bluuebunny/crossref_metadata_2025_split huggingface dataset:
The 10 mL syringe is useful in generating the recommended standard of 40 mmHg intrathoracic pressure for the Valsalva manoeuvre
Authors: Smith Gavin , Boyle Malcolm J 
Published: November 2009

AbstractObjective:  The Valsalva manoeuvre (VM) continues to be first‐line management for haemodynamically stable supraventricular tachycardia in the acute setting. 40 mmHg of intrathoracic pressure is seen as an essential component of the VM. Anecdotally, blowing into a 10 mL syringe to move the plunger is one method of pressure generation; however, to date its effectiveness has not been tested. The objective of the present study was to assess if blowing into a syringe sufficient to move the plunger could produce the required 40 mmHg of pressure.Methods:  A two‐part experimental study tested the pressure required to move the plunger, and sustain that movement for 15 s, in a Terumo syringe. Part one tested a range of syringe sizes. Part two, a repeated measures study, tested the syringe to ascertain if a pressure reduction occurred after repeated use. A sphygmomanometer was attached to the syringe via a 10 cm length of tubing with another length of tubing attached to the sphygmomanometer enabling an investigator to blow into the syringe.Results:  In part one, the 10 mL syringe was the only size noted to provide the required 40 mmHg pressure to move the plunger. In part two, the mean for each of the three tests per syringe varied between 37.0 mmHg (95% CI 34.2–39.8) and 40.2 mmHg (95% CI 37.5–43.0). There was no statistically significant fall noted over three uses of the same syringe.Conclusion:  The present study has demonstrated that blowing into a 10 mL Terumo syringe, to move the plunger, generated 40 mmHg intrathoracic pressure, thereby meeting the recommended intrathoracic pressure for optimum VM performance.
Current level of training, experience and perceptions of emergency physicians as expert witnesses: A pilot study
Authors: Cunningham Nicola Y , Weiland Tracey J 
Published: November 2009

AbstractThe objective of the present study was to determine emergency physicians' training, experience and perceptions as expert witnesses. Emergency physicians of an adult tertiary referral and teaching hospital participated in a pilot survey regarding their experiences in report writing and in court as expert witnesses. The 28‐item survey also examined the amount of formalized forensic medical teaching that emergency physicians had received during their training. Of the participants, 41% (95% CI 21.6–64.1; 7/17) had never received any undergraduate or postgraduate training in forensic medicine, 11/17 (65%, 95% CI 41.2–82.8) had provided a written expert opinion for court, and 12/17 (71%, 95% CI 46.6–87.0) had attended court as an expert witness. All participants considered themselves ‘skilled in attending an emergency resuscitation’, whereas 3/13 (23%, 95% CI 7.5–50.9) considered themselves ‘skilled in attending a courtroom trial’. Nearly 90% (95% CI 64.7–98.0; 15/17) thought that medical evidence training should be a requirement of emergency speciality training. The most commonly preferred forms of medical evidence training were mock court sessions (76%, 95% CI 52.2–91.0; 13/17) and forensic workshops (76%, 95% CI 52.2–91.0; 13/17). From 10 non‐technical skills required of an EP, ‘appearing in court as an expert witness’ was perceived to be the second most difficult skill by most respondents. Emergency physicians in this pilot study have limited training for the role of expert witness and see it as one of the most difficult non‐technical skills they have to perform. Further research is required regarding the current and future scope of forensic training.
Emergency physicians as expert witnesses: ‘From frontline wise to courtroom woes’
Authors: Cunningham Nicola Y 
Published: November 2009

AbstractA ‘Medical Expert’ witness is one who has been accepted by the court as having special knowledge of the subject about which they are testifying and as a result is allowed to give evidence of their medical opinion. In contrast, ordinary witnesses can only give evidence regarding facts that they have observed. Emergency medicine is one of a few speciality areas of medicine more likely to be involved in legal proceedings. Preparing the emergency physician to be an expert witness is an invaluable part of their training. Education in this area should concentrate on the purpose of the evidence, the legal framework in which it is delivered and the specific skill requirements of medical expert witnesses.
Short‐term risk of adverse outcome is significantly higher in patients returning an abnormal troponin result when tested in the emergency department
Authors: Flindell Jade A , Finn Judith C , Gibson Nicholas P , Jacobs Ian G 
Published: November 2009

AbstractObjective:  Describe short‐term mortality and hospitalization outcomes in patients undergoing troponin testing in Western Australia tertiary public hospital ED.Methods:  Retrospective cohort study of adults presenting to urban tertiary ED between July 2000 and December 2004, and undergoing troponin inhibitory or tropomyosin binding testing. Patient data relating to ED attendance, troponins, hospitalization and death were linked using probabilistic data linkage. Troponin results were dichotomized (normal/abnormal) according to hospitals' cut‐offs across various time periods. Presentations undergoing ED troponin testing, provided that it was not within 28 days of a previous discharge involving ED troponin testing, met study inclusion criteria. Logistical regression analyses quantified risk of subsequent hospitalization and death.Results:  A total of 119 646 troponin tests were performed during 83 635 ED presentations involving 54 214 patients. For the 73 965 ED presentations meeting the study criteria, 6779 (9.2%) recorded an abnormal peak troponin level and 168 (2.5%) of these presentations were discharged directly from ED. After adjusting for covariates, those discharged directly from ED with abnormal troponin results were significantly more likely to die within 2 days (OR 60.4, 95% CI 31.9–114.2), 7 days (OR 31.2, 95% CI 17.9–54.3) and 28 days (OR 19.4, 95% CI 12.5–30.1) of discharge, compared with those with normal troponin results. Adjusted odds of subsequent hospital admission within 28 days following discharge from ED were 3.3 (95% CI 2.4–4.5) times greater for presentations with abnormal versus normal troponin results.Conclusion:  An abnormal ED troponin result appears to be associated with increased risk of subsequent hospitalization and death within 28 days of discharge.
The Association Between Sexual Satisfaction and Body Image in Women
Authors: Pujols Yasisca , Meston Cindy M. , Seal Brooke N. 
Published: November 2009

ABSTRACT

Introduction
Although sexual functioning has been linked to sexual satisfaction, it only partially explains the degree to which women report being sexually satisfied. Other factors include quality of life, relational variables, and individual factors such as body image. Of the few studies that have investigated the link between body image and sexual satisfaction, most have considered body image to be a single construct and have shown mixed results.

Aim
The present study assessed multiple body image variables in order to better understand which aspects of body image influence multiple domains of sexual satisfaction, including sexual communication, compatibility, contentment, personal concern, and relational concern in a community sample of women.

Methods
Women between the ages of 18 and 49 years in sexual relationships (N = 154) participated in an Internet survey that assessed sexual functioning, five domains of sexual satisfaction, and several body image variables.

Main Outcome Measures
Body image variables included the sexual attractiveness, weight concern, and physical condition subscales of the Body Esteem Scale, the appearance-based subscale of the Cognitive Distractions During Sexual Activity Scale, and body mass index. Total score of the Sexual Satisfaction Scale for Women was the main outcome measure. Sexual functioning was measured by a modified Female Sexual Function Index.

Results
Consistent with expectations, correlations indicated significant positive relationships between sexual functioning, sexual satisfaction, and all body image variables. A multiple regression analysis revealed that sexual satisfaction was predicted by high body esteem and low frequency of appearance-based distracting thoughts during sexual activity, even after controlling for sexual functioning status.

Conclusion
Several aspects of body image, including weight concern, physical condition, sexual attractiveness, and thoughts about the body during sexual activity predict sexual satisfaction in women. The findings suggest that women who experience low sexual satisfaction may benefit from treatments that target these specific aspects of body image.
Association Analysis of Endothelial Nitric Oxide Synthase G894T Gene Polymorphism and Erectile Dysfunction Complaints in a Population-Based Survey
Authors: Andersen Monica L. , Guindalini Camila , Santos-Silva Rogerio , Bittencourt Lia Rita A. , Tufik Sergio 
Published: November 2009

ABSTRACTIntroductionErectile dysfunction (ED) is a common disorder leading to a serious, negative impact on the quality of the patient’s life. The gene encoding endothelial nitric oxide synthase (eNOS) is an interesting candidate gene for understanding the physiopathology of ED, as it is involved in the catalytic production of nitric oxide (NO), the neurotransmitter that plays a critical role in penile tumescence and erection.AimTo evaluate a potential association between the G894T polymorphism in the eNOS gene and ED complaints in a population-based sample in São Paulo, Brazil.Main Outcome MeasuresThe prevalence of ED complaints was estimated according to the answer to the question “How would you describe your ability to get and keep an erection that is adequate for satisfactory intercourse?” ED was considered to be present if the response was “sometimes” or “never.”MethodsA total of 449 men were enrolled in the study and answered an eight-item questionnaire to ascertain sexual performance/ED and satisfaction. The eNOS G894T polymorphism was genotyped using a standard polymerase chain reaction method.ResultsUnivariate analysis demonstrated that ED was associated with diabetes, hypertension, sleep apnea severity, increasing age and body mass index, as well as testosterone levels (P &lt;0.05). Forward multiple regression models indicated that age was the only independent factor associated with ED in this population (odds ratio=1.09; 95% CI 1.06–1.11; P &lt;0.0001). Genotypic and allelic analyses provided no evidence for an association between this polymorphism and the risk for ED complaints in this sample. Population stratification did not affect the association test results.ConclusionsThis is the first study to examine the effect of polymorphisms in the eNOS gene and the risk for ED utilizing a case-control approach in the Brazilian population. Our results do not support a major role for eNOS gene polymorphisms in ED in this population.
EFFECTS OF EXTRUSION TREATMENT ON ENZYMATIC HYDROLYSIS PROPERTIES OF WHEAT GLUTEN
Authors: CUI CHUN , ZHAO HAIFENG , ZHAO MOUMING , CHAI HUA 
Published: November 2009

ABSTRACT Degree of hydrolysis (DH), protein recovery (PR), Fourier transform infrared spectroscopy (FTIR), molecular weight distribution and amino acid composition were examined to investigate effects of extrusion treatment on Pancreatin‐induced hydrolysis properties of wheat gluten in the present study. Results showed that extrusion treatment had significant impacts on enzymatic hydrolysis properties of wheat gluten. It not only resulted in significant increases of 19.2% in DH after 36 h of hydrolysis and 13.4% in PR after 60 h of hydrolysis, but also changed considerably FTIR spectroscopy, molecular weight distribution and amino acid composition of wheat gluten hydrolysates. The conformational changes and structural rearrangements of wheat gluten treated with extrusion might modify the catalytic sites of proteases and be responsible for the improvement of enzymatic hydrolysis efficiency of wheat gluten. PRACTICAL APPLICATIONSThere were increasing interests in expanding the usage fields of wheat gluten, as it is available in large amounts and at relatively low cost. However, its usage was limited due to lack of some desirable functional properties. Although enzymatic hydrolysis is able to improve the solubility and develop the emulsifying and foaming properties of wheat gluten, the low enzymatic hydrolysis efficiency remains one of the major problems present in the industrial scale production. Therefore, increasing enzymatic hydrolysis efficiency of wheat gluten gets more important. Our results clearly showed that enzymatic hydrolysis efficiency of extruded wheat gluten was increased significantly. Results from this preliminary study will provide a better understanding on enzymatic hydrolysis mechanisms of extruded wheat gluten and allow the screening of pretreatment method to improve the enzymatic hydrolysis efficiency during the industrial scale wheat gluten hydrolysates production.
Depressive Symptoms and Economic Outcomes of Low‐Income Women: A Review of the Social Causation, Social Selection, and Interactionist Hypotheses
Authors: Gupta Anjali E. , Huston Aletha C. 
Published: November 2009

We review research that connects depression and depressive symptoms to employment and economic factors for low‐income women. Women who have low incomes and are unemployed or underemployed are vulnerable to mental health distress. The strain of balancing work and family life can be exacerbated by poor psychological health or nonsufficient economic resources. Research on the barriers that impede self‐sufficiency can lead to policies that improve the economic and psychological health of low‐income populations. The discussion is framed by contrasting evidence for three theoretical perspectives: the social causation, social selection, and interactionist (bidirectional) hypotheses. The only causal relation reported is an effect of increased income on reduced depressive symptoms. Yet strong associations are found among psychological distress, earnings, employment stability, income, and job characteristics. The effects of programs to increase employment and the benefits of (and barriers to) depression treatment are also discussed. A bidirectional or interactionist perspective best conceptualizes the relationship between depression and economic factors. The reported negative effects of both poor mental well‐being and low‐quality employment suggest the need for stronger policies in the areas of mental health and work supports. We present policy recommendations addressing mental health treatment and outreach, employment placement, and workplace flexibility.
Frequent STAT3 activation is associated with Mcl‐1 expression in nasal NK‐cell lymphoma
Authors: TSUTSUI M. , YASUDA H. , SUTO H. , IMAI H. , ISOBE Y. , SASAKI M. , KOJIMA Y. , OSHIMI K. , SUGIMOTO K. 
Published: November 2009

SummaryNasal natural killer (NK)‐cell lymphoma was resistant to various antitumor agents. Although high expression of p‐glycoprotein has been reported, other molecular mechanism of the chemo‐resistance is largely unknown. Activation of STAT3 and expression of major apoptosis‐related proteins Bcl‐2, Bcl‐x, and Mcl‐1 were analyzed by immunohistochemistry. Effects of STAT3 inhibitor AG490 on NK‐YS cell line were analyzed by Western blotting and flow cytometric apoptosis assay. STAT3 was activated in six of the nine nasal NK‐cell lymphomas (67%). In contrast, STAT3 activation was detected in 35% of diffuse large B‐cell lymphoma (DLBCL) and in 10% of follicular lymphoma (FL). Frequent activation of STAT3 was significantly correlated with Mcl‐1 expression in nasal NK‐cell lymphoma, i.e., Mcl‐1 was positive in five of six STAT3‐active cases and negative in all three STAT3‐inactive ones. In DLBCL, not only six out of seven STAT3‐active cases (86%) but also eight out of thirteen STAT3‐inactive cases (62%) were positive for Mcl‐1 expression. Latent membrane protein‐1 was positive in four nasal NK‐cell lymphomas, among which three cases showed intermediate STAT3 activation. Inhibition of STAT3 activation by JAK inhibitor AG490 decreased Mcl‐1 expression and induced apoptosis in STAT3‐active NK‐YS cells. Serum starvation rather increased the Mcl‐1 level in NK‐YS cells, and this effect was also canceled by AG490. These results suggest that activation of STAT3‐Mcl‐1 axis may play a role in the chemotherapy resistance of nasal NK‐cell lymphoma. The pathway may be one of the future therapeutic targets of this intractable disease.
Natural gas markets: how sensitive are they to crude oil price changes?
Authors: Onour Ibrahim A. 
Published: November 2009

AbstractThis paper investigates sensitivity of US natural gas price with crude oil price changes, using time‐varying coefficient models. Identification of the range of variation of the sensitivity of natural gas price to oil price change allows more accurate assessment of upper and minimum risk levels that can be utilised in pricing natural gas derivatives such as gas futures and option contracts, and gas storage facility contracts.
Automatic estimation of the arteriolar‐to‐venular diameter ratio (AVR) in retinal images
Authors: RUGGERI A , TRAMONTAN L , GRISAN E 
Published: November 2009

Abstract Purpose The Arteriolar‐to‐Venular diameter Ratio (AVR), a parameter derived from vessel caliber measurements in a specific region of retinal images, is used as a descriptor of generalized arteriolar narrowing. We developed a computerized system to compute AVR in a totally automatic way. Methods Images are at first enhanced to highlight the vessel network, which is then traced by a vessel tracking algorithm. From the detected vessel structure, the position of the optic disc is derived and the region inside which the AVR data are to be measured is determined. Vessels within this region are classified as either arteries or veins, their caliber estimated and the AVR parameter is eventually computed. Results provided by the system have been compared with manually derived AVR values on 20 eye fundus images. Results Mean and SD values from the two sets of measurements are the same, and automatic/manual ratios have an average value of 1 and 95% confidence interval of (0.98‐1.02). The correlation coefficient between the two methods is 0.88. In only two images the ratio is appreciably different from unity, 1.14 and 0.89 respectively. A detailed analysis of these cases revealed that in each image the wrong classification of one vessel only was the cause for these unsatisfactory results. When these misclassifications are manually corrected, e.g. with a quick editing tool that can be easily made available to the user, the ratios become 0.95 and 0.99, respectively, and the overall correlation coefficient becomes 0.97. Conclusion Additional evaluation on a larger set of images, acquired from subjects exhibiting wide variations of AVR, will be performed in order to fully assess the reliability and clinical applicability of this automatic procedure.
Choroidal neovascularization management in uveitic patients – our experience
Authors: URBANCIC M , KRAUT A 
Published: November 2009

Abstract Purpose Choroidal neovascularization (CNV) is well documented complication of posteroir uveitis which can lead to severe visual loss. There are varying management options for this condition. We present our experience in managing CNV in uveitic patients. Methods Retrospective study of uveitic patients with CNV treated in our hospital during last eight years. Data collected were: gender and age of patient, type of uveitis, CNV localization, visual acuity at the time of diagnosis, visual acuity at the last follow‐up visit, management of condition. Results 38 patients with posterior uveitis developed CNV in one or both eyes (12 males, 26 females). Average age at the time of diagnosis was 41,7 years. Management of CNV depended on clinical presentation. Treatment options that were used: laser photocoagulation, photodynamic therapy, corticosteroids, vitreoretinal procedure and anti‐VEGF therapy. Different treatment options were combined in some patients. Some patients were only observed. Follow‐up period ranged from one to eight years. Visual acuity improved in 19 eyes and remained stable in 9 eyes. Conclusion The results of varying management options for CNV in uveitic patients are limited. Individual approach in the management decision is necessary because of various clinical presentations. Additional clinical trials are needed to define an optimal approach.
Expression of galectin molecules in intraocular tissue and inflammation
Authors: YAMAKI K , AMANO M 
Published: November 2009

Abstract Purpose To study the role of Galectin molecules in intraocular tissue. We examined the expression of Galectin molecules in intraocular tissues in normal and inflammatory conditions. Methods Lewis rats eye ball and cultured human retinal pigment epithelial cells were used for experiment. Expression levels of Galectin – 1, 3, and 9 were examined with immune staining for the proteins and in situ hybridization for the mRNAs in normal and inflammatory conditions. Expression levels of the mRNA from established retinal pigment epithelium (RPE) derived cells of ARPE‐19 and hTERT were also examined with real time PCR Results Galectin ‐ 1in normal condition: the protein expression was detected in ciliary body, RPE, retinal outer and inner segments. In inflammatory condition, expression levels were not changed dramatically. Galectin – 3 in normal and inflammatory condition: ubiquitous expression was detected in almost all tissues of the eye (ciliary body, RPE and neural retinal layers). Galectin – 9 in normal condition: a little amount of expression was detected in ciliary body, choroid RPE, and some layers of neural retina. In inflammatory condition, expression levels increased in the above tissues. In cultured RPE cells expressed galectin molecules in normal conditions. When the cells were stimulated by proinflammatory cytokines, only expression of Galectin – 9 increased. Conclusion Recently It is reported that Galectin – 9 and Tim – 3 bind and negatively regulates Th1 immunity. In intraocular tissue,Galectin – 9 also may play important roles for modulating intraocular immune responses.