bluuebunny/crossref_metadata_2025 huggingface dataset:
Social Networks and Best Practices in Public Health: The Example of Regional Billing Groups
Authors: Whitmer Deborah A. , Hawley Suzanne R. , Orr Shirley A. , Romain Theresa St. , Molgaard Craig A.
Published: November 2006

ABSTRACT
Objective: Rising health care costs, increased demand for clinical services, and reimbursement difficulties created a funding shortage among local health departments in the state of Kansas. This intervention established regional billing groups to provide professional support and increase third‐party reimbursement.

Design: Through feedback sessions, billing clerks provided qualitative responses about training needs. These informed the process of establishing billing groups in each state health district.

Sample: All billing clerks in the state's 6 regional health districts were invited to participate, as were insurance and billing software representatives.

Intervention: Between April 2002 and September 2004, 6 collaborative groups were established. Billing clerks received professional support and training from peers, insurance representatives, and software providers. An interagency billing advisory team was established to coordinate training activities between groups.

Results: These groups have allowed local health departments to increase reimbursement revenue by 50%–75%, allowing for the provision of expanded health services to client populations.

Conclusions: These methods can serve as a model for other states, particularly those with considerable rural populations or decentralized health care systems. Still, funding shortages persist, and public health billing clerks will continue to need ongoing training in the most current and effective billing methods.
Cross‐Validation and Discriminant Validity of Adolescent Health Promotion Scale Among Overweight and Nonoverweight Adolescents in Taiwan
Authors: Chen Mei‐Yen , Wang Edward K. , Chang Chee‐Jen
Published: November 2006

ABSTRACT
This study used cross‐validation and discriminant analysis to evaluate the construct and discriminant validity of Adolescent Health Promotion (AHP) scale between the overweight and nonoverweight adolescents in Taiwan. A cross‐sectional survey method was used and 660 adolescents participated in this study. Cluster and discriminant analyses were used to analyze the data. Our findings indicate that the AHP is a valid and reliable scale to discriminate between the health‐promoting behaviors of overweight and nonoverweight adolescents. For the total scale, cluster analyses revealed two distinct patterns, which we designated the healthy and unhealthy groups. Discriminate analysis supported this clustering as having good discriminant validity, as nonoverweight adolescents tended to be classified as healthy, while the overweight tended to be in the unhealthy group. In general, overweight adolescents practiced health‐related behaviors at a significantly lower frequency than the nonoverweight. These included exercise behavior, stress management, life appreciation, health responsibility, and social support. These findings can be used to further develop and refine knowledge of adolescent overweight and related strategies for intervention.
Learning to Live with Our Children
Authors: Fleck Henrietta
Published: November 2006

ABSTRACT
As the title suggests, being perplexed by one's children is not unique to the 21st century. In her paper, published in the original Public Health Nursing, Henrietta Fleck (1949), chair of Home Economics at New York University, addressed this persistent problem by providing advice on parent education methods for public health nurses. The materials—films, newspapers, cartoons, posters—are all within the nurse's arsenal today, supplemented by television, and the Internet. More interesting was Fleck's philosophy about parenting and family life. The excerpt omits the dated description of resources, focusing instead on her point of view. It reflects post‐World War II optimism about the meaning and power of democracy in shaping familial behavior. The United States was readjusting to civilian life following World War II, fathers were returning home from military fields of action overseas, women were gradually being displaced from the industrial workplace—the country was expanding into suburbia and baby boomers were making their first appearances in the world. Fleck's assumptions include belief in the value of individualism, the importance of sharing both privilege and obligation, and the nature of maturity evidenced in an ability to make reasoned and reasonable choices and to hold oneself accountable for them. The limitations of her view are left to us to ponder.
Cognitive and Behavioral Outcome in West Syndrome
Authors: Guzzetta Franco
Published: November 2006

Summary:  Cognitive and behavioral impairments in West syndrome are analyzed at the onset of the disease. Multimodal sensory impairments, namely of the visual function, that are usually associated with the acute stage of the disease, are stressed as possible mechanisms interfering with cognitive development. This notion could open a rehabilitation prospective for functional disorders. Long‐term developmental outcome is dependent on various factors, ranging from the primary lesions to the epilepsy evolution and use of drugs, up to environmental factors such as the quality of the family or that of the community within which the infant grows up.
Neuropsychological Findings: Myoclonic Astatic Epilepsy (MAE) and Lennox‐Gastaut Syndrome (LGS)
Authors: Filippini Melissa , Boni Antonella , Dazzani Gloria , Guerra Angelo , Gobbi Giuseppe
Published: November 2006

Summary:  Purpose: To identify a specific neuropsychological profile associated with myoclonic astatic epilepsy (MAE) and Lennox‐Gastaut syndrome (LGS).

Methods: Seven patients diagnosed with MAE and four patients diagnosed with LGS were selected from patients referred to our Child Neurology Unit. The patients were assessed both clinically (awake, sleep, Holter EEG, seizures frequency, and semiology) and neuropsychologically (IQ, language, attention, visuospatial and visuomotor abilities, and behavior). One representative case of each syndrome is presented here.

Results: The clinical picture of the MAE patient resembled that of an MAE condition associated with transitory epileptic encephalopathy. The neuropsychological findings suggest that electroclinical anomalies can temporarily affect cognitive and behavioral functioning. Early effective antiepileptic drug (AED) treatment was found to improve cognitive outcome. In contrast, LGS was associated with mental retardation, which persisted after seizure control.

Conclusions: At present, it remains difficult to delineate a precise neuropsychological profile associated with MAE and LGS. The cognitive outcome of MAE is variable and depends on the clinical pattern. With regard to LGS, the hypothesis of a genetic predisposition underlying both the epilepsy and the mental retardation is still valid. Alternatively, exposure to subclinical electrophysiological anomalies during a critical period of cerebral development may be responsible for the mental retardation. At the time the clinical manifestations appear, drug treatment, even if effective, would have only limited impact on cognitive outcome. However, early multidisciplinary intervention may help to improve behavior and communicative abilities, enhancing the quality of life of these children and their families.
Neuropsychological Findings in Rolandic Epilepsy and Landau‐Kleffner Syndrome
Authors: Metz‐Lutz Marie‐Noëlle , Filippini Melissa
Published: November 2006

Summary:  In an attempt to correlate neuropsychological deficits and various neurophysiological aspects of focal epileptic activity in benign childhood epilepsy, we have reviewed the findings of a longitudinal group study of benign childhood epilepsy with centrotemporal spikes (BCECTS) and several case studies of continuous spike‐waves during slow sleep syndrome (CSWS). We first distinguish the temporary neuropsychological impairments often observed in the natural history of BCECTS from the more long‐lasting and more specific neuropsychological deficits associated with CSWS, of which the Landau‐Kleffner syndrome (LKS) is the most studied clinical form. A series of metabolic findings from 18FDG‐PET studies in BCECTS and CSWS children have shown that specific cognitive impairment is related to increased glucose uptake in cortical areas restricted to the associative cortex coincident with the focus of spike‐wave discharges. From recent functional neuroimaging data of three patients recovered from LKS, we address the issue of the pathophysiology of cognitive impairment persisting after complete recovery of epilepsy. Finally, we discuss the reliability of the study of mismatch negativity to address the issue of the early effect of interictal discharges in typical and atypical BCECTS on the auditory cortex and the development of speech processing essential to verbal learning.
Autistic Spectrum Disorder: Evaluating a Possible Contributing or Causal Role of Epilepsy
Authors: Deonna Thierry , Roulet Eliane
Published: November 2006

Summary:  The onset of epilepsy in brain systems involved in social communication and/or recognition of emotions can occasionally be the cause of autistic symptoms or may aggravate preexisting autistic symptoms. Knowing that cognitive and/or behavioral abnormalities can be the presenting and sometimes the only symptom of an epileptic disorder or can even be caused by paroxysmal EEG abnormalities without recognized seizures, the possibility that this may apply to autism has given rise to much debate. Epilepsy and/or epileptic EEG abnormalities are frequently associated with autistic disorders in children but this does not necessarily imply that they are the cause; great caution needs to be exercised before drawing any such conclusions. So far, there is no evidence that typical autism can be attributed to an epileptic disorder, even in those children with a history of regression after normal early development. Nevertheless, there are several early epilepsies (late infantile spasms, partial complex epilepsies, epilepsies with CSWS, early forms of Landau‐Kleffner syndrome) and with different etiologies (tuberous sclerosis is an important model of these situations) in which a direct relationship between epilepsy and some features of autism may be suspected. In young children who primarily have language regression (and who may have autistic features) without evident cause, and in whom paroxysmal focal EEG abnormalities are also found, the possible direct role of epilepsy can only be evaluated in longitudinal studies.
Cognitive Outcomes in Patients with Frontal Lobe Epilepsy
Authors: Risse Gail L.
Published: November 2006

Summary:  A typical “cognitive profile” or defining behavioral syndrome for patients with frontal lobe epilepsy (FLE) has not been described. While there have been numerous reports of impaired “executive functions” in this population, the nature and severity of these deficits is highly variable, ranging from impaired attention to difficulty with the more complex behaviors involved in planning, selecting goals, anticipating outcomes, and initiating action. These findings have been more difficult to demonstrate in children, in part due to the later appearance of these abilities in normal development. When a clear focal seizure onset is identified, or in cases of a structural lesion, cognitive impairment may be specific to the side, size, and localization of the abnormal cortex. Children who have undergone surgical resection of the dominant frontal lobe frequently show declines in verbal fluency, and sometimes verbal IQ, visual confrontation naming, and conceptual reasoning. Adult surgical cases have shown the most specific frontal lobe findings, including reduced word fluency with relatively small lesions of the dominant dorsolateral frontal cortex, the analogous finding of impaired nonverbal fluency with nondominant frontal lesions, and other executive deficits following large resections of prefrontal cortex bilaterally. These reports support the likelihood that it may not be possible to identify a specific cognitive syndrome associated with FLE in the absence of a structural lesion.
Cognitive Impairments in Children with Nonidiopathic Temporal Lobe Epilepsy
Authors: Laurent Agathe , Arzimanoglou Alexis
Published: November 2006

Summary:  Ictal and interictal activities occurring in a mature brain can disorganize the neural network activity involved in one or various specific cognitive processes. In children, the situation might be more complex: the epileptic process occurs in a period when the cortex is still maturing and it may interfere with normal cerebral development. Although neural plasticity in children is greater than it is in adults, greater plasticity does not necessarily mean adaptive plasticity. Studies have shown that temporal lobe epilepsy in children is not systematically associated with global mental retardation. However, various difficulties in specific cognitive domains are more often found in children than in patients with adult‐onset epilepsy. Language, memory, socioperceptive competence, and also executive functions, which can be impaired by the disruption of the temporofrontal circuit, are among such cognitive functions that need to be evaluated. Early detection of specific deficits is of primary importance for the implementation of appropriate remediation measures.
Effect of Microwave Disinfection Procedures on Torsional Bond Strengths of Two Hard Chairside Denture Reline Materials
Authors: Machado Ana Lucia , Breeding Larry C. , Puckett Aaron D.
Published: November 2006

Purpose: This study evaluated the potential effects of denture base resin water storage time and an effective denture disinfection method (microwave irradiation at 650 W for 6 minutes) on the torsional bond strength between two hard chairside reline resins (GC Reline and New Truliner) and one heat‐polymerizing denture base acrylic resin (Lucitone 199).

Materials and Methods: Cylindrical (30 × 3.9 mm) denture base specimens (n= 160) were stored in water at 37°C (2 or 30 days) before bonding. A section (3.0 mm) was removed from the center of the specimens, surfaces prepared, and the reline materials packed into the space. After polymerization, specimens were divided into four groups (n= 10): Group 1 (G1)—tests performed after bonding; Group 2 (G2)—specimens immersed in water (200 ml) and irradiated twice (650 W for 6 minutes); Group 3 (G3)—specimens irradiated daily until seven cycles of disinfection; Group 4 (G4)—specimens immersed in water (37°C) for 7 days. Specimens were submitted to a torsional test (0.1 Nm/min), and the torsional strengths (MPa) and the mode of failure were recorded. Data from each reline material were analyzed by a two‐way analysis of variance, followed by Neuman‐Keuls test (p= 0.05).

Results: For both Lucitone 199 water storage periods, before bonding to GC Reline resin, the mean torsional strengths of G2 (2 days—138 MPa; 30 days—132 MPa), G3 (2 days—126 MPa; 30 days—130 MPa), and G4 (2 days—130 MPa; 30 days—137 MPa) were significantly higher (p < 0.05) than G1 (2 days—108 MPa; 30 days—115 MPa). Similar results were found for Lucitone 199 specimens bonded to New Truliner resin, with G1 specimens (2 days—73 MPa; 30 days—71 MPa) exhibiting significantly lower mean torsional bond strength (p < 0.05) than G2 (2 day—86 MPa; 30 days—90 MPa), G3 (2 days—82 MPa; 30 days—82 MPa), and G4 specimens (2 days—78 MPa; 30 days—79 MPa). The adhesion of both materials was not affected by water storage time of Lucitone 199 (p > 0.05). GC reline showed a mixed mode of failure (adhesive/cohesive) and New Truliner failed adhesively.

Conclusions: Up to seven microwave disinfection cycles did not decrease the torsional bond strengths between the hard reline resins, GC Reline and New Truliner to the denture base resin Lucitone 199. The effect of additional disinfection cycles on reline material may be clinically significant and requires further study.
Effect of Sintering Temperature on Flexural Properties of Alumina Fiber‐Reinforced, Alumina‐Based Ceramics Prepared by Tape Casting Technique
Authors: Tanimoto Yasuhiro , Nemoto Kimiya
Published: November 2006

Purpose: The purpose of this study was to investigate the effect of sintering temperature on flexural properties of an alumina fiber‐reinforced, alumina‐based ceramic (alumina‐fiber/alumina composite) prepared by a tape casting technique.

Materials and Methods: The alumina‐based ceramic used a matrix consisting of 60 wt% Al2O3 powder and 40 wt% SiO2‐B2O3 glass powder with the following composition in terms of wt%: 33 SiO2, 32 B2O3, 20 CaO, and 15 MgO. Prepreg sheets of alumina‐fiber/alumina composite in which uniaxial aligned alumina fibers were infiltrated with the alumina‐based matrix were fabricated continuously using a tape casting technique employing a doctor blade system. Four sintering temperatures were investigated: 900°C, 1000°C, 1100°C, and 1200°C, all for 4 hours under atmospheric pressure in a furnace. The surface of the alumina‐fiber/alumina composite after sintering was observed with a field‐emission scanning electron microscope (FE‐SEM). A three‐point bending test was carried out to measure the flexural strength and modulus of alumina‐fiber/alumina composite specimens. In addition, sintered alumina fiber was characterized by X‐ray diffraction (XRD).

Results: FE‐SEM observation showed that alumina‐fiber/alumina composite was confirmed to be densely sintered for all sintering temperatures. Three‐point bending measurement revealed that alumina‐fiber/alumina composite produced at sintering temperatures of 1100°C and 1200°C exhibit flexural strengths lower than those of alumina‐fiber/alumina composite produced at sintering temperatures of 900°C and 1000°C; alumina‐fiber/alumina composite produced at sintering temperatures of 1100°C and 1200°C exhibit flexural moduli lower than that of alumina‐fiber/alumina composite produced at a sintering temperature of 1000°C. Additional XRD pattern of alumina fiber indicated that with increasing sintering temperature, the crystallographic structure of γ‐alumina transformed to mullite.

Conclusions: There were significant differences in the flexural properties between the alumina‐fiber/alumina composite sintered at the four temperatures. This indicates that the choice of optimum sintering temperature is an important factor for successful dental applications of alumina‐fiber/alumina composite developed by the tape casting system.
Transesophageal Echocardiography in the Diagnosis of Thrombosis Associated with Permanent Transvenous Pacemaker Electrodes
Authors: KORKEILA PETRI J. , SARASTE MARKKU K. , NYMAN KAI M. , KOISTINEN JUHANI , LUND JUHA , JUHANI AIRAKSINEN KARL EINO
Published: November 2006

Objectives: We sought to assess the value of transesophageal echocardiography (TEE) in the diagnosis of PM‐lead‐associated central venous thrombi.

Background: Venous thrombosis is not infrequent after pacemaker (PM) or implantable cardioverter‐defibrillator (ICD) implantation. Previous incidence studies of thrombosis have been based on venography or Doppler ultrasound, but the role of TEE has not been systematically evaluated in this setting.

Methods: Study group comprised 66 consecutive patients (mean age 64 years, 67 % male) referred for implantation of their first PM or ICD and with a successful TEE, transthoracic echocardiography (TTE) and venography at 6 months after implantation. The total number of implanted leads was 110. During the 6 months of clinical follow‐up, nuclear ventilation‐perfusion scan or spiral computed tomography was performed when symptoms aroused a clinical suspicion of PE.

Results: TEE revealed a right atrium (RA) or lower superior vena cava (SVC) thrombus in 6 (9%) patients. These thrombi were not visualized by TTE or venography. Additionally, 12 (20%) patients were found to have venographic subclavian or innominate vein thrombi, but none of those could be diagnosed with TEE. Symptomatic pulmonary embolism (PE) was diagnosed in two and an asymptomatic PE in one individual and two of these occurred among the six patients with a thrombus in TEE. No clinical predictors for thrombosis were found.

Conclusions: TEE is an excellent method to visualize electrodes within the RA and proximal SVC. Electrode‐associated RA thrombi appear to be relatively common after PM implantation, and they may remain undetectable by venography or TTE. Although these thrombi are mostly asymptomatic, they can give rise to pulmonary embolism and should also be kept in mind in the differential diagnosis of endocarditis. TEE is the method of choice for the diagnosis of these lesions.
Wavelet‐Based Tachycardia Discrimination in ICDs: Impact of Posture and Electrogram Configuration
Authors: WOLBER THOMAS , BINGGELI CHRISTIAN , HOLZMEISTER JOHANNES , BRUNCKHORST CORINNA , STROBEL ULLA , BOES CLAUDIA , MOSER RAY , BECKER DANIEL , DURU FIRAT
Published: November 2006

Background: Inappropriate therapy delivery is an important concern in the management of patients with implantable cardioverter defibrillators (ICDs). Recently, a morphology‐based algorithm (wavelet feature) has been introduced for differentiation of ventricular and supraventricular tachycardia. In this study, we evaluated the performance of the wavelet algorithm using various electrogram (EGM) configurations during different body positions.

Methods: Patients with a single‐chamber Medtronic model 7230 ICD (Minneapolis, MN, USA) and a double‐coil lead were included. EGM templates were collected during baseline rhythm in supine position for different EGM sources (right ventricular [RV] coil‐can, RV coil‐superior vena cava [SVC] coil, tip‐ring, SVC coil‐can). For each EGM configuration, morphologic similarity (match percentage) of EGMs obtained during different body positions (supine, left and right lateral, sitting, standing, walking) were compared with the templates.

Results: Twenty‐eight patients (24 males; age 58 ± 17 years) were studied. A total of 9,775 intracardiac EGMs were analyzed. Median match percentage (interquartile range) was 88% (85–94), 88% (82–94), 82% (76–88), and 73 (58–85) for the RV coil‐can, RV coil‐SVC coil, tip‐ring, and SVC coil‐can configurations, respectively. Correct classification rates, as defined by match percentage of 70% or higher, were significantly higher with the RV coil‐can, RV coil‐SVC coil, and tip‐ring EGM configurations, as compared to the SVC coil‐can configuration (95, 91, and 91 vs 58%≥70% match percent, P < 0.001).

Conclusion: Wavelet‐based morphology scores in ICDs may change with various body positions. These variations are relatively minor using the nominal configuration (RV coil‐can), as well as by using RV coil‐SVC coil and tip‐ring. However, morphology scores can vary considerably when SVC coil‐can is used; therefore, this configuration should be avoided while using the wavelet algorithm.
Recurrent Postcardiac Injury Syndrome Mimicking Cardiac Perforation Following Transvenous Pacing: An Unusual Presentation
Authors: KRISHNAN MANGALATH N. , LUQMAN NAZAR , NAIR RAMACHANDRAN , MONCY OOMMEN J. , CHONG CHEAN L. , CHONG CHEE F.W. , LAU NGO B.
Published: November 2006

We report a case of recurrent postcardiac injury syndrome (PCIS) after pacemaker lead insertion. Each episode was attended by hemorrhagic pleuro‐pericardial effusion with drop in hemoglobin levels leading us to consider cardiac perforation and subject the patient to surgical pericardiotomy. However, no perforation or active bleeding was detected on exploration. This unusual case illustrates the occurrence of PCIS following pacemaker lead insertion, mimicking cardiac perforation. This entity should be considered in patients who, after pacemaker lead insertion, develop pericardial and pleural effusion associated with markers of inflammation.
Opportunistic Access: Successful Retrograde Guide Wire Advancement to the Pocket Through a Track Created by Laser Lead Extraction
Authors: SPRAGG DAVID D. , BRINKER JEFFREY A. , HENRIKSON CHARLES A.
Published: November 2006

Obtaining vascular access can be difficult following lead extraction if a wire is not retained within the vessel. We describe a unique situation in which retrograde passage of a guidewire to the explanted internal cardioverter/defibrillator pocket facilitated regaining subclavian venous access.
Surface Structure of Converter Slag Stabilized by Heating
Authors: Tsuyuki Naomitsu , Koizumi Koshiro , Umemura Yasuhiro
Published: November 2006

Converter slag contains free lime (CaO) and unstable iron oxides (FeO, FeOOH) that may lead to expansive self‐destruction. A typical industry practice for converter slag has been stabilization by steam curing and autoclaving; however, the stabilization can only reach the surface, and not the inside, of slag particles. A new method is proposed in this study to stabilize the converter slag by heating at a low temperature. After magnetic separation, specimens of converter slag were subjected to heating for 2 h at a temperature of 500°C, resulting in a decrease of free lime content irrespective of the particle size. This effect was attributed to the formation of Ca2Fe9O13 and complicated apatite groups owing to the heating. The iron oxides in the converter slag were analyzed by X‐ray photoelectron spectra. It was found that after heating, the unstable FeO (wustite) content decreased and an oxidized α‐Fe2O3 (hematite) increased. This led to the prevention of the iron‐induced expansion. The rate of heat liberation by the free lime in converter slag was smaller than that of the reagent CaO. This suggests that the presumed free lime is in a different form based on the Ca bond energy in the surface of slag particles.
Nano‐Sized Hydroxyapatite Coatings on Ti Substrate with TiO2 Buffer Layer by E‐beam Deposition
Authors: Lee Su‐Hee , Kim Hyoun‐Ee , Kim Hae‐Won
Published: November 2006

A nano‐sized hydroxyapatite (HA) layer was coated on a Ti substrate with a titanium oxide (TiO2) buffer layer by the electron‐beam deposition method. The morphological features as well as the mechanical and biological properties of the HA/TiO2‐layered coating were noticeably different from those of a conventional HA coating on Ti. The HA on the TiO2 layer replicated the fine grain structure of the TiO2 layer, with grain sizes of just a few tens of nanometers. The TiO2 buffer layer was highly effective in preserving the adhesion strength of the coating layer following the heat treatment at 500°C, which was necessary to crystallize the structure. Moreover, in contrast to the HA single coating wherein severe cracking was observed under moist conditions, the HA/TiO2 coating retained its mechanical stability under the same conditions. The dissolution of the HA/TiO2 coating in a physiological saline solution exhibited a more favorable pattern than that of the HA single coating, with a reduced initial burst and a subsequent steady release rate. Preliminary in vitro cellular tests showed that osteoblastic cells expressed a significantly higher alkaline phosphatase level on the HA/TiO2 coating than on the HA single coating. Conclusively, the nano‐sized HA coating with the TiO2 buffer layer holds great promise as a bioactive coating system.
Novel Processing to Produce Polymer/Ceramic Nanocomposites by Atomic Layer Deposition
Authors: Liang Xinhua , Hakim Luis F. , Zhan Guo‐Dong , McCormick Jarod A. , George Steven M. , Weimer Alan W. , Spencer Joseph A. , Buechler Karen J. , Blackson John , Wood Charles J. , Dorgan John R.
Published: November 2006

An innovative process to uniformly incorporate dispersed nanoscale ceramic inclusions within a polymer matrix was demonstrated. Micron‐sized high density polyethylene particles were coated with ultrathin alumina films by atomic layer deposition in a fluidized bed reactor at 77°C. The deposition of alumina on the polymer particle surface was confirmed by Fourier transform infrared spectroscopy and X‐ray photoelectron spectroscopy. Conformal coatings of alumina were confirmed by transmission electron microscopy and focused ion beam cross‐sectional scanning electron microscopy. The results of inductively coupled plasma atomic emission spectroscopy suggested that there was a nucleation period. The results of scanning electron microscopy, particle size distribution, and surface area of the uncoated and nanocoated particles showed that there was no aggregation of particles during the coating process. The coated polymer particles were extruded by a heated extruder at controlled temperatures. The successful dispersion of the crushed alumina shells in the polymer matrix following extrusion was confirmed using cross‐sectional transmission electron microscopy. The dispersion of alumina flakes can be controlled by varying the polymer particle size.
Use of platelet‐rich plasma under autogenous onlay bone grafts
Authors: Miranda Sandra Regina , Filho Hugo Nary , Marques Padovan Luís Eduardo , Ribeiro Daniel Araki , Nicolielo Daniela , Matsumoto Mariza Akemi
Published: November 2006

Objectives: To analyze the healing of autogenous onlay bone grafts in three different situations, focusing on the interface area.

Material and methods: Sixteen rabbits underwent autogenous bone graft surgeries in the calvaria. The block bone grafts were positioned in three different situations: direct contact between bone graft and receptor bed, graft interposed by particulate bone, and graft interposed by platelet‐rich plasma (PRP). After 7, 15, 30, and 60 days, the specimens were retrieved for histological and morphometric evaluation.

Results: All groups healed uneventfully and presented incorporation of the grafts after 30 days. A slightly more evident new bone formation could be observed in the PRP group in the first analyzed period, and an earlier maturation of bone in the last period, although no statistically significant differences were achieved.

Conclusion: The use of additional material between the bone graft and the receptor bed when using the onlay technique must be carefully considered, taking into account the size of the reconstruction and the cost/benefit relation. The addition of PRP in between autogenous bone blocks and the receptor bed did not confer significant benefit for the new bone formation and healing on the calvaria of bone of rabbits.
Oral health counselling in changing schoolchildren's oral hygiene habits: a qualitative study
Authors: Kasila Kirsti , Poskiparta Marita , Kettunen Tarja , Pietilä Ilpo
Published: November 2006

Abstract –  Objective:  This study explored oral health counselling concerning changes of oral hygiene habits in 11‐ to 13‐year‐old schoolchildren within a theoretical framework of the transtheoretical model and the motivational interview.

Methods:  The follow‐up data (2002–2003) formed two sequential parts: the first part comprised 66 counselling sessions in 2002; the second part included 31 counselling sessions in 2003. Thirty‐one (n = 31) schoolchildren were included in the counselling sessions that were conducted by four dental hygienists. The audiotaped and transcribed data were analysed qualitatively by using content analysis.

Results:  In 2002, nearly every schoolchild needed to establish changes in oral hygiene habits but the assessment of schoolchildren's readiness for change often remained unclear. In 2002, giving normative advice was the most commonly used counselling strategy when addressing the need for change, but dental hygienist‐centred change discussion and goal setting were also apparent and were related to the schoolchildren's rarely manifested changes of oral hygiene habits after a follow‐up year.

Conclusions:  Our results suggest that the theoretical framework might be useful in constructing and focusing on oral hygiene counselling for schoolchildren that concentrates on the personal dynamics of change. Further qualitative research is called for.
Risk indicators for early childhood caries in Taiwan
Authors: Tsai Aileen I. , Chen Chien‐Yuan , Li Lung‐An , Hsiang Chia‐Lan , Hsu Kuang‐Hung
Published: November 2006

Abstract –  Objectives:  The purpose of this study was to investigate the prevalence, patterns, and etiological factors for caries in children.

Methods:  A total of 981 children less than 6 years of age were examined using a dental mirror and explorer. A parent or a caregiver was asked to complete a questionnaire regarding information about the child, the household, and oral hygiene. The prevalence and patterns of dental caries including pit and fissure caries, facial/lingual caries, molar proximal caries, and facial/lingual molar proximal lesions, were analyzed. Each child was classified as caries free or as having one of these four caries patterns.

Results:  Weighted mean deft was 0.14 at age 2, 2.58 at age 3, 4.41 at age 4, 6.94 at age 5, and 7.31 at age 6. Weighted mean defs was 4.71, 8.44, 16.45 and 18.64 at ages 3, 4, 5, and 6, respectively. By age 2, 5.09% of children had caries. By age 6, 89.38% of children had caries. By age 3, 30.02% of children fitted the facial and lingual pattern of caries and by age 6, 52.90% of children fit the ‘facial‐lingual and molar‐proximal’ pattern, indicating extensive smooth surface decay. The total prevalence of early childhood caries was 56%. Multivariate‐adjusted odds ratios identified factors associated with the high caries experience of the young children and found caries was strongly associated with the lack of proper tooth brushing and high consumption of sweets. Higher caries scores were also associated with areas of low urbanization.

Conclusions:  The findings of this survey indicated a high level of untreated caries among children in Taiwan.
Factors related to job satisfaction among South Korean dentists
Authors: Jeong Seong‐Hwa , Chung Jae‐Kyun , Choi Youn‐Hee , Sohn Woosung , Song Keun‐Bae
Published: November 2006

Abstract –  Objectives:  The purposes of this study were to investigate the level and distribution of job satisfaction and to explore work environment factors associated with job satisfaction of South Korean dentists.

Methods:  A stratified systematic random sample of 1029 dentists was selected from the 10 357 registered dentists in the Korean Dental Association. They were surveyed via a self‐administered mail questionnaire. Job satisfaction was measured by a modified version of the Dentist Satisfaction Survey.

Results:  The response rate was 62.2%. The mean score of overall job satisfaction among South Korean dentists was 3.2 out of 5. In terms of work environment factors, the most satisfying aspect was patient relations (3.7) and the least satisfying aspect was personal time (2.8). Multiple regression analysis identified a model including patient relations, perception of income, personal time, staff, and specialty training that accounted for 35% of variation in overall job satisfaction. The majority of the variance was explained by patient relations.

Conclusions:  This study suggests that patient relations, perception of income, personal time, staff, and specialty training are important work environment factors for job satisfaction among South Korean dentists. The findings of this study will be helpful to policy makers to design plans to increase the level of job satisfaction among South Korean dentists.
A controlled trial of the impact of exposure to positive images of dentistry on anticipatory dental fear in children
Authors: Fox C. , Newton J. T.
Published: November 2006

Abstract –  Objectives:  Dental anxiety is common in children. This study sought to determine the impact of viewing positive images of dentistry prior to a dental appointment on the anticipatory dental anxiety levels of children attending for dental treatment.

Methods:  Controlled trial. Assessment of anxiety and analysis of data were conducted blind to experimental condition. Assessment of anxiety was carried out in the waiting room postintervention but before the patient entered the dental surgery for treatment.

Participants:  Thirty‐eight children and young adults attending a dental clinic in South West England.

Intervention:  Participants were randomly assigned to one of two conditions. In both conditions the participant was asked to look at photographs for 2 min in the waiting area prior to their appointment. The intervention consisted of viewing positive images of dentistry and dental treatment, the control condition consisted of dentally neutral images. Positive and neutral images were validated independently by four paediatric dentists. The assessment of anticipatory dental anxiety was made blind to experimental condition and statistical analysis was conducted blind to group membership.

Outcome measure:  Anticipatory anxiety assessed by the Venham Picture Test.

Findings:  A significant difference in anticipatory dental anxiety was found between the two groups (median‐positive images = 0, median‐neutral images = 3; P < 0.001). Anticipatory anxiety was not correlated to age (rho = 0.04 P > 0.05), there was no difference between male and female participants in their level of anticipatory anxiety (median‐males = 0.5, median‐females = 1 P > 0.05).

Conclusions:  Viewing positive images of dentistry and dentists results in short‐term reductions in anticipatory anxiety in children.
Human natural killer cell development
Authors: Freud Aharon G. , Caligiuri Michael A.
Published: November 2006

Summary:  Our understanding of human natural killer (NK) cell development lags far behind that of human B‐ or T‐cell development. Much of our recent knowledge of this incomplete picture comes from experimental animal models that have aided in identifying fundamental in vivo processes, including those controlling NK cell homeostasis, self‐tolerance, and the generation of a diverse NK cell repertoire. However, it has been difficult to fully understand the mechanistic details of NK cell development in humans, primarily because the in vivo cellular intermediates and microenvironments of this developmental pathway have remained elusive. Although there is general consensus that NK cell development occurs primarily within the bone marrow (BM), recent data implicate secondary lymphoid tissues as principal sites of NK cell development in humans. The strongest evidence stems from the observation that the newly described stages of human NK cell development are naturally and selectively enriched within lymph nodes and tonsils compared with blood and BM. In the current review, we provide an overview of these recent findings and discuss these in the context of existing tenets in the field of lymphocyte development.
NK cell regulation by SLAM family receptors and SAP‐related adapters
Authors: Veillette André
Published: November 2006

Summary:  Signaling lymphocytic activating molecule (SLAM) family receptors and SLAM‐associated protein (SAP)‐related adapters play several important roles in the immune system. Natural killer (NK) cells express at least three members of the SLAM family. They are 2B4, NK, T‐ and B‐cell antigen (NTB‐A), and CD2‐like receptor‐activating cytotoxic cells (CRACC), which recognize their respective ligands CD48, NTB‐A, and CRACC on target cells and possibly on other NK cells. In mature human NK cells, SLAM family receptors appear to have activating functions. In mature mouse NK cells, however, the only available information is for 2B4, which reportedly has the capacity to either stimulate or inhibit NK cell activation. The ability of SLAM family receptors to regulate NK cell functions seems to be largely dependent on their capacity to associate, by way of their cytoplasmic domain, with members of the SAP family of adapters, including SAP, Ewing’s sarcoma‐activated transcript‐2 (EAT‐2), and EAT‐2‐related transducer (ERT). By binding to SAP, SLAM family receptors are coupled to the Src kinase FynT, thereby evoking protein tyrosine phosphorylation signals. In human NK cells, SAP is likely to be crucial for the activating function of 2B4 and NTB‐A but not of CRACC and also crucial for the activating function of 2B4 in mouse NK cells. EAT‐2. SAP is ERT link SLAM family receptors to distinct, albeit poorly understood, signals. These two SAP‐related adapters may be implicated in the inhibitory function of 2B4 observed in mouse NK cells. While much work remains to be carried out to fully understand the roles and mechanisms of action of the SLAM and SAP families in human and mouse NK cells, the published findings clearly establish that these molecules have important functions in NK cell biology.
Licensing of natural killer cells by self‐major histocompatibility complex class I
Authors: Yokoyama Wayne M. , Kim Sungjin
Published: November 2006

Summary:  Natural killer (NK) cells have potent capacities to immediately kill cellular targets and produce cytokines that may potentially damage normal self‐tissues unless they are kept in check. Such tolerance mechanisms are incompletely understood. Here we discuss recent studies suggesting that NK cells undergo a host major histocompatibility complex (MHC) class I‐dependent functional maturation process, termed ‘licensing’. Ironically, licensing directly involves inhibitory receptors that recognize target cell MHC class I molecules and block activation of NK cells in effector responses. This process results in two types of tolerant NK cells: functionally competent (licensed) NK cells, whose effector responses are inhibited by self‐MHC class I molecules through the same receptors that conferred licensing, and functionally incompetent (unlicensed) NK cells.
KIR and disease: a model system or system of models?
Authors: Khakoo Salim I. , Carrington Mary
Published: November 2006

Summary:  The discovery of an unexpected level of diversity among the killer cell immunoglobulin‐like receptors has led to a search for their role in human disease. Due to their polymorphism and also that of their human leukocyte antigen class I ligands, these studies are difficult to perform and complex to interpret. Nevertheless, as the number of data sets increase, consistent trends and themes are beginning to emerge in both viral and inflammatory disorders. In this review, we summarize the findings from a number of disease association studies and discuss these in the context of the activating and inhibitory roles of the members of this gene family.
Taking license with natural killer cell maturation and repertoire development
Authors: Parham Peter
Published: November 2006

Summary:  Combining population analysis with in‐depth analysis of selected individuals, the tolerance of human natural killer (NK) cells to autologous major histocompatibility complex (MHC) class I and potential reactivity to allogeneic MHC class I have been studied. Analysis of NK cell clones in long‐term culture and peripheral blood NK cells after short‐term culture (20–24 h) shows that NK cell tolerance is determined by interactions of autologous MHC class I with CD94:NKG2A and inhibitory killer cell immunoglobulin‐like receptors (KIRs). Alloreactivity is predicted whenever the donor of the allogeneic target lacks a cognate MHC class I–KIR, ligand–receptor pair that is present in the NK cell donor. In the human population, there is a wide variation in the NK cell repertoire of KIRs and CD94:NKG2A expression. Variation is principally due to KIR gene variation and polymorphism, with a smaller effect due to MHC class I. The presence of MHC class I increases the frequency of NK cells expressing the cognate KIR, an effect that is diminished by the presence of other cognate–ligand pairs. The minor influence of MHC class I on the KIR repertoire indicates that NK cell development is an efficient process in which the expression of inhibitory MHC class I receptors at the final stages ensures that functionally active human NK cells are self‐tolerant.
Natural killer cells in viral infection: more than just killers
Authors: Andoniou Christopher E. , Andrews Daniel M. , Degli‐Esposti Mariapia A.
Published: November 2006

Summary:  Innate immunity was believed originally to serve simply as the first‐line defense against infection and malignancy, with adaptive immunity imposing specificity and ensuring that appropriate responses are mounted against chronic or reoccurring challenges. In this model of immunity, innate and adaptive immune responses are sequential, essentially non‐overlapping, and interactions between components of each response limited or non‐existent. Over the last 5 years, it has become increasingly evident that interactions between elements of the innate and adaptive immune systems are common. Indeed, it is now clear that the generation and maintenance of effective immunity require an extensive array of interactions between multiple components of the immune system. This review discusses recent advances in this area with particular emphasis on the role of natural killer cells in shaping the adaptive immune response to viral infection.
Neurobiology of exercise
Authors: Dishman R. K. , Berthoud H. R. , Booth F. W. , Cotman C. W. , Edgerton V. R. , Fleshner M. R. , Gandevia S. C. , Gomez‐Pinilla F. , Greenwood B. N. , Hillman C. H. , Kramer A. F. , Levin B. E. , Moran T. H. , Russo‐Neustadt A. A. , Salamone J. D. , Van Hoomissen J. D. , Wade C. E. , York D. A. , Zigmond M. J.
Published: November 2006

Voluntary physical activity and exercise training can favorably influence brain plasticity by facilitating neurogenerative, neuroadaptive, and neuroprotective processes. At least some of the processes are mediated by neurotrophic factors. Motor skill training and regular exercise enhance executive functions of cognition and some types of learning, including motor learning in the spinal cord. These adaptations in the central nervous system have implications for the prevention and treatment of obesity, cancer, depression, the decline in cognition associated with aging, and neurological disorders such as Parkinson's disease, Alzheimer's dementia, ischemic stroke, and head and spinal cord injury. Chronic voluntary physical activity also attenuates neural responses to stress in brain circuits responsible for regulating peripheral sympathetic activity, suggesting constraint on sympathetic responses to stress that could plausibly contribute to reductions in clinical disorders such as hypertension, heart failure, oxidative stress, and suppression of immunity. Mechanisms explaining these adaptations are not as yet known, but metabolic and neurochemical pathways among skeletal muscle, the spinal cord, and the brain offer plausible, testable mechanisms that might help explain effects of physical activity and exercise on the central nervous system.