Living with genital Pain: women's experience of treatment seeking

Female Genital Pain (FGP) is a sexual dysfunction that is difficult to diagnose and treat, which can make treatment seeking a distressing experience. In the present study the lived experience of women with genital pain as explored in order to develop a grounded model of treatment seeking for FGP. A constructivist lived experience perspective underpinned this research. Participants were 26 women with genital pain, specifically vaginismus (n=4) and (n=22). The average age of the participants was 27. Identified motivations for seeking treatment were the belief that they might have an infection, optimistic views about their health or an expectation that relationships include intercourse. Barriers occurred when they normalised or discounted their symptoms or held negative treatment beliefs. Unsurprisingly, the identified barriers were associated with delayed treatment seeking. The women described three agendas for their consultation with a health care professional (HCP) – validation of their symptoms, an informed HCP, and a strong HCP–patient alliance. Agendas that were met played a significant role in decreasing distress. Identified salient survivorship resources were a supportive HCP and personal agency. These resources encouraged consistent treatment seeking. The personal narratives that contributed to more consistent treatment seeking were personal agency, communion, redemption, creating meaning of suffering, positive sexual identity and positive resolution. Identities that were characterised by contamination and negative sexual self-schema were associated with no treatment seeking or delayed treatment seeking. The findings of this study allow HCPs and researchers to better understand the needs of women with genital pain. Furthermore, this research will help guide future research and the development of future initiatives to improve the treatment of genital pain conditions, thus improving the outcomes and quality of life for women with genital pain

Structural and Biophysical Insights into SPINK1 Bound to Human Cationic Trypsin

(1) The serine protease inhibitor Kazal type 1 (SPINK1) inhibits trypsin activity in zymogen granules of pancreatic acinar cells. Several mutations in the SPINK1 gene are associated with acute recurrent pancreatitis (ARP) and chronic pancreatitis (CP). The most common variant is SPINK1 p.N34S. Although this mutation was identified two decades ago, the mechanism of action has remained elusive. (2) SPINK1 and human cationic trypsin (TRY1) were expressed in E. coli, and inhibitory activities were determined. Crystals of SPINK1–TRY1 complexes were grown by using the hanging-drop method, and phases were solved by molecular replacement. (3) Both SPINK1 variants show similar inhibitory behavior toward TRY1. The crystal structures are almost identical, with minor differences in the mutated loop. Both complexes show an unexpected rotamer conformation of the His63 residue in TRY1, which is a member of the catalytic triad. (4) The SPINK1 p.N34S mutation does not affect the inhibitory behavior or the overall structure of the protein. Therefore, the pathophysiological mechanism of action of the p.N34S variant cannot be explained mechanistically or structurally at the protein level. The observed histidine conformation is part of a mechanism for SPINK1 that can explain the exceptional proteolytic stability of this inhibitor

Macro- and micro-geographic variation of short-beaked common dolphin’s whistles in the Mediterranean Sea and Atlantic Ocean

Author Posting. © The Author(s), 20113. This is the author's version of the work. It is posted here by permission of Taylor & Francis for personal use, not for redistribution. The definitive version was published in Ethology Ecology & Evolution 26 (2014): 392-404, doi:10.1080/03949370.2013.851122.Genetic studies have shown that there are small but significant differences between the short-beaked common dolphin populations in the Atlantic Ocean and those in the Mediterranean Sea. The short-beaked common dolphin is a highly vocal species with a wide sound production repertoire including whistles. Whistles are continuous, narrowband, frequency-modulated signals that can show geographic variation in dolphin species. This study tests whether the differences, highlighted by genetic studies, are recognisable in the acoustic features of short-beaked common dolphin’s whistles in the two adjacent areas of the Atlantic Ocean and the Mediterranean Sea. From a selected sample of good quality whistles (514 recorded in the Atlantic and 193 in the Mediterranean) 10 parameters of duration, frequency and frequency modulation were measured. Comparing data among basins, differences were found for duration and all frequency parameters except for minimum frequency. Modulation parameters showed the highest coefficient of variation. Through discriminant analysis we correctly assigned 75.7% of sounds to their basins. Furthermore, micro-geographic analysis revealed similarity between the sounds recorded around the Azores and the Canary archipelagos and between the Bay of Biscay and the Mediterranean Sea. Results are in agreement with the hypothesis proposed by previous genetic studies that two distinct populations are present, still supposing a gene flow between the basins. This study is the first to compare shortbeaked common dolphin’s whistles of the Atlantic Ocean and the Mediterranean areas.Data collection and processing in the Azores was conducted under projects POCTI/BSE/38991/01, PTDC/MAR/74071/2006 and M2.1.2/F/012/2011, supported by FCT (Fundação para a Ciência e a Tecnologia) and DRCTC/SRCTE (Secretaria Regional de Ciência, Tecnologia e Equipamentos), FEDER funds, the Competitiveness Factors Operational (COMPETE), QREN European Social Fund and Proconvergencia Açores Program. We acknowledge funds provided by FCT to LARSyS Associated Laboratory & IMAR-University of the Azores/ the Thematic Area E of the Strategic Project (OE & Compete) and by the DRCTC – Government of the Azores pluriannual funding. M.A. Silva was supported by an FCT postdoctoral grant (SFRH/ BPD/29841/2006). I. Cascão and R. Prieto were supported by FCT doctoral grants (SFRH/BD/ 41192/2007 and SFRH/BD/32520/2006, respectively) and R. Prieto by a research grant from the Azores Regional Fund for Science and Technology (M3.1.5/F/115/2012). Data collection by SECAC (Society for the Study of Cetaceans in the Canary Archipelago) was funded by the U.E. LIFE programme – project LIFE INDEMARES (LIFE 07/NAT/E/000732)- and the Fundación Biodiversidad, under the Spanish Ministry of Environment, Rural and Marine Affairs (project ZEC-TURSIOPS).2014-11-0

Pathways to paediatric urology subspecialisation:a study of casemix, incumbent attitudes and opinions

Objective: To identify any self-reported differences or attitudes towards certification, publication, or practice patterns between adult urology and paediatric general surgery-trained paediatric urology providers. There are no known published differences in clinical/operative/research outcomes in either group. Methods: An 18-item cross-sectional survey was compiled through the EAU Young Academic Urologists (YAU) office and disseminated to a trans-Atlantic convenience sample of current practising paediatric urologists. This was created using a mini-Delphi method to provide current semi-quantitative data relating to current opinions and attitudes of this cohort. Results: A total of 228 respondents completed the survey, with female respondents representing 37% and 34% for urology and paediatric general surgery, respectively. Nearly 90% overall respondents felt that a full 2-year paediatric fellowship program was very important and 94% endorsed a collaborative dedicated paediatric urology on call service, with 92% supporting the joint development of transitional care. Urology managed higher numbers of bedwetting (p = 0.04), bladder bowel dysfunction (p = 0.02), endourological procedures (p = 0.04), and robotics (p = 0.04). Paediatric general surgery managed higher numbers of laparoscopic reconstruction (p = 0.03), and posterior urethral valve ablation (p = 0.002). Conclusion: This study represents the first time that a cross-sectional cohort of paediatric urologists from different training backgrounds were compared to assess their productivity, practice patterns and attitudes. Paediatric urology is in a unique position to have two contributing specialities, with the ability to provide optimal transitional and lifelong care. We believe that there should be a strong emphasis on collaboration and to remove any historically-created barriers under policies of equity, diversity and inclusivity.</p

The relative and absolute timing accuracy of the EPIC-pn camera on XMM-Newton, from X-ray pulsations of the Crab and other pulsars

Reliable timing calibration is essential for the accurate comparison of XMM-Newton light curves with those from other observatories, to ultimately use them to derive precise physical quantities. The XMM-Newton timing calibration is based on pulsar analysis. However, as pulsars show both timing noise and glitches, it is essential to monitor these calibration sources regularly. To this end, the XMM-Newton observatory performs observations twice a year of the Crab pulsar to monitor the absolute timing accuracy of the EPIC-pn camera in the fast Timing and Burst modes. We present the results of this monitoring campaign, comparing XMM-Newton data from the Crab pulsar (PSR B0531+21) with radio measurements. In addition, we use five pulsars (PSR J0537-69, PSR B0540-69, PSR B0833-45, PSR B1509-58 and PSR B1055-52) with periods ranging from 16 ms to 197 ms to verify the relative timing accuracy. We analysed 38 XMM-Newton observations (0.2-12.0 keV) of the Crab taken over the first ten years of the mission and 13 observations from the five complementary pulsars. All the data were processed with the SAS, the XMM-Newton Scientific Analysis Software, version 9.0. Epoch folding techniques coupled with \chi^{2} tests were used to derive relative timing accuracies. The absolute timing accuracy was determined using the Crab data and comparing the time shift between the main X-ray and radio peaks in the phase folded light curves. The relative timing accuracy of XMM-Newton is found to be better than 10^{-8}. The strongest X-ray pulse peak precedes the corresponding radio peak by 306\pm9 \mus, which is in agreement with other high energy observatories such as Chandra, INTEGRAL and RXTE. The derived absolute timing accuracy from our analysis is \pm48 \mus.Comment: 16 pages, 9 figures. Accepted for publication on A&