bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rheology of Dead Sea shampoo containing the antidandruff climbazole
Authors: Abu‐Jdayil B. , Mohameed H. A. 
Published: November 2004

SynopsisIn this study, the effect of the antidandruff climbazole on the rheology of hair shampoo containing Dead Sea (DS) salt was investigated. The presence of either DS salt or the climbazole led to increase in the shampoo viscosity. An optimum concentration was found where the viscosity of shampoo was maximum. In the absence of DS salt, the viscosity of hair shampoo increased with increasing the climbazole concentration to reach a maximum value at 1.0 wt%. Further addition of climbazole decreased the viscosity of shampoo. Adjusting the pH of the shampoo at 5.5 and 5.0 shifted the optimum climbazole concentration (corresponds to maximum viscosity) to 0.8 wt% and led to increase in the viscosity of shampoo. On the other hand, the addition of climbazole to the shampoo containing DS salt resulted in a decrease in shampoo viscosity. This decrease of shampoo viscosity became more pronounced with increasing the climbazole and/or DS salt concentrations. By controlling the pH of shampoo, an optimum formula of shampoo comprising both climbazole and DS salt and having maximum viscosity was obtained.
The validity of transvaginal ultrasound measurement of endometrial thickness: a comparison of ultrasound measurement with direct anatomical measurement
Authors: Saha Tapash K. , Amer Saad A.K.S. , Biss Judith , Thakare Hemlata , Williams Susan , Farrell Tom , Calvert John 
Published: November 2004

Objectives  To compare transvaginal ultrasound measurements of endometrial thickness with direct anatomical measurements and consider the implications of these findings on clinical practice.Design  Prospective observational study using two modalities blinded to each other's findings.Setting  Singleton Hospital, Swansea, a medium‐sized District General Hospital.Sample  Forty‐seven women admitted for hysterectomy.Methods  All women underwent transvaginal ultrasound scan to measure the endometrial thickness within 16 hours of surgery. Anatomical measurement of the fresh specimen was carried out immediately after surgery.Main outcome measures  Agreement between ultrasound and anatomical measurements of the endometrial thickness.Results  No ultrasound measurement was possible in 15% of patients. When both values were obtained, transvaginal ultrasound measurements were >2 mm different from the ruler measurement in 13/40 (33%) with an obvious tendency of the ultrasound scan to over‐estimate the endometrial thickness. The mean difference between the two measurements was −0.8 mm (limits of agreement −7.1 to +5.5 mm). The discrepancy was greater in women with endometrial thickness ≤5 mm (−1.6 mm, limits of agreement −5.7 to +2.6 mm) compared with that in women with endometrial thickness >5 mm (−0.2 mm, limits of agreement −7.6 to +7.2 mm). Kappa statistics showed good agreement between the two measurements in discriminating between thin and thick endometrium in 77% (κ= 0.55). Transvaginal ultrasound misdiagnosed a thick endometrium as thin in 3/40 (8%) and misdiagnosed a thin endometrium as thick in 6/40 (15%).Conclusions  Transvaginal ultrasonography is of limited value as a screening test for abnormal endometrium in patients with postmenopausal bleeding if the only parameter of normality is an endometrial thickness of 5 mm or less.
Research jobs: how good is the training?
Authors: Hawkins Emma 
Published: November 2004

Objectives  To determine if a period in a research job improves confidence in research skills and to assess the quality of research training.Design and setting  A questionnaire was designed and piloted to assess the content, structure and process of research training.Population/Sample  All individuals who had passed MRCOG in the five years prior to 1999 and were residents of England or Wales.Methods  Confidence scores were compared between those with and those without research experience. The availability and value of differing strategies for research training were compared.Main outcome measures  Confidence in research skills and attitudes to training.Results  Of the 532 usable questionnaires returned, 226 respondents had done or were doing research and these individuals had higher confidence on a variety of research skills than those with no experience of a formal research job. Confidence was patchy with less than 50% feeling confident at assessing bias in a case‐controlled study, understanding the statistics used in a paper or assessing the power of a study. Of those who had done research, 50% or less felt their training had been good or excellent in any area. Self‐directed learning and discussion with peers were felt to be the most useful strategies for research training. Short intensive courses were not available for many respondents, but were felt to be useful.Conclusion  The high levels of dissatisfaction with the training in key skills required for research suggests that there is a need for a system for recognition of research posts. Reform of training in the research job should build on the current strength of encouraging self‐directed learning.
The relationship between delivery mode and mortality in very low birthweight singleton vertex‐presenting infants
Authors: Riskin Arieh , Riskin‐Mashiah Shlomit , Lusky Ayala , Reichman Brian ,   In collaboration with the Israel Neonatal Network
Published: November 2004

Objective  To investigate the factors associated with caesarean delivery and the relationship between mode of delivery and mortality in singleton vertex‐presenting very low birthweight (≤1500 g) live born infants.Design  Observational population‐based study.Setting  Data collected from all 28 neonatal departments comprise the Israel National Very Low Birth Weight Infant Database.Population  2955 singleton vertex‐presenting very low birthweight infants registered in the database from 1995 to 2000, and born at 24–34 weeks of gestation.Methods  The demographic, obstetric and perinatal factors associated with caesarean delivery and subsequent mortality were studied. The independent effect of the mode of delivery on mortality was tested by multiple logistic regression.Main outcome measure  Mortality was defined as death prior to discharge.Results  Caesarean delivery rate was 51.7%. Caesarean delivery was directly associated with increasing maternal age and gestational age, small for gestational age infants, maternal hypertensive disorders and antepartum haemorrhage, and was inversely related to premature labour and prolonged rupture of membranes. Factors associated with increased survival were increasing gestational age, antenatal corticosteroid therapy, maternal hypertensive disorders and no amnionitis. Mortality rate prior to discharge was lower after caesarean delivery (13.2%vs 21.8%), but in the multivariate analysis, adjusting for the other risk factors associated with mortality, delivery mode had no effect on infant survival (OR 1.00, 95% CI 0.74–1.33). In a subgroup with amnionitis, a protective effect of caesarean delivery was found.Conclusions  Caesarean delivery did not enhance survival of vertex‐presenting singleton very low birthweight babies. Caesarean delivery cannot be routinely recommended, unless there are other obstetric indications.
A qualitative study of conceptions and attitudes regarding maternal mortality among traditional birth attendants in rural Guatemala
Authors: Rööst Mattias , Johnsdotter Sara , Liljestrand Jerker , Essén Birgitta 
Published: November 2004

Objective  To explore conceptions of obstetric emergency care among traditional birth attendants in rural Guatemala, elucidating social and cultural factors.Study design  Qualitative in‐depth interview study.Setting  Rural Guatemala.Sample  Thirteen traditional birth attendants from 11 villages around San Miguel Ixtahuacán, Guatemala.Method  Interviews with semi‐structured, thematic, open‐ended questions. Interview topics were: traditional birth attendants' experiences and conceptions as to the causes of complications, attitudes towards hospital care and referral of obstetric complications.Main outcome measures  Conceptions of obstetric complications, hospital referrals and maternal mortality among traditional birth attendants.Results  Pregnant women rather than traditional birth attendants appear to make the decision on how to handle a complication, based on moralistically and fatalistically influenced thoughts about the nature of complications, in combination with a fear of caesarean section, maltreatment and discrimination at a hospital level. There is a discrepancy between what traditional birth attendants consider appropriate in cases of complications, and the actions they implement to handle them.Conclusion  Parameters in the referral system, such as logistics and socio‐economic factors, are sometimes subordinated to cultural values by the target group. To have an impact on maternal mortality, bilateral culture‐sensitive education should be included in maternal health programs.
Carbohydrate solution intake during labour just before the start of the second stage: a double‐blind study on metabolic effects and clinical outcome
Authors: Scheepers H.C.J. , de Jong P.A. , Essed G.G.M. , Kanhai H.H.H. 
Published: November 2004

Objective  To study the effects of oral carbohydrate ingestion on clinical outcome and on maternal and fetal metabolism.Design  Prospective, double‐blind, randomised study.Setting  Leyenburg Hospital, The Hague, The Netherlands.Population  Two hundred and two nulliparous women.Methods  In labour, at 8 to 10 cm of cervical dilatation, the women were asked to drink a solution containing either 25 g carbohydrates or placebo. In a subgroup of 28 women, metabolic parameters were measured.Main outcome measures  Number of instrumental deliveries, fetal and maternal glucose, free fatty acids, lactate, pH, Pco2, base excess/deficit and β‐hydroxybutyrate.Results  Drinking a carbohydrate‐enriched solution just before starting the second stage of labour did not reduce instrumental delivery rate (RR 1.1, 95% CI 0.9–1.3). Caesarean section rate was lower in the carbohydrate group, but the difference did not reach statistical significance (1%vs 7%, RR 0.2, 95% CI 0.02–1.2). In the carbohydrate group, maternal free fatty acids decreased and the lactate increased. In the umbilical cord there was a positive venous–arterial lactate difference in the carbohydrate group and a negative one in the placebo group, but the differences in pH and base deficit were comparable.Conclusion  Intake of carbohydrates just before the second stage does not reduce instrumental delivery rate. The venous–arterial difference in the umbilical cord suggested lactate transport to the fetal circulation but did not result in fetal acidaemia.
The role of clinical follow up in early stage cervical cancer in South Wales
Authors: Lim K.C.K. , Howells R.E.J. , Evans A.S. 
Published: November 2004

Objective  To assess the effectiveness of clinical follow up after primary surgery for early stage cervical cancer.Design  Retrospective analysis of clinical follow up after radical hysterectomy and node dissection for early stage cervical cancer.Setting  Gynaecological Oncology Cancer Centre.Sample  Two hundred and ninety‐one patients who underwent surgery for cervical cancer.Methods  Follow up data were collected retrospectively from hand‐searched patients notes, as well as a computerised database (Information System for Clinical Organisation [ISCO]). The data were analysed using the SPSS for windows (SPSS, Chicago, Illinois) statistics package, using χ2, Kaplan–Meier life tables and Cox Linear regression analysis.Main outcome measures  To determine whether routine follow up was useful for detecting early recurrent disease.Results  Two hundred and ninety‐one patients treated by radical hysterectomy and node dissections were followed up. The cumulative five‐year survival for all cases in our series was 80% and 53/291 patients (18.2%) were found to have recurrent disease. The median period from surgery to recurrence was 17.6 months (3.0–60.0). Seven patients with recurrence were detected at a routine follow up examination, and two out of seven of the patients were asymptomatic. Detection of the recurrence on routine follow up was not an independent prognostic factor for survival when compared with age, stage and whether the patient received post‐operative adjuvant therapy.Conclusions  Routine follow up in patients following radical hysterectomy and node dissection for early stage cervical cancer is not a sensitive way of detecting recurrent disease, as a high proportion of patients were symptomatic at the time of detection. As there are other reasons for follow up, we propose alternative methods of structuring the programme.
Do maternity care provider groups have different attitudes towards birth?
Authors: Reime Birgit , Klein Michael C. , Kelly Ann , Duxbury Nancy , Saxell Lee , Liston Robert , Prompers Frédérique Josephine Petra Maria , Entjes Robert Stefan Willem , Wong Victor 
Published: November 2004

Objective  To compare family physicians', obstetricians' and midwives' self‐reported practices, attitudes and beliefs about central issues in childbirth.Design  Mail‐out questionnaire.Setting/Population  All registered midwives in the province, and a sample of family physicians and obstetricians in a maternity care teaching hospital. Response rates: 91% (n= 50), 69% (n= 97) and 89% (n= 34), respectively.Methods  A postal survey.Main outcome measures  Twenty‐three five‐point Likert scale items (strongly agree to strongly disagree) addressing attitudes toward routine electronic fetal monitoring, induction of labour, epidural analgesia, episiotomy, doulas, vaginal birth after caesarean section (VBACs), birth centres, provision educational material, birth plans and caesarean section.Results  Cluster analysis identified three distinct clusters based on similar response to the questions. The ‘MW’ cluster consisted of 100% of midwives and 26% of the family physicians. The ‘OB’ cluster was composed of 79% of the obstetricians and 16% of the family physicians. The ‘FP’ cluster was composed of 58% the family physicians and 21% the obstetricians. Members of the ‘OB’ cluster more strongly believed that women had the right to request a caesarean section without maternal/fetal indications (P < 0.001), that epidurals early in labour were not associated with development of fetal malpositions (P < 0.001) and that increasing caesarean rates were a sign of improvement in obstetrics (P < 0.001). The ‘OB’ cluster members were more likely to say they would induce women as soon as possible after 41 3/7 weeks of gestation (P < 0.001) and were least likely to encourage the use of birth plans (P < 0.001). The ‘MW’ cluster's views were the opposite of the ‘OBs’ while the ‘FP’ cluster's views fell between the ‘MW’ and ‘OB’ clusters.Conclusions  In our environment, obstetricians were the most attached to technology and interventions including caesarean section and inductions, midwives the least, while family physicians fell in the middle. While generalisations can be problematic, obstetricians and midwives generally follow a defined and different approach to maternity care. Family physicians are heterogeneous, sometimes practising more like midwives and sometimes more like obstetricians.
Gestational trophoblastic disease: is intensive follow up essential in all women?
Authors: Pisal Narendra , Tidy John , Hancock Barry 
Published: November 2004

Objective  To determine the timescale of the registration process for gestational trophoblastic disease and its impact on hCG level at registration and subsequent need for chemotherapy.Design  A prospective observational study using a standardised protocol for registration, assessment and treatment for molar pregnancy.Setting  A supra‐regional tertiary referral centre for gestational trophoblastic disease.Participants  A total of 2046 consecutive women registered between January 1994 and December 1998 with a diagnosis of molar pregnancy.Methods  Data at and after registration, collected prospectively on a computerised database, were statistically analysed (by multiple logistic regression and ANOVA).Main outcome measures  Relationship between length of time to and hCG value at registration; also the subsequent need for chemotherapy.Results  A total of 2046 women with a diagnosis of molar pregnancy were registered in the study period. The mean time interval between first evacuation and registration at the referral centre was 47 days (median 37, range 0–594). One hundred and five out of 2046 (5.1%) women needed chemotherapy. Sixty‐three precent of the women (1296 out of 2046) had a normal level of urinary hCG (less than 40 IU/24 hours) at the time of registration and only one (0.08%) needed chemotherapy. Binary logistic regression analysis showed a statistically significant relationship between time to registration, hCG value, histology, pretreatment risk score and decision to administer chemotherapy.Conclusion  Women with gestational trophoblastic disease who were registered late were significantly more likely to have normal levels of hCG and were less likely to need chemotherapy. A less intensive follow up may be justified in women with gestational trophoblastic disease who are registered with a normal hCG level.
Prevalence, nature, severity and correlates of postpartum depressive symptoms in Vietnam
Authors: Fisher J.R.W , Morrow M.M. , Nhu Ngoc N.T. , Hoang Anh L.T. 
Published: November 2004

Objective  To examine depressive symptomatology in women after childbirth in Ho Chi Minh City, Vietnam.Design  A cross sectional survey.Setting  Hung Vuong Obstetrics and Gynaecology Hospital and the Maternal, Child Health and Family Planning Center of Ho Chi Minh City, Vietnam.Population  Mothers of infants aged ±six weeks attending well‐baby clinics.Method  Participants were recruited consecutively in the postnatal wards and invited to take part in the study at the first clinic visit. Individual structured interviews about health and social circumstances, including the Edinburgh Postnatal Depression Scale (EPDS) were administered during clinic visits. The interview schedule was translated into Vietnamese, back translated for verification and piloted. Interviewers were specifically trained members of staff of the two centres.Main outcome measures  EPDS scores and responses to structured questions about specific and non‐specific symptoms.Results  Of 506 women who participated, 166 (33%) had EPDS scores in the clinical range of >12 and 99 (19%) acknowledged suicidal ideation. In a forward stepwise logistic regression analysis, 77% of cases with EPDS scores >12 were correctly classified in a model which included unwelcome pregnancy, lack of a permanent job, <30 days complete rest after childbirth, an unsettled baby, not being given special foods, avoiding proscribed foods and being unable to confide in their husbands.Conclusion  Depressive symptomatology is more prevalent among parturient women in Ho Chi Minh City, Vietnam than reported rates in developed countries and is at present unrecognised.
Mitochondrial hTERT exacerbates free‐radical‐mediated mtDNA damage
Authors: Santos Janine Hertzog , Meyer Joel N. , Skorvaga Milan , Annab Lois A. , Van Houten Bennett 
Published: November 2004

SummaryTelomerase is often re‐activated in human cancers and is widely used to immortalize cells in culture. In addition to the maintenance of telomeres, telomerase has been implicated in cell proliferation, genomic instability and apoptosis. Here we show that human telomerase reverse transcriptase (hTERT) is targeted to the mitochondria by an N‐terminal leader sequence, and that mitochondrial extracts contain telomerase activity. In seven different human cell lines, mitochondrial telomerase increases hydrogen‐peroxide‐mediated mitochondrial DNA damage. hTERT expression did not alter the rate of hydrogen peroxide breakdown or endogenous cellular levels. Because the damaging effects of hydrogen peroxide are mediated by divalent metal ions (Fenton chemistry), we examined the levels of bioavailable metals. In all cases, higher levels of chelatable metals were found in hTERT‐expressing cells. These results suggest that mitochondrial telomerase sensitizes cells to oxidative stress, which can lead to apoptotic cell death, and imply a novel function of telomerase in mitochondrial DNA transactions.
Cellular lifespan and senescence signaling in embryonic stem cells
Authors: Miura Takumi , Mattson Mark P. , Rao Mahendra S. 
Published: November 2004

SummaryMost mammalian cells when placed in culture will undergo a limited number of cell divisions before entering an unresponsive non‐proliferating state termed senescence. However, several pathways that are activated singly or in concert can allow cells to bypass senescence at least for limited periods. These include the telomerase pathway required to maintain telomere ends, the p53 and Rb pathways required to direct senescence in response to DNA damage, telomere shortening and mitogenic signals, and the insulin‐like growth factor – Akt pathway that may regulate lifespan and cell proliferation. In this review, we summarize recent findings related to these pathways in embryonic stem (ES) cells and suggest that ES cells are immortal because these pathways are tightly regulated.
Alterations in the TGFβ signaling pathway in myogenic progenitors with age
Authors: Beggs Marjorie L. , Nagarajan Radhakrishnan , Taylor‐Jones Jane M. , Nolen Greg , MacNicol Melanie , Peterson Charlotte A. 
Published: November 2004

SummaryMyogenic progenitors in adult muscle are necessary for the repair, maintenance and hypertrophy of post‐mitotic muscle fibers. With age, fat deposition and fibrosis contribute to the decline in the integrity and functional capacity of muscles. In a previous study we reported increased accumulation of lipid in myogenic progenitors obtained from aged mice, accompanied by an up‐regulation of genes involved in adipogenic differentiation. The present study was designed to extend our understanding of how aging affects the fate and gene expression profile of myogenic progenitors. Affymetrix murine U74 Genechip analysis was performed using RNA extracted from myogenic progenitors isolated from adult (8‐month‐old) and aged (24‐month‐old) DBA/2JNIA mice. The cells from the aged animals exhibited major alterations in the expression level of many genes directly or indirectly involved with the TGFβ signaling pathway. Our data indicate that with age, myogenic progenitors acquire the paradoxical phenotype of being both TGFβ activated based on overexpression of TGFβ‐inducible genes, but resistant to the differentiation‐inhibiting effects of exogenous TGFβ. The overexpression of TGFβ‐regulated genes, such as connective tissue growth factor, may play a role in increasing fibrosis in aging muscle.