bluuebunny/crossref_metadata_2025 huggingface dataset:
Three screening methods for cognitive dysfunction using the Mini‐Mental State Examination and Korean Dementia Screening Questionnaire
Authors: Choi Seong Hye , Park Moon Ho
Published: February 2015

Aim

To screen for and determine cognitive dysfunction, cognitive tests and/or informant reports are commonly used. However, these cognitive tests and informant reports are not always available. The present study investigated three screening methods using the Mini‐Mental State Examination (MMSE) as the cognitive test, and the Korean dementia screening questionnaire (KDSQ) as the informant report.

Methods

Participants were recruited from the Korea Clinical Research Center for Dementia of South Korea, and included 2861 patients with Alzheimer's disease (dementia), 3519 patients with mild cognitive impairment and 1375 controls with no cognitive dysfunction. Three screening methods were tested: (i) MMSE alone (MMSEcut‐off); (ii) a conventional combination of MMSE and KDSQ (MMSE+KDSQcut‐off); and (iii) a decision tree with MMSE and KDSQ (MMSE+KDSQdecision tree).

Results

For discriminating any cognitive dysfunction from controls, MMSE+KDSQcut‐off had the highest area under the receiver operating characteristic curve (0.784). For discriminating dementia from controls, MMSE+KDSQcut‐off had the highest area under the receiver operating characteristic curve (0.899). For discriminating mild cognitive impairment from controls, MMSEcut‐off had the highest area under the receiver operating characteristic curve (0.683). MMSE+KDSQdecision tree showed the highest sensitivity for all discriminations. For overall classification accuracy, MMSE+KDSQdecision tree had the highest value (70.0%).

Conclusions

These three methods had different advantageous properties for screening and staging cognitive dysfunction. As there might be different availability across clinical settings, these three methods can be selected and used according to situational needs. Geriatr Gerontol Int 2016; 16: 252–258.
The Pharmacological Treatment of Migraine in Brazil
Authors: Krymchantowski Abouch Valenty , Jevoux Carla da Cunha
Published: February 2015

Background/Objectives

Migraine is a chronic, disabling, and recurrent illness. Despite its burden, preventive medications are often underused, while acute strategies are frequently used injudiciously. Patients may benefit from comprehensive approaches with general informative orientation and formal medication strategies. In developing countries like Brazil, the access to comprehensive tertiary headache centers or updated specialists is somewhat limited, as are the resources available out of some private specialty care clinics. In addition, centers from the public system may not deliver effective care. The aim of this review is to perform a general description of the pharmacological treatments of migraine in tertiary headache centers of Brazil.

Methods

The data of 4 public and 6 private tertiary centers under the care of 16 neurologists involved with headache assistance in different cities of Brazil were gathered. Answers to questions directed to headache specialists, and analyzing data from previous care of patients was used to estimate a description of the general pharmacological approach used in Brazilian centers. The therapeutic options adopted by general practitioners were not considered as those from other medical specialties and holistic medicine, which also treat migraine on a common basis.

Results

Estimated data of nearly 4800 patients from 16 neurologists acting in headache clinics from 2005 to 2013 were collected. Headache approach by specialists in Brazil is basically divided into 2 groups. The public services, which assist nonpaying patients, deliver traditional and noncomprehensive approaches as well as prescribe mostly monotherapy. Roughly 30% of their patients do not receive preventive treatments that are generally tricyclic antidepressants or β‐blockers. Private centers, which are usually where paying people attend, as well as a few public centers of excellence, use multidisciplinary approaches and combination of drugs, despite the usual allegation of scarce evidence. Nearly 90% of the patients from these centers receive the prescription of preventive treatments, which are generally tricyclic antidepressants and/or neuromodulators and/or β‐blockers.

Comments

There is no consensus on whether patients turning to private tertiary centers are different from those seen in public nonpaying services. However, since it is directly related to economic status and public services may render free specific medications as well as official dispensation of work, it may be argued that patients have less headache impact, and suboptimal care is delivered in these instances. As for the studied private centers as well as for the few public excellence centers, care provided is usually varied, includes a combination of drugs, and prevention is commonly used.
A Comprehensive Review of the Use of Deep Brain Stimulation (DBS) in Treatment of Psychiatric and Headache Disorders
Authors: Altinay Murat , Estemalik Emad , Malone Donald A.
Published: February 2015

Background

Neurostimulation as a treatment option for refractory neuropsychiatric disorders has been increasingly utilized in recent years. For patients with such refractory disorders who have often failed to respond to various medical interventions, deep brain stimulation (DBS) has emerged as a promising treatment modality. DBS is a reversible and adjustable form of brain stimulation (also known as functional neurosurgery) in which desired brain structures (or circuits) are given focal electric stimulation via electrodes that are implanted in the brain tissue during a surgical procedure. It has been utilized among various psychiatric and neurological illnesses, in particular headache disorders.

This article reviews the most relevant data regarding DBS for psychiatric and primary headache disorders.

Methods

Authors conducted a detailed literature search of Medline/PubMed database and studies that used DBS for the treatment of refractory neuropsychiatric disorders were reviewed. Response, remission, and safety measures of these studies were obtained.

Results

Despite the advancement in DBS treatment, the number of randomized controlled studies remains very limited due to ethical and methodological difficulties of setting up invasive procedures of this magnitude. So at present, DBS represents a modality used only in the most refractory patients.

Conclusion

Current data support DBS as a promising treatment option for neuropsychiatric disorders that do not respond to conventional treatments; however, it is clear that more research and patient volume is needed to demonstrate its efficacy in treating these conditions. The use of functional imaging to understand the pathophysiology of these disorders has been crucial for the utilization of DBS.
Evaluation of the impact of urban pollution on the quality of skin: a multicentre study in Mexico
Authors: Lefebvre M.‐A. , Pham D.‐M. , Boussouira B. , Bernard D. , Camus C. , Nguyen Q.‐L.
Published: February 2015

Synopsis

Objective

After pilot and preliminary studies aimed at identifying pertinent biochemical parameters, a multicenter clinical study was performed to evaluate the effect of pollution on human skin.

Methods

The clinical study was performed in collaboration with the ‘Centre Régional de lutte contre le cancer de Montpellier’ and the ‘National Institute of Public Health of Mexico’ on 96 subjects in Mexico City (exposed to pollution) and 93 subjects in Cuernavaca (less exposed to pollution). Both biochemical and clinical skin parameters were studied.

Results

The study demonstrated significant quantitative and qualitative modifications of parameters related to sebum excretion in Mexico City compared to Cuernavaca one: An increased level of sebum excretion rate, a lower level of vitamin E and squalene in sebum, an increase of lactic acid and a higher erythematous index on the face of the subjects. In the stratum corneum, a significant higher level of carbonylated proteins and a lower level of IL 1α were noticed, as well as a decrease of ATP concentration with a decrease of chymotrysin like activity, without modifications of corneodesmosin content and trypsin like activity. From a clinical point of view, a higher frequency of atopic and urticarial skins, a higher frequency of red dermographism, an important seborrheic status at the forehead level and a lower level of dandruffs were noted in Mexico City population. The analysis taking into account the sex does not modify the observed results.

Conclusion

The study demonstrated an important impact of polluted environmental conditions on skin quality, evidencing important modifications of superficial biochemical parameters. The cause/effects relationships of these modifications remain, however, to be further assessed by a complementary in vitro/in vivo approaches.
Fabrication and Characterization of Dysprosium‐Doped Bismuth Oxide Films for IT‐SOFCs via Slurry Spin Coating Technique
Authors: Ersoy Ersay , Cakar Soner , Yildiz Esra , Yilmaz Serdar , Turkoglu Orhan , Sarioz Ozlem
Published: February 2015

The production and stabilization of the fcc‐phase Bi2O3 solid solution (δ‐DSB) in the binary system of (Bi2O3)1−x(Dy2O3)x have been investigated in the doping range of 0.10 ≤ x ≤ 0.25 by adding Dy2O3 into pure α‐Bi2O3. All δ‐DSB samples were stabilized and exhibited single δ‐phase at 800°C. Thick film solid electrolytes were produced by the spin coating method. All of the coating and sintering parameters were optimized. Crystallographic, microstructural, and electrical characterizations were made for the produced films. The highest value of conductivity was ~1–10 Scm−1 for 11–15 mol% δ‐DSB film samples. The electrical conductivity curves of samples showed regular increase.
Melanoma of the lower extremities: foot site is an independent risk factor for clinical outcome
Authors: Sanlorenzo Martina , Osella‐Abate Simona , Ribero Simone , Marenco Federica , Nardò Tiziana , Fierro Maria Teresa , Novelli Mauro , Cervetti Ornella , Bernengo Maria Grazia , Quaglino Pietro
Published: February 2015

Background

Despite the better prognosis of melanomas localized on lower extremities, some studies have suggested that melanomas on the foot are related to a poorer survival and should be considered separately.

Objective

To review our case series of cutaneous melanomas on the lower extremities and to analyze the clinicopathological association, time course, types of progression, and survival differences.

Methods

We included 1671 patients (stage 0–II) with a cutaneous melanoma on the lower extremities (subungual melanomas were excluded). Of these, 327 were localized on the foot. Multivariate analyses were performed to evaluate disease‐specific survival and disease‐free interval.

Results

Distribution of known prognostic factors and patterns of progression of foot and leg melanoma differ across genders. The foot site was confirmed as a negative independent prognostic factor on disease‐specific survival and disease‐free interval.

Conclusion

Foot melanoma could represent a particular subgroup, which could require specific management in the future.
Electrical stimulation for post‐prostatectomy urinary incontinence: is it useful when patients cannot learn muscular exercises?
Authors: Terzoni Stefano , Montanari Emanuele , Mora Cristina , Ricci Cristian , Sansotera Jessica , Micali Martina , Cossi Simona , Destrebecq Anne Lucie
Published: February 2015

Urinary incontinence is common after radical prostatectomy. Pelvic floor muscle training (PFMT) and functional electrical stimulation (FES) can be used to reduce urine leakage. Some patients have difficulty in performing PFMT, and do not obtain clinically significant results. FES might be helpful to them, but its role is unclear in the literature. To verify if FES can reduce urine leakage in patients who do not benefit from PFMT. To obtain mid‐term data regarding the persistence of the results through FES or PFMT, associated with a maintenance programme. Prospective and retrospective study (104 PFMT patients, 34 FES) using 24‐h pad‐test to quantify leakage. Rehabilitation ended when patients obtained leakage <10 g/day. Rehabilitated patients followed a maintenance PFMT programme and performed a follow‐up 24‐h pad test after 3 months; 51% (PFMT) and 32% (FES) of patients reached leakage <10 g/day. Overall, 82.3% in the PFMT group and 82.3% in the FES group reduced leakage by at least 50% through rehabilitation. No significant difference existed between the two treatments (p = 0.32). After 3 months, 51 rehabilitated patients out of 56 (PFMT) and 11 out of 11 (FES), respectively, showed persistence of the results. PFMT cannot be replaced by machines, but FES can help those who are unable to execute PFMT to strengthen their sphincter and later learn PFMT. Even those who did not achieve rehabilitation had clinically relevant results in both groups. These methods seem useful for incontinent patients after prostatectomy.
Finding what is hidden: a method to measure implicit attitudes for nursing and health‐related behaviours
Authors: Manns‐James Laura
Published: February 2015

Aim

To discuss a research method, the Implicit Association Test, for use in nursing research. The Implicit Association Test measures implicit attitudes, which may mediate health‐related and caregiving behaviours.

Background

Implicit attitudes are automatic and often unconscious, but may affect the behaviours of nurses and their patients. The Implicit Association Test has been used to measure implicit attitudes in fields from health care to marketing, but has seldom appeared in nursing. The Implicit Association Test is a computer‐based tool consisting of a series of categorization tasks. Implicit Association Tests are scored based on the speed of matching either words or images to categories. Assumptions of the Implicit Association Test method, its administration, psychometrics and potential use in nursing research are reviewed.

Design

Discussion paper.

Data sources

PubMed, the Cumulative Index to Nursing and Allied Health Literature, PsychINFO® and Health and Psychosocial Instrument databases were searched from the Implicit Association Test's introduction in 1998–April 2013. Search terms used were ‘Implicit Association Test’ OR ‘IAT’.

Implications for nursing

Nursing theories include attitudes as mediators of behaviour and health, but measurement has been limited to explicit attitudes. A reliable, valid and flexible tool is available to measure implicit attitudes. This tool largely circumvents self‐report bias related to socially sensitive topics.

Conclusion

Nursing research is needed to investigate implicit attitudes held by nurses and patients when these may influence health‐related behaviours and outcomes. The Implicit Association Test can measure implicit attitudes and is suitable for adoption in nursing research.
Blood pressure control in patients with hypertension: a retrospective cohort study
Authors: Aydogan Umit , Doganer Yusuf C. , Atik Aslı , Rohrer James E. , Engin Gok Deniz , Cirpan Ebru , Yilmaz Mahmut I. , Saglam Kenan
Published: February 2015

Rationale, aims and objectives

Hypertension (HT) is prevalent in Turkey and even with pharmacological interventions HT control rates do not meet guideline recommendations. We aimed to estimate the proportion of hypertensive patients who achieved target blood pressure (BP) and seek to determine the predictors responsible for failure of to reach goals.

Methods

We conducted a retrospective cohort study involving patients with HT. A total of 437 patients were identified with a current diagnosis of HT at baseline. All available predictors for BP improvements were included in the multivariate linear regression model.

Results

Follow‐up data on HT goal achievements was available for 276 (63.1%) participants. Only 18.1% of the patients at the baseline visit, and 48.6% at the follow‐up visit achieved the overall SBP/DBP targets specified by the JNC‐8 guideline. Significant differences were determined by baseline and 1st visit measurements of mean SBP/DBP levels (P < 0.001, P < 0.001, respectively). DM and baseline SBP were positively associated with SBP improvement (β = 8.410, P = 0.003; β = 0.692, P < 0.001, respectively), whereas being prescribing more HT medications and being older were negatively associated with improvement (β = −7.968, P = 0.005; β = −5.707, P = 0.037; respectively). DM, baseline DBP and HT duration were positively associated with DBP improvement (β = 4.539, P = 0.012; β = 0.702, P < 0.001; β = 0.023, P = 0.012; respectively), whereas additional HT medications and GFR values were negatively associated with improvement (β = −5.682, P = 0.002; β = −0.098, P = 0.005; respectively).

Conclusions

Although the progress in achieving in BP targets was encouraging, only half of patients had reached the HT goals. Adequate pharmacological approaches and comprehensive management strategies should be implemented in hypertensive patients.
What Should Be Held Steady in a Steady‐State Economy?: Interpreting Daly's Definition at the National Level
Authors: O'Neill Daniel W.
Published: February 2015

Within this article, I investigate a number of the conceptual issues that arise when attempting to translate Herman Daly's definition of a steady‐state economy (SSE) into a set of national biophysical indicators. Although Daly's definition gives a high‐level view of what would be held steady in an SSE, it also leaves many questions unanswered. How should stocks and flows be aggregated? What is the role of international trade? How should nonrenewable resources be treated? And where does natural capital fit in? To help answer these questions, I relate Daly's definition to key concepts and terminology from material and energy flow accounting. I explore topics such as aggregation, international trade, the relevance of throughput, and hidden flows. I conclude that a set of biophysical accounts for an SSE should include three types of indicators (stocks, flows, and scale), track how stocks and flows are changing over a 5‐ to 10‐year period, use aggregated data that measure the quantity of resource use (rather than its quality), measure both total and nonrenewable resource use, adopt a consumption‐based approach, include hidden flows, and exclude indicators that measure characteristics of the stock of natural capital (with the notable exception of indicators that measure the regenerative and assimilative capacities of ecosystems).
Life Cycle Assessment of a Magazine, Part I: Tablet Edition in Emerging and Mature States
Authors: Ahmadi Achachlouei Mohammad , Moberg Åsa , Hochschorner Elisabeth
Published: February 2015

Information and communication technology (ICT) is providing new ways to access media content. ICT has environmental benefits and burdens. The overall goal of the present study was to assess the environmental impacts of production and consumption of magazines read on tablets from a life cycle perspective. Important goals were to identify the activities giving rise to the main impacts and the key factors influencing the overall environmental impacts. Data gaps and uncertainties were also addressed. The results are compared against those for the print edition of the magazine in a separate article (part 2). The methodology used in the study was life cycle assessment. The environmental impacts assessed included climate change, cumulative energy/exergy demand, metal depletion, photochemical oxidant formation, particulate matter formation, terrestrial acidification, freshwater/marine eutrophication, fossil depletion, human toxicity, and ecotoxicity. The results indicate that content production can be the major contributor to environmental impacts if readers are few (as for the emerging version of the magazine studied). Assuming more readers (more mature version) or a larger file size for the tablet magazine, electronic storage and distribution may be the major contributor. Thus, in contrast to previous studies on electronic media, which reported a dominant impact of the use phase, this study found a higher impact for content production (emerging version) and electronic storage and distribution (mature version). However, with inefficient, low overall use of the tablet with a mature version of the tablet magazine, the greatest impact was shown to come from the reading activity (i.e., the use phase). In conclusion, the relative impacts of the tablet magazine would decrease considerably with high numbers of readers, their efficient use of the tablet (i.e., for many purposes over a long life of the device), and a smaller magazine file.
Coats‐like retinopathy in a Young Indian Rhesus Macaque (Macaca mulatta)
Authors: Liu David X. , Gilbert Margaret H. , Wang Xiaolei , Didier Peter J. , Shields Carol L. , Lackner Andrew A.
Published: February 2015

A 1‐year‐old male Indian rhesus macaque presented with a bilateral blindness. Ocular examination, gross and histopathological evaluation, and immunohistochemistry were performed. The major findings were retinal telangiectasia, accumulation of exudate in the intraretinal and subretinal space, and retinal detachment. Coat‐like retinopathy was diagnosed, and it has not been previously reported in veterinary medicine.
Testing hypotheses of bat baculum function with 3D models derived from microCT
Authors: Herdina Anna Nele , Kelly Diane A. , Jahelková Helena , Lina Peter H. C. , Horáček Ivan , Metscher Brian D.
Published: February 2015

The baculum (os penis) has been extensively studied as a taxon‐specific character in bats and other mammals but its mechanical function is still unclear. There is a wide consensus in the literature that the baculum is probably a sexually selected character. Using a novel approach combining postmortem manipulation and three‐dimensional (3D) imaging, we tested two functional hypotheses in the common noctule bat Nyctalus noctula, the common pipistrelle Pipistrellus pipistrellus, and Nathusius’ pipistrelle Pipistrellus nathusii: (i) whether the baculum can protect the distal urethra and urethral opening from compression during erection and copulation; and (ii) whether the baculum and corpora cavernosa form a functional unit to support both the penile shaft and the more distal glans tip. In freshly dead or frozen and thawed bats, we compared flaccid penises with artificially ‘erect’ penises that were inflated with 10% formalin. Penises were stained with alcoholic iodine and imaged with a lab‐based high‐resolution x‐ray microtomography system. Analysis of the 3D images enabled us to compare the changes in relative positions of the baculum, corpora cavernosa, urethra, and corpus spongiosum with one another between flaccid and ‘erect’ penises. Our results support both functional hypotheses, indicating that the baculum probably performs two different roles during erection. Our approach should prove valuable for comparing and testing the functions of different baculum morphologies in bats and other mammals. Moreover, we have validated an essential component of the groundwork necessary to extend this approach with finite element analysis for quantitative 3D biomechanical modeling of penis function.
The WACC Fallacy: The Real Effects of Using a Unique Discount Rate
Authors: KRÜGER PHILIPP , LANDIER AUGUSTIN , THESMAR DAVID
Published: February 2015

In this paper, we test whether firms properly adjust for risk in their capital budgeting decisions. If managers use a single discount rate within firms, we expect that conglomerates underinvest (overinvest) in relatively safe (risky) divisions. We measure division relative risk as the difference between the division's asset beta and a firm‐wide beta. We establish a robust and significant positive relationship between division‐level investment and division relative risk. Next, we measure the value loss due to this behavior in the context of acquisitions. When the bidder's beta is lower than that of the target, announcement returns are significantly lower.
The Impact of Incentives and Communication Costs on Information Production and Use: Evidence from Bank Lending
Authors: QIAN JUN (QJ) , STRAHAN PHILIP E. , YANG ZHISHU
Published: February 2015

In 2002 and 2003, many Chinese banks implemented reforms that delegated authority to individual loan officers. The change followed China's entrance into the WTO and offers a plausibly exogenous shock to loan officer incentives to produce information. We find that the bank's internal risk rating becomes a stronger predictor of loan interest rates and ex post outcomes after reform. When the loan officer and the branch president who approves the loan work together longer, the rating also becomes more strongly related to loan prices and outcomes. Our results highlight how incentives and communication costs affect information production and use.
Capital and Labor Reallocation within Firms
Authors: GIROUD XAVIER , MUELLER HOLGER M.
Published: February 2015

We document how a positive shock to investment opportunities at one plant (“treated plant”) spills over to other plants within the same firm, but only if the firm is financially constrained. To provide the treated plant with resources, the firm's headquarters withdraws capital and labor from other plants, especially plants that are relatively less productive, not part of the firm's core industries, and located far away from headquarters. As a result of the resource reallocation, aggregate firm‐wide productivity increases. We do not find evidence of capital or labor spillovers among plants of financially unconstrained firms.
Expression of advanced glycation end products in placenta and concentration in maternal and umbilical serum in pre‐eclampsia
Authors: Yan Jian‐ying , Jiang Ling‐ling
Published: February 2015

Aim

To study the function of free fatty acid (FFA) in maternal serum and advanced glycation end products (AGE) in maternal serum, umbilical cord blood and in the placenta of women with pre‐eclampsia.

Methods

Sixty women with pre‐eclampsia and 60 normal pregnant women as controls participated in this study. Women with pre‐eclampsia were divided into an early‐onset group and late‐onset group, with 30 normal pregnant women as the early control group and 30 as the late control group. Competitive enzyme‐linked immunosorbent assay was used to measure AGE in maternal serum and umbilical cord blood. Western blotting was performed to analyze AGE in the placenta. Improved copper agent colorimetry was performed to measure FFA in maternal serum.

Results

Mean AGE in maternal serum in the early‐onset and late‐onset pre‐eclampsia groups was significantly higher than in the control groups. Mean concentration of umbilical cord blood AGE was significantly higher in the early‐onset and late‐onset pre‐eclampsia groups when compared with the control groups. On western blot the level of placental AGE in the early‐onset and late‐onset pre‐eclampsia groups was significantly higher than in normal placenta. Serum FFA in the early‐onset and late‐onset pre‐eclampsia groups was higher than in healthy pregnant women. Maternal serum FFA in the early‐onset and late‐onset pre‐eclampsia groups correlated positively with maternal serum AGE (r = 0.764 and r = 0.774, P < 0.05).

Conclusions

AGE and FFA, which are upregulated in pre‐eclampsia, are likely to be involved in pre‐eclampsia through some common mechanism.
Effects of a phyto complex on well‐being of climacteric women
Authors: Quattrocchi Tomasella , Micali Elvira , Gentile Antonino , La Ferrera Ettore Giuseppe , Barbaro Luisa , Ciarcià Stella , Corrado Francesco , Di Costa Maria , Fazio Roberto , Licenziato Roberto , Marcazzò Annamaria , Minniti Rosaria , Riccobene Rosaria , Russello Carmela Maria , Cancellieri Francesco
Published: February 2015

Aim

The aim of this study was to assess the effects of a phyto complex on menopausal symptoms.

Material and Methods

A total of 151 women aged 42–67 years were enrolled. They were in spontaneous or surgical menopause by at least 12 months, reporting symptoms referable to the climacteric syndrome. Two validated and standardized tests were given to the whole sample at the entrance of the study (T0) and after 6 months of treatment (T6): the Greene Climacteric Scale (GCS) and the Beck Depression Inventory (BDI). Interim evaluations were carried out at 1–3 months (T1 and T3) on five symptoms selected from the GCS. The phyto complex was given to each enrolled woman, from the T0 to T6 time‐points, for a total of 180 days.

Results

At the T0 time‐point, the average scores were: GCS, 28.98 (standard deviation [SD] ± 10.71); BDI, 14.48 (SD ± 6.5). At the T1 time‐point, five parameters of the GCS were assessed with a reduction of 36.25% in symptoms (5.69, SD ± 3.53). At the T6 time‐point the assessment was completed: average GCS results were 11.54 (SD ± 8.01) with a 60.17% improvement; and average BDI results were 6.11 (SD ± 4.6) with a 58.91% improvement in the depressive symptoms.

Conclusions

The phyto complex under consideration is an effective tool to counter, in a quick and long‐lasting manner, the most common and nagging symptoms of the climacteric syndrome, such as hot flushes, insomnia and depression.
Ureterovaginal fistula after insertion of a McDonald suture: Case report and review of published reports
Authors: Ng Kai Lyn , Kale Anita Sugam , Gosavi Arundhati Tushar
Published: February 2015

Complications associated with cerclage that are commonly described in the existing published reports include injuries to the cervix or bladder, premature rupture of membranes, chorioamnionitis and bleeding. We report an unusual complication of a ureterovaginal fistula formation after the insertion of a McDonald suture.
Ocular blood flow in polycystic ovary syndrome
Authors: Örnek Nurgül , İnal Mikail , Tulmaç Özlem Banu , Özcan‐Dağ Zeynep , Örnek Kemal
Published: February 2015

Aim

The aim of this study was to evaluate whether the presence of polycystic ovary syndrome (PCOS) alters ocular blood flow parameters.

Material and Methods

Color Doppler imaging of the orbital vessels was performed in 41 eyes of 41 patients with PCOS. Forty‐eight eyes of 48 age‐matched volunteers served as controls. The ophthalmic artery (OA), the central retinal artery and the posterior ciliary artery were examined. Ocular blood flow indices of the peak systolic velocity, diastolic velocity, end‐diastolic velocity, systolic/diastolic ratio, resistive index and pulsatility index were computed.

Results

The peak systolic velocity, diastolic velocity and end‐diastolic velocity of the OA, central retinal artery and posterior ciliary artery were significantly increased in PCOS patients in comparison to the controls (all P < 0.001). The mean systolic/diastolic ratio, resistive index and pulsatility index of the OA in PCOS patients were significantly decreased (all P < 0.05). Ocular blood flow velocity was positively correlated with serum luteinizing hormone, follicle‐stimulating hormone and total cholesterol levels. There was a significant negative correlation between serum glucose and insulin levels and ocular blood flow velocity.

Conclusion

Ocular blood flow velocity is increased in PCOS patients and vascular resistance seems to decrease only in the OA.
The adjunctive use of platelet concentrates in the therapy of gingival recessions: a systematic review and meta‐analysis
Authors: Luo H.Y. , Li R.M. , Wang C.L. , Peng L. , Ye L.
Published: February 2015

This systematic review aims to evaluate the adjunctive efficacy of platelet concentrates in surgical treatment of gingival recessions. The MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials were searched for entries up to January 2014. Only clinical randomised controlled trials (RCTs) with a follow‐up ≥3 months that evaluated recession areas (Miller Class I or II) were included. Outcome variables include changes of recession depth (RD), keratinised tissue width (KTW), clinical attachment level (CAL) and wound healing index. Data were adjusted for a meta‐analysis. Nine researches were included in meta‐analysis. With the adjunctive use of platelet concentrates, there was statistically significant reduction in RD and KTW improvement while no significant effect was found in CAL. The adjunctive use of platelet concentrates also showed better healing in gingival recessions. Platelet concentrates might exert a positive effect on treatment of gingival recessions. It could accelerate early wound healing and reduce post‐surgery complications in recession defects. However, more high‐quality, long follow‐up and large‐scale RCTs are still needed in future.
Photoelastic Stress Distribution Produced by Different Retention Systems for a Single‐Implant Mandibular Overdenture
Authors: Nascimento João Francisco Machado , Aguiar‐Júnior Fábio Afrânio , Nogueira Túlio Eduardo , Rodrigues Renata Cristina Silveira , Leles Cláudio Rodrigues
Published: February 2015

Purpose

For patients poorly adapted to conventional dentures, the single‐implant mandibular overdenture has been proposed as a simplified alternative for the two‐implant treatment, together with the use of immediate loading of the implant. The aim of this in vitro study was to compare the photoelastic characteristics of stress transfer around the implant in a single‐implant mandibular overdenture using different types of attachments.

Materials and Methods

A photoelastic model of an edentulous mandible with a resilient edentulous ridge and a unique implant located at the symphyseal region was obtained to reproduce a single implant‐retained mandibular overdenture. Six 2.0 mm height attachments were selected and inserted in the same photoelastic model in a random order. A universal testing machine was used to induce axial vertical loads of 70 Ncm applied at the central incisor and at the central region of the first right molar without contact on the contralateral side. The photoelastic analysis was performed using a polariscope integrated into the testing machine. Standard separate views were photographed, using only one model per system. A visual qualitative analysis of stress‐induced fringes was performed to comparatively rank the different attachment systems.

Results

All attachments showed a similar tension distribution concentrated in the apical third, and the highest stress concentration was at the apical level. There was a low stress concentration at the coronal third of the implant, with no discernible stress in the first threads of the implants, except for Dalla Bona, which showed low stress at the coronal part of the implant (1 fringe). No identifiable fringes were observed when the load was applied in the molar region, which resulted from the low amount of stress transmitted by the implant for all attachments.

Conclusion

The load transferred to a single mandibular implant was evenly distributed around the implant with low stress concentration, irrespective of the type of retention system.
Nutritional status of patients with ataxia‐telangiectasia: A case for early and ongoing nutrition support and intervention
Authors: Ross Lynda J , Capra Sandra , Baguley Brenton , Sinclair Kate , Munro Kate , Lewindon Peter , Lavin Martin
Published: February 2015

Aim

Ataxia‐telangiectasia (A‐T) is a rare genomic syndrome resulting in severe disability. Chronic childhood disorders can profoundly influence growth and development. Nutrition‐related issues in A‐T are not well described, and there are no nutritional guidelines. This study investigated the nutrition‐related characteristics and behaviours of Australian A‐T patients attending a national clinic.

Methods

A cross‐sectional analysis of 13 A‐T patients (nine females; aged: 4–23 years): nutritional status was assessed by anthropometric and body cell mass (BCM) calculations. Parents reported their child's diet history and physical and behavioural factors that affect nutrition including fatigue and need for assistance.

Results

Ten (77%) had short stature (height for age z scores <−1), and seven (54%) were underweight for height (weight/height z scores <−1). Significant malnutrition (BCM z scores <−2) was detected in nine (69%) including the one adult who was severely malnourished. Malnutrition increased significantly with age (BCM for height z scores and age, r = −0.937, P < 0.001). Eight (62%) patients ate poorly compared with estimated energy requirement for weight. Poor diet quality was characterised by high fat and sugar choices. Parents reported significant nutritional barriers as chronic tiredness and the need for care giver assistance with meals.

Conclusions

This study confirms profound malnutrition in Australian A‐T patients. Poor intakes and diet quality suggest the need for early nutrition intervention. Ongoing support for families and early discussions on tube feeding are required to address changing needs in childhood and likely nutritional decline into adulthood. A prospective study is required to assess feasibility and effectiveness of nutrition interventions in young people with A‐T.
Screening for prediabetes and type 2 diabetes in dental offices
Authors: Herman William H. , Taylor George W. , Jacobson Jed J. , Burke Ray , Brown Morton B.
Published: February 2015

Objectives

Most Americans see dentists at least once a year. Chair‐side screening and referral may improve diagnosis of prediabetes and diabetes. In this study, we developed a multivariate model to screen for dysglycemia (prediabetes and diabetes defined as HbA1c ≥5.7 percent) using information readily available to dentists and assessed the prevalence of dysglycemia in general dental practices.

Methods

We recruited 1,033 adults ≥30 years of age without histories of diabetes from 13 general dental practices. A sample of 181 participants selected on the basis of random capillary glucose levels and periodontal status underwent definitive diagnostic testing with hemoglobin A1c. Logistic models were fit to identify risk factors for dysglycemia, and sample weights were applied to estimate the prevalence of dysglycemia in the population ≥30 years of age.

Results

Individuals at high risk for dysglycemia could be identified using a questionnaire that assessed sex, history of hypertension, history of dyslipidemia, history of lost teeth, and either self‐reported body mass index ≥35 kg/m2 (severe obesity) or random capillary glucose ≥110 mg/dl. We estimate that 30 percent of patients ≥30 years of age seen in these general dental practices had dysglycemia.

Conclusions

There is a substantial burden of dysglycemia in patients seen in general dental practices. Simple chair‐side screening for dysglycemia that includes or does not include fingerstick random capillary glucose testing can be used to rapidly identify high‐risk patients.

Practical implications

Further studies are needed to demonstrate the acceptability, feasibility, effectiveness, and cost‐effectiveness of chair‐side screening.
Association of environmental tobacco smoke and snacking habits with the risk of early childhood caries among 3‐year‐old Japanese children
Authors: Nakayama Yoshimi , Mori Mitsuru
Published: February 2015

Objectives

The aim of this study was to investigate the association of environmental tobacco smoke (ETS) and other risk factors with early childhood caries (ECC) in 3‐year‐old Japanese children by a cross‐sectional study.

Methods

Study subjects were 1,801 children aged 3 years old. The self‐administered questionnaire was completed by parents or guardians of the children. The survey contents included such things as if there was a smoker in the home, snack times, the kinds of snacks consumed more than or equal to four times a week, the kinds of drinks consumed more than or equal to four times a week, parents brushing their child's teeth daily, and the use of fluoride toothpaste. We obtained the number of decayed, missing, or filled teeth per person (dmft) from the dental examinations. Logistic regression analysis was performed to estimate odds ratio of ECC.

Results

The average number of decayed, missing and filled teeth (dmft index) was 1.00. The prevalence of dental caries was 22.4 percent. There was at least one smoker in the homes of 1,121 subjects (62.2 percent). After excluding items of multicollinearity, the results of multivariate analysis were as follows: drinking or eating sweets after dinner, irregular snack times, frequent intake of chocolate, frequent intake of sugar‐sweetened gum, frequent intake of isotonic drink, and maternal smoking were significantly associated with the risk of ECC.

Conclusions

This study suggests that there is a significant correlation between ETS from family members and snacking habits and ECC.
Tackling medication non‐adherence in severe mental illness: where are we going wrong?
Authors: Brown E. , Gray R.
Published: February 2015

Accessible summary

Although people with schizophrenia require medication to manage symptoms such as hearing voices, most do not take it as prescribed (they are non‐adherent).

We talked to psychiatrists, nurses and pharmacists about how they work with patients to help them be better at sticking with their medication.

Although the professionals that we talked to recognized that treatment adherence was a major issue in their clinical work, they did not make best use of evidence‐based interventions to address the problem. Often their practice was based on what they believed would work (e.g. patient education) even when the research shows that way of working to be ineffective.

As far as we can determine, this is the first study to examine what interventions different mental health professionals report that they use in clinical practice to address patient's medication non‐adherence.

Non‐adherence with medication is common in patients with schizophrenia. Addressing adherence to treatment may enhance clinical outcomes. Our aim was to explore mental health professionals experience and practise managing medication adherence in patients with schizophrenia. In this qualitative study, we interviewed mental health professionals from three key groups involved in promoting adherence: pharmacists, psychiatrists and nurses. Interviews were transcribed and analysed using a thematic approach. Thirty‐five health professionals participated. From these interviews, we identified five main themes: my beliefs inform my practice; withholding information; adherence is important; who is responsible for promoting adherence?; and is it ok to pay people to take medication? Our overarching meta‐theme was that practice with regard to promoting adherence was informed by beliefs and not by evidence. To the best of our knowledge, this is the first study to explore different mental health professionals' approaches to working with patients who do not want to take medication. The significance of participants' personal beliefs is an important observation. Our findings suggest that to support clinicians to more effectively help patients manage their medication, it may be first necessary to challenge pre‐existing beliefs about adherence.
Re‐storying narrative identity: a dialogical study of mental health recovery and survival
Authors: Grant A. , Leigh‐Phippard H. , Short N. P.
Published: February 2015

Accessible summary

Current UK mental health nursing policy is critiqued for neglecting the storied complexities of recovery‐survival.

Within a critical framework, creative non‐fiction is used in a relational auto‐ethnographic design to produce two short stories that demonstrate the utility of narrative re‐storying in recovery‐survival.

New insights emerge for mental health nurse practice and research. These are: that narrative re‐storying may help the recovery process for individuals and communities; that hybrid transcultural writing positively undermines barriers between professionals and consumers of mental health; and that all of this constitutes contemporary methodological innovation in narrative inquiry and related practice.

Some of the complexities of recovery and survival are arguably relatively neglected in current UK mental health nursing policy and, by association, clinical and research practice. In order to redress this, this paper, part of larger research project, will present two short stories, contextualized in a critical theoretical and methodological position. The overall significance of the argument in the paper is in its emerging benefits and implications for users of mental health services, practitioners and researchers. The central, orienting principle in the paper, cohering with all of its strands, is ‘narrative re‐storying’. Organized in three parts, the first reviews selected relevant background policy and related literature, the contextual and theoretical bases of the paper, and related methodological and ethical issues. The second presents the two stories, and the third brings the paper to a close. It does so in discussing specific and global emerging implications for mental health nursing practice and research, around narrative re‐storying as a recovery tool and methodological innovations that include ‘hybrid’ writing.
Multi‐gene phylogenetic analyses of New Zealand coralline algae: Corallinapetra Novaezelandiae gen. et sp. nov. and recognition of the Hapalidiales ord. nov.
Authors: Nelson Wendy A. , Sutherland Judith E. , Farr Tracy J. , Hart Darren R. , Neill Kate F. , Kim Hee Jeong , Yoon Hwan Su
Published: February 2015

Coralline red algae from the New Zealand region were investigated in a study focused on documenting regional diversity. We present a multi‐gene analysis using sequence data obtained for four genes (nSSU, psaA, psbA, rbcL) from 68 samples. The study revealed cryptic diversity at both genus and species levels, confirming and providing further evidence of problems with current taxonomic concepts in the Corallinophycidae. In addition, a new genus Corallinapetra novaezelandiae gen. et sp. nov. is erected for material from northern New Zealand. Corallinapetra is excluded from all currently recognized families and orders within the Corallinophycidae and thus represents a previously unrecognized lineage within this subclass. We discuss rank in the Corallinophycidae and propose the order Hapalidiales.
An invasive non‐native mammal population conserves genetic diversity lost from its native range
Authors: Veale A. J. , Holland O. J. , McDonald R. A. , Clout M. N. , Gleeson D.M.
Published: February 2015

Invasive, non‐native species are one of the major causes of global biodiversity loss. Although they are, by definition, successful in their non‐native range, their populations generally show major reductions in their genetic diversity during the demographic bottleneck they experience during colonization. By investigating the mitochondrial genetic diversity of an invasive non‐native species, the stoat Mustela erminea, in New Zealand and comparing it to diversity in the species’ native range in Great Britain, we reveal the opposite effect. We demonstrate that the New Zealand stoat population contains four mitochondrial haplotypes that have not been found in the native range. Stoats in Britain rely heavily on introduced rabbits Oryctolagus cuniculus as their primary prey and were introduced to New Zealand in a misguided attempt at biological control of rabbits, which had also been introduced there. While invasive stoats have since decimated the New Zealand avifauna, native stoat populations were themselves decimated by the introduction to Britain of Myxoma virus as a control measure for rabbits. We highlight the irony that while introduced species (rabbits) and subsequent biocontrol (myxomatosis) have caused population crashes of native stoats, invasive stoats in New Zealand, which were also introduced for biological control, now contain more genetic haplotypes than their most likely native source.