bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effect of Emergency Department Crowding on Education: Blessing or Curse?
Authors: Shayne Philip , Lin Michelle , Ufberg Jacob W. , Ankel Felix , Barringer Kelly , Morgan‐Edwards Sarah , DeIorio Nicole , Asplin Brent 
Published: October 2008

AbstractEmergency department (ED) crowding is a national crisis that contributes to medical error and system inefficiencies. There is a natural concern that crowding may also adversely affect undergraduate and graduate emergency medicine (EM) education. ED crowding stems from a myriad of factors, and individually these factors can present both challenges and opportunities for education. Review of the medical literature demonstrates a small body of evidence that education can flourish in difficult clinical environments where faculty have a high clinical load and to date does not support a direct deleterious effect of crowding on education. To provide a theoretical framework for discussing the impact of crowding on education, the authors present a conceptual model of the effect of ED crowding on education and review possible positive and negative effects on each of the six recognized Accreditation Council for Graduate Medical Education (ACGME) core competencies.
Early Modern Digital Scholarship and DEEP: Database of Early English Playbooks
Authors: Farmer Alan B. , Lesser Zachary 
Published: October 2008

AbstractThis paper discusses recent trends in digital resources for early modern literary studies, as well as the implications of these resources for research and scholarship. In addition to comparing the use by scholars of print reference works and online databases, the essay analyzes the recent shift from ‘first‐generation’ digital resources, such as the English Short Title Catalogue (ESTC) and Early English Books Online (EEBO), to newer ‘second‐generation’ resources like DEEP: Database of Early English Playbooks. Rather than strive for comprehensive coverage of early modern print culture, as ESTC and EEBO do, these ‘second‐generation’ sites typically aim for in‐depth coverage of a particular kind of text or document. DEEP, for example, is a searchable database of all extant plays printed in England to 1660, while the English Broadside Ballad Archive focuses on sixteenth‐ and seventeenth‐century ballads. This shift in emphasis – from comprehensiveness to specialized subject matter – has resulted in, and been driven by, changes in thinking about the fundamental architecture of the databases, their searchability, and their analytical and editorial principles, all of which have significant ramifications for the type of research they enable.
Sexual Activity, Erectile Dysfunction and Their Correlates Among 1,566 Older Chinese Men in Southern China
Authors: Wong Samuel Yeung Shan , Leung Jason Chi Shun , Woo Jean 
Published: October 2008

ABSTRACT

Introduction
Few studies on sexuality and it correlates in adults have been conducted in Asia; most studies in Asia have focused instead on erectile dysfunction in men rather than sexuality or sexual activities.

Aim
This study was conducted to evaluate the prevalence and factors associated with sexual activity and erectile dysfunction in elderly Chinese men aged 65 years and above.

Main Outcome Measures
Sexual activity and sexual functions were assessed using the International Index of Erectile Function-5. Depressive symptoms were measured by the Chinese version of the Geriatric Depression Scale. Lower urinary tract symptoms (LUTS) were measured by the International Prostatic Symptom Score.

Methods
Cross-sectional data from a large prospective cohort study of Chinese elderly men were used in this study. A questionnaire that included demographic, lifestyle, and medical risk factors and physical examination were administered to 1566 Chinese men aged between 65 to 92 years in Hong Kong.

Results
Only 30.7% of men were sexually active in the previous 6 months in this sample and among those who were sexually active, 88% had some form of erectile dysfunction. Being sexually inactive in the previous 6 months was associated with being older (odds ratio [OR] = 1.80; confidence interval [CI]: 1.56–2.09), single (OR = 1.87; CI = 1.19–2.94) and the presence of peripheral arterial disease (OR = 2.43; CI: 1.25–4.71). In multiple multinomial logistic regression, having clinically relevant depressive symptoms (OR = 3.37; CI: 1.31–8.70) and having moderate to severe LUTS (OR = 1.63; CI: 1.01–2.64) were independently associated with increased risk of having erectile dysfunction.

Conclusion
We showed that a large proportion of elderly men were not sexually active in Hong Kong. For those who were sexually active, most suffered from some degree of erectile dysfunction. Having clinically relevant depressive symptoms and LUTS were independently associated with increased risk of erectile dysfunction.
Association of Sexual Functioning and Quality of Partnership in Patients in Cardiovascular Rehabilitation—A Gender Perspective
Authors: Günzler Cindy , Kriston Levente , Harms Anja , Berner Michael M. 
Published: October 2008

ABSTRACT

Introduction
In the general population, studies indicate a strong association between sexual dysfunction and partnership quality. Despite a high prevalence of sexual problems in patients with cardiovascular diseases, this association has not yet been examined in this sample.

Aim
The central task of this paper is to determine the association between sexual dysfunction and quality of partnership under a gender-specific view.

Methods
A written survey was handed out to all newly admitted patients in five participating inpatient rehabilitation centers for cardiovascular diseases in Germany. The survey included a gender-specific questionnaire to assess sexual functioning (International Index of Erectile Function for men, and Female Sexual Function Index for women), and a Partnership Questionnaire.

Main Outcome Measures
Correlations were calculated between sexual function and relationship satisfaction, and differences between groups (cardiovascular diseased men and women with and without sexual problems) were tested using covariance analyses.

Results
Overall, 44.3% of 98 female participants and 52.7% of 395 male participants stated to have at least one sexual problem. Patients with sexual problems showed significantly more quarrelling (P = 0.001), significantly less tenderness (P &lt; 0.001), communication (P &lt; 0.001), as well as significantly lower overall quality of partnership (P &lt; 0.001), compared with cardiac men and women without sexual problems. Suffering from a sexual problem impaired partnership quality for women to a significantly greater extent than for men.

Conclusions
Possible shortcomings of our study are selection bias, i.e., it is unknown whether all newly admitted patients received the questionnaire by their physician, as well as an overall low response rate, probably because of the private character of questions. This study suggests for the first time that men and women who suffer from cardiovascular diseases and sexual problems show a significantly decreased partnership satisfaction compared with those without sexual dysfunction. Further longitudinal studies might confirm the causal nature of found correlations.
The Effects of Treating Male Hypogonadism on Couples’ Sexual Desire and Function
Authors: Conaglen John V. , Conaglen Helen M. 
Published: October 2008

ABSTRACT

Introduction
Hypogonadism is a common endocrine condition characterized by low levels of testosterone (T) and marked by numerous symptoms, one of which is low sexual desire. Studies comparing T delivery systems have suggested that hypogonadal men’s partners may be at risk from exposure to T gels. Little other mention is found of the impact of hypogonadism and its treatment on a man’s partner and the couple’s sexual function.

Aim
To assess sexual desire and sexual function in hypogonadal men and their woman partners before and after treatment with T replacement therapy.

Methods
Twenty-one hypogonadal men and 18 partners were recruited from a tertiary endocrine clinic, and were compared with a control group of 20 eugonadal age-matched men and their partners. All men had baseline blood tests to confirm their status as hypogonadal or eugonadal, and hypogonadal men repeated tests at 3-month intervals. All participants completed the Sexual Desire Inventory (SDI) and sexual function questionnaires at baseline and at 3-month intervals until the hypogonadal men attained normal T levels.

Main Outcome Measures
Pre- and post-treatment SDI and sexual function questionnaires were compared once T normalization was achieved. Between- and within-group comparisons were carried out.

Results
Pretreatment hypogonadal men recorded lower levels of sexual desire and function than controls, but significantly improved once hypogonadism was corrected. Eugonadal controls recorded no significant changes in either sexual desire or function during the study. Partners of the hypogonadal men reported no changes on the SDI, but significant improvements in sexual function as their partners recovered.

Conclusion
SDI and sexual function measures reflect sexual changes that accompany rising serum T levels during correction of male hypogonadism. Women partners reported more satisfaction, less pain, and improved sexual function following the men’s treatment. Treatments affecting one partner potentially have important effects on the other.
Recommendations for Improving Sexual Health Curricula in Medical Schools: Results from a Two-Arm Study Collecting Data from Patients and Medical Students
Authors: Wittenberg Alyssa , Gerber Judith 
Published: October 2008

ABSTRACT

Introduction
Although patients commonly have sexual concerns, providers often feel uncomfortable or inadequately trained to address these concerns.

Aims
The first aim of this study was to determine how patients most prefer to receive sexual health information and how provider characteristics affect patient comfort. The second aim was to look at the sexual health curriculum at one medical school and determine its effectiveness. The third aim was to incorporate student and patient responses to create guidelines for more effective sexual health curricula.

Methods
Undergraduate and graduate students served as the study sample in arm one (N = 501). Medical students in their third and fourth year served as the study sample in arm two (N = 125). Participants were surveyed anonymously using standard forms.

Main Outcome Measures
A cross-sectional descriptive analysis was generated from all collected data using SPSS software.

Results
Patients most prefer to receive sexual health information from their provider who initiates the conversation (45.1%) and least prefer information from the Internet (25.4%). Patients are most comfortable with providers who are “knowledgeable about sexual concerns” (74.5%) and “seem comfortable addressing sexual concerns” (68.3%). The majority of medical students (75.2%) feels that taking a sexual history will be an important part of their future careers, yet only 57.6% feel adequately trained to do so. Furthermore, 68.8% feel that addressing and treating sexual concerns will be an important part of their future careers, and only 37.6% feel adequately trained to do so.

Conclusion
Patients prefer to receive sexual health information from knowledgeable providers who are comfortable with sexual health. Current medical students see value in sexual health curricula and feel this training will be important to their future careers, however, they feel inadequately trained. Sexual health curricula must be modified for increased effectiveness with additional lectures and opportunity for students to practice these skills.
Relative Roles of Disturbance and Propagule Pressure on the Invasion of Humid Tropical Forest by Cordia alliodora (Boraginaceae) in Tanzania
Authors: Edward Ezekiel , Munishi Pantaleo K. T. , Hulme Philip E. 
Published: October 2008

ABSTRACTCurrent understanding of the vulnerability of tropical forests to plant invasion is limited but is widely believed to increase where forests: (1) suffer marked natural or man‐made disturbance; and/or (2) are exposed to high propagule pressure of alien species. This study aimed, for the first time, to address the importance of propagule pressure and disturbance by examining the spread of an introduced tree, Cordia alliodora, from a single plantation into a surrounding mosaic of humid forest in the East Usambara Mountains, Tanzania. By assessing vulnerability to invasion along transects radiating from the plantation, the effects of distance (measure of propagule pressure), and disturbance could be discerned. For all life stages, distance from source population was the strongest correlate of density. A marked influence of disturbance was only evident for C. alliodora seedlings. Spatial variation in the densities of later life stages may be a function of past disturbances, less easy to assess from current surveys, especially following the marked self‐thinning between seedling and adult densities. Nevertheless, the evidence suggests that propagule pressure is a more important determinant of Cordia density than disturbance. If this is true for other alien tree species in tropical forests, controlling for introduction effort is essential to assess the drivers of plant invasion. Given an annual population growth rate of ca 3.5 percent, equivalent to the population doubling every 20 yr, C. alliodora poses a significant threat to the East Usambaras as well as other humid forests where it is promoted for agroforestry.
Barriers to health care and health‐seeking behaviors faced by Black men
Authors: Cheatham Cessaly T. , Barksdale Debra J. , Rodgers Shielda G. 
Published: October 2008

AbstractPurpose: To describe unique barriers to health care and health‐seeking behaviors faced by Black men and to make recommendations to healthcare providers for improving healthcare access for Black men.Data sources: A PubMed search for research articles published after 1999 was conducted.Conclusions: The articles selected for this state of the science clinical paper addressed barriers to access faced by Black men and/or management strategies used to mitigate barriers and improve access. The barriers identified include socioeconomic status, masculinity, racism, lack of awareness of the need for primary care, religious beliefs, and peer influences. As singular entities, these may not appear unique, but when viewed collectively, they represent an overwhelming constellation of obstacles for Black men.Implications for practice: Individual, community, state, and national level recommendations for nurse practitioner actions to improve healthcare access for Black men include public service announcements, radio commercials, and billboards aimed at raising awareness of healthcare issues in the Black community, provision of preventive services through health fairs, and development of positive provider–patient relationships.
Socioeconomic differences in smoking trends among pregnant women at first antenatal visit in Sweden 1982–2001: increasing importance of educational level for the total burden of smoking
Authors: Moussa K , Östergren P O , Grahn M , Kunst A E , Eek F , Essén B 
Published: October 2008

Background:There was a decrease in smoking during early pregnancy in Swedish women between 1982 and 2001. We sought to determine whether there was a parallel decrease in socioeconomic inequality in smoking.Methods:Registry data indicating educational level and smoking status at first antenatal visit in all 2 022 469 pregnancies in Sweden 1982–2001 were analysed. Prevalence differences, odds ratios based on prevalences and total attributable fractions were compared for five-year intervals.Results:The prevalence differences of smoking showed a greater decrease at the lowest and middle educational level compared with the highest educational level (14.5%, 15.7% and 10.2%, respectively) indicating reduced inequality in absolute terms. However, odds ratios regarding low educational attainment versus high, increased from 5.6 to 14.2, signifying increased inequality in relative terms. Moreover, the total attributable fraction of low and intermediate educational level regarding smoking at first antenatal visit increased from 61% to 76% during the period studied.Conclusions:Smoking at first antenatal visit in Sweden between 1982 to 2001 decreased in a way that conclusions regarding trends in inequalities in smoking at first antenatal visit depend on the type of measure applied. However, using the measure of total attributable fraction, which takes into consideration the impact of the exposure on the individual as well as the effect of the varying size of the group of exposed, the growing importance of educational level for the behaviour in the population was demonstrated.
Imatinib Mesylate Induces Quiescence in Gastrointestinal Stromal Tumor Cells through the CDH1-SKP2-p27Kip1 Signaling Axis
Authors: Liu Ying , Perdreau Sophie A. , Chatterjee Payel , Wang Linan , Kuan Shih-Fan , Duensing Anette 
Published: October 2008

Abstract
Gastrointestinal stromal tumors (GIST) are caused by activating mutations in the KIT or platelet-derived growth factor receptor α receptor tyrosine kinase genes. Approximately 85% of GIST patients treated with imatinib mesylate achieve disease stabilization, however, often in the presence of residual tumor masses. Complete remissions are rare and a substantial proportion of patients develop resistance to imatinib. Our study was designed to determine whether imatinib-associated responses may account for these clinical findings. We report here that imatinib stimulates cellular quiescence in a proportion of GIST cells as evidenced by up-regulation of the CDK inhibitor p27Kip1, loss of cyclin A, and reduced BrdUrd incorporation. Mechanistically, these events are associated with an imatinib-induced modulation of the APC/CDH1 signaling axis. Specifically, we provide evidence that imatinib down-regulates SKP2 and that this event is associated with increased nuclear CDH1, an activator of the APC that has been shown to regulate SKP2 stability. We also show that those GIST cells that do not undergo apoptosis in response to imatinib overexpress nuclear p27Kip1, indicating that they have withdrawn from the cell cycle and are quiescent. Lastly, we provide evidence that a fraction of primary GISTs with high SKP2 expression levels may have an increased risk of disease progression. Taken together, our results support a model in which GIST cells that do not respond to imatinib by apoptosis are removed from the proliferative pool by entering quiescence through modulation of the APC/CDH1-SKP2-p27Kip1 signaling axis. These results encourage further studies to explore compounds that modulate this pathway as antitumor agents in GISTs. [Cancer Res 2008;68(21):9015–23]
Gestational Hypertension, Preeclampsia, and Risk of Testicular Cancer
Authors: Pettersson Andreas , Richiardi Lorenzo , Cnattingius Sven , Kaijser Magnus , Akre Olof 
Published: October 2008

Abstract
Altered levels of pregnancy hormones have been suggested to initiate testicular cancer prenatally in the male fetus. The placenta is the main source of pregnancy hormones, and pregnancy hypertension and preeclampsia are associated with placental malfunction, including altered levels of hormones such as estrogen and human chorionic gonadotropin. We therefore evaluated fetal exposure to pregnancy hypertension and preeclampsia in relation to risk of testicular cancer in adolescent and adult life. We identified 293 cases of germ cell testicular cancer in the Swedish Cancer Register, and 861 controls in the Swedish Medical Birth Register. The standardized antenatal and delivery charts of the cases and controls were traced in the archives of the delivery units, and information about maternal and pregnancy characteristics such as gestational hypertension, proteinuria, anemia, and glucosuria were extracted. Odds ratios (OR) with 95% confidence intervals (CI) were calculated using conditional logistic regression. We found a strongly decreased risk of testicular cancer among subjects exposed to severe gestational hypertension (OR, 0.29; 95% CI, 0.12–0.74, compared with no hypertension), whereas the risk was increased among those exposed to mild gestational hypertension (OR, 1.62; 95% CI, 0.98–2.69) during the fetal period. The mechanism behind the association between pregnancy hypertension and testicular cancer is unclear, but our findings may reflect a potentially protective effect of the altered pregnancy hormones such as human chorionic gonadotropin that occur in severe gestational hypertension and preeclampsia. [Cancer Res 2008;68(21):8832–6]
Plumbagin, a Medicinal Plant–Derived Naphthoquinone, Is a Novel Inhibitor of the Growth and Invasion of Hormone-Refractory Prostate Cancer
Authors: Aziz Moammir H. , Dreckschmidt Nancy E. , Verma Ajit K. 
Published: October 2008

Abstract
Prostate cancer (PCa) is the second leading cause of cancer-related deaths in men. Hormone-refractory invasive PCa is the end stage and accounts for the majority of PCa patient deaths. We present here that plumbagin (PL), a quinoid constituent isolated from the root of the medicinal plant Plumbago zeylanica L., may be a potential novel agent in the control of hormone-refractory PCa. Specific observations are the findings that PL inhibited PCa cell invasion and selectively induced apoptosis in PCa cells but not in immortalized nontumorigenic prostate epithelial RWPE-1 cells. In addition, i.p. administration of PL (2 mg/kg body weight), beginning 3 days after ectopic implantation of hormone-refractory DU145 PCa cells, delayed tumor growth by 3 weeks and reduced both tumor weight and volume by 90%. Discontinuation of PL treatment in PL-treated mice for as long as 4 weeks did not result in progression of tumor growth. PL, at concentrations as low as 5 μmol/L, inhibited in both cultured PCa cells and DU145 xenografts (a) the expression of protein kinase Cε (PKCε), phosphatidylinositol 3-kinase, phosphorylated AKT, phosphorylated Janus-activated kinase-2, and phosphorylated signal transducer and activator of transcription 3 (Stat3); (b) the DNA-binding activity of transcription factors activator protein-1, nuclear factor-κB, and Stat3; and (c) Bcl-xL, cdc25A, and cyclooxygenase-2 expression. The results indicate for the first time, using both in vitro and in vivo preclinical models, that PL inhibits the growth and invasion of PCa. PL inhibits multiple molecular targets including PKCε, a predictive biomarker of PCa aggressiveness. PL may be a novel agent for therapy of hormone-refractory PCa. [Cancer Res 2008;68(21):9024–32]
Autonomic control of heart rate exhibits diurnal shifts in a crocodilian
Authors: Micheli Mariana , Campbell Hamish 
Published: October 2008

AbstractOver the diurnal cycle most reptiles show large changes in internal body temperature and heart rate (fH). The raising of fH, as the surface of a heliothermic reptile warms, increases cardiac output and facilitates in optimising the preferred daily body temperature (PDBT). In mammals, the fine tuning of cardiac output by the autonomic system can be observed through distinct oscillatory patterns in fH. This study examined Caiman latirostris (n = 6) to determine if similar oscillations in fH were present, and to assess if they exhibited a diurnal component associated with daily shifts in body temperature. A surgically implanted miniature datalogger recorded every heart beat and the dorsal surface temperature (Tds) of animals free-ranging in a semi-natural habitat. All C. latirostris exhibited rapid warming of Tds between 0700 and 1200. This was correlated with a rapid increase in fH, accompanied by erratic beat-to-beat oscillations in instantaneous fH. As Tds cooled, fH decreased and the short-term oscillations were abolished, resulting in a much slower rate of change in instantaneous fH. The two distinct fH rhythms may serve to optimise the PDBT over the diurnal cycle.