Cervical cancer, human papillomavirus (HPV), and HPV vaccination: exploring gendered perspectives, knowledge, attitudes, and cultural taboos among Mexican American adults.

Background: Gendered perspectives may be particularly important in shaping norms and values around HPV and HPV vaccination, as previous research suggests that sexuality taboos (e.g. promiscuity) may contribute to low perceived risk among adolescent and young adult Hispanic females. However, research to date focuses primarily on Hispanic mothers, adolescent females, and women of HPV vaccine-eligible age. Hispanic father's perspectives are relatively unknown despite father's important role in shaping norms for their female children.Objective: To close this gap, this study examines gendered perspectives in knowledge, beliefs, and attitudes about HPV and HPV vaccination from Hispanic parents (mothers and fathers), women of vaccine-eligible age (18-26 years old), and women eligible for Pap Test screening (>26 years old) living in two counties along the Texas-Mexico border.Design: We conducted eight focus groups. Research staff transcribed audio recordings verbatim and uploaded them into Atlas(ti) 5.0 for analysis. The research team analyzed the data for content, meaning, patterns and themes using the constant comparison approach.Results: Perspectives were highly gendered. Women's (all groups combined) beliefs focused on misconceptions around how the HPV virus is contracted (e.g. toilet surfaces). Women also linked HPV-related sexual risk to adultery and indiscretion of male partners. Fathers (men) were more likely to link risk to female promiscuity. Fathers also worried that HPV vaccination might increase promiscuity. All groups believe that HPV vaccination is a way to protect Hispanic females in the face of beliefs around sexual behavior and risk of contracting HPV.Conclusion: Results suggest gendered differences in risk beliefs concerning HPV among Hispanics living along the Texas-Mexico border. Researchers can use these findings to address barriers to HPV vaccination, as well as to create culturally appropriate prevention messages that may help reduce disparities in HPV among Hispanic women.

The Minnesota Multiphasic Personality Inventory-2-RF in Treatment-Seeking Veterans with History of Mild Traumatic Brain Injury.

OBJECTIVE: This study examined the Minnesota Multiphasic Personality Inventory-Second Edition-Restructured Form (MMPI-2-RF) to better understand symptom presentation in a sample of treatment-seeking Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) Veterans with self-reported history of mild traumatic brain injury (mTBI). METHOD: Participants underwent a comprehensive clinical neuropsychological battery including performance and symptom validity measures and self-report measures of depressive, posttraumatic, and post-concussive symptomatology. Those with possible symptom exaggeration (SE+) on the MMPI-2-RF were compared with those without (SE-) with regard to injury, psychiatric, validity, and cognitive variables. RESULTS: Between 50% and 87% of participants demonstrated possible symptom exaggeration on one or more MMPI-2-RF validity scales, and a large majority were elevated on content scales related to cognitive, somatic, and emotional complaints. The SE+ group reported higher depressive, posttraumatic, and post-concussive symptomatology, had higher scores on symptom validity measures, and performed more poorly on neuropsychological measures compared with the SE- group. There were no group differences with regard to injury variables or performance validity measures. Participants were more likely to exhibit possible symptom exaggeration on cognitive/somatic compared with traditional psychopathological validity scales. CONCLUSIONS: A sizable portion of treatment-seeking OEF/OIF Veterans demonstrated possible symptom exaggeration on MMPI-2-RF validity scales, which was associated with elevated scores on self-report measures and poorer cognitive performance, but not higher rates of performance validity failure, suggesting symptom and performance validity are distinct concepts. These findings have implications for the interpretation of clinical data in the context of possible symptom exaggeration and treatment in Veterans with persistent post-concussive symptoms.

Giving up or finding a solution? The experience of attempted suicide in later life.

Older people constitute one of the highest risk groups for suicide. Existing research in this area has been largely dominated by a risk factor approach. This is of limited usefulness since only a minority of those at risk go on to make an attempt. Therefore, prediction, prevention and the management of risk remain challenging. The present study aimed to capture the subjective experience of older people who had recently made a suicide attempt through exploring their understanding of the pathway to and from this attempt, within the context of ageing. Fifteen participants were interviewed. Transcripts were analysed using Interpretative Phenomenological Analysis. Three broad themes emerged--Struggle (experiencing life as a struggle before and after the attempt, and in relation to growing older), Control (trying to maintain control over life before the attempt, and following it either failing or succeeding to regain control) and Visibility (feeling invisible or disconnected from others and trying to fight against this before the attempt and either becoming more or less connected afterwards). Risk factors identified in the literature were often absent or construed by participants as not relevant to their attempt. Individual accounts highlight the diversity and complexity of experience of older people who attempt suicide.

Polymorphic behavior of an NK1 receptor antagonist.

Four anhydrous polymorphic forms (I, II, III and IV) of an NK1 receptor antagonist, Compound A, have been discovered. The pure compound can exist as either Forms I or II at room temperature and Forms III or IV at elevated temperatures. The four polymorphs were characterized by differential scanning calorimetry (DSC), thermogravimetric analysis, X-ray powder diffraction (XRPD) and solid-state NMR spectroscopy (SSNMR). Polymorphic transformations in the solid phase were studied using DSC, hot stage XRPD, temperature-modulated SSNMR and hot stage optical microscopy. The solubilities of Forms I and II in tert-butyl acetate at different temperatures were measured and the relative stability of the two forms was established. The thermodynamic transformation temperatures between Forms I and III, as well as Forms II and IV, were estimated by DSC. Transformation from Form III to IV, which is undetectable in a normal calorimetric run, was revealed through careful thermal programming. An interesting conversion route from Form I, a more stable form at room temperature, to Form II, a less stable form at room temperature was discovered.

Development of a nanofiltration process to improve the stability of a novel anti-MRSA carbapenem drug candidate.

The benzenesulfonate salt of an anti-methicillin-resistant Staphylococcus aureus carbapenem antibiotic studied is a crystalline, nonhygroscopic powder which is stable at room temperature, making it an ideal compound for long-term storage. However, the limited aqueous solubility of this salt prohibits parenteral administration. Conversely, the chloride salt of this carbapenem demonstrates opposing characteristics; it is quantitatively soluble in water, however is amorphous and subject to significant hydrolytic degradation in the solid state. Given two such extreme alternatives for pharmaceutical salt selection, a common approach taken is to develop the bioavailable salt and devise manufacturing and storage conditions that minimize degradation. This report describes a different approach to this manufacturing dilemma via the application of a simple and efficient nanofiltration process to convert the benzenesulfonate salt (storage entity) to the chloride salt (formulated drug product). Such an approach combines the positive attributes of these two salt forms into a single scalable process that reduces processing cycle times via elimination of redundant unit operations, increases the flexibility in manufacturing schedule, and improves overall product quality.

Mechanistic aspects of chiral discrimination on an amylose tris(3,5-dimethylphenyl)carbamate.

The separation of [2R-[2alpha(R*),3alpha]]-5-[[2-[1-[3,5-bis-(trifluoromethyl)phenyl]ethoxy]-3(S)-4-fluorophenyl)4-morpholinyl]-methyl]-N,N-dimethyl-1H-1,2,3-triazole-4-methanamine hydrochloride from its enantiomer was achieved on an amylose tris-3,5-dimethylphenyl carbamate stationary phase. The retention of the enantiomers is dominated by weak hydrogen bonds while the enantioselectivity is governed by other kinds of interactions, e.g., inclusion in the amylose carbamate chains. Van't Hoffplots of 1nalpha vs. reciprocal temperature were non-linear and could be divided into two linear regions. One region at low temperature (5 degrees C- approximately 20 degrees C) and another one between 25 degrees C-70 degrees C with the change in slope occurring between 16 degrees C and 20 degrees C. DSC experiments suggested that the behavior can be attributed to breakage of H-bonds triggering a conformational change. Molecular simulation indicated a correlation between the interaction energies and the elution order obtained experimentally. The most retained enantiomer (R,R,S-enantiomer) interacts with the stationary phase through a hydrogen bond between the triazole proton and the C=O groups of the stationary phase, as well as through an inclusion in the cleft of the stationary phase. The other enantiomer exhibits a bifurcated H-bond between the triazolic proton and the C=O groups of the stationary phase leading to a less stable complex.

A simple quantitative FT-IR approach for the study of a polymorphic transformation under crystallization slurry conditions.

The pharmaceutical compound (2R,3S)-2-([(1R)-1-[3,5-bis(trifluoromethyl)phenyl]ethyl]oxy)-3-(4-fluorophenyl)morpholine hydrochloride (denoted here as Compound X), has been found to crystallize in at least two polymorphic forms. Using only two frequencies (1009 and 1058 cm(-1)) in the infrared, a linear (R=0.998) calibration plot, consisting of the ratio of the peak absorbances plotted against polymorph concentration, was constructed. This plot allowed the quantification of binary mixtures of polymorphs ranging from <3 to approximately 100 wt% Form II in Form I. Spectra were acquired in transmission mode using mineral oil (Nujol) mull sample preparation, for reasons of compatibility with wet cake and slurry samples. The transformation of the less thermodynamically stable polymorph (Form II) to the more stable form (Form I), in stirred methyl isobutyl ketone (MIBK) slurries, was monitored spectroscopically as a function of time. Performing the experiment at various temperatures allowed the energy of activation for the process to be estimated (42 kJ/mol).

In vitro development of porcine nuclear transfer embryos constructed using fetal fibroblasts.

The in vitro development of porcine nuclear transfer embryos constructed using primary cultures from day 25 fetal fibroblasts which were either rapidly dividing (cycling) or had their cell-cycle synchronized in G0/G1 using serum starvation (serum-starved) was examined. Oocyte-karyoplast complexes were fused and activated simultaneously and then cultured in vitro for seven days to assess development. Fusion rates were not different for either cell population. The proportion of reconstructed embryos that cleaved was higher in the cycling group compared to the serum-starved group (79 vs. 56% respectively; P < 0.05). Development to the 4-cell stage was not different using either population. Both treatments supported similar rates of development to the morula (1.5 vs. 7%, cycling vs. serum-starved) and blastocyst stage (1.5 vs. 3%, cycling vs. serum-starved). The blastocyst produced using cycling cells had a total cell number of 10. Total cell numbers for the three blastocysts produced serum-starved cells were 22, 24, and 33. These blastocysts had inner cell mass numbers of 0, 15, and 4, respectively. Six hundred and thirty-five nuclear transfer embryos reconstructed using serum-starved cells were transferred to 15 temporarily mated recipients for 3-4 days. Of these, 486 were recovered (77% recovery rate) of which 106 (22%) had developed to the 4-cell stage or later. These were transferred to a total of 15 recipients which were either unmated or mated. Seven recipients farrowed a total of 51 piglets. Microsatellite analysis revealed that none of these were derived from the nuclear transfer embryos transferred.

Influence of processed corn grain in diets of dairy cows on digestion of nutrients and milk composition.

Five primiparous Holstein cows (55 d in milk) that were fitted with ruminal and duodenal cannulas were used in a 4 x 5 incomplete Latin square to determine the effects of blends of steam-flaked and dry-rolled corn on site and extent of nutrient digestion and milk yield and composition. Diets were fed as total mixed rations and consisted of 45% forage and 55% concentrate; each diet contained 27% corn grain. Dietary treatments were composed of blends of dry-rolled and steam-flaked corn in ratios of 100:0, 67:33, 33:67, and 0:100. Intake of dry matter; digestibilities of dry matter, organic matter, acid detergent fiber, cellulose, neutral detergent fiber, fatty acids, and N; and microbial efficiency were unaffected by diet. Ruminal, postruminal, and total tract digestion of starch increased linearly, and starch passage to the duodenum decreased linearly, as the proportion of dry-rolled corn in the diet decreased. Ruminal propionate and valerate increased linearly, and acetate, butyrate, isovalerate, and the acetate to propionate ratio decreased linearly, as proportions of dry-rolled corn in the diet decreased; however, no changes in total volatile fatty acid concentrations in ruminal fluid were observed. Ruminal fluid pH was similar across diets. A decrease in dry-rolled corn decreased ruminal ammonia N and plasma urea N linearly. Milk yield and composition, as well as milk N fractions, were similar across diets. Although changes in fatty acid composition of milk fat were small, linear decreases in percentages of trans-C16:1 and cis-9- and cis-10-C18:1, as well as a linear increase in the percentage of C18:2 occurred as the proportion of dry-rolled corn in the diet decreased. An increased proportion of dry-rolled corn in the diet decreased digestion of starch in the rumen, and patterns of volatile fatty acid concentrations shifted accordingly. However, no effects on lactational parameters were observed.

Ash content of detergent fibers in feeds, digesta, and feces and its relevance in fiber digestibility calculations.

The influence of insoluble ash in diet, digesta, and fecal samples was evaluated. Ash-free values of neutral detergent fiber (NDF) and acid detergent fiber (ADF) for feed, digesta, and fecal samples were compared with uncorrected values of NDF and ADF in two digestibility experiments. Six feed samples were selected at random along with four duodenal and two fecal samples; the latter two were a part of two digestion studies. The silica composition of feed samples was low with the exception of oat hay and rice straw. Ash-free values of NDF and ADF for digesta and fecal samples were lower than uncorrected values of NDF and ADF, and silica accounted for the majority of the differences. The use of ash-free values of NDF and ADF in both digestibility experiments with dairy cows resulted in more realistic digestibility estimates and reduced the amount of variability associated with the calculation of the digestibility of NDF and ADF in the rumen and total digestive tract. The source of the insoluble ash was not identified but could have come from individual feedstuffs or the consumption of sand. Sample contamination by silica and other ash components may influence NDF and ADF composition if the fiber residues are not ashed prior to calculation of NDF and ADF.

Two methods for the measurement of the dissociation pressure of a crystalline hydrate.

Two methods for the measurement of the characteristic dissociation pressures of a system containing water vapor and two different crystalline hydrates of the pharmaceutical compound MK-0677 are described. One method involves the spectroscopic determination of water in gases equilibrated with the solids at controlled temperatures, using an infrared spectrometer. The second method utilized the extrapolated onset temperature of the transition from one hydrate to the other at controlled humidities, as observed by differential scanning calorimetry. The methods give similar results for the system of interest.

Mechanistic aspects of chiral discrimination on modified cellulose.

Cellulose and cellulose derivatives are biopolymers which are often used as stationary phases for the separation of enantiomers. Describing the mechanism of such separations is a difficult task due to the complexity of these phases. In the present study, we attempt to elucidate the types of interactions occurring between a diol intermediate for a LTD(4) antagonist and a tris(4-methylbenzoate)-derivatized cellulose stationary phase. Thermodynamic studies indicate that, at low temperatures, the enantioselectivity is entropy driven. At higher temperatures, the separation is enthalpy driven. DSC and IR experiments reveal that the transitions between the enthalpic and the entropic regions of the van't Hoff plots are a result of a change in conformation of the stationary phase. Investigation of chromatographic kinetic parameters reveals that, at low temperature, the second eluted enantiomer undergoes sluggish inclusion interactions. Subtle changes in the structure of the analyte indicates that π-π interactions do not contribute to enantioselectivity. Finally, molecular modeling of (R)- and (S)-diol and the stationary phase suggests that hydrogen bonding is a primary factor in the separation, and the calculated energy values obtained from the molecular modeling correlate well with the chromatographic elution order.

Comparison of the crystallinity of imipenem samples by X-ray diffraction of amorphous material.

The intensity of X-rays diffracted by amorphous material in samples of the beta-lactam antibiotic imipenem [(5R,6S)-3-[[2-(formimidoyl-amino)ethyl]thio]-6-[(R)-1- hydroxyethyl]-7-oxo-1-azabicyclo[3.2.0]hept-2-ene-2-carboxylic acid] was used to compare the crystallinity of the samples. The method makes use of the intensity in the X-ray powder diffraction (XRPD) pattern at a diffraction angle of 28 degrees (2 theta), at which no crystalline peaks are observed. A linear relationship (R2 = 0.9999) exists between amorphous intensity and crystallinity for synthetic mixtures of amorphous and crystalline imipenem. Sample preparation techniques ordinarily used in XRPD experiments were utilized.

A longitudinal study of cardiac output in normal human pregnancy.

OBJECTIVE: Our purpose was to investigate the maternal hemodynamic and cardiac structural changes that occur during pregnancy. STUDY DESIGN: Eighteen women underwent serial echocardiography beginning at 8 to 11 weeks' gestation, then at monthly intervals throughout pregnancy and at 6 and 12 weeks post partum. Cardiac output was measured by pulsed- and continuous-wave Doppler at the aortic valve. Left ventricular chamber size, wall thickness, and mass were determined by M-mode echocardiography. Ventricular diastolic function was assessed by Doppler recording of mitral inflow. RESULTS: Cardiac output by pulsed Doppler increased from 6.7 +/- 0.6 L/min at 8 to 11 weeks' gestation to 8.7 +/- 1.4 L/min at 36 to 39 weeks' gestation before falling to 5.7 +/- 0.7 L/min 12 weeks post partum. Heart rate increased 29%, and stroke volume increased 18%. Left ventricular mass increased because of an increase in wall thickness. Peak mitral A wave velocity increased in late pregnancy. Cardiac output by pulsed and continuous-wave Doppler was similar. CONCLUSION: Cardiac output continues to increase even in late pregnancy. Left ventricular mass increases because of increased wall thickness. The mitral flow velocity findings suggested decreased ventricular compliance or increased preload.

Site-specific transgene insertion: an approach.

Methods to improve the production of transgenic animals are being developed. Conventional transgenesis, involving microinjection of DNA into fertilized eggs, has a number of limitations. These result from the inability to control both the site of transgene insertion and the number of gene copies inserted. The approach described seeks to overcome these problems and to allow single copy insertion of transgenes into a defined site in animal genomes. The method involves the use of embryonic stem cells, gene targeting and the FLP recombinase system.

Secretion of eukaryotic growth hormones in Escherichia coli is influenced by the sequence of the mature proteins.

We report the construction of secretion plasmids expressing the fusion proteins, OmpA::pGH (pSpGH.01) and OmpA::hGH (phGH.01), and compare the secretion of mature porcine growth hormone (pGH) and human growth hormone (hGH) employing Escherichia coli. E. coli [phGH.01] secreted 10-15 micrograms hGH/ml/A600 cells into the periplasmic space, representing 30% of total periplasmic proteins. E. coli [pSpGH.01], however, secreted 30-fold less mature pGH. On the basis that both pSpGH.01 and phGH.01 are stably maintained in E. coli and in vitro transcription/translation data showed equivalent expression of OmpA::pGH and OmpA::hGH precursors, we attribute the higher secretion of hGH to the translocation-competent OmpA::hGH protein configuration. Two OmpA::GHF (growth hormone fusion) precursors, OmpA::GHF.02 and OmpA::GHF.03, both with hGH helix 3/helix 4 together instead of the pGH equivalent, secreted mature proteins as efficiently as OmpA::hGH. We propose that hGH helices 3 and 4 in these OmpA::GHF precursors play a major role in the folding of the precursor to a translocation-competent state, mimicking the translocation-competent nature of the OmpA::hGH precursor.

Induction versus expectant management in premature rupture of the membranes with mature amniotic fluid at 32 to 36 weeks: a randomized trial.

OBJECTIVE: Our objective was to compare maternal and perinatal outcomes between two management schemes for women with preterm premature rupture of the membranes and documented fetal pulmonary maturity. STUDY DESIGN: Of 164 women with preterm premature rupture of the membranes at 32 weeks to 36 weeks 6 days' gestation, 93 eligible and consenting women were randomly selected for either induction of labor (n = 46) or expectant management (n = 47). Expectant management included hospitalization, assessment for fetal heart rate abnormalities, chorioamnionitis, and labor. Digital cervical examinations were prohibited until progressive labor occurred. Follow-up was also done for the 71 women who did not participate. RESULTS: The women in the induction of labor and expectant management groups had similar demographic characteristics and gestational ages (34.1 vs 34.3 weeks). Expectant management was associated with prolonged latencies to labor, delivery, and maternal hospitalization (p < 0.001), as well as increased hospitalization of infants at 2 to 5 days after delivery (p < 0.05). These patients had increased chorioamnionitis and fetal heart rate abnormalities before labor (p = 0.01, 0.03). Infants received more frequent (p < 0.001) and prolonged antimicrobial therapy after expectant management (p = 0.003) with no reduction in proven sepsis (6.8% vs 4.4%). These latter differences were influenced by the neonatologist's concern over potential neonatal infection. CONCLUSIONS: Among women with preterm premature rupture of the membranes at 32 to 36 weeks with mature surfactant profiles, immediate induction of labor reduces the duration of hospitalization and infection in both mothers and neonates.

Clinical characteristics and outcome of twin gestation complicated by preterm premature rupture of the membranes.

OBJECTIVE: Our purpose was to report the clinical characteristics and outcome of twin pregnancy complicated by preterm premature rupture of membranes. STUDY DESIGN: Pregnancy outcome is compared between 99 twin pregnancies and 99 well matched singleton pregnancies complicated by preterm rupture of the membranes. RESULTS: Preterm premature rupture of membranes occurs more frequently in twin than singleton gestations (7.4% vs 3.7%, p < 0.001, odds ratio 2.1). Midtrimester premature rupture of membranes (< 26 weeks' gestation) complicated 1.37% of twin gestations (18.2% of those with preterm premature rupture of membranes) versus 0.52% of singleton gestations (p < 0.001, odds ratio 2.71). The mean gestational age at preterm premature rupture of membranes was 30.1 +/- 4.3 weeks. The median latency to delivery for twins was 1.1 days with 91% of patients delivered within 7 days (vs 1.7 days, 90% delivered at 7 days for singleton gestations). Latency was prolonged with preterm premature rupture of membranes < 30 weeks' versus > or = 30 weeks' gestation (p = 0.03). The nonpresenting infant more frequently had hyaline membrane disease and required more oxygen therapy than the presenting infant. No significant differences in infectious morbidity, cord prolapse, or abruptio placentae were seen between twin and singleton gestations. CONCLUSION: This investigation provides the basis for patient counseling and management subsequent to preterm premature rupture of membranes in twin gestation.