bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Optimal Retrospective Change Point Detection Policy
Authors: VEXLER ALBERT , WU CHENGQING 
Published: April 2009

Abstract. Since the middle of the twentieth century, the problem of making inferences about the point in a surveyed series of observations at which the underlying distribution changes has been extensively addressed in the economics, biostatistics and statistics literature. Cumulative sum‐type statistics have commonly been thought to play a central role in non‐sequential change point detections. Alternatively, we present and examine an approach based on the Shiryayev–Roberts scheme. We show that retrospective change point detection policies based on Shiryayev–Roberts statistics are non‐asymptotically optimal in the context of most powerful testing.
Contraception and Women with Intellectual Disabilities
Authors: McCarthy Michelle 
Published: April 2009

Background  Contraception is widely prescribed to women with intellectual disabilities, yet little is known about what the women think and feel about this. One of the aims of the study was to explore what women understood and to what extent they were able to exercise choice and control.Method  Twenty‐three women with mild and moderate intellectual disabilities in South East England were interviewed about their current and past use of contraception, their knowledge of contraception more broadly, the process of being prescribed contraception and sources of information and support.Results  Knowledge of how contraception works was very limited and approximately half the women also lacked basic knowledge about reproduction. Few women attended medical appointments alone and none had been given any accessible information about contraception.Conclusions  There is a role for increased education, support and advocacy for women with intellectual disabilities when they are prescribed contraception. This would help to ensure women are prescribed methods which are best for them as individuals and to help maximize their participation in the process.
Starting a New Job: The Social and Emotional Experience of People with Intellectual Disabilities
Authors: Jahoda Andrew , Banks Pauline , Dagnan Dave , Kemp Jeremy , Kerr Wendy , Williams Victoria 
Published: April 2009

Background Employment is viewed by policy makers as both a human right and as a means of changing the marginalized status of people with intellectual disabilities, with important social and emotional benefits. However, there has been little longitudinal research examining the experience of people with intellectual disabilities in the workplace.Methods Thirty‐five individuals with mild to borderline intellectual disabilities participated in this study. They were recruited from supported employment agencies in Scotland. A longitudinal approach was adopted, with the participants being interviewed around the time of starting their jobs, and again 9–12 months later.Results The content analyses of the semi‐structured interviews indicated that the participants perceived continuing benefits from entering mainstream employment, including more purposeful lives and increased social status. However, over the follow‐up period the participants reported few social opportunities that extended beyond the workplace, and an anxiety about their competence to meet employers’ demands remained a concern for some.Conclusions The discussion addresses the importance of understanding work in relation to the participants’ wider lives, along with the longer‐term role for supported employment agencies to help people achieve their social and emotional goals in a vocational context.
Adhesion molecules in endometrial epithelium: tissue integrity and embryo implantation
Authors: Singh Harmeet , Aplin John D. 
Published: April 2009

AbstractCell adhesion in endometrial epithelium is regulated to maintain the continuity and protectiveness of the luminal covering cell layer while permitting interstitial implantation of the embryo during a restricted period of about 4 days. Many apparently normal embryos fail to implant, and epithelial‐embryo adhesion remains a poorly understood phenomenon. After menstruation, epithelial regeneration occurs by epiboly from the basal residues of glands, an activity that requires migration on extracellular matrix as well as cell–cell cohesion. Here we review current knowledge of adhesion molecules in the epithelium.
Estrogen and tamoxifen reverse manganese‐induced glutamate transporter impairment in astrocytes
Authors: Lee Eun‐Sook Y. , Sidoryk Marta , Jiang Haiyan , Yin Zhaobao , Aschner Michael 
Published: April 2009

AbstractChronic exposure to manganese (Mn) can cause manganism, a neurodegenerative disorder similar to Parkinson’s disease. The toxicity of Mn includes impairment of astrocytic glutamate transporters. 17β‐Estradiol (E2) has been shown to be neuroprotective in various neurodegenerative diseases including Parkinson’s disease and Alzheimer’s disease, and some selective estrogen receptor modulators, including tamoxifen (TX), also possess neuroprotective properties. We have tested our hypothesis that E2 and TX reverse Mn‐induced glutamate transporter impairment in astrocytes. The results established that E2 and TX increased glutamate transporter function and reversed Mn‐induced glutamate uptake inhibition, primarily via the up‐regulation of glutamate/aspartate transporter (GLAST). E2 and TX also increased astrocytic GLAST mRNA levels and attenuated the Mn‐induced inhibition of GLAST mRNA expression. In addition, E2 and TX effectively increased the expression of transforming growth factor β1, a potential modulator of the stimulatory effects of E2/TX on glutamate transporter function. This effect was mediated by the activation of MAPK/extracellular signal‐regulated kinase (ERK) and phosphoinositide 3‐kinase (PI3K)/Akt signaling pathways. These novel findings suggest, for the first time, that E2 and TX enhance astrocytic glutamate transporter expression via increased transforming growth factor β1 expression. Furthermore, the present study is the first to show that both E2 and TX effectively reverse Mn‐induced glutamate transport inhibition by restoring its expression and activity, thus offering a potential therapeutic modality in neurodegenerative disorders characterized by altered glutamate homeostasis.
Protein kinase C regulation of neuronal zinc signaling mediates survival during preconditioning
Authors: Aras Mandar A. , Hara Hirokazu , Hartnett Karen A. , Kandler Karl , Aizenman Elias 
Published: April 2009

AbstractSub‐lethal activation of cell death processes initiate pro‐survival signaling cascades. As intracellular Zn2+liberation mediates neuronal death pathways, we tested whether a sub‐lethal increase in free Zn2+could also trigger neuroprotection. Neuronal free Zn2+transiently increased following preconditioning, and was both necessary and sufficient for conferring excitotoxic tolerance. Lethal exposure to NMDA led to a delayed increase in Zn2+that contributed significantly to excitotoxicity in non‐preconditioned neurons, but not in tolerant neurons, unless preconditioning‐induced free Zn2+was chelated. Thus, preconditioning may trigger the expression of Zn2+‐regulating processes, which, in turn, prevent subsequent Zn2+‐mediated toxicity. Indeed, preconditioning increased Zn2+‐regulated gene expression in neurons. Examination of the molecular signaling mechanism leading to this early Zn2+signal revealed a critical role for protein kinase C (PKC) activity, suggesting that PKC may act directly on the intracellular source of Zn2+. We identified a conserved PKC phosphorylation site at serine‐32 (S32) of metallothionein (MT) that was important in modulating Zn2+‐regulated gene expression and conferring excitotoxic tolerance. Importantly, we observed increased PKC‐induced serine phosphorylation in immunopurified MT1, but not in mutant MT1(S32A). These results indicate that neuronal Zn2+serves as an important, highly regulated signaling component responsible for the initiation of a neuroprotective pathway.
Distinct modulation of voltage‐gated and ligand‐gated Ca2+ currents by PPAR‐γ agonists in cultured hippocampal neurons
Authors: Pancani Tristano , Phelps Jeremiah T. , Searcy James L. , Kilgore Michael W. , Chen Kuey‐Chu , Porter Nada M. , Thibault Olivier 
Published: April 2009

AbstractType 2 diabetes mellitus is a metabolic disorder characterized by hyperglycemia and is especially prevalent in the elderly. Because aging is a risk factor for type 2 diabetes mellitus, and insulin resistance may contribute to the pathogenesis of Alzheimer’s disease (AD), anti‐diabetic agents (thiazolidinediones‐TZDs) are being studied for the treatment of cognitive decline associated with AD. These agents normalize insulin sensitivity in the periphery and can improve cognition and verbal memory in AD patients. Based on evidence that Ca2+ dysregulation is a pathogenic factor of brain aging/AD, we tested the hypothesis that TZDs could impact Ca2+ signaling/homeostasis in neurons. We assessed the effects of pioglitazone and rosiglitazone (TZDs) on two major sources of Ca2+ influx in primary hippocampal cultured neurons, voltage‐gated Ca2+ channel (VGCC) and the NMDA receptor (NMDAR). VGCC‐ and NMDAR‐mediated Ca2+ currents were recorded using patch‐clamp techniques, and Ca2+ intracellular levels were monitored with Ca2+ imaging techniques. Rosiglitazone, but not pioglitazone reduced VGCC currents. In contrast, NMDAR‐mediated currents were significantly reduced by pioglitazone but not rosiglitazone. These results show that TZDs modulate Ca2+‐dependent pathways in the brain and have different inhibitory profiles on two major Ca2+ sources, potentially conferring neuroprotection to an area of the brain that is particularly vulnerable to the effects of aging and/or AD.
Mental Health of Children in Palestinian Kindergartens: Resilience and Vulnerability
Authors: Massad Salwa , Javier Nieto F. , Palta Mari , Smith Maureen , Clark Roseanne , Thabet Abdel‐Aziz 
Published: April 2009

Background:  Exposure to adversity does not necessarily lead to the development of psychopathology in all affected children. This study examined the factors associated with resilience and vulnerability in mental health in the Gaza Strip in 2007.Methods:  Children selected from a random sample of kindergartens (3‐6 years old, N = 350) were assessed for growth and their mothers administered an interview including a psychometric test battery.Results:  Factors associated with resilience were maternal rated good health, higher maternal level of education, and less child exposure to traumatic events. Factors associated with vulnerability were poor maternal mental health, and male gender.Conclusions:  Our findings highlight the importance of maternal health and education in affecting children’s mental health.
The prevalence and related risk factors of anxiety and depression symptoms among Chinese pregnant women in Shanghai
Authors: QIAO Yong‐Xia , WANG Jing , LI Jue , ABLAT Alimujiang 
Published: April 2009

Objective: To investigate the prevalence of anxiety and depression of the pregnant women during the prenatal period, and provide information for further epidemiological study.Methods: With ethics committee approval, a total of 527 recruited pregnant women from the Department of Obstetrics and Gynecology, Tongji University Medical School were selected at four hospitals that affiliated to the University. By applying a self‐designed questionnaire for hospital anxiety and depression (HAD) scale, we evaluated anxious and depressive symptoms in these women.Results: The prevalence rates of anxiety and depression in these Chinese pregnant women during prenatal period were 6.8% and 4.8%, respectively, whereas the co‐prevalence rate of both anxiety and depression was 3.4%, and anxiety and/or depression 15.0%. The relationship between the prevalence rate of anxiety/depression and the age distribution was proven negatively correlated (χ2 = 1.478, P = 0.016) by the trend chi‐squared test. Among all three groups, the prevalence rate of anxiety and depression was highest in the group of below 20 years old, lowest in the group of over 30 years old, and in‐between in the group of 20 to 30 years old. Logistic regression analysis showed that lower age was a risk factor (odds ratio (OR) = 10.094, 95% confidence interval (CI): 1.418~71.838). Meanwhile, poor educational background (OR = 1.929, 95%CI: 1.101~3.379) was a relevant risk factor as well.Conclusions: We suggest that introduction of psychological health instruction programs for pregnant women, especially the younger ones, should be strengthened. Besides, the essential intervention measures may be applied if necessary.
Use of Bakri balloon in post‐partum haemorrhage: A series of 15 cases
Authors: VITTHALA Srisailesh , TSOUMPOU Ioanna , ANJUM Zulqarnain K. , AZIZ Nagi A. 
Published: April 2009

Background: Post‐partum haemorrhage (PPH) is a major complication of delivery. Hysterectomy is commonly performed when medical treatment of PPH fails. We assessed the effectiveness of Bakri balloon tamponade, a non‐surgical technique in the management of PPH.Aim(s): Our objective is to report our experience in the use of Bakri balloon in treating PPH.Method: A retrospective study of 15 patients who underwent Bakri balloon insertion after unsuccessful medical management of PPH.Results: Fifteen cases of PPH were managed with Bakri balloon insertion. It was effective in all cases of PPH after vaginal delivery and in four cases of caesarean section; the overall effectiveness was 80%.Conclusion: Insertion of Bakri balloon is a simple alternative procedure in the management of PPH. It should be consider before any further surgical intervention including hysterectomy. Junior doctors and midwives can effectively apply it. It can be used during transfer or while waiting for a surgical procedure to reduce blood loss.
The effect of single or multiple courses of antenatal corticosteroid therapy on neonatal respiratory distress syndrome in singleton versus twin pregnancies
Authors: CHOI Suk‐Joo , SONG Seung Eun , SEO Eun Sung , OH Soo‐young , KIM Jong‐Hwa , ROH Cheong‐Rae 
Published: April 2009

Background: Antenatal corticosteroid (ACS) treatment is widely used for the prevention of respiratory distress syndrome (RDS) in preterm infants. However, the efficacy and safety of ACS treatment remains controversial in twin pregnancies.Aims: To investigate the effect of ACS therapy, single or multiple courses, on the incidence of neonatal RDS in singleton and twin pregnancies.Methods: We retrospectively evaluated the pregnancy and neonatal outcomes of 450 singleton and 117 twin pregnancies delivered at 24–34 weeks of gestation due to preterm labour or preterm premature rupture of membranes. The subjects were categorised into four groups according to ACS exposure: 0, 1, 2 and ≥ 3 courses.Results: Overall, RDS occurred more frequently in twins compared to singletons (41.0% vs 25.3%, P < 0.001). In singleton pregnancy, the incidence of RDS was significantly lower in the ACS user groups than in the non‐user group, with the lowest incidence in the multiple course groups. An increase in the number of courses of ACS was associated with a reduction in the incidence of RDS (odds ratio 0.349, 95% confidence interval 0.226, 0.537, P < 0.001) independent of confounding variables. In twin pregnancies, however, the incidence of RDS was not significantly different in comparisons among the four groups.Conclusion: Multiple courses of ACS were associated with a significantly decreased risk of RDS in singleton pregnancies. However, the current standard dose or interval for ACS administration in singleton pregnancy, as either a single or multiple courses, did not reduce RDS in twins.
A survey of New Zealand RANZCOG Fellows on their use of the levonorgestrel intrauterine device in adolescents
Authors: PATERSON Helen , MILLER Dawn , DEVENISH Celia 
Published: April 2009

Background: The levonorgestrel intrauterine device (LNG‐IUD) is an established treatment for adult women. Although it is being used in adolescents, there is little published research in this age group to date. Recent reviews and editorials have challenged the long‐held views that intrauterine devices should not be used in young women.Aims: This study aimed to identify the patterns of use, including indications and contraindications of the LNG‐IUD in adolescents by RANZCOG Fellows practising in New Zealand.Methods: A postal survey of New Zealand RANZCOG Fellows on their use of the LNG‐IUD in females aged 10–19 years.Results: There was a 72% response rate. Half of the respondents had inserted the LNG‐IUD in adolescents. Non‐inserters identified a significantly greater number of contraindications than inserters (χ2, P < 0.0001). Over half of those respondents who had inserted a device in an adolescent did so fewer than three times per year. Intellectual disability and endometriosis, both unlicensed indications, were the two most commonly identified circumstances for insertion by respondents.Conclusions: Patterns of insertion of the LNG‐IUD in adolescents by RANZCOG Fellows in New Zealand differ and there was equipoise over its use. Further research is required to establish the efficacy, safety and acceptability of the LNG‐IUD in adolescents.
MotherSafe: Review of three years of counselling by an Australian teratology Information Service
Authors: LIM Joy Marie , SULLIVAN Elizabeth , KENNEDY Debra 
Published: April 2009

Background: MotherSafe was established in January 2000 at the Royal Hospital for Women as Australia's first ‘purpose‐built’ Teratogen Information Service and since then has received over 75 000 calls regarding exposures during pregnancy and lactation.Aim: To describe the patterns of use of MotherSafe over a three‐year period.Methods: Retrospective descriptive epidemiological study using data from the database established at MotherSafe. Records from all the calls logged at MotherSafe between January 2005 and December 2007 were analysed to determine total number of calls, demographic characteristics of callers, including age, caller category and postcode, reason for call, source of referral and type of exposure.Results: A total of 47 138 calls were recorded to the MotherSafe service from January 2005 to December 2007. The majority of calls were regarding exposures in pregnancy (55%) and breast‐feeding (38%). Average age of patients was 32.3 years. Of the calls made, 81.9% (38 485 of 46 968) were by consumers (the pregnant or lactating woman herself or a relative). The most common primary exposure categories were: over‐the‐counter medications (11.3%), psychotropic medication (9.0%), herbal or vitamin products (8.2%), antibiotics (7.0%), gastrointestinal medications (6.8%) and topical products (6.6%). Forty per cent of callers enquired about multiple exposures.Conclusions: The utilisation of MotherSafe by consumers and general practitioners continues to increase, reflecting the strong demand for a teratogen counselling service that provides high‐quality, evidence‐based information on exposures during pregnancy and lactation.
Assessment of the effect of psychosocial support during childbirth in Ibadan, south‐west Nigeria: A randomised controlled trial
Authors: MORHASON‐BELLO Imran O. , ADEDOKUN Babatunde O. , OJENGBEDE Oladosu A. , OLAYEMI Oladapo , OLADOKUN Adesina , FABAMWO Adetokunbo O. 
Published: April 2009

Objective: To assess the effect of psychosocial support on labour outcomes.Methodology: A randomised control trial conducted at the University College Hospital Ibadan, Nigeria, from November 2006 to 30 March 2007. Women with anticipated vaginal delivery were recruited and randomised at the antenatal clinic. The experimental group had companionship in addition to routine care throughout labour until two hours after delivery, while the controls had only routine care. The primary outcome measure was caesarean section rate. Others included duration of active phase, pain score, time of breast‐feeding initiation and description of labour experience. Multivariable analyses were used to adjust for potential confounders. The level of statistical significance was set at 5%.Results: Of the 632 recruited, 585 were eventually studied: 293 and 292 were in experimental and control groups, respectively. Husbands constituted about two‐thirds of the companions. Women in the control group were about five times more likely to deliver by caesarean section (95% confidence interval (CI) 1.98–12.05), had significantly longer duration of active phase (P < 0.001), higher pain scores (P = 0.011) and longer interval between delivery and initiation of breast‐feeding (P < 0.001). However, those in experimental group had a more satisfying labour experience (odds ratio 3.3 95% CI 2.15–5.04).Conclusion: Women with companionship had better labour outcomes compared to those without. It is desirable to adopt this practice in our health‐care settings as an alternative strategy to provide comparable quality services to would‐be mothers in labour.
Role of a second stage partogram in predicting the outcome of normal labour
Authors: BASU Jayati K. , BUCHMANN Eckhart J. , BASU Debashis 
Published: April 2009

Background: Management of the second stage of labour is dictated by arbitrary time limits rather than true measures of progress. No partogram is available for second stage of labour.Objectives: To evaluate a partogram designed for use for the second stage of labour.Methods: This prospective cross‐sectional analytical study included low‐risk pregnant women with singleton fetuses with vertex presentations at term. From onset of the second stage, vaginal examinations were performed every 30 min until delivery. A scoring system developed by Sizer et al. was used based on station and position of fetal head. Scores were plotted on a second stage partogram and used to predict labour outcomes, such as duration of second stage and mode of delivery.Results: Of 79 women examined, 73 had spontaneous vaginal delivery. Of the remaining six, four required oxytocin infusion and other two required vacuum extraction. The median durations of the second stage of labour for primigravidas (n = 34) and multigravidas (n = 45) were 35 and 25 min, respectively. The median Sizer's partogram score at the onset of second stage was 4. Multiple regression analysis showed that the partogram score (r2 = 0.27) and gravidity (r2 = 0.10) were independent predictors of duration of the second stage. There was a significant association between second stage progress plotted to the right of the partogram line and non‐spontaneous delivery (P = 0.01).Conclusion: The second stage partogram score at onset can predict the duration of second stage. Poor progress plotted on the partogram is associated with non‐spontaneous delivery.