rs1042173T>G and MOH risk (TT vs. TG + GG, OR: 1.58 95% CI: 1.05–2.37, P = 0.028). In the linear regression analysis adjusted for age, gender, primary headache diagnosis, acute drug overused and monthly drug number, STin2 VNTR was found nominally associated with monthly headache days (12/12 vs. others, difference: 1.55 days, 95% CI: 0.01–3.08, P = 0.050). When STin2 VNTR and rs1042173T>G were analyzed in haplotypic combination, a global haplotype association emerged with monthly headache days which remained significant after Bonferroni correction for multiple comparisons (global haplotype association P = 0.0056).

Conclusion:  Although a minor contribution of SLC6A4 variants in the genetic liability of MOH cannot be excluded, haplotype‐based analysis of STin2 VNTR and rs1042173T>G polymorphisms allowed to identify a subgroup of MOH patients with a higher number of monthly headache and, possibly, with a more severe disease.
Reminiscences, Patriotism, Participation: Approaching External Voting in Ecuadorian Immigration to Italy
Authors: Boccagni Paolo
Published: May 2011

The paper explores the meanings and effects of external voting in the context of a recent migration flow ‐‐ of Ecuadorian migrants to Italy ‐‐ approached through an original fieldwork investigation. During the first long‐distance voting experience of Ecuadorian immigrants, in October 2006, an exploratory survey was conducted in the cities hosting polls in Italy. This provided an opportunity for an inquiry into the motivations and expectations underlying emigrants’ electoral participation, with a focus on their patterns of inclusion overseas and their transnational ties. While Ecuador has been appealing to emigrants as a non‐territorial “Fifth Region” with unbroken loyalties and citizenship rights, expatriates’ involvement was largely dictated by patriotism, homesickness and the desire to reproduce their social milieu abroad, rather than by a primary concern with political life in the motherland. A more nuanced understanding of emigrant transnational participation is hence advanced, appealing to categories such as visibility, recognition and communal identification, and with an emphasis on the processes reproducing and negotiating “Ecuadorianness” from overseas. The paper ends with some critical remarks on the scope for migrant political transnationalism, and on the agendas and expectations underpinning it.
Diversity in Transnationalism: Surinamese Organizational Networks
Authors: Mügge Liza M.
Published: May 2011

This study of Surinamese organizational networks in the Netherlands examines how ethnic and religious diversity among migrants from the same “homeland” influences their transnational involvement on the collective ‐‐ that is, associational ‐‐ level. Taken together, ethnic and religious diversity were found to generate lowly institutionalized transnational activities that are narrow in scope and fleeting in duration. Diversity within the migrant group thus discourages practices that address the Surinamese state or society as a whole, while transnationalism geared at the ancestral homeland rarely goes beyond the symbolic level. By having the entire migrant organizational network in the country of residence as its sample, this article reveals not only which organizations are transnationally active, but also which ones are not. It thus avoids “sampling on the dependent variable” ‐‐ a key criticism of transnational migration scholarship.
Capital Structure: New Evidence from the Ownership Structure*
Authors: PINDADO JULIO , DE LA TORRE CHABELA
Published: May 2011

This paper provides theory and empirical evidence supporting a complementary perspective on capital structure based on corporate ownership structure. According to our ownership view, capital structure is partly determined by the incentives and the goals of those who are in control of the firm. Our results strongly support this view. As a consequence of managerial entrenchment and rent expropriation phenomena, self‐interested agents (entrenched managers and controlling owners) chose the capital structure most appropriate for their own best interest. Additionally, we find evidence of an interaction effect between managerial ownership and ownership concentration, in particular, the larger debt increments promoted by outside owners when managers are entrenched.
Is the Negative Relation Between Leverage and Historical Market‐To‐Book Specific to US and Information and Communication Technology Firms?*
Authors: BRUINSHOOFD W. ALLARD , DE HAAN LEO
Published: May 2011

This paper examines the relationship between corporate capital structures and historical market‐to‐book ratios using panel data for US, UK, and continental European firms for the period 1991–2001. We confirm the negative effect on leverage found for the United States, but find that this effect is weak for the United Kingdom and continental Europe and moreover specific to information and communication technology (ICT) firms and the ICT boom episode in continental Europe.
The Degree of Judicial Enforcement and Credit Markets: Evidence from Japanese Household Panel Data*
Authors: HORIOKA CHARLES YUJI , SEKITA SHIZUKA
Published: May 2011

The length of trials in Japan has become shorter over time. Theory predicts that better judicial enforcement (i.e., faster court proceedings) will decrease the probability of being credit rationed, increase loan size, and increase the probability of bankruptcy. Our estimation results based on micro data from a panel survey of consumers in conjunction with judicial data by court district show that better judicial enforcement increases the probability of being rationed in some cases and decreases loan size (contrary to expectation) but increases the probability of bankruptcy (as expected). Thus, better judicial enforcement facilitates the recovery of loans but may be socially harmful.
Eligibility for statutory learning disability services in the north‐west of England. Right or luxury? Findings from a pilot study
Authors: McInnis Erica E , Hills Alan , Chapman Melanie J
Published: May 2011

Accessible summary

 There are often rules about who can use learning disability services.

 We used a questionnaire to ask clinical psychologists in the north‐west of England about the rules where they work. We also asked them what psychologists do when it comes to deciding about who can use learning disability services.

 We found out that different places had some things in common in how they defined learning disabilities and how they decided who used services. However, there were also differences between different places.

 Differences between different areas can make it difficult for people with learning disabilities if they move.

Access to learning disability services in England is often governed by eligibility criteria. A semistructured questionnaire was completed by clinical psychologists in the north‐west of England about service eligibility criteria and psychologists’ role within the referral process to learning disability services. The survey highlighted both variations and similarities across the region in terms of definitions of learning disabilities, eligibility for accessing local services and the psychometric measures used to assess functioning. Differences in how services assess eligibility can lead to difficulties, for example when people move area. The use of standard eligibility criteria could be one means of overcoming this.
The effect of two types of mould inoculants on the microbiological composition, physicochemical properties and protein hydrolysis in two Gorgonzola‐type cheese varieties during ripening
Authors: SERATLIĆ SANJA V , MILORADOVIĆ ZORANA N , RADULOVIĆ ZORICA T , MAĆEJ OGNJEN D
Published: May 2011

The aim of this paper was to investigate the role of two types of Penicillium roqueforti moulds (type esportazione and dolce) in the ripening of two Gorgonzola‐type cheese varieties. Cheeses were analysed after 4, 14, 30 and 60 days of ripening. Microbiological analysis showed high numbers of total bacterial count, yeasts and moulds in both 60‐day‐old cheese varieties. The concentration of water‐soluble N, nonprotein N and 5% phosphotungstic acid‐soluble N increased significantly during ripening. Patterns of proteolysis by urea‐polyacrylamide gel electrophoresis showed that rind‐to‐core gradients and age‐related changes in moisture and salt content influenced mould and other enzyme activities, which are reflected in various rates of protein degradation. The hydrolysis of αs1‐ and β‐caseins was more extensive in the core than under the rind of both cheese varieties.
Lithuanian nurses’ assessments of their empowerment
Authors: Istomina Natalja , Suominen Tarja , Razbadauskas Artūras , Martinkenas Arvydas , Kuokkanen Liisa , Leino‐Kilpi Helena
Published: May 2011

Scand J Caring Sci; 2012; 26; 3–11
 
Lithuanian nurses’ assessments of their empowerment

Aims and objectives:  The aim was to explore nurse empowerment and the factors associated with it from the viewpoint of surgical nurses.

Design:  A multicentre cross‐sectional, descriptive, correlational study design was used.

Setting and participants:  The data were collected from 11 units of seven largest Lithuanian hospitals located in three major cities during the period of 11/2007 to 01/2008. All the nurses (N = 270) working in the abdominal perioperative settings were invited to participate in the study; 247 questionnaires were returned giving the response rate of 91 %. The data were analyzed on the basis of 218 responses. The statistical analysis was performed by SPSS (12.0 version).

Instruments:  Two instruments, both originally developed in Finland and adapted to the Lithuanian cultural context, were used: Nurse Empowerment Scale (NES) and Good Nursing Care Scale for Nurses (GNCS‐N).

Results:  Surgical nurses evaluated their work empowerment positively. Several background factors were associated with nurse empowerment, such as nurse education, type of nurse license (working area), the continuing nurse education (completed courses during last 5 years), the workload at hospital, the work independence, and work satisfaction. The connection between nurse empowerment and quality of nursing care was also identified (r = 0.139–0.525, p < 0.01).

Conclusions:  Surgical nurses feel empowered at their work when they have higher education and have completed the continuing education courses. Nurses should have possibility to continue their studies at the university. Independent at work, satisfied, and motivated nurses have more power at their work in the surgical units in Lithuania. However, further research is needed to explore nurse empowerment in other fields of nursing care nationally and internationally.
A pain in her arm: Romantic attachment orientations and the tourniquet task
Authors: WILSON CAROL L. , RUBEN MOLLIE A.
Published: May 2011

Prior research has linked attachment anxiety to heightened perceptions of chronic pain. However, few studies have examined attachment and acute pain, and none of these to our knowledge have included partner attachment effects in a dyadic context. Sixty‐five healthy undergraduate women were exposed to an ischemic pain task in the presence of their romantic partners. As expected, women's higher attachment anxiety predicted lower pain thresholds, greater subjective pain, and greater catastrophizing. Higher avoidance was associated with longer pain tolerances and, unexpectedly, lower physiological arousal. More avoidant and more anxious women responded negatively to pain when accompanied by a high‐anxiety romantic partner. Implications exist for attachment insecurity and hyperactivating emotion regulation strategies as vulnerability factors in coping with pain.
Pegylated interferon plus ribavirin therapy improves pancreatic β‐cell function in chronic hepatitis C patients
Authors: Huang Jee‐Fu , Dai Chia‐Yen , Yu Ming‐Lung , Huang Chung‐Feng , Huang Ching‐I , Yeh Ming‐Lun , Yang Jeng‐Fu , Hou Nei‐Jen , Hsiao Pi‐Jung , Lin Zu‐Yau , Chen Shinn‐Chern , Shin Shyi‐Jang , Chuang Wan‐Long
Published: May 2011

Background/Aims:Pretreatment insulin resistance (IR) is associated with treatment response to peginterferon plus ribavirin (PegIFN/RBV) combination therapy in chronic hepatitis C (CHC) infection. However, the impact of PegIFN/RBV therapy on both IR and β‐cell function in CHC patients has rarely been investigated.

Methods:A total of 277 non‐diabetic patients treated with PegIFN‐α and weight‐based RBV, with 80/80/80 adherence, were recruited. Their IR and β‐cell function by homeostasis model assessment model (HOMA‐IR and HOMA‐%B) before treatment and at 24 week after treatment [end of follow‐up (EOF)] was measured.

Results:A sustained virological response (SVR) was achieved by 79.4% (220/277) of all patients: 63.6% (75/118) of genotype‐1 and 91.2% (145/159) of genotype‐non‐1 patients. There was no significant change of HOMA‐IR post‐therapy (2.25 ± 2.46 vs 2.04 ± 2.12,P=0.42). By contrast, there was a significant reduction of HOMA‐%B of all patients at EOF (122.9 ± 145.2 vs 92.4 ± 73.2,P=0.001), particularly in those responders (119.1 ± 142.1 vs 89.6 ± 70.3,P=0.002). In 80 patients with high baseline HOMA‐IR, both HOMA‐IR and HOMA‐%B decreased significantly at EOF, irrespective of SVR achievement.

Conclusion:This study demonstrated pancreatic β‐cell function was ameliorated by PegIFN/RBV therapy in CHC patients, particularly in those responders.
Racial Identity, School Racial Climate, and School Intrinsic Motivation Among African American Youth: The Importance of Person–Context Congruence
Authors: Byrd Christy M. , Chavous Tabbye
Published: May 2011

Researchers have been concerned with whether strong racial identification promotes or inhibits achievement motivation among African American youth, but current literatures have paid little attention to the role of youths' contexts. In this study, we outline a racial identity–context congruence framework that predicts positive benefits of a strong, positive racial identity when the context is congruent with youths' beliefs. To test this framework, we examined school racial climate as a moderator in the relationships of three racial identity variables (centrality, private regard, and public regard) with intrinsic motivation for attending school in a sample of 11th graders. Overall, results support the congruence perspective and also demonstrate how feelings of belonging at school mediate the relationship between racial identity–racial climate congruence and school intrinsic motivation.
Iatrogenic Coronary Dissection Causing Flush Side Branch Occlusion: Use of Intravascular Ultrasound to Reopen Vessel
Authors: WILLIAMS PAUL D. , HADI HAIDAR , FRASER DOUGLAS G.
Published: May 2011

Iatrogenic complications present a major challenge to the interventional cardiologist. We describe a case of extensive right coronary artery dissection caused by engagement of a 0.035″ guidewire. Attempts to reopen the flush‐occluded posterior descending artery using conventional methods were unsuccessful. However, the vessel was successfully restored with the use of intravascular ultrasound guidance and we describe the steps involved in this technique. (J Interven Cardiol 2012;25:170–173)
Frames of Influence: U.S. Environmental Rulemaking Case Studies
Authors: Rinfret Sara R
Published: May 2011

The purpose of this article was to question whether interest group actions during the pre‐proposal stage of U.S. federal rulemaking influences the language proposed in natural resource agency rules. The influence of interest groups during this stage was examined across three case studies: (1) the United States Fish and Wildlife Service (USFWS) critical habitat designation for Nebraska's Salt Creek tiger beetle, (2) the USFWS critical habitat designation for the Utah/Arizona Shivwits and Holmgren milk vetch, and (3) the USFWS delisting of the Northern Rocky Mountain gray wolf population from the endangered species list. To analyze these three cases, a frame analysis approach is used and offers evidence to support the proposition that the instructive, expertise, and fiscal feasibility frames that stakeholders used during the pre‐proposal stage can shape the language of a Notice of Proposed Rulemaking. These cases suggest the rich potential for careful study of the earliest stages in the regulatory and administrative rulemaking process in the United States and beyond.
Characterization of a new acne vulgaris treatment device combining light and thermal treatment methods
Authors: Joo Yeail , Kang Heesung , Choi Eung Ho , Nelson J. Stuart , Jung Byungjo
Published: May 2011

Background/purpose: Conventional treatment methods for acne vulgaris have various side effects such as the development of bacterial resistance, phototoxicity, vertigo, gastro‐intestinal problems, and drug eruptions. To minimize such side effects, light and thermal methods have been alternately suggested. This study characterized a new acne vulgaris treatment device (AVTD) that combines both light and thermal methods and evaluated its clinical efficacy.

Methods: We characterized the thermal and light properties of the AVTD itself and evaluated its thermal characteristics in ex vivo porcine skin samples. The Arrhenius equation was used to calculate the skin thermal injury coefficient to confirm the skin safety of the AVTD. Finally, the clinical efficacy of the AVDT was evaluated by analyzing cross‐polarization and erythema index images, which were obtained from 13 volunteers undergoing treatment with the AVTD.

Results: The temperature of the AVTD itself was maintained at 49.1 °C on the tip and 39.7 °C in the porcine skin samples. The peak intensity of the light‐emitting diode (LED) light was observed at 468 nm. The skin safety of the AVTD was confirmed and 84.2% of the volunteers presented positive treatment results.

Conclusion: The treatment of acne using the AVTD resulted in a high treatment rate in a clinical study, minimizing side effects. On the basis of these results, we can be sure that the AVTD may be effectively used for the treatment of acne vulgaris.
Molecular structures and functional relationships in clostridial neurotoxins
Authors: Swaminathan Subramanyam
Published: May 2011

The seven serotypes of Clostridium botulinum neurotoxins (A–G) are the deadliest poison known to humans. They share significant sequence homology and hence possess similar structure–function relationships. Botulinum neurotoxins (BoNT) act via a four‐step mechanism, viz., binding and internalization to neuronal cells, translocation of the catalytic domain into the cytosol and finally cleavage of one of the three soluble N‐ethylmaleimide‐sensitive factor attachment protein receptors (SNARE) causing blockage of neurotransmitter release leading to flaccid paralysis. Crystal structures of three holotoxins, BoNT/A, B and E, are available to date. Although the individual domains are remarkably similar, their domain organization is different. These structures have helped in correlating the structural and functional domains. This has led to the determination of structures of individual domains and combinations of them. Crystal structures of catalytic domains of all serotypes and several binding domains are now available. The catalytic domains are zinc endopeptidases and share significant sequence and structural homology. The active site architecture and the catalytic mechanism are similar although the binding mode of individual substrates may be different, dictating substrate specificity and peptide cleavage selectivity. Crystal structures of catalytic domains with substrate peptides provide clues to specificity and selectivity unique to BoNTs. Crystal structures of the receptor domain in complex with ganglioside or the protein receptor have provided information about the binding of botulinum neurotoxin to the neuronal cell. An overview of the structure–function relationship correlating the 3D structures with biochemical and biophysical data and how they can be used for structure‐based drug discovery is presented here.
Procedural sedation practices in Australian Emergency Departments
Authors: Bell Anthony , Taylor David McD , Holdgate Anna , MacBean Catherine , Huynh Truc , Thom Ogilvie , Augello Michael , Millar Robert , Day Robert , Williams Aled , Ritchie Peter , Pasco John
Published: May 2011

Objective: The aim of the present study was to describe procedural sedation practices undertaken in a spectrum of Australian EDs.

Methods: Eleven Australian EDs enrolled consecutive adult and paediatric patients between January 2006 and December 2008. Patients were included if a sedative drug was administered for an ED procedure. Data collection was prospective and used a specifically designed data collection document.

Results: 2623 patients were enrolled. 1581 were male (60.3%, 95% CI 58.4–62.2) and the mean patient age was 39.2 (SD 25.2) years. Reductions of fracture/dislocated shoulders (694 cases, 26.7%), wrist/forearm fractures (403, 15.5%) and tibia/fibula fractures (341, 13.1%) were the most common procedures. Procedures were supervised by consultants and registrars in 1424 (54.3%) and 1025 (39.1%) cases, respectively. Of 2413 patients with complete fasting status data, 1252 (51.9%, 95% CI 49.9–53.9) patients had consumed food or fluid in the previous 6 h. 1399 (53.3%, 95% CI 51.4–55.3) patients received pre‐procedural medication. Pre‐procedural morphine (894, 34.1%) exceeded fentanyl use (323, 12.3%), both as a sole agent and in combination with another agent. The principal sedatives used alone were propofol (857, 38.5%), midazolam (224, 10%) and ketamine (165, 7.4%). Ketamine and nitrous oxide were most commonly used in children with propofol, midazolam and opiates largely restricted to adults (P < 0.001). The intra‐procedural use of adjunct fentanyl exceeded that of morphine (ratio 4:1).

Conclusions: Procedural sedation practice across Australian EDs is varies considerably. Procedural sedation ‘best practice’ guidelines, based upon the findings of the present study and the available evidence, are recommended.
Factors associated with failure to successfully complete a procedure during emergency department sedation
Authors: Holdgate Anna , Taylor David McD , Bell Anthony , MacBean Catherine , Huynh Truc , Thom Ogilvie , Augello Michael , Millar Robert , Day Robert , Williams Aled , Ritchie Peter , Pasco John
Published: May 2011

Objective: To determine factors associated with failure to successfully complete a procedure during sedation in the ED.

Methods: Eleven Australian EDs enrolled consecutive adult and paediatric patients between January 2006 and December 2008. Patients were included if a sedative drug was administered for an ED procedure and the success or failure of the procedure was recorded.

Results: Data were available for 2567 patients. Of these, 1548 (60.3%, 95% CI 58.4–62.2) were male and 456 (17.8%, 95% CI 16.3–19.3) were age <16 years. The most common procedures performed were reduction of major joints and laceration repair. A total of 149 procedures (5.8%, 95% CI 5.0–6.8) failed. There were significant differences in failure rates between the types of procedure undertaken, with reduction of hips, digits and mandibles associated with the highest failure rates (P < 0.001). In adults, body weight >100 kg was also associated with increased risk of procedural failure (odds ratio 2.3, 95% CI 1.3–4.1). Ketamine used as a single agent had the lowest procedural failure rate (2.5%, 95% CI 1.1–5.4) whereas propofol had the highest (5.9%, 95% CI 4.6–7.6). However, these two drugs were generally used in different age groups and for different procedures.

Conclusions: Procedures performed under sedation in the ED have a low failure rate. However, increased body weight and specific procedures, such as hip reduction, are associated with significantly higher failure rates. Special consideration should be given to these patient groups before undertaking sedation in the ED.
Moderate Alcohol Intake, Genital Vascularization, and Sexuality in Young, Healthy, Eumenorrheic Women. A Pilot Study
Authors: Battaglia Cesare , Battaglia Bruno , Mancini Fulvia , Nappi Rossella E. , Paradisi Roberto , Venturoli Stefano
Published: May 2011

Introduction

The relationship between alcohol and sexual function is complex and not completely understood.

Aim

To evaluate (in the early follicular phase and independently from sexual stimulation) in young, eumenorrheic, healthy, lean women the genital vascular effects of the light and moderate use of alcohol.

Methods

Eighty-four women undertook, in the early follicular phase of the menstrual cycle (days 3–5), the administration of the two-factor Italian McCoy Female Sexuality (MFSQ) and the Beck Depression Inventory (BDI) questionnaires; ultrasonographic measurement of the carotid intima-media thickness (IMT); and color Doppler evaluation of the carotid, clitoral, and labia minora arteries. Hormonal (estradiol, androstenedione, and testosterone) and biochemical (lipids, glucose, and insulin) parameters were tested.

Main Outcome Measures

The MFSQ and BDI questionnaires; the carotid IMT; the Pulsatility Index of internal carotid, clitoral, and labia minora arteries; blood pressure measurement; and hormonal and biochemical assays.

Results

The subjects were divided in: nondrinkers (group I); current (>1 year) light drinkers—1–10 drinks/month (group II); and current moderate drinkers—11–20 drinks/month (group III). The majority of the studied parameters did not vary among the different groups. The mean BDI was normal in the studied women. However, the lowest values were observed in the moderate drinkers group. The MFSQ did not show any difference among all the studied women. However, the number of intercourses/week and the incidence of vaginal orgasm were significantly higher in group III (moderate drinkers). The relationship between the drinking habits and different parameters showed an inverse relationship with the BDI. Furthermore, the BDI inversely correlated with orgasm frequency and with orgasm intensity.

Conclusions

Chronic slight/moderate alcohol consumption has no effects on genital vessels and vaginal lubrication. However, a moderate consumption of alcohol, through psychological and social disinhibiting effects, may favor sexual activities.
No (Wo)Man Is an Island—The Influence of Physicians' Personal Predisposition to Labia Minora Appearance on Their Clinical Decision Making: A Cross-Sectional Survey
Authors: Reitsma Welmoed , Mourits Marian J.E. , Koning Merel , Pascal Astrid , van der Lei Berend
Published: May 2011

Introduction

Physicians are increasingly presented with women requesting a labia minora reduction procedure.

Aim

To assess the influencing factor of personal predisposition in general practitioners, gynecologists, and plastic surgeons to labia minora appearance in relation to their willingness to refer for, or perform, a surgical labia minora reduction.

Methods

Cross-sectional self-administered questionnaire survey. Between May 2009 and August 2009, 210 physicians were surveyed. Primary care: general practitioners working in the north of the Netherlands. Secondary care: gynecologists and plastic surgeons working in five hospitals in the north of the Netherlands.

Main Outcome Measures

A five-point Likert scale appraisal of four pictures showing a vulva, each displaying different sizes of labia minora, indicating a physician's personal predisposition, manifesting as willingness to refer for, or perform, a labia minora reduction.

Results

A total of 164/210 (78.1%) physicians completed the questionnaire, consisting of 80 general practitioners, 41 gynecologists, and 43 plastic surgeons (96 males, 68 females). Ninety percent of all physicians believe, to a certain extent, that a vulva with very small labia minora represents society's ideal (2–5 on the Likert scale). More plastic surgeons regarded the picture with the largest labia minora as distasteful and unnatural, compared with general practitioners and gynecologists (P < 0.01), and regarded such a woman as a candidate for a labia minora reduction procedure (P < 0.001). Irrespective of the woman's labia minora size and the absence of physical complaints, plastic surgeons were significantly more open to performing a labia minora reduction procedure than gynecologists (P < 0.001). Male physicians were more inclined to opt for a surgical reduction procedure than their female colleagues (P < 0.01).

Conclusions

The personal predisposition of physicians (taking account of their specific gender and specialty) concerning labia minora size and appearance influences their clinical decision making regarding a labia minora reduction procedure. Heightened awareness of one's personal predisposition vis-à-vis referral and willingness to operate is needed.
Access to assisted reproductive technology for cancer patients in Australia
Authors: MCCONNELL Ryan , STANKIEWICZ Marcin , KOCZWARA Bogda
Published: May 2011

Aim:  To evaluate patterns of care and equity of access to assisted reproductive technology (ART) for cancer patients in Australia

Methods:  A review of state and national legislation and Medicare numbers relevant to ART and phone interviews with representative fertility facilities in each State and Territory.

Results:  There appears to be little legal restriction to ART for cancer patients although in some states, clinical practice is in fact contrary to legislation. The cost of ART is influenced by Medicare rebates and the overall cost of fertility treatments as set out by the specific fertility unit. There is no rebate for embryo and sperm storage. Costs of receiving an ART intervention vary greatly. Out‐of‐pocket costs ranged from nil to approximately $3000 per year for an in vitro fertilization or intracytoplasmic sperm injection cycle, from nil to $700 for embryo storage and from nil to $1500 for embryo transfer. All but two of the fertility clinics felt that the numbers of oncology patients accessing ART were low. The most common barrier to access identified by the fertility clinics interviewed was time restriction in a setting where there is a time pressure for a patient to commence anti‐cancer treatment.

Conclusion:  Legislation is unlikely to be a barrier to the use of ART by cancer patients. The main reasons for limited access to ART may be cost or other factors including time pressure, the lack of a partner and age. Further research in this area is warranted.