bluuebunny/crossref_metadata_2025 huggingface dataset:
Correlation to Serum Ionized Calcium and Magnesium Concentration with Sympathetic Nerve Functions in Type 2 Diabetes Mellitus
Authors: Alam Khairul , Begum Noorzahan , Begum Selina , Eva Hossnara
Published: February 2014

Background : In type 2 DM, a metabolic disorder causes disturbances of different metabolic processes of the body including electrolyte imbalance. Therefore changes in serum level of Ca2+ and Mg2+ may have some relationship to the occurrence of neuropathy. Objective : The study has been designed to observe the sympathetic nerve function status in type 2 diabetic subjects in order to assess the relationship between serum ionized calcium & magnesium. Study design : This cross section study was carried out in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. Forty seven type 2 diabetic subjects were included in two groups. Group B consisted of 25 recently diagnosed diabetic subjects aged 40-68 years and group C consisted of 22 subjects having duration of diabetes for 10-20 years. Twenty five (25) age and BMI matched healthy subjects were included in group A (non-diabetic) for control. Methods : Sympathetic nerve function were assessed by two simple non-invasive cardiovascular reflex tests. These were systolic blood pressure, response to lying to standing up and diastolic blood pressure response to distain hand grip test. Ionized serum calcium and magnesium were measured by ion sensitive electrode method using NOVA electrode. Data were analyzed by t test, Pearsons correlation co-efficient. Results: Serum ionized calcium levels were significantly higher in both the diabetic group B (P<0.001) and C (P<0.001) than that of control group A. Serum ionized magnesium level was significantly higher in diabetic group C (P<0.001) compared to that of control group A. Pearsons correlation of ionized calcium and magnesium with sympathetic nerve function parameters were done. Statistically significant relation was found in group B between sustained hand grip test with ionized calcium and in group C between systolic blood pressure response to standing with ionized magnesium. Conclusion : Serum ionized calcium & magnesium level was increased in type 2 diabetic patients irrespective of duration and some correlation was found with sympathetic nerve function parameters DOI: http://dx.doi.org/10.3329/updcj.v3i2.17991 Update Dent. Coll. j: 2013; 3 (2): 03-08
Effect of curing time on the strain at break of heat cured acrylic resin.
Authors: Islam Kazi Ziaul , Khan Md Ali Afzal
Published: February 2014

Objectives: The aim of this study was to find out the effect of curing time on the strain at break of heat cured acrylic resin (1) cured at 1000c with time difference. Methods : In this study , 60 heat cured acrylic resin samples were processed with compression moulding technique at 1000c among which each of 20 samples were cured for 20, 40 and 60 minutes separately. Strain at break of heat cured acrylic resin were determined by using the Universal Testing Machine(4) with the help of QMAT software in computer. Results : The ANOVA result showed that there was no significant differences among the groups with respect to the strain at break of heat cured acrylic resin. The p- value of strain at break of heat cured acrylic resin is 0.590. The mean strain at break of heat cured acrylic resin cured at 1000c for 20 minutes was 3.5458% , 40 minutes was 3.4195 % , 60 minutes was 3.3187 % and standard deviation respectively 0.4158 % , 3.8640 % , 0.3902 %. Conclusion : The strain at break of heat cured acrylic resin cured at 1000c for different period of time ( at 20 , 40 & 60 minutes ) have given no significant differences. DOI: http://dx.doi.org/10.3329/updcj.v3i2.17993 Update Dent. Coll. j: 2013; 3 (2): 09-12
Effect of gingival retraction cord and retraction paste on gingival tissue in fixed prosthodontics impression
Authors: Shamsuzzaman Mohammad , Quader Sheikh Md Shahriar , Fatema Shakila , Gofur Md Abdul , Akter Khaleda
Published: February 2014

Background & Objectives: Of the various gingival retraction systems available in the market, a cordless paste system is fairly new entrant into this field. This system promises to provide an easier method to obtain optimum retraction with excellent hemorrhage control. The present study was designed to clinically evaluate the efficacy of paste retraction system and medicated retraction cords on the basis of relative easy of working, hemorrhage control and amount of vertical gingival retraction. Methods: 40 subjects were selected requiring full veneer restoration where more than one abutment teeth were to be prepared. After the preparation of the abutment teeth flexible scales were used to measure the sulcus depth before retraction and after retraction. Medicated retraction cord technique was used on one abutment tooth and on the other abutment tooth paste retraction system was employed. Subjectively easy of placement and hemorrhage scores was assessed. Results: The mean time taken for paste retraction technique was 45.13 seconds and for medicated retraction cord technique was 105.4 seconds. In all the subjects paste retraction technique was relatively easier as compared with medicated retraction cord technique. Mean hemorrhage scores using paste retraction technique was 0.05 and using medicated retraction cord technique it was 1.70. Mean vertical gingival retraction using paste retraction technique was .36mm and using medicated retraction cord technique was 0.54mm Conclusion: Within the limitations of this study, paste retraction system requires reduced time for application, is easier to place, and provides excellent hemorrhage control in comparison to medicated retraction cord. However, medicated retraction cord provides increased amount of vertical retraction as compared to paste retraction technique. DOI: http://dx.doi.org/10.3329/updcj.v3i2.17995 Update Dent. Coll. j: 2013; 3 (2): 20-27
A Demographic Study on Oral Non Squamous Cell Malignant Tumors
Authors: Islam Md Amirul , Ali Md Shahjahan , Hossain Md Mahfuz , Hasan Md Nazmul , Chowdhury Tazdik G
Published: February 2014

Background: Nonsquamous cell malignant tumors of jaw and oral soft tissue are rare constituting between 6%-10% of all malignancies in the region. A few case reports of individual tumors are available while reviews of significant series is lacking. This report presents 22 cases of Nonsquamous cell malignant tumors collected over 8 months at a tertiary oral care centre in Dhaka, Bangladesh. Objective: To find out the distribution & pattern of oral nonsquamous cell malignant tumors among all oral malignancy and to find out the age, sex, site, clinical presentation, the histological types of these tumors. Method: This descriptive cross sectional study was done in Oral and Maxillofacial Surgery Department, Dhaka Dental College and Hospital.The entire patient histopathologically diagnosed as any type of Nonsquamous cell tumor were selected. Data were collected in a summarized data sheet. Then histopathological types of them were analyzed to indicate the distribution according to age, gender, site and clinical presentation. Result: There were 107 Oral malignancies of which 22(20.56%) were Nonsquamous cell malignant tumors which is significant in comparison to Squamous cell carcinoma in Bangladesh. Among the respondents, 9(40.91%) were diagnosed as minor salivary glands malignant tumors, 7(31.2%) were diagnosed as sarcomas, Malignant melanoma were 4(18.18%) and Non- Hodgkins lymphoma were 2(9.09%). The male to female ratio was 1:1.2 with ages were between 9 years to 70 years old (mean age 35.45 ± 21.76 years) with most patients (36.36%) in 16 to 30 years of life. Cases presented with symptoms such as swelling (100%), pain, paresthesia, loose tooth and tissue ulceration. Conclusion: In Dhaka Dental College Hospital, nonsquamous cell malignant tumors account for 20.56% of all oral malignancies among them minor salivary glands malignant neoplasm and malignant melanoma were the predominant type. Most affected were people in the 2nd and 3rd decades of life with no sex predilection. Most common site of involvement was maxilla. The need for improved medical awareness, diagnostic facilities and upgrading of infrastructure was stressed. DOI: http://dx.doi.org/10.3329/updcj.v3i2.17997 Update Dent. Coll. j: 2013; 3 (2): 34-38
Management of an upper central incisor having periapical pathology with unusual presentation
Authors: Islam Mohammad Aminul , Wakia Tasnim , Afroz Shamima , Moral Md Ali Asgor
Published: February 2014

The aim of this report is to discuss a case about a traumatized upper left central incisor presented with chronic periapical pathology with unusual presentation. In this case, the apical area of the tooth was exposed for a long period and the apex was open due to loss of affected tooth materials and its surrounding bone and soft tissue loss. The apical area was corrected with apical curettage and retrograde filling with Mineral Trioxide Aggregate (MTA) as well as soft tissue managed with pedicle flap design. The discolouration and mild shortening of the crown due to intrusive effect was managed by lamination of cosmetic restorative material. After 12 months follow up, the offending tooth was accepted both functionally and aesthetically. DOI: http://dx.doi.org/10.3329/updcj.v3i2.17998 Update Dent. Coll. j: 2013; 3 (2): 39-42
Pemphigus Vulgaris as Oral Mucosal Ulcer Progressive to Skin Lesion:
Authors: Sadat SM Anwar , Imam Akhter
Published: February 2014

Among all the life threatening diseases, autoimmune diseases are among most notorious and complicated diseases. As these diseases have no specific cause or responsible organism, it is therefore very difficult to distinguish and diagnose and thus stands as a major threat for public health. It is assumed that the reason for these diseases may be from genetic to environmental factors, from stress to idiopathic origin. Pemphigus Vulgaris(PV) is such an autoimmune blistering disease that frequently affects the mucous membrane and skin. Very often it starts from oral cavity and Dentists therefore the first to recognize. This paper describes the case of a patient presenting with a one-year history of painful ulcerated gingiva, tongue, floor of the mouth and even on GIT who is finally diagnosed as having PV spreading to generalized skin. DOI: http://dx.doi.org/10.3329/updcj.v3i2.17999 Update Dent. Coll. j: 2013; 3 (2): 43-47
Fibromatosis of the maxillary sinus and muscles of mastication; a case report.
Authors: Islam Md Ariful , Hossain Md Mahfuz , Tymur Fazla Rubby , Azad Md Alauddin Al , Rubel ATM Tarifuzzaman
Published: February 2014

Fibromatosis is a rare and locally aggressive benign tumour arising from the musculoaponeurotic structures of the whole body. Although it may occur in oral and maxillofacial region, is extremely rare in the paranasal sinus and involving the muscles of mastication. A 26 years old Bangladeshi male presented with severe trismus will be reported here to focus attention on this rare disease. Post operative histopathology confirmed the disease as fibromatosis. DOI: http://dx.doi.org/10.3329/updcj.v3i2.18000 Update Dent. Coll. j: 2013; 3 (2): 48-54
Availability of Biomass Residues for Co-Firing in Peninsular Malaysia: Implications for Cost and GHG Emissions in the Electricity Sector
Authors: Grifﬁn W. , Michalek Jeremy , Matthews H. , Hassan Mohd
Published: February 2014

Fossil fuels comprise 93% of Malaysia’s electricity generation and account for 36% of the country’s 2010 Greenhouse Gas (GHG) emissions. The government has targeted the installation of 330 MW of biomass electricity generation capacity by 2015 to avoid 1.3 Mt of CO2 emissions annually and offset some emissions due to increased coal use. One biomass option is to co-fire with coal, which can result in reduced GHG emissions, coal use, and costs of electricity. A linear optimization cost model was developed using seven types of biomass residues for Peninsular Malaysia. Results suggest that about 12 Mt/year of residues are available annually, of which oil-palm residues contribute 77%, and rice and logging residues comprise 17%. While minimizing the cost of biomass and biomass residue transport, co-firing at four existing coal plants in Peninsular Malaysia could meet the 330 MW biomass electricity target and reduce costs by about $24 million per year compared to coal use alone and reduces GHG emissions by 1.9 Mt of CO2. Maximizing emissions reduction for biomass co-firing results in 17 Mt of CO2 reductions at a cost of $23/t of CO2 reduced.
Exposure to Atrazine during Gestation and Lactation Periods: Toxicity Effects on Dopaminergic Neurons in Offspring by Downregulation of Nurr1 and VMAT2
Authors: Sun Yan , Li Yan-Shu , Yang Jun-Wei , Yu Jia , Wu Yan-Ping , Li Bai-Xiang
Published: February 2014

High atrazine (2-chloro-4-ethytlamino-6-isopropylamine-1,3,5-triazine; ATR) contents in the environment threaten the health conditions of organisms. We examined the effects of ATR exposure on Sprague-Dawley rats during gestation and on the dopaminergic neurons of offspring during lactation. Pregnant dams were orally treated with 0 mg/kg/day to 50 mg/kg/day of ATR from gestational day 5 to postnatal day 22. Afterward, neither offspring nor dams received ATR. Dopamine (DA) content was examined in striatum samples by HPLC-FL; the mRNA expressions of tyrosine hydroxylase (TH), orphan nuclear hormone (Nurr1), dopamine transporter (DAT), and vesicular monoamine transporter 2 (VMAT2) in the ventral midbrain samples were examined by fluorescence PCR when the offspring reached one year of age. After the pregnant rats were exposed to ATR, the DA concentrations and mRNA levels of Nurr1 were decreased in their offspring. Decreased Nurr1 levels were also accompanied by changes in the mRNA levels of VMAT2, which controls the transport and reuptake of DA.
Mechanical Behavior of AZ31B Mg Alloy Sheets under Monotonic and Cyclic Loadings at Room and Moderately Elevated Temperatures
Authors: Nguyen Ngoc-Trung , Seo Oh , Lee Chung , Lee Myoung-Gyu , Kim Ji-hoon , Kim Heon
Published: February 2014

Large-strain monotonic and cyclic loading tests of AZ31B magnesium alloy sheets were performed with a newly developed testing system, at different temperatures, ranging from room temperature to 250 °C. Behaviors showing significant twinning during initial in-plane compression and untwinning in subsequent tension at and slightly above room temperature were recorded. Strong yielding asymmetry and nonlinear hardening behavior were also revealed. Considerable Bauschinger effects, transient behavior, and variable permanent softening responses were observed near room temperature, but these were reduced and almost disappeared as the temperature increased. Different stress–strain responses were inherent to the activation of twinning at lower temperatures and non-basal slip systems at elevated temperatures. A critical temperature was identified to account for the transition between the twinning-dominant and slip-dominant deformation mechanisms. Accordingly, below the transition point, stress–strain curves of cyclic loading tests exhibited concave-up shapes for compression or compression following tension, and an unusual S-shape for tension following compression. This unusual shape disappeared when the temperature was above the transition point. Shrinkage of the elastic range and variation in Young’s modulus due to plastic strain deformation during stress reversals were also observed. The texture-induced anisotropy of both the elastic and plastic behaviors was characterized experimentally.
Liquid-Crystal-Enabled Active Plasmonics: A Review
Authors: Si Guangyuan , Zhao Yanhui , Leong Eunice , Liu Yan
Published: February 2014

Liquid crystals are a promising candidate for development of active plasmonics due to their large birefringence, low driving threshold, and versatile driving methods. We review recent progress on the interdisciplinary research field of liquid crystal based plasmonics. The research scope of this field is to build the next generation of reconfigurable plasmonic devices by combining liquid crystals with plasmonic nanostructures. Various active plasmonic devices, such as switches, modulators, color filters, absorbers, have been demonstrated. This review is structured to cover active plasmonic devices from two aspects: functionalities and driven methods. We hope this review would provide basic knowledge for a new researcher to get familiar with the field, and serve as a reference for experienced researchers to keep up the current research trends.
Review of the Potential of the Ni/Cu Plating Technique for Crystalline Silicon Solar Cells
Authors: Rehman Atteq , Lee Soo
Published: February 2014

Developing a better method for the metallization of silicon solar cells is integral part of realizing superior efficiency. Currently, contact realization using screen printing is the leading technology in the silicon based photovoltaic industry, as it is simple and fast. However, the problem with metallization of this kind is that it has a lower aspect ratio and higher contact resistance, which limits solar cell efficiency. The mounting cost of silver pastes and decreasing silicon wafer thicknesses encourages silicon solar cell manufacturers to develop fresh metallization techniques involving a lower quantity of silver usage and not relying pressing process of screen printing. In recent times nickel/copper (Ni/Cu) based metal plating has emerged as a metallization method that may solve these issues. This paper offers a detailed review and understanding of a Ni/Cu based plating technique for silicon solar cells. The formation of a Ni seed layer by adopting various deposition techniques and a Cu conducting layer using a light induced plating (LIP) process are appraised. Unlike screen-printed metallization, a step involving patterning is crucial for opening the masking layer. Consequently, experimental procedures involving patterning methods are also explicated. Lastly, the issues of adhesion, back ground plating, process complexity and reliability for industrial applications are also addressed.
Radiolabeling Strategies for Tumor-Targeting Proteinaceous Drugs
Authors: Sugiura Grant , Kühn Helen , Sauter Max , Haberkorn Uwe , Mier Walter
Published: February 2014

Owing to their large size proteinaceous drugs offer higher operative information content compared to the small molecules that correspond to the traditional understanding of druglikeness. As a consequence these drugs allow developing patient-specific therapies that provide the means to go beyond the possibilities of current drug therapy. However, the efficacy of these strategies, in particular “personalized medicine”, depends on precise information about individual target expression rates. Molecular imaging combines non-invasive imaging methods with tools of molecular and cellular biology and thus bridges current knowledge to the clinical use. Moreover, nuclear medicine techniques provide therapeutic applications with tracers that behave like the diagnostic tracer. The advantages of radioiodination, still the most versatile radiolabeling strategy, and other labeled compounds comprising covalently attached radioisotopes are compared to the use of chelator-protein conjugates that are complexed with metallic radioisotopes. With the techniques using radioactive isotopes as a reporting unit or even the therapeutic principle, care has to be taken to avoid cleavage of the radionuclide from the protein it is linked to. The tracers used in molecular imaging require labeling techniques that provide site specific conjugation and metabolic stability. Appropriate choice of the radionuclide allows tailoring the properties of the labeled protein to the application required. Until the event of positron emission tomography the spectrum of nuclides used to visualize cellular and biochemical processes was largely restricted to iodine isotopes and 99m-technetium. Today, several nuclides such as 18-fluorine, 68-gallium and 86-yttrium have fundamentally extended the possibilities of tracer design and in turn caused the need for the development of chemical methods for their conjugation.
Prions and Prion-Like Pathogens in Neurodegenerative Disorders
Authors: Peggion Caterina , Sorgato Maria , Bertoli Alessandro
Published: February 2014

Prions are unique elements in biology, being able to transmit biological information from one organism to another in the absence of nucleic acids. They have been identified as self-replicating proteinaceous agents responsible for the onset of rare and fatal neurodegenerative disorders—known as transmissible spongiform encephalopathies, or prion diseases—which affect humans and other animal species. More recently, it has been proposed that other proteins associated with common neurodegenerative disorders, such as Alzheimer’s and Parkinson’s disease, can self-replicate like prions, thus sustaining the spread of neurotoxic entities throughout the nervous system. Here, we review findings that have contributed to expand the prion concept, and discuss if the involved toxic species can be considered bona fide prions, including the capacity to infect other organisms, or whether these pathogenic aggregates share with prions only the capability to self-replicate.
Antimicrobial Plant Extracts Encapsulated into Polymeric Beads for Potential Application on the Skin
Authors: Rijo Patrícia , Matias Diogo , Fernandes Ana , Simões M. , Nicolai Marisa , Reis Catarina
Published: February 2014

In this study, the in vitro bacterial growth inhibition, antioxidant activity and the content in bioactive components of Plectranthus barbatus, P. hadiensis var. tomentosus, P. madagascarensis, P. neochilus and P. verticillatus aqueous extracts were investigated and compared by three extraction methods (infusion, decoction and microwave extractions). The microwave extract of P. madagascariensis showed the higher antimicrobial activity against the Staphylococcus epidermidis strain with a minimum inhibitory concentration of 40 µg/mL. This extract also showed no toxicity in a general toxicity assay and no considerable cytotoxicity against a human keratinocyte cell line. The antioxidant activity of the extracts was assessed using 2,2-diphenyl-1-picrylhydrazyl (DPPH method), and all showed antioxidant activity. The microwave extract of P. madagascariensis was the one with the highest antioxidant activity (IC50 value of 41.66 µg/mL). To increase extract stability, the microwave P. madagascariensis extract was then successfully encapsulated into alginate beads with high efficiency. This effective and low-cost strategy seems to be easy to extrapolate to an industrial scale with a future application on the skin.
Vicarious Calibration of Beijing-1 Multispectral Imagers
Authors: Chen Zhengchao , Zhang Bing , Zhang Hao , Zhang Wenjuan
Published: February 2014

For on-orbit calibration of the Beijing-1 multispectral imagers (Beijing-1/MS), a field calibration campaign was performed at the Dunhuang calibration site during September and October of 2008. Based on the in situ data and images from Beijing-1 and Terra/Moderate Resolution Imaging Spectroradiometer (MODIS), three vicarious calibration methods (i.e., reflectance-based, irradiance-based, and cross-calibration) were used to calculate the top-of-atmosphere (TOA) radiance of Beijing-1. An analysis was then performed to determine or identify systematic and accidental errors, and the overall uncertainty was assessed for each individual method. The findings show that the reflectance-based method has an uncertainty of more than 10% if the aerosol optical depth (AOD) exceeds 0.2. The cross-calibration method is able to reach an error level within 7% if the images are selected carefully. The final calibration coefficients were derived from the irradiance-based data for 6 September 2008, with an uncertainty estimated to be less than 5%.
Optimal Sensor Placement for Measuring Physical Activity with a 3D Accelerometer
Authors: Boerema Simone , Van Velsen Lex , Schaake Leendert , Tönis Thijs , Hermens Hermie
Published: February 2014

Accelerometer-based activity monitors are popular for monitoring physical activity. In this study, we investigated optimal sensor placement for increasing the quality of studies that utilize accelerometer data to assess physical activity. We performed a two-staged study, focused on sensor location and type of mounting. Ten subjects walked at various walking speeds on a treadmill, performed a deskwork protocol, and walked on level ground, while simultaneously wearing five ProMove2 sensors with a snug fit on an elastic waist belt. We found that sensor location, type of activity, and their interaction-effect affected sensor output. The most lateral positions on the waist belt were the least sensitive for interference. The effect of mounting was explored, by making two subjects repeat the experimental protocol with sensors more loosely fitted to the elastic belt. The loose fit resulted in lower sensor output, except for the deskwork protocol, where output was higher. In order to increase the reliability and to reduce the variability of sensor output, researchers should place activity sensors on the most lateral position of a participant’s waist belt. If the sensor hampers free movement, it may be positioned slightly more forward on the belt. Finally, sensors should be fitted tightly to the body.
Anti-Tumor Effects of an Oncolytic Adenovirus Expressing Hemagglutinin-Neuraminidase of Newcastle Disease Virus in Vitro and in Vivo
Authors: He Dongyun , Sun Lili , Li Chang , Hu Ningning , Sheng Yuan , Chen Zhifei , Li Xiao , Chi Baorong , Jin Ningyi
Published: February 2014

Oncolytic virotherapy has been an attractive drug platform for targeted therapy of cancer over the past few years. Viral vectors can be used to target and lyse cancer cells, but achieving good efficacy and specificity with this treatment approach is a major challenge. Here, we assessed the ability of a novel dual-specific anti-tumor oncolytic adenovirus, expressing the hemagglutinin-neuraminidase (HN) gene from the Newcastle disease virus under the human telomerase reverse transcriptase (hTERT) promoter (Ad-hTERTp-E1a-HN), to inhibit esophageal cancer EC-109 cells in culture and to reduce tumor burden in xenografted BALB/c nude mice. In vitro, infection with Ad-hTERT-E1a-HN could inhibit the growth of EC-109 cells significantly and also protect normal human liver cell line L02 from growth suppression in 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assays. Ad-hTERT-E1a-HN also effectively and selectively decreased the sialic acid level on EC-109 cells, but not on L02 cells. Furthermore, Ad-hTERT-E1a-HN was shown to induce the apoptosis pathway via acridine orange and ethidium bromide staining (AO/EB staining), increase reactive oxygen species (ROS), reduce mitochondrial membrane potential and release cytochrome c. In vivo, xenografted BALB/c nude mice were treated via intratumoral or intravenous injections of Ad-hTERT-E1a-HN. Although both treatments showed an obvious suppression in tumor volume, only Ad-hTERT-E1a-HN delivered via intratumoral injection elicited a complete response to treatment. These results reinforced previous findings and highlighted the potential therapeutic application of Ad-hTERT-E1a-HN for treatment of esophageal cancer in clinical trials.
Une nouvelle espèce de Theobroma
Authors: Cuatrecasas José
Published: February 2014

A new species of Theobrom a, discovered in the forest of Esmeraldas in western Ecuador by M. Gii.er, is described. T. gileri Cuatr. belongs to the section Telmatocarpus Bern, which until now comprised only one species (T. microcarpum Bern.). T. gileri differs from T. microcarpum in its larger fruits which are less marked with rips when ripe, in its sparsely stellate-pubescent penninervate leaves, in its sepals which are pubescent outside, and in its slenderer staminodia.
It’s Time for Health Record Banking!
Authors: Shabo Shvo A.
Published: February 2014

This article is part of a Focus Theme of Methods of Information in Medicine on Health Record Banking. This Focus Theme aims at describing the Health Record Banking (HRB) paradigm, which offers an alternative constellation of health information exchange and integration through sustainability of health records over the lifetime of individuals by independent and trusted organizations.

It also aims at describing various approaches to HRB and reporting on the state-of-the-art HRB through actual implementations and lessons learned, as described in articles of this Focus Theme.
Vitamin D3 Supplementation Increases Fibroblast Growth Factor-23 in HIV-Infected Youths Treated with Tenofovir Disoproxil Fumarate
Authors: Havens Peter L , Hazra Rohan , Stephensen Charles B , Kiser Jennifer J , Flynn Patricia M , Wilson Craig M , Rutledge Brandy , Bethel James , Pan Cynthia G , Woodhouse Leslie R , Van Loan Marta D , Liu Nancy , Lujan-Zilbermann Jorge , Baker Alyne , Kapogiannis Bill G , Gordon Catherine M , Mulligan Kathleen ,   the Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) 063 study team
Published: February 2014

Background

Tenofovir (TDF) is associated with phosphaturia and elevated 1,25 dihydroxy vitamin D (1,25-OH(2)D). Fibroblast growth factor 23 (FGF23) causes phosphaturia and increases in response to elevated 1,25-OH(2)D. Vitamin D-binding protein (VDBP) binds to 1,25-OH(2)D, decreasing its biological activity, and is elevated in individuals with higher plasma tenofovir concentrations. We compared FGF23 and VDBP before and after vitamin D3 (VITD) supplementation in youths treated with combination antiretroviral therapy (cART) containing or not containing TDF.

Methods

A randomized controlled trial in HIV-positive youths aged 18–25 years enrolled participants based on cART treatment with TDF (TDF; n=118) or without TDF (no-TDF; n=85), and randomized within those groups to VITD (50,000 IU every 4 weeks) or placebo (PL). We measured FGF23 and VDBP and calculated free 1,25-OH(2)D at baseline and week 12, and compared changes by TDF treatment and VITD randomized group.

Results

At baseline, serum FGF23 concentration showed a quadratic relationship with 1,25-OH(2)D most pronounced in the TDF group. At week 12, total and free 1,25-OH(2)D increased in the VITD but not PL groups, independent of TDF use. FGF23 increased in the TDF group receiving VITD, but there was no FGF23 change in the no-TDF group receiving VITD or the PL groups. The adjusted mean change in FGF23 from baseline to week 12 was 7.7 pg/ml in the TDF/VITD group, compared with -1.7 (no-TDF/VITD, P=0.010), -1.3 (TDF/PL, P=0.006) and 1.1 (no-TDF/PL, P=0.035).

Conclusions

These results suggest that TDF-containing cART may alter the FGF23 response to vitamin D supplementation in HIV-infected youths. Clinical trials number: NCT00490412.
Le suffrage universel dans la république
Authors: Prélot Pierre-Henri
Published: February 2014

La période 1871-1875 est essentielle du point de vue de l’affermissement du suffrage universel en France. L’objet de cette étude n’est pas de revenir sur cette question bien connue, mais qui a eu tendance à occulter une autre réalité moins visible. Il s’agit ici de montrer, dans une perspective plus institutionnelle, à quel point les débats sur le scrutin (droit de vote et inéligibilité, domiciliation, vote familial, électorat droit ou fonction, mode de scrutin, registres électoraux, lieu du vote, référendum) sont en réalité dominés pendant ces quatre années par les enjeux constitutionnels qui restent indécis jusqu’au bout. Autrement dit, lorsqu’on débat de la loi électorale, qu’elle soit municipale ou législative, c’est encore et toujours les institutions futures, que l’on ne connaît pas encore, que l’on a en tête.
Bladder Buzz: The Effect of a 6-Week Evidence-Based Staff Education Program on Knowledge and Attitudes Regarding Urinary Incontinence in a Nursing Home
Authors: Mathis Sherri , Ehlman Katie , Dugger B. Renee , Harrawood Amanda , Kraft Christine M.
Published: February 2014

Background:

Research shows that there is a basic gap in the knowledge of nursing home staff about urinary incontinence and the previous societal belief that urinary incontinence is a normal part of aging. This study examines the knowledge of nursing home staff about the types and treatment of urinary incontinence as well as attitudes toward urinary incontinence.

Methods:

A quasi-experimental, within-subject, longitudinal pretest/posttest design was used. Nursing home staff members received a 6-week educational intervention on the types and treatment of urinary incontinence and attitudes toward urinary incontinence.

Results:

Changes in knowledge about the types of urinary incontinence showed statistical significance for stress (
p
< .001), functional (
p
< .003), and overflow (
p
< .00) urinary incontinence. Changes in attitudes toward urinary incontinence showed statistical significance (
p
< .000). Changes in staff knowledge of the assessment and treatment of urinary incontinence did not reach statistical significance.

Conclusion:

This study showed that creative, evidence-based educational programming can improve staff knowledge about urinary incontinence and change staff attitudes toward urinary incontinence. Further research is needed on staff knowledge about the assessment and treatment of urinary incontinence.

J Contin Educ Nurs
2013;44(11):498–506.
Reflections on the Starfish and the Spider
Authors: DeSilets Lynore D.
Published: February 2014

Organizations have varied configurations—top down, bottom up, matrixed, or flattened. This column explores the organizational structures described as resembling either a starfish or a spider in relation to the Professional Nurse Educators Group (PNEG), continuing education providers, and, most especially, the annual PNEG conference. The characteristics of effective catalysts within decentralized organizations are included.
J Contin Educ Nurs.
2013;44(12):529–530.
A Nursing Education Strategic Plan for Conquering Catheter-Associated Urinary Tract Infections
Authors: Woolforde Launette , Castro Emily
Published: February 2014

Catheter-associated urinary tract infections (CAUTIs) intercept opportunities for hospitals to achieve quality patient care outcomes, maintain sound financial performance, and ensure a positive health care experience. Nurse educators play a key role in designing effective strategies and establishing important partnerships aimed at reducing CAUTIs in hospitalized patients.

J Contin Educ Nurs.
2013;44(12):531–532.
The Language of Scholarship for Novice Writers
Authors: Freysteinson Wyona M.
Published: February 2014

This article is an introduction to the language that is required to convey nursing knowledge through essays, dissertations, and articles in peer-reviewed journals. The tentative style of scholarly language is explored. Key elements of the uniform structure of headings, citations, and references are considered. Guidelines for reviewing one’s own paper using computer-processing strategies are shared.

J Contin Educ Nurs.
2013;44(12):533–534.
Ethical Principles of Informed Consent: Exploring Nurses’ Dual Role of Care Provider and Researcher
Authors: Judkins-Cohn Tanya M. , Kielwasser-Withrow Kiersten , Owen Melissa , Ward Jessica
Published: February 2014

This article describes the ethical principles of autonomy, beneficence, and justice within the nurse researcher–participant relationship as these principles relate to the informed consent process for research. Within this process, the nurse is confronted with a dual role. This article describes how nurses, who are in the dual role of care provider and researcher, can apply these ethical principles to their practice in conjunction with the American Nurses Association’s code of ethics for nurses. This article also describes, as an element of ethical practice, the importance of using participant-centered quality measures to aid informed decision making of participants in research. In addition, the article provides strategies for improving the informed consent process in nursing research. Finally, case scenarios are discussed, along with the application of ethical principles within the awareness of the dual role of the nurse as care provider and researcher.

J Contin Educ Nurs.
2014;45(1):35–42.
The Essence of Leadership
Authors: Bleich Michael R.
Published: February 2014

Leadership is an attribute needed to advance clinical and organizational performance. Professional development educators play an important role in advancing leadership

J Contin Educ Nurs
. 2014;45(1):6–7.
The Novice Nurse's Guide to Calling “Code Blue”
Authors: Brice Wayne Thomas
Published: February 2014

Would new graduate nurses activate rapid response teams (RRT) sooner if they learned a simple and effective decision-making model for determining hemodynamic instability? A significant number of scholarly articles report poor outcomes associated with delayed rescue interventions in the face of mental status changes preceding code blue activation. However, current RRT protocols do not stratify or give greater weight to changes in patient mental status compared with any other symptom associated with RRT activation. A decision-making model to improve the recognition of unstable patients was implemented on a cardiothoracic telemetry ward at a military medical center, resulting in an anecdotal 50% improvement in the unit's code blue survival rate. A controlled educational pilot program is needed to add scientific rigor and provide the necessary data to validate the original anecdotal findings associated with the decision-making model described in this article.
J Contin Educ Nurs.
2014;45(3):132–135.
Intensive Short-Term Dynamic Psychotherapy in the Private Practice of Psychiatry
Authors: Wolff David M.
Published: February 2014

CME Educational Objectives

1.

Understand the potential benefits of combined psychotherapy and medication management.

2.

Appreciate subtleties in conducting these two processes simultaneously.

3.

Develop a further understanding of the intensive short-term dynamic psychotherapy (ISTDP) model.

Intensive short-term dynamic psychotherapy (ISTDP) is based on the psychoanalytic theory of unconscious conflict but departs from standard psychodynamic therapy in a number of significant ways. This highly active form of treatment is designed to mobilize intense feelings, regulate anxiety, and overcome defense and resistance. It has a growing body of evidence of clinical effectiveness across a wide range of patients and has demonstrated significant cost savings.
1
This article explores unique elements of ISTDP, as well as practical issues that arise when ISTDP is introduced into a psychiatrist’s practice. It will offer examples of how ISTDP can positively impact an outpatient practice where psychotherapy and medications are integrated. ISTDP’s unique approach to assessment and diagnosis will be described and compared to the standard psychiatric evaluation. Additionally, the relationship between ISTDP and medication treatment is explored.
Emerging Evidence for Intensive Short-Term Dynamic Psychotherapy with Personality Disorders and Somatic Disorders
Authors: Town Joel M. , Driessen Ellen
Published: February 2014

CME Educational Objectives

1.

Review the outcome evidence of prior meta-analytic reviews of intensive short-term dynamic psychotherapy (ISTDP).

2.

Provide an additional meta-analysis of ISTDP for the treatment of personality and somatic disorders.

3.

Suggest areas for future study in the use of psychodynamic psychotherapy for personality and somatic disorders.

The literature reviewing studies of psychodynamic psychotherapy clearly demonstrates evidence for the efficacy of both short-term and long-term models.
1–3
Meta-analytic reviews synthesizing effects across different psychodynamic psychotherapy formats have been conducted for common mental disorders,
1
depression,
4,5
depression in the setting of personality disorder,
6
personality disorders,
7
and somatic disorders.
8
Psychodynamic psychotherapy demonstrates superiority to control condition,
1,9
and no significant difference to other formal psychotherapies, including cognitive behavioral therapies.
4,5,7,9,10
Building upon a recently published systematic review and meta-analysis,
11
the aim of this article is to further examine the evidence for a contemporary psychodynamic psychotherapy treatment protocol,
12,13
intensive short-term dynamic psychotherapy (ISTDP), in the treatment of personality and somatic disorders.
Residency Training in Intensive Short-Term Dynamic Psychotherapy: Methods and Cost-Effectiveness
Authors: Abbass Allan , Kisely Steve , Rasic Daniel , Katzman Jeffrey W.
Published: February 2014

CME Educational Objectives

1.

Understand the role of training in psychodynamic psychotherapy in psychiatry residency training programs.

2.

Learn a potential model for training residents in a short-term model of psychodynamic psychotherapy.

3.

Review the efficacy and cost-savings data in a study training residents in this model.

Whereas psychiatry grows as a field through contributions from neuroscience, genetics, psychopharmacology, and diagnostic specificity, psychiatrists continue to value the importance of psychodynamic assessment and intervention. This is reflected in the current Royal College of Physicians and Surgeons of Canada
1
and American College of Graduate Medical Education (ACGME) guidelines in psychiatry,
2
requiring the demonstration of competency in psychodynamic psychotherapy. This has been further underscored through the roll out of the Next Accreditation System,
3
requiring faculty in psychiatry training programs to delineate the achievement of resident milestones in the area of psychodynamic psychotherapy.
Resilience in the Face of Chronic Illness and Family Caregiving in Middle and Later Life
Authors: Fortinsky Richard H. , Tennen Howard , Steffens David C.
Published: February 2014

CME Educational Objectives

1.

Understand the role of perceived personal control and accommodative strategies in adults coping with common challenges of old age.

2.

Describe the effect of positive affect on resilience in older adults.

3.

Discuss a proposed model that links conceptualizations of resilience with intervention strategies among older adults faced with chronic illness, disability, and family caregiving responsibilities.

In the context of aging, resilience — the process of positive adaptation in response to threatening life circumstances, including chronic illness, disability, and providing personal and other types of care to older relatives in middle and later life — involves effective coping;
1
the ability to ‘bounce back;’
2
and rapid recovery, sustainability of purpose, and personal growth
3
while facing adversity. Although the idea of growth through adversity is appealing and has generated considerable interest, the research methods required to capture growth have lagged behind theoretical formulations, leaving this aspect of resilience more speculative.
4
Resilience has been studied as an aspect of personality, and the concept of resilience has been applied to organizations, neighborhoods, and communities.
A 6-Month-Old Boy with Persistent Pruritic Eruption
Authors: Kruse Lacey , Chamlin Sarah L.
Published: February 2014

A previously healthy 6-month-old boy presented to the pediatric dermatology clinic for evaluation of a persistent, pruritic eruption. This eruption involved the scalp, extremities, and inguinal creases and was intensely pruritic. The patient had been previously treated with multiple topical corticosteroids and antifungals, all with minimal improvement. He born at full term and was otherwise well and thriving. Review of systems was negative.

Examination revealed erythematous to yellow scaly, greasy plaques, some with underlying purpuric papules in the frontal, temporal, and vertex of the scalp, post-auricular regions, and the conchae of both ears. There were also scattered papules and purpura noted in the inguinal creases, and hyperkeratotic yellow papules on the extensor extremities. He had no abnormal lymphadenopathy or hepatosplenomegaly. The remainder of his examination was normal. A diagnostic skin biopsy was performed.

To read more and to earn CME credit for reading this article, access the full text by going to
Healio.com/Pediatrics
and searching: doi: 10.3928/00904481-20131223-10.
A 1-Year-Old Boy with Persistent, Generalized Eruption
Authors: Mir Adnan , Chamlin Sarah L.
Published: February 2014

A healthy 1-year-old boy born at full term after an uncomplicated pregnancy presented to the dermatology clinic for a widespread eruption with gradual onset since 3 months of age. He was otherwise well, afebrile, feeding well, and gaining weight appropriately. The child was overall asymptomatic, though some of his lesions occasionally became red and pruritic. His mother noticed that after mild illnesses, he was more prone to these flares. She denied flushing, vomiting, diarrhea, respiratory distress, and irritability. He was meeting all developmental milestones and started walking at 11 months of age. The remainder of his review of systems was unremarkable, and family history was noncontributory.

Physical exam revealed a well-appearing, well-nourished, playful, and interactive toddler. There were innumerable discrete and coalescing pink-brown macules and papules concentrated on the trunk and extending onto the proximal upper and lower extremities bilaterally, as well as the neck and lower face. Stroking the lesions quickly led to development of erythematous edematous wheals. There was no hepatosplenomegaly, and the lymph node exam was unremarkable.

To read more and to earn CME credit for reading this article, access the full text by going to
Healio.com/Pediatrics
and searching: doi: 10.3928/00904481-20131223-11.
A 20-Day-Old Boy with a Blue Skin Lesion
Authors: Asztalos Lori , Gray Jayla , Chamlin Sarah L.
Published: February 2014

A 20-day-old boy presented for evaluation of a blue nodule on the right shoulder that had been present since birth. The mother noted no changes in the size of the lesion since birth, and no bleeding or ulceration was noted. The patient’s past medical history was unremarkable. He was a full-term baby born at 39 weeks gestation via a normal, spontaneous vaginal delivery. The pregnancy was uncomplicated. The mother had no history of maternal hypertension and had no history of chorionic villus sampling or amniocentesis. The patient was not taking any medications and had no known allergies.

Physical exam revealed a well-developed, well-nourished male in no apparent distress. A full skin exam revealed a 1.8 cm × 2 cm discrete, blue-purple vascular nodule with coarse surface telangiectasias and a surrounding rim of pallor on the right shoulder. There was no bleeding or breakdown noted. There was no lymphadenopathy present.

To read more and to earn CME credit for reading this article, access the full text by going to
Healio.com/Pediatrics
and searching: doi: 10.3928/00904481-20131223-13.
An 8-Month-Old Girl with an Enlarging Lesion on Her Face
Authors: Reserva Jeave , Chamlin Sarah L.
Published: February 2014

An otherwise healthy 8-month-old girl presented to the pediatric dermatology clinic for evaluation of an enlarging lesion on her right cheek. The child’s mother first noticed this “bump” a month prior to presentation and denied any inciting event. The lesion had increased in size since it was first noted but was not symptomatic. No bleeding was noted. Perinatal history and review of systems were unremarkable.

On physical examination, a solitary, well-demarcated, 3-mm yellow erythematous papule with central erosion was noted on the right upper cheek. No other lesions were identified. Lymph node examination was unremarkable. Clinical observation was recommended, with excision if significant enlargement or atypical features developed. Two months later, the lesion remained asymptomatic but had grown to 9 mm in size. The central erosion persisted, but no bleeding occurred.

To read more and to earn CME credit for reading this article, access the full text by going to
Healio.com/Pediatrics
and searching: doi: 10.3928/00904481-20131223-14.