bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comorbidities Among Women with Vulvovaginal Complaints in Family Practice
Authors: Leusink Peter , Kaptheijns Anne , Laan Ellen , van Boven Kees , Lagro-Janssen Antoine 
Published: January 2016

ABSTRACT

Background
The lifetime prevalence of women suffering from provoked vestibulodynia (PVD) is estimated to be approximately 15%. The etiology of PVD is not yet clear. Recent studies approach PVD as a chronic multifactorial sexual pain disorder. PVD is associated with pain syndromes, genital infections, and mental disorders, which are common diseases in family practice. PVD, however, is not included in the International Classification of Primary Care. Hence, the vulvovaginal symptoms, which could be suggestive of PVD, are likely to be missed.

Aim
To explore the relationship between specific vulvovaginal symptoms that could be suggestive of PVD (genital pain, painful intercourse, other symptoms/complaints related to the vagina/vulva), and related diseases such as pain syndromes, psychological symptom diagnoses, and genital infections in family practice.

Methods
A retrospective analysis of all episodes from 1995 to 2008 in 784 women between 15 and 49 years were used to determine the posterior probability of a selected diagnosis in the presence of specific vulvovaginal symptoms suggestive of PVD expressed in an odds ratio. Selected comorbidities were pain syndromes (muscle pain, general weakness, irritable bowel syndrome [IBS]), psychological symptom diagnoses (anxiety, depression, insomnia), vulvovaginal candidiasis, and sexual and physical abuse.

Results
Women with symptoms suggestive of PVD were 4 to 7 times more likely to be diagnosed with vulvovaginal candidiasis and 2 to 4 times more likely to be diagnosed with IBS. Some symptoms suggestive of PVD were 1 to 3 times more likely to be diagnosed with complaints of muscle pain, general weakness, insomnia, depressive disorder, and feeling anxious.

Conclusion
Data from daily family practice showed a clear relationship between symptoms suggestive of PVD and the diagnoses of vulvovaginal candidiasis and IBS in premenopausal women. Possibly, family doctors make a diagnosis of vulvovaginal candidiasis or IBS based only on clinical manifestations in many women in whom a diagnosis of PVD would be more appropriate.
Sexual Activity, Psychosexual Distress, and Fear of Progression in Women with Human Papillomavirus-Related Premalignant Genital Lesions
Authors: Nagele Eva , Reich Olaf , Greimel Elfriede , Dorfer Martha , Haas Josef , Trutnovsky Gerda 
Published: January 2016

ABSTRACT

Introduction
Genital human papillomavirus (HPV) infections are very common in women 18 to 30 years old and substantially affect women's sexual health.

Aim
To examine sexual activity, psychosexual distress, and fear of progression in women diagnosed with HPV-related precancerous genital lesions.

Methods
In this observational study, women diagnosed with premalignant lesions of the cervix, vagina, or vulva were recruited from a university hospital–based colposcopy clinic.

Main Outcome Measures
Quantitative data from three validated patient-administered questionnaires (Sexual Activity Questionnaire, German version of the Cervical Dysplasia Distress Questionnaire, and Fear of Progression Questionnaire) were compared within the study population, according to the location of the genital lesion, and with relevant reference populations. Qualitative data from two written open-ended questions about women's thoughts regarding diagnosis and information were analyzed.

Results
Two-hundred nine women completed the questionnaires. Seventy-eight percent of women (n = 162) were referred for evaluation of suspect lesions of the cervix, 8% (n = 17) of the vagina, and 14% (n = 30) of the vulva. There were no significant differences in questionnaire results among the three patient groups, except for sexual consequences (Cervical Dysplasia Distress Questionnaire) and recent sexual activity (Sexual Activity Questionnaire). Women with vulvar lesions were most likely to worry about sexual consequences (ie, being unable to have children, being sexually less attractive, or infecting a sexual partner; P = .04). The Sexual Activity Questionnaire subscales sexual pleasure (P = .15) and sexual habits (P = 1.00) were similar to those in a healthy control population, whereas sexual discomfort (P = .51) was comparable to that in a reference population of women who survived cervical cancer. The subscale partner-specific concerns (Fear of Progression Questionnaire) was similar to that in a reference population of patients with cancer (P = .28).

Conclusion
HPV-related precancerous genital lesions, especially of the vulva, are likely to cause concerns about sexual health. Effective information and communication are important to lessen negative sexual consequences and anxiety.
Swallowing Training Combined With Game‐Based Biofeedback in Poststroke Dysphagia
Authors: Li Chih‐Ming , Wang Tyng‐Guey , Lee Hsiao‐Yu , Wang Hsueh‐Pei , Hsieh Shang‐Heng , Chou Michelle , Jason Chen Jia‐Jin 
Published: January 2016

AbstractBackgroundFor patients with dysphagia due to stroke, in addition to compensatory strategies, exercises are used to help improve motor function. Biofeedback is used in neuromuscular training and is promising for swallowing training.ObjectiveTo evaluate the functional value of game‐based biofeedback in swallowing therapy for patients with poststroke dysphagia.DesignA case‐control study.SettingAcademic tertiary hospital.ParticipantsSubjects with poststroke dysphagia (n = 20) were individually matched to 2 separate groups, a game‐based biofeedback group (n = 10) or a control group (n = 10), for age, gender, duration of dysphagia, and dysphagia grades.InterventionsEach participant underwent 1‐hour sessions 3 times per week for a total of 16 treatment sessions. Each session included a 30‐minute session of traditional swallow treatment and a 30‐minute session of laryngeal elevation exercises. In the experimental group, laryngeal elevation exercises were combined with additional game‐based biofeedback.Main Outcome MeasuresOutcomes assessed before and after interventions included hyoid bone displacement, Functional Oral Intake Scale (FOIS) scores, and nasogastric (NG) tube removal rate.ResultsIntergroup analyses showed larger differences in hyoid bone displacement and FOIS scores (before and after treatment) in the experimental group than in the control group, with statistical significance (P = .007 and P = .014, respectively). Intergroup analyses showed that the hyoid bone displacement change and FOIS scores before and after treatment exhibited statistically significant improvement only in the experimental group (P = .002 and P = .004, respectively). In all, 8 of 10 patients (80%) in the experimental group and 2 of 10 patients (20%) in the control group discontinued NG tube insertion after therapy. Participation in the experimental group was associated with an increased probability of tube removal (odds ratio = 6.00; 95% confidence interval = 1.08‐33.27, P = .009).ConclusionsLaryngeal elevation training combined with game‐based biofeedback augments the change in hyoid bone displacement and FOIS scores, and increases the NG tube removal rate in patients with poststroke dysphagia.
THE FIRST WORD: TO BE HUMAN IS TO BE FREE
Authors: Tutu Desmond M. 
Published: January 2016

AbstractIn this essay, Archbishop Tutu explains how Christianity understands the inherent freedom, dignity, and human rights of each person to be a consequence of being created in the image of God. This idea contains radical liberative potential to challenge oppression and create structures for human flourishing. While Christianity has not always lived up to the liberative potential of its teachings, and too often has contributed to hatred, oppression, and violence, Archbishop Tutu argues, the power of religious voices remains essential in the struggle against oppression and for the protection of human dignity.
LAW, DEMOCRACY, AND CONSTITUTIONALISM: REFLECTIONS ON EVANS v ATTORNEY GENERAL
Authors: Allan T.R.S. 
Published: January 2016

AbstractThe difference of judicial opinion in the Supreme Court in Evans provokes reflection on fundamental constitutional principles, such as parliamentary sovereignty and the rule of law. A statute that on its face seems to permit a government minister to override a judicial decision of which he disapproves inevitably raises acute concern; the correct reading of the statute depends on the most persuasive integration of basic principles, placing the text within its wider constitutional context. The Justices deployed distinctions between law, fact, and public interest in rather different ways, reflecting their divergent interpretative approaches. The role of constitutional convention is also of particular interest – central to the legal issues arising, on one view, but largely irrelevant on another. At the root of these disagreements lie contrasting conceptions of law and adjudication.
Good, Good For, and Good Relative To: Relative and Relational in Value Theory
Authors: Fritzson Fritz-Anton 
Published: January 2016

AbstractThis paper discusses how we are to understand claims to the effect that something is good relative to a person. It is argued that goodness relative to should not be equated with good for as the latter is a relational value notion and the former is a value theoretical notion. It is argued further that good relative to a person should be understood as good from the perspective or the point of view of the person. But this analysis of the notion ‘good relative to’ leaves open questions about the full nature of relative goodness. For that, a positive proposal about what it is for something to be good relative to a person's point of view is needed. One such proposal is put forward on which the relevant perspective is determined or fixed in terms of the pro and con attitudes of the individual person.
The knowledge gap in world politics: Assessing the sources of citizen awareness of the United Nations Security Council
Authors: Dellmuth Lisa Maria 
Published: January 2016

AbstractThe past decades have seen a significant expansion in the scope and authority of international organisations (IOs), raising questions about who participates and is represented in the public contestation of IOs. An important precondition for citizens to become critically involved in the public debate about an IO is that they are aware of the politics of that IO. This article sheds light on this largely unexplored issue, asking why some citizens are more aware of IOs than others. This question is examined in the context of a powerful international organisation, the United Nations Security Council. Using a multilevel analysis of citizens in 17 Asian and European countries, this article argues that citizen knowledge about the Council is shaped by economic conditions and cosmopolitan identity. Higher levels of knowledge are found among the wealthier, and there is some evidence that income inequality depresses knowledge among poorer citizens. Furthermore, citizens identifying with groups or individuals across nation-state borders are more likely to know more about the Council. The article sketches broader implications for the study of the politicisation of IOs and citizen representation in the public contestation of IOs.
Rethinking national temporal orders: the subaltern presence and enactment of the political
Authors: Väyrynen Tarja 
Published: January 2016

AbstractHow the past is remembered is fundamental to the production and reproduction of postwar sovereign political power. However, Internation Relations’ (IR) explicit interest in the practices of remembrance, and particularly in time remains a relatively new one. This article seeks to show how Jacques Rancière’s discussion of temporality, subaltern history, and politics – which allows the study of parallel and enmeshing temporal universes – contributes to the IR literature on time. In this view, when speech is acquired by those whose right to speak is not recognised they can produce temporalities that disturb hegemonic representations of time constellations and reorganise the nation’s relationship to its past. The article analyses the moment of Kaisu Lehtimäki’s telling her war story in public, and understands it to be a material and symbolic event that shatters the hegemonic distribution of the Finnish postwar national history and truth.
AGGREGATING MORAL PREFERENCES
Authors: Adler Matthew D. 
Published: January 2016

Abstract:Preference-aggregation problems arise in various contexts. One such context, little explored by social choice theorists, is metaethical. ‘Ideal-advisor’ accounts, which have played a major role in metaethics, propose that moral facts are constituted by the idealized preferences of a community of advisors. Such accounts give rise to a preference-aggregation problem: namely, aggregating the advisors’ moral preferences. Do we have reason to believe that the advisors, albeit idealized, can still diverge in their rankings of a given set of alternatives? If so, what are the moral facts (in particular, the comparative moral goodness of the alternatives) when the advisors do diverge? These questions are investigated here using the tools of Arrovian social choice theory.
CHANGING FACE OF MEDICARE’S NATIONAL COVERAGE DETERMINATIONS FOR TECHNOLOGY
Authors: Chambers James D. , Chenoweth Matthew D. , Pyo Junhee , Cangelosi Michael J. , Neumann Peter J. 
Published: January 2016

Objectives: The Centers for Medicare and Medicaid Services (CMS) issues National Coverage Determinations (NCDs) for medical interventions expected to have a significant impact on Medicare, the health insurance program for US citizens aged 65 years and older and certain people with disabilities under the age of 65 years. The objective of this study was to evaluate NCDs issued from 1999 to 2013 to identify key trends, and to discuss implications for future CMS policy.Methods: We used the Tufts Medical Center Medicare National Coverage Determination Database to examine characteristics of NCDs from 1999 through 2013. We examined various characteristics of NCDs, including: whether the intervention under review is used for prevention or treatment of disease, the type of intervention considered, evidence limitations cited by CMS, and coverage determination outcome. We evaluated longitudinal trends in categorical and continuous variables in the database, using Cochran-Armitage trend tests and linear regression, respectively.Results: We found that NCDs increasingly focus on preventive care (p = 0.072), pertain to diagnostic imaging (p = 0.033), and evaluate health education/behavioral therapy interventions (p = 0.051). CMS increasingly cites the lack of relevant outcomes (p = 0.019) and the lack of applicability of study results to the Medicare population (p < 0.001) as evidence limitations. CMS less often restricts coverage to certain population subgroups in NCDs (p < 0.001), but increasingly applies coverage with evidence development policies (p < 0.001).Conclusions: Identified trends reflect broader changes in Medicare as CMS shifts its focus from treatment to prevention of disease, addresses potentially overutilized technologies, and attempts to issue flexible coverage policies.
Comparative sequence analyses of rhodopsin and RPE65 reveal patterns of selective constraint across hereditary retinal disease mutations
Authors: HAUSER FRANCES E. , SCHOTT RYAN K. , CASTIGLIONE GIANNI M. , VAN NYNATTEN ALEXANDER , KOSYAKOV ALEXANDER , TANG PORTIA L. , GOW DANIEL A. , CHANG BELINDA S.W. 
Published: January 2016

AbstractRetinitis pigmentosa (RP) comprises several heritable diseases that involve photoreceptor, and ultimately retinal, degeneration. Currently, mutations in over 50 genes have known links to RP. Despite advances in clinical characterization, molecular characterization of RP remains challenging due to the heterogeneous nature of causal genes, mutations, and clinical phenotypes. In this study, we compiled large datasets of two important visual genes associated with RP: rhodopsin, which initiates the phototransduction cascade, and the retinoid isomerase RPE65, which regenerates the visual cycle. We used a comparative evolutionary approach to investigate the relationship between interspecific sequence variation and pathogenic mutations that lead to degenerative retinal disease. Using codon-based likelihood methods, we estimated evolutionary rates (dN/dS) across both genes in a phylogenetic context to investigate differences between pathogenic and nonpathogenic amino acid sites. In both genes, disease-associated sites showed significantly lower evolutionary rates compared to nondisease sites, and were more likely to occur in functionally critical areas of the proteins. The nature of the dataset (e.g., vertebrate or mammalian sequences), as well as selection of pathogenic sites, affected the differences observed between pathogenic and nonpathogenic sites. Our results illustrate that these methods can serve as an intermediate step in understanding protein structure and function in a clinical context, particularly in predicting the relative pathogenicity (i.e., functional impact) of point mutations and their downstream phenotypic effects. Extensions of this approach may also contribute to current methods for predicting the deleterious effects of candidate mutations and to the identification of protein regions under strong constraint where we expect pathogenic mutations to occur.
Mandatory Rest Stops Improve Athlete Safety during Event Medical Coverage for Ultramarathons
Authors: Joslin Jeremy , Mularella Joshua , Bail Allison , Wojcik Susan , Cooney Derek R. 
Published: January 2016

AbstractIntroductionProvisions of medical direction and clinical services for ultramarathons require specific attention to heat illness. Heat stress can affect athlete performance negatively, and heat accumulation without acclimatization is associated with the development of exertional heat stroke (EHS). In order to potentially mitigate the risk of this safety concern, the Jungle Marathon (Para, Brazil) instituted mandatory rest periods during the first two days of this 7-day, staged, Brazilian ultramarathon.MethodsRace records were reviewed retrospectively to determine the number of runners that suffered an emergency medical complication related to heat stress and did not finish (DNF) the race. Review of records included three years before and three years after the institution of these mandatory rest periods.ResultsA total of 326 runners competed in the Jungle Marathon during the 2008-2013 period of study. During the pre-intervention years, a total of 46 athletes (21%) DNF the full race with 25 (54.3%) cases attributed to heat-related factors. During the post-intervention years, a total of 26 athletes (24.3%) DNF the full race with four (15.4%) cases attributed to heat-related factors.ConclusionMandatory rest stops during extreme running events in hot or tropical environments, like the Jungle Marathon, are likely to improve athlete safety and improve the heat acclimatization process.JoslinJ, MularellaJ, BailA, WojcikS, CooneyDR. Mandatory rest stops improve athlete safety during event medical coverage for ultramarathons. Prehosp Disaster Med. 2016;31(1):43–45.
A Course on Terror Medicine: Content and Evaluations
Authors: Cole Leonard A. , Natal Brenda , Fox Adam , Cooper Arthur , Kennedy Cheryl A. , Connell Nancy D. , Sugalski Gregory , Kulkarni Miriam , Feravolo Michael , Lamba Sangeeta 
Published: January 2016

AbstractIntroductionThe development of medical school courses on medical responses for disaster victims has been deemed largely inadequate. To address this gap, a 2-week elective course on Terror Medicine (a field related to Disaster and Emergency Medicine) has been designed for fourth year students at Rutgers New Jersey Medical School in Newark, New Jersey (USA). This elective is part of an overall curricular plan to broaden exposure to topics related to Terror Medicine throughout the undergraduate medical education.RationaleA course on Terror Medicine necessarily includes key aspects of Disaster and Emergency Medicine, though the converse is not the case. Courses on Disaster Medicine may not address features distinctively associated with a terror attack. Thus, a terror-related focus not only assures attention to this important subject but to accidental or naturally occurring incidents as well.MethodsThe course, implemented in 2014, uses a variety of teaching modalities including lectures, videos, and tabletop and hands-on simulation exercises. The subject matter includes biological and chemical terrorism, disaster management, mechanisms of injury, and psychiatry. This report outlines the elective’s goals and objectives, describes the course syllabus, and presents outcomes based on student evaluations of the initial iterations of the elective offering.ResultsAll students rated the course as “excellent” or “very good.” Evaluations included enthusiastic comments about the content, methods of instruction, and especially the value of the simulation exercises. Students also reported finding the course novel and engaging.ConclusionAn elective course on Terror Medicine, as described, is shown to be feasible and successful. The student participants found the content relevant to their education and the manner of instruction effective. This course may serve as a model for other medical schools contemplating the expansion or inclusion of Terror Medicine-related topics in their curriculum.ColeLA, NatalB, FoxA, CooperA, KennedyCA, ConnellND, SugalskiG, KulkarniM, FeravoloM, LambaS. A course on Terror Medicine: content and evaluations. Prehosp Disaster Med. 2016;31(1):98–101.
High Dynamic Range Pixel Array Detector for Scanning Transmission Electron Microscopy
Authors: Tate Mark W. , Purohit Prafull , Chamberlain Darol , Nguyen Kayla X. , Hovden Robert , Chang Celesta S. , Deb Pratiti , Turgut Emrah , Heron John T. , Schlom Darrell G. , Ralph Daniel C. , Fuchs Gregory D. , Shanks Katherine S. , Philipp Hugh T. , Muller David A. , Gruner Sol M. 
Published: January 2016

AbstractWe describe a hybrid pixel array detector (electron microscope pixel array detector, or EMPAD) adapted for use in electron microscope applications, especially as a universal detector for scanning transmission electron microscopy. The 128×128 pixel detector consists of a 500 µm thick silicon diode array bump-bonded pixel-by-pixel to an application-specific integrated circuit. The in-pixel circuitry provides a 1,000,000:1 dynamic range within a single frame, allowing the direct electron beam to be imaged while still maintaining single electron sensitivity. A 1.1 kHz framing rate enables rapid data collection and minimizes sample drift distortions while scanning. By capturing the entire unsaturated diffraction pattern in scanning mode, one can simultaneously capture bright field, dark field, and phase contrast information, as well as being able to analyze the full scattering distribution, allowing true center of mass imaging. The scattering is recorded on an absolute scale, so that information such as local sample thickness can be directly determined. This paper describes the detector architecture, data acquisition system, and preliminary results from experiments with 80–200 keV electron beams.