bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes of Crural Ligation Surgery for Isolated Crural Venous Leak
Authors: Flores Stefan , Tal Raanan , O’Brien Keith , Mulhall John P. 
Published: July 2011

ABSTRACT

Introduction
Venous ligation surgery results for diffuse venous leak have been disappointing, although in isolated crural venous leak (ICVL) cases, efficacy for crural ligation surgery (CLS) has been demonstrated.

Aim
The purpose of this study was to present our experience with treatment of ICVL with CLS.

Methods
All patients underwent preoperative cavernosometry. Cavernosography (CG) or perineal compression (PC) was used to define the diagnosis of ICVL. If CG demonstrated ICVL or flow-to-maintain values normalized with PC, the patient was counseled regarding CLS. Baseline and postoperative erectile function (EF) was assessed by the International Index of Erectile Function (IIEF) questionnaire.

Main Outcome Measures
EF, using the EF domain (EFD) score of the IIEF, a domain with six questions with a maximum score of 30 and a minimum score of 6 in the sexually active male. All patients completed the questionnaire preoperatively and in a serial fashion after surgery at a time point after 12 months postoperatively.

Results
14 patients underwent CLS. Mean age was 29 ± 7 years. Also, 64% had primary erectile dysfunction. Mean baseline IIEF-EF score was 18 ± 6. Furthermore, 71% of patients had failed phosphodiesterase type 5 (PDE5) inhibitors and 6/10 (60%) failed intracavernosal injections (ICI). Mean postoperative EFD score was 24 ± 3 representing a mean change of 6.5 points per patient. No patient needed ICI after CLS; however, 4/14 patients needed PDE5 inhibitors, all of whom had been using ICI preoperatively. In addition, 71% experienced unassisted sexual intercourse after CLS.

Conclusions
In a highly selected population of young men with ICVL, CLS cures 70% and improves EF in more than 90% of men. Surgical treatment of ICVL by CLS can be performed safely and with sufficient efficacy that larger and longer term studies should be undertaken.
Women's Clitoris, Vagina, and Cervix Mapped on the Sensory Cortex: fMRI Evidence
Authors: Komisaruk B. R. , Wise N. , Frangos E. , Liu W. , Allen K. , Brody S. 
Published: July 2011

Abstract

Introduction
The projection of vagina, uterine cervix, and nipple to the sensory cortex in humans has not been reported.

Aims
The aim of this study was to map the sensory cortical fields of the clitoris, vagina, cervix, and nipple, toward an elucidation of the neural systems underlying sexual response.

Methods
Using functional magnetic resonance imaging (fMRI), we mapped sensory cortical responses to clitoral, vaginal, cervical, and nipple self-stimulation. For points of reference on the homunculus, we also mapped responses to the thumb and great toe (hallux) stimulation.

Main Outcome Measures
The main outcome measures used for this study were the fMRI of brain regions activated by the various sensory stimuli.

Results
Clitoral, vaginal, and cervical self-stimulation activated differentiable sensory cortical regions, all clustered in the medial cortex (medial paracentral lobule). Nipple self-stimulation activated the genital sensory cortex (as well as the thoracic) region of the homuncular map.

Conclusion
The genital sensory cortex, identified in the classical Penfield homunculus based on electrical stimulation of the brain only in men, was confirmed for the first time in the literature by the present study in women applying clitoral, vaginal, and cervical self-stimulation, and observing their regional brain responses using fMRI. Vaginal, clitoral, and cervical regions of activation were differentiable, consistent with innervation by different afferent nerves and different behavioral correlates. Activation of the genital sensory cortex by nipple self-stimulation was unexpected, but suggests a neurological basis for women's reports of its erotogenic quality.
A Randomized Controlled Trial of Guided Internet-delivered Cognitive Behavioral Therapy for Erectile Dysfunction
Authors: Andersson Erik , Walén Christian , Hallberg Jonas , Paxling Björn , Dahlin Mats , Almlöv Jonas , Källström Reidar , Wijma Klaas , Carlbring Per , Andersson Gerhard 
Published: July 2011

Abstract

Introduction
Men with erectile dysfunction are often worried about their condition, have interpersonal difficulties, and have a reduced quality of life. Internet-delivered cognitive behavior therapy (ICBT) has been shown effective for a number of health problems but evidence is limited concerning the treatment of erectile dysfunction.

Aim
The study investigated the effects of ICBT for erectile dysfunction.

Methods
Seventy-eight men were included in the study and randomized to either ICBT or to a control group, which was an online discussion group. Treatment consisted of a 7-week Web-based program with e-mail-based therapist support. Each therapist spent an average of 55 minutes per participant.

Main Outcome Measure
The International Index of Erectile Functioning five-item version was administered via the telephone at pretreatment, post-treatment, and 6 months after receiving ICBT.

Results
At post-treatment, the treatment group had significantly greater improvements with regard to erectile performance compared with the control group. Between-group differences at post-treatment were small (d = 0.1), but increased at the 6-month follow-up (d = 0.88).

Conclusions
This study provides support for the use of ICBT as a possible treatment format for erectile dysfunction.
Sexual Function Following Trocar-guided Mesh or Vaginal Native Tissue Repair in Recurrent Prolapse: A Randomized Controlled Trial
Authors: Milani Alfredo L. , Withagen Mariella I.J. , The Hok S. , Nedelcu-van der Wijk Ileana , Vierhout Mark E. 
Published: July 2011

Abstract

Introduction
Surgical treatment of pelvic organ prolapse (POP) affects sexual function. Generally, this results in improved sexual function, but deterioration is reported also.

Aim
The purpose of this study was to evaluate and compare sexual function in patients with recurrent POP undergoing either a vaginal surgical repair with native tissue or a trocar-guided mesh insertion.

Methods
Sexually active patients randomly assigned to either native tissue repair or trocar-guided mesh insertion, which had completed the pelvic organ prolapse (POP)/urinary incontinence sexual questionnaire (PISQ-12) both at baseline and at 12 months, were included. Total, subscale, and individual question analysis were performed. Logistic regression was used to identify factors that were independently associated with improvement/deterioration in total PISQ-12 scores.

Main Outcome Measures
Primary outcome was sexual function at 12 months following surgery, measured by the short form of the pelvic organ prolapse/urinary incontinence sexual questionnaire (PISQ-12). Secondary outcomes were the identification of factors independently associated with change in PISQ-12 scores and changes in individual PISQ-12 question scores.

Results
Sixty patients were included; 32 in the mesh arm and 28 in the native tissue arm. At 12 months, PISQ-12 scores were not different in both treatment arms (34.3, standard deviation [SD] 6.7 vs. 34.7, SD 5.7), but improvement was detected in the native tissue arm, whereas PISQ-12 total score remained unchanged in the mesh arm. Deteriorations were observed in the behavioral/emotive subscale and partner-related items in the mesh arm. In the native tissue arm, significant improvements in the physical and partner-related subscales were observed. The presence of mesh exposure was independently associated with deterioration in total PISQ-12 score.

Conclusion
At 12 months, PISQ-12 scores were not different in either treatment arm, but were affected differently by trocar-guided mesh insertion or by native tissue repair. Mesh exposure was independently associated with deterioration in sexual function.
Pre‐flood inundation mapping for flood early warning
Authors: Billa L. , Mansor S. , Mahmud A.R. 
Published: July 2011

AbstractIn this study the results of two rainfall‐run‐off simulations were used as input into a MIKE11 GIS and hydrological modelling process for flood inundation mapping based on the flood event (27 September to 8 October 2000) in Malaysia of the Langat River Basin area. Separate inundation maps were generated for the recorded observed rainfall and from a developed quantitative precipitation forecast (QPF), which was based on top of the cloud reflectance and brightness temperature (TB) derive from Advanced Very High Resolution Radiometer (AVHRR) and Geostationary Meteorological Satellite (GMS) satellite data sets. The QPF had rain rates between 3 and 12 mm/h for the 264 h rainfall duration. While the actual recorded rainfall for the same duration was used for the observed. The objective of the study was to compare the similarities of the flood inundation generated from the QPF run‐off with that generated from the rainfall‐run‐off of the actual flood event. The accuracies of the maps were verified using grid point locations of flooded areas taken during the event. The selected sampled point of the verification showed an accuracy of 70% of the QPF on the observed flood map. Sampled points measured flood extent, coverage and depth of flood in the basin area.
Improved management of acute gout during hospitalization following introduction of a protocol
Authors: KAMALARAJ Narainraj , GNANENTHIRAN Sonali R. , KATHIRGAMANATHAN Theepan , HASSETT Geraldine M. , GIBSON Kathryn A. , McNEIL H. Patrick 
Published: July 2011

AbstractAim:  To determine whether implementation of a protocol to manage in‐hospital acute gout has improved the care of patients by non‐rheumatologists.Method:  Two systematic case‐file reviews were performed to determine the management of acute gout in all episodes occurring in hospitalized patients before (April 2005–December 2006) and after (November 2008–September 2009) introduction of a protocol for acute gout management in a tertiary referral hospital. The protocol targeted non‐rheumatologists with primary intentions to continue baseline anti‐gout medications on admission, prevent inappropriate prescriptions of colchicine, non‐steroidal anti‐inflammatory drugs (NSAIDs) and allopurinol in the hospital, encourage invitations for assistance by rheumatology, and promote combination therapy in cases of severe gout.Results:  Excluding patients under the primary care of a rheumatologist, 118 cases of acute gout occurring during hospitalization were reviewed before and 89 cases after introduction of the gout protocol. Post‐protocol, there was a significant increase in continuation of baseline allopurinol (P = 0.01), significantly less inappropriate prescriptions of colchicine (P < 0.001) and allopurinol (P = 0.02), and a fall in the occurrence of overall adverse events (P = 0.01). After protocol introduction, when monotherapy was prescribed, NSAID usage declined and prednisone usage increased (P = 0.04), but there was no significant shift toward combination therapy use. Delays from symptom recognition to treatment were significantly reduced (P < 0.001), and rheumatology involvement significantly increased from 33.9% pre‐protocol to 51.7% post‐protocol.Conclusion:  Following introduction of a hospital‐wide protocol for acute gout management, there have been significant improvements in the management of acute gout by non‐rheumatologist clinicians.
Pharmacy professionalism and the digital age
Authors: Rutter Paul M , Duncan Gregory 
Published: July 2011

Abstract

Objectives
To explore how the use of digital media could affect how people view professional behaviour.

Key findings
The growth in social networking sites has been phenomenal and they are now an extremely popular medium for interacting with others both commercially and privately. This as-yet-uncontrolled digital media provides ample opportunities for public and professional scrutiny for the unwary. Instances of employer screening and employee dismissal are already documented. All pharmacists who use digital media now need to be conscious that their virtual presence could be subject to regulator investigation.

Conclusions
It is important that individuals are aware of the risks associated with using digital media and that pharmacy organisations begin to provide clear leadership to help pharmacists know what is and is not acceptable.
Self‐control as predictor of school grades, life balance, and flow in adolescents
Authors: Kuhnle Claudia , Hofer Manfred , Kilian Britta 
Published: July 2011

Background. Recently, several studies have shown that strength of self‐control is a crucial factor in determining positive outcomes in individuals’ lives. Most attention has been directed to the relationships that self‐control has with learning and academic achievement.Aims. This article analyses the effects of self‐control not only on school grades but also on the experience of life balance and flow. It is theorized that students with a higher level of self‐control are better able to distribute their time in a satisfying way over academic and leisure matters, and are better able to shield their studying against distractions.Samples. A total of 697 eighth graders with a mean age of 13.4 years participated in the longitudinal study.Method. Students completed a questionnaire containing measures of self‐control, school grades, subjective life balance, and flow while studying at the beginning and at the end of the school year. Structural equation modelling was used to analyse the relationships between the constructs.Results and conclusions. Results of cross‐lagged analyses show that self‐control predicted school grades, life balance, and flow. The findings suggest that self‐control may assist adolescents to be better prepared, not only for school, but also for coordinating their investments in different areas of their lives.
Microdosimetric study on influence of low energy photons on relative biological effectiveness under therapeutic conditions using 6 MV linac
Authors: Okamoto Hiroyuki , Kohno Toshiyuki , Kanai Tatsuaki , Kase Yuki , Matsumoto Yoshitaka , Furusawa Yoshiya , Fujita Yukio , Saitoh Hidetoshi , Itami Jun 
Published: July 2011

Purpose:Microdosimetry has been developed for the evaluation of radiation quality, and single‐event dose‐mean lineal energy is well‐used to represent the radiation quality. In this study, the changes of the relative biological effectiveness (RBE) values under the therapeutic conditions using a 6 MV linac were investigated with a microdosimetric method.Methods:The values under the various irradiation conditions for x‐rays from a 6 MV linac were measured with a tissue‐equivalent proportional counter (TEPC) at an extremely low dose rate of a few tens of μGy/min by decreasing the gun grid voltage of the linac. According to the microdosimetric kinetic model (MK model), the RBEMK values for cell killing of the human salivary gland (HSG) tumor cells can be derived if the values are obtained from TEPC measurements. The Monte Carlo code GEANT4 was also used to calculate the photon energy distributions and to investigate the changes of the values under the various conditions.Results:The changes of the values were less than approximately 10% when the field size and the depth in a phantom varied. However, in the measurements perpendicular to a central beam axis, large changes were observed between the values inside the field and those outside the field. The maximum increase of approximately 50% in the value outside the field was obtained compared with those inside the field. The GEANT4 calculations showed that there existed a large relative number of low energy photons outside of the field as compared with inside of the field. The percentages of the photon fluences below 200 keV outside the field were approximately 40% against approximately 8% inside the field. By using the MK model, the field size and the depth dependence of the RBEMK values were less than approximately 2% inside the field. However, the RBEMK values outside the field were 6.6% higher than those inside the field.Conclusions:The increase of the RBEMK values by 6.6% outside the field was observed. This increase is caused by the change of the photon energy distributions, especially the increase of the relative number of low energy photons outside the field.
Development of 5‐ and 10‐year‐old pediatric phantoms based on polygon mesh surfaces
Authors: de Melo Lima V. J. , Cassola V. F. , Kramer R. , de Oliveira Lira C. A. B. , Khoury H. J. , Vieira J. W. 
Published: July 2011

Purpose:The purpose of this study is the development of reference pediatric phantoms for 5‐ and 10‐year‐old children to be used for the calculation of organ and tissue equivalent doses in radiation protection.Methods:The study proposes a method for developing anatomically highly sophisticated pediatric phantoms without using medical images. The 5‐ and 10‐year‐old male and female phantoms presented here were developed using 3D modeling software applied to anatomical information taken from atlases and textbooks. The method uses polygon mesh surfaces to model body contours, the shape of organs as well as their positions, and orientations in the human body. Organ and tissue masses comply with the corresponding data given by the International Commission on Radiological Protection (ICRP) for the 5‐ and 10‐year‐old reference children. Bones were segmented into cortical bone, spongiosa, medullary marrow, and cartilage to allow for the use of micro computer tomographic (μCT) images of trabecular bone for skeletal dosimetry.Results:The four phantoms, a male and a female for each age, and their organs are presented in 3D images and their organ and tissue masses in tables which show the compliance of the ICRP reference values. Dosimetric data, calculated for the reference pediatric phantoms by Monte Carlo methods were compared with corresponding data from adult mesh phantoms and pediatric stylized phantoms. The comparisons show reasonable agreement if the anatomical differences between the phantoms are properly taken into account.Conclusions:Pediatric phantoms were developed without using medical images of patients or volunteers for the first time. The models are reference phantoms, suitable for regulatory dosimetry, however, the 3D modeling method can also be applied to medical images to develop patient‐specific phantoms.
Immunogenicity, Boostability, and Sustainability of the Immune Response after Vaccination against Influenza A Virus (H1N1) 2009 in a Healthy Population
Authors: Huijskens Elisabeth , Rossen John , Mulder Paul , van Beek Ruud , van Vugt Hennie , Verbakel Johannes , Rimmelzwaan Guus , Koopmans Marion , Peeters Marcel 
Published: July 2011

ABSTRACTThe emergence of a new influenza A virus (H1N1) variant in 2009 led to a worldwide vaccination program, which was prepared in a relatively short period of time. This study investigated the humoral immunity against this virus before and after vaccination with a 2009 influenza A virus (H1N1) monovalent MF59-adjuvanted vaccine, as well as the persistence of vaccine-induced antibodies. Our prospective longitudinal study included 498 health care workers (mean age, 43 years; median age, 44 years). Most (89%) had never or only occasionally received a seasonal influenza virus vaccine, and 11% were vaccinated annually (on average, for >10 years). Antibody titers were determined by a hemagglutination inhibition (HI) assay at baseline, 3 weeks after the first vaccination, and 5 weeks and 7 months after the second vaccination. Four hundred thirty-five persons received two doses of the 2009 vaccine. After the first dose, 79.5% developed a HI titer of ≥40. This percentage increased to 83.3% after the second dose. Persistent antibodies were found in 71.9% of the group that had not received annual vaccinations and in 43.8% of the group that had received annual vaccinations. The latter group tended to have lower HI titers (P=0.09). With increasing age, HI titers decreased significantly, by 2.4% per year. A single dose of the 2009 vaccine was immunogenic in almost 80% of the study population, whereas an additional dose resulted in significantly increased titers only in persons over 50. Finally, a reduced HI antibody response against the 2009 vaccine was found in adults who had previously received seasonal influenza virus vaccination. More studies on the effect of yearly seasonal influenza virus vaccination on the immune response are warranted.
Mycobacterium bovis BCG-Mediated Protection against W-Beijing Strains of Mycobacterium tuberculosis Is Diminished Concomitant with the Emergence of Regulatory T Cells
Authors: Ordway Diane J. , Shang Shaobin , Henao-Tamayo Marcela , Obregon-Henao Andres , Nold Laura , Caraway Megan , Shanley Crystal A. , Basaraba Randall J. , Duncan Colleen G. , Orme Ian M. 
Published: July 2011

ABSTRACT

Despite issues relating to variable efficacy in the past, the
Mycobacterium bovis
BCG vaccine remains the basis for new-generation recombinant vaccines currently in clinical trials. To date, vaccines have been tested mostly against laboratory strains and not against the newly emerging clinical strains. In this study, we evaluated the ability of BCG Pasteur to protect mice from aerosol infections with two highly virulent W-Beijing clinical strains, HN878 and SA161. In a conventional 30-day protection assay, BCG was highly protective against both strains, but by day 60 of the assay, this protection was diminished. Histological examination of the lungs of vaccinated animals showed reduced lung consolidation and smaller and more-organized granulomas in the vaccinated mice after 30 days, but in both cases, these tissues demonstrated worsening pathology over time. Effector T cell responses were increased in the vaccinated mice infected with HN878, but these diminished in number after day 30 of the infections concomitant with increased CD4
+
Foxp3
+
T cells in the lungs, draining lymph nodes, and the spleen. Given the concomitant decrease in effector immunity and continued expansion of regulatory Foxp3
+
cells observed here, it is reasonable to hypothesize that downregulation of effector immunity by these cells may be a serious impediment to the efficacy of BCG-based vaccines.
Neutralizing Activity of Saliva against Cytomegalovirus
Authors: Saccoccio Frances M. , Gallagher Mary K. , Adler Stuart P. , McVoy Michael A. 
Published: July 2011

ABSTRACTCongenital cytomegalovirus (CMV) disease is the leading cause of permanent disability in neonates in the United States. Neutralizing antibodies in saliva may protect against maternal CMV infection by blocking viral entry into oral epithelial cells, but the antibody response to CMV in the saliva following natural infection is not well characterized. Saliva specimens from naturally infected individuals were tested for CMV-neutralizing activity using epithelial and fibroblast cells. Saliva from seronegative adults had no inherent anti-CMV activity. Neutralizing activity of saliva from naturally infected adults was not detectable using fibroblast cells, and saliva from young children, adolescents, and Towne vaccine recipients did not have activity using either cell type. However, when using epithelial cells, neutralizing activity was present in saliva from 50% of seropositive adults, correlated with serum-neutralizing activity, and was more prevalent in mothers of children in day care than in non-day care-associated adults. Three day care mothers with high salivary neutralizing activities (>1:20) had exceptionally high serum-neutralizing titers (3- to 8-fold higher than typical seropositives) and were immunoblot positive for serum antibodies to the epithelial entry mediator UL130. These results suggest that salivary neutralizing activities are attainable by induction of high serum IgG levels and could be utilized to evaluate candidate cytomegalovirus vaccines.