bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sociocultural Influences on Men’s Penis Size Perceptions and Decisions to Undergo Penile Augmentation: A Qualitative Study
Authors: Sharp Gemma , Oates Jayson 
Published: May 2019

Abstract

Background
An increasing number of men, dissatisfied with their penises, are seeking cosmetic procedures to enhance their penis size. However, little is known about the social and cultural factors that influence men to consider these procedures.

Objectives
The aim of this study was to investigate the sociocultural factors affecting men’s attitudes toward their penis size as well as their decisions to undergo penile augmentation.

Methods
One-on-one semistructured interviews were conducted with 6 adult men who had previously undergone a penile augmentation. The men were asked about the sociocultural factors that they thought contributed to dissatisfaction with their penis size, and their motivations for having penile augmentation. All interviews were audio recorded and then transcribed verbatim. Interview transcripts were analyzed through the use of thematic analysis.

Results
Three main themes emerged from the interviews, namely “influence of pornography,” “comparison with peers,” and “indirect appearance-related teasing.” The men noted that the large penises of male actors in pornography had skewed their perception of normal penis size. All men had compared their penises with those of their peers, usually in the locker room, and often felt their own penis was smaller as a result. None of the participants had received direct negative comments about their penis size, but were aware that having a small penis was a source of mockery from exposure to jokes on mainstream media sources.

Conclusions
These new insights into the sociocultural factors, namely media and peers, that influence men’s desire for penile augmentation may assist clinicians in enhancing their communication with prospective patients.
Correcting for individual quality reveals trade-offs in performance among multiple modes of limbless locomotion in snakes
Authors: Gerald Gary W , Wass Emma D 
Published: May 2019

AbstractTrade-offs among performance traits are often difficult to detect despite the physiological and morphological incompatibilities that underlie disparate traits being well understood. However, recent studies that have corrected for individual quality have found trade-offs in human athletes performing various performance tasks. Few studies have found trade-offs among multiple performance tasks after correcting for individual quality in non-human animals because of the difficulty in motivating many animals to perform biomechanically different tasks. We examined potential trade-offs in maximal speeds among ten locomotor conditions that involved the utilization of different locomotor modes in cornsnakes (Pantherophis guttatus). Snakes were assessed during terrestrial lateral undulation, swimming, concertina movements (small and large width) and six conditions of arboreal locomotion (combinations of three perch diameters and two inclines). We found no trade-offs among locomotor conditions when analysing uncorrected speeds or speeds corrected for body condition. However, we found several trade-offs among modes and treatments for speeds corrected for individual quality. Terrestrial lateral undulation speeds were negatively related to speeds of concertina and two of the arboreal locomotion conditions. A trade-off between speeds on large and small perch diameters on a 30° incline was also detected and probably reflects potential conflicts in traits that maximize lateral undulation and concertina.
A Method for Controlled Odor Delivery in Olfactory Field-Testing
Authors: Simon Alison G , DeGreeff Lauryn E , Frank Kelvin , Peranich Kimberly , Holness Howard , Furton Kenneth G 
Published: May 2019

Abstract
A widely recognized limitation in mammalian olfactory research is the lack of current methods for measuring odor availability (i.e., the quantifiable amount of odor presented and thus available for olfaction) of training or testing materials during behavioral or operational testing. This research utilized an existing technology known as Controlled Odor Mimic Permeation Systems (COMPS) to produce a reproducible, field-appropriate odor delivery method that can be analytically validated and quantified, akin to laboratory-based research methods, such as permeation devices that deliver a stable concentration of a specific chemical vapor for instrumental testing purposes. COMPS were created for 12 compounds across a range of carbon chain lengths and functional groups in such a way to produce similar permeation rates for all compounds. Using detection canines as a model, field-testing was performed to assess the efficacy of the method. Additionally headspace concentrations over time were measured as confirmation of odor availability using either externally sampled internal standard-solid phase microextraction-gas chromatography-mass spectrometry (ESIS-SPME-GC-MS) or collection onto a programmable temperature vaporizing (PTV) GC inlet with MS detection. Finally, lifetime usage was considered. An efficient method for producing and measuring reliable odor availabilities across various chemical functional groups was developed, addressing a noted gap in existing literature that will advance canine and other nonhuman mammal research testing.
The Limitations of the Rheumatogenic Concept for Group A Streptococcus: Systematic Review and Genetic Analysis
Authors: de Crombrugghe Gabrielle , Baroux Noemie , Botteaux Anne , Moreland Nicole J , Williamson Deborah A , Steer Andrew C , Smeesters Pierre R 
Published: May 2019

Abstract

Background
The concept that a minority of group A streptococcus (GAS) emm types are more “rheumatogenic” than others has been widely disseminated. We aimed to provide a comprehensive list of acute rheumatic fever–associated GAS isolates and assess the presence of associated rheumatogenic motifs.

Methods
Articles reporting GAS emm-type or emm-type–specific antibody responses associated with rheumatic fever were identified from 1 January 1944 to 31 July 2018. The revised Jones criteria were used to define rheumatic fever with a maximum period of 4 weeks between disease onset and microbiological characterization. A database of 175 representative M-protein sequences was used to analyze the protein diversity of rheumatic fever–associated strains in a phylogenetic tree and to identify the presence of 10 previously recognized rheumatogenic motifs.

Results
We included 411 cases of rheumatic fever, for which microbiological characterization identified 73 different emm types associated with the disease. The classic rheumatogenic emm types represented only 12.3% of the 73 emm types and were responsible for 31.6% of the 411 clinical cases. Rheumatic fever–associated emm types were disseminated throughout the phylogeny, suggesting they belong to various genetic backgrounds. Rheumatic fever–associated motifs were present in only 15.1% of the rheumatic fever–associated emm types and only 24.8% of clinical cases.

Conclusions
The concept of rheumatogenicity should be extended to include strains other than those classically described. Our results highlight significant knowledge gaps in the understanding of rheumatic fever pathogenesis and suggest that a GAS vaccine candidate should offer broad coverage against a variety of GAS genetic variants in order to protect against this serious sequela.
Fluoride varnish for the prevention of white spot lesions during orthodontic treatment with fixed appliances: a randomized controlled trial
Authors: Sonesson Mikael , Brechter Anna , Abdulraheem Salem , Lindman Rolf , Twetman Svante 
Published: May 2019

Summary

Background
Self-applied and professional fluorides are key elements to limit caries-related side-effects during orthodontic treatment with fixed appliances.

Objective
To evaluate the effectiveness of a new fluoride varnish formula containing 1.5% ammonium fluoride in preventing white spot lesions (WSLs) in adolescents undergoing multi-bracket orthodontic treatment.

Subjects and methods
The study employed a randomized controlled triple-blinded design with two parallel arms. One hundred eighty-two healthy adolescents (12–18 years) referred to three orthodontic specialist clinics were eligible and consecutively enrolled. Informed consent was obtained from 166 patients and they were randomly allocated to a test or a placebo group (with aid of a computer program, generating sequence numbers in blocks of 15). In the test group, fluoride varnish was applied in a thin layer around the bracket base every sixth week during the orthodontic treatment, while patients in the placebo group received a varnish without fluoride. The intervention started at onset of the fixed appliances and continued until debonding. The endpoint was prevalence and severity of WSLs on the labial surfaces of the maxillary incisors, canines, and premolars as scored from high-resolution pre- and post-treatment digital photos with aid of a four-level score.

Results
One hundred forty-eight patients completed the trial, 75 in the test group and 73 in the placebo group (dropout rate 10.8%). The total prevalence of WSL’s on subject level after debonding was 41.8% in the test group and 43.8% in the placebo group. The number of patients exhibiting more severe lesions (score 3 + 4) was higher in the placebo group (P &lt; 0.05); the absolute risk reduction was 14% and the number needed to treat was 7.1.

Limitations
The multicentre design with somewhat diverging routines at the different clinics may have increased risk for performance bias. No health-economic evaluation was carried out.

Conclusions
Regular applications of an ammonium fluoride varnish reduced the prevalence of advanced WSL during treatment with fixed orthodontic appliances.

Clinical trial registration
ClinicalTrials.gov (NCT03725020).

Protocol
The protocol was not published before trial commencement.
Alert-based computerized decision support for high-risk hospitalized patients with atrial fibrillation not prescribed anticoagulation: a randomized, controlled trial (AF-ALERT)
Authors: Piazza Gregory , Hurwitz Shelley , Galvin Claire E , Harrigan Lindsay , Baklla Sofia , Hohlfelder Benjamin , Carroll Brett , Landman Adam B , Emani Srinivas , Goldhaber Samuel Z 
Published: May 2019

Abstract

Aims
Despite widely available risk stratification tools, safe and effective anticoagulant options, and guideline recommendations, anticoagulation for stroke prevention in atrial fibrillation (AF) is underprescribed. We created and evaluated an alert-based computerized decision support (CDS) strategy to increase anticoagulation prescription in hospitalized AF patients at high risk for stroke.

Methods and results
We enrolled 458 patients (CHA2DS2-VASc score ≥1) with AF who were not prescribed anticoagulant therapy and were hospitalized at Brigham and Women’s Hospital. Patients were randomly allocated, according to Attending Physician of record, to intervention (alert-based CDS) vs. control (no notification). The primary efficacy outcome was the frequency of anticoagulant prescription. The CDS tool assigned 248 patients to the alert group and 210 to the control group. Patients in the alert group were more likely to be prescribed anticoagulation during the hospitalization (25.8% vs. 9.5%, P &lt; 0.0001), at discharge (23.8% vs. 12.9%, P = 0.003), and at 90 days (27.7% vs. 17.1%, P = 0.007). The alert reduced the odds of a composite outcome of death, myocardial infarction (MI), cerebrovascular event, and systemic embolic event at 90 days [11.3% vs. 21.9%, P = 0.002; odds ratio (OR) 0.45; 95% confidence interval (CI) 0.27–0.76]. The alert reduced the odds of MI at 90 days by 87% (1.2% vs. 8.6%, P = 0.0002; OR 0.13; 95% CI 0.04–0.45) and cerebrovascular events or systemic embolism at 90 days by 88% (0% vs. 2.4%, P = 0.02; OR 0.12; 95% CI 0.0–0.91).

Conclusion
An alert-based CDS strategy increased anticoagulation in high-risk hospitalized AF patients and reduced major adverse cardiovascular events, including MI and stroke.

ClinicalTrials.gov Identifier
NCT02339493.
Development and validation of a ceramide- and phospholipid-based cardiovascular risk estimation score for coronary artery disease patients
Authors: Hilvo Mika , Meikle Peter J , Pedersen Eva Ringdal , Tell Grethe S , Dhar Indu , Brenner Hermann , Schöttker Ben , Lääperi Mitja , Kauhanen Dimple , Koistinen Kaisa M , Jylhä Antti , Huynh Kevin , Mellett Natalie A , Tonkin Andrew M , Sullivan David R , Simes John , Nestel Paul , Koenig Wolfgang , Rothenbacher Dietrich , Nygård Ottar , Laaksonen Reijo 
Published: May 2019

Abstract

Aims
Distinct ceramide lipids have been shown to predict the risk for cardiovascular disease (CVD) events, especially cardiovascular death. As phospholipids have also been linked with CVD risk, we investigated whether the combination of ceramides with phosphatidylcholines (PCs) would be synergistic in the prediction of CVD events in patients with atherosclerotic coronary heart disease in three independent cohort studies.

Methods and results
Ceramides and PCs were analysed using liquid chromatography–mass spectrometry (LC-MS) in three studies: WECAC (The Western Norway Coronary Angiography Cohort) (N = 3789), LIPID (Long-Term Intervention with Pravastatin in Ischaemic Disease) trial (N = 5991), and KAROLA (Langzeiterfolge der KARdiOLogischen Anschlussheilbehandlung) (N = 1023). A simple risk score, based on the ceramides and PCs showing the best prognostic features, was developed in the WECAC study and validated in the two other cohorts. This score was highly significant in predicting CVD mortality [multiadjusted hazard ratios (HRs; 95% confidence interval) per standard deviation were 1.44 (1.28–1.63) in WECAC, 1.47 (1.34–1.61) in the LIPID trial, and 1.69 (1.31–2.17) in KAROLA]. In addition, a combination of the risk score with high-sensitivity troponin T increased the HRs to 1.63 (1.44–1.85) and 2.04 (1.57–2.64) in WECAC and KAROLA cohorts, respectively. The C-statistics in WECAC for the risk score combined with sex and age was 0.76 for CVD death. The ceramide-phospholipid risk score showed comparable and synergistic predictive performance with previously published CVD risk models for secondary prevention.

Conclusion
A simple ceramide- and phospholipid-based risk score can efficiently predict residual CVD event risk in patients with coronary artery disease.
Myocardial blood flow reserve assessed by positron emission tomography myocardial perfusion imaging identifies patients with a survival benefit from early revascularization
Authors: Patel Krishna K , Spertus John A , Chan Paul S , Sperry Brett W , Al Badarin Firas , Kennedy Kevin F , Thompson Randall C , Case James A , McGhie A Iain , Bateman Timothy M 
Published: May 2019

Abstract

Aims
Positron emission tomography (PET) myocardial perfusion imaging (MPI) can non-invasively measure myocardial blood flow reserve (MBFR). We aimed to examine whether MBFR identifies patients with a survival benefit after revascularization, helping to guide post-test management.

Methods and results
We examined all-cause mortality in 12 594 consecutive patients undergoing Rb82 rest/stress PET MPI from January 2010 to December 2016, after excluding those with cardiomyopathy, prior coronary artery bypass surgery (CABG), and missing MBFR. Myocardial blood flow reserve was calculated as the ratio of stress to rest absolute myocardial blood flow. A Cox model adjusted for patient and test characteristics, early revascularization (percutaneous coronary intervention or CABG ≤90 days of MPI), and the interaction between MBFR and early revascularization was developed to identify predictors of all-cause mortality. After a median follow-up of 3.2 years, 897 patients (7.1%) underwent early revascularization and 1699 patients (13.5%) died. Ischaemia was present in 4051 (32.3%) patients, with 1413 (11.2%) having ≥10% ischaemia. Mean MBFR was 2.0 ± 1.3, with MBFR &lt;1.8 in 4836 (38.5%). After multivariable adjustment, every 0.1 unit decrease in MBFR was associated with 9% greater hazard of all-cause death (hazard ratio 1.09, 95% confidence interval 1.08–1.10; P &lt; 0.001). There was a significant interaction between MBFR and early revascularization (P &lt; 0.001); such that patients with MBFR ≤1.8 had a survival benefit with early revascularization, regardless of type of revascularization or level of ischaemia.

Conclusion
Myocardial blood flow reserve on PET MPI is associated with all-cause mortality and can identify patients who receive a survival benefit with early revascularization compared to medical therapy. This may be used to guide revascularization, and prospective validation is needed.
Predictivity and Manifestation Factors in Aging Effects on the Orienting of Spatial Attention
Authors: Zivony Alon , Erel Hadas , Levy Daniel A 
Published: May 2019

Abstract

Objective
Prior attention research has asserted that endogenous orienting of spatial attention by willful focusing may be differently influenced by aging than exogenous orienting, the capture of attention by external cues. However, most such studies confound factors of manifestation (locational vs symbolic cues) and the predictivity of cues. We therefore investigated whether age effects on orienting are mediated by those factors.

Method
We measured accuracy and response times of groups of younger and older adults in a discrimination task with flanker distracters, under three spatial cueing conditions: nonpredictive locational cues, predictive symbolic cues, and a hybrid predictive locational condition.

Results
Age differences were found to be related to the factor of cue predictivity, but not to the factor of spatial manifestation. These differences were not modulated by flanker congruency.

Discussion
The results indicate that the orienting of spatial attention in healthy aging may be adversely affected by less effective perception or utilization of the predictive value of cues, but not by the requirement to voluntarily execute a shift of attention.
Neglect of Older People: Touching on Forensic and Pathophysiological Aspects
Authors: Altendorf Annette , Draper Brian , Wijeratne Chanaka , Schreiber Jason , Kanareck Daniella 
Published: May 2019

AbstractBackground and ObjectivesNeglect of older people is common and may result in fatal and nonfatal outcomes. Normal changes of aging and disease-related symptoms may overlap with markers of neglect and lead to under-detection. This review aims to delineate medical, psychiatric, and pathophysiological indicators in the victim—identified in forensic case reports—to point out areas of overlap and raise awareness in Health Care Professionals.Research Design and MethodsMedical and forensic databases were searched with the search terms: neglect, elder, elderly, forensic, homicide for detailed case reports on elder neglect. Cases were reviewed as to victim age, sex, medical/psychiatric diagnosis, perpetrator, victim-to-perpetrator relationship, cause of death (if fatal), location of incident, autopsy findings (if fatal), and ancillary studies. A total of 168 publications were retrieved, of these 11 publications, containing a total of 25 cases, yielded sufficient detail on each case to be included in the qualitative analysis.ResultsNeglect is associated with poor physical, psychological, and mental health. Neglect can be a direct cause of death or contribute to a fatal outcome by exacerbating existing conditions. Red flags of neglect included malnutrition, dehydration, poor hygiene, untreated decubitus ulcers, hypothermia, contractures, and an uncooperative caregiver. However, incontrovertible evidence of neglect is not always easy to obtain due to age and disease-related changes.Discussion and ImplicationsThe findings document the extent and seriousness of elder neglect and highlight the importance of detailed documentation as well as collaboration between clinicians, allied health professionals, law enforcement and medical forensic services to improve patient outcomes and reduce the risk of further incidents.
Culture-centeredness in community-based participatory research: contributions to health education intervention research
Authors: Wallerstein Nina , Oetzel John G , Duran Bonnie , Magarati Maya , Pearson Cynthia , Belone Lorenda , Davis Joyce , DeWindt Lori , Kastelic Sarah , Lucero Julie , Ruddock Charmaine , Sutter Erika , Dutta Mohan J 
Published: May 2019

Abstract
Health education research emphasizes the importance of cultural understanding and fit to achieve meaningful psycho-social research outcomes, community responsiveness and external validity to enhance health equity. However, many interventions address cultural fit through cultural competence and sensitivity approaches that are often superficial. The purpose of this study was to better situate culture within health education by operationalizing and testing new measures of the deeply grounded culture-centered approach (CCA) within the context of community-based participatory research (CBPR). A nation-wide mixed method sample of 200 CBPR partnerships included a survey questionnaire and in-depth case studies. The questionnaire enabled the development of a CCA scale using concepts of community voice/agency, reflexivity and structural transformation. Higher-order confirmatory factor analysis demonstrated factorial validity of the scale. Correlations supported convergent validity with positive associations between the CCA and partnership processes and capacity and health outcomes. Qualitative data from two CBPR case studies provided complementary socio-cultural historic background and cultural knowledge, grounding health education interventions and research design in specific contexts and communities. The CCA scale and case study analysis demonstrate key tools that community–academic research partnerships can use to assess deeper levels of culture centeredness for health education research.
Asexual parasites and their extraordinary host ranges
Authors: Gibson Amanda K 
Published: May 2019

AbstractIn diverse parasite taxa, from scale insects to root-knot nematodes, asexual lineages have exceptionally large host ranges, larger than those of their sexual relatives. Phylogenetic comparative studies of parasite taxa indicate that increases in host range and geographic range increase the probability of establishment of asexual lineages. At first pass, this convergence of traits appears counter-intuitive: intimate, antagonistic association with an enormous range of host taxa correlates with asexual reproduction, which should limit genetic variation within populations. Why would narrow host ranges favor sexual parasites and large host ranges favor asexual parasites? To take on this problem I link theory on ecological specialization to the two predominant hypotheses for the evolution of sex. I argue that both hypotheses predict a positive association between host range and the probability of invasion of asexual parasites, mediated either by variation in population size or in the strength of antagonistic coevolution. I also review hypotheses on colonization and the evolution of niche breadth in asexual lineages. I emphasize parasite taxa, with their diversity of reproductive modes and ecological strategies, as valuable assets in the hunt for solutions to the classic problems of the evolution of sex and geographic parthenogenesis.