bluuebunny/crossref_metadata_2025_split huggingface dataset:
Orolingual angioedema after alteplase therapy of acute ischaemic stroke: incidence and risk of prior angiotensin‐converting enzyme inhibitor use
Authors: Lin S.‐Y. , Tang S.‐C. , Tsai L.‐K. , Yeh S.‐J. , Hsiao Y.‐J. , Chen Y.‐W. , Chen K.‐H. , Yip B.‐S. , Shen L.‐J. , Wu F.‐L. Lin , Jeng J.‐S. 
Published: June 2014

Background and purposeOrolingual angioedema (OA) is an uncommon but potentially life‐threatening complication of treatment with recombinant tissue plasminogen activator (rt‐PA; alteplase) during acute ischaemic stroke. This study aimed to determine the incidence of rt‐PA‐related OA in an Asian stroke population and the risk of pre‐stroke anti‐hypertensive drug use for development of this complication.MethodsA multi‐center stroke registry was used to identify the pre‐stroke medications of acute ischaemic stroke patients receiving intravenous rt‐PA from January 2002 to December 2013. The clinical manifestations of rt‐PA‐related OA were recorded and the incidence of this complication was determined. The risks of pre‐stroke use of different anti‐hypertensive agents for the occurrence of rt‐PA‐related OA were determined from this study and from a meta‐analysis.ResultsA total of 559 patients received intravenous rt‐PA over a 12‐year period. Five patients (two males) developed OA after rt‐PA administration. The incidence of OA amongst these patients was 0.89% (95% confidence interval 0.29%–2.09%), which was lower than that obtained by meta‐analysis (1.9%). Amongst pre‐stroke anti‐hypertensive medications, angiotensin‐converting enzyme (ACE) inhibitors were found in this study to have the highest relative risk for rt‐PA‐related OA (17.1; 95% confidence interval 3.0–96.9). Meta‐analysis also revealed that pre‐stroke use of ACE inhibitors was associated with a high relative risk of OA after intravenous rt‐PA (12.9; 95% confidence interval 4.5–37.0).ConclusionsThe incidence of rt‐PA‐related OA in the Asian population is lower than that in the Caucasian population. Pre‐stroke use of ACE inhibitors significantly increases the risk of this complication.
FAMILY REUNIONS IN GERMAN ADVENTURE LITERATURE ON AFRICA OF THE 1880S – A VISION FOR COLONIAL INTERVENTION: KARL BURMANN AND KARL MAY
Authors: Krobb Florian 
Published: June 2014

ABSTRACTLiterature for young readers provides a pertinent barometer for the moods and preoccupations of a society at a given time. The study of two examples of adventure literature set in Africa, Karl Burmann's Im Herzen von Afrika (1880) and Karl May's Die Sklavenkarawane (1889/90), illustrates the preponderance of certain motifs like family reunions in the imaginary conquest of colonial space and the definition of the role Germans assigned to themselves on the continent of desire. The separation and reunion of members of a travelling party serve to demonstrate how the foreign intruders cope with the hostile conditions without losing themselves and their sense of community. In the process, they assemble groups of indigenous people into family units of their making and under their tutelage, thus assuming the role of mentor to African societies and claiming a kind of leadership without which, or so the suggestion goes, Africa would not achieve any awareness of self. In Karl May's novel, this role is asserted in competition with slave hunters, rivals for dominance over inner Africa. Adventure literature thus provides a blueprint for, and a legitimisation of, colonialist interference in Africa and allows a new generation to imagine themselves as both adventurers and benefactors.
Caregiver Experiences of Supporting Adults with Intellectual Disabilities in Pain
Authors: Findlay Laura , Williams Amanda C. de C. , Baum Sandra , Scior Katrina 
Published: June 2014

BackgroundCaregivers have an intimate knowledge of the individuals they care for and are therefore an important source of information on pain experiences. They are often relied upon to recognize pain‐related behaviours and report them, but little is known as to how they experience their role.MethodsInformation was collected from 11 caregivers using semi‐structured interviews about their experiences of caring for adults with intellectual disabilities who were suspected or definitely in pain. Transcripts were analysed using Interpretative Phenomenological Analysis.ResultsSix superordinate themes were identified from participants' experiences: suffering in silence; searching for meaning to explain the complaint; knowledge and skills needed to recognize and manage pain; perceptions of the pain experience; acting to try and reduce pain; and the emotional impact of pain.ConclusionsThere seems an art to detect pain using existing skills and knowledge of the individual's ways of expressing pain. Despite best efforts, recognizing and treating pain was experienced as complex and ambiguous. Some caregivers described a negative emotional impact and dissatisfaction with the management of pain by health care services.
Objective assessment of facial skin aging and the associated environmental factors in Japanese monozygotic twins
Authors: Ichibori Ryoko , Fujiwara Takashi , Tanigawa Tomoko , Kanazawa Shigeyuki , Shingaki Kenta , Torii Kosuke , Tomita Koichi , Yano Kenji ,   Osaka Twin Research Group, Sakai Yasuo , Hosokawa Ko 
Published: June 2014

SummaryTwin studies, especially those involving monozygotic (MZ) twins, facilitate the analysis of factors affecting skin aging while controlling for age, gender, and genetic susceptibility. The purpose of this study was to objectively assess various features of facial skin and analyze the effects of environmental factors on these features in MZ twins. At the Osaka Twin Research Center, 67 pairs of MZ twins underwent medical interviews and photographic assessments, using the VISIA® Complexion Analysis System. First, the average scores of the right and left cheek skin spots, wrinkles, pores, texture, and erythema were calculated; the differences between the scores were then compared in each pair of twins. Next, using the results of medical interviews and VISIA data, we investigated the effects of environmental factors on skin aging. The data were analyzed using Pearson's correlation coefficient test and the Wilcoxon signed‐rank test. The intrapair differences in facial texture scores significantly increased as the age of the twins increased (P = 0.03). Among the twin pairs who provided answers to the questions regarding history differences in medical interviews, the twins who smoked or did not use skin protection showed significantly higher facial texture or wrinkle scores compared with the twins not exposed to cigarettes or protectants (P = 0.04 and 0.03, respectively). The study demonstrated that skin aging among Japanese MZ twins, especially in terms of facial texture, was significantly influenced by environmental factors. In addition, smoking and skin protectant use were important environmental factors influencing skin aging.
Remodeling of periorbital, temporal, glabellar, and crow's feet areas with hyaluronic acid and botulinum toxin
Authors: Beer Kenneth R , Julius Hillary , Dunn Monica , Wilson Fred 
Published: June 2014

SummaryBotulinum toxins are currently used to reduce facial muscle activity, and hyaluronic acid is used to correct volume loss. This study evaluates the combination of abobotulinumtoxinA (Dysport) and hyaluronic acid 20 mg/mL (Perlane) for rejuvenating specific areas of the upper face. Subjects (n = 20) with mild to moderate temporal volume loss as well as glabellar and/or periorbital rhytids were enrolled in this single‐center, open‐label, nonrandomized pilot study. Subjects were randomly assigned a number and treated with hyaluronic acid, divided between temporal and glabellar region, and abobotulinumtoxinA in the periorbital and glabellar region. A 1‐month touch‐up was given if needed. Subjects were evaluated by the investigator, and each subject completed a questionnaire at baseline and at 3, 6, and 9 months after treatment. For glabellar lines and crow's feet, median grades decreased from baseline at 1 month and at 3 months, but returned to baseline values at 6 months. For temporal assessments, the median grade decreased from baseline at 1, 3, and 6 months and returned to baseline at 9 months. Similar trends were observed in subjects’ perceived age, perceived social and professional limitations, and desire to alter their facial appearance. Among subjects previously treated with botulinum toxin alone, 64% rated the combination treatment said “superior.” Adverse effects were mild and transient. The combination of abobotulinumtoxinA and hyaluronic acid appears to rejuvenate the periorbital, temporal, glabellar, and crow's feet areas with minimal adverse effects.
A prospective, open‐label, multicenter, observational, postmarket study of the use of a 15 mg/mL hyaluronic acid dermal filler in the lips
Authors: Philipp‐Dormston Wolfgang G , Hilton Said , Nathan Myooran 
Published: June 2014

SummaryHyaluronic acid (HA)‐based injectable fillers three‐dimensionally restore the natural contours of the lips and perioral area, thereby reducing some signs of aging lips. To evaluate the short‐term aesthetic impact of treatment with the HA dermal filler Juvéderm® VOLBELLA® with Lidocaine, formulated utilizing VYCROSS™ technology, for enhancement or correction of asymmetry of the lips, evaluated using a patient‐centric approach. Sixty‐two subjects were enrolled in this study, conducted at two sites in Germany. Primary endpoints were satisfaction with improvement, look and feel of the lips, assessed by subject and physician at first visit and 4 weeks post‐treatment. Immediately after injection at first visit, 83.6% of subjects were Extremely Satisfied, Very Satisfied or Satisfied with improvement in the lips, which increased to 94.1% and 93.0% of subjects with/without top‐up treatment at follow‐up, respectively. After injection at first visit, 61.7% of subjects rated the look and feel of their lips as Extremely Natural or Very Natural, which increased to 75.0% and 93.0% of subjects with/without top‐up treatment, respectively. The HA dermal filler was associated with minimal discomfort, bruising or swelling of the lips; almost two‐thirds of subjects (62%) returned to social engagements on the same day. The high degree of subject satisfaction with aesthetic improvement in the lips, as well as the natural look and feel, indicates that this HA dermal filler represents an effective treatment option for patients requiring lip enhancement.
An evaluation of the patient population for aesthetic treatments targeting abdominal subcutaneous adipose tissue
Authors: Friedmann Daniel P , Avram Mathew M , Cohen Steven R , Duncan Diane I , Goldman Mitchel P , Weiss Elliot T , Leroy Young V 
Published: June 2014

SummaryA large and growing population of patients currently seeks minimally invasive therapeutic options for the aesthetic treatment of localized, central abdominal subcutaneous adipose tissue (SAT). We sought to evaluate the ideal population for aesthetic treatment of central abdominal SAT, highlight the existing disparities between SAT in obese (body mass index [BMI] ≥ 30; BMI) and nonobese (BMI < 30) patients, and review the available FDA‐cleared, minimally invasive treatment options for central abdominal adiposity. The cosmetic issue of localized, central (periumbilical) abdominal adiposity in nonobese individuals is quite distinct from abdominal bulging secondary to obesity. Given the recognized clinical and physiologic differences between obese and nonobese counterparts, the exclusion of obese patients from clinical study by currently available FDA‐cleared devices targeting abdominal fat, and the status of obesity as a chronic, systemic disease requiring medical, surgical, and/or lifestyle‐altering therapies, minimally invasive therapeutic options for aesthetic reductions in central abdominal SAT must be limited to the nonobese population.
A double‐blind vehicle‐controlled study of a preparation containing undecylenoyl phenylalanine 2% in the treatment of melasma in females
Authors: Katoulis Alexander , Alevizou Antigoni , Soura Efthymia , Mantas Nikolaos , Bozi Evangelia , Gregoriou Stamatis , Makris Michalis , Rigopoulos Dimitris 
Published: June 2014

Abstract BackgroundUndecylenoyl phenylalanine is a novel skin‐lightening agent, probably acting as α‐melanocyte‐stimulating hormone (α‐MSH) and beta‐adrenergic receptor (β‐ADR) antagonist.ObjectivesThe objective of this double‐blind randomized comparative study was to evaluate the efficacy and safety of a preparation containing undecylenoyl phenylalanine 2% in the topical treatment of melasma in females.MethodsForty female patients with melasma were randomly assigned to apply either the active preparation or the vehicle alone, twice daily for 12 weeks. Patients were evaluated monthly for efficacy and safety.ResultsIn all, 37 patients completed the study. Of the 20 patients on active treatment, no one responded completely, but 17 (85%) had partial response. Of them, 11 had moderate improvement and six had marked improvement. Lightening of the lesions was evident from the first follow‐up visit at 4 weeks. A statistically significant difference (P < 0.001) in efficacy between the active preparation and the vehicle was documented. Using patient assessment ratings, 80% were extremely satisfied or satisfied with the result. The reported side effects were minor and included erythema and itching or burning at the site of application.ConclusionsUndecylenoyl phenylalanine 2% achieved a significant lightening of melasma lesions with minimal side effects.
The Long‐Term Effects of Building Strong Families: A Program for Unmarried Parents
Authors: Wood Robert G. , Moore Quinn , Clarkwest Andrew , Killewald Alexandra 
Published: June 2014

AbstractThe authors present findings from a large‐scale, random‐assignment evaluation of Building Strong Families (BSF), a program offering group sessions on relationship skills education to low‐income, unmarried parents who were expecting or had recently had a baby. Findings based on a 3‐year follow‐up survey of over 4,000 couples indicate that BSF did not succeed in its central objectives of improving the couple relationship, increasing the quality of coparenting, or enhancing father involvement. In fact, the program had modest negative effects on some of these outcomes. BSF also had little impact on child well‐being, with no effect on children's family stability or economic well‐being and only a modest positive effect on children's socioemotional development. Impacts varied across the 8 study sites. Although attendance at group sessions was relatively low, there is little evidence of program effects even among couples who attended sessions regularly.
Confirmatory factor analysis of the Oral Health Impact Profile
Authors: John M. T. , Feuerstahler L. , Waller N. , Baba K. , Larsson P. , Čelebić A. , Kende D. , Rener‐Sitar K. , Reissmann D. R. 
Published: June 2014

SummaryPrevious exploratory analyses suggest that the Oral Health Impact Profile (OHIP) consists of four correlated dimensions and that individual differences in OHIP total scores reflect an underlying higher‐order factor. The aim of this report is to corroborate these findings in the Dimensions of Oral Health‐Related Quality of Life (DOQ) Project, an international study of general population subjects and prosthodontic patients. Using the project's Validation Sample (n = 5022), we conducted confirmatory factor analyses in a sample of 4993 subjects with sufficiently complete data. In particular, we compared the psychometric performance of three models: a unidimensional model, a four‐factor model and a bifactor model that included one general factor and four group factors. Using model‐fit criteria and factor interpretability as guides, the four‐factor model was deemed best in terms of strong item loadings, model fit (RMSEA = 0·05, CFI = 0·99) and interpretability. These results corroborate our previous findings that four highly correlated factors – which we have named Oral Function, Oro‐facial Pain, Oro‐facial Appearance and Psychosocial Impact – can be reliably extracted from the OHIP item pool. However, the good fit of the unidimensional model and the high interfactor correlations in the four‐factor solution suggest that OHRQoL can also be sufficiently described with one score.
Tube‐weaning infants and children: A survey of Australian and international practice
Authors: Gardiner Alison Y , Fuller David G , Vuillermin Peter J 
Published: June 2014

AimThe aim of this study was to describe paediatric feeding‐tube weaning practice in Australian children's hospitals and to compare this with practice in tube weaning programmes internationally.MethodsA literature review regarding tube weaning practices was conducted to inform questionnaire design. Six Australian children's hospitals and six international paediatric service providers completed a written questionnaire.ResultsFour of six Australian children's hospitals surveyed reported that they have adopted informal paediatric tube weaning practices; four of six lacked clinical practice guidelines (CPGs), and five of six lacked a clearly defined case leadership. Practice varied substantially within and between these Australian feeding teams. By comparison, all six international feeding teams reported having developed formal CPGs. Five of six reported clearly defined case leadership with no more than three lead professionals overseeing cases and concordantly reported a high level of practice consistency within and between teams.ConclusionsThe majority of Australian children's hospitals lack a formal CPG and clearly defined case leadership to guide tube weaning practices, and accordingly, there is considerable practice variation. This is in contrast to the situation in a select group of international centres. There is a need for further research to define best practice models and for Australian CPGs.
Education, safe drinking practices and fetal alcohol spectrum disorder in the Kimberley region of Western Australia
Authors: Kavanagh Phillip S , Payne Jennifer S 
Published: June 2014

AimThere are alarming rates of fetal alcohol spectrum disorder (FASD) in the Kimberley region of Western Australia despite numerous international studies demonstrating the links between alcohol consumption during pregnancy and FASD. The aim of this research was to help determine factors that may be associated with correct knowledge about safe drinking practices during pregnancy, with these factors used to help inform future interventions.MethodNinety‐nine residents (40 males, 59 females, 39% of which self‐identified as Indigenous) from the Kimberley region (Broome and smaller remote communities) completed a survey examining knowledge of currently recommended safe drinking practices during pregnancy and knowledge of the outcomes for children with FASD over a period of approximately 2 months.ResultsThe results revealed that education level (i.e. not completing high school through to completing university) is the biggest predictor (β = 0.44, P < 0.01) of knowledge of safe drinking practices during pregnancy, and having heard of FASD (β = 0.67, P < 0.001) was the biggest predictor of knowledge of outcomes for children with FASD. Other variables such as age, sex, Indigenous status and income level were not as important.ConclusionsThese findings suggest that early education regarding the consequences of alcohol consumption for women of childbearing age should be paramount in this or similar communities. Suggestions for targeted interventions are discussed in light of these findings.
Improving junior doctors' confidence in paediatric musculoskeletal assessment
Authors: Boulter Emily L , Rogers Jeremy R , Borland Meredith L 
Published: June 2014

AimMusculoskeletal symptoms are a common cause for presentation of children and adolescents to health‐care settings. Junior doctors report lack of confidence in assessment of the paediatric musculoskeletal system. Our aim was to assess the confidence of junior medical officers (JMOs) working in the emergency department (ED) with paediatric musculoskeletal assessment and determine if a readily available teaching module would improve confidence.MethodsJMOs rostered to the paediatric ED were surveyed regarding their confidence in paediatric musculoskeletal assessment at the start and end of their ED rotation. A subgroup of these JMOs received formal teaching on paediatric musculoskeletal assessment using the paediatric gait, arm, leg and spine examination as part of their protected teaching time during their rotation.ResultsForty‐three JMOs were considered in the final analysis. Of those, 27 received teaching (intervention group), and 16 received no teaching (non‐intervention group). In the intervention subgroup, there was a trend towards an increase in confidence in paediatric musculoskeletal assessment with the commonest response prior to the teaching intervention being ‘some confidence’ (11/27 41%) and the commonest response after teaching being ‘fairly confident’ (14/27 52%) without achieving statistical significance (P = 0.068). Of the JMOs in the intervention group, 26/27 (96%) found the teaching session useful, and 25/27 (93%) considered it relevant to their future practice.ConclusionsA clinical examination teaching intervention resulted in a trend towards an increase in confidence for JMOs in paediatric musculoskeletal assessment. Formal evaluation of a teaching module was feasible within the ED.
German Medical Students' Interest in and Knowledge about Human Sexuality in 1972 and 2012
Authors: Turner Daniel , Jopt Konstantin , Nieder Timo O. , Briken Peer 
Published: June 2014

Abstract

Introduction
During the 1970s, a growing number of medical schools began to recognize the importance of medical education concerning human sexuality. Currently, most medical schools provide at least some instruction in human sexuality.

Aim
In light of this development, the present study aimed to compare the interest in and knowledge about human sexuality of medical students from two different time periods.

Methods
The answers to a self-constructed questionnaire of 236 students in 1972 were compared with those of 259 students in 2012. Students were asked whether they were interested in education regarding human sexuality and which specific topics they felt should be included in the medical curriculum. The students' knowledge in the following domains was assessed: sexual development, sexual behavior, sexual physiology and psychology, and sexual medicine.

Main Outcome Measures
The two cohorts were compared with regard to those specific sexuality-related topics in which the students were most and least interested in. Furthermore, the number of correct responses to the knowledge questions was compared.

Results
While in 1972, 99.2% of the students were interested in medical education about human sexuality, in 2012, 80.3% showed an interest. The connection of disorders from different medical disciplines with sexuality was rated as most interesting by both the students from 1972 and 2012. Medical students from 2012 gave 50.3% correct answers to the knowledge questions, whereas students from 1972 correctly answered 46.3% of the questions.

Conclusions
Although interest in education concerning human sexuality has decreased, the majority of students view it as an important topic. Nevertheless, medical students still lack knowledge about important aspects of human sexuality (e.g., psychosexual development and relative safety of different contraceptives). Therefore, more time should be dedicated to education concerning human sexuality and its cultural, societal, and health aspects in particular.