bluuebunny/crossref_metadata_2025 huggingface dataset:
Immediate Functional Loading of Dental Implants Supporting a Bar‐Retained Maxillary Overdenture: Preliminary 12‐Month Results
Authors: Pieri Francesco , Aldini Nicolò Nicoli , Fini Milena , Marchetti Claudio , Corinaldesi Giuseppe
Published: November 2009

Background: The present study evaluated the efficacy of a treatment consisting of placing and immediately loading implants with a bar‐retained overdenture in edentulous maxillae.

Methods: Twenty‐two consecutive patients were treated with four or five implants rigidly connected with a bar, which were then loaded with a maxillary overdenture within 48 hours post‐surgery. The patients were followed clinically and radiographically for 1 year after loading. The implant outcome with regard to survival and success was analyzed. Visual analog scale questionnaires were used to record patient function and satisfaction before and after implant treatment.

Results: Of the 103 implants, three failed within 1 year. Two implants, although integrated, presented with marginal bone resorption (MBR) values higher than those proposed for successful implants. Cumulative survival and success rates of implants were 97.1% and 95.2%, respectively. The average MBR after 1 year was low (0.78 ± 0.79 mm). The main prosthetic complication was the frequent need for complete relining of the prosthesis in the initial weeks after loading (27.2%). The questionnaire revealed a significant increase in all comfort, functional, and esthetic parameters (Friedman test; P <0.0001), except in the cleaning feasibility category; a significant decrease in satisfaction was observed in this category (Friedman test; P <0.05), indicating the difficulty patients had in maintaining a high level of oral hygiene.

Conclusion: These preliminary results suggest that immediate loading of multiple implants supporting a bar‐retained overdenture may represent a predictable treatment option for the rehabilitation of the edentulous maxilla.
Clinical Evaluation of a Biphasic Calcium Composite Grafting Material in the Treatment of Human Periodontal Intrabony Defects: A 12‐Month Randomized Controlled Clinical Trial
Authors: Stein Jamal M. , Fickl Stefan , Yekta Sareh Said , Hoischen Ulrich , Ocklenburg Christina , Smeets Ralf
Published: November 2009

Background: The aim of this study was to compare the clinical outcome of a novel biphasic calcium composite (BCC) biomaterial versus autogenous bone spongiosa (ABS) or open flap debridement (OFD) for the treatment of intrabony periodontal defects.

Methods: Forty‐five subjects with at least one intrabony defect with a probing depth (PD) ≥7 mm and a vertical radiographic bone loss ≥3 mm were enrolled in the study. Subjects were randomly assigned to treatment with BCC (n = 15), ABS (n = 15), or OFD (n = 15). Clinical parameters were recorded at baseline and 12 months after surgery and included the plaque index, gingival index, PD, clinical attachment level (CAL), and gingival recession.

Results: In all treatment groups, significant PD reductions and CAL gains occurred during the study period (P <0.0001). At 12 months, patients treated with BCC exhibited a mean PD reduction of 3.6 ± 0.7 mm and a mean CAL gain of 3.0 ± 0.8 mm compared to baseline. Corresponding values for patients treated with ABS were 3.4 ± 0.8 mm and 2.9 ± 0.9 mm, whereas OFD sites produced values of 2.8 ± 0.8 mm and 1.6 ± 0.7 mm. Compared to OFD, the additional CAL gain was significantly greater in patients treated with BCC (P = 0.002) and ABS (P = 0.001). The additional PD reduction was significant for the BCC group (P = 0.011) and borderline significant for the ABS group (P = 0.059). There were no significant differences of PD and CAL changes between BCC and ABS groups.

Conclusions: The clinical benefits of BCC were equivalent to ABS and superior to OFD alone. BCC may be an appropriate alternative to conventional graft materials.
Soft Tissue Augmentation Using Silk Gels: An In Vitro and In Vivo Study
Authors: Etienne Olivier , Schneider Aurore , Kluge Jonathan A. , Bellemin‐Laponnaz Claire , Polidori Camille , Leisk Gary G. , Kaplan David L. , Garlick Jonathan A. , Egles Christophe
Published: November 2009

Background: Restoration of a three‐dimensional shape with soft tissue augmentation is a challenge for surgical reconstruction and esthetic improvement of intraoral mucosa and perioral skin tissues. A connective tissue graft or free gingival graft, classically used for such indications, requires a donor site, which may lead to various clinical complications.

Methods: In this article, a new three‐dimensional scaffold made of silk fibroin that could be of great interest for these indications was studied. Mechanical tests were conducted to characterize the physical properties of the materials. The biocompatibility of such scaffolds was positively assessed in vitro using a combination of immunostaining, 5‐bromo‐2′‐deoxyuridine proliferation assays, and histologic staining. Finally, the shaped material was grafted subcutaneously in nude mice for a long‐time implantation study.

Results: Human fibroblasts embedded in this material had a survival rate up to 68.4% and were able to proliferate and synthesize proteins. One month after subcutaneous implantation, the three‐dimensional soft tissue augmentation was stable, and histologic analysis revealed revascularization of the area through the biomaterial. A mild inflammatory reaction disappeared after 12 weeks.

Conclusion: The results indicate that silk‐gel material was able to create a lasting three‐dimensional soft tissue augmentation and is a promising biomaterial for periodontal and maxillofacial therapies, either as a scaffold for cells or alone as a biomaterial.
Alanine Aminopeptidase and Dipeptidyl Peptidase IV in Saliva of Chronic Periodontitis Patients
Authors: Aemaimanan Piyamas , Sattayasai Nison , Wara‐aswapati Nawarat , Pitiphat Waranuch , Suwannarong Waraporn , Prajaneh Saengsome , Taweechaisupapong Suwimol
Published: November 2009

Background: Alanine aminopeptidase (ALAP) and dipeptidyl peptidase IV (DPPIV) are ectopeptidases that play a role in collagen degradation and are thought to be involved in the destruction of periodontal tissue. This study compared the activities of salivary ALAP and DPPIV in patients with periodontitis and periodontally healthy subjects. The correlations of enzyme activities with clinical variables and the presence of Porphyromonas gingivalis were also evaluated.

Methods: Whole saliva was collected from 30 periodontally healthy subjects, 30 localized chronic periodontitis (LCP) patients, and 30 generalized chronic periodontitis (GCP) patients to determine the activities of ALAP and DPPIV. The presence of P. gingivalis in subgingival plaque was detected by polymerase chain reaction. Periodontal clinical assessments included probing depth, clinical attachment level, and bleeding on probing.

Results: The activities of DPPIV in the LCP and GCP groups were not significantly different from one another, but both groups had significantly higher enzyme activities than the periodontally healthy group (P = 0.001). DPPIV activity was positively correlated with all clinical parameters and the prevalence of P. gingivalis. The ALAP activities were not significantly different among the three study groups. There was no significant correlation of ALAP activity with any of the clinical and bacterial parameters.

Conclusion: DPPIV, but not ALAP, activity is associated with periodontitis and the presence of P. gingivalis.
Periodontal Disease Is Associated With Gestational Diabetes Mellitus: A Case‐Control Study
Authors: Xiong Xu , Elkind‐Hirsch Karen E. , Vastardis Sotirios , Delarosa Robert L. , Pridjian Gabriella , Buekens Pierre
Published: November 2009

Background: Few studies have specifically examined the relationship between periodontal disease and gestational diabetes mellitus (GDM). The objective of this study was to examine whether maternal periodontal disease is associated with GDM.

Methods: A case‐control study was conducted of 53 pregnant women with GDM and 106 pregnant women without GDM at Woman's Hospital, Baton Rouge, Louisiana. The periodontal examinations were performed by a calibrated dentist who was masked to the diabetic status of the pregnant women. Periodontitis was defined as the presence of any site with a probing depth (PD) ≥4 mm or a clinical attachment loss (AL) ≥4 mm. The severity of periodontal disease was measured in quartiles of PD and clinical AL. Univariable analysis and multivariable logistic regression were used to examine the relationships between periodontal disease and GDM.

Results: The percentage of periodontitis was 77.4% in women with GDM and 57.5% in women without GDM, with an odds ratio (OR) of 2.5 and a 95% confidence interval (CI) of 1.2 to 5.3. After adjusting for confounding variables of maternal age, parity, race, marital status, education, family income, smoking, alcohol consumption, systemic antibiotics during pregnancy, family history of diabetes, income, dental insurance coverage, and body mass index, the adjusted OR (95% CI) was 2.6 (1.1 to 6.1). The adjusted ORs (95% CIs) of GDM comparing the highest‐to‐lowest quartiles of PD and clinical AL were 3.8 (1.0 to 14.0) and 4.5 (1.2 to 16.9).

Conclusion: This study supports the hypothesis of an association between periodontal disease and GDM.
Bacterial Adhesion on Smooth and Rough Titanium Surfaces After Treatment With Different Instruments
Authors: Duarte Poliana Mendes , Reis André Figueiredo , de Freitas Patrícia Moreira , Ota‐Tsuzuki Claudia
Published: November 2009

Background: Newly formed biofilm after implant debridement may challenge the long‐term stability of peri‐implant therapy. This in vitro study aimed to assess the roughness and adherence of Streptococcus sanguinis after treatment of smooth and rough titanium surfaces with an erbium‐doped:yttrium, aluminum, and garnet (Er:YAG) laser, metal and plastic curets, and an air‐powder abrasive system.

Methods: Forty titanium disks with smooth‐machined surfaces and 40 with sand‐blasted and acid‐etched surfaces were divided into the following treatment groups: Er:YAG laser; plastic curet; metal curet, and air‐powder abrasive system. The surface roughness (roughness average [Ra]) before and after treatments was determined using a profilometer. S. sanguinis (American Type Culture Collection 10556) was grown on treated and untreated specimens, and the amounts of retained bacteria on the surfaces were measured by the culture method. Rough and smooth surfaces with and without a suspension of S. sanguinis were also analyzed using scanning electron microscopy (SEM).

Results: For smooth surfaces, the roughest surfaces were produced by metal curets (repeated‐measures analysis of variance [ANOVA] and Tukey test; P <0.05). The rough‐surface profile was not altered by any of the treatments (repeated‐measures ANOVA; P >0.05). Rough surfaces treated with metal curets and air‐powder abrasion showed the lowest level of bacterial adhesion (two‐way ANOVA and Tukey test; P <0.05). SEM analysis revealed distinct surface profiles produced by all devices.

Conclusions: Metal curets are not recommended for smooth titanium surface debridement due to severe texture alteration. Rough surfaces treated with a metal curet and the air‐powder abrasive system were less susceptible to bacterial adhesion, probably due to texture modification and the presence of abrasive deposits.
Offshore Field Test of a New System for Model Integrated Closed-Loop Drilling Control
Authors: Iversen Fionn , Cayeux Eric , Dvergsnes Erik Wolden , Ervik Ragna , Welmer Morten , Balov Mohsen Karimi
Published: November 2009

A new system for real-time optimization and automated control of the drilling process has been tested successfully on the Statfjord C platform in the Norwegian sector of the North Sea.

The demonstrated system uses continuously calibrated dynamic process models combined with real-time drilling-data input to calculate available parameter windows, and forward-model simulations are applied to provide optimized operational parameter sequences. The calculation results are applied directly in machine control. The system further applies automated testing combined with continuous diagnostics to provide process advisory.

In the field test, pipe-movement control automation, pump-rate control automation, and automated wellbore-condition diagnostics were demonstrated, proving fail-safe application of process safeguard enforcement and optimization of operational procedures. Results from active and passive testing indicated that the new methodology has the ability to improve drilling-process reliability, safely increase drilling efficiency, and reduce the risk of human error.

The authors provide a thorough description of the preparations and testing and present an evaluation of the test results, with reference to success criteria that were developed in cooperation with the field operator and drilling contractors involved in the test. Implications for the work organization are also discussed, particularly in relation to control of data input, decision making, and responsibility.

The demonstrated technology applies direct integration of current know-how and best practices into the drilling-control system, and available real-time information is applied directly in controlling the drilling process.
The impact of geological control on flow accretion in lowland permeable catchments
Authors: Arnott S. , Hilton J. , Webb B. W.
Published: November 2009

The results of two comprehensive catchment-scale flow accretion surveys that were conducted in the lowland permeable catchments of the Rivers Frome and Piddle in Dorset, UK are presented. The surveys, undertaken as part of the NERC lowland catchment and research (LOCAR) program, were conducted under baseflow conditions during the summer of 2005. Results were adjusted for seasonal variation, the occurrence of intense precipitation events and anthropogenic inputs. A number of significant groundwater–surface water interactions related to various geological formations and boundaries were identified in this study. These included inputs of groundwater associated with the Greensand/Chalk (18–51 L s−1 km−1) and Chalk/Palaeogene (68–152 L s−1 km−1) boundaries and the Oakdale Clay Member (52–79 L s−1 km−1), as well as substantial surface water losses associated with the Broadstone Sand Formation (158–171 L s−1 km−1). The study suggests that it may be possible to predict groundwater–surface water interactions from basic information on solid geology, which would be of considerable benefit to the implementation of the Water Framework Directive in England and Wales.
Support of an Interdisciplinary Team
Authors: O'Connor Patrice
Published: November 2009

In development of a new approach, there is almost always a group of like-minded people. Such was the case in the 1970s when Dame Cicely Saunders came to the United States. She shared her concept of pain management, and care of terminal cancer patients and their families with interested American colleagues.
Starting a Prison Hospice Program
Authors: Zimmermann Nealy
Published: November 2009

Starting in the late 1970s, the incarcerated population in the United States increased in large part due to the use and abuse of drugs. At the same time, and also related to drug usage, inmates came into the system sicker and more of them began to die while in prison. These concerns came to the attention of the late Florence Wald, a founder of the hospice movement in this country. With determination, discipline, and collaboration, Florence spearheaded the founding of a prison hospice and palliative care program in Connecticut, keeping in mind both the need for creating a long lasting and sustainable program and to act as a model for other states. Since 2001, with the use of trained inmate hospice volunteers, the program has provided compassionate care for over 50 inmates at three correctional facilities in Connecticut.
Caring for Prison Inmates the Hospice Way
Authors: Thompson A. Siobhan
Published: November 2009

The purpose of this article is to describe the evolution of a prison hospice program. The article provides a historical background of the role of Florence Wald, a pioneer of the national hospice movement, and the natural extension of her role in the development of the Connecticut prison hospice program. The article also includes personal narrative of the author regarding her relationship with Florence Wald that led to the development of the Connecticut prison hospice program.
Influence of Boundary Conditions on CFD Simulation of Gas- particle Hydrodynamics in a Conical Fluidized Bed Unit
Authors: Bahramian Alireza , Kalbasi Mansour , Olazar Martin
Published: November 2009

The hydrodynamics of gas-particle conical fluidized bed containing dried TiO2 micro-size particles were studied experimentally and computationally. The pressure drop was studied by pressure measurements and mean solid velocity in the different axial and radial positions and their experimental values were measured by a parallel 3-fiber optical probe. The Eulerian-Eulerian multiphase model, including kinetic theory of granular flow using Gidaspow (1994) drag function was used in the computational fluid dynamics (CFD) simulation. The frictional viscosity of solids is predicted from the equation proposed by Schaeffer (1987), whereas semi-empirical boundary equations developed by Johnson and Jackson (1987) were applied for the tangential velocity and granular temperature of the solids at the wall. Three different types of boundary conditions (BC), consisting in free-slip/no-friction, no-slip/friction and high-slip/small-friction, were used in this work to compare the results of the model with the experimental data. The numerical predictions using free-slip/no-friction BC agreed reasonably well with the experimental pressure drop measurements, especially at superficial gas velocities higher than the minimum fluidization velocity, Umf. The results for simulated mean axial solid velocity show that the free-slip BC was in better agreement with the experimental data compared with the other boundary conditions. The model also provides reasonable predictions for particle circulation and formation of fountain zone, gulf-effect and air velocity.
Performance Analysis of Anaerobic Downflow Stationary Fixed Film (DSFF) Bioreactors and Software Development
Authors: C.M. Narayanan
Published: November 2009

The performance of an anaerobic downflow stationary fixed film bioreactor has been simulated mathematically and a software package developed. Each flow channel of the reactor is assumed equivalent to a tubular reactor with a specific degree of axial dispersion. The variation of axial dispersion coefficient along the length of the flow channel (due to the change in gas velocity ) is accounted for and so is resistance to substrate transfer into biofilm which is taken into account by incorporating effectiveness factor into performance equations. Effectiveness factor is computed by numerically integrating the expression for intrinsic rate and the package is applicable to all forms of kinetic equations. Experimental data from pilot plants exhibit encouraging agreement with results predicted by the developed simulation package.
Optimal Design, Modeling and Simulation of an Ethanol Steam Reforming Reactor
Authors: Arteaga Luis E , Peralta Luis M , Casas Yannay , Castro Daikenel
Published: November 2009

The optimum design, modeling and simulation of a fixed bed multi-tube reformer for the renewable hydrogen production are carried out in the present paper. The analogies between plug flow model and a fixed bed reactor are used as design patterns. The steam reformer is designed to produce enough hydrogen to feed a 200kW fuel cell system (>2.19molH/s) and considering 85% of fuel utilization in the cell electrodes. The reactor prototype is optimized and then analyzed using a multiphysics and axisymmetric model, implemented on FEMLABM(R) where the differential mass balance by convection-diffusion and the energy balance for convection-conduction are solved. The temperature profile is controlled to maximize hydrogen production. The catalyst bed internal profiles and the effect of temperature on ethanol conversion and carbon monoxide production are discussed as well.
Revisiting the Tobin Tax, in the Context of Development and the Financial Crisis
Authors: Yates Nicholas A
Published: November 2009

In the climate of a global financial crisis the problem of financial stability is particularly potent, especially given the difficulties faced around the world in both developed and developing countries. A defence for future crises alongside a means of improving global development problems could possibly be found in the oft-debated Tobin tax. Furthermore, it is shown that the possibilities for global improvement as a result of such a move are too important to be disregarded without proper consideration. As a result of extensive research of the arguments surrounding the tax, it is suggested that the time is ripe for a re-evaluation of Professor Tobin's suggestion.
The Threat of Pandemic Influenza: Why Today is Not 1918
Authors: Koblentz Gregory D
Published: November 2009

The specter of the 1918‐1919 influenza pandemic, which killed an estimated 40‐100 million people worldwide, hangs over analyses of and responses to the current pandemic of swine‐origin novel influenza A (H1N1). There are four major differences between today and 1918 that reduce the likelihood that the current pandemic—or the next one—will be as deadly as the one in 1918. Today we have advance warning of the threat of a highly lethal influenza pandemic, we have a global human health surveillance and response system, we have new medical countermeasures, and there is no global conflict like World War I to act as an incubator and vector for a highly lethal influenza virus and an impediment to medical and public health responses to the pandemic.
Functional outcome following restorative rectal cancer surgery
Authors: Zbar A.P. , Kennedy P.J. , Singh V.
Published: November 2009

The trend towards preoperative adjuvant and neoadjuvant therapies in selected patients with rectal cancer has led to increases in sphincter preservation with a limited understanding of the factors governing unsatisfactory functional outcomes. Data would suggest the need for a more selective use of standard radiotherapeutic fields in low- to intermediate-risk cases where there appears to be limited survival or locoregional recurrence benefit and where there is under-reported toxicity. This article discusses the complex factors which impact on functional outcome following open rectal cancer surgery particularly when it is accompanied by adjuvant therapy.
Cardiac neoplasma: Results of the surgical treatment between 2000. and 2008
Authors: Vukovic P.M. , Milojevic P.S. , Peric M.S. , Gradinac S.D. , Micovic S.V. , Cirkovic M.V. , Borovic S.D. , Labudovic-Borovic M. , Djukanovic B.P.
Published: November 2009

Introduction: The goal of this study was to show early and midterm results of surgical treatment of cardiac neoplasma. Methods: Between 2000. and 2008., sixty-seven patients with a cardiac tumor or a subdiaphragmatic neoplasma with right atrial extension were operated in our institution. In 22 patients (32.8%), not only a simple extirpation of neoplasma, but an additional surgical procedure was done. Results: A patient reoperated for a recurrence of biatrial myxoma died early after operation (1.5% mortality rate). During follow-up period of 3.3 years, two patients (3.4%) out of 58 that were contacted died because of the neoplasma (Methastasis of adenocarcinoma, Carcinoma renis). Conclusion: Surgical treatment of cardic tumors resulted in low early mortality and an excellent survival rate after a follow-up period of 3.3 years.
Successful treatment of second hepatoblastoma relapse: Case report
Authors: Krstovski N. , Radlovic N. , Janic D. , Dokmanovic L. , Smoljanic Z. , Sretenovic A.
Published: November 2009

Introuduction: The prognosis of hepatoblastoma has changed since effective adjuvant chemotherapy had been introduced in 1980's. There is a general agreement that complete resection is the cornerstone of treatment for children with hepapatoblastoma and the only way for eventual cure. Case report: We describe a boy with relapsed hepatoblastoma presenting with elevated-fetoprotein (AFP) and no visible tumor by ultrasound and computed tomography (CT). The relapse was treated with chemotherapy. Second relapse occurred shortly after therapy was completed, but this time we waited for tumor mass to appear. Combined surgery and chemotherapy resulted in remission status with 48 months of follow up. Conclusion: Hepatoblastoma relapse without evidence of tumor is not unusual but its treatment remains controversial. Radiological investigations should be repeated until site of relapse is identified. Based on our experience it seems of no benefit to treat isolated elevation of AFP.
A relation between Fourier coefficients of holomorphic cusp forms and exponential sums
Authors: Ernvall-Hytönen Anne-Maria
Published: November 2009

We consider certain specific exponential sums related to holomorphic cusp forms, give a reformulation for the Lehmer conjecture and prove that certain exponential sums of Fourier coefficients of holomorphic cusp forms contain information on other similar non-overlapping exponential sums. Also, we prove an Omega result for short sums of Fourier coefficients.
Relations of Dietary Magnesium Intake to Biomarkers of Inflammation and Endothelial Dysfunction in an Ethnically Diverse Cohort of Postmenopausal Women
Authors: Chacko Sara A. , Song Yiqing , Nathan Lauren , Tinker Lesley , de Boer Ian H. , Tylavsky Fran , Wallace Robert , Liu Simin
Published: November 2009

OBJECTIVE

Although magnesium may favorably affect metabolic outcomes, few studies have investigated the role of magnesium intake in systemic inflammation and endothelial dysfunction in humans.

RESEARCH DESIGN AND METHODS

Among 3,713 postmenopausal women aged 50–79 years in the Women's Health Initiative Observational Study and free of cardiovascular disease, cancer, and diabetes at baseline, we measured plasma concentrations of high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), turnor necrosis factor-α receptor 2 (TNF-α-R2), soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), and E-selectin. Magnesium intake was assessed using a semiquantitative food frequency questionnaire.

RESULTS

After adjustment for age, ethnicity, clinical center, time of blood draw, smoking, alcohol, physical activity, energy intake, BMI, and diabetes status, magnesium intake was inversely associated with hs-CRP (P for linear trend = 0.003), IL-6 (P < 0.0001), TNF-α-R2 (P = 0.0006), and sVCAM-1 (P = 0.06). Similar findings remained after further adjustment for dietary fiber, fruit, vegetables, folate, and saturated and trans fat intake. Multivariable-adjusted geometric means across increasing quintiles of magnesium intake were 3.08, 2.63, 2.31, 2.53, and 2.16 mg/l for hs-CRP (P = 0.005); 2.91, 2.63, 2.45, 2.27, and 2.26 pg/ml for IL-6 (P = 0.0005); and 707, 681, 673, 671, and 656 ng/ml for sVCAM-1 (P = 0.04). An increase of 100 mg/day magnesium was inversely associated with hs-CRP (−0.23 mg/l ± 0.07; P = 0.002), IL-6 (−0.14 ± 0.05 pg/ml; P = 0.004), TNF-α-R2 (−0.04 ± 0.02 pg/ml; P = 0.06), and sVCAM-1 (−0.04 ± 0.02 ng/ml; P = 0.07). No significant ethnic differences were observed.

CONCLUSIONS

High magnesium intake is associated with lower concentrations of certain markers of systemic inflammation and endothelial dysfunction in postmenopausal women.
Antibiotic Consumption in the Latvian Teaching Hospital 2000-2008
Authors: Dimiņa Elīna , Akermanis Mārtiņš , Dumpis Uga
Published: November 2009

Antibiotic Consumption in the Latvian Teaching Hospital 2000-2008

Antibiotics are one of the most commonly used drugs in hospital care and significantly contribute to healthcare costs. Recently, there has been significant interest raised on the environmental impact of antibiotic use, in particular on how it effects resistance selection pressure. Rapid global spread of multiresistant bacteria requires improved understanding on how changes in antibiotic use affect resistance selection. We present a unique study on antibiotic consumption and its trends over an eight-year period. Data were obtained from the pharmaceutical database system. The study period extended from January 2000 through December 2008. Antibiotic use was expressed as a rate — defined daily doses (DDD) per 100 patient days (DDD/100) in a quarter year. The total amount of antibiotics used for systemic treatment at the beginning of the period (first quarter of 2000) was 38.7 DDD per 100 bed days and increased to 72.6 DDD per 100 bed days (r = 0.81) by the 4th quarter of 2008. Despite variability during the study period, a significant trend was observed with an average increase of 0.97 (95% CI: 1.2; 3.2) per quarter. Penicillin was the most common antibiotic group used at the hospital in the study period and demonstrated the greatest increase in consumption (r = 0.92). The consumption rates of fluoroquinolones were high and also showed a significant increase (r = 0.76). We observed a significant increase of antibiotic consumption in our hospital during the study period, which lacked a clear explanation. This increase was mostly due to increased use of amoxicillinum/enzyme inhibitor and ceftriaxone. Analysis of consumption should be continued to assess the impact of educational interventions.
Cellular Immunity in Human Herpes Viruses 6 and 7 Infected Gastrointestinal Cancer Patients
Authors: Jaunalksne Inta , Doniņa Simona , Čapenko Svetlana , Čstjakovs Maksims , Murovska Modra
Published: November 2009

Cellular Immunity in Human Herpes Viruses 6 and 7 Infected Gastrointestinal Cancer Patients

CD4+ T lymphocytes appear to be the preferential target for replication of HHV-6 (human herpes virus) as well as HHV-7 viruses in vivo. In addition, CD8+ T cells, monocytes/macrophages, natural killer cells, epithelial, endothelial, neural cells and fibroblasts may be infected. By definition, however, even a tumour designated by pathologists to be early stage may be late stage when considered by the immune system. Certainly, even early stage tumours have evaded immune control, suggesting that they have acquired many immunosuppressive characteristics. The aim of the study was to clarify the influence of beta-herpes viruses on cellular immune response. In 95 gastrointestinal cancer patients we determined the immunocompetent cell level CD3, CD4, CD8, CD19, CD38, CD95, CD25 using laser flow cytofluorimeter and B- herpes viruses HHV-6, HHV-7 presence using a nested polymerase chain reaction method. Our data showed no statistically significant difference in immunocompetent cell level between negative, latent and active HHV-6, HHV-7 infection. Patients with immunocompromised immune status (lymphopenia) had a tendency to decreased CD4+, CD19+ absolute count. It may be suggested that virus-mediated immune response inhibition seems to be similar to cancer mediated, but differences in immune response among the same group of individuals had no influence on the average number of the immunocompetent cells in the group. Therefore, to characterise host-virus-tumour interactions, individual interpretation of each case is needed.
Detailed NMR, Including 1,1-ADEQUATE, and Anticancer Studies of Compounds from the Echinoderm Colobometra perspinosa
Authors: Wright Anthony D. , Nielson Jonathan L. , Tapiolas Dianne M. , Motti Cherie A. , Ovenden Simon P. B. , Kearns Philip S. , Liptrot Catherine H.
Published: November 2009

From the dichloromethane/methanol extract of the crinoid Colobometra perspinosa, collected south east of Richards Island (Bedara), Family Islands, Central Great Barrier Reef, Australia, 3-(1'-hydroxypropyl)-1,6,8-trihydroxy-9,10-anthraquinone [one of the two stereoisomers of rhodoptilometrin, (1)], 3-propyl-1,6,8-trihydroxy-9,10-anthraquinone (3), 2-[(phenylacetyl)amino]ethanesulfonic acid (4), and 4-hydroxybutanoic acid (5) were isolated. Comparison of 1H- and 13C-NMR data for rhodoptilometrin (1) with those reported in the literature showed significant differences for some resonances associated with rings A and C. In an attempt to provide accurately assigned 1H- and 13C-NMR data, as well as to confirm the structure of 1, a thorough NMR investigation of this compound was undertaken. Measurements included: concentration dependent 13C, 1D selective NOE, HSQC, HMBC and 1,1-ADEQUATE. The NMR data for 4 and 5 are reported here for the first time, as is their occurrence from the marine environment. The in vitro anticancer activity of the original extract was found to be associated with 1, 3 and 5.
Headspace Volatile Composition of the Flowers of Caralluma europaea N.E.Br. (Apocynaceae)
Authors: Formisano Carmen , Senatore Felice , Della Porta Giovanna , Scognamiglio Mariarosa , Bruno Maurizio , Maggio Antonella , Rosselli Sergio , Zito Pietro , Sajeva Maurizio
Published: November 2009

The volatile constituents of the flowers of Caralluma europaea (Guss.) N.E.Br (Apocynaceae) from Lampedusa Island were analyzed by a headspace GC method. The analyses allowed the identification and quantification of 41 compounds. The main components were, among the monoterpenoids, terpinolene (23.3%), α-terpinene (19.1%) and linalool (18.4%), whereas, among the carbonylic compounds the major constituents were heptanal (2.0%), octanoic acid (2.4%) and hexanoic acid (1.7%). The presence of a nitrogen containing compound, indole (0.8%) and of a sulphur containing compound, dimethylsulphide (t), noteworthy. The compounds found in the flowers of C. europaea have been compared with data available in the literature as regard to their odor, presence in other sapromyiophilous taxa, possible role as semiochemicals, and presence in decaying organic matter. 89.3% of total constituents have been described in other sapromyiophilous taxa. Some of the compounds are present in several types of decaying organic matter (excrements, decomposing bodies, and spoiled fish, etc). Several volatiles found in C. europaea flowers are used as semiochemicals by Hymenoptera, Coleoptera, Diptera, Lepidoptera and other insects. Sixteen volatiles, accounting for 32.4% of the total constituents, are described as attractants of some Diptera families, with a biology linked to decaying organic matter. Our data thus confirm that C. europaea floral bouquet falls within the sapromyiophilous pollination syndrome.
Towards Sustainable Urban Water and Sanitation Services: Barriers and Bridges
Authors: Hjorth Peder
Published: November 2009

The Mar del Plata International Water Conference provided the first global assessment of the water sector. It was found that in most developing countries the state of water supply and sanitation services were deplorable. Consequently, a call for concerted action to improve coverage and efficiency of the water supply and sanitation sector was launched. This call resulted in the International Water Supply and Sanitation Decade (1981–1990). The Decade provided important lessons concerning effective methodologies to improve the state of the WSS sector. The paper discusses why the poor state of the water supply and sanitation conditions still tend to be the greatest development failure during the 20th century. The recipe for success was there, and the money was there. So, why were governments and big donors like the World Bank refusing to apply the lessons from the Decade? The basic conditions for success are spelled out, and some successful cases are used to illustrate these. The conclusion is that change is possible but that civil society organizations have to be empowered to make governments "feel the heat" and spend more money on water and sanitation, and to spend it more wisely.
Genetic diversity, structure, and demographic change in tanoak,Lithocarpus densiflorus(Fagaceae), the most susceptible species to sudden oak death in California
Authors: Nettel Alejandro , Dodd Richard S. , Afzal‐Rafii Zara
Published: November 2009

Knowledge of population genetic structure of tanoak (Lithocarpus densiflorus) is of interest to pathologists seeking natural variation in resistance to sudden oak death disease, to resource managers who need indications of conservation priorities in this species now threatened by the introduced pathogen (Phytophthora ramorum), and to biologists with interests in demographic processes that have shaped plant populations. We investigated population genetic structure using nuclear and chloroplast DNA (cpDNA) and inferred the effects of past population demographic processes and contemporary gene flow. Our cpDNA results revealed a strong pattern of differentiation of four regional groups (coastal California, southern Oregon, Klamath mountains, and Sierra Nevada). The chloroplast haplotype phylogeny suggests relatively deep divergence of Sierra Nevada and Klamath populations from those of coastal California and southern Oregon. A widespread coastal California haplotype may have resulted from multiple refugial sites during the Last Glacial Maximum or from rapid recolonization from few refugia. Analysis of nuclear microsatellites suggests two major groups: (1) central coastal California and (2) Sierra Nevada/Klamath/southern Oregon and an area of admixture in north coastal California. The low level of nuclear differentiation is likely to be due to pollen gene flow among populations during postglacial range expansion.
Pharmacists' Perspectives on Providing Chronic Disease Management Services in the Community — Part II: Development and Implementation of Services
Authors: Rosenthal Meagen , Grindrod Kelly A. , Lynd Larry , Marra Carlo A. , Bougher David , Wilgosh Chuck , Tsuyuki Ross T.
Published: November 2009

Background:

The need for alternative methods of providing primary care and chronic disease management (CDM) is becoming more urgent. To understand pharmacists' role in this changing health care system, we must better understand their desire and capacity to provide these services.

Methods:

Key stakeholders from all facets of pharmacy practice were recruited to participate in focus groups held in Alberta and British Columbia. Qualitative methodologies involving a phenomenological approach with content analysis were used to gather and analyze information.

Results:

In total, 36 pharmacists participated in 8 focus groups to identify enablers and challenges to the provision of CDM (reported in Part I). The topic of how such services could be implemented in the community developed naturally from these discussions. Participants expressed a need for changes to both the physical layout of pharmacies (to incorporate private counselling spaces) and the documentation and information systems used (to improve communication and continuity of care). Furthermore, the intentions of both pharmacists and employers must be communicated effectively to all parties, including patients. Participants also identified an alternative remuneration model as being essential, to allow adequate time for provision of CDM services and to ensure that current high-quality dispensing practices can be continued.

Conclusion:

Pharmacists have a tremendous opportunity to change practice and to contribute more to patient care. To guide and implement such change will require that pharmacists restructure their physical and information environments, strengthen their relationships with key stakeholders and develop a sustainable model of practice that includes the needs of the business, the client (patient) and the pharmacist.
Why Not Just Ask the Resident? Refinement of a Preference Assessment Tool for Nursing Homes
Authors: Housen Patricia , Shannon George R. , Simon Barbara , Edelen Maria Orlando , Cadogan Mary P. , Jones Malia , Buchanan Joan , Saliba Debra
Published: November 2009

This research evaluated a draft preference assessment tool (draft-PAT) designed to replace the current Customary Routine section of the Minimum Data Set (MDS) for nursing homes. The draft-PAT was tested with a sample of nursing home residents to evaluate survey-level administration time and noncompletion rates, as well as item-level nonresponse rates, response distributions, and test-retest reliability. Modifications to the draft-PAT were then re-tested with a subsample of residents. Completion times were brief (generally less than 10 minutes), and only a small percentage of residents were unable to complete the interview. Item-level nonresponse rates were low for the draft-PAT (0% to 8%) and even lower during retesting for items advanced to the national field trial (0% to 4%). Item response distributions indicated reasonable use of all options across both testing occasions, and item-level test-retest reliability was high. This study found that nursing home residents can reliably report their preferences. Eighteen items from the modified draft-PAT were advanced to the national field trial of the MDS 3.0. Inclusion of the PAT in the MDS revision underscores increased emphasis on including residents' voice in the assessment process.
Biomechanical Evaluation of 3-Part Proximal Humerus Fractures: A Cadaveric Study
Authors: Gillespie Robert J. , Ramachandran Vimala , Lea Ethan S. , Vallier Heather A.
Published: November 2009

Proximal humerus fractures occur frequently, and treatment remains controversial. This study compares stiffness in axial loading for 3 methods of fixation (locking compression plate, standard (nonlocking) proximal humerus plate, and blade plate) in a 3-part proximal humerus fracture model.

Twelve paired proximal humeri were obtained from embalmed human cadavers and separated into 3 groups. Osteotomies of the surgical neck and greater tuberosity were created to simulate a 3-part proximal humerus fracture. After fixation, constructs were axially loaded in 20° of abduction for 200 cycles in an Instron materials testing machine (Norwood, Massachusetts). The blade plate (mean, 146.87±28.9 N/mm) demonstrated 29% more mean stiffness than the standard plate (mean, 113.0±22.3 N/mm;
P
=.19). The locking compression plate (mean, 130.71±39.2 N/mm) exhibited 15% greater stiffness compared to the standard plate in our 3-part model (
P
=.58). The blade plate demonstrated 12% greater stiffness than the locking compression plate (
P
=.64).

There was no significant difference in mean stiffness between the fixed-angle devices and the standard plate. Future in vitro and clinical studies of plate devices for proximal humerus fractures would be worthwhile to determine the benefits and limitations of various implants for specific types of fractures, including clinical performance and cost of care.
Accelerating Autograft Maturation in Instrumented Posterolateral Lumbar Spinal Fusions Without Donor Site Morbidity
Authors: Rogozinski Abraham , Rogozinski Chaim , Cloud Gregory
Published: November 2009

Properly harvested iliac crest bone autograft applied to a meticulously prepared fusion bed produces a consistently high rate of fusion with a low incidence of donor site morbidity. Some reports advocate substituting bone morphogenic protein (BMP) for iliac crest bone autograft, but in posterolateral lumbar spinal fusion, BMP appears better suited to facilitate iliac crest bone autograft maturation than to substitute for it.

In this single-center, nonrandomized, prospective study (minimum 2-year follow-up), cancellous-only iliac crest bone autograft was harvested for use in posterolateral lumbar spinal fusion. Reviewers blinded to graft condition and age assigned fusion scores to the random radiographs of 31 consecutive patients who underwent 1- to 3-level posterolateral lumbar spinal fusion using iliac crest bone autograft supplemented with either an implanted spinal fusion stimulator or BMP.

There was no significant immediate or remote iliac crest bone autograft harvest morbidity, and there was a significant reduction in pain scores postoperatively (
P
<.001). At 12 months, BMP radiographs were more likely than spinal fusion stimulator radiographs to be rated as fused (
P
<.019). All BMP patients were deemed fused at 12 months and all spinal fusion stimulator patients at 24 months.

In this study, iliac crest bone autograft supplemented with either BMP or spinal fusion stimulator resulted in a solid contiguous fusion without significant iliac crest bone autograft harvest-related morbidity. Bone morphogenic protein-supplemented iliac crest bone autograft fused at a faster rate, producing the more mature-appearing, trabeculated, robust fusion.
Regeneration of the Fibula Using a Periosteum-preserving Technique in Children
Authors: Xin Zeng Feng , Kim Ki Hyeong , Jung Sung Taek
Published: November 2009

Bone grafting is a commonly used surgical procedure, particularly in reconstructive orthopedic surgery. Bone grafts may be used to fill skeletal defects created by trauma, infection, tumors, or congenital malformation. Fibular graft is an ideal option and is widely used to treat massive segmental defects; however, it leads to various complications, especially in children. This article describes our experience with donor site bone grafts using a periosteum-preserving technique with respect to minimizing donor site complications and performing effective reconstruction of bone defects in children.

Seventeen patients who were followed after fibula resection and bone grafting in the donor site using a periosteum-preserving technique were evaluated radiologically and clinically. The patients were divided into 2 groups: 1 group was filled with cancellous allograft (n=9), and the other group was filled with calcium sulfate (n=8) in the donor site. Mean patient age was 8.4 years (range, 2–13 years), and mean follow-up was 31 months (range, 7–65 months). Complete regeneration of the donor sites occurred in all patients; mean time to regeneration at donor sites was 12 weeks (range, 4–21 weeks). There were no significant donor site complications intraoperatively or immediately postoperatively. The average regeneration index was 0.5 (range, 0.2–1.1), and it was found to increase with age (
r
=0.75,
P
<.001), indicating that younger patients had faster regeneration. The periosteum-preserving technique was found to lead to the reconstruction of bone defects effectively in children with minimal donor site complications.
El uso de metadatos en la administración electrónica española: los retos de la interoperabilidad
Authors: Hernández-Pérez Tony , Rodríguez-Mateos David , Martín-Galán Bonifacio , García-Moreno María Antonia
Published: November 2009

Se analiza el concepto de interoperabilidad, las distintas iniciativas sobre interoperabidad adoptadas por la Unión Europea y se hace un estudio sobre el uso de metadatos en la administración electrónica española en los distintos ministerios. Se analizaron más de 42.000 páginas web distintas, más de 260.000 etiquetas meta de 18 ministerios distintos y el uso que se hace de cada una de estas etiquetas. Se observa que en la administración central española no existe ninguna política sobre descripción de recursos electrónicos ni sobre interoperabilidad. No se hace ni un buen uso de metadatos ni de vocabularios controlados e incluso los mismos valores son expresados de muy distinta forma por los ministerios. Solo el Ministerio de Cultura hace un uso parcial de etiquetas Dublin Core. Un número muy elevado de las páginas presentan errores básicos en el uso de etiquetas meta.
A METHOD FOR REARING NYSIUS ERICAE (HEMIPTERA: LYGAEIDAE), THE FALSE CHINCH BUG
Authors: Burgess L. , Weegar H.H.
Published: November 2009

The false chinch bug, Nysius ericae (Schilling), was reared successfully in clear polystyrene containers in the laboratory. Nymphs were fed hulled sunflower seeds and radish slices; adults were fed hulled sunflower seeds and seedlings of Brassica juncea mustard or B. napus canola. Eggs were laid in rolls of compacted cotton, stored at 5 ± 1°C, and brought out to room temperature for hatching.