bluuebunny/crossref_metadata_2025_split huggingface dataset:
Expression of clock genes Per1 and Bmal1 in total leukocytes in health and Parkinson’s disease
Authors: Cai Y. , Liu S. , Sothern R. B. , Xu S. , Chan P. 
Published: November 2009

Background:  There is a growing number of clinical studies that revealed a variety of behavioral and physiological desynchronies in patients with Parkinson’s disease (PD). However, these desynchronies have not been defined at the molecular level.Methods:  Using real‐time RT‐PCR assay, we analyzed the expression profiles of two principle clock genes, PER1 and BMAL1, in total leukocytes for 12 h during the evening, overnight and morning in subjects with PD and age/sex‐matched healthy controls.Results:  A difference in the expression pattern of BMAL1 but not PER1 was apparent during the dark span, where the relative abundance of BMAL1 was significantly lower in PD patients versus control subjects at 21:00, 00:00 and 06:00 h. Furthermore, expression levels of BMAL1 in PD patients correlated with their United Parkinson’s Disease Rating Scale score at 06:00, 09:00 h, and with Pittsburgh Sleep Quality Index score at 06:00 h.Conclusion:  These results suggest that a peripheral molecular clock, as reflected in the dampened expression of the clock genes BMAL1 in total leukocytes, is altered in PD patients. In addition, the relative BMAL1 levels correlate positively with PD severity, which could provide a molecular basis to help monitor disease progression and response to investigational drugs.
Conservation genetics of a critically endangered Iberian minnow: evidence of population decline and extirpations
Authors: Sousa V. , Penha F. , Pala I. , Chikhi L. , Coelho M. M. 
Published: November 2009

AbstractThe endangered minnow Iberochondrostoma almacai is an endemic Iberian cyprinid with a restricted and fragmented distribution. Here, we describe the genetic structure of the species and infer its demographic history from six nuclear‐encoded microsatellite loci and mitochondrial cytochrome b sequences. Genetic diversity was low (microsatellite He<0.45; mtDNA π<0.0015), and both markers resolved two groups: one from the northern Mira drainage and one from the Arade and Bensafrim drainages. The relatively low differentiation between these groups (0.09<FST<0.29; 0.31< ΦST <0.57) suggests past headwater captures and/or that populations were large until recently. The genetic diversity and differentiation estimates were compared with those for other three endangered cyprinids inhabiting similar intermittent rivers. Microsatellite data indicate a population decrease in the last 100–2400 years, probably as a result of anthropogenic disturbance. Human activities together with an intermittent flow of these rivers apparently led to local extinctions with consequent fragmentation and contraction in range. We recognize two management units corresponding to the two genetic groups identified. To maintain/increase genetic diversity, we recommend habitat restoration actions and measures to increase gene flow within and/or between the two units, under controlled reproductive programmes. Ecological experiments should be performed to ensure the success of supplementation among the two units. Moreover, the reintroductions in unoccupied drainages are suggested if further data confirm the presence of I. almacai in the recent past.
Platelet aggregation responses are critically regulated in vivo by endogenous nitric oxide but not by endothelial nitric oxide synthase
Authors: Tymvios C , Moore C , Jones S , Solomon A , Sanz‐Rosa D , Emerson M 
Published: November 2009

Background and purpose:  Although exogenous nitric oxide (NO) clearly modifies platelet function, the role and the source of endogenous NO in vivo remain undefined. In addition, endothelial NO synthase (NOS‐3) critically regulates vessel tone but its role in modulating platelet function is unclear. In this paper we have investigated the roles of endogenous NO and NOS‐3 in regulating platelet function in vivo and determined the functional contribution made by platelet‐derived NO.Experimental approach:  We used a mouse model for directly assessing platelet functional responses in situ in the presence of an intact vascular endothelium with supporting in vitro and molecular studies.Key results:  Acute NOS inhibition by Nω‐nitro‐L‐arginine methyl ester hydrochloride (L‐NAME) enhanced platelet aggregatory responses to thrombin and platelets were shown to be regulated primarily by NO sources external to the platelet. Elevation of endogenous NOS inhibitors to mimic effects reported in patients with cardiovascular diseases did not enhance platelet responses. Platelet responsiveness following agonist stimulation was not modified in male or female NOS‐3−/− mice but responses in NOS‐3−/− mice were enhanced by L‐NAME.Conclusions and implications:  Platelets are regulated by endogenous NO in vivo, primarily by NO originating from the environment external to the platelet with a negligible or undetectable role of platelet‐derived NO. Raised levels of endogenous NOS inhibitors, as reported in a range of diseases were not, in isolation, sufficient to enhance platelet activity and NOS‐3 is not essential for normal platelet function in vivo due to the presence of bioactive NO following deletion of NOS‐3.
Triggering Pulmonary Veins: A Paradoxical Predictor for Atrial Fibrillation Recurrence After PV Isolation
Authors: DE GREEF YVES , TAVERNIER RENE , VANDEKERCKHOVE YVES , DUYTSCHAEVER MATTIAS 
Published: November 2009

Triggering Pulmonary Veins and Recurrence After Ablation. Purpose: To identify procedural parameters predicting recurrence of atrial fibrillation (AF) after a first circumferential pulmonary vein isolation (CPVI).
Methods:
One hundred seventy‐one patients undergoing CARTO‐guided CPVI for recurrent AF with a left atrial (LA) diameter <45 mm were studied. Follow‐up (symptoms and 7‐day Holter) was performed at 1 and 3 months and every 3 months thereafter. Clinical and procedural characteristics between successful patients and patients undergoing repeat ablation were compared. In addition, procedural parameters of the first procedure were compared with parameters during repeat ablation.
Results:
After first CPVI, 80% of patients were free of AF without antiarrhythmic drugs after a follow‐up (FU) of 28 ± 11 months (N = 136). Thirty‐five patients (20%) had recurrence of AF of which 25 underwent repeat ablation (N = 25). Clinical characteristics did not differ between the successful and repeat group. A triggering vein during the index procedure was significantly more observed in the repeat group (56% vs 11%, P < 0.001). At repeat ablation, 2.6 ± 1.2 veins per patient were reconnected. Whereas there was no preferential reconnecting PV, all PVs triggering at index were reconnected (100%).
Conclusions:
(1) In patients with symptomatic recurrent AF, the presence of a triggering pulmonary vein during ablation is a paradoxical predictor for AF recurrence after PV isolation. (2) The consistent finding of reconnection of the triggering PV at repeat ablation, suggests that, in these patients, the triggering PV is the culprit vein and that reconnection invariably results in clinical AF recurrence. (3) The present study advocates a strategy of even more stringent PV isolation in case of a triggering PV. (J Cardiovasc Electrophysiol, Vol. 21, pp. 381–388, April 2010)
What You See (Sonographically) Is What You Get: Vein and Patient Characteristics Associated With Successful Ultrasound‐guided Peripheral Intravenous Placement in Patients With Difficult Access
Authors: Panebianco Nova L. , Fredette Jenna M. , Szyld Demian , Sagalyn Emily B. , Pines Jesse M. , Dean Anthony J. 
Published: November 2009

AbstractObjectives:  Ultrasound (US) has been shown to facilitate peripheral intravenous (IV) placement in emergency department (ED) patients with difficult IV access (DIVA). This study sought to define patient and vein characteristics that affect successful US‐guided peripheral IV placement.Methods:  This was a prospective observational study of US‐guided IV placement in a convenience sample of DIVA patients in an urban, tertiary care ED. DIVA patients were defined as having any of the following: at least two failed IV attempts or a history of difficult access plus the inability to visualize or palpate any veins on physical exam. Patient characteristics (demographic information, vital signs, and medical history) were collected on enrolled patients. The relationships between patient characteristics, vein depth and diameter, US probe orientation, and successful IV placement were analyzed.Results:  A total of 169 patients were enrolled, with 236 attempts at access. Increasing vessel diameter was associated with a higher likelihood of success (odds ratio [OR] = 1.79 per 0.1‐cm increase in vessel diameter, 95% confidence interval [CI] = 1.37 to 2.34). Increasing vessel depth did not affect success rates (OR = 0.96 per 0.1‐cm increase of depth, 95% CI = 0.89 to 1.04) until a threshold depth of 1.6 cm, beyond which no vessels were successfully cannulated. Probe orientation and patient characteristics were unrelated to success.Conclusions:  Success was solely related to vessel characteristics detected with US and not influenced by patient characteristics or probe orientation. Successful DIVA was primarily associated with larger vessel, while vessel depth up to >1.6 cm and patient characteristics were unrelated to success. Clinically, if two vessels are identified at a depth of <1.6 cm, the larger diameter vessel, even if comparatively deeper, should yield the greatest likelihood of success.
Effect of an Independent‐capacity Protocol on Overcrowding in an Urban Emergency Department
Authors: Cha Won Chul , Shin Sang Do , Song Kyoung Jun , Jung Sung Koo , Suh Gil Joon 
Published: November 2009

AbstractObjectives:  The authors hypothesized that a new strategy, termed the independent‐capacity protocol (ICP), which was defined as primary stabilization at the emergency department (ED) and utilization of community resources via transfer to local hospitals, would reduce ED overcrowding without requiring additional hospital resources.Methods:  This is a before‐and‐after trial that included all patients who visited an urban, tertiary care ED in Korea from July 2006 to June 2008. To improve ED throughput, introduction of the ICP gave emergency physicians (EPs) more responsibility and authority over patient disposition, even when the patients belonged to another specific clinical department. The ICP utilizes the ED as a temporary, nonspecific place that cares for any patient for a limited time period. Within 48 hours, EPs, associated specialists, and transfer coordinators perform secondary assessment and determine patient disposition. If the hospital is full and cannot admit these patients after 48 hours, the EP and transfer coordinators move the patients to other appropriate community facilities. We collected clinical data such as sex, age, diagnosis, and treatment. The main outcomes included ED length of stay (LOS), the numbers of admissions to inpatient wards, and the mortality rate.Results:  A total of 87,309 patients were included. The median number of daily patients was 114 (interquartile range [IQR] = 104 to 124) in the control phase and 124 (IQR = 112 to 135) in the ICP phase. The mean ED LOS decreased from 15.1 hours (95% confidence interval [CI] = 14.8 to 15.3) to 13.4 hours (95% CI = 13.2 to 13.6; p < 0.001). The mean LOS in the emergency ward decreased from 4.5 days (95% CI = 4.4 to 4.6 days) to 3.1 days (95% CI = 3.0 to 3.2 days; p < 0.001). The percentage of transfers from the ED to other hospitals decreased from 3.5% to 2.5% (p < 0.001). However, transfers from the emergency ward to other hospitals increased from 2.9% to 8.2% (p < 0.001). Admissions to inpatient wards from the ED were significantly reduced, and admission from the emergency ward did not change. The ED mortality and hospital mortality rates did not change (p = 0.15 and p = 0.10, respectively).Conclusions:  After introduction of the ICP, ED LOS decreased without an increase in hospital capacity.
Predictors of response to immunosuppressive therapy with antithymocyte globulin and cyclosporine and prognostic factors for survival in patients with severe aplastic anemia
Authors: Chang Myung H. , Kim Kyoung H. , Kim Hyo S. , Jun Hyun J. , Kim Dong H. , Jang Jun H. , Kim Kihyun , Jung Chul W. 
Published: November 2009

AbstractBackground:  Immunosuppressive therapy (IST) with antithymocyte globulin (ATG) plus cyclosporine (CSA) is standard therapy in patients with severe aplastic anemia (SAA) who do not have an available HLA‐matched sibling donor.Methods and patients:  The current study aimed to determine the predictive factors for response to IST in patients with SAA and to identify prognostic factors following IST. A total of 62 patients diagnosed with SAA who received IST with either rabbit ATG (n = 33) or horse ATG (n = 29) plus CSA between October 1994 and December 2007 were included.Results:  With a median follow‐up duration of 60.5 months, complete response and overall response were estimated to be 31% and 53%, respectively. The 4 yr overall survival rate was 75 ± 6%. In terms of predicting the response to IST, neutrophil counts above 0.3 × 109/L prior to IST were the only significant predictive factor (P = 0.02). Survival following IST was significantly different in favor of both the group showing high absolute reticulocyte counts (ARC) above 10.9 × 109/L prior to IST (P = 0.004) and the group achieving any response following IST (P = 0.002).Conclusions:  Pre‐IST neutrophil counts might predict the response to IST, while absolute ARCs prior to IST and response status after IST could be prognostic factors following IST.
History of Sexual and Physical Abuse in Women with Dyspareunia: Association with Pain, Psychosocial Adjustment, and Sexual Functioning
Authors: Leclerc Bianca , Bergeron Sophie , Binik Yitzchak M. , Khalifé Samir 
Published: November 2009

ABSTRACTAimDyspareunia is a women’s sexual health problem that still often goes undiagnosed despite its high prevalence and its detrimental impact on sexual, relationship, and psychological adjustment. Although sexual and physical abuse may constitute risk factors for the development of dyspareunia, the effects of past abuse on current pain and associated sexual and psychosocial impairments have never been examined. Thus, the aim of this study is to determine the relation between a history of sexual and physical abuse and a series of pain, psychological, dyadic, and sexual functioning variables in a sample of women with dyspareunia.MethodsA hundred and fifty-one women took part in the study via health professional referrals and advertisements in local newspapers. Each participant underwent a standardized gynecological examination and a structured interview in order to confirm the diagnosis of dyspareunia. They also completed self-report questionnaires investigating past sexual and physical abuse, in addition to current pain, psychosocial adjustment, and sexual functioning. Dependent measures included: (i) The Brief Symptom Inventory; (ii) the Sexual History Form; and (iii) the Locke-Wallace Marital Adjustment Scale. Pain was assessed via the McGill Pain Questionnaire and a visual analogue scale.ResultsResults revealed that a history of sexual abuse involving penetration was associated with poorer psychological adjustment and sexual functioning. Additionally, findings showed that women who perceived a link between their dyspareunia and their past sexual abuse reported worse sexual functioning than those who did not. Finally, the experience of sexual abuse was not associated with pain intensity and physical abuse was not associated with any of the outcome measures.ConclusionsFindings suggest that the presence of a sexual abuse history in women with dyspareunia is associated with increased psychological distress and sexual impairment, although there is no relation between a history of physical abuse and these outcomes.
The ACTIV Study: Acupuncture Treatment in Provoked Vestibulodynia
Authors: Curran Stephanie , Brotto Lori A. , Fisher Harris , Knudson Gail , Cohen Trevor 
Published: November 2009

ABSTRACT

Introduction
Provoked vestibulodynia (PVD) is a distressing genital pain condition affecting 12% of women. Treatment modalities vary and although vestibulectomy has the highest efficacy rates, it is usually not a first-line option. Acupuncture has a long history in the traditional Chinese medicine (TCM) system and operates on the premise that pain results from the blockage or imbalance of important channels. The main principle of treatment is to move Qi and blood to cease genital pain.

Aim
To explore effect sizes and feasibility in a pilot study of acupuncture for women with PVD.

Methods
Eight women with PVD (mean age 30 years) underwent 10 1-hour acupuncture sessions. Specific placement of the needles depended on the woman’s individual TCM diagnosis. TCM practitioners made qualitative notes on participants’ feedback after each session.

Main Outcome Measures
Self-reported pain (investigator-developed), pain-associated cognitions (Pain Catastrophizing Scale [PCS], Pain Vigilance and Awareness Questionnaire), and sexual response (Female Sexual Function Index) were measured before and after treatment sessions 5 and 10. Qualitative analyses of TCM practitioner notes were performed along with one in-depth case report on the experience of a participant.

Results
A repeated measures analysis of variance revealed significant decreases in pain with manual genital stimulation and helplessness on the PCS. An examination of effect sizes also revealed strong (though nonsignificant) effects for improved ability to have intercourse and sexual desire. Qualitative analyses were overall more positive and revealed an improvement in perceived sexual health, reduced pain, and improved mental well-being in the majority of participants.

Conclusions
Effect sizes and qualitative analyses of practitioner-initiated interviews showed overall positive effects of acupuncture, but there were statistically significant improvements only in pain with manual genital stimulation and helplessness. These findings require replication in a larger, controlled trial before any definitive conclusions on the efficacy of acupuncture for PVD can be made.
A Cross-Sectional Study for the Analysis of Clinical, Sexual and Laboratory Conditions Associated to Peyronie’s Disease
Authors: Rhoden Ernani Luis , Riedner Charles Edison , Fuchs Sandra , Ribeiro Eduardo Porto , Halmenschlager Graziele 
Published: November 2009

ABSTRACTIntroductionAlthough Peyronie’s Disease (PD) was first described over 250 years ago, its precise etiology remains obscure.AimAnalyze a variety of potential associated factors with PD, including erectile dysfunction.Materials and MethodsThis cross-sectional study included 83 consecutive men with PD and 252 age-matched controls. All men completed the International Index of Erectile Function (IIEF) and were evaluated regarding their clinical and demographic characteristics, comorbidities, and used medications. Anthropometric measures included body mass index and waist circumference (WC). Fasting blood glucose, lipid profile, total testosterone, and dehydroepiandrosterone-sulfate were determined.Main Outcome MeasuresClinical and laboratory characteristics associated to PD.ResultsThe mean age was 59.2 ± 10 years in the cases and 59.7 ± 12 years in the controls. Marital status, current smoking, and excessive consumption of alcoholic beverages were similar between groups (P &gt; 0.05). PD was more common among white skin color males (P = 0.001). The mean score for each IIEF domain and the androgen levels were similar in the two groups. Thiazides were the only medication associated to PD (P = 0.03). Dupuytren’s disease was more frequent among individuals with PD (P = 0.001). The distribution of all other comorbidities investigated was similar between groups (P &gt; 0.05). The characteristics WC &gt; 102 cm and levels of low-density lipoprotein (LDL) &gt; 130 mg/dL were more prevalent in the controls (P &lt;0.05). After multivariate analysis, white skin color (OR: 8.47, 95%CI: 1.98–36.24) and thiazide use (OR: 2.29, 95%CI: 1.07–4.90) were associated to PD, and LDL &gt; 130 mg/dL (OR: 0.55, 95%CI: 0.32–0.92) and WC &gt; 102 cm (OR: 0.53, 95%CI: 0.29–0.96) were inversely associated to PD.ConclusionsIn this study, PD was more common among white skin colored males. An inverse relationship with the presence of elevated serum levels of LDL and WC was observed. We found no association with medications other than thiazides and comorbidities other than Dupuytren’s disease. Androgen serum levels and sexual dysfunction had also no association to PD.
Changes in Sexual Function after Treatment for Prolapse Are Related to the Improvement in Body Image Perception
Authors: Lowenstein Lior , Gamble Tondalaya , Sanses Tatiana V. Deniseiko , Van Raalte Heather , Carberry Cassie , Jakus Sharon , Pham Thythy , Nguyen Aimee , Hoskey Kay , Kenton Kimberly 
Published: November 2009

ABSTRACT

Introduction
In a previous study, sexual function was related to a woman’s self-perceived body image and degree of bother from pelvic organ prolapse (POP).

Aims
To evaluate sexual function, prolapse symptoms, and self-perceived body image 6 months following treatment for POP and to explore differences in body image perception and sexual function following conservative and surgical treatment for POP.

Methods
After institutional review board approval, consecutive women with ≥stage II POP were invited to participate. In addition to routine urogynecologic history and physical examination, including Pelvic Organ Prolapse Quantification (POP-Q), the participants completed three validated questionnaires before, and 6 months after, treatment for POP: Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire, Modified Body Image Perception Scale and Prolapse subscale of Pelvic Floor Distress Inventory to assess condition specific bother from POP.

Main Outcome Measures
Changes in sexual function and body image perception following treatment for POP.

Results
A total of 235 women with a mean age of 62 ± 12 years returned for a 6-month follow-up. The majority of our participants had surgical repair for POP (88%). At 6-month follow-up visits, the patients reported significant improvement in sexual function from baseline (33 ± 0.6 vs. 43 ± 0.8, respectively P &lt; 0.0001). Improvement in sexual function, as measured by PISQ-12, was not significant among sexually active patients treated with a pessary compared with those treated surgically (–2.5 ± 5.5 vs. 11.5 ± 1, respectively P &lt; 0.0001). A multivariate linear regression model demonstrated that body mass index and changes in body image perception were the only independent factors associated with changes in PISQ score following POP treatment (β = −0.5, P &lt; 0.01 and β = −0.4, P &lt; 0.03, respectively).

Conclusions
Resolution of POP symptoms after treatment improves women’s self-perceived body image and sexual function. Not surprisingly, pessary is less effective in improving sexual function compared with surgical repair of POP.