bluuebunny/crossref_metadata_2025 huggingface dataset:
TRBP alters human precursor microRNA processing in vitro
Authors: Lee Ho Young , Doudna Jennifer A.
Published: September 2012

MicroRNAs play central roles in controlling gene expression in human cells. Sequencing data show that many miRNAs are produced at different levels and as multiple isoforms that can vary in length at their 5′ or 3′ ends, but the biogenesis and functional significance of these RNAs are largely unknown. We show here that the human trans-activation response (TAR) RNA binding protein (TRBP), a known molecular partner of the miRNA processing enzyme Dicer, changes the rates of pre-miRNA cleavage in an RNA-structure-specific manner. Furthermore, TRBP can trigger the generation of iso-miRNAs (isomiRs) that are longer than the canonical sequence by one nucleotide. We show that this change in miRNA processing site can alter guide strand selection, resulting in preferential silencing of a different mRNA target. These results implicate TRBP as a key regulator of miRNA processing and targeting in humans.
The current and future direction of the General Dental Council
Authors: O’Brien Kevin
Published: September 2012

I have been asked to provide an update on the way that we see the General Dental Council (GDC) evolving over the duration of time that I will be Chairman (until September 2013). I have been in post for almost twelve months and am pleased to report that we are seeing a consistent improvement in performance across all areas. This is due to the improved working of the council and the extraordinary effort that the chief executive, the executive directors and all the staff have put in over the last year.
If ever we needed clinical leadership, it is now
Authors: Lees Peter , Mitchell Laura
Published: September 2012

Thanks to the recession, the National Health Service (NHS) is in a dangerous place. If we are to still have an NHS with the founding principles we hold dear, there needs to be a concerted effort to deliver new models of care that protect and enhance quality while reducing costs. The scale of the challenge (£20 billion and rising) is such that this will not be resolved by central dictate or by local management. Instead, it needs full engagement of clinicians who truly understand how to deliver care and how to deliver it better, now.
The management of unerupted maxillary incisors
Authors: Chawla Ourvinder , Atack Nicola
Published: September 2012

Missing upper centrals incisors can have a major effect on a patients’ self esteem, psychological wellbeing and can also be a significant concern for parents. It is important that this problem is detected and managed as early as possible to minimise these negative consequences. This article offers a summary of the updated guidelines on the management of unerupted maxillary incisors, published by The Royal College of Surgeons of England.1
Impacted maxillary canines: contemporary management and review of the literature
Authors: Doğramacı Esma J , Naini Farhad B
Published: September 2012

Management of impacted maxillary canines forms a sizeable proportion of orthodontic treatment provided in dental school and district general hospital settings. Patients presenting with impacted canines fall into the highest category on the Index of Orthodontic Treatment Need (IOTN). Patients who agree to have surgical exposure and subsequent orthodontic alignment of an impacted canine are committing themselves to a course of treatment that could take up to three years, towards the end of which the patient's enthusiasm may be waning. Prevention, or at least early interception of the impacted canine, could save a protracted course of treatment and avert not only the surgical morbidity associated with exposure of the impacted tooth but also the general risks associated with orthodontic treatment.
Dip into the garden of e-Den
Authors: Lambert-Humble Stephen , Brunton Paul
Published: September 2012

Back in the days when the NHS had money, especially for training its workforce, e-Learning for Healthcare (e-LfH) was formed with the express aim of providing an electronic learning resource for the entire NHS workforce. One of the first disciplines (after radiology) to be progressed was dentistry; the programme was named e-Den: an electronic dental learning platform was born.
Different Strategies for Controlling Output Power Smoothing of a PMSG-Based Wind Energy Conversion Systems
Authors: Pratap Alok , Howlader Abdul Motin , Senjyu Tomonobu , Yona Atsushi , Urasaki Naomitsu , Funabashi Toshihisa
Published: September 2012

This paper deals with controlling the output power smoothing of a wind energy conversion systems (WECS) by using permanent magnet synchronous generator (PMSG). It uses the inertia control of the wind turbine and DC-link voltage control. The PMSG is connected to the grid through a generator-side converter and a grid-side inverter based on AC-DC-AC methods. The generator-side converter is used to control the torque of the PMSG while the grid-side inverter is used to control DC-Link voltage and grid voltage. Fuzzy logic is implemented to determine the torque command by using inertia of wind turbine. The inputs of the fuzzy logic are given by the operating point of the rotational speed of the PMSG and the difference between the wind turbine torque and the generator torque. From the proposed method, the generator torque is smoothed and kinetic energy generated by the inertia of the wind turbine is used to smooth the power fluctuations of PMSG. Also, a stable operation of WECS is achieved during the system fault by using the chopper circuit in the DC-link circuit. The output power smoothing is achieved with stability and low cost. The effectiveness of the proposed method is verified by the numerical simulations.
Response Surface Evaluation of the Sensory Quality of Turkish Dry Fermented Sausage (sucuk) as Affected by Ripening Period, Nitrite Level and Heat Treatment
Authors: Kurt Şükrü , Zorba Ömer
Published: September 2012

In order to determine the potential for the reduction of nitrite levels and ripening period with heat treatment, the effects of the ripening period (1, 3, 7, 11 and 13 days), nitrite level (45, 70, 120, 170 and 195 ppm) and heat treatment (30, 40, 60, 80 and 90 °C) on the sensory quality of sucuk were investigated using central composite rotatable design setup based upon response surface methodology. The linear and quadratic effects of the ripening period and heat treatment were found to be significant for the sensory quality. However, the effects of higher nitrite levels on the sensory parameters of sucuk were not found to be significant (p>0.05). Optimum values for the ripening period, heat level and nitrite level for overall acceptability were 8 days, 59.3 °C and 109.4 ppm, respectively.
Experience Benefits and Firm Organization
Authors: Alger Ingela , Ma Ching-to Albert , Renault Regis
Published: September 2012

A principal needs a worker for the production of a good. The worker can be hired as an internal agent, or an external agent under a contract. These two organizational modes correspond to in-house production and outsourcing, respectively. In each case, the agent earns experience benefits: future monetary returns from managing production, reputation, and enjoyment. The principal would like to extract experience benefits, and can do so when production is outsourced. However, the external agent earns information rent from private information about production costs. The principal cannot fully extract experience benefits when production is in-house because the internal agent must be provided with a minimum income, although the principal has full information on production costs. Our theory proposes a new trade-off, one between information rent under outsourcing and experience rent under in-house production. The principal chooses outsourcing when experience benefits are high, but her organizational choice may be socially inefficient.
Erdős–Rényi graph, Szemerédi–Trotter type theorem, and sum-product estimates over finite rings
Authors: Thang Pham Van , Vinh Le Anh
Published: September 2012

We study a variant of Erdős–Rényi graph over finite rings. We then use this graph to obtain a Szemerédi–Trotter type theorem a sum-product estimate in finite rings.
Micromechanical detection of growth stress in wood cell wall by wide-angle X-ray diffraction (WAX)
Authors: Toba Keisuke , Yamamoto Hiroyuki , Yoshida Masato
Published: September 2012

The present study is aimed at the detection of mechanical stresses generated in the cellulose microfibril (CMF) crystals situated in the secondary wall (S2) of living cells. Green wood specimens were boiled in water to release the internal stress in the CMF by the hygrothermal softening of the lignin-hemicellulose matrix (MT). Thereafter, the changes in d
200 and d
004 lattice spacings of crystalline cellulose were observed in boiled and nonboiled samples by wide-angle X-ray diffraction. The d
200 lattice spacing increased, whereas d
004 lattice spacing decreased. The results show that a mechanical stress still remained in the CMF and the MT region in the green cell wall, even after releasing the macroscopic surface growth stresses by removal of the wood block from the living stem. The interpretation is that CMF generates tensile stress in the longitudinal direction, and surrounding MT substances generate compressive stress in the living cell wall, which compresses the CMF in the lateral direction. The results confirm the “unified hypothesis” for explaining the mechanism of growth stress generation.
The influence of hot-press temperature and cooling rate on thermal and physicomechanical properties of bamboo particle-polylactic acid composites
Authors: Wu Tung-Lin , Chien Yi-Chi , Chen Tsai-Yung , Wu Jyh-Horng
Published: September 2012

Extrusion and injection moldings are standard processes for fabricating natural fiber-reinforced plastic composites, but both processes are generally not suitable for production of large-size pieces and products with high loadings of lignocelluloses. In this study, a medium-density bamboo plastic composite (BPC) was completely and successfully manufactured from bamboo fibers and polylactic acid (PLA) in the ratio of 1:1 by the flat-platen pressing process. The effects of pressing and cooling parameters on the thermomechanical properties of the BPCPLA have been investigated. The BPCPLA prepared at temperatures >180°C and cooling rates >10°C min-1 exhibited superior mechanical properties and matrix crystallinity. Under these conditions, a stronger interaction between the filler and the polymer matrix occurs and the mobility of the molecular chains at the interface decreases, which leads to a higher stiffness of the composite.
Activities of FexO in Industrial Slags Used for External Removal of Phosphorous from Hot Metal
Authors: Uchida Yu-ichi , Kishimoto Yasuo , Miki Yuji , Iwase Masanori
Published: September 2012

In order to obtain a physicochemical knowledge of complex industrial slags, the activities of FexO in the industrial slags used for external dephosphorization of hot metal performed at practical steelmaking plants in Japan were measured by means of a solid-oxide galvanic cell in a temperature range between 1523 K and 1673 K. XRD study showed the presence of solid phases in all the slags, showing the heterogeneous character of the slags employed. With respect to the effect of CaF2 on FexO activity, the FexO activities of the heterogeneous slags were correlated with the ratio X(FeO)/X(CaF2). High X(FeO)/X(CaF2) values corresponded to high FeO activity. This tendency is interpreted based on the phase relationship in a CaO-CaF2-FexO ternary system. A favorable condition for external dephosphorization with less addition of CaF2 is discussed.
Recent Development in the Investigation on Thermal Conductivity of Silicate Melts
Authors: Hasegawa Hiroki , Ohta Hiromichi , Shibata Hiroyuki , Waseda Yoshio
Published: September 2012

Accurate values of thermal conductivity of the silicate melts systematically measured as a function of chemical composition are necessary to understand a mechanism of heat transfer in the silicate melts. Hot wire method and laser flash methods have been used to measure thermal conductivity or thermal diffusivity of oxides melts at high temperatures. Laser flash method has been improved to measure thermal diffusivity of oxides melts with high accuracy. However the effects of radiative heat transfer and low electrical resistivity of samples have been made it difficult to derive precise values. To overcome these difficulties, a front-heating front-detection laser flash method with use of high time resolution detector has been proposed. The temperature response at the bottom surface of thin platinum cell containing sample irradiated by pulse laser is measured. The measurement techniques used for measurement oxide melts are compared. Then, thermal conductivity of Al2O3-Na2O-CaO-SiO2 silicate melts was measured at temperature up to 1830 K. Thermal conductivity of the molten silicate shows insignificant temperature dependence for all investigated melts. A fairly good correlation has been found between the thermal conductivity and the value of NBO/T (Non-Bridging Oxygen ions/Tetrahedrally coordinated cation) calculated from the chemical composition. The thermal conductivity increases with decrease of NBO/T for small NBO/T value and becomes constant for larger NBO/T value.
Thermodynamic Prediction of Spinodal Decomposition in Multi-component Silicate Glass for Design of Functional Porous Glass Materials
Authors: Suzuki Masanori , Tanaka Toshihiro
Published: September 2012

The authors have investigated metastable phase separation in multi-component silicate glass for the fabrication of porous glass from multi-component slag. Spinodal decomposition forms an interconnected microstructure in glass spontaneously, and porous glass is obtained by leaching one of the decomposed phases with an acid solution. This porous glass can be used for a filter to remove impurities in polluted water or air. In this study, the metastable miscibility gap was predicted in multi-component silicate glass using thermodynamic analyses where glass was regarded as a super-cooled liquid phase. Occurrence of spinodal decomposition was observed in annealed glass, and it corresponded to the predicted miscibility gap. Then, we fabricated porous glass using spinodal decomposition in multi-component borosilicate glass and by removing one of the decomposed phases. Furthermore, for the creation of functional porous glass applicable for environmental purification, the spinodal decomposition was prepared in multi-component borosilicate glass containing titanium oxide based on the predicted metastable miscibility gap in multi-component silicate glass.
Additions of Salt Cake and KAlF4 from Aluminum Production to Steelmaking Slags
Authors: Sweet G.A. , Ferenczy S. , Caley W.F. , Kipouros G.J.
Published: September 2012

Fluorspar, a mineral primarily composed of CaF2 is the most commonly used slag fluidizer in steelmaking. Due to increasing costs for fluorspar steelmakers are seeking alternative means of achieving slag fluidity. The research has concentrated on other minerals or the wastes of other high temperature operating industries. A promising alternative to fluorspar has been identified in a previous work from this laboratory which is the salt cake from secondary aluminum production such as the flux in remelting aluminum scrap and dross. This material is widely available and also considered toxic (meaning that use in steelmaking helps to reduce environmental impacts from disposal). The present work is an investigation of the viability of using mixtures of salt cake and KAlF4 in slag-fluidizing applications by measurements of viscosity and weight loss at high temperatures (to evaluate whether large amounts of potentially harmful gases are formed). In addition, characterization of raw materials and melted slags has been performed. In terms of fluidity the mixtures of aluminum salt cake and KAlF4 are qualified for use as fluidizers. The results of the present study will be used to design plant trials.
Amitriptyline Cream Ingestion in a 1-Year-Old Boy
Authors: Lak Nathalie S.M. , Malingre Mirte M. , Hogeman Paul H.G.
Published: September 2012

A 1-year-old boy presented to the emergency department with drowsiness after intoxication from amitriptyline cream. The amitriptyline level in his blood was in the high-therapeutic range for adults. He was admitted for cardiac monitoring. Except for a short episode with irregular heart rate, he recovered completely within 24 hours without adjuvant treatment. Amitriptyline is known as an antidepressant but is also prescribed for neuropathic pain. It is usually prescribed in tablet form; the cream is a novel application. In children, intoxication with amitriptyline may cause drowsiness, seizures, coma, hypotension, tachycardia, and life-threatening cardiac arrhythmias. This is the first case report presenting intoxication in a child with amitriptyline cream. It stresses the importance of keeping children away from the medicine cabinet, even from creams or ointments.
Increased Expression of the Glucocorticoid Receptor β in Infants With RSV Bronchiolitis
Authors: Diaz Patricia V. , Pinto Ricardo A. , Mamani Rossana , Uasapud Paola A. , Bono Maria R. , Gaggero Aldo A. , Guerrero Julia , Goecke Annelise
Published: September 2012

OBJECTIVES:

The majority of studies on glucocorticoid treatment in respiratory syncytial virus (RSV) bronchiolitis concluded that there are no beneficial effects. We hypothesized that RSV-infected patients may have an increased glucocorticoid receptor (GR) β expression, the isoform that is unable to bind cortisol and exert an antiinflammatory action.

METHODS:

By using real-time polymerase chain reaction, we studied the expression of α and β GR in the peripheral blood mononuclear cells obtained from 49 RSV-infected infants (<1 year of age) with severe (n = 29) and mild to moderate (n = 20) illness. In plasma, we analyzed the level of cortisol by radioimmunoassay and inflammatory cytokines interleukin (IL)-10, IL-6, tumor necrosis factor-α, IL-1β, IL-8, IL-12p70, IL-2, IL-4, IL-5, interferon-γ, and IL-17 by cytometric beads assay. Statistical analysis was performed by nonparametric analysis of variance.

RESULTS:

We found a significant increase of β GR expression in patients with severe illness compared with those with mild disease (P < .001) and with a group of healthy controls (P < .01). The α:β GR ratio decreased significantly in infants with severe disease compared with those with mild illness (P < .01) and with normal controls (P < .001). The expression of β GR was positively correlated with the clinical score of severity (r = .54; P < .0001).

CONCLUSIONS:

The decrease of the α:β GR ratio by an increase of β receptors expression is related to illness severity and may partly explain the insensitivity to corticoid treatment in RSV-infected infants. The increased expression of β GR could be a marker of disease severity.
Evaluation of Interobserver Agreement of Apgar Scoring in Preterm Infants
Authors: Bashambu Monuj T. , Whitehead Halana , Hibbs Anna Maria , Martin Richard J. , Bhola Monika
Published: September 2012

BACKGROUND AND OBJECTIVES:

Apgar scoring is accepted by medical professionals both as a measure of the infant’s clinical status and the infant’s response to resuscitation. Recent studies, however, have suggested significant variability when used for scoring preterm infants. We hypothesized that agreement in Apgar scoring would improve with increasing gestational age and at low levels of respiratory support. We also hypothesized that grimace and muscle tone would demonstrate the least agreement.

METHODS:

Neonatologists from the Perinatal Section of the American Academy of Pediatrics were presented with 4 film clip cases via a secure online survey: (1) full-term infant in room air; (2) 28 weeks’ gestation infant with continuous positive airway pressure; (3) 28 weeks’ gestation infant intubated; and (4) 24 weeks’ gestation infant intubated. Participants were shown 30-second clips at 1, 5, and 10 minutes of life and were asked to provide Apgar scores. κ coefficients were used to compare agreement for each component.

RESULTS:

A total of 335 neonatologists participated in the survey. κ coefficients in the full-term infant for respiratory effort (0.94, 0.91), grimace (0.91, 0.90), and muscle tone (0.91, 0.89) demonstrated almost perfect agreement at 1 and 5 minutes. For preterm infants, respiratory effort (range: 0.07–0.40), muscle tone (range: 0.10–0.75), and grimace (range: 0.11–0.71) all demonstrated disagreement at 1, 5, and 10 minutes of life unless the infants were apneic and limp.

CONCLUSIONS:

An improved delivery room score that decreases variability among medical care professionals is needed to accurately reflect the clinical status of preterm infants.
Erythropoietin for Neuroprotection in Neonatal Encephalopathy: Safety and Pharmacokinetics
Authors: Wu Yvonne W. , Bauer Larry A. , Ballard Roberta A. , Ferriero Donna M. , Glidden David V. , Mayock Dennis E. , Chang Taeun , Durand David J. , Song Dongli , Bonifacio Sonia L. , Gonzalez Fernando F. , Glass Hannah C. , Juul Sandra E.
Published: September 2012

OBJECTIVE:

To determine the safety and pharmacokinetics of erythropoietin (Epo) given in conjunction with hypothermia for hypoxic-ischemic encephalopathy (HIE). We hypothesized that high dose Epo would produce plasma concentrations that are neuroprotective in animal studies (ie, maximum concentration = 6000–10 000 U/L; area under the curve = 117 000–140 000 U*h/L).

METHODS:

In this multicenter, open-label, dose-escalation, phase I study, we enrolled 24 newborns undergoing hypothermia for HIE. All patients had decreased consciousness and acidosis (pH < 7.00 or base deficit ≥ 12), 10-minute Apgar score ≤ 5, or ongoing resuscitation at 10 minutes. Patients received 1 of 4 Epo doses intravenously: 250 (N = 3), 500 (N = 6), 1000 (N = 7), or 2500 U/kg per dose (N = 8). We gave up to 6 doses every 48 hours starting at <24 hours of age and performed pharmacokinetic and safety analyses.

RESULTS:

Patients received mean 4.8 ± 1.2 Epo doses. Although Epo followed nonlinear pharmacokinetics, excessive accumulation did not occur during multiple dosing. At 500, 1000, and 2500 U/kg Epo, half-life was 7.2, 15.0, and 18.7 hours; maximum concentration was 7046, 13 780, and 33 316 U/L, and total Epo exposure (area under the curve) was 50 306, 131 054, and 328 002 U*h/L, respectively. Drug clearance at a given dose was slower than reported in uncooled preterm infants. No deaths or serious adverse effects were seen.

CONCLUSIONS:

Epo 1000 U/kg per dose intravenously given in conjunction with hypothermia is well tolerated and produces plasma concentrations that are neuroprotective in animals. A large efficacy trial is needed to determine whether Epo add-on therapy further improves outcome in infants undergoing hypothermia for HIE.
Assessment and Management of Inguinal Hernia in Infants
Authors: Wang Kasper S. ,   COMMITTEE ON FETUS AND NEWBORN,   SECTION ON SURGERY, Papile Lu-Ann , Baley Jill E. , Benitz William , Cummings James , Carlo Waldemar A. , Kumar Praveen , Polin Richard A. , Tan Rosemarie C. , Watterberg Kristi L. , Brandt Mary L. , Shamberger Robert C. , Caty Michael G. , Heiss Kurt F. , Holcomb George W. , Meyers Rebecka L. , Moss R. Lawrence , Rescorla Frederick J.
Published: September 2012

This Clinical Report was reaffirmed May 2021.

Inguinal hernia repair in infants is a routine surgical procedure. However, numerous issues, including timing of the repair, the need to explore the contralateral groin, use of laparoscopy, and anesthetic approach, remain unsettled. Given the lack of compelling data, consideration should be given to large, prospective, randomized controlled trials to determine best practices for the management of inguinal hernias in infants.
Trampoline Safety in Childhood and Adolescence
Authors:   COUNCIL ON SPORTS MEDICINE AND FITNESS
Published: September 2012

Despite previous recommendations from the American Academy of Pediatrics discouraging home use of trampolines, recreational use of trampolines in the home setting continues to be a popular activity among children and adolescents. This policy statement is an update to previous statements, reflecting the current literature on prevalence, patterns, and mechanisms of trampoline-related injuries. Most trampoline injuries occur with multiple simultaneous users on the mat. Cervical spine injuries often occur with falls off the trampoline or with attempts at somersaults or flips. Studies on the efficacy of trampoline safety measures are reviewed, and although there is a paucity of data, current implementation of safety measures have not appeared to mitigate risk substantially. Therefore, the home use of trampolines is strongly discouraged. The role of trampoline as a competitive sport and in structured training settings is reviewed, and recommendations for enhancing safety in these environments are made.
Fertility Preservation and Pregnancy in Women With and Without BRCA Mutation–Positive Breast Cancer
Authors: Rodriguez-Wallberg Kenny A. , Oktay Kutluk
Published: September 2012

Learning Objectives

After completing this course, the reader will be able to: Discuss the difficulties in fertility preservation for women with BRCA positive/negative breast cancer.Cite some of the effective methods for preserving fertility.Describe the utilization of aromatase inhibitors as ovarian stimulants to reduce estrogen exposure in women with breast cancer attempting fertility preservation via embryo or oocyte cryopreservation.

CME This article is available for continuing medical education credit at CME.TheOncologist.com

Women with breast cancer face many challenges when considering fertility preservation. Delayed referral results in the limitation of fertility preservation options because most established methods, such as embryo and oocyte cryopreservation, require several weeks to complete. Women with BRCA mutations, on the other hand, may be more aware of fertility issues and motivated to see fertility preservation specialists earlier. Fear of exposure to estrogen limits access to fertility preservation via embryo or oocyte cryopreservation; however, the use of aromatase inhibitors as ovarian stimulants reduces such concern. Ovarian cryopreservation can be used when there is insufficient time to perform ovarian stimulation because this technique does not require hormonal stimulation, but there are safety concerns both in women with BRCA mutations and in patients with hormone receptor–positive disease as well. There does not seem to be a proven ovarian suppression strategy to preserve fertility in women with breast cancer. Pregnancy appears to be safe for breast cancer survivors but studies specific for women with BRCA mutations are lacking. Women with BRCA mutations may elect to use preimplantation genetic diagnosis during in vitro fertilization to avoid transmitting the mutation, but there may be psychosocial difficulties in entertaining this option. Overall, the last decade has brought many options for women with breast cancer considering fertility preservation, but numerous challenges remain. The presence of BRCA mutations further contributes to these challenges.
Optimizing the Management of Prostate Cancer in Senior Adults: Call to Action
Authors: Fitzpatrick John M.
Published: September 2012

This article briefly reviews the current state of therapy for older patients with prostate cancer and provides a call-to-action highlighting the need for an improved global standard of care in this patient population.
A Comment on the International Society of Geriatric Oncology Guidelines: Evidence-Based Advice for the Clinical Setting
Authors: Fitzpatrick John M. , Graefen Markus , Payne Heather A. , Scotté Florian , Aapro Matti S.
Published: September 2012

Largely a disease of older men, prostate cancer is likely to become a growing burden in the developed world as the population ages and overall life expectancy increases. Furthermore, prostate cancer management in older men is not optimal, reflecting the lack of training dedicated to senior adults in fellowship programs and the lack of specific guidelines to manage senior adults. The International Society of Geriatric Oncology (SIOG) convened a multidisciplinary Prostate Cancer Working Group to review the evidence base and provide advice on the management of the disease in senior age groups. The Working Group reported that advancing age, by itself, is not a reliable guide to treatment decision making for men with either localized or advanced prostate cancer. Instead, the SIOG guidelines advise health care teams to assess the patient's underlying health status, which is largely dictated by associated comorbid conditions, but also by dependency in activities of daily living and nutritional status, and to use the findings to categorize the individual into one of four groups: healthy, vulnerable, frail, or terminally ill. The guidelines recommend that a patient categorized as healthy or vulnerable (i.e., with reversible problems following geriatric intervention) should receive the same approach to treatment as a younger patient. Frail patients should be managed using adapted treatment strategies, and the terminally ill should receive symptomatic/palliative care only. The guidelines may have ongoing relevance as the treatment options for prostate cancer expand.
Multiple Victimization Experiences, Resources, and Co-Occurring Mental Health Problems Among Substance-Using Adolescents
Authors: Sabri Bushra , University Johns Hopkins , Coohey Carol , Campbell Jacquelyn
Published: September 2012

This study examined the relationship between multiple types of victimization experiences, psychological and social resources, and co-occurring mental health problems among substance-using adolescents. Data for this cross-sectional study were obtained from a multisite research project in which adolescents ages 11–18 years participated in a comprehensive screening program for substance misuse. Multiple types of victimization, low self-efficacy beliefs, lack of support for victimization issues, and available sources of emotional support were positively related to co-occurring mental health problems. These findings suggest that treatment planning and interventions may focus on helping adolescents cope effectively with their victimization experiences and addressing their mental health needs. Particular emphasis may be placed on enhancing self-efficacy and social skills so that adolescents may benefit from their available sources of social support.
Comparison of Surgical Stripping; Erbium‐Doped:Yttrium, Aluminum, and Garnet Laser; and Carbon Dioxide Laser Techniques for Gingival Depigmentation: A Clinical and Histologic Study
Authors: Hegde Rashmi , Padhye Ashvini , Sumanth S. , Jain A. Sanjay , Thukral Naresh
Published: September 2012

Background: Gingival melanin depigmentation procedures are commonly associated with recurrence of pigmentation, which starts with migration of melanocytes from the adjacent free gingiva. The extent and rate of recurrence varies according to the treatment modalities used and duration of follow‐up. The aim of this study is to compare the surgical stripping; carbon dioxide (CO2); and erbium‐doped:yttrium, aluminum, and garnet (Er:YAG) laser techniques for gingival depigmentation and to evaluate their effect on histologic changes in melanocyte activity and clinical repigmentation.

Methods: In this study, 140 sites from 35 patients with bilateral melanin hyperpigmentation were treated with surgical stripping (two sites per patient), “epithelial‐peel” (CO2 laser, 2 to 4 W, continuous wave),and “brushstroke” (Er:YAG laser, 180 mJ, 10 Hz, long pulse) techniques. Surgical microscope monitoring was performed intraoperatively. Patient preference and perception of pain, change in Dummett oral pigmentation index (DOPI), Hedin index, and change in area of pigmentation from baseline to 6 months postoperatively were recorded. Twenty samples each from the three treatment modalities were selected for histologic analysis using hematoxylin and eosin and dihydroxyphenylalanine oxidase special stains.

Results: At the 6‐month postoperative visit, 15 of 70 (21.4%) and three of 20 (15%) of the surgical‐treated; 10 of 35 (28.6%) and six of 20 (30%) of the Er:YAG‐laser‐treated; and eight of 35 (22.8%) and four of 20 (20%) of the CO2‐laser‐treated sites showed clinical and histologic repigmentation, respectively. Paired t test, analysis of variance, and χ2 tests were used for statistical analyses. P values for comparison of microscopic evaluation, change in DOPI, Hedin index, and area of pigmentation were 0.001, which were statistically significant. Comparison for patient preference and pain indices gave statistically significant values for Er:YAG laser depigmentation (P = 0.001).

Conclusions: Clinical repigmentation after gingival depigmentation is an outcome of histologic changes in the melanocyte activity and density of the melanin pigments. Surgical stripping for gingival depigmentation remains the gold standard; however, Er:YAG laser and CO2 lasers can be effectively used but with distinct differences.
Bone‐to‐Implant Contact Around Immediately Loaded Direct Laser Metal‐Forming Transitional Implants in Human Posterior Maxilla
Authors: Shibli Jamil A. , Mangano Carlo , Mangano Francesco , Rodrigues José A. , Cassoni Alessandra , Bechara Karen , Ferreia Jose Divino B. , Dottore Alexandre M. , Iezzi Giovanna , Piattelli Adriano
Published: September 2012

Objective:Direct laser metal forming (DLMF) is a procedure in which a high‐power laser beam is directed onto a metal powder bed and programmed to fuse particles according to a computer‐aided design file, generating a thin metal layer. This histologic study evaluated the bone‐to‐implant contact (BIC%) around immediately loaded DLMF transitional implants retrieved after 2 months from posterior human maxillae.

Methods:Twelve totally edentulous individuals (mean age, 66.14 ± 2.11 years) received DLMF transitional implants divided in twelve immediately loaded (IL) and twelve unloaded (UI) implants. These transitional implants were placed between conventional implants to support the interim complete maxillary denture during the healing period. After 8 weeks, the transitional implants and the surrounding tissue were removed and prepared for histomorphometric analysis.

Results:Mature woven preexisting bone lined by newly formed bone in early stages of maturation were found around all retrieved implants. Histometric evaluation indicated that the mean BIC% was 45.20 ± 7.68% and 34.10 ± 7.85% for IL and UI, respectively (P<0.05).

Conclusion:The present data obtained in humans showed that, although both IL and UI presented good BIC%, IL DLMF implants had a higher BIC% in the posterior maxilla.
Doxycycline‐Loaded β‐Tricalcium Phosphate Release Following EDTA Root Surface Etching Improved the Clinical Outcomes in Chronic Periodontitis: An In Vivo Study
Authors: Gamal Ahmed Y. , Kumper Radi M. , Al Gendy Abd El Reheem R.
Published: September 2012

Background: The main objective of the present study is to quantify doxycycline (DOX) release from β‐tricalcium phosphate (β‐TCP) after EDTA root surface treatment.

Methods: Thirty systemically healthy patients with ≥1 paired contralateral interproximal intrabony defect ≥4 mm deep along with an interproximal probing depth ≥6 mm and clinical attachment level ≥4 mm were randomized into two groups. Group 1 (G1) consisted of sites treated with open flap debridement followed by placement of DOX blended with β‐TCP (DOX‐β‐TCP), whereas group 2 (G2) sites were treated with flap surgery followed by the placement of DOX blended with β‐TCP after EDTA etching of the exposed root surfaces (DOX‐β‐TCP + EDTA). Samples of gingival crevicular fluid (GCF) were obtained 1, 3, 7, 14, and 21 days after surgery. Quantitative measurements of DOX were taken with high‐performance liquid chromatography. Clinical evaluation and follow‐up for 6 months were performed.

Results: At 21 days, the DOX‐β‐TCP + EDTA–treated group showed a 194.7 µg/mL value. The DOX‐β‐TCP + EDTA–treated group retained more DOX during the periods of 3, 7, 10, 14, and 21 days than the DOX‐β‐TCP–treated group. Six months after therapy, DOX‐β‐TCP + EDTA–treated sites showed more significant clinical improvements compared to DOX‐β‐TCP–treated sites (P ≤ 0.05).

Conclusions: EDTA root surface etching enhances DOX availability in the GCF following its release from β‐TCP as a drug carrier.
Induction of Toll‐Like Receptor Expression by Porphyromonas gingivalis
Authors: Wara‐aswapati Nawarat , Chayasadom Anek , Surarit Rudee , Pitiphat Waranuch , Boch Jason A. , Nagasawa Toshiyuki , Ishikawa Isao , Izumi Yuichi
Published: September 2012

Background: Toll‐like receptors (TLRs) play pivotal roles in host immune responses and have been suggested to be involved in the development of many infectious diseases. In this study, the mRNA expression levels of TLR2, TLR4, and TLR9 and their relationship with periodontopathic bacteria in periodontal tissue are examined. Furthermore, the mechanism of TLR induction by Porphyromonas gingivalis is investigated in human gingival fibroblasts (HGFs).

Methods: Gingival tissue and subgingival plaque samples were collected from 19 patients with chronic periodontitis (CP) and 16 control individuals without periodontitis. Gene expression levels in the tissues and in HGFs were analyzed by reverse transcription‐polymerase chain reaction (RT‐PCR). The numbers of periodontopathic bacteria were determined by quantitative real‐time PCR.

Results: The expression levels of TLR2 and TLR9 were significantly higher in the tissues of patients with CP compared to the tissues of control individuals. The mRNA levels of TLR2 and TLR9, but not TLR4, were positively correlated with the number of P. gingivalis in subgingival plaque. P. gingivalis sonicated extract, P. gingivalis lipopolysaccharide, P. gingivalis DNA, and tumor necrosis factor‐α(TNF‐α) could significantly upregulate the mRNA expression of TLR2 in HGFs. Furthermore, P. gingivalis–mediated TLR2 expression was suppressed by TNF‐α antibody.

Conclusions: This study suggests that P. gingivalis infection induces TLR2 and TLR9 upregulation in patients with CP. P. gingivalis–induced TLR2 expression in HGFs is partially dependent on TNF‐α and may lead to sensitization of HGFs to bacterial components encountered in the periodontal microenvironment.
Aggressive Periodontitis Defined by Recursive Partitioning Analysis of Immunologic Factors
Authors: Papantonopoulos G. , Takahashi K. , Bountis T. , Loos B.G.
Published: September 2012

Background: The present study aims to extend recent findings of a non‐linear model of the progression of periodontitis supporting the notion that aggressive periodontitis (AgP) and chronic periodontitis (CP) are distinct clinical entities. This approach is based on the implementation of recursive partitioning analysis (RPA) to evaluate a series of immunologic parameters acting as predictors of AgP and CP.

Methods: RPA was applied to three population samples, that were retrieved from previous studies, using 17 immunologic parameters. The mean values of the parameters in control subjects were used as the cut‐off points. Leave‐one‐out cross‐validation (LOOCV) prediction errors were estimated in the proposed models, as well as the Kullback‐Leibler divergence (DKL) of the distribution of positive results in AgP compared to CP and negative results in CP compared to AgP.

Results: Seven classification trees were derived showing that the relationship of interleukin (IL)‐4, IL‐1, IL‐2 has the highest potential to rule out or rule in AgP. On the other hand, immunoglobulin (Ig)A, IgM used to rule out AgP and cluster of differentiation 4 (CD4)/CD8, CD20 used to rule in AgP showed the least LOOCV cost. Penalizing DKL with LOOCV cost promotes the IL‐4, IL‐1, IL‐2 model for ruling out AgP, whereas the single CD4/CD8 ratio with a lowered discrimination cut‐off point was used to rule in AgP.

Conclusions: Although a test is unlikely to have both high sensitivity and high specificity, the use of immunologic parameters in the right model can efficiently complement a clinical examination for ruling out or ruling in AgP.
Modeling and Simulation of Nanoparticle Transport in Multiphase Flows in Porous Media: CO2 Sequestration
Authors: El-Amin M. F. , Sun Shuyu , Salama Amgad
Published: September 2012

Geological storage of anthropogenic CO2 emissions in deep saline aquifers has recently received tremendous attention in the scientific literature. Injected CO2 plume buoyantly accumulates at the top part of the deep aquifer under a sealing cap rock, and some concern that the high-pressure CO2 could breach the seal rock. However, CO2 will diffuse into the brine underneath and generate a slightly denser fluid that may induce instability and convective mixing. Onset times of instability and convective mixing performance depend on the physical properties of the rock and fluids, such as permeability and density contrast. The novel idea is to adding nanoparticles to the injected CO2 to increase density contrast between the CO2-rich brine and the underlying resident brine and, consequently, decrease onset time of instability and increase convective mixing.

As far as it goes, only few works address the issues related to mathematical and numerical modeling aspects of the nanoparticles transport phenomena in CO2 storages. In the current work, we will present mathematical models to describe the nanoparticles transport carried by injected CO2 in porous media. Buoyancy and capillary forces as well as Brownian diffusion are important to be considered in the model. IMplicit Pressure Explicit Saturation-Concentration (IMPESC) scheme is used and a numerical simulator is developed to simulate the nanoparticles transport in CO2 storages.
The extension of EPANET source code to simulate unsteady flow in water distribution networks with variable head tanks
Authors: Avesani Diego , Righetti Maurizio , Righetti Davide , Bertola Paolo
Published: September 2012

This paper describes the modifications applied to EPANET, a public-domain water distribution system modelling software package, that does not correctly compute the hydraulics of a water distribution network (WDN) with variable tank heads in (slow) unsteady flow conditions. Firstly the methodology adopted to extend the Global Gradient Algorithm (GGA) implemented in the original EPANET source code to the Extended Period Simulation-GGA (EPS-GGA) is described. Then the convergence and stability conditions of the theta method, used for the discretisation in time of the set of differential equations describing the hydraulic behaviour of a WDN, are discussed. The reasons for EPS-GGA numerical stability are demonstrated and a fully implicit discretisation of differential equations (i.e. theta = 1) is suggested as the optimal choice as implicitly proposed in Giustolisi et al. but without theoretical justification. Both the modified and original versions of EPANET are applied to a particularly severe test case of a WDN. Moreover, the procedures for the correct numerical representation of the tanks' maximum and minimum level boundary conditions are developed and compared with previously proposed procedures. The modified version of EPANET source code does not show the significant instabilities which are evident in the original version, nor the lack of consistency due to the improper maximum and minimum level boundary condition schematisations formerly proposed in the scientific literature.
Principal component analysis of surface water quality data of the River Drava in eastern Croatia (24 year survey)
Authors: Gvozdić Vlatka , Brana Josip , Malatesti Nela , Roland Danijela
Published: September 2012

The River Drava is one of the major, inexhaustible water sources not only for Croatia, but also for the other European countries it flows through. This study is based on the observations of 15 water variables at three sampling stations in the lower River Drava over a 24 year period. Although the obtained results revealed an improvement of most of the parameters, the values of some of them (i.e. NH4-N, NO3-N, BOD5, total coliform and heterotrophic bacteria) are still above the approved limits for water Class II. The results of principal component analysis (PCA) confirmed an existence of three clearly separated zones. The first zone corresponds to a rural upstream part of River Drava, which is characterised with low level pollution. The influences of untreated domestic waters become more noticeable in the second more densely populated suburban zone (II) located upstream of the city of Osijek. According to the results of the PCA, untreated wastewaters from Osijek are becoming contributing factors to the high pollution level of the river in the third (III) suburban zone. This study shows the usefulness of the PCA method for analysis and interpretation of complex data sets as well as for determination of pollution sources.
Parameter calibration and uncertainty estimation of a simple rainfall-runoff model in two case studies
Authors: Zhang X. , Hörmann G. , Fohrer N. , Gao J.
Published: September 2012

The simple rainfall-runoff conceptual KIDS (Kielstau Discharge Simulation) model using PCRaster is applied to simulate continuously daily discharge of the Kielstau and XitaoXi basins. This work focuses on parameter calibration procedure and, in particular, assessment of model prediction uncertainty. We employ a simplistic analysis routine SUFI-2, coupled with the implementation of a Monte Carlo based sampling strategy for the joint investigation of parameter calibration and uncertainty estimation. The scatter plots of model performance and parameter exhibit high equifinality of parameter sets in fitting observations, while their histogram distribution patterns imply that most parameters can be well defined. This study investigates parameter sensitivities and finds interesting local results: soil and groundwater parameters are more sensitive in Kielstau models than in XitaoXi models, and only the soil parameters ‘Sfk’ and ‘Kc’ are found strongly correlated. Finally, the uncertainty bounds are always thin and the global shape of the hydrograph is well approximated for both basins. As the validated uncertainty bounds also represent the desired coverage (P factor >50%) of the observations, and the calculated R factor values are in the targeted range (R factor < 1), it demonstrates the efficiency and suitability of this revised SUFI method for the two case studies.
Estimating the impacts and uncertainty of changing spatial input data resolutions on streamflow simulations in two basins
Authors: Zhang X. , Hörmann G. , Fohrer N. , Gao J.
Published: September 2012

The impact of different grid resolutions of spatial input data on modelled river runoff are investigated using the simple rainfall-runoff model KIDS (Kielstau Discharge Simulations) in PCRaster modelling language for two watersheds – Kielstau and XitaoXi. In this study, the grid-based spatial data are aggregated to coarser resolutions to support the multi-resolution, multi-calibration and multi-site analysis for grid-scale investigations. Daily streamflow is simulated and model parameters are calibrated at each spatial resolution. The study suggests that re-calibration is critically needed when the grid resolution is changed. Altering grid sizes has an apparent impact on the parameter distribution patterns. Resolution uncertainty bands obtained by the overlapping hydrographs generated with different resolutions of input data are reported with a sufficient coverage of the observations for both basins. The analysis of model efficiency in terms of IC-ratio (a ratio between the input grid area and the catchment area) indicates that coarser resolutions with an IC-ratio of <0.001 may be used as an effective alternative for conducting preliminary analyses in streamflow simulation for the Kielstau basin. The modelling outputs are more sensitive to the spatial distribution of input data at the XitaoXi watershed, showing that accurate input data are required to achieve optimum modelling performance.