bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stress symptoms and burnout in obstetric and gynaecology residents
Authors: Castelo‐Branco C , Figueras F , Eixarch E , Quereda F , Cancelo MJ , González S , Balasch J 
Published: December 2006

Objective  This study was designed to examine the burnout syndrome among residents in obstetrics and gynaecology in Spain, and to analyse the predisposing factors for this condition.Setting  Eight Spanish University hospitals.Sample  A total of 162 residents representative of all active residents in obstetrics and gynaecology in Spain with regards to age, sex and year of residency were asked to take part in this survey.Methods  The Maslach Burnout Inventory was mailed to each resident of eight Spanish hospitals representative of all active residents in obstetrics and gynaecology in Spain with regards to age, sex and year of residency. Burnout was defined as a high score on the emotional exhaustion or depersonalisation subscores, according to validated standard cutoff values. The demographic and predisposing work factors were noted for each participant using a self‐reported questionnaire. A binary logistic regression model was constructed from all predisposing factors as covariates for the prediction of the burnout syndrome.Results  Sixty‐seven percent of the 162 eligible residents returned their questionnaires within a 3‐month period. Of those, 58% fulfilled the criteria for the burnout syndrome. In the multivariate analysis, marital status and workload in office practice were found to be significant predisposing factors. Single marital status increased the odds ratio for burnout by 5.2 (95% CI 1.3–21). For every extra ten patients attended in the office per week, the odds ratio for burnout increased by 1.25 (95% CI 1.0–1.5). A stratified multivariate subanalysis showed that this risk remained significant only in the group of residents without staff supervision with an odds ratio of 2.1 (95% CI 1.3–2.9).Conclusion  The prevalence of the burnout syndrome during obstetrics and gynaecology residency is high. Single marital status and workload in office practice without staff supervision are significant predisposing factors.
Trends in maternal obesity incidence rates, demographic predictors, and health inequalities in 36 821 women over a 15‐year period
Authors: Heslehurst N , Ells LJ , Simpson H , Batterham A , Wilkinson J , Summerbell CD 
Published: December 2006

Objective  The aim of this study was to identify trends in maternal obesity incidence over time and to identify those women most at risk and potential‐associated health inequalities.Design  Longitudinal database study.Setting  James Cook University Hospital maternity unit, Middlesbrough, UK.Sample  A total of 36 821 women from 1 January 1990 to 31 December 2004.Methods  Trends in maternal obesity incidence over time were analysed using chi‐square test for trend. Demographic predictor variables were analysed using multivariate logistic regression, adjusting for confounding factors after testing for multicollinearity. National census data were used to place the regional data into the context of the general population.Main outcome measure  Trends in maternal obesity incidence. Demographic predictor variables included ethnic group, age, parity, marital status, employment and socio‐economic disadvantage.Results  The proportion of obese women at the start of pregnancy has increased significantly over time from 9.9 to 16.0% (P < 0.01). This is best described by a quadratic model (P < 0.01) showing that the rate is accelerating; by 2010, the rate will have increased to 22% of this population if the trend continues. There is also a significant relationship with maternal obesity and mothers’ residing in areas of most deprivation (odds ratio [OR] = 2.44, 95% CI = 1.98, 3.02, P < 0.01), with increasing age (OR = 1.04, 95% CI = 1.04, 1.05, P < 0.01), and parity (OR = 1.17, 95% CI = 1.12, 1.21, P < 0.01).Conclusions  The incidence of maternal obesity at the start of pregnancy is increasing and accelerating. Predictors of maternal obesity are associated with health inequalities, particularly socio‐economic disadvantage.
Adenomyosis and risk of preterm delivery
Authors: Juang C‐M , Chou P , Yen M‐S , Twu N‐F , Horng H‐C , Hsu W‐L 
Published: December 2006

Objective  To evaluate the risk of preterm delivery in patients with adenomyosis.Design  A 1:2 nested case–control study.Setting  Tertiary‐care institution.Population  A base cohort population of 2138 pregnant women who attended routine prenatal check‐up between July 1999 and June 2005.Methods  From this base cohort population, gravid women with singleton pregnancy who delivered prior to the completion of 37 weeks of gestation were identified and formed the study group. Singleton gravid women who had term delivery and who matched with age, body mass index, smoking, and status of previous preterm delivery were recruited concurrently and served as control group. Preterm delivery cases were further divided into spontaneous preterm delivery and preterm premature rupture of membranes (PPROM) cases.Main outcome measures  Risk analysis of preterm delivery between gravid women with and without adenomyosis.Results  One‐hundred and four preterm delivery case subjects and 208 control subjects were assessed. Overall, gravid women with adenomyosis were associated with significantly increased risk of preterm delivery (adjusted odds ratio 1.96, 95% CI 1.23–4.47, P = 0.022). For subgroup analysis, gravid women with adenomyosis had an adjusted 1.84‐fold risk of spontaneous preterm delivery (95% CI 1.32–4.31, P = 0.012) and an adjusted 1.98‐fold risk of PPROM (95% CI 1.39–3.15, P = 0.017).Conclusions  Gravid women with adenomyosis were associated with increased risk of both spontaneous preterm delivery and PPROM. A common pathophysiological pathway may exist in these two disorders. Further in‐depth biochemical and molecular studies are necessary to explore this phenomenon.
Factors associated with fall in neonatal intubation rates in the United Kingdom – prospective study
Authors: Little MP , Järvelin M‐R , Neasham DE , Lissauer T , Steer PJ 
Published: December 2006

Objective  To investigate the trend of neonatal resuscitation by intubation or mask ventilation over time and to assess its association with changes in prevalence of caesarean section and use of general anaesthesia in labour.Methods  All women booking pregnancy at any of 15 maternity units, analysed using logistic regression.Design  Prospective study.Setting  UK hospital‐based maternity units (15 centres).Population  A total of 221 322 first singleton births of babies weighing 200 g or more in the St Mary’s Maternity Information System cohort, 1988–2000, covering the North West Thames area of London.Main outcome measures  Prevalence of intermittent positive‐pressure ventilation (IPPV) (by intubation or mask) by calendar year.Results  Overall use of IPPV decreased markedly (two‐sided P < 0.01) over the course of the study, and this decrease was evident by all modes of delivery. Adjusted mean prevalence of intubated IPPV decreased from 0.51% (95% CI 0.44–0.58) in 1988 to 0.07% (95% CI 0.06–0.09) in 2000. There was a similar decrease in the prevalence of IPPV by mask. However, despite substantial increases in prevalence of caesarean sections and reductions in the use of general anaesthesia over the course of the study, adjusting for these variables made little difference to the temporal trends in intubation or use of mask ventilation.Conclusions  There has been a marked reduction in the prevalence of infants given resuscitation by positive‐pressure ventilation that cannot be explained by changes in the prevalence of caesarean section or use of general anaesthesia in labour.
Novel modulators of amyloid‐β precursor protein processing
Authors: Tang Bor Luen , Liou Yih Cherng 
Published: December 2006

AbstractProteolytic processing of the amyloid precursor protein (APP) is modulated by the action of enzymes α‐, β‐ and γ‐secretases, with the latter two mediating the amyloidogenic production of amyloid‐β (Aβ). Cellular modulators of APP processing are well known from studies of genetic mutations (such as those found in APP and presenilins) or polymorphisms (such as the apolipoprotein E4 ɛ‐allele) that predisposes an individual to early or late‐onset Alzheimer's disease. In recent years, several classes of molecule with modulating functions in APP processing and Aβ secretion have emerged. These include the neuronal Munc‐18 interacting proteins (Mints)/X11s, members of the reticulon family (RTN‐3 and RTN‐4/Nogo‐B), the Nogo‐66 receptor (NgR), the peptidyl‐prolyl isomerase Pin1 and the Rho family GTPases and their effectors. Mints and NgR bind to APP directly, while RTN3 and Nogo‐B interact with the β‐secretase BACE1. Phosphorylated APP is a Pin1 substrate, which binds to its phosphor‐Thr668‐Pro motif. These interactions by and large resulted in a reduction of Aβ generation both in vitro and in vivo. Inhibition of Rho and Rho‐kinase (ROCK) activity may underlie the ability of non‐steroidal anti‐inflammatory drugs and statins to reduce Aβ production, a feat which could also be achieved by Rac1 inhibition. Detailed understanding of the underlying mechanisms of action of these novel modulators of APP processing, as well as insights into the molecular neurological basis of how Aβ impairs leaning and memory, will open up multiple avenues for the therapeutic intervention of Alzheimer's disease.
Isolation and characterization of polymorphic microsatellite markers in Anthyllis vulneraria
Authors: VAN GLABEKE S. , COART E. , HONNAY O. , ROLDÁN‐RUIZ I. 
Published: December 2006

AbstractTo study the reproductive system of the putative autogamous species Anthyllis vulneraria in Belgian calcareous grasslands, eight polymorphic microsatellite loci were developed using the sequence‐tagged microsatellite profiling technique and 35 plants were typed for all loci. No linkage disequilibrium was found between any pair of loci. Over the loci, the number of alleles ranged from two to five. Observed and expected heterozygosities ranged from 0.053 to 0.688 and from 0.053 to 0.631, respectively. The estimated FIS values (FIS = 0.031 and 0.122) are not in accordance with a predominantly selfing reproductive system.
Characterization of 12 polymorphic microsatellite loci for eastern chipmunks (Tamias striatus)
Authors: ANDERSON SARA J. , FIKE JENNIFER A. , DHARMARAJAN GUHA , RHODES OLIN E. 
Published: December 2006

AbstractEastern chipmunks are small forest rodents for which ecological data at multiple spatial scales exist, but no molecular markers have been developed that provide adequate resolution to examine genetic structure at fine scales in this species. Thus, we developed 12 variable microsatellite loci, which amplified in three multiplexed reactions, and screened them in 27 individuals from northern Indiana, USA. Observed heterozygosities across loci ranged from 0.26 to 0.91 and number of alleles per locus ranged from three to 10. We will use these markers along with ecological data to understand population dynamics of eastern chipmunks at small spatial scales.
Microsatellite loci for Australian agamid lizards
Authors: SCHWARTZ TONIA S. , WARNER DANIEL A. , BEHEREGARAY LUCIANO B. , OLSSON MATS 
Published: December 2006

AbstractWe characterize 15 microsatellite loci from two microsatellite libraries developed from the Australian agamid lizards Amphibolurus muricatus and Ctenophorus pictus. All loci were tested for amplification in four other agamids: Ctenophorus fordi, Ctenophorus decresii, Chlamydosaurus kingii, and Physignathus lesueurii. These loci were highly polymorphic within and across species, with nine to 12 loci amplifying for each species tested.
Skin‐derived fibroblasts from long‐lived species are resistant to some, but not all, lethal stresses and to the mitochondrial inhibitor rotenone
Authors: Harper James M. , Salmon Adam B. , Leiser Scott F. , Galecki Andrzej T. , Miller Richard A. 
Published: December 2006

SummaryFibroblast cell lines were developed from skin biopsies of eight species of wild‐trapped rodents, one species of bat, and a group of genetically heterogeneous laboratory mice. Each cell line was tested in vitro for their resistance to six varieties of lethal stress, as well as for resistance to the nonlethal metabolic effects of the mitochondrial inhibitor rotenone and of culture at very low glucose levels. Standard linear regression of species‐specific lifespan against each species mean stress resistance showed that longevity was associated with resistance to death induced by cadmium and hydrogen peroxide, as well as with resistance to rotenone inhibition. A multilevel regression method supported these associations, and suggested a similar association for resistance to heat stress. Regressions for resistance to cadmium, peroxide, heat, and rotenone remained significant after various statistical adjustments for body weight. In contrast, cells from longer‐lived species did not show significantly greater resistance to ultraviolet light, paraquat, or the DNA alkylating agent methylmethanesulfonate. There was a strong correlation between species longevity and resistance to the metabolic effects of low‐glucose medium among the rodent cell lines, but this test did not distinguish mice and rats from the much longer‐lived little brown bat. These results are consistent with the idea that evolution of long‐lived species may require development of cellular resistance to several forms of lethal injury, and provide justification for evaluation of similar properties in a much wider range of mammals and bird species.
N−3 polyunsaturated fatty acids impair lifespan but have no role for metabolism
Authors: Valencak Teresa G. , Ruf Thomas 
Published: December 2006

SummaryAlthough generally considered as beneficial components of dietary fats, polyunsaturated fatty acids (PUFA) have been suspected to compromise maximum lifespan (MLSP) in mammals. Specifically, high amounts of phospholipid PUFAs are thought to impair lifespan due to an increase in the susceptibility of membranes to lipid peroxidation and its damaging effect on cellular molecules. Also, there is evidence from in vitro studies suggesting that highly unsaturated PUFAs elevate basal metabolic rate (BMR). Previous comparative studies in this context were based on small sample sizes, however, and, except for one study, failed to address possible confounding influences of body weight and taxonomic relations between species. Therefore, we determined phospholipid membrane composition in skeletal muscle from 42 mammalian species to test for a relation with published data on MLSP, and with literature data on BMR (30 species). Using statistical models that adjust for the effects of body weight and phylogeny, we found that among mammals, MLSP indeed decreases as the ratio of n−3 to n−6 PUFAs increases. In contrast to previous studies, we found, however, no relation between MLSP and either membrane unsaturation (i.e. PUFA content or number of double bonds) or to the very long‐chain, highly unsaturated docosahexaenoic acid (DHA). Similarly, our data set gave no evidence for any notable relation between muscle phospholipid fatty acid composition and BMR, or MLSP and BMR in mammals. These results contradict the ‘membrane pacemaker theory of aging’, that is, the concept of a direct link between high amounts of membrane PUFAs, elevated BMR, and thus, impaired longevity.
The Impact of Welfare Reform on Insurance Coverage before Pregnancy and the Timing of Prenatal Care Initiation
Authors: Gavin Norma I. , Adams E. Kathleen , Manning Willard G. , Raskind‐Hood Cheryl , Urato Matthew 
Published: December 2006

Objective. This study investigates the impact of welfare reform on insurance coverage before pregnancy and on first‐trimester initiation of prenatal care (PNC) among pregnant women eligible for Medicaid under welfare‐related eligibility criteria.Data Sources. We used pooled data from the Pregnancy Risk Assessment Monitoring System for eight states (AL, FL, ME, NY, OK, SC, WA, and WV) from 1996 through 1999.Study Design. We estimated a two‐part logistic model of insurance coverage before pregnancy and first‐trimester PNC initiation. The impact of welfare reform on insurance coverage before pregnancy was measured by marginal effects computed from coefficients of an interaction term for the postreform period and welfare‐related eligibility and on PNC initiation by the same interaction term and the coefficients of insurance coverage adjusted for potential simultaneous equation bias. We compared the estimates from this model with results from simple logistic, ordinary least squares, and two‐stage least squares models.Principal Findings. Welfare reform had a significant negative impact on Medicaid coverage before pregnancy among welfare‐related Medicaid eligibles. This drop resulted in a small decline in their first‐trimester PNC initiation. Enrollment in Medicaid before pregnancy was independent of the decision to initiate PNC, and estimates of the effect of a reduction in Medicaid coverage before pregnancy on PNC initiation were consistent over the single‐ and two‐stage models. Effects of private coverage were mixed. Welfare reform had no impact on first‐trimester PNC beyond that from reduced Medicaid coverage in the pooled regression but separate state‐specific regressions suggest additional effects from time and income constraints induced by welfare reform may have occurred in some states.Conclusions. Welfare reform had significant adverse effects on insurance coverage and first‐trimester PNC initiation among our nation's poorest women of childbearing age. Improved outreach and insurance options for these women are needed to meet national health goals.
Do Increases in Patient Activation Result in Improved Self‐Management Behaviors?
Authors: Hibbard Judith H. , Mahoney Eldon R. , Stock Ronald , Tusler Martin 
Published: December 2006

Objective. The purpose of this study is to determine whether patient activation is a changing or changeable characteristic and to assess whether changes in activation also are accompanied by changes in health behavior.Study Methods. To obtain variability in activation and self‐management behavior, a controlled trial with chronic disease patients randomized into either intervention or control conditions was employed. In addition, changes in activation that occurred in the total sample were also examined for the study period. Using Mplus growth models, activation latent growth classes were identified and used in the analysis to predict changes in health behaviors and health outcomes.Data Sources. Survey data from the 479 participants were collected at baseline, 6 weeks, and 6 months.Principal Findings. Positive change in activation is related to positive change in a variety of self‐management behaviors. This is true even when the behavior in question is not being performed at baseline. When the behavior is already being performed at baseline, an increase in activation is related to maintaining a relatively high level of the behavior over time. The impact of the intervention, however, was less clear, as the increase in activation in the intervention group was matched by nearly equal increases in the control group.Conclusions. Results suggest that if activation is increased, a variety of improved behaviors will follow. The question still remains, however, as to what interventions will improve activation.
Trauma: physiology, pathophysiology, and clinical implications
Authors: Muir William 
Published: December 2006

AbstractObjective: To review the physiology, pathophysiology, and consequences of trauma. The therapeutic implications of hypovolemia, hypotension, hypothermia, tissue blood flow, oxygen delivery, and pain will be discussed.Data Sources: Human and veterinary clinical and research studies.Human and veterinary data synthesis: Trauma is defined as tissue injury that occurs more or less suddenly as a result of violence or accident and is responsible for initiating hyothalamic–pituitary–adrenal axis, immunologic and metabolic responses that are designed to restore homeostasis. Tissue injury, hemorrhage, pain, and fear are key components of any traumatic event. Trauma and blood loss result in centrally integrated autonomic‐mediated cardiovascular responses that are designed to increase heart rate, systemic vascular resistance, and maintain arterial blood pressure (ABP) to vital organs at the expense of blood flow to the gut and skeletal muscle. Severe trauma elicits exuberant physiologic, immunologic, and metabolic changes predisposing the animal to organ malfunction, a systemic inflammatory response, infection, and multiple organ dysfunctions. The combination of both central and local influences produces regional redistribution of blood flow among and within tissue beds which, when combined with impaired vascular reactivity, leads to maldistribution of blood flow to tissues predisposing to tissue hypoperfusion and impaired oxygen delivery and extraction. Gut blood flow and viability may serve as a sentinel of patient survival. These consequences are magnified in animals suffering from pain or that become hypothermic. Successful treatment of traumatized animals goes beyond the restoration of blood pressure and urine output, is dependent on a fundamental understanding of the pathophysiologic processes responsible for the animals current physical status, and incorporates the reduction of pain, stress, and the systemic inflammatory response and methods that restore microcirculatory blood flow and tissue oxygenation.Conclusions: Severe trauma is a multifaceted event and is exacerbated by hypothermia, pain, and stress. Therapeutic approaches must go beyond the simple restoration of vascular volume and ABP by maintaining tissue blood flow, restoring tissue oxygenation, and preventing systemic inflammation.
Longevity Bonds: Financial Engineering, Valuation, and Hedging
Authors: Blake David , Cairns Andrew , Dowd Kevin , MacMinn Richard 
Published: December 2006

AbstractThis article examines the main characteristics of longevity bonds (LBs) and shows that they can take a large variety of forms which can vary enormously in their sensitivities to longevity shocks. We examine different ways of financially engineering LBs and consider problems arising from the dearth of ultra‐long government bonds and the choice of the reference population index. The article also looks at valuation issues in an incomplete markets context and finishes with an examination of how LBs can be used as a risk management tool for hedging longevity risks.
A Two‐Factor Model for Stochastic Mortality with Parameter Uncertainty: Theory and Calibration
Authors: Cairns Andrew J. G. , Blake David , Dowd Kevin 
Published: December 2006

AbstractIn this article, we consider the evolution of the post‐age‐60 mortality curve in the United Kingdom and its impact on the pricing of the risk associated with aggregate mortality improvements over time: so‐called longevity risk. We introduce a two‐factor stochastic model for the development of this curve through time. The first factor affects mortality‐rate dynamics at all ages in the same way, whereas the second factor affects mortality‐rate dynamics at higher ages much more than at lower ages. The article then examines the pricing of longevity bonds with different terms to maturity referenced to different cohorts. We find that longevity risk over relatively short time horizons is very low, but at horizons in excess of ten years it begins to pick up very rapidly.A key component of the article is the proposal and development of a method for calculating the market risk‐adjusted price of a longevity bond. The proposed adjustment includes not just an allowance for the underlying stochastic mortality, but also makes an allowance for parameter risk. We utilize the pricing information contained in the November 2004 European Investment Bank longevity bond to make inferences about the likely market prices of the risks in the model. Based on these, we investigate how future issues might be priced to ensure an absence of arbitrage between bonds with different characteristics.