bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characterization of the oestrogenic activity of non‐aromatic steroids: are there male‐specific endogenous oestrogen receptor modulators?
Authors: Wang Pan , Wen Yujing , Han Gui‐Zhen , Sidhu Pritam Kaur , Zhu Bao Ting 
Published: November 2009

Background and purpose:  The endogenous oestrogens have important biological functions in men as well as in women. Because 17β‐oestradiol and oestrone are also formed in the male body, these aromatic oestrogens are generally thought to be responsible for exerting the required oestrogenic functions in the male. In the present study, we tested the hypothesis that some of the non‐aromatic steroids that are androgen precursors or metabolites with hydroxyl groups at C‐3 and/or C‐17 positions may also be able to serve as ligands for the oestrogen receptors (ER) in the male.Experimental approach:  A total of sixty non‐aromatic steroids (selected from families of androstens, androstans, androstadiens, oestrens and oestrans) were analysed for their ability to bind and activate the human ERα and ERβin vitro and in cultured cells.Key results:  Six of the non‐aromatic steroids, that is, 5‐androsten‐3β,17β‐diol, 5α‐androstan‐3β,17β‐diol, 5(10)‐oestren‐3α,17β‐diol, 5(10)‐oestren‐3β,17β‐diol, 4‐oestren‐3β,17β‐diol and 5α‐oestran‐3β,17β‐diol, were found to have physiologically relevant high binding affinity (∼50% of that of oestrone) for human ERα and ERβ. These non‐aromatic steroids also activated the transcriptional activity of human ERs and elicited biological responses (such as growth stimulation) in two representative ER‐positive human cancer cell lines (MCF‐7 and LNCaP) with physiologically relevant potency and efficacy. Molecular docking analysis of these six active compounds showed that they could bind to ERα and ERβ in a manner similar to that of 17β‐oestradiol.Conclusions and implications:  These results provide evidence for the possibility that some of the endogenous androgen precursors or metabolites could serve as male‐specific ER ligands.
Basal hypercortisolism and trauma in patients with psychogenic nonepileptic seizures
Authors: Bakvis Patricia , Spinhoven Philip , Giltay Erik J. , Kuyk Jarl , Edelbroek Peter M. , Zitman Frans G. , Roelofs Karin 
Published: November 2009

SummaryPurpose:  Several studies have indicated that psychogenic nonepileptic seizures (PNES) are associated with psychological trauma, but only a few studies have examined the associations with neurobiologic stress systems, such as the hypothalamus–pituitary–adrenal (HPA) axis and its end‐product cortisol. We tested several relevant HPA‐axis functions in patients with PNES and related them to trauma history.Methods:  Cortisol awakening curve, basal diurnal cortisol, and negative cortisol feedback (using a 1 mg dexamethasone suppression test) were examined in 18 patients with PNES and 19 matched healthy controls (HCs) using saliva cortisol sampling on two consecutive days at 19 time points. Concomitant sympathetic nervous system (SNS) activity was assessed by analyzing saliva α‐amylase (sAA).Results:  Patients with PNES showed significantly increased basal diurnal cortisol levels compared to HCs. This effect was driven mainly by patients reporting sexual trauma who showed a trend toward higher cortisol levels as compared to patients without a sexual trauma report. Importantly, the increased basal diurnal cortisol levels in patients were not explained by depression, medication, or smoking, or by current seizures or group differences in SNS activity.Discussion:  This is the first study showing that basal hypercortisolism in patients with PNES is independent of the acute occurrence of seizures. In addition, basal hypercortisolism was more pronounced in traumatized patients with PNES as compared to nontraumatized patients with PNES. These findings suggest that HPA‐axis activity provides a significant neurobiologic marker for PNES.
Definition of drug resistant epilepsy: Consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies
Authors: Kwan Patrick , Arzimanoglou Alexis , Berg Anne T. , Brodie Martin J. , Allen Hauser W. , Mathern Gary , Moshé Solomon L. , Perucca Emilio , Wiebe Samuel , French Jacqueline 
Published: November 2009

SummaryTo improve patient care and facilitate clinical research, the International League Against Epilepsy (ILAE) appointed a Task Force to formulate a consensus definition of drug resistant epilepsy. The overall framework of the definition has two “hierarchical” levels: Level 1 provides a general scheme to categorize response to each therapeutic intervention, including a minimum dataset of knowledge about the intervention that would be needed; Level 2 provides a core definition of drug resistant epilepsy using a set of essential criteria based on the categorization of response (from Level 1) to trials of antiepileptic drugs. It is proposed as a testable hypothesis that drug resistant epilepsy is defined as failure of adequate trials of two tolerated, appropriately chosen and used antiepileptic drug schedules (whether as monotherapies or in combination) to achieve sustained seizure freedom. This definition can be further refined when new evidence emerges. The rationale behind the definition and the principles governing its proper use are discussed, and examples to illustrate its application in clinical practice are provided.
Aluminum Stock and Flows in U.S. Passenger Vehicles and Implications for Energy Use
Authors: Cheah Lynette , Heywood John , Kirchain Randolph 
Published: November 2009

SummaryIn this article, a methodology to model the annual stock and flows of aluminum in a key end‐use sector in the United States—passenger vehicles—from 1975–2035 is described. This dynamic material flow model has enabled analysis of the corresponding energy embodied in automotive aluminum as well as the cumulative aluminum production energy demand. The former was found to be significant at 2.6 × 109 gigajoules (GJ) in year 2008 under baseline assumptions. From 2008–2035, the cumulative energy required to produce aluminum to be used in vehicles is estimated at 7.8 × 109 GJ. Although the automotive aluminum stock is expected to increase by 1.8 times by 2035, the corresponding energy embodied is not expected to grow as rapidly due to efficiency improvements in aluminum processing over time. The model's robustness was tested by checking the sensitivity of the results to variations in key input assumptions, including future vehicle sales, lifetimes, and scrap recovery. Sensitivity of energy embodied in automotive aluminum to changes in aluminum production efficiency and aluminum applications within the vehicle were also explored. Using more recycled aluminum or improving the energy efficiency of aluminum production at a faster rate can lower production energy demands. However, aggressive and sustained changes are needed beginning today to achieve meaningful reductions. This may potentially be countered by increased use of stamped aluminum in vehicles.
Safety and tolerability of intravenous ferric carboxymaltose in patients with iron deficiency anemia
Authors: BAILIE George R. , MASON Nancy A. , VALAORAS Thomas G. 
Published: November 2009

AbstractThere is limited safety information about ferric carboxymaltose (FCM), a new intravenous iron preparation. This randomized, crossover study compared the safety and tolerability of double‐blinded intravenous doses of FCM or placebo in patients with iron deficiency anemia. Subjects (559) with iron deficiency anemia received a dose of either FCM (15 mg/kg, maximum 1000 mg) over 15 minutes or placebo on day 0. On day 7, subjects received the other agent. Safety evaluations were performed on days 7 and 14. The primary endpoint was the incidence of treatment‐emergent adverse events during each 7‐day study period. During the first 24 hours and during the 7‐day treatment period, at least one treatment‐emergent adverse event was experienced by 15.0% and 29.3% of subjects after FCM and 11.4% and 19.7% after placebo, respectively. Most were classified as Grade 1 or 2. Six subjects had Grade 3 treatment‐emergent adverse events after FCM and 9 subjects after placebo. One subject had a Grade 4, and 1 subject had a Grade 5 treatment‐emergent adverse event, but neither was considered study drug‐related. During the first 24 hours of the treatment period, drug‐related adverse events were reported in 9.3% of subjects receiving FCM and 4.8% receiving placebo. Of drug‐related Grade 3 events, 4 subjects received FCM and 5 subjects received placebo. Administration of FCM (15 mg/kg, maximum of 1000 mg) over 15 minutes was well tolerated and associated with minimal risk of adverse reactions in patients with iron deficiency anemia.
C.E.R.A. once every 4 weeks in patients with chronic kidney disease not on dialysis: The ARCTOS extension study
Authors: KESSLER Michèle , MARTÍNEZ‐CASTELAO Alberto , SIAMOPOULOS Kostas C. , VILLA Giuseppe , SPINOWITZ Bruce , DOUGHERTY Frank C. , BEYER Ulrich 
Published: November 2009

AbstractC.E.R.A., a continuous erythropoietin receptor activator is approved for the treatment of anemia in patients with chronic kidney disease (CKD). The ARCTOS (administration of C.E.R.A. in CKD patients to treat anemia with a twice‐monthly schedule) phase 3 study demonstrated the efficacy and safety of C.E.R.A. in correcting anemia when administered once every 2 weeks (Q2W) subcutaneously in patients with CKD not on dialysis. We assessed the feasibility and long‐term safety of converting patients who responded to treatment with C.E.R.A. Q2W to C.E.R.A. once every 4 weeks (Q4W) during a 24‐week extension period. After the core ARCTOS study period (28 weeks), 296 patients entered the 24‐week extension period. At week 29, patients who responded to C.E.R.A. Q2W during the core period were rerandomized to receive subcutaneous C.E.R.A. Q2W or Q4W. Patients in the comparator arm could receive darbepoetin alfa once weekly or Q2W. Dosage was adjusted to maintain hemoglobin (Hb) between 11 and 13 g/dL. Mean Hb levels remained stable in all groups, and were comparable at the end of the extension period (mean [standard deviation], C.E.R.A. Q2W, 11.92 [0.90] g/dL; C.E.R.A. Q4W, 11.70 [0.86] g/dL; darbepoetin alfa, 11.89 [0.98] g/dL). Mean within‐patient standard deviation values for Hb were also comparable in all groups (0.66, 0.62, and 0.65 g/dL for C.E.R.A. Q2W, C.E.R.A. Q4W and darbepoetin alfa, respectively). All treatments were well tolerated. Subcutaneous C.E.R.A. Q4W is safe and effective in maintaining stable Hb levels in patients with CKD not on dialysis following correction with subcutaneous C.E.R.A. Q2W.
“It's Just You and Satan, Hanging Out at a Pre‐School:” Notions of Evil and the Rehabilitation of Sexual Offenders
Authors: Waldram James B. 
Published: November 2009

SUMMARYNotions of “evil” are a feature of everyday discourse in civil society. Sexual offenders, individuals often labeled as “evil,” are well aware of public images of themselves and their crimes. This article examines public discourses of “evil” as they pertain to sexual offenders, and the views of sexual offenders themselves on what this means to them. The ethnographic research was undertaken in a prison unit designed for the treatment of sexual offenders. As a result, the issue of rehabilitation figured centrally in their conceptualizations of evil. While admitting to being bad, and perhaps even having committed evil acts, they generally reject the label of “evil” as understood in essentialist terms. The fundamental issue of concern for my analysis here is how secular views on the nature of evil speak to the issue of rehabilitation, an inherently human, “natural” capability. To be essentially “evil,” in their view, is to be almost nonhuman—a view shared by much of the public as well—and, therefore, beyond rehabilitation.
Three‐Dimensional Digital Subtraction Angiography in Evaluation of Vertebro‐Basilar Artery Dissections: Comparison with 2D DSA
Authors: Sorimachi Takatoshi , Suzuki Kenji , Sasaki Osamu , Koike Tetsuo , Fujii Yukihiko 
Published: November 2009

ABSTRACTBACKGROUND AND PURPOSE The purpose of this study was to clarify characteristic findings on three‐dimensional (3D) digital subtraction angiography (DSA), and to investigate diagnostic usefulness of 3D DSA in vertebro‐basilar dissections (VBD). METHODS In 25 consecutive patients with VBD, two‐dimensional (2D) DSA, and 3D DSA findings were evaluated by a scoring system. The effects of 3D DSA results on diagnosis were scored in comparison with 2D DSA results. RESULTS A proximal stenosis, a distal stenosis, a bleb, and a relationship between the posterior inferior cerebellar artery and the dissection were significantly better visualized in 3D DSA than those in 2D DSA (P < .05). A characteristic finding of VBD on 3D DSA was a combination of an aneurysmal bulging and its proximal and distal stenoses, which was observed in 92% of the 25 patients. CONCLUSIONS Three‐dimensional DSA was more useful for diagnosis in patients with VBD in comparison with 2D DSA.
Intimate Partner Violence: Development of a Brief Risk Assessment for the Emergency Department
Authors: Snider Carolyn , Webster Daniel , O’Sullivan Chris S. , Campbell Jacquelyn 
Published: November 2009

AbstractObjectives:  Women assaulted by intimate partners are frequently patients in emergency departments (EDs). Many victims and health care providers fail to take into account the potential risks of repeat partner violence. The objective of this study was to use data from a larger study of domestic violence risk assessment methods to develop a brief assessment for acute care settings to identify victims at highest risk for suffering severe injury or potentially lethal assault by an intimate partner or former partner.Methods:  Victims of intimate partner violence (IPV) were interviewed twice between 2002 and 2004. The baseline interview included the 20 items of Campbell’s Danger Assessment (DA; predictor). The follow‐up interview, conducted 9 months later on average, assessed abuse inflicted since the baseline interview (outcome). Multiple logistic regression was used to identify questions on the DA most predictive of severe abuse and potentially lethal assaults. Female IPV victims were recruited from New York City family courts, Los Angeles County Sheriff’s Department 9‐1‐1 calls, New York City and Los Angeles shelters, and New York City hospitals; 666 women responded to the DA at baseline, and 60% participated in follow‐up interviews.Results:  Severe injuries or potentially lethal assaults were experience by 14.9% of retained study participants between the baseline and follow‐up interviews. The best brief prediction instrument has five questions. A positive answer to any three questions has a sensitivity of 83% (95% confidence interval = 70.6% to 91.4%).Conclusions:  This instrument can help predict which victims may be at increased risk for severe injury or potentially lethal assault and can aid clinicians in differentiating which patients require comprehensive safety interventions.
Emergency Medicine Resident Attitudes and Perceptions of HIV Testing Before and After a Focused Training Program and Testing Implementation
Authors: Hsieh Yu‐Hsiang , Jung Julianna J. , Shahan Judy B. , Moring‐Parris Daniel , Kelen Gabor D. , Rothman Richard E. 
Published: November 2009

AbstractObjectives:  The objectives were to determine attitudes and perceptions (A&P) of emergency medicine (EM) residents toward emergency department (ED) routine provider‐driven rapid HIV testing services and the impact of both a focused training program (FTP) and implementation of HIV testing on A&P.Methods:  A three‐phase, consecutive, anonymous, identity‐unlinked survey was conducted pre‐FTP, post‐FTP, and 6 months postimplementation. The survey was designed to assess residents’ A&P using a five‐point Likert scale. A preimplementation FTP provided both the rationale for the HIV testing program and the planned operational details of the intervention. The HIV testing program used only indigenous ED staff to deliver HIV testing as part of standard‐of‐care in an academic ED. The impact of the FTP and implementation on A&P were analyzed by multivariate regression analysis using generalized estimating equations to control for repeated measurements in the same individuals. A “favorable” A&P was operationally defined as a mean score of >3.5, “neutral” as mean score of 2.5 to 3.5, and “unfavorable” as mean score of <2.5.Results:  Thirty of 36 residents (83.3%) participated in all three phases. Areas of favorable A&P found in phase I and sustained through phases II and III included “ED serving as a testing venue” (score range = 3.7–4.1) and “emergency medicine physicians offering the test” (score range = 3.9–4.1). Areas of unfavorable and neutral A&P identified in phase I were all operational barriers and included required paperwork (score = 3.2), inadequate staff support (score = 2.2), counseling and referral requirements (score range = 2.2–3.1), and time requirements (score = 2.9). Following the FTP, significant increases in favorable A&P were observed with regard to impact of the intervention on modification of patient risk behaviors, decrease in rates of HIV transmission, availability of support staff, and self‐confidence in counseling and referral (p < 0.05). At 6 months postimplementation, all A&P except for time requirements and lack of support staff scored favorably or neutral. During the study period, 388 patients were consented for and received HIV testing; six (1.5%) were newly confirmed HIV positive.Conclusions:  Emergency medicine residents conceptually supported HIV testing services. Most A&P were favorably influenced by both the FTP and the implementation. All areas of negative A&P involved operational requirements, which may have influenced the low overall uptake of HIV testing during the study period.
Emergency Medicine Public Health Research Funded by Federal Agencies: Progress and Priorities
Authors: D’Onofrio Gail , Goldstein Amy B. , Denisco Richard A. , Hingson Ralph , Heffelfinger James D. , Post Lori A. 
Published: November 2009

AbstractThe emergency department (ED) visit provides an opportunity to impact the health of the public throughout the entire spectrum of care, from prevention to treatment. As the federal government has a vested interest in funding research and providing programmatic opportunities that promote the health of the public, emergency medicine (EM) is prime to develop a research agenda to advance the field. EM researchers need to be aware of federal funding opportunities, which entails an understanding of the organizational structure of the federal agencies that fund medical research, and the rules and regulations governing applications for grants. Additionally, there are numerous funding streams outside of the National Institutes of Health (NIH; the primary federal health research agency). EM researchers should seek funding from agencies according to each agency’s mission and aims. Finally, while funds from the Department of Health and Human Services (HHS) are an important source of support for EM research, we need to look beyond traditional sources and appeal to other agencies with a vested interest in promoting public health in EDs. EM requires a broad skill set from a multitude of medical disciplines, and conducting research in the field will require looking for funding opportunities in a variety of traditional and not so traditional places within and without the federal government. The following is the discussion of a moderated session at the 2009 Academic Emergency Medicine consensus conference that included panel discussants from the National Institutes of Mental Health, Drug Abuse, and Alcoholism and Alcohol Abuse and the Centers for Disease Control and Prevention (CDC). Further information is also provided to discuss those agencies and centers not represented.
Erectile Dysfunction and Correlated Factors in Brazilian Men Aged 18–40 years
Authors: Martins Fernando Gonini , Abdo Carmita Helena Najjar 
Published: November 2009

ABSTRACT

Introduction
Few population-based studies in erectile dysfunction (ED) included subjects less than 40 years old and analyzed the several factors and consequences potentially associated with this condition.

Aim
Evaluation of the prevalence of erectile dysfunction (ED) and associated factors in a sample of Brazilian men aged 18 to 40 years old.

Methods
Cross-sectional study in which subjects were contacted in public places of 18 major Brazilian cities and interviewed using an anonymous questionnaire. Survey data were submitted to chi-squared, student’s t-test and logistic regression analyses.

Main Outcome Measures
The data were collected by means of a self-administered questionnaire with 87 questions about sociodemographic variables, general health, habits and lifestyle-related factors, sexual behavior and sexual difficulties, including ED which was assessed by a single question.

Results
Prevalence of ED in 1,947 men was 35.0% (73.7% mild, 26.3% moderate/complete). Greater frequency of ED was seen in subjects that never had information about sex, experienced difficulties in the beginning of sexual life and have never masturbated. ED was associated to lower level of education, but not to race, sexual orientation, employment or marital status. Also, no association was found between ED and smoking, alcoholism, obesity, sedentary life, diabetes, hypertension, cardiovascular disease, hyperlipidemia, depression or anxiety. ED caused negative impact in men’s self-esteem, interpersonal relationships, work and leisure activities, and in sexual life satisfaction. Less than 10% of men with ED had received medical treatment for this problem.

Conclusions
Prevalence of ED in this young population was high, mostly of mild severity. Low education and psychosocial problems were associated to ED and, due probably to the sample subjects’ young age, no association was found with organic problems. Measures in the fields of education and psychosocial difficulties prevention would have a positive impact in the control of erectile dysfunction in the young population.
More than Sexual Function: Predictors of Sexual Satisfaction in a Sample of Women Age 40–70
Authors: Dundon Carolyn Marie , Rellini Alessandra H. 
Published: November 2009

ABSTRACT

Introduction
The literature provides a complex picture of sexual satisfaction and its predictors. To date, studies have provided a list of predictors of sexual satisfaction, including relational and psychological factors, but very little information is available on the direct effects of these predictors in midlife women, independently from the effects of sexual function on sexual satisfaction.

Aim
The main aim of this article is to provide empirical evidence on factors that predict sexual satisfaction in middle-aged women above and beyond the explanation provided by sexual function.

Main Outcome Measures
The three items on sexual satisfaction from the Female Sexual Functioning Index were used to assess different aspects of sexual satisfaction.

Methods
A sample of 86 women age 40–70 years recruited from a clinic completed a battery of questionnaires on sexual satisfaction and potential predictors, including, psychological well-being, body attitudes, menopausal symptoms, and relationship adjustment.

Results
Relationship adjustment, psychological well-being, and menopausal symptoms predicted sexual satisfaction above and beyond sexual functioning. Body attitudes did not predict sexual satisfaction in midlife women.

Conclusions
Data supported the hypothesis that sexual satisfaction is only partially explained by sexual function. Other factors involved in women’s lives, such as psychological well-being, relationship adjustment, and, to a lesser extent, menopausal symptoms, affect sexual satisfaction independently from sexual function.