bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of Tribulus terrestris for the treatment of hypoactive sexual desire disorder in postmenopausal women: a randomized, double-blinded, placebo-controlled trial
Authors: de Souza Karla Zanolla Dias , Vale Fabiene Bernardes Castro , Geber Selmo 
Published: October 2016

Abstract

Objective:
The objective of this study was to evaluate the efficacy of Tribulus terrestris for the treatment of hypoactive sexual desire disorder in postmenopausal women and evaluate its effect on the serum levels of testosterone.

Methods:
We performed a prospective randomized, double-blinded, placebo-controlled study, during 18 months. A total of 45 healthy sexually active postmenopausal women reporting diminished libido were selected to participate in the study and were randomly assigned to receive 750 mg/d of T terrestris or placebo for 120 days. Randomization was performed using sealed envelopes. All participants answered the Female Sexual Function Index and the Sexual Quotient—female version questionnaires and had their serum levels of prolactin, thyroid-stimulating hormone, total testosterone, and sex hormone-binding globulin measured.

Results:
A total of 36 participants completed the study, because 3 from each group were excluded due to side effects and 3 dropped out due to personal reasons. FSFI questionnaire results demonstrated an improvement in all domains in both groups (P < 0.05) except for lubrication which was improved only in the study group. QS-F results showed a significant improvement in the domains of desire (P < 0.01), arousal/lubrication (P = 0.02), pain (P = 0.02), and anorgasmia (P < 0.01) in women who used T terrestris, whereas no improvement was observed in the placebo group (P > 0.05). Moreover, free and bioavailable testosterone levels showed a significant increase in the T terrestris group (P < 0.05).

Conclusions:

Tribulus terrestris might be a safe alternative for the treatment of hypoactive sexual desire disorder in postmenopausal women, because it was effective in reducing symptoms with few side effects. Its probable mechanism of action involves an increase in the serum levels of free and bioavailable testosterone.
Surgical Treatment of Tubular Breast Type II
Authors: Galych Sergey P. , Dabizha Oleksii Y. , Kostenko Alona A. , Gomolyako Irina V. , Samko Kristina A. , Borovyk Denys V. 
Published: October 2016

Background:
Tubular breasts are caused by connective tissue malformation and occur in puberty. The main clinical characteristics of the tubular breast are breast asymmetry, dense fibrous ring around the areola, hernia bulging of the areola, megaareola, and hypoplasia of quadrants of the breast. Pathology causes great psychological discomfort to patients.

Methods:
This study included 17 patients, aged 18 to 34 years, with tubular breast type II who had bilateral pathology and were treated from 2013 to 2016. They had surgical treatment by method of the clinic. Correction technique consisted of mobilization of the central part of the gland and formation of a glandular flap with vertical and horizontal scorings, which looks like a “chessboard,” that was sufficient to cover the lower pole of the implant. The flap was fixed to the submammary folds with stitches that prevented its reduction and accented a new submammary fold. To underscore the importance of the method and to study the structural features of the vascular bed of tubular breast tissue, a morphological study was conducted.

Results:
Mean follow-up time was 25 months (range between 13 and 37 mo). The proposed technique achieved good results. Complications (hematoma, circumareolar scarring, and “double-bubble” deformity) were identified in 4 patients.

Conclusions:
Our morphological study confirmed that tubular breast tissue has increased vascularity due to the vessels with characteristic minor malformation and due to the high restorative potential of the vascular bed. Therefore, an extended glandular flap could be freely mobilized without damaging its blood supply; thus, the flap in most cases covered the implant completely and good aesthetic results were achieved.
Duloxetine Augmentation in Resistant Obsessive-Compulsive Disorder
Authors: Mowla Arash , Boostani Sanaz , Dastgheib Seyed Ali 
Published: October 2016

Introduction
The aim of this study is to evaluate the efficacy of duloxetine augmentation in treatment of resistant obsessive-compulsive disorder (OCD).

Methods
This augmentation trial was designed as an 8-week randomized controlled, double-blind study. Forty-six patients experiencing OCD who had failed to respond to at least 12 weeks of treatment with a selective serotonin reuptake inhibitor (fluoxetine, citalopram, or fluvoxamine) were randomly allocated to receive duloxetine or sertraline plus their current anti-OCD treatment. The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) was the primary outcome measure. Treatment response was defined as 25% or more decrease in scores of Y-BOCS. The mean dosage of duloxetine was 44.4 mg/d (range, 20–60 mg/d), and the mean dosage of sertraline was 123.8 mg/d (range, 50–200 mg/d).

Results
Forty-six patients (24 of 30 in duloxetine group and 22 of 27 in sertraline group) completed the trial. Both groups showed improvement during the 8-week study period (mean Y-BOCS total score at week 8 as compared with baseline: P < 0.001 & P < 0.001) without significant difference (P = 0.861). Those receiving duloxetine plus their initial medications experienced a mean decrease of 33.0% in Y-BOCS score, and the patients with sertraline added to their initial medication experienced a mean decrease of 34.5% in Y-BOCS.

Discussion
Our double-blind controlled clinical trial showed duloxetine to be as effective as sertraline in reducing obsessive and compulsive symptoms in patients with resistant OCD. However, it needs to be noted that our study is preliminary, and larger double-blind placebo-controlled studies are necessary to confirm the results.
Acceptability and Effectiveness of Assisted Human Immunodeficiency Virus Partner Services in Mozambique: Results From a Pilot Program in a Public, Urban Clinic
Authors: Myers R. Serene , Feldacker Caryl , Cesár Freide , Paredes Zulmira , Augusto Gerito , Muluana Chadreque , Citao Sinesia , Mboa-Ferrao Catarina , Karajeanes Esmeralda , Golden Matthew R. 
Published: October 2016

Background
Assisted partner services (APS) involves offering persons with human immunodeficiency virus (HIV) assistance notifying and testing their sex partners. Assisted partner services is rarely available in sub-Saharan Africa. We instituted a pilot APS program in Maputo, Mozambique.

Methods
Between June and September 2014, community health workers (CHWs) offered APS to persons with newly diagnosed HIV (index patients [IPs]). Community health workers interviewed IPs at baseline, 4 and 8 weeks. At baseline, CHWs counseled IPs to notify partners and encourage their HIV testing, but did not notify partners directly. At 4 weeks, CHWs notified partners directly. We compared 4- and 8-week outcomes to estimate the impact of APS on partner notification, HIV testing and HIV case finding.

Results
Community health workers offered 223 IPs APS, of whom 220 (99%) accepted; CHWs collected complete follow-up data on 206 persons; 79% were women, 74% were married, and 50% named >1 sex partner. Index patients named 262 HIV-negative partners at baseline. At 4 weeks, before APS, IPs had notified 193 partners (74%), but only 82 (31%) had HIV tested; 43 (13%) tested HIV positive. Assisted partner services resulted in the notification of 22 additional partners, testing of 83 partners and 43 new HIV diagnoses. In relative terms, APS increased partner notification, testing, and HIV case finding by 13%, 101%, and 125%. Seventy-two (35%) of 206 IPs were in ongoing HIV serodiscordant partnerships. Only 2.5 IPs needed to receive APS to identify a previously undiagnosed HIV-infected partner or an ongoing HIV serodiscordant partnership. Two (1%) IPs reported APS-related adverse events.

Conclusions
Assisted partner services is acceptable to Mozambicans newly diagnosed with HIV, identifies large numbers of serodiscordant partnerships and persons with undiagnosed HIV, and poses a low risk of adverse events.
New or Progressive Multiple Organ Dysfunction Syndrome in Pediatric Severe Sepsis: A Sepsis Phenotype With Higher Morbidity and Mortality*
Authors: Lin John C. , Spinella Philip C. , Fitzgerald Julie C. , Tucci Marisa , Bush Jenny L. , Nadkarni Vinay M. , Thomas Neal J. , Weiss Scott L. 
Published: October 2016

Objectives:
To describe the epidemiology, morbidity, and mortality of new or progressive multiple organ dysfunction syndrome in children with severe sepsis.

Design:
Secondary analysis of a prospective, cross-sectional, point prevalence study.

Setting:
International, multicenter PICUs.

Patients:
Pediatric patients with severe sepsis identified on five separate days over a 1-year period.

Interventions:
None.

Measurements and Main Results:
Of 567 patients from 128 PICUs in 26 countries enrolled, 384 (68%) developed multiple organ dysfunction syndrome within 7 days of severe sepsis recognition. Three hundred twenty-seven had multiple organ dysfunction syndrome on the day of sepsis recognition. Ninety-one of these patients developed progressive multiple organ dysfunction syndrome, whereas an additional 57 patients subsequently developed new multiple organ dysfunction syndrome, yielding a total proportion with severe sepsis–associated new or progressive multiple organ dysfunction syndrome of 26%. Hospital mortality in patients with progressive multiple organ dysfunction syndrome was 51% compared with patients with new multiple organ dysfunction syndrome (28%) and those with single-organ dysfunction without multiple organ dysfunction syndrome (10%) (p < 0.001). Survivors of new or progressive multiple organ dysfunction syndrome also had a higher frequency of moderate to severe disability defined as a Pediatric Overall Performance Category score of greater than or equal to 3 and an increase of greater than or equal to 1 from baseline: 22% versus 29% versus 11% for progressive, new, and no multiple organ dysfunction syndrome, respectively (p < 0.001).

Conclusions:
Development of new or progressive multiple organ dysfunction syndrome is common (26%) in severe sepsis and is associated with a higher risk of morbidity and mortality than severe sepsis without new or progressive multiple organ dysfunction syndrome. Our data support the use of new or progressive multiple organ dysfunction syndrome as an important outcome in trials of pediatric severe sepsis although efforts are needed to validate whether reducing new or progressive multiple organ dysfunction syndrome leads to improvements in more definitive morbidity and mortality endpoints.
The Lymphatic Response to Injury with Soft-Tissue Reconstruction in High-Energy Open Tibial Fractures of the Lower Extremity
Authors: van Zanten Malou C. , Mistry Raakhi M. , Suami Hiroo , Campbell-Lloyd Andrew , Finkemeyer James P. , Piller Neil B. , Caplash Yugesh 
Published: October 2016

Background:
Severe compound tibial fractures are associated with extensive soft-tissue damage, resulting in disruption of lymphatic pathways that leave the patient at risk of developing chronic lymphedema. There are limited data on lymphatic response following lower limb trauma. Indocyanine green fluorescence lymphography is a novel, real-time imaging technique for superficial lymphatic mapping. The authors used this technique to image the superficial lymphatic vessels of the lower limbs in patients with severe compound tibial fracture.

Methods:
Baseline demographics and clinical and operative details were recorded in a prospective cohort of 17 patients who had undergone bone and soft-tissue reconstruction after severe compound tibial fracture between 2009 and 2014. Normal lymphatic images were obtained from the patients’ noninjured limbs as a control. In this way, the authors investigated any changes to the normal anatomy of the lymphatic system in the affected limbs.

Results:
Of the 17 patients, eight had free muscle flaps with split-thickness skin grafting, one had a free fasciocutaneous flap, one had a full-thickness skin graft, six had local fasciocutaneous flaps, and one had a pedicled gastrocnemius flap. None of the free flaps demonstrated any functional lymphatic vessels; the fasciocutaneous flaps and the skin graft demonstrated impaired lymphatic vessel function and dermal backflow pattern similar to that in lymphedema. Local flaps demonstrated lymphatic blockage at the scar edge.

Conclusion:
Severe compound fractures and the associated soft-tissue injury can result in significant lymphatic disruption and an increased risk for the development of chronic lymphedema.
Hippocampal Engagement during Recall Depends on Memory Content
Authors: Ross David A. , Sadil Patrick , Wilson D. Merika , Cowell Rosemary A. 
Published: October 2016

SummaryThe hippocampus is considered pivotal to recall, allowing retrieval of information not available in the immediate environment. In contrast, neocortex is thought to signal familiarity, and to contribute to recall only when called upon by the hippocampus. However, this view is not compatible with representational accounts of memory, which reject the mapping of cognitive processes onto brain regions. According to representational accounts, the hippocampus is not engaged by recall per se, rather it is engaged whenever hippocampal representations are required. To test whether hippocampus is engaged by recall when hippocampal representations are not required, we used functional imaging and a non-associative recall task, with images (objects, scenes) studied in isolation, and image-patches used as cues. As predicted by a representational account, hippocampal activation increased during recall of scenes – which are known to be processed by hippocampus – but not during recall of objects. Object recall instead engaged neocortical regions known to be involved in object-processing. Further supporting the representational account, effective connectivity analyses revealed that recall was associated with increased information flow out of lateral occipital cortex (object recall) and parahippocampal cortex (scene recall), suggesting that recall-related activation spread from neocortex to hippocampus, not the reverse.
Prioritizing services and facilities in a higher education institution
Authors: Latif Latifah Abdol , Bahroom Ramli , Khalil Mohamad Afzhan Khan Mohamad 
Published: October 2016

Purpose
The purpose of this paper is to identify the “selling points” for Open University Malaysia (OUM) to be used in its marketing activities and the “critical points” that OUM should focus on for further improvements in providing its services to its students. These selling and critical points are derived from the analysis of the importance and satisfaction data collected from OUM’s postgraduate students.

Design/methodology/approach
This study employs a two-dimensional, i.e., Importance-Satisfaction Survey which consists of 47 items, categorized under eight dimensions. Items are phrased as positive statements and students are asked to indicate how important it is to them using a seven-point Likert scale ranging from not at all important (1) to very important (7). They are then asked to rate their level of satisfaction, using the same scale from very dissatisfied (1) to very satisfied (7). A total of 709 postgraduate students responses were used in this study. A multiple regression analysis was conducted to explain the relationship between the dependent variable, overall satisfaction and eight independent variables. The “selling points” and “critical points” are determined by combining the quadrant and gap analyses. The “selling point” items are the high-importance-high-satisfaction (HIHS) items with relatively small gap scores while the “critical points” are those in the high-importance-low-satisfaction and HIHS quadrants with relatively large gap scores.

Findings
The overall results of the Importance-Satisfaction Survey showed that the postgraduate students are generally satisfied with OUM’s programmes and services. The multiple regression analysis of all dimensions against overall satisfaction as the dependent variable showed that the five dimensions of facilitator, curriculum, faculty, support services and learning centre account for 75.7 per cent of the variation in overall satisfaction. The selling points include: the learning management system (MyVLE), online registration, course contents, modules and facilitators. The critical points include those related to facilitator interaction and feedback, students’ sense of connectedness with the faculty staff, timely responses to enquiries and complaints and accessibility to digital library and learning centre staff.

Practical implications
Importance-Satisfaction Surveys can be used to help an institution to identify the services and facilities that can be marketed and also those that need to be improved in order to better meet its students’ expectations.

Originality/value
While many similar studies had been conducted elsewhere, this study had identified the “selling points” and “critical points” which are unique to OUM. In addition, most previous studies were focused on conventional institutions, carried out in many different countries with differing learning environments and cultures.
Factors leading to effective teaching of MOOCs
Authors: Wong Billy Tak-ming 
Published: October 2016

Purpose
The purpose of this paper is to survey the factors which facilitate effective teaching through massive open online courses (MOOCs).

Design/methodology/approach
A descriptive meta-analysis was conducted to first examine the literature covering the characteristics of teaching in MOOCs, the profile of participants, the instructional design of course materials and/or the course assessment methods – and then to summarise the factors which are conducive to the teaching effectiveness of MOOCs. A random sample of MOOCs was then reviewed to sort out the extent to which the factors can be identified in these courses.

Findings
The factors leading to effective teaching of MOOCs revolve around six areas according to the stages of course delivery, namely, preparation, attraction, participation, interaction, consolidation and post-course support. They address the application of technology to achieve educational purposes, while coping with the potentials and constraints of the MOOC environment. In practice, however, existing MOOCs show varying degrees of the implementation of the factors.

Research limitations/implications
As this is an exploratory study summarising and categorising the factors, further work should be done, in particular on the proper adoption of these factors in teaching, their effectiveness and ways of assessing such effectiveness.

Originality/value
The factors identified will help institutions and academics who plan to offer MOOCs to be aware of how teaching can be best delivered to promote effective student learning.
Transient technologies: the end of the username and password?
Authors: McMullen Anthony 
Published: October 2016

Purpose
The purpose of this paper is to provide insights and commentary into issues encountered in providing computing services to library users in an era of shrinking budgets, reductions in staffing and increased costs.

Design/methodology/approach
Uses examples and illustrations from the technology literature and both anecdotal and analytic information from the author’s library to highlight some of the implications and resulting costs of password fatigue.

Findings
Web users are increasingly finding themselves in situations where they are overwhelmed by the stress induced by the need to remember many usernames and password combinations of varying complexities to complete their tasks at home, work and school.

Originality/value
This paper describes the shortcomings and counter-productive nature of the exceedingly complex and increasingly insecure world of usernames and password-protected web-based services. The cost of help desk-mediated password resets is enormous. Libraries are not immune to a large volume of calls generated by access issues.
Training academic library staff using an online learning management system (LMS)
Authors: Bell Brigitte 
Published: October 2016

Purpose
This column aims to propose the idea of using learning management systems (LMSs) as a platform for online training and development within academic libraries.

Design/methodology/approach
A background and literature review are used as a basis for these recommendations.

Findings
The column argues that LMSs possess untapped potential as an effective online library training platform.

Originality/value
The column proposes further widespread use of LMSs for online training and development in academic libraries, despite a historical lack of use for this purpose.
How can companies succeed in forming CSR reputation?
Authors: Lee Sun Young 
Published: October 2016

PurposeThe purpose of this paper is to explore the channels companies use to communicate their corporate social responsibility (CSR) messages and to test the effectiveness of those channels – specifically, press releases, corporate websites, CSR reports, corporate Facebook pages, and TV advertising – on forming companies’ CSR reputations.Design/methodology/approachThe two primary methods used in this study were secondary analysis of existing data and content analysis. The study sample was the 101 companies in the Reputation Institute’s 2014 CSR ranking of the 100 most highly regarded companies (two companies were tied) across 15 countries.FindingsCorporate websites and CSR reports were the most common channels for CSR communications, but press releases – through their impact on news articles – and general corporate Facebook pages were the only effective channels in forming CSR reputation.Originality/valueThis study provides empirical evidence of the effectiveness of various CSR communication channels; it not only focuses on CSR reputation, a specific aspect of corporate reputation which has not been studied in this context before, but also examines several different channels simultaneously, in contrast to previous studies which have only investigated one or two channels at a time.
Storytelling in organisations: supporting or subverting corporate strategy?
Authors: Spear Sara , Roper Stuart 
Published: October 2016

PurposeStorytelling is claimed to be an effective way of communicating corporate strategy within organisations. However, previous studies have tended to focus holistically on storytelling in organisations rather than investigating how different groups may use and be influenced by stories. The purpose of this paper is to address these gaps in the literature by investigating how storytelling in internal communication can either support or subvert corporate strategy.Design/methodology/approachA qualitative study was conducted into storytelling in two large companies in the UK energy industry. Data were collected through 70 semi-structured interviews, documentary research, and observation research. Impression management theory was used to analyse how stories supported or subverted corporate strategy.FindingsStorytelling by employees in the corporate and customer service areas of the organisations showed the greatest support for corporate strategy. There was more subversive storytelling in the operational areas, particularly by lower level employees. Stories subverted corporate strategy by recounting incidents and encouraging behaviour that contradicted the organisation’s vision/goals and values.Originality/valueThe study shows the important contribution of employees to the collective sensemaking process in organisations, by narrating supportive or subversive stories. Engaging employees in storytelling can enhance support for corporate strategy, however, managers should also see subversive stories as an opportunity to identify and address problems in the organisation.