bluuebunny/crossref_metadata_2025_split huggingface dataset:
Design and Implementation of a Controlled Clinical Trial to Evaluate the Effectiveness and Efficiency of Routine Opt‐out Rapid Human Immunodeficiency Virus Screening in the Emergency Department
Authors: Haukoos Jason S. , Hopkins Emily , Byyny Richard L. , Conroy Amy A. , Silverman Morgan , Eisert Sheri , Thrun Mark , Wilson Michael , Boyett Brian , Heffelfinger James D. ,   for the Denver ED HIV Opt‐Out Study Group
Published: July 2009

AbstractIn 2006, the Centers for Disease Control and Prevention (CDC) released revised recommendations for performing human immunodeficiency virus (HIV) testing in health care settings, including implementing routine rapid HIV screening, the use of an integrated opt‐out consent, and limited prevention counseling. Emergency departments (EDs) have been a primary focus of these efforts. These revised CDC recommendations were primarily based on feasibility studies and have not been evaluated through the application of rigorous research methods. This article describes the design and implementation of a large prospective controlled clinical trial to evaluate the CDC’s recommendations in an ED setting. From April 15, 2007, through April 15, 2009, a prospective quasi‐experimental equivalent time‐samples clinical trial was performed to compare the clinical effectiveness and efficiency of routine (nontargeted) opt‐out rapid HIV screening (intervention) to physician‐directed diagnostic rapid HIV testing (control) in a high‐volume urban ED. In addition, three nested observational studies were performed to evaluate the cost‐effectiveness and patient and staff acceptance of the two rapid HIV testing methods. This article describes the rationale, methodologies, and study design features of this program evaluation clinical trial. It also provides details regarding the integration of the principal clinical trial and its nested observational studies. Such ED‐based trials are rare, but serve to provide valid comparisons between testing approaches. Investigators should consider similar methodology when performing future ED‐based health services research.
Side population of a murine mantle cell lymphoma model contains tumour‐initiating cells responsible for lymphoma maintenance and dissemination
Authors: Vega Francisco , Davuluri Yogesh , Cho‐Vega Jeong Hee , Singh Rajesh R. , Ma Shuguang , Wang Rui‐Yu , Multani Asha S. , Drakos Elias , Pham Lan V. , Lee Yen‐Chiu Lin , Shen Long , Ambrus Jr Julian , Medeiros L. Jeffrey , Ford Richard J. 
Published: July 2009

Abstract‘Cancer stem cells’ or ‘tumour initiating cells’ in B‐cell non‐Hodgkin lymphomas have not been demonstrated, although some studies focused on other cancer types suggest that such populations exist and represent tumour cells resistant to therapy and involved in relapse. These cells may also represent a putative neoplastic ‘cell of origin’ in lymphomas, but there is little substantive data to support this suggestion. Using cell lines derived from a recently established murine IL‐14α× c‐Myc double transgenic/mantle cell lymphoma‐blastoid variant model, heretofore referred to as DTG cell lines, we identified a subset of cells within the side population (SP) with features of ‘tumour‐initiating cells’. These features include higher expression of ABCG2 and BCL‐2, longer telomere length, greater self‐renewal ability and higher in vitro clonogenic and in vivo tumorigenic capacities compared with non‐SP. In addition, in vitro viability studies demonstrated that the non‐SP lymphoma subpopulation has a limited lifespan in comparison with the SP fraction. Syngenic transplant studies showed that non‐SP derived tumours, in comparison to the SP‐derived tumours, exhibit greater necrosis/apoptosis and less systemic dissemination capability. In conclusion, our data support the interpretation that the DTG SP fraction contains a cell population highly capable of tumour maintenance and systemic dissemination and lends support to the concept that ‘tumour‐initiating cells’ occur in lymphomas.
Temporal triangular alopecia with decreased follicular density
Authors: Silva C. Y. , Lenzy Y. M. , Goldberg L. J. 
Published: July 2009

Temporal triangular alopecia (TTA) is a type of alopecia that is often congenital, and clinically exhibits hair loss on one or both temples. It is characterized histologically by a normal number of small hair follicles without significant inflammation. We report a patient with TTA whose biopsy exhibited a decreased number of hair follicles. There are limited reports of the histopathology of TTA, and most have utilized standard vertical sections. Of the handful of patients with transversely sectioned biopsies, follicular numbers have been reportedly normal. Our finding of a patient with TTA with a decreased number of hair follicles broadens the histologic spectrum of this disorder, and may have implications for pathogenesis.Silva CY, Lenzy YM, Goldberg LJ. Temporal triangular alopecia with decreased follicular density
Patients’ self‐assessment of oral malodour and its relationship with organoleptic scores and oral conditions
Authors: Romano F , Pigella E , Guzzi N , Aimetti M 
Published: July 2009

Abstract:  Objectives:  The aim of this study was to compare patients’ self‐rating of oral malodour with organoleptic evaluation and to relate them to oral conditions.Methods:  One hundred and eighty systemically healthy patients with a primary complaint of oral malodour participated in this cross‐sectional study. They were asked to complete a questionnaire regarding family and social discomfort and type of halitosis complaint, and to score the degree of their own oral malodour. The quality of the mouth air was assessed organoleptically by a calibrated odour judge. Odour‐judge scores and self‐assessments of bad breath were compared with one another as well as with clinical parameters (plaque index, bleeding index, probing depth and tongue coating score).Results:  The organoleptic test revealed that 93.9% of the subjects were found actually to have halitosis. The self‐rating of oral malodour varied widely among patients. In 37.8% of patients, there was a correspondence between subjective and organoleptic measurements. The better correspondence was evident at 2–3 scores. The organoleptic ratings were significantly related to clinical parameters, whereas patients’ self‐measurements did not. The bleeding index had the highest correlation coefficient among the periodontal parameters examined (r = 0.665, P < 0.001).Conclusions:  Self‐estimation of bad breath correlated well with the presence of oral malodour as determined by organoleptic examination. Patients with slight or moderate oral halitosis presented the highest correlation rate between self‐ and odour‐judge assessment.
The relationship between oral hygiene and oral colonization with Candida species in healthy adult subjects*
Authors: Darwazeh AM‐G , Hammad MM , Al‐Jamaei AA 
Published: July 2009

To cite this article:

Int J Dent Hygiene
DOI: 10.1111/j.1601‐5037.2009.00371.x Darwazeh AM‐G, Hammad MM, Al‐Jamaei AA. The relationship between oral hygiene and oral colonization with Candida species in healthy adult subjects.Abstract:  Poor oral hygiene has been frequently suggested as a predisposing factor for oral candidal colonization, but the convincing evidence is lacking.Objective:  To assess and compare oral candidal colonization, both quantitatively and qualitatively, in groups of healthy dentate subjects with different levels of oral hygiene as determined by the plaque index (PI) and gingival index (GI) scores.Methods:  The concentrated oral rinse technique was used to isolate Candida species from 149 healthy dentate subjects. Candida species were cultured on Sabouraud’s dextrose agar plates and identified by germ‐tube test and the automated Vitek® system biochemical yeast card. According to the PI and GI scores, subjects were divided into different groups of oral hygiene level.Results:  Candida species were isolated from 86 (57.7%) subjects. The prevalence of candidal carriage increased significantly as a function of age (P = 0.023), but was comparable between males and females (58.7% and 56.7% respectively; P = 0.87). Oral candidal carriage rate and density were not affected by the levels of dental plaque or gingival condition. The prevalence of oral candididal carriage was significantly higher in the subjects who were not using dental floss compared with those who were using dental floss (P = 0.032).Conclusion:  Oral hygiene status, as determined by the PI and the GI scores per se, does not affect oral candidal colonization in healthy dentate subjects.
Periovulatory Morphometric and Vascular Modifications of the Clitoris in Young Adult and Middle-Aged Women. A Pilot Study
Authors: Battaglia Cesare , Nappi Rossella Elena , Cianciosi Arianna , Busacchi Paolo , Sisti Giovanni , Paradisi Roberto , Venturoli Stefano 
Published: July 2009

ABSTRACT

Introduction
A decline in sexual activity has been reported as women age.

Aim
To compare, in young adult and middle-aged women, the clitoral volumetric and vascular modifications during the periovulatory phase of the menstrual cycle, and to analyze their relationship with circulating hormones, nitric oxide levels, and with questionnaires on sexuality, relationship, and depression.

Methods
Fifteen young (18–25 years; Group I), and 16 middle-aged (35–45 years; Group II) eumenorrheic women were submitted, on day 14 of their menstrual cycle, to utero-ovarian and clitoral ultrasonographic analysis, and to color Doppler evaluation of the uterine and dorsal clitoral arteries. On the same day, hormonal parameters and plasma concentrations of nitrites/nitrates were assayed, and the two-factor Italian McCoy female questionnaire and the Beck’s Depression Inventory questionnaire were administered.

Main Outcomes Measures
Utero-ovarian and clitoral ultrasonographic analysis, color Doppler evaluation of the uterine and dorsal clitoral arteries; evaluation of hormonal and nitrites/nitrates plasma concentrations; administration of the two-factor Italian McCoy Female Sexuality Questionnaire and the Beck’s Depression Inventory questionnaire.

Results
The plasma levels of estradiol, testosterone, sex hormone binding globulin, and nitrites/nitrates were similar in both groups. Neither the ultrasonographic assessment of the clitoral body volume (0.82 ± 0.24 mL vs. 0.73 ± 0.26 mL) nor the Doppler analysis of the dorsal clitoral artery [pulsatility index (PI) = 1.35 ± 0.31 vs. PI = 1.36 ± 0.19] evidenced any significant differences in either Group I or Group II. The two-factor Italian McCoy Female Sexuality Questionnaire and the Beck Depression Inventory questionnaire gave the same results in Group I and Group II. The relationship between the different parameters evidenced that the NO2−/NO3− circulating levels are inversely correlated with uterine artery (r = −0.4611; P = 0.008) and dorsal clitoral artery (r = −0.331; P = 0.041) PIs. Furthermore, estradiol resulted inversely correlated with depression (r = −0.332; P = 0.045). The two sections (sexuality and partnership) of Italian McCoy Female Sexuality Questionnaire were positively correlated (r = 0.849; P &lt; 0.0001) between each other.

Conclusions
In eumenorrheic young adult and middle-aged women, the periovulatory clitoral anatomic and vascular modifications similarly occur.
Menopause Leading to Increased Vaginal Wall Thickness in Women with Genital Prolapse: Impact on Sexual Response
Authors: Da Silva Lara Lúcia Alves , Da Silva Alfredo Ribeiro , Rosa-e-Silva Júlio César , Chaud Fernando , Silva-de-Sá Marcos Felipe , Meireles e Silva Antônio Renato , De Sá Rosa-e-Silva Ana Carolina Japur 
Published: July 2009

ABSTRACTIntroductionHypoestrogenism causes structural changes in the vaginal wall that can lead to sexual dysfunction. A reduction in vaginal wall thickness has been reported to occur after menopause, although without precise morphometry.AimTo measure vaginal wall thickness in women with genital prolapse in normal and hypoestrogenic conditions and to correlate sexual dysfunction with vaginal wall thickness and estradiol levels.MethodsSurgical vaginal specimens from 18 normoestrogenic and 13 postmenopausal women submitted to surgery for genital prolapse grades I and II were examined. Patients were evaluated for FSH, estradiol, prolactin, glycemia, and serum TSH levels. For histological analysis, samples were stained with Masson’s trichrome and hematoxylin-eosin. Sexual function was assessed by the Golombok-Rust Inventory of Sexual Satisfaction (GRISS).Main Outcome MeasuresGRISS questionnaire, histological analysis, morphometric methods, Masson’s trichrome.ResultsThe vaginal wall was thicker in the postmenopausal than premenopausal group (2.72 ± 0.72 mm and 2.16 ± 0.43, P = 0.01, and 2.63 ± 0.71 mm and 2.07 ± 0.49 mm, P = 0.01, for the anterior and posterior walls, respectively). These thicknesses seem to be due to the muscular layer, which was also thicker in the postmenopausal group (1.54 ± 0.44 and 1.09 ± 0.3 mm, P = 0.02, and 1.45 ± 0.47 and 1.07 ± 0.44 mm, P = 0.03, for the anterior and posterior wall, respectively). The vaginal epithelium was thinner in the middle segment than in the proximal one in the posterior wall (0.17 ± 0.07 mm, 0.15 ± 0.05 mm, 0.24 ± 0.09 mm, P = 0.02). There was no correlation between coital pain, vaginal wall thickness, and estradiol levels in either group.ConclusionThe vaginal wall is thicker after menopause in women with genital prolapse. In this study, vaginal thickness and estrogen levels were not related to sexual dysfunction.
Ethical Conflicts over the Management of Transsexual Adolescents—Report of Two Cases
Authors: Baltieri Danilo Antonio , Prado Cortez Fernanda Cestaro , De Andrade Arthur Guerra 
Published: July 2009

ABSTRACT

Introduction
The diagnosis and the treatment of transsexualism, particularly during adolescence, generate considerable discussion among specialists. Many health and legal professionals have not yet reached a strong consensus on medical treatment for juvenile transsexuals. Hormonal therapy cannot only represent a medical procedure to adjust the somatic sex to the psychological gender, but can also be a reasonable means of preventing some juvenile transsexuals from engaging in undesirable and risky behavior.

Aim
To report the cases of two transsexual adolescents who resorted to prostitution to afford hormonal medications when treatment was denied because of age criteria.

Results
Hormonal medications were not recommended by the endocrinology staff because specific laws regulating this medical procedure for juvenile transsexuals in Brazil are lacking. In response, these adolescents chose to use illegally obtained sex hormones to treat themselves.

Conclusions
We propose “harm reduction” as a means of coping with this dilemma in some cases.
COMPARISON STUDY OF THE EFFECTS OF DIFFERENT CRUDE GREEN TEA POLYPHENOLS ON THE QUALITY OF DRIED CATFISH DURING AMBIENT STORAGE
Authors: DEMBELE S. , WANG D.F. , SUN J.P. , DONG S.Y. 
Published: July 2009

ABSTRACT The comparative antioxidant effect of adding different crude green tea polyphenols (GTP) and vitamin C (VC) on the susceptibility of dried catfish (Clarias gariepinus) quality changes during ambient storage was investigated. Catfish fillet was treated with different concentrations of GTP: 1% NaCl plus 0.01% GTP, 1% NaCl plus 0.03% GTP and 1% NaCl plus 0.01% of VC before drying process. Control muscle sample (CK) was treated only with 1% of NaCl solution (without GTP extract) contained only 1% NaCl, but not GTP. Samples were oven‐dried for 5 days at 45C. The quality change was evaluated over a course of 4 weeks for pH, volatile basis nitrogen, peroxide value, thiobarbituric acid reactive substances and free fatty acid. The results indicated that the most effective antioxidant was GTP and there was no significant differences (P < 0.01) between laboratory‐extracted crude green tea polyphenol and commercial crude green tea polyphenol. This study pointed out that GTP is a good natural antioxidant in comparison with VC and CK, so, it could be easily used in food industry to improve quality and shelf life of food products.PRACTICAL APPLICATIONSFish is a very important foodstuff because of its high protein content and nutritional value. It is also a greatly perishable product, especially in hot climates and tropical areas where cold preservation techniques are often missing and quality losses can occur very rapidly after catch. Addition of antioxidants during drying process can be used to inhibit lipid oxidation and microbial and insect infestation. However, questions regarding the safety of synthetic antioxidants together with consumer's preference have led to increased interest and research on natural antioxidants. Consumers favor natural antioxidants, which may have a positive effect on human health. Green tea polyphenol (GTP) as a natural antioxidant has lower toxicity than synthetic antioxidants like butylated hydroxyanisole and butylated hydroxytoluene, and more effectiveness than VC. It can be used as an alternative to VC to extend the quality of fish and fish products during storage.
RHEOLOGICAL CHANGES IN REFRIGERATED DOUGH DURING STORAGE IN RELATION TO PROTEINS
Authors: ZHANG YU , SIMSEK SENAY , CAMPANELLA OSVALDO H. , OHM JAE B. , CHANG HECTOR , REUHS BRADLEY L. , MERGOUM MOHAMED 
Published: July 2009

ABSTRACT Refrigerated dough is a flour‐based, unbaked product that is stored between 4 and 7C. The aim of this work was to study the rheological properties of refrigerated dough during storage and determine their correlations with dough proteins. Rheological properties were determined using texture analyzer and dynamic oscillatory rheometry during 34 days of storage. The protein analysis was performed by size‐exclusion high performance liquid chromatography. On day 34, Rmax was 93.8% higher than day 0. Both, the G′and G″moduli decreased during storage. Dough exhibited the major decreases on the moduli on day 3 and day 16. By comparing the viscoelastic properties of day 0 and day 16, a 50% decrease on the elastic modulus and a roughly 30% decrease in the loss modulus were observed. Changes in the protein fractions of dough samples were related to their rheological properties. The high and low molecular weight polymeric protein and gliadin were positively correlated to dough extensibility (r > 0.8343).PRACTICAL APPLICATIONSBy definition, refrigerated dough is a flour‐based, unbaked product that is stored between 4 and 7C. Today's refrigerated dough industry traces its origin to a small bakery that started business in Louisville, KY in 1937. The first refrigerated dough product was a chemically leavened biscuit with a shelf life of about 3 weeks. Today, the refrigerated dough market encompasses a wide range of products available in the U.S.A. as well as the international market, including Western Europe and Canada. There are very limited peer review articles on the topic. This study investigated the stability of refrigerated dough during storage. The results obtained in the present work showed that protein composition of dough is altered during storage and these changes affect the rheological properties of dough samples. We believe that the refrigerated dough industry will find the presented research very useful in their applications.
Burning mouth syndrome: Identification, diagnosis, and treatment
Authors: Rivinius Carey 
Published: July 2009

AbstractPurpose: To provide an overview of burning mouth syndrome (BMS), describe the role of the clinician when a patient presents with the burning mouth complaint, offer guidance in differentiating the cause of the complaint, and identify potential treatment options for the patient suffering from BMS.Data sources: A search of MD Consult, Medline, and EBSCO Host Research Databases with the terms “burning mouth” and “BMS.”Conclusions: BMS is a common, chronic disorder of unknown etiology with no underlying or systemic causes or oral signs identified. It affects more than 1 million people in the United States, predominantly postmenopausal women. Despite the common nature of the disorder, it is often misunderstood. Palliative treatment, education, and support should be offered to the patient with idiopathic BMS. A variety of treatment options exist, including benzodiazepines, tricyclic antidepressants, anticonvulsants, alpha‐lipoic acid, topical capsaicin, and cognitive therapy can be added to the medication regimen for greater benefit.Implications for practice: The role of the clinician is to obtain a meticulous history and physical examination of the patient, order relevant diagnostic tests, and rule out treatable conditions that may be causing the burning mouth symptom. If secondary causes of BMS are ruled out, the clinician should present treatment options to the patient and consider referral to specialists as necessary. A combination of medications may be more effective than a single medication.
A phenomenological perspective on advanced practice nurse–physician collaboration within an interdisciplinary healthcare team
Authors: O'Brien Jill L. , Martin Donald R. , Heyworth Judith A. , Meyer Nancy R. 
Published: July 2009

AbstractPurpose: To investigate how advanced practice nurses (APNs) and physicians (MDs) within a multisite nursing home practice perceive and describe their experiences of collaboration in an interdisciplinary team.Data sources: A phenomenological analysis of in‐depth interviews of eight APNs and five MDs working in team practice across multiple nursing homes.Conclusions: This phenomenological analysis reveals that the lived experience of these professionals affirms four thematic clusters (meaning units) as essential for collaboration: approachability, interpersonal skills, listening, and verbal message skills. However, APNs and MDs diverge in their perceptions of the behaviors currently operative or required to achieve the collaboration components sought. The invariants—that without which a phenomenon cannot be—differ for APNs and MDs.Implications for practice: Although both parties reference identical terms, when the language is unpacked, different behaviors are sought by APNs and MDs to achieve collaboration. This suggests that discussions concerning collaboration between APNs and MDs should not remain at the level of generalizations wherein apparent agreement might be assumed; instead, focused exchanges must concern specific behaviors in discrete instances.
An intervention to change clinician behavior: Conceptual framework for the multicolored simplified asthma guideline reminder (MSAGR)
Authors: O'Laughlen Mary C. , Hollen Patricia , Ting Stanislaus , Goolsby Mary Jo 
Published: July 2009

AbstractClinical practice guidelines decrease variation in health care because they standardize the care offered by healthcare providers. Seventeen years after publication, the National Asthma Education and Prevention Program (NAEPP) guidelines are considered the “gold standard” in asthma care, yet they remain underutilized despite three revisions with the latest in July 2007. Multiple factors are presented for lack of adherence to the guidelines. This article discusses the Multicolored, Simplified Asthma Guideline Reminder (MSAGR), an algorithm chart intervention for helping change clinicians' behavior for better adherence to the NAEPP guidelines, and describes the conceptual framework underpinning this intervention as a means of predicting better outcomes for providers and children.