bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dealing with Female Sexuality: Training, Attitude, and Practice of Obstetrics and Gynecology Residents from a Developing Country
Authors: Vieira Teresa Cristina Souza Barroso , de Souza Eduardo , da Silva Ivaldo , Torloni Maria Regina , Ribeiro Meireluci Costa , Nakamura Mary Uchiyama 
Published: April 2015

Abstract

Introduction
There is little research on how obstetrics and gynecology (Ob/Gyn) residents deal with female sexuality, especially during pregnancy.

Aim
The aim of this study was to assess the training, attitude, and practice of Ob/Gyn residents about sexuality.

Methods
A cross-sectional survey of Brazilian Ob/Gyn residents enrolling in an online sexology course was conducted. A questionnaire assessed their training in sexuality during medical school and residency and their attitude and practice on sexual issues during pregnancy.

Main Outcome Measures
Training, attitude, and practice of Ob/Gyn residents regarding sexuality were the main outcome measures.

Results
A total of 197 residents, from 21 different programs, answered the online questionnaire. Mean age was 27.9 ± 2.2, most were female (87%), single (79%), and had graduated in the last 5 years (91%). Almost two-thirds (63%) stated that they did not receive any training at all and 28% reported having only up to 6 hours of training about sexuality in medical school. Approximately half of the respondents (49%) stated that they had received no formal training about sexuality during their residency up to that moment and 29% had received ≤6 hours of training. Over half (56%) never or rarely took a sexual history, 51% stated that they did not feel competent or confident to answer their pregnant patients’ questions about sexuality, and 84% attributed their difficulties in dealing with sexual complaints to their lack of specific knowledge on the topic.

Conclusion
The vast majority of Brazilian Ob/Gyn residents enrolling in a sexuality course had little previous formal training on this topic in medical school and during their residency programs. Most residents do not take sexual histories of pregnant patients, do not feel confident in answering questions about sexuality in pregnancy, and attribute these difficulties to lack of knowledge. These findings point to a clear need for additional training in sexuality among Brazilian Ob/Gyn residents.
Acute Phase Proteins in Racehorses with Inflammatory Airway Disease
Authors: Leclere M. , Lavoie‐Lamoureux A. , Lavoie J.‐P. 
Published: April 2015

BackgroundSystemic inflammation is observed in horses with heaves and could also be present in horses with a lesser degree of pulmonary inflammation.Hypothesis/ObjectivesIt was hypothesized that racehorses with inflammatory airway disease (IAD) have increased concentration of circulating acute phase proteins. The objective of this study was to compare serum acute phase proteins of racehorses with and without lower airway inflammation.AnimalsSerum from 21 client‐owned Standardbred racehorses with exercise intolerance and lower airway inflammation and serum from 10 client‐owned Standardbred racehorses with exercise intolerance without lower airway inflammation.MethodsIn a case–control study, serum samples from previously characterized horses presented for exercise intolerance with or without lower airway inflammation based on bronchoalveolar lavage fluid cytology were analyzed for serum amyloid A protein (SAA), C‐reactive protein (CRP), and haptoglobin using commercialELISAs.ResultsThere was no significant differences between groups forSAA(non‐IADversusIAD, median (range): 3.47 (0.06–34.94) versus 6.33 (0.06–80) μg/mL,P = .49),CRP(10.87 (2.05–29.03) versus 4.63 (0.02–31.81) μg/mL,P = .23) or haptoglobin (900.36 (607.99–2018.84) versus 749.54 (530.81–1076.95) μg/mL,P = .09).Conclusions and Clinical ImportanceIn this population of poorly performing racehorses in training, serumSAA,CRP, and haptoglobin were not helpful in distinguishing between horses withIADfrom horses with exercise intolerance from other causes.
Tor1, Sch9 and PKA downregulation in quiescence rely on Mtl1 to preserve mitochondrial integrity and cell survival
Authors: Sundaram Venkatraghavan , Petkova Mima I. , Pujol‐Carrion Nuria , Boada Jordi , de la Torre‐Ruiz Maria Angeles 
Published: April 2015

SummaryHere we show that Mtl1, member of the cell wall integrity pathway of Saccharomyces cerevisiae, plays a positive role in chronological life span (CLS). The absence of Mtl1 shortens CLS and causes impairment in the mitochondrial function. This is reflected in a descent in oxygen consumption during the postdiauxic state, an increase in the uncoupled respiration and mitochondrial membrane potential and also a descent in aconitase activity. We demonstrate that all these effects are a consequence of signalling defects suppressed by TOR1 (target of rapamycin) and SCH9 deletion and less efficiently by Protein kinase A (PKA) inactivation. Mtl1 also plays a role in the regulation of both Bcy1 stability and phosphorylation, mainly in response to glucose depletion. In postdiauxic phase and in conditions of glucose depletion, Mtl1 negatively regulates TOR1 function leading to Sch9 inactivation and Bcy1 phosphorylation converging in PKA inhibition. Slt2/Mpk1 kinase partially contributes to Bcy1 phosphorylation, although additional targets are not excluded. Mtl1 links mitochondrial dysfunction with TOR and PKA pathways in quiescence, glucose being the main signalling molecule.
Social functioning and socioeconomic changes after introduction of regular dialysis treatment and impact of dialysis modality: A multi‐centre survey of Japanese patients
Authors: Nakayama Masaaki , Ishida Mari , Ogihara Masahiko , Hanaoka Kazushige , Tamura Masahito , Kanai Hidetoshi , Tonozuka Yukio , Marshall Mark R 
Published: April 2015

AbstractAimPatient socialization and preservation of socioeconomic status are important patient‐centred outcomes for those who start dialysis, and retention of employment is a key enabler. This study examined the influence of dialysis inception and modality upon these outcomes in a contemporary Japanese cohort.MethodsWe conducted a survey of prevalent chronic dialysis patients from 5 dialysis centres in Japan. All patients who had been on peritoneal dialysis (PD) since dialysis inception were recruited, and matched with a sample of those on in‐centre haemodialysis (ICHD). We assessed patients' current social functioning (Short Form 36 Health Survey), and evaluated changes to patient employment status, annual income, and general health condition from the pre‐dialysis period to the current time.ResultsA total of 179 patients were studied (102 PD and 77 ICHD). There were no differences in social functioning by modality. Among them, 113 were employed in the pre‐dialysis period with no difference by modality. Of these, 22% became unemployed after dialysis inception, with a corresponding decline in average working hours and annual income. The odds of unemployment after dialysis inception were 5.02 fold higher in those on ICHD compared to those on PD, after adjustment for covariates. There were no changes for those who were already unemployed in the pre‐dialysis period.ConclusionsEmployment status is significantly hampered by dialysis inception, although PD was associated with superior retention of employment and greater income compared to ICHD. This supports a positive role for PD in preservation of socioeconomic status and potentially other patient‐centred outcomes.
Are nocturnal hypoxemia and hypercapnia associated with desaturation immediately after adenotonsillectomy?
Authors: Dalesio Nicholas M. , McMichael Douglas H. , Benke James R. , Owens Sean , Carson Kathryn A. , Schwengel Deborah A. , Schwartz Alan R. , Ishman Stacey L. 
Published: April 2015

SummaryBackgroundChildren who undergo adenotonsillectomy for sleep‐disordered breathing frequently have postoperative oxygen desaturations. Nocturnal hypoxia has been shown to predict postoperative respiratory complications; however, other gas exchange abnormalities detected on polysomnography (PSG) have not been evaluated.AimWe sought to determine whether hypercapnia seen on preoperative nocturnal PSG can predict postoperative hypoxemia.MethodsWe conducted a retrospective review of 319 children who underwent polysomnography before adenotonsillectomy. Saturation levels were recorded for at least 2 h postoperatively, and the primary outcome was desaturation (<90%).ResultsThe median patient age was 5 years (range, 5 months–17 years). Patients who desaturated postoperatively had higher median peak endtidal CO2 (EtCO2) levels (55.5 vs 52 mmHg; P = 0.02), lower saturation nadirs (80.5% vs 88%; P = 0.048), and were younger (2 vs 6 years; P < 0.001) than those without desaturation. Age was significantly correlated with peak EtCO2 (r = −0.16), respiratory disturbance index (RDI; r = −0.23), and oxygen saturation nadir (r = 0.25; all P < 0.01). In unadjusted analysis, age <3 years compared to ≥9 years (odds ratio [OR] = 10.09; 95% confidence interval [CI] = 2.13–96.26), peak EtCO2 > 55 mmHg (OR = 3.38; 95% CI = 1.21–9.47), and RDI ≥ 10 (OR = 2.89; 95% CI = 1.05–8.42) were associated with increased odds of desaturation. Multivariable logistic regression on age, race, sex, peak EtCO2, RDI, opioid use, and saturation nadir showed that only age was significantly associated with postoperative desaturation. Patients 0–2 years old were 10.43 (95% CI = 1.89–110.9) times more likely to have desaturation than patients 9–17 years old.ConclusionPatients <3 years of age are most likely to have postoperative hypoxemia after adenotonsillectomy. Gas exchange abnormalities did not correlate with postoperative desaturations, although age and peak EtCO2 did strongly correlate.
Dyslipidemia in Dialysis Patients
Authors: Qunibi Wajeh Y. 
Published: April 2015

AbstractDyslipidemia is a well‐established traditional risk factor for cardiovascular events in the general population, particularly those with preexisting cardiovascular disease (CVD). In this population, reductions in total and low density lipoprotein cholesterol (LDL‐C) levels are effective in reducing coronary artery events and mortality. Dyslipidemia is more common in patients with chronic kidney disease (CKD) and is believed to contribute to the high prevalence of CVD in these patients. To date, the treatment of dyslipidemia in patients with CKD followed the guidelines recommended by the US National Cholesterol Education Program Adult Treatment Panel III (ATP III) for the treatment of lipid abnormalities. These guidelines recommend that initiation of lipid‐lowering therapy be based on LDL‐C level and the projected 10‐year risk for coronary artery disease (CAD). However, we now recognize that the relationship between serum cholesterol and CVD is more complex in patients with CKD, particularly those receiving maintenance hemodialysis. This has been demonstrated by the failure of three large randomized clinical trials to show a beneficial effect of lipid‐lowering therapy in reducing mortality in dialysis patients despite significant reduction in LDL‐C levels. These results have caused uncertainty among nephrologists about how best to manage dyslipidemia in their patients. In this review, the role of dyslipidemia as a risk factor for atherosclerosis in ESRD patients and the results of the 3 clinical trials and other studies, including their limitations will be discussed, and a schema for treating dyslipidemia in dialysis patients will be proposed.
The Chronic Kidney Disease—Colonic Axis
Authors: Pahl Madeleine V. , Vaziri Nosratola D. 
Published: April 2015

AbstractChronic kidney disease (CKD) has long been known to cause significant gastrointestinal and colonic pathology. Recent advances in understanding of the role of colonic bacterial microbiome and its function and composition in health and disease have revealed previously unappreciated effects of CKD‐associated colonic pathology on the development of uremic complications. CKD can result in profound changes in the microbiome composition and biosynthetic pattern, and the structure and function of the colon. Increases in bacteria that produce urease, uricase, p‐cresol‐ and indole‐forming enzymes and the depletion of bacteria that possess short chain fatty acid forming enzymes have been described in human and animal models. Disruption of the colonic epithelial tight junction in different animal models of CKD has been reported and is largely due to the conversion of luminal urea to ammonia by urease possessing bacteria. Together, these changes contribute to the pathogenesis of systemic inflammation and uremic toxicity by allowing the translocation of endotoxin and microbial fragments into the circulation. Additionally, colonic bacteria are the main source of several well‐known pro‐inflammatory uremic toxins such as indoxyl sulfate, P‐cresol sulfate. This review is intended to provide an overview of the effects of CKD on the colonic microbiome and the intestinal epithelial barrier structure and function and their role in the pathogenesis the systemic inflammation and uremic toxicity.
An Objective Bayesian Criterion to Determine Model Prior Probabilities
Authors: Villa Cristiano , Walker Stephen 
Published: April 2015

AbstractWe discuss the problem of selecting among alternative parametric models within the Bayesian framework. For model selection problems, which involve non‐nested models, the common objective choice of a prior on the model space is the uniform distribution. The same applies to situations where the models are nested. It is our contention that assigning equal prior probability to each model is over simplistic. Consequently, we introduce a novel approach to objectively determine model prior probabilities, conditionally, on the choice of priors for the parameters of the models. The idea is based on the notion of theworthof having each model within the selection process. At the heart of the procedure is the measure of thisworthusing the Kullback–Leibler divergence between densities from different models.
Detection of bacterial contamination in apheresis platelets: is apheresis technology a factor?
Authors: Bravo Marjorie , Shaz Beth H. , Kamel Hany , Vanderpool Sandra , Tomasulo Peter , Custer Brian , Townsend Mary 
Published: April 2015

BACKGROUNDApheresis platelet (AP) contamination may be influenced by manufacturing methods because bacteria are subject to the same forces that permit separation of blood cells. This study assesses whether apheresis technology influences in‐process detection of bacterial contamination.STUDY DESIGN AND METHODSBlood Systems, Inc. (BSI) and New York Blood Center (NYBC) use Amicus and Trima devices to collect APs. Manufacturing (arm disinfection and in‐line diversion) was consistent for both devices in the study period. Detection was performed using BacT/ALERT. True‐positive (TP) rates were calculated and significance testing was performed using chi‐square tests separately for BSI and NYBC. For BSI, multivariable logistic regression analysis was also performed to identify factors associated with TP results.RESULTSFor BSI, there were 49 TPs in 354,946 donations (1.4/10,000): 2.5 per 10,000 for Amicus and 1.0 per 10,000 for Trima (p < 0.05). Multivariable logistic regression analysis showed significant association between TP and devices (odds ratio, 2.8; 95% confidence interval [CI], 1.01‐8.0) and for one collection region. For NYBC, there were 18 TPs in 161,840 donations (1.1/10,000): 2.1 per 10,000 for Amicus and 0.4 per 10,000 for Trima (p < 0.05).CONCLUSIONSThe TP rate was significantly higher in Amicus collections than in Trima collections at NYBC and BSI. These results do not allow for conclusions regarding the relative clinical risk of PLTs collected by Amicus and Trima. Future evaluations of component quality and clinical outcomes should consider different collection technologies.
Safe transition to surgery: working differently to make blood transfusion process safer for elective surgery
Authors: Badjie Karafa S.W. , Rogers James C. , Jenkins Sarah M. , Bundy Kevin L. , Stubbs James R. , Cima Robert R. 
Published: April 2015

BACKGROUNDOur institutional policy allows patients who are scheduled for elective surgery with no history of a pregnancy or blood transfusion in the preceding 3 months to have a presurgical sample (PSS) collected and tested up to 56 days before their scheduled surgery; however, our PSS TS completion rate in eligible patients before the morning of surgery was 83%. In 2011, a team was charged to develop a standardized process along with other process improvements while ensuring no increase in transfusion‐related events.STUDY DESIGN AND METHODSThe team followed the DMAIC framework in appraising the effectiveness and efficiency of the current state process including baseline data collection such as PSS TS completion rate, number of eligible patients needing a PSS TS on the day of surgery, benchmarking, SSBO utilization, and future state mapping.RESULTSFirst quarter (Q1) 2011 versus Q1 2012 postimplementation results showed significant improvements of the process including a 53% decrease in PSS TS on the day of surgery; a 13% increase in PSS TS completion before the morning of surgery; a 26% reduction in total XM RBCs; and a 58.8% reduction in XM RBCs not issued, plus a 47% decrease in RBC wastage. Q1 2011 versus Q1 2013 showed a 41% reduction in total XM RBCs and an 88.4% reduction in XM RBCs not issued but overall RBCs issued versus returned increased slightly and represents a future opportunity for improvement.CONCLUSIONSThe redesigned, transformational process eliminated SSBO and improved ordering process and PSS TS completion rate as well as blood product ordering and utilization.
Pseudomonas aeruginosa and Periodontal Pathogens in the Oral Cavity and Lungs of Cystic Fibrosis Patients: a Case-Control Study
Authors: Rivas Caldas Rocio , Le Gall Florence , Revert Krista , Rault Gilles , Virmaux Michèle , Gouriou Stephanie , Héry-Arnaud Geneviève , Barbier Georges , Boisramé Sylvie 
Published: April 2015

ABSTRACT

Cystic fibrosis (CF) is the most frequent lethal genetic disease in the Caucasian population. Lung destruction is the principal cause of death by chronic
Pseudomonas aeruginosa
colonization. There is a high prevalence of oropharyngeal anaerobic bacteria in sputum of CF patients. This study was carried out due to the lack of results comparing subgingival periodontal pathogenic bacteria between the oral cavity and lungs in patients with CF in relation with
P. aeruginosa
presence. Our first goal was to detect
P. aeruginosa
in oral and sputum samples by culture and molecular methods and to determine clonality of isolates. In addition, subgingival periodontal anaerobic bacteria were searched for in sputum. A cross-sectional pilot case-control study was conducted in the CF Reference Center in Roscoff, France. Ten CF patients with a ΔF508 homozygous mutation (5 chronically colonized [CC] and 5 not colonized [NC]) were enrolled.
P. aeruginosa
was detected in saliva, sputum, and subgingival plaque samples by real-time quantitative PCR (qPCR). Subsequently, periodontal bacteria were also detected and quantified in subgingival plaque and sputum samples by qPCR. In CC patients,
P. aeruginosa
was recovered in saliva and subgingival plaque samples. Sixteen
P. aeruginosa
strains were isolated in saliva and sputum from this group and compared by pulsed-field gel electrophoresis (PFGE). Subgingival periodontal anaerobic bacteria were found in sputum samples. A lower diversity of these species was recovered in the CC patients than in the NC patients. The presence of the same
P. aeruginosa
clonal types in saliva and sputum samples underlines that the oral cavity is a possible reservoir for lung infection.
Unexpected Diagnosis of Cerebral Toxoplasmosis by 16S and D2 Large-Subunit Ribosomal DNA PCR and Sequencing
Authors: Kruse Alexandra Y. C. , Kvich Lasse , Eickhardt Steffen , Omland Lars H. , Bjarnsholt Thomas , Moser Claus 
Published: April 2015

ABSTRACT

The protozoan parasite
Toxoplasma gondii
causes severe opportunistic infections. Here, we report an unexpected diagnosis of cerebral toxoplasmosis.
T. gondii
was diagnosed by 16S and D2 large-subunit (LSU) ribosomal DNA (rDNA) sequencing of a cerebral biopsy specimen and confirmed by
T. gondii
-specific PCR and immunohistochemistry. The patient was later diagnosed with HIV/AIDS.
Mutations in Coronavirus Nonstructural Protein 10 Decrease Virus Replication Fidelity
Authors: Smith Everett Clinton , Case James Brett , Blanc Hervé , Isakov Ofer , Shomron Noam , Vignuzzi Marco , Denison Mark R. 
Published: April 2015

ABSTRACT

Coronaviruses (CoVs) are unique in encoding a 3′→5′ exoribonuclease within nonstructural protein 14 (nsp14-ExoN) that is required for high-fidelity replication, likely via proofreading. nsp14 associates with the CoV RNA-dependent RNA polymerase (nsp12-RdRp), and nsp14-ExoN activity is enhanced by binding nsp10, a small nonenzymatic protein. However, it is not known whether nsp10 functions in the regulation of CoV replication fidelity. To test this, we engineered single and double alanine substitution mutations into the genome of murine hepatitis virus (MHV-A59) containing ExoN activity [ExoN(+)] at positions within nsp10 known to disrupt the nsp10-nsp14 interaction
in vitro
. We show that an nsp10 mutant, R80A/E82A-ExoN(+), was five to ten times more sensitive to treatment with the RNA mutagen 5-fluorouracil (5-FU) than wild-type (WT)-ExoN(+), suggestive of decreased replication fidelity. This decreased-fidelity phenotype was confirmed using two additional nucleoside analogs, 5-azacytidine and ribavirin. R80A/E82A-ExoN(+) reached a peak titer similar to and demonstrated RNA synthesis kinetics comparable to those seen with WT-ExoN(+). No change in 5-FU sensitivity was observed for R80A/E82A-ExoN(−) relative to MHV-ExoN(−), indicating that the decreased-fidelity phenotype of R80A/E82A-ExoN(−) is linked to the presence of ExoN activity. Our results demonstrate that nsp10 is important for CoV replication fidelity and support the hypothesis that nsp10 functions to regulate nsp14-ExoN activity during virus replication.

IMPORTANCE
The adaptive capacity of CoVs, as well as all other RNA viruses, is partially attributed to the presence of extensive population genetic diversity. However, decreased fidelity is detrimental to CoV replication and virulence; mutant CoVs with decreased replication fidelity are attenuated and more sensitive to inhibition by RNA mutagens. Thus, identifying the viral protein determinants of CoV fidelity is important for understanding CoV replication, pathogenesis, and virulence. In this report, we show that nsp10, a small, nonenzymatic viral protein, contributes to CoV replication fidelity. Our data support the hypothesis that CoVs have evolved multiple proteins, in addition to nsp14-ExoN, that are responsible for maintaining the integrity of the largest known RNA genomes.