bluuebunny/crossref_metadata_2025_split huggingface dataset:
Self-Castration by a Transsexual Woman: Financial and Psychological Costs: A Case Report
Authors: St. Peter Matthew , Trinidad Anton , Irwig Michael S. 
Published: January 2012

ABSTRACT

Introduction
The out-of-pocket cost for an elective orchiectomy, which is often not covered by health insurance, is a significant barrier to male-to-female transsexuals ready to proceed with their physical transition. This and other barriers (lack of access to a surgeon willing to perform the operation, waiting times, and underlying psychological and psychiatric conditions) lead a subset of transsexual women to attempt self-castration. Little information has been published on the financial costs and implications of self-castration to both patients and health care systems.

Aim
We compare the financial and psychological costs of elective surgical orchiectomy vs. self-castration in the case of a transsexual woman in her 40s.

Methods
We interviewed the patient and her providers and obtained financial information from local reimbursement and billing specialists.

Results
After experiencing minor hemorrhage following the self-castration, our patient presented to the emergency department and underwent a bilateral inguinal exploration, ligation and removal of bilateral spermatic cords, and complicated scrotal exploration, debridement, and closure. She was admitted to the psychiatric service for a hospital stay of three days. The total bill was US $14,923, which would compare with US $4,000 for an elective outpatient orchiectomy in the patient’s geographical area.

Conclusions
From a financial standpoint, an elective orchiectomy could have cost the health care system significantly less than a hospital admission with its associated additional costs. From a patient safety standpoint, elective orchiectomy is preferable to self-castration which carries significant risks such as hemorrhage, disfigurement, infection, urinary fistulae, and nerve damage. Healthcare providers of transsexual women should carefully explore patient attitudes toward self-castration and work toward improving access to elective orchiectomy to reduce the number of self-castrations and costs to the overall health care system. Further research on the financial implications of self-castration from different health care systems and from a series of patients is needed.
Erectile Function Outcome After Bilateral Nerve Sparing Radical Prostatectomy: Which Patients May Be Left Untreated?
Authors: Gallina Andrea , Ferrari Matteo , Suardi Nazareno , Capitanio Umberto , Abdollah Firas , Tutolo Manuela , Bianchi Marco , Saccà Antonino , Salonia Andrea , Rigatti Patrizio , Montorsi Francesco , Briganti Alberto 
Published: January 2012

ABSTRACT

Introduction
Several studies have shown that erectile function (EF) recovery in patients undergoing bilateral nerve sparing radical prostatectomy (BNSRP) improves significantly when phosphodiesterase type 5 inhibitors (PDE5) are administered following surgery.

Aim
The aim of this article was to identify patients who may recover EF after retropubic BNSRP (BNSRRP) without PDE5.

Methods
We included 293 patients treated with BNSRRP at a single center. Postoperative EF recovery was defined as an EF domain score of the International Index of Erectile Function (IIEF) ≥22. No patient received any treatment for postoperative erectile dysfunction (ED). Kaplan–Meier curves assessed time to EF recovery according to patient age, preoperative EF, and Charlson comorbidity index (CCI). Univariable and multivariable Cox regression models tested the association between predictors and EF recovery. Finally, the rate of EF recovery of untreated patients after BNSRP was compared with a subset of patients with similar preoperative characteristics but receiving PDE5.

Main Outcome Measure
The main outcome measure of this article was the IIEF-EF domain score.

Results
Overall, 105/293 (35.8%) reached an IIEF-EF ≥22 after a mean follow-up of 26.8 months. At multivariable analyses, age, preoperative IIEF-EF, and CCI achieved independent predictor status (all P ≤ 0.04). Patients &lt;55 years had a 72.4% EF recovery rate compared with 30% of patients &gt;70 years (P &lt; 0.001). Similarly, preoperatively fully potent patients (IIEF-EF ≥26) had a 56.6% chance of recovering EF after surgery compared with 18% of patients with severe ED before surgery (P &lt; 0.001). The rate of EF recovery in untreated patients &lt;55 years and with a pre-op IIEF-EF ≥22 was higher but did not differ significantly from comparable patients receiving PDE5 (P = 0.11).

Conclusions
Overall, the rate of EF postoperative recovery in patients left untreated after surgery is modest (35.8%). Although younger patients with a good preoperative EF may experience good EF recovery rates even without any treatment, use of PDE5 after surgery further improved their functional outcomes. Therefore, a therapy for ED should be offered to all patients treated with BNSRP.
Couples’ Reasons for Adherence to, or Discontinuation of, PDE Type 5 Inhibitors for Men with Erectile Dysfunction at 12 to 24-Month Follow-Up After a 6-Month Free Trial
Authors: Conaglen Helen M. , Conaglen John V. 
Published: January 2012

ABSTRACT

Introduction
The history of treatments for erectile dysfunction (ED) has involved a repeated pattern of uptake, followed by abandonment of the various therapies in the medium term. Even effective and simple to use medications are not necessarily continued; discontinuation rates range between 15% and 60%. Despite the association between partner sexual function and men’s use of PDE5, no previous studies have reported any contact with partners of men taking PDE5 for their ED. This study involved both partners in couples followed up at least 1 year after treatment of ED.

Aim
The study sought clarification of factors influencing adherence to, or discontinuation of, oral ED medications from couples. We hypothesized that many factors contribute to decision making about ED medication use at &gt;12 months.

Main Outcome Measures
The main outcome measures of this article were interviews and International Index of Erectile Function-erectile function domain.

Methods
A total of 155 interviews were conducted seeking details of frequency of usage and preference for the drugs available; reasons for that choice, or for discontinuation of use, were also sought.

Results
Of men interviewed, 71% were using PDE5 at 18 months. Most men interviewed were using the oral medications either 1–2x/week or 1–2x/month. Forty-four percent of men who had decreased their use of the medications reported less need for them. Thirty-four men said the main reason they were using less medication was cost. “Partner issues” from the men’s perspective were seldom reported in this study. However, for a number of women, “partner issues” meant a range of problems from separation to alcohol abuse, lack of communication, and lack of confidence, or fear of failure.

Conclusions
This is the first study to ask couples why they decided to continue or stop using PDE5 when followed up. Female partners provided a different perspective on “partner issues” often cited as reasons for discontinuing PDE5 use. It was also clear that discontinuation did not mean couples were no longer sexually active.
Life and Spirit in Max Scheler’s Philosophy
Authors: Sandmeyer Robert 
Published: January 2012

AbstractMax Scheler was a philosopher of intuition who rarely worked out his ideas systematically. Consequently, his philosophical writings present something of a challenge for the reader. There is little unifying his disparate studies. In this paper, I suggest that a distinction between life and spirit which Scheler formulated early and held onto throughout his career can provide a heuristic principle by which to study his works. This paper is a clarification of this distinction. In the first part of the paper, I show that Scheler’s dualistic metaphysics has its roots in Rudolf Eucken’s idealistic philosophy. In the second and third parts of this essay, I clarify Scheler’s concept of spirit as he develops it in confrontation with Edmund Husserl’s phenomenological philosophy. Particularly, in the second part, I show that as he confronts Husserl’s conception of philosophy as rigorous science he postulates a radically different idea of the nature of philosophy, an idea that is rooted in this distinction between life and spirit. I explicate in the next section the unique theory of the phenomenological reduction Scheler develops on the basis of this distinction. In the last part, I briefly present how this conception of life and spirit are worked out in Scheler’s philosophical anthropology, particularly in his last work, The Human Place in the Cosmos.
Schopenhauer’s Aesthetics and Philosophy of Art
Authors: Shapshay Sandra 
Published: January 2012

AbstractThis essay focuses on Schopenhauer’s aesthetics and philosophy of art, areas of his philosophy which have attracted the most philosophical attention in recent years. After discussing the subjective and objective aspects of aesthetic experience on his account, I shall offer interpretations of Schopenhauer’s theory of the sublime and solution to the problem of tragedy. In addition, I shall touch upon the liveliest interpretive debates concerning his aesthetic theory: the intelligibility of the “Platonic Ideas” as the objects of aesthetic experience and the very possibility of aesthetic experience within Schopenhauer’s system. Another aim of this essay is to suggest how some of Schopenhauer’s aesthetic doctrines may be interpreted in a less metaphysically extravagant way. When understood in this manner, contemporary aestheticians might be inclined to take a closer look at Schopenhauer’s aesthetic theory and philosophy of art, for it is distinctive in the tradition of Western philosophical aesthetics in its attempt to highlight and balance the hedonic and cognitive importance of aesthetic experiences; in its sensitivity both to the aesthetic experience of nature as well as of art; in the high value placed on the experience of music (a higher value than afforded by any previous aesthetic theory); and in the innovative solution to the problem of tragedy it offers.
Generation of a cholangiocyte‐specific cDNA expression library for the identification of B and T cell autoantigens in murine biliary disease
Authors: Tucker Rebecca M. , Mack Cara L. 
Published: January 2012

Aim:  Several mouse models of inflammatory cholangiopathies exist, including biliary atresia, primary biliary cirrhosis, autoimmune hepatitis, and primary sclerosing cholangitis. In an ongoing effort to identify the target antigens of both infiltrating autoreactive T cells and serum autoantibodies, we aimed to generate a cholangiocyte‐derived cDNA library capable of expressing a wide variety of proteins.Methods:  mRNA was isolated from a normal mouse cholangiocyte cell line and reverse transcribed into cDNA. After initial cloning of the cDNA into a transfer vector (pDONR222), the entire library was shuttled into an Escherichia coli expression vector (pDEST160).Results:  The library contains 2.3 × 106 independent clones and expresses proteins up to 100 kD in molecular weight. Using a variety of techniques, including western blot analysis, mass spectrometry of individual clones, and direct DNA sequencing of plasmids, a number of both ubiquitously expressed and cholangiocyte‐specific proteins (e.g. cytokeratin 19) have been identified within.Conclusion:  A comprehensive mouse cholangiocyte cDNA expression library has been generated and is available for use as a source of multiple cholangiocyte‐specific antigens for immunological studies. The library can be used to screen for specificity of T cell lines or hybridomas. Furthermore, this library has potential uses in SEREX analysis of autoantibody reactivity. The cholangiocyte‐specific cDNA library is a powerful tool for the identification of target antigens in murine inflammatory cholangiopathies and is available as a shared resource.
Tissue‐specific differences in inflammatory infiltrate and matrix metalloproteinase expression in adipose tissue and liver of mice with diet‐induced obesity
Authors: de Meijer Vincent E. , Sverdlov Deanna Y. , Le Hau D. , Popov Yury , Puder Mark 
Published: January 2012

Aim:  While low grade inflammation persists in both visceral fat and hepatic tissue in obesity, these changes often result in progressive disease and fibrosis only in the liver and not in adipose tissue. We hypothesized that a tissue‐specific difference in obesity‐induced inflammatory cell infiltrate may be responsible for such organ difference in susceptibility to fibrosis.Methods:  Mice were fed either standard chow or a high fat diet over 19 weeks. Hepatic steatosis was assessed by histology and quantified via magnetic resonance spectroscopy. Immunohistochemistry staining for macrophage subsets and quantitative reverse transcription‐polymerase chain reaction for matrix metalloproteinase (MMP)‐ and fibrosis‐related gene expression was performed in paired livers and visceral (epididymal) fat pads at early (9 weeks) and advanced (19 weeks) stages of progressive diet‐induced obesity.Results:  Up to 19 weeks of high fat feeding led to the development of obesity and hepatic steatosis, as well as increased gene expression of Mmp12, Mmp13 and Timp1 in predominantly adipose tissue, and to a lesser extent of liver tissue. In contrast to visceral fat, cell counts for macrophages as well as profibrogenic gene signaling in liver tissue during development of diet‐induced obesity remained largely unchanged.Conclusions:  Development of diet‐induced obesity in the mouse increased inflammatory macrophages counts in adipose tissue rather than the liver. This was associated with greater increases in MMP expression in adipose tissue compared with liver. We propose that attenuated hepatic MMP expression in livers and adipose tissue of obese mice shifts the balance of fibrogenesis/fibrolysis and predispose the liver to development of fibrosis.
Follow up of the 987 blood donors found with hepatitis C virus infection over 9–18 years
Authors: Matsuo Junko , Mizui Masaaki , Okita Hajime , Katayama Keiko , Aimitsu Shiomi , Sakata Tatsuro , Obayashi Makoto , Nakanishi Toshio , Chayama Kazuaki , Miyakawa Yuzo , Yoshizawa Hiroshi , Tanaka Junko ,   for the Hiroshima Hepatitis Study Group
Published: January 2012

Aim:  To follow up blood donors found with hepatitis C virus (HCV) infection, to improve the outcome by antiviral treatments.Methods:  Between 1991 and 2001, 3377 of the 1 925 860 donors (0.18%) were found to have HCV infection at the Hiroshima Red Cross Blood Center in Japan. Of them, 987 were able to be followed regularly over 9–18 years until 2009, and received antiviral treatments as required.Results:  At the start, chronic hepatitis was diagnosed in 541 (54.8%), cirrhosis in five (0.5%) and hepatocellular carcinoma (HCC) in one (0.1%), whereas the remaining 439 (44.5%) had persistently normal aminotransferase levels (PNAL). Hospital visits were terminated voluntarily in 24.3% within the first year, 46.8% by 10 years and 50.9% by 17 years. Liver disease improved in 178 (18.0%), remained stable in 606 (61.4%) and aggravated in 170 (17.2%). Of the 541 donors with chronic hepatitis, HCC developed in 28 (5.2%) and cirrhosis in 11 (2.0%), whereas HCV infection was cleared in 107 (19.8%) by antiviral treatments. In addition, HCV infection resolved in 54 of the 439 donors (12.3%) with PNAL after they had developed chronic hepatitis and received treatments. In donors with chronic hepatitis, the cumulative incidence of HCC was 4.1% at 10 years. By multivariate analysis, age and diagnosis of chronic hepatitis at the entry were found to be independent risk factors for the development of HCC.Conclusion:  Individuals with undiagnosed HCV infection need to be identified and receive medical care. They have to be motivated to merit from this health‐care program.
Air sampling in the breathing zone of neonatal foals for prediction of subclinical Rhodococcus equi infection
Authors: CHICKEN C. , MUSCATELLO G. , FREESTONE J. , ANDERSON G. A. , BROWNING G. F. , GILKERSON J. R. 
Published: January 2012

SummaryReasons for performing the study: Disease caused by Rhodococcus equi is a significant burden to the horse breeding industry worldwide. Early detection of rhodococcal pneumonia, albeit important to minimise treatment costs, is difficult because of the insidious nature of the disease and the lack of definitive diagnostic tests.Objectives: To investigate air sampling from the breathing zone of neonatal foals as a predictor of subsequent rhodococcal pneumonia.Methods: Air samples were collected from the breathing zone of 53 neonatal foals (age ≤10 days) and again at the time of routine ultrasonographic screening for R. equi pneumonia (age 1–2 months).Results: Pneumonia was diagnosed ultrasonographically in 23% of foals. Virulent R. equi was detected in air from the breathing zone of 19% of neonatal foals and 45% of foals at age 1–2 months. There was no association between virulent R. equi in the breathing zone of foals and the subsequent ultrasonographic diagnosis of rhodococcal pneumonia. The median concentration of virulent R. equi in the breathing zone of both neonates (0 [range 0–4] colony‐forming units [cfu]/250 l) and older foals (0 [range 0–3] cfu/250 l) was not significantly different from that in background air samples (0 [range 0–6] cfu/250 l). There was no difference in the concentration of virulent R. equi in the breathing zone of older foals that were diagnosed with rhodococcal pneumonia or clinically normal foals.Conclusion: Detection of virulent R. equi in air from the breathing zone was not a positive predictor of rhodococcal pneumonia in foals up to age ≤2 months.Potential relevance: Selective culture of air samples from the breathing zone of young foals is not better at diagnosing rhodococcal pneumonia than early ultrasonographic screening. However, culture of air samples from the breathing zone of older foals remains a useful herd‐based epidemiological tool.
Comparison of Immunoglobulin G Subclass Concentrations in Severe Community-Acquired Pneumonia and Severe Pandemic 2009 Influenza A (H1N1) Infection
Authors: Gordon Claire L. , Holmes Natasha E. , Grayson M. Lindsay , Torresi Joseph , Johnson Paul D. R. , Cheng Allen C. , Charles Patrick G. P. 
Published: January 2012

ABSTRACTWe compared immunoglobulin G (IgG) subclasses in patients with severe noninfluenza community-acquired pneumonia (CAP) to those in patients with severe pandemic 2009 influenza (H1N1) virus infection. Low IgG1 and IgG2 levels occurred often in the CAP group; however, H1N1 patients had lower IgG1 and IgG2 levels (5.4 versus 3.3 g/liter [P= 0.008] and 2.5 versus 1.2 g/liter [P< 0.001], respectively). Low IgG2 levels may be specifically linked to severe H1N1; however, it is not clear whether this association is related to H1N1 or to other features of severity.
Antibodies to a Novel Leptospiral Protein, LruC, in the Eye Fluids and Sera of Horses with Leptospira-Associated Uveitis
Authors: Verma Ashutosh , Matsunaga James , Artiushin Sergey , Pinne Marija , Houwers Dirk J. , Haake David A. , Stevenson Brian , Timoney John F. 
Published: January 2012

ABSTRACTScreening of an expression library ofLeptospira interroganswith eye fluids from uveitic horses resulted in identification of a novel protein, LruC. LruC is located in the inner leaflet of the leptospiral outer membrane, and anlruCgene was detected in all tested pathogenicL. interrogansstrains. LruC-specific antibody levels were significantly higher in eye fluids and sera of uveitic horses than healthy horses. These findings suggest that LruC may play a role in equine leptospiral uveitis.
Monitoring of Peptide-Specific and Gamma Interferon-Productive T Cells in Patients with Active and Convalescent Tuberculosis Using an Enzyme-Linked Immunosorbent Spot Assay
Authors: Yang Fang-Fang , Tu Zhi-Quan , Fang Yi-Min , Li Yan , Peng Yi , Dong Tao , Wang Cong , Lin Shu-Xian , Zhan Neng-Yong , Ma Zhi-Ming , Feng Yong-Zhong , Tan Shou-Yong , Lai Xiao-Min 
Published: January 2012

ABSTRACTTo establish a high-efficiency gamma interferon-specific enzyme-linked immunosorbent spot assay (IFN-γ ELISPOT assay) for detection of tuberculosis (TB), peptides (E6, E7, and C14) and peptide mixtures (E6 plus E7 and E6 plus E7 plus C14) were used to monitor peripheral blood (PBL) samples from patients with pulmonary TB (PTB), as well as control samples. The positive detection rates of the five IFN-γ ELISPOT assays were 78.38%, 74.86%, 55.83%, 90.43%, and 91.51%, respectively, and there were similar detection rates between the two combined peptide mixture IFN-γ ELISPOT assays and the tuberculin skin test (TST) (90.62% versus 95.59%). No significant difference was found between the detection rates of the two combined peptide mixture IFN-γ ELISPOT assays and the T-SPOT.TB assay for 86 patients with PTB (P> 0.05), but the median number of spot-forming cells/106cells (SFP value) for positive results was higher by the former than by the latter assay (P< 0.05). In contrast, the 29.93% positive detection rate and median SFP value of 482 by the two combined peptide mixture IFN-γ ELISPOT assays were significantly higher than the corresponding values of 14.29% and 152 by T-SPOT.TB assay for the same 147 community donors (P< 0.05). For nine PTB patients tracked, the SFP value of 7 for the two peptide mixture IFN-γ ELISPOT assays began to decrease from the second month after regular treatment. A relatively low, almost normal, SFP level was reached and maintained after the third or fourth month. Two in-house IFN-γ ELISPOT assays and the T-SPOT.TB assay could reduce the false-positive and false-negative detection rates of TST and sputum acid-fast staining. Therefore, these two combined peptide mixture IFN-γ ELISPOT assays have a potential advantage, beyond their greater specificity and sensitivity, for use in screening and detection of active TB infection (TBI) and latent TB infection (LTBI) in China.
Evaluation of Gamma Interferon (IFN-γ)-Induced Protein 10 Responses for Detection of Cattle Infected with Mycobacterium bovis: Comparisons to IFN-γ Responses
Authors: Waters W. R. , Thacker T. C. , Nonnecke B. J. , Palmer M. V. , Schiller I. , Oesch B. , Vordermeier H. M. , Silva E. , Estes D. M. 
Published: January 2012

ABSTRACTGamma interferon (IFN-γ)-induced protein 10 (IP-10) has recently shown promise as a diagnostic biomarker ofMycobacterium tuberculosisinfection of humans. The aim of the current study was to compare IP-10 and IFN-γ responses uponMycobacterium bovisinfection in cattle by using archived samples from two aerosol inoculation studies. In the first study (104CFUM. bovisby aerosol,n= 7),M. bovispurified protein derivative (PPDb)-specific IP-10 and IFN-γ gene expression was detected as early as 29 days after challenge. PPDb-specific IP-10 and IFN-γ mRNA responses followed a similar pattern of expression over the course of this study and were highly correlated (r= 0.87). In the second study (105CFUM. bovisby aerosol,n= 5), IP-10 and IFN-γ (protein) responses to mycobacterial antigens were compared following challenge. IFN-γ responses to mycobacterial antigens were detected at 29 days after challenge and were sustained during the remainder of the study. IFN-γ responses to mycobacterial antigens exceeded corresponding responses in nonstimulated cultures. IP-10 responses to mycobacterial antigens exceeded preinfection responses at 7, 29, and 63 days after challenge. In contrast to IFN-γ responses, IP-10 responses to mycobacterial antigens generally did not exceed the respective responses in nonstimulated cultures. IP-10 responses to medium alone and to mycobacterial antigens followed a similar pattern of response. Correlations between IP-10 and IFN-γ (protein) responses were modest (r≈ 0.50 to 0.65). Taken together, these findings do not support the use of IP-10 protein as a biomarker for bovine tuberculosis using the current testing protocol and reagents; however, mRNA-based assays may be considered for further analysis.