bluuebunny/crossref_metadata_2025_split huggingface dataset:
Baseline dimensions of the human vagina
Authors: Barnhart Kurt T. , Izquierdo Adriana , Pretorius E. Scott , Shera David M. , Shabbout Mayadah , Shaunik Alka 
Published: February 2006

Abstract
BACKGROUND: Vaginal anatomy has been poorly studied. This study aimed to measure baseline dimensions of the undistended vagina of women of reproductive age. METHODS: We combined baseline information collected from five clinical trials using magnetic resonance imaging (MRI) to quantify distribution of a vaginal gel. Seventy-seven MRI scans were performed on 28 women before gel application to establish baseline vaginal measurements. Average dimensions were calculated for each woman and for the population. The influence of potential covariates (age, height, weight and parity) on these dimensions was assessed. RESULTS: MRI measurements are reproducible. The SD surrounding the mean at each anatomical site, and with summary measurements, was significantly smaller with each subject compared with the population. Mean vaginal length from cervix to introitus was 62.7 mm. Vaginal width was largest in the proximal vagina (32.5 mm), decreased as it passed through the pelvic diaphragm (27.8 mm) and smallest at the introitus (26.2 mm). Significant positive associations were parity with vaginal fornix length, age with pelvic flexure width and the height with width at the pelvic flexure. CONCLUSION: No one description characterized the shape of the human vagina. Although there is variation among women, variables such as parity, age and height are positively associated with differences in baseline dimensions.
High incidence of myelodysplasia and secondary leukaemia in the UK Medical Research Council Pilot of autografting in chronic lymphocytic leukaemia
Authors: Milligan Donald W. , Kochethu Geothy , Dearden Claire , Matutes Estella , MacConkey Christopher , Catovsky Daniel ,   the UK National Cancer Research Institute (NCRI) Haematological Studies Group
Published: February 2006

SummaryWe report a high incidence of myelodysplastic syndrome (MDS)/acute myeloid leukaemia (AML) in patients entered into the Medical Research Council Chronic Lymphocytic Leukaemia‐5 trial. Of 115 newly diagnosed patients treated with fludarabine, 65 patients proceeded to autologous transplant. Conditioning was cyclophosphamide and total body irradiation in 49 (75%) patients and chemotherapy in 12 (18%). Ten patients have developed MDS/AML; eight had undergone an autograft. Five‐year actuarial risk of developing MDS/AML postautograft was 12·4% (95% confidence interval, 2·5–24%). No analysed potential risk factor was predictive for MDS/AML development. We hypothesise that potential causative factors are fludarabine, low cell dose and transplant conditioning.
Prognostic model for disease‐specific and overall mortality in newly diagnosed symptomatic patients with Waldenstrom macroglobulinaemia
Authors: Ghobrial Irene M. , Fonseca Rafael , Gertz Morie A. , Plevak Matthew F. , Larson Dirk R. , Therneau Terry M. , Wolf Robert C. , Hoffmann Randi J. , Lust John A. , Witzig Thomas E. , Lacy Martha Q. , Dispenzieri Angela , Vincent Rajkumar S. , Zeldenrust Stephen R. , Greipp Philip R. , Kyle Robert A. 
Published: February 2006

SummaryWe sought to define prognostic factors for survival in Waldenstrom macroglobulinaemia (WM). Of 585 patients diagnosed with WM and seen at Mayo Clinic between 1960 and 2001, 337 symptomatic patients met the inclusion criteria and were analysed for overall and disease‐specific survival. The median survival from the time of diagnosis was 6·4 years. The median disease‐specific survival was 11·2 years. Univariate analysis for overall survival identified the following adverse prognostic factors: age >65 years (P < 0·001), organomegaly (P < 0·001), elevatedβ2‐microglobulin (<0·001), anaemia (Hb < 10·0 g/dl) (P = 0·01), leucopenia (<4·0 × 109/l) (P = 0·03), thrombocytopenia (<150 × 109/l) (P = 0·01), serum albumin <40 g/l (P = 0·001), and quantitative IgM < 0·4 g/l (P = 0·04). On multivariate analysis, age >65 years and organomegaly were associated with poor prognosis. A prognostic model was built based on these two variables. Patients at high risk (1–2 risk factors, median survival 4·2 years) experienced worse survival than patients at low risk (0 risk factors, median survival 10·6 years),P < 0·001. The prognostic model was validated in 204 patients who were not included in the analysis cohort.β2‐microglobulin ≥4 mg/l was associated with a threefold increase in the risk of death when added to the prognostic model. We describe a simple prognostic model for overall survival for newly diagnosed patients with WM.
Bruising and bleeding in infants and children – a practical approach
Authors: Khair Kate , Liesner Ri 
Published: February 2006

SummaryBruising and bleeding are commonly seen in children and are usually associated with minor injury and trauma. However, in two groups of children the bruising may be more significant than expected: those with an underlying haemostatic abnormality, such as an inherited bleeding disorder, or those who have been subjected to non‐accidental injury (NAI). Diagnosing inherited bleeding disorders in children is fraught with difficulty, from venous access to interpretation of results; the possibility of NAI should be borne in mind, even in those children with proven significant bleeding disorders when the severity of the injury and the history are non‐compatible. We describe the investigation of the haemostatic system in children with bruising and/or bleeding with emphasis on the key haemostatic disorders that need to be excluded.
Abnormal bone remodelling and increased levels of macrophage inflammatory protein‐1 alpha (MIP‐1α) in Waldenström macroglobulinaemia
Authors: Terpos Evangelos , Anagnostopoulos Athanasios , Kastritis Efstathios , Bamias Aristotelis , Tsionos Konstantinos , Dimopoulos Meletios‐Athanassios 
Published: February 2006

SummarySerum levels of macrophage inflammatory protein‐1 alpha (MIP‐1α) and bone remodelling markers were evaluated in 38 patients with Waldenström macroglobulinaemia (WM) and correlated with clinical and laboratory variables. MIP‐1α was elevated in WM; untreated patients had higher MIP‐1α levels than patients in remission or with active disease after treatment. MIP‐1α correlated with increased bone resorption, β2‐microglobulin and splenomegaly. Receptor activator of nuclear factor‐κB ligand serum levels were elevated in WM patients; the subsequent increased bone resorption was balanced by a comparable elevation of osteoprotegerin production and bone formation. These findings may explain the absence of lytic lesions in WM patients and suggest a potential role of MIP‐1α in WM.
The inhibition of the human sperm phosphatidylinosytol 3‐kinase by LY294002 does not interfere with sperm/oocyte interaction
Authors: Barbonetti A. , Zugaro A. , Sciarretta F. , Santucci R. , Necozione S. , Ruvolo G. , Francavilla S. , Francavilla F. 
Published: February 2006

SummaryIt has recently been reported that the selective inhibition of phosphatidylinosytol 3‐kinase (PI3K) enhances human sperm motility. However, little information exists on a possible role of PI3K in other sperm functions involved in the fertilization process. In this study, we investigated whether LY294002 could affect human sperm ability to fuse with oocytes, by means of the hamster egg penetration test (HEPT). The effect on acrosome reactions (AR) and on sperm/zona pellucida (ZP) binding was also evaluated. The pre‐incubation with scalar doses of LY294002 (0.1, 1 and 10 μm) did not interfere with sperm ability to fuse with oocytes either in the conventional version of the HEPT or in the version enhanced with progesterone (P). No interference with the stimulatory effect on AR exerted by P or mannose–bovine serum albumin (mannose–BSA) was revealed. Finally, LY294002 had no effect on sperm/ZP binding. These results indicate that the inhibition of PI3K by LY294002 does not interfere with sperm interaction with oocytes. This is noteworthy in the view of a possible clinical use of LY294002 as an in vitro stimulator of the sperm motility of asthenozoospermic patients for assisted reproduction techniques.
Acrosome‐reacted human sperm in insemination medium do not bind to the zona pellucida of human oocytes
Authors: Liu D. Y. , Garrett C. , Baker H. W. G. 
Published: February 2006

SummaryIn the literature there is still confusion whether acrosome‐reacted sperm in medium can initiate primary binding to human zona pellucida (ZP). The ability of acrosome‐reacted sperm to bind to ZP in vitro can be deduced by measuring the acrosome reaction (AR) of ZP‐bound sperm compared with sperm in medium after incubation under different conditions inhibiting the ZP‐induced AR. Motile sperm from fertile men, normospermic men and infertile men diagnosed with disordered ZP‐induced AR (DZPIAR) were selected by swim‐up (2 × 106 in 1 mL medium) and incubated for 1–2 h with four oocytes from failed in vitro fertilization (IVF). The acrosome status of sperm was assessed using pisum sativum agglutinin labelled with fluorescein. The ZP‐induced AR was inhibited in experiments using sperm from DZPIAR patients, hyper‐osmotic medium (400 mOsm/kg) and medium containing soybean trypsin inhibitor (SBTI; 4 mg/mL). Pre‐treatment with calcium ionophore was used to create a sperm population with elevated AR. In all experiments with factors inhibiting the ZP‐induced AR, the AR was significantly lower for ZP‐bound sperm compared with sperm in medium: DZPIAR patients 4% vs. 15%, hyper‐osmotic medium 3% vs. 12%, SBTI 2% vs. 12% and SBTI 3% vs. 23% after treatment with calcium ionophore. In conclusion, acrosome‐reacted sperm in vitro have significantly reduced, in fact probably zero ability to bind to the ZP.
An investigation into food preferences and the neural basis of food‐related incentive motivation in Prader–Willi syndrome
Authors: Hinton E. C. , Holland A. J. , Gellatly M. S. N. , Soni S. , Owen A. M. 
Published: February 2006

AbstractBackground  Research into the excessive eating behaviour associated with Prader–Willi syndrome (PWS) to date has focused on homeostatic and behavioural investigations. The aim of this study was to examine the role of the reward system in such eating behaviour, in terms of both the pattern of food preferences and the neural substrates of incentive in the amygdala and orbitofrontal cortex (OFC).Method  Participants with PWS (n = 18) were given a food preference interview to examine food preferences and to inform the food‐related incentive task to be conducted during the neuroimaging. Thirteen individuals with PWS took part in the positron emission tomography (PET) study, the design of which was based on a previous study of non‐obese, non‐PWS controls. For the task, participants were asked to consider photographs of food and to choose the food they would most like to eat in two conditions, one of high and one of low incentive foods, tailored to each participant’s preferences. For comparison of the food preference data, 12 non‐PWS individuals were given one part of the interview.Results  Individuals with PWS expressed relative liking of different foods and showed preferences that were consistent over time, particularly for sweet foods. The participants with PWS did give the foods in the high incentive condition a significantly higher incentive value than the foods in the low incentive condition. However, activation of the amygdala and medial OFC was not associated with the prospect of highly valued foods as predicted in those with PWS.Conclusions  It would appear that incentive motivation alone plays a less powerful role in individuals with PWS than in those without the syndrome. This is likely to be due to the overriding intrinsic drive to eat because of a lack of satiety in those with PWS, and the impact of this on activity in the incentive processing regions of the brain. Activity in such reward areas may not then function to guide behaviour selectively towards the consumption of high preference foods.
Assessment of the economic value of the INTERCEPT blood system in Belgium
Authors: Moeremans K. , Warie H. , Annemans L. 
Published: February 2006

summary.  Emerging pathogens continue to threaten blood safety, requiring novel safety approaches. INTERCEPT Blood System for platelets (IBSP) inactivates pathogens, aiming at eliminating the risk of transmitting current and emerging pathogens. The objective was to evaluate the incremental cost‐effectiveness ratio (ICER) for IBSP in Belgium.A decision model comparing a ‘world with IBSP’ to a ‘world without IBSP’ calculates lifetime costs and ‘quality adjusted life years’ (QALYs) following platelet transfusion in different indications. Disease‐specific life expectancy and consequences of transfusion‐transmitted infections were obtained from literature. Transfusion safety and costs were obtained from official sources. Hepatitis C virus‐like emerging pathogen was simulated.A wide range of ICERs was observed, highly sensitive to the risk of emerging pathogen trans‐ mission, underlying disease and age. In the most conservative approach, ICER ranged from 3,459,201€/QALY in absence of emerging pathogen to 195,364€/QALY. The mean threshold of emerging infection risk for IBSP dominance (saving money and producing health gains) ranged from 1/1,079 to 1/2,858 transfusions.Considering the high value authorities appear to place on preventing accidental injury, and ICER of recent implementations in transfusion medicine (NAT: up to €2·3 million per lifeyear), IBSP can be considered cost‐effective, taking into account the potential risk of emerging pathogens.
A multistate cluster of red blood cell transfusion reactions associated with use of a leucocyte reduction filter
Authors: Alvarado‐Ramy F. , Kuehnert M. J. , Alonso‐Echanove J. , Sledge L. , Haley N. R. , Epstein J. , Vostal J. , Pearson M. 
Published: February 2006

summary.  In 2000, the American Red Cross (ARC) received reports of unusual transfusion reactions of unknown aetiology among patients receiving leucocyte‐reduced (LR) red blood cell (RBC) units in multiple distribution regions.We evaluated potential risk factors of reactions among patients who received LR‐RBC transfusions. A case–patient was defined as any patient with onset of back pain while receiving an LR‐RBC transfusion from 1 January to 25 May 2000. Controls were chosen randomly and selected in a 1:3 case : control ratio from healthcare facilities in which case–patients were transfused. Product‐specific risk factors of reactions were further determined through nested case–control study, procedural review of blood collection facility and quality‐control‐testing record review of product processing. Reaction incidence rates were determined through ARC blood product distribution data by region of blood collection and processing.There were 29 reactions detected in patients who received transfusions in 13 healthcare facilities in five states. Eighteen case–patients and 78 controls were included in the case–control study. In univariate analysis, case–patients were more likely than controls to have a haematologic malignancy, to have received the transfusion as an outpatient, to have received an RBC transfusion within the previous 3 months, to have received medication used to prevent reactions or to diminish their intensity upon transfusion (i.e. premedication) or to have received LR‐RBC units prepared with the HemaSure r\LS System™ (HS) rather than two other filters used. In multivariate analysis limited to recipients of HS‐filtered RBC units, transfusion premedication [adjusted odds ratio (AOR) = 7; 95% confidence interval (CI) 1·4–37; P = 0·02] and transfusion as an outpatient (AOR = 5; 95% CI 1·1–20; P = 0·03) were independently associated with reactions. The rate of reported transfusion reactions was 2·0 reactions per 10 000 RBC units distributed.A multistate cluster of transfusion reactions was significantly associated with leucocyte filtration of RBC units prepared with a specific product, the HS filter. The reactions also were independently associated with premedication and transfusion as an outpatient; these may be surrogates for an increased risk of reaction or for greater likelihood of detection. The mechanism for these reactions has not been elucidated. This cluster of reactions underscores the importance of surveillance efforts to detect adverse events after transfusion, particularly when new methods to modify blood products are introduced.
The Onset of Song Learning and Song Tutor Selection in Fledgling Zebra Finches
Authors: Roper Annabelle , Zann Richard 
Published: February 2006

AbstractWe investigated song development in the pre‐independent zebra finch (aged 15–35 d), a period when neural pathways for song learning and production are forming and social influences outside the family are limited. Expt 1 investigated the onset and the minimum duration of tutoring needed for song learning in fledglings. We found most begin to learn song from 25 d of age and need about 10 d contact with the father tutor to make accurate copies. This onset corresponds with major developments in the formation of the neural circuitry implicated in song acquisition. Subsong also begins on day 25 suggesting that the sensory and motor phases of song learning fully overlap in the zebra finch. Our findings support the hypothesis that the song circuitry is fully functional by 35 d of age and the sensitive phase for zebra finches extends therefore from about days 25–65. However, only the first 10 d of this period are necessary to learn a tutor's song with fair accuracy. Expt 2 investigated the role of the paternal bond, spatial proximity and mating status in a fledgling's choice of song tutor where the father was the sole parent. Young chose the father over single unrelated males (expt 2a) or unrelated males in company with their female partners (expt 2b). Given the close spatial proximity of both potential tutors to the fledglings it is probably the filial bond, established via paternal care that is the cause of this preference. Zebra finches sing the same song phrase in two contrasting contexts: female‐directed song during pre‐copulatory courtship and undirected song where no female or display is involved. In expt 3 we tested the song learning preference of pre‐independent young for two categories of non‐paternal tutors: those singing predominantly female‐directed song and those singing exclusively undirected song. There was a small, but significant, preference for fledgling zebra finches to copy songs from males that sang female‐directed song. This preference is consistent with the hypothesis that young males not only learn the acoustic features of their tutor's song but also the visual and dynamic movements that constitute the courtship display.
Maternal Condition Affects the Offspring Testosterone Concentration in Early Nestling Period: An Experimental Test on Tawny Owls
Authors: Sasvári Lajos , Hegyi Zoltán , Péczely Péter 
Published: February 2006

AbstractThis study addressed the question of whether maternal condition during egg laying or the rearing environment has a greater effect on offspring testosterone levels. We tested this in field experiments on a population of tawny owls Strix aluco in Duna‐Ipoly National Park, Hungary. In the experiments with females of poor condition, when broods were supplied with extra food none of the nestlings died, whereas in control broods, which were not supplied with extra food, some nestlings did die. Large differences in testosterone levels were correlated positively with hatching order both in experimental and control broods. However, it was only in control broods that the later‐hatched nestlings with low testosterone concentrations, died. In the experiments with females of good condition, the males were removed and females and their broods were supplied with restricted amounts of food. In these broods starving nestlings, whose growth had stopped, were considered as having died and were removed from the nest and hand‐reared. In control broods all nestlings fledged, and both in experimental and control broods testosterone concentrations were more even between siblings. Both types of trials confirmed a maternal influence on offspring testosterone concentration: large between‐sibling differences in concentrations in the broods of females of poor condition, where some nestlings died, could not be reduced with increased food supply, and the more even concentrations in the broods of females in good condition, where all nestlings survived, could also not be increased by restricting the food supply.
Role of Helicobacter pylori virulence factor and genotypes in non‐ulcer dyspepsia¶
Authors: TAN HUCK JOO , RIZAL ABDUL MANAF , ROSMADI MOHAMED‐YUSOFF , GOH KHEAN‐LEE 
Published: February 2006

AbstractBackground and Aim:  The role of Helicobacter pylori (HP) in non‐ulcer dyspepsia is debatable. Eradicating HP will help a small group of non‐ulcer dyspeptic patients. However, it is unclear which subgroup of patients will benefit from eradication therapy. The aim of the present study was to compare the cagA and cagE status, as well as vacA genotypes, of HP in non‐ulcer dyspeptic patients who responded successfully to eradication therapy compared with those patients who did not.Methods:  Consecutive patients with moderate to severe (Likert 2 or 3) non‐ulcer dyspepsia with HP were recruited prospectively. Gastric biopsies were taken, DNA extracted and polymerase chain reaction performed to determine the cagA and cagE status and vacA alleles. Eradication therapy was offered until HP was eradicated successfully. The HP status was checked 1 month after eradication therapy using the [13C]‐urea breath test. All patients were assessed by one interviewer using Gastrointestinal Symptom Rating Scale (GSRS), a four‐point Likert scale, and SF‐36 for quality of life over 12 months. Treatment success was defined as minimal or no symptoms (Likert 1 or 0). The cagA, cagE and vacA status was blinded to the investigators until completion of the study.Results:  Seventy‐three patients (36 males, 37 females) were recruited to the study. The mean ± SD patient age was 53.38 ± 12.09 years. When the 36 patients who improved (group A) were compared with the 37 (group B) who did not, no significant difference was found in the cagE positive rate (55.6 vs 43.2%, respectively; P = 0.638), cagA positive rate (83.1 vs 73.0%, respectively; P = 0.247), vacA m1 versus m2 subtype (84.0 vs 55.6%, respectively; P = 0.472) or vacA s1a versus s1c (39.4 vs 57.1%, respectively; P = 0.166). There was also no significant difference noted in the SF‐36 scores between the two groups after the conclusion of eradication therapy.Conclusions:  Stratification of HP genotypes and virulence factor has no significant impact on the treatment success of non‐ulcer dyspepsia.