bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management of Antipsychotic-Related Sexual Dysfunction: Systematic Review
Authors: Allen Kirsty , Baban Alan , Munjiza Jasna , Pappa Sofia 
Published: October 2019

Abstract

Introduction
Sexual dysfunction is one of the most frequently occurring side-effects of antipsychotic medication, impacting both quality of life and adherence to treatment. Despite this, limited evidence-based guidance on treatment options is available.

Aim
To synthesize and analyze the evidence on management of antipsychotic-related sexual dysfunction, specifically taking note of the more recently developed antipsychotics that have been incorporated in studies over the past decade.

Methods
EMBASE, Medline, and PsychINFO databases were searched using search terms related to sexual or erectile dysfunction, treatments, and antipsychotics. 2 reviewers independently assessed papers for the inclusion criteria for randomized controlled trials (RCTs) of treatments for antipsychotic-related sexual dysfunction, including adjunctive medications and a switch of antipsychotic. Studies were excluded if participants did not have recorded sexual dysfunction at baseline.

Main Outcome Measure
The primary outcome measure was any change in sexual function.

Results
6 RCTs were identified, all of which investigated different interventions; hence, it was not possible to synthesize the data quantitatively. Results were overall limited by small sample size, brief treatment duration, and the potential for bias. 2 studies, one assessing adjunctive sildenafil and the other adjunctive aripiprazole, reported a reduction in antipsychotic-related sexual dysfunction.

Clinical Implications
Due to the lack of high-quality data, no clinical recommendations can be made.

Strengths & Limitations
A comprehensive search strategy was used with an extensive number of relevant search terms including “erectile dysfunction” and newer antipsychotics such as aripiprazole. In light of evidence that prolactin is not a reliable marker for sexual dysfunction, this review focused its inclusion criteria on participants presenting with sexual dysfunction rather than with hyperprolactinemia, which should give its recommendations more validity. However, only 6 RCTs were identified, and results were overall limited by small sample size, brief treatment duration, and the potential for bias.

Conclusion
Our findings highlight the paucity of high-quality research in this area, and conjecture that it may be difficult to recruit participants with antipsychotic-related sexual dysfunction. Future research may be necessary to unlock and address these difficulties. Furthermore, fully powered future studies should focus on the management of sexual dysfunction rather than the surrogate marker of hyperprolactinemia.
The competency-based medical education evolution of Canadian emergency medicine specialist training
Authors: Sherbino Jonathan , Bandiera Glen , Doyle Ken , Frank Jason R. , Holroyd Brian R. , Jones Gord , Norum Joanne , Snider Carolyn , Magee Kirk 
Published: October 2019

ABSTRACTCanadian specialist emergency medicine (EM) residency training is undergoing the most significant transformation in its history. This article describes the rationale, process, and redesign of EM competency-based medical education. The rationale for this evolution in residency education includes 1) improved public trust by increasing transparency of the quality and rigour of residency education, 2) improved fiscal accountability to government and institutions regarding specialist EM training, 3) improved assessment systems to replace poor functioning end-of-rotation assessment reports and overemphasis on high-stakes, end-of-training examinations, and 4) and tailored learning for residents to address individualized needs. A working group with geographic and stakeholder representation convened over a 2-year period. A consensus process for decision-making was used. Four key design features of the new residency education design include 1) specialty EM-specific outcomes to be achieved in residency; 2) designation of four progressive stages of training, linked to required learning experiences and entrustable professional activities to be achieved at each stage; 3) tailored learning that provides residency programs and learner flexibility to adapt to local resources and learner needs; and 4) programmatic assessment that emphasizes systematic, longitudinal assessments from multiple sources, and sampling sentinel abilities. Required future study includes a program evaluation of this complex education intervention to ensure that intended outcomes are achieved and unintended outcomes are identified.
Hegel and Aristotle on Ethical Life: Duty-Bound Happiness and Determined Freedom
Authors: Stein Sebastian 
Published: October 2019

AbstractHegel's account of ethical life can be shown to contradict Aristotle's in two main ways: first, Hegel follows Kant in emancipating virtue/duty from the particularity associated with the content of motivational drives and with Aristotle's eudaimonia. Hegel thus rejects Aristotelian happiness as the final end of rational action and prioritizes duty. However, against Kant, Hegel unites (1) abstract duty and (2) determined drives within a speculative notion of ethical duty: rational agents find happiness in heeding duty's call. Second, Hegel follows Kant in emancipating agency's subjective dimension from the all-encompassing determinacy of Aristotelian substance metaphysics. At the same time and against Kant, Hegel unifies agency's undetermined, subjective dimension with the determinacy of objective norms and habitual praxis: ethical praxis must be animated by undetermined subjectivity whilst being determined. In both cases, Hegel goes beyond Aristotle by resting his argument on the speculative structure of ‘the concept of the will’.
A Dyadic Perspective on Sexual Subjectivity and Romantic Relationship Functioning
Authors: Kohlberger Brittany , Simon Valerie A. , Rivera Zenaida 
Published: October 2019

AbstractSexual subjectivity is a central feature of healthy sexuality that is believed to shape and be shaped by relationship experiences. However, no studies have examined sexual subjectivity within a dyadic context. The current study examined partner similarity in sexual subjectivity within 75 heterosexual couples and associations with sexual relationship functioning using actor-partner interdependence models. Within couples, partners’ scores were significantly correlated on three of five elements of sexual subjectivity and showed similar mean levels on four of the five elements. Men's and women's sexual self-efficacy were positively associated with their own sexual communication. Other associations varied by gender. Men's sexual body esteem and entitlement to self-pleasure predicted their reports of sexual relationship functioning, and women's entitlement to pleasure from partners and sexual reflection predicted their reports of relationship functioning. Few partner effects were observed. Findings suggest that partners’ sexual subjectivity is relevant for dyadic functioning in emerging adulthood. Longitudinal research is needed to examine how experiences within and across relationships contribute to the development of sexual self-concepts and sexual functioning.
Geographical value spaces and gender norms in post-Maidan Ukraine: the failed ratification of the Istanbul Convention
Authors: Ketelaars Elise 
Published: October 2019

AbstractWith RRW populist actors’ discovery of gender norms as a useful foreign policy tool, narratives constructed in terms of geographical value spaces have become central to the struggle for women's rights. Through a detailed examination of international and domestic actors’ engagement with the failed ratification process of the Istanbul Convention in Ukraine, this article aims to enhance understanding of the appropriateness of the use of these geographical value spaces when describing the struggle to combat GBV in Ukraine, and how connecting gender justice issues to geographically restricted value spaces impacts this fight. It finds that in practice neither the EU – despite Russia's allegations to the contrary – nor domestic political elites in favour of closer cooperation with Europe have provided meaningful support to the ratification of the Istanbul Convention. Faced with this situation, some Ukrainian feminists have increasingly sought to present the struggle to combat gender-based violence in a locally acceptable vernacular. This article, however, concludes that framing the struggle for women's rights in any type of geographical terms – be they of an international or domestic nature – increases the risk of either instrumentalisation of or selective engagement with the feminist agenda.
Optimization of sperm freezability in Bactrian camel using various dilution rates and equilibration times
Authors: Vahedi Vahid , Mostafaei Mohsen , Vaseghi Dodaran Hossein , Hedayat Evrigh Nemat 
Published: October 2019

SummaryThe effect of different dilution rates and equilibration times on the cryopreservation of Bactrian camel spermatozoa was evaluated in the current study. Semen samples from four healthy adult males were collected, processed and pooled. They were then subjected to a completely randomized 4×2 factorial design including four dilution rates (DR; 1:1, 1:2, 1:4 or 1:8; v:v with SHOTOR diluent) and two equilibration times (ET; 1 or 2 h at 5ºC). After freezing and thawing, sperm kinematic parameters as well as viability, plasma membrane integrity, abnormality and seminal malondialdehyde level were assessed. According to the results, four-fold diluted samples recorded significantly higher values (P < 0.05) for sperm total (39.58 vs 31.83 and 33.33,%) and progressive motility (19.50 vs 14.00 and 14.25,%), viability (55.37 vs 43.50 and 48.75,%) and plasma membrane integrity (46.75 vs 37.25 and 37.37,%) than those of both less (1:1) and high (1:8) concentrated samples, respectively. By contrast, the percentage of abnormal spermatozoa and the concentration of seminal malondialdehyde were comparable among all treated groups. Moreover, ET revealed that 1 h equilibration had significantly higher sperm motility (37.04 vs 33.33%), linearity (42.29 vs 32.26%), beat cross-frequency (13.15 vs 8.70 Hz), plasma membrane integrity (42.25 vs 39.75%) and viability (51.37 vs 48.12%) compared with 2 h of ET (P < 0.05). Taken together, a four-fold dilution along with 1 h equilibration can be an optimal procedure to cryopreserve Bactrian camel sperm.
Trends and presentation patterns of acute rheumatic fever hospitalisations in the United States
Authors: Bradley-Hewitt Tyler , Longenecker Chris T. , Nkomo Vuyisile , Osborne Whitney , Sable Craig , Scheel Amy , Zühlke Liesl , Watkins David , Beaton Andrea 
Published: October 2019

AbstractObjective:Rheumatic fever, an immune sequela of untreated streptococcal infections, is an important contributor to global cardiovascular disease. The goal of this study was to describe trends, characteristics, and cost burden of children discharged from hospitals with a diagnosis of RF from 2000 to 2012 within the United States.Methods:Using the Kids’ Inpatient Database, we examined characteristics of children discharged from hospitals with the diagnosis of rheumatic fever over time including: overall hospitalisation rates, age, gender, race/ethnicity, regional differences, payer type, length of stay, and charges.Results:The estimated national cumulative incidence of rheumatic fever in the United States between 2000 and 2012 was 0.61 cases per 100,000 children. The median age was 10 years, with hospitalisations significantly more common among children aged 6–11 years. Rheumatic fever hospitalisations among Asian/Pacific Islanders were significantly over-represented. The proportion of rheumatic fever hospitalisations was greater in the Northeast and less in the South, although the highest number of rheumatic fever admissions occurred in the South. Expected payer type was more likely to be private insurance, and the median total hospital charges (adjusted for inflation to 2012 dollars) were $16,000 (interquartile range: $8900–31,200). Median length of stay was 3 days, and the case fatality ratio for RF in the United States was 0.4%.Conclusions:Rheumatic fever persists in the United States with an overall downwards trend between 2003 and 2012. Rheumatic fever admissions varied considerably based on age group, region, and origin.
I think, therefore I forget – using experimental simulation of dementia to understand functional cognitive disorders
Authors: McWhirter Laura , Sargent Brendan , Ritchie Craig , Stone Jon , Carson Alan 
Published: October 2019

AbstractBackground.Symptoms of functional neurological disorder have traditionally been thought to depend, in part, on patients’ ideas about symptoms rather than on the rules of pathophysiology. The possibility that functional cognitive symptoms might similarly reflect ideas of dementia has not been explored. We aimed to assess beliefs, through performance, about symptoms of dementia in healthy non-medical adults with the intention of identifying potential markers of functional cognitive disorders.Methods.Healthy volunteers were asked to simulate symptoms of mild dementia during testing with the Montreal Cognitive Assessment (MoCA), coin-in-hand forced-choice test, short digit span trials, Luria 3-step test and interlocking finger test. Family history of dementia was recorded.Results.In 50 participants aged 18–27, simulating dementia, mean MoCA score was 16 (SD 5.5, range 5–26). Delayed recall was the most frequently failed item (100%) and cube drawing least frequently failed (42%). Twenty-six percent failed forward three-digit span and 36% failed reverse two-digit span. On the coin-in-hand test, 32% scored at or below chance level. Inconsistent response patterns were common.Conclusions.Cognitively healthy young adults simulating mild dementia perform similarly to older adults with mild dementia, demonstrating beliefs that dementia is associated with significant global impairment, including attention, motor function, and letter vigilance, but preservation of cube drawing. Inconsistent response patterns were common. Contrary to expectation, family history of dementia did not influence performance. Two and three digit span showed particular promise as a bedside test for simulation. Further investigation will establish whether similar patterns of results are produced in individuals with functional cognitive symptoms.
Climate impact from diet in relation to background and sociodemographic characteristics in the Västerbotten Intervention Programme
Authors: Strid Anna , Hallström Elinor , Hjorth Therese , Johansson Ingegerd , Lindahl Bernt , Sonesson Ulf , Winkvist Anna , Huseinovic Ena 
Published: October 2019

AbstractObjective:The objective of this study was to examine climate impact from diet across background and sociodemographic characteristics in a population-based cohort in northern Sweden.Design:A cross-sectional study within the Västerbotten Intervention Programme. Dietary data from a 64-item food frequency questionnaire collected during 1996–2016 were used. Energy-adjusted greenhouse gas emissions (GHGE) for all participants, expressed as kg carbon dioxide equivalents/day and 4184 kJ (1000 kcal), were estimated using data from life cycle analyses. Differences in background and sociodemographic characteristics were examined between participants with low and high GHGE from diet, respectively. The variables evaluated were age, BMI, physical activity, marital status, level of education, smoking, and residence.Setting:Västerbotten county in northern Sweden.Participants:In total, 46 893 women and 45 766 men aged 29–65 years.Results:Differences in GHGE from diet were found across the majority of examined variables. The strongest associations were found between GHGE from diet and age, BMI, education, and residence (all P < 0·001), with the highest GHGE from diet found among women and men who were younger, had a higher BMI, higher educational level, and lived in urban areas.Conclusions:This study is one of the first to examine climate impact from diet across background and sociodemographic characteristics. The results show that climate impact from diet is associated with age, BMI, residence and educational level amongst men and women in Västerbotten, Sweden. These results define potential target populations where public health interventions addressing a move towards more climate-friendly food choices and reduced climate impact from diet could be most effective.
Adherence to the Dietary Approaches to Stop Hypertension (DASH) diet is associated with lower presence of non-alcoholic fatty liver disease in middle-aged and elderly adults
Authors: Xiao Mian-Li , Lin Jie-Sheng , Li Yi-Hong , Liu Meng , Deng Yun-Yang , Wang Chang-Yi , Chen Yu-Ming 
Published: October 2019

AbstractObjective:Previous studies have shown that the Dietary Approaches to Stop Hypertension (DASH) diet might contribute to managing risk factors of non-alcoholic fatty liver disease (NAFLD), but evidence is limited. We examined the association of DASH diet score (DASH-DS) with NAFLD, as well as the intermediary effects of serum retinol-binding protein-4 (RBP4), serum high-sensitivity C-reactive protein (hs-CRP), serum TAG, homeostasis model assessment of insulin resistance (HOMA-IR) and BMI.Design:We performed a cross-sectional analysis of a population-based cohort study. Dietary data and lifestyle factors were assessed by face-to-face interviews and the DASH-DS was then calculated. We assessed serum RBP4, hs-CRP and TAG and calculated HOMA-IR. The presence and degree of NAFLD were determined by abdominal sonography.Setting:Guangzhou, China.Participants:Guangzhou Nutrition and Health Study participants, aged 40–75 years at baseline (n3051).Results:After adjusting for potential covariates, we found an inverse association between DASH-DS and the presence of NAFLD (Ptrend= 0·009). The OR (95 % CI) of NAFLD for quintiles 2–5 were 0·78 (0·62, 0·98), 0·74 (0·59, 0·94), 0·69 (0·55, 0·86) and 0·77 (0·61, 0·97), respectively. Path analyses indicated that a higher DASH-DS was associated with lower serum RBP4, hs-CRP, TAG, HOMA-IR and BMI, which were positively associated with the degree of NAFLD.Conclusions:Adherence to the DASH diet was independently associated with a marked lower prevalence of NAFLD in Chinese adults, especially in women and those without abdominal obesity, and might be mediated by reducing RBP4, hs-CRP, TAG, HOMA-IR and BMI.
Dietary patterns and metabolic phenotypes in Brazilian adults: a population-based cross-sectional study
Authors: Pereira Dayana LM , Juvanhol Leidjaira L , Silva Danielle CG , Longo Giana Z 
Published: October 2019

AbstractObjective:Dietary patterns have been pointed out as useful diet quality indicators, but evidence about their relationship to metabolic phenotypes is still scarce. Thus, the present study aimed to verify the relationship between dietary patterns and metabolic phenotypes in Brazilian adults.Design:Cross-sectional study. A food consumption frequency questionnaire assessed food consumption profiles. Metabolic phenotypes were defined based on the criteria of the National Health and Nutrition Examination Survey: overweight or normal weight and metabolically healthy (MHOW and MHNW) or unhealthy (MUOW and MUNW). Dietary patterns were established through exploratory factor analysis and principal component analysis. The associations were tested using multinomial logistic regression.Setting:Viçosa, Minas Gerais, Brazil.Participants:Individuals (n 896) aged 20–59 years of both sexes, selected using probabilistic sampling.Results:Three dietary patterns were identified: Unhealthy pattern (alcoholic beverages, oils and fats, condiments, soda and juice, sugars and sweets, snacks, and meat and derivatives), Traditional pattern (culinary preparations, beans, milk and dairy products, and coffee and tea) and Healthy pattern (vegetables and fruits, whole grains, chicken and fish, and skimmed milk). Unhealthy pattern was positively associated with the MHOW and MUOW phenotypes in the fourth quartile (OR = 1·84; 95 % CI 1·06, 3·22) and in the third (OR = 1·94; 95 % CI 1·11, 3·39) and fourth (OR = 2·56; 95 % CI 1·41, 4·64) quartiles of consumption, respectively. Healthy pattern was also associated with these phenotypes.Conclusions:Both the pattern comprising energy-dense foods and the healthier pattern were associated with overweight phenotypes among Brazilian adults.
What makes one respond to acupuncture for insomnia? Perspectives of cancer survivors
Authors: Romero Sally A.D. , Jiang Eileen , Bussell Jason , Eriksen Whitney , Duhamel Katherine N. , Barg Frances K. , Mao Jun J. 
Published: October 2019

AbstractObjectiveLike any therapy, acupuncture is effective for some patients, while not helpful for others. Understanding from a patients' perspective what makes one respond or not to acupuncture can help guide further intervention development. This study aimed to identify factors that influence the perception of acupuncture's therapeutic effect among cancer survivors with insomnia.MethodWe conducted post-treatment semi-structured interviews with cancer survivors who were randomized to the acupuncture group in a clinical trial for the treatment of insomnia. Survivors were categorized into Responders and Non-Responders to acupuncture treatment based on the change in the Insomnia Severity Index with a reduction of eight points or greater as the cut-off for the response. An integrated approach to data analysis was utilized by merging an a priori set of codes derived from the key ideas and a set of codes that emerged from the data through a grounded theory approach. Codes were examined for themes and patterns.ResultsAmong 28 cancer survivors interviewed, 18 (64%) were classified as Responders. Participants perceived the ability to respond to acupuncture as dependent on treatment that effectively: (1) alleviated co-morbidities contributing to insomnia, (2) supported sleep hygiene practices, and (3) provided a durable therapeutic effect. Acupuncture treatment that did not address one of these themes often detracted from positive treatment outcomes and diminished perceived benefit from acupuncture.Significance of resultsWe identified patient-perceived contributors to response to acupuncture, such as co-morbid medical conditions, adequate support for sleep hygiene practices, and temporary therapeutic relief. Addressing these factors may improve the overall effectiveness of acupuncture for insomnia.