bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of Loss of Removable Dentures on Oral Health after the Great East Japan Earthquake: A Retrospective Cohort Study
Authors: Sato Yukihiro , Aida Jun , Takeuchi Kenji , Ito Kanade , Koyama Shihoko , Kakizaki Masako , Sato Mari , Osaka Ken , Tsuji Ichiro
Published: September 2014

Purpose

The Great East Japan Earthquake in March 2011 destroyed many communities, and as a result many older victims lost their removable dentures. No previous studies have documented the prevalence of denture loss after a natural disaster or examined its negative impact. Therefore, investigation of the consequences of such a disaster on oral health is of major importance from a public health viewpoint.

Materials and Methods

Three to five months after the disaster, questionnaire surveys were conducted in two coastal towns, Ogatu and Oshika, located in the area of Ishinomaki city, Miyagi prefecture. Among the survey participants, 715 individuals had used one or more removable dentures before the disaster, and these comprised the population analyzed. The effect of denture loss on oral health‐related quality life (OHRQoL) was examined by a modified Poisson regression approach with adjustment for sex, age, subjective household economic status, dental caries, tooth mobility, psychological distress (K6), access to a dental clinic, physical activity, and town of residence.

Results

There were 123 (17.2%) participants who had lost their dentures. In comparison with participants who had not lost their dentures, those lacking dentures showed a significantly higher relative risk for eating difficulties (RR = 2.65, 95%CI = 1.90–3.69), speech problems (RR = 4.37, 95%CI = 2.46–7.76), embarrassment upon smiling, laughing, or showing their teeth (RR = 5.32, 95%CI = 2.34–12.1), emotional distress (RR = 2.38, 95%CI = 1.41–4.03), and problems related to social interaction (RR = 6.97, 95%CI = 1.75–27.7).

Conclusions

Denture loss appeared to impair eating and speaking ability, thus discouraging communication with others. Public health intervention after major natural disasters should include dental care.
Implant‐Supported Prosthetic Rehabilitation of a Patient with Localized Severe Attrition: A Clinical Report
Authors: Cekic‐Nagas Isil , Ergun Gulfem
Published: September 2014

Patients usually adapt to their existing occlusal vertical dimension (OVD). It is essential to resolve each of the problems associated with decreased vertical dimension as a result of attrition. This report describes the multidisciplinary dental treatment of a 40‐year‐old male patient who had severe tooth wear, resulting in reduced vertical dimension. After clinical evaluations, extraoral examination showed a reduction of the lower facial height, drooping, and overclosed commissures. Ten dental implants were placed into the maxillary and mandibular alveolar processes. During the osseointegration period, an interim removable partial denture was made at increased OVD to use in the first stage of rehabilitation. It was used for 3 months as a guide for preparing the definitive restorations. The patient's adaptation to the increased OVD was evaluated. During this period, he was asymptomatic. Following the evaluation period, the provisional fixed restoration was used for 3 months. Then, full‐mouth definitive prostheses supported by a combination of implants and teeth were fabricated to upper and lower jaws. Osseointegration of the implants, peri‐implant mucosa health, prosthesis function, and esthetics were assessed after 1 week and 1, 3, and 6 months. After 3 years of follow‐up, no functional or esthetic difficulties with the implants and restorations were noted.
Esthetic Assessment of the Effect of Gingival Exposure in the Smile of Patients with Unilateral and Bilateral Maxillary Incisor Agenesis
Authors: Pinho Teresa , Bellot‐Arcís Carlos , Montiel‐Company José María , Neves Manuel
Published: September 2014

Purpose

The aim of this study was to determine the dental esthetic perception of the smile of patients with maxillary lateral incisor agenesis (MLIA); the perceptions were examined pre‐ and post‐treatment. Esthetic determinations were made with regard to the gingival exposure in the patients’ smile by orthodontists, general dentists, and laypersons.

Materials and Methods

Three hundred eighty one people (80 orthodontists, 181 general dentists, 120 laypersons) rated the attractiveness of the smile in four cases before and after treatment, comprising two cases with unilateral MLIA and contralateral microdontia and two with bilateral MLIA. For each case, the buccal photograph was adjusted using a computer to apply standard lips to create high, medium, and low smiles. A numeric scale was used to measure the esthetic rating perceived by the judges. The resulting arithmetic means were compared using an ANOVA test, a linear trend, and a Student's t‐test, applying a significance level of p < 0.05. The predictive capability of the variables, unilateral, or bilateral MLIA, symmetry of the treatment, gingival exposure of the smile, group, and gender were assessed using a multivariable linear regression model.

Results

In the pre‐ and post‐treatment cases, medium smile photographs received higher scores than the same cases with high or low smiles, with significant differences between them. In all cases, orthodontists were the least‐tolerant evaluation group (assigning lowest scores), followed by general dentists. In a predictive linear regression model, bilateral MLIA was the more predictive variable in pretreatment cases. The gingival exposure of the smile was a predictive variable in post‐treatment cases only.

Conclusion

The medium‐height smile was considered to be more attractive. In all cases, orthodontists gave the lowest scores, followed by general dentists. Laypersons and male evaluators gave the highest scores. Symmetrical treatments scored higher than asymmetrical treatments. The gingival exposure had a significant influence on the esthetic perception of smiles in post‐treatment cases.
Clinical Marginal and Internal Adaptation of Maxillary Anterior Single All‐Ceramic Crowns and 2‐year Randomized Controlled Clinical Trial
Authors: Akın Aslı , Toksavul Suna , Toman Muhittin
Published: September 2014

Purpose

The aims of this randomized‐controlled clinical trial were to compare marginal and internal adaptation of all‐ceramic crowns fabricated with CAD/CAM and heat‐pressed (HP) techniques before luting and to evaluate the clinical outcomes at baseline and at 6, 12, and 24 months after luting.

Materials and Methods

Fifteen CAD/CAM (CC) and 15 HP all‐ceramic crowns were placed in 15 patients. A silicone replica was obtained to measure marginal and internal adaptation of each all‐ceramic crown before luting, and they were sectioned buccolingually and mesiodistally. Marginal and internal adaptations were measured using computerized light microscope at 40× magnification. Clinical evaluations took place at baseline (2 days after luting) and at 6, 12, and 24 months after luting. Replica scores were analyzed with Mann‐Whitney U and Student's t‐test (α = 0.05). Survival rate of crowns was determined using Kaplan‐Meier statistical analysis.

Results

The median marginal gap for the CC group was 132.2 μm and was 130.2 μm for the HP group. The mean internal adaptation for the CC group was 220.3 ± 51.3 μm and 210.5 ± 31 μm for the HP group. There were no statistically significant differences with respect to marginal opening (Mann‐Whitney U test; p = 0.95) and internal adaptation (Student's t‐test; p = 0.535) between the 2 groups. Based on modified Ryge criteria, 100% of the crowns were rated satisfactory during the 2‐year period.

Conclusion

In this in vivo study, CAD/CAM and HP all‐ceramic crowns exhibited similar marginal and internal adaptations. A 100% success rate was recorded for the 15 CAD/CAM and for the 15 HP all‐ceramic crowns during the 2‐year period.
Intraoral Digital Impression Technique: A Review
Authors: Ting‐shu Su , Jian Sun
Published: September 2014

With the techniques of computer‐aided design and computer‐aided manufacturing (CAD/CAM) being applied in the field of prosthodontics, a concept of intraoral digital impressions was put forward in the early 1980s. It has drawn comprehensive attention from dentists and has been used for dental prosthesis fabrication in a number of cases. This new digital impression technique is expected to bring about absolute digitization to the mode of prosthodontics. A few published articles have indicated that dental prostheses fabricated from intraoral digital impressions have exhibited remarkable advantages over those from conventional impressions in several respects. The present review discusses intraoral digital impression techniques in terms of the following aspects: (1) categories and principles of intraoral digital impression devices currently available; (2) operating characteristics of the devices; and (3) comparison of the manipulation, accuracy, and repeatability between intraoral digital impression and conventional impression.
A Collapsible Partial Denture for a Patient with Limited Mouth Opening Induced by Scleroderma: A Clinical Report
Authors: Gözde Türk Ayşe , Ulusoy Mübin
Published: September 2014

A limited opening of the mouth is defined as microstomia. Microstomia is caused by burns, postoperative head and neck trauma, radiotherapy, or scleroderma. The prosthetic treatment of microstomia presents particular challenges, and patients often complain of an inability to insert or remove the prosthesis. The cause and severity of microstomia can influence the approach to treatment. Different treatment methods have been suggested, including the fabrication of two‐piece partial dentures. This clinical report describes the construction of a sectional impression tray and a collapsed partial denture using a hinge attachment for a patient with microstomia.
The Effect of Offset Implant Configuration on Bone Stress Distribution: A Systematic Review
Authors: de Souza Batista Victor Eduardo , Junior Joel Ferreira Santiago , de Faria Almeida Daniel Augusto , de Toledo Piza Lopes Leonardo Ferreira , Verri Fellippo Ramos , Pellizzer Eduardo Piza
Published: September 2014

Purpose

The aim of this systematic review was to compare straight‐line and offset implant configurations for three‐element implant‐retained prostheses.

Materials and Methods

Two independent reviewers conducted a review on PubMed/Medline, EMBASE, and Cochrane Library for studies published in English, from January 1, 1995 to January 17, 2014. A systematic review was conducted following the PRISMA statement. All relevant titles were selected according to inclusion/exclusion criteria. From this pool of titles, abstracts and full texts were reviewed.

Results

A total of 6080 titles were identified with the initial search. Twenty‐one were selected based on title and abstract. Of these, after discussion and complete reading, 12 studies were selected according to the inclusion and exclusion criteria, all of which were in vitro studies.

Conclusions

A systematic review of the current literature showed only in vitro evidence that there is no consensus on the advantage of using an offset configuration implant compared to those in straight‐line configuration, even though some studies present a slight improvement of bone stress distribution when an offset implant is under oblique loading (PICO).
THE ROLE OF ALDOSTERONE ANTAGONISM AGENTS IN DIABETIC KIDNEY DISEASE
Authors: Wombwell Eric , Naglich Andrew
Published: September 2014

Background

Diabetic kidney disease is a common consequence of the development of diabetes. In the United Kingdom 18–30% of chronic kidney disease cases and 44% of end‐stage renal disease cases in the United States have been attributed to complications of diabetic kidney disease. Angiotensin blockade using angiotensin converting enzyme inhibitors or angiotensin receptor blockers is the standard for slowing the progression of diabetic kidney disease. Evidence suggests that aldosterone antagonism added to standard therapy may be beneficial.

Aim of Review

This paper aims to explore the pathophysiological contribution of aldosterone in diabetic kidney disease and review available literature for aldosterone antagonism through mineralocorticoid receptor blockade.

Methods

A comprehensive literature search was conducted. Results were analysed and summarised.

Results

Nine trials evaluating a total of 535 patients with diabetic kidney disease were identified that evaluated the use of aldosterone antagonists for reducing the signs of diabetic kidney disease. All trials demonstrated a marked decrease in urinary protein excretion when compared to, or added to angiotensin converting enzyme inhibition or angiotensin receptor blockade. The most commonly reported side effect in all of the trials was hyperkalaemia, which occurred in 6.1% of all patients evaluated. Aldosterone antagonists were generally well tolerated in the evaluated patient populations.

Conclusion

Aldosterone antagonism may represent a safe and effective complimentary therapy to the use of angiotensin converting enzyme inhibition, or angiotensin receptor blockade, for slowing the progression of diabetic kidney disease.
Development of Pathogenicity and AFLP to Characterize Fusarium oxysporum f.sp. momordicae Isolates from Bitter Gourd in China
Authors: Chen Zhen‐Dong , Huang Ru‐Kui , Li Qi‐Qin , Wen Jun‐Li , Yuan Gao‐Qing
Published: September 2014

Bitter gourd (Momordica charantia L.) cultivated in China is regarded as an important vegetable crop and is of considerable economic importance. However, it is susceptible to fusarium wilt, which causes heavy economic losses. Forty‐eight isolates were isolated from diseased bitter gourd plants that displayed typical fusarium wilt symptoms. Based on the morphological features, the rDNA internal transcribed space (ITS) sequences, pathogenicity and host biotypes, all of the isolates tested were pathogenic to the susceptible bitter gourd plants species (cv. ‘Guinongke No. 2’) and were identified as Fusarium oxysporum f. sp. momordicae (FOM). Our results classified different isolates as slightly, moderately or highly virulent. Among the isolates tested, 43 isolates slightly infected bottle gourd (Lagenaria siceraria var. clavata), whereas they did not infect other species from the family Cucurbitaceae. Genetic diversity among 48 isolates was characterized using amplified fragment length polymorphism (AFLP) analysis. The number of bands amplified by each primer pairs ranged from 41 to 66, with sizes ranging from 200 to 500 bp. A total of 366 bands were observed, out of which 363 were polymorphic (99.14%). The Nei's genetic identity of the six geographical populations varied from 0.7362 to 0.9707. The mean Nei's gene diversity index (H = 0.2644) and the mean Shannon's information index (I = 0.4071) at species level were higher than ones at populations level, indicated that the variation within populations was greater than that among populations. The Nei's GST (0.5103) and gene flow (Nm = 0.4923) revealed that genetic differentiation was mainly among populations and few gene exchanges. The dendrogram obtained from AFLP marker showed that there was a good correlation between isolates from different geographical locations and their pathogenicity. The AFLP marker effectively distinguished the high virulent isolates from the less virulent isolates. The highly virulent isolates were distinctly separated in different clusters, which indicated a significantly high correlation with the geographical origin in the AFLP dendrogram. The pathogenicity and molecular marker analysis confirmed the presence of variation in virulence as well as genetic diversity among the FOM isolates studied.
Grapevine Viruses' Detection and Sanitary Selection in Grapevine Germplasm of Calabria (Southern Italy)
Authors: Leo Giovanna , Luison Davide , Grande Saverio Bruno , Albanese Giuliana , Faggioli Francesco
Published: September 2014

A survey of grapevine viruses present in the region of Calabria (southern Italy) was carried out, and the sanitary selection was conducted on various indigenous varieties. Serological (ELISA) and molecular (multiplex RT‐PCR) tests were used to detect the viruses included in the Italian certification programme: Arabis mosaic virus (ArMV), Grapevine fanleaf virus (GFLV), Grapevine leafroll associated virus 1 (GLRaV‐1), Grapevine leafroll associated virus 2 (GLRaV‐2), Grapevine leafroll associated virus 3 (GLRaV‐3), Grapevine virus A (GVA), Grapevine virus B (GVB) and Grapevine fleck virus (GFkV). The frequency with which the above viruses have been detected was 37.4, 32.6, 12.8, 7.7, 7.3, 1.9 and 0.3%, respectively, for GVA, GLRaV‐3, GFLV, GFKV, GLRaV‐1, GLRaV‐2 and GVB. ArMV was never found. The sanitary selection allowed for the detection of 6 putative clones of ‘Arvino’, 2 of ‘Magliocco dolce’ and 2 of the rootstock ‘17–37’ free of the above‐mentioned viruses. The necessary process for the commercialization of these clones as ‘certified’ propagation material was accomplished, and their official approval by the Italian Ministry of Agriculture is currently in progress.
Contamination of Groundnut in South‐Western Nigeria by Aflatoxigenic Fungi and Aflatoxins in Relation to Processing
Authors: Afolabi Clement G. , Ezekiel Chibundu N. , Kehinde Iyabode A. , Olaolu Ayodeji W. , Ogunsanya Olaide M.
Published: September 2014

Groundnut is commonly consumed in its roasted form by many Nigerians. This study was therefore conducted to determine the levels of aflatoxin in roasted groundnut retailed in south‐western Nigeria with a view to assessing the fitness of the processed nut for human consumption. The effects of roasting and de‐coating as alternative methods for reducing the ‘aflatoxin scare’ in the nut were further assessed on aflatoxigenic fungal load and aflatoxin content of the nuts. Forty‐eight samples of retailed raw and roasted groundnut were collected and assessed by mycological and thin‐layer chromatographic analysis for changes in aflatoxigenic fungal population and aflatoxin concentration, respectively. Consequently, 480 isolates of the Aspergillus section Flavi group, A. flavus L strain (n = 410), A. tamarii (n = 56), A. parasiticus (n = 7) and A. parvisclerotigenus (n = 7), were recovered from all samples. Aflatoxigenic isolates of A. flavus L strain (58.8%) had a significantly (P < 0.05) higher incidence than the non‐aflatoxigenic isolates (41.2%). Aflatoxins were detected in 43 (89.6%) of the samples. Approximately 25% of all samples exceeded the 20 ng/g limit for aflatoxin B1 (AFB1) adopted by the National Agency for Food and Drug Administration and Control while 83 and 79% of all samples contained AFB1 and total aflatoxins above the European Union limits of 2 and 4 ng/g, respectively. Aflatoxin concentrations in the raw and coated samples were as much as five times higher than those in the roasted and de‐coated nuts, respectively. However, no significant difference was recorded between aflatoxin levels in the coated and de‐coated samples. This study has shown that roasting of groundnut and testa removal (de‐coating) are effective processing interventions that can significantly lower aflatoxin quantities in the kernels, thus making it fit for human consumption.
Characteristics of hepatic fatty acid compositions in patients with nonalcoholic steatohepatitis
Authors: Yamada Kazutoshi , Mizukoshi Eishiro , Sunagozaka Hajime , Arai Kuniaki , Yamashita Tatsuya , Takeshita Yumie , Misu Hirofumi , Takamura Toshinari , Kitamura Seiko , Zen Yoh , Nakanuma Yasuni , Honda Masao , Kaneko Shuichi
Published: September 2014

Background & Aims

Nonalcoholic fatty liver disease (NAFLD) is closely related to insulin resistance and lipid metabolism. Recent studies have suggested that the quality of fat accumulated in the liver is associated with the development of nonalcoholic steatohepatitis (NASH). In this study, we investigated the fatty acid composition in liver tissue and its association with the pathology in NAFLD patients.

Methods

One hundred and three patients diagnosed with NAFLD [simple steatosis (SS): 63, NASH: 40] were examined and their hepatic fatty acids were measured using gas chromatography. In addition, relationships between the composition and composition ratios of various fatty acids and patient backgrounds, laboratory test values, histology of the liver, and expression of fat metabolism‐related enzymes were investigated.

Results

The C16:1n7 content, the C16:1n7/C16:0 and C18:1n9/C18:0 ratios were increased and the C18:0/C16:0 ratio was decreased in the NASH group. The C18:0/C16:0 and C18:1n9/C18:0 ratios were associated with the steatosis score in liver tissue, and the C16:1n7/C16:0 ratio was associated with the lobular inflammation score. The expressions levels of genes: SCD1, ELOVL6, SREBP1c, FAS and PPARγ were enhanced in the NASH group. In multivariate analysis, the C18:0/C16:0 ratio was the most important factor that was correlated with the steatosis score. In contrast, the C16:1n7/C16:0 ratio was correlated with lobular inflammation.

Conclusion

The fatty acid composition in liver tissue and expression of genes related to fatty acid metabolism were different between the SS and NASH groups, suggesting that the acceleration of fatty acid metabolism is deeply involved in pathogenesis of NASH.
Correctional Officers and the Incarcerated Mentally Ill: Responses to Psychiatric Illness in Prison
Authors: Galanek Joseph D.
Published: September 2014

Based on ethnographic fieldwork in a U.S. men's prison, I investigate how this social and cultural context structures relations between correctional officers and inmates with severe mental illness. Utilizing interpretivist perspectives, I explore how these relations are structured by trust, respect, and meanings associated with mental illness. Officers’ discretionary responses to mentally ill inmates included observations to ensure psychiatric stability and flexibility in rule enforcement and were embedded within their role to ensure staff and inmate safety. Officers identified housing, employment, and social support as important for inmates’ psychiatric stability as medications. Inmates identified officers’ observation and responsiveness to help seeking as assisting in institutional functioning. These findings demonstrate that this prison's structures and values enable officers’ discretion with mentally ill inmates, rather than solely fostering custodial responses to these inmates’ behaviors. These officers’ responses to inmates with mental illness concurrently support custodial control and the prison's order.
Roles of plant hormones in the regulation of host–virus interactions
Authors: Alazem Mazen , Lin Na‐Sheng
Published: September 2014

Hormones are tuners of plant responses to biotic and abiotic stresses. They are involved in various complicated networks, through which they modulate responses to different stimuli. Four hormones primarily regulate plant defence to pathogens: salicylic acid (SA), jasmonic acid (JA), ethylene (Et) and abscisic acid (ABA). In susceptible plants, viral infections result in hormonal disruption, which manifests as the simultaneous induction of several antagonistic hormones. However, these antagonistic hormones may exhibit some sequential accumulation in resistant lines. Virus propagation is usually restricted by the activation of the small interfering RNA (siRNA) antiviral machinery and/or SA signalling pathway. Several studies have investigated these two systems, using different model viruses. However, the roles of hormones other than SA, especially those with antagonistic properties, such as ABA, have been neglected. Increasing evidence indicates that hormones control components of the small RNA system, which regulates many processes (including the siRNA antiviral machinery and the microRNA system) at the transcriptional or post‐transcriptional level. Consequently, cross‐talk between the antagonistic SA and ABA pathways modulates plant responses at multiple levels. In this review, we summarize recent findings on the different roles of hormones in the regulation of plant–virus interactions, which are helping us to elucidate the fine tuning of viral and plant systems by hormones.
Considerations for rice fortification in public health: conclusions of a technical consultation
Authors: De‐Regil Luz M. , Peña‐Rosas Juan Pablo , Laillou Arnaud , Moench‐Pfanner Regina
Published: September 2014

Fortification of staple foods and commonly used condiments with vitamins and minerals has been considered one of the most cost‐effective interventions to prevent and control micronutrient deficiencies. Because of its wide local consumption, acceptability, reach, and quantum of consumption, rice (Oryza sativa) far exceeds the requirements of a staple food vehicle that can be considered for fortification purposes at a population‐level intervention. The World Health Organization (WHO) has the mandate to develop evidence‐informed guidelines for the fortification of staple foods as a public health intervention, including rice fortification with micronutrients. The WHO, in collaboration with the Global Alliance for Improved Nutrition (GAIN), convened a consultation on “Technical Considerations for Rice Fortification in Public Health” in Geneva, Switzerland on October 9–10, 2012 to provide technical inputs to the guideline development process, particularly with reference to feasibility and implementability. The industrial and regulatory technical considerations in rice fortification, as well as the considerations for implementing it as a public health strategy and assuring equitable access and universal coverage, were reviewed in this consultation. This paper summarizes the discussions and priority research areas for the forthcoming years.
An overview of global rice production, supply, trade, and consumption
Authors: Muthayya Sumithra , Sugimoto Jonathan D. , Montgomery Scott , Maberly Glen F.
Published: September 2014

Rice is the staple food for over half the world's population. Approximately 480 million metric tons of milled rice is produced annually. China and India alone account for ∼50% of the rice grown and consumed. Rice provides up to 50% of the dietary caloric supply for millions living in poverty in Asia and is, therefore, critical for food security. It is becoming an important food staple in both Latin America and Africa. Record increases in rice production have been observed since the start of the Green Revolution. However, rice remains one of the most protected food commodities in world trade. Rice is a poor source of vitamins and minerals, and losses occur during the milling process. Populations that subsist on rice are at high risk of vitamin and mineral deficiency. Improved technologies to fortify rice have the potential to address these deficiencies and their associated adverse health effects. With the rice industry consolidating in many countries, there are opportunities to fortify a significant share of rice for distribution or for use in government safety net programs that target those most in need, especially women and children. Multisectoral approaches are needed for the promotion and implementation of rice fortification in countries.
Losing connections and receiving support to reconnect: experiences of frail older people within care programmes implemented in primary care settings
Authors: Bindels Jill , Cox Karen , De La Haye Jean , Mevissen Ger , Heijing Servé , van Schayck Onno C.P. , Widdershoven Guy , Abma Tineke A.
Published: September 2014

Aims and objectives

The objective of this study was to evaluate whether care provided in the care programmes matched the needs of older people.

Background

Care programmes were implemented in primary‐care settings in the Netherlands to identify frail older people and to prevent further deterioration of health.

Design and methods

In total, 23 older people participated in in‐depth interviews. Within this study, three older people participated as co‐researchers; they gathered and analysed the data together with the academic researchers. Content analysis was used to analyse the data.

Results

Two categories emerged from the data: ‘Losing connections’ and ‘Receiving support to reconnect.’ ‘Losing connections’ reflects the needs of older people and ‘Receiving support to reconnect’ reflects their experience and the appreciated aspects of the provided care. A relationship of trust with the practice nurse (PN) appeared to be an important aspect of care, as it fostered the sharing of feelings and issues other than physical or medical problems that could not be shared with the general practitioner. The PNs are experienced as connectors, who help to restore feelings of connectedness and older peoples’ access to resources in the community.

Conclusions

The relationship with the PN was experienced as valuable because of the feelings of ‘connectedness’ it created. Through this connectedness, older people could discuss feelings of loneliness, depression and frustration in receiving and acquiring the appropriate resources and services with the PNs. Furthermore, the relationship with the PN helped the older people to gain access to other health professionals and services.

Implications for practice

The results imply that care for frail older people should include an awareness of the importance of the trusting relationship. Nurses can play a vital role in creating a trusting relationship and are able to bridge the gap between older people and other professionals and services.
Eigencorneas: application of principal component analysis to corneal topography
Authors: Rodríguez Pablo , Navarro Rafael , Rozema Jos J.
Published: September 2014

Purpose

To determine the minimum number of orthonormal basis functions needed to accurately represent the great majority of corneal topographies from a normal population.

Methods

Principal Component Analysis was applied to the elevation topographies of the anterior and posterior corneal surfaces and central thickness of 368 eyes of 184 healthy subjects. PCA was applied directly to the input elevation data points and after fitting them to Zernike polynomials (up to 8th order, 8 mm diameter). The anterior and posterior surfaces, as well as right eye and left eye data, were analysed both separately and jointly. A threshold based on the amount of explained variance (99%) was applied to determine the minimum number of basis functions (eigencorneas) or degrees of freedom (DoF) in the population.

Results

The eigenvectors directly obtained from elevation data resemble Zernike polynomials. The separate principal component analysis on the Zernike coefficients of anterior and posterior surfaces yielded 5 and 9 DoF, respectively. An additional reduction to 11 DoF (instead of 15 DoF) was achieved when performing a joint PCA that included both surfaces as well as central thickness. Finally, a further reduction was obtained by pooling right and left eye data together, to only 18 DoF.

Conclusions

The combination of Zernike fit and Principal Component Analysis yields a strong reduction of dimensionality of elevation topography data, to only 19 independent parameters (18 DoF plus population average), which indicates a high degree of correlation existing between anterior and posterior surfaces, and between eyes. The resulting eigencorneas are especially well suited for practical applications, as they are uncorrelated and orthonormal linear combinations of Zernike polynomials.
MANAGERIAL GOALS IN A PERFORMANCE‐DRIVEN SYSTEM: THEORY AND EMPIRICAL TESTS IN HIGHER EDUCATION
Authors: RUTHERFORD AMANDA , MEIER KENNETH J.
Published: September 2014

Factors influencing managerial goals and decision‐making processes have been debated for decades among public administration scholars. Previous literature has explained goal setting through theories of performance gaps, bureaucratic control, and isomorphic rationality. However, there exists no direct empirical test of these theories to determine which theoretical expectation may have more or less weight with managers when setting organizational goals. Using an original survey of university presidents, this study tests how public managers prioritize competing performance goals. Findings suggest that the goal setting decisions of these public managers is primarily driven by political control mechanisms.
Anti‐infective proteins in breast milk and asthma‐associated phenotypes during early childhood
Authors: Zhang Guicheng , Lai Ching Tat , Hartmann Peter , Oddy Wendy H. , Kusel Merci M. H. , Sly Peter D. , Holt Patrick G.
Published: September 2014

Background

The impact of breast milk feeding on susceptibility to asthma in childhood is highly controversial, due in part to failure of the majority of studies in the area to adequately account for key confounders exemplified by respiratory infection history, plus the effects of recall bias.

Methods

As part of a prospective cohort study on the role of respiratory infections in asthma development in high‐risk children, we measured the concentration of a panel of anti‐infective proteins in maternal milk samples and analyzed associations between these and subsequent atopy‐, infection‐, and asthma‐related outcomes prospectively to age 10 years.

Results

We observed significant but transient inverse associations between the concentration of milk proteins and susceptibility to upper respiratory infections in year 1 only, and parallel but positive transient associations with early lower respiratory infections and atopy. No associations were seen with asthma‐related outcomes.

Conclusions

Breast milk feeding may influence the expression of inflammatory symptoms associated with respiratory infections and atopy in early life, but these effects appear to be inconsistent and transient. The heterogeneous nature of breast‐feeding effects suggests it may influence systemic immunoinflammatory function at several different levels.
Cotyledons are the main source of secondary spread of Acidovorax citrulli in melon nurseries
Authors: Chalupowicz L. , Dror O. , Reuven M. , Burdman S. , Manulis‐Sasson S.
Published: September 2014

Acidovorax citrulli (Ac) is the causal agent of bacterial fruit blotch (BFB) disease resulting in substantial economic damage to cucurbit crops worldwide. The plant parts and cultural practices (irrigation methods and bactericidal sprays) that affect the secondary spread of Ac in melon nurseries were investigated in this study. Overhead irrigation dispersed the pathogen from infected seedlings to 95% of the neighbouring healthy seedlings, with 80% of them displaying high disease severity. In contrast, when sub‐irrigation by floating was employed, the neighbouring plants of the infected ones did not display disease symptoms and were not colonized by Ac. Foliar treatment with Kocide after cotyledon emergence reduced disease incidence to 40%, with 37% of the plants displaying low disease severity. Assessment of Ac populations in different parts of the seedlings revealed that cotyledons were the most colonized part of the plant. Images of fluorescent binocular and confocal laser‐scanning microscopy of seedlings infected with a GFP‐labelled Ac strain showed that the pathogen forms abundant aggregates on the surface of cotyledons, colonizes the intercellular spaces of the parenchymatic tissues extensively, and moves through the vascular system of the hypocotyls, leading to infection of emerging leaves. Results of this study indicate that preventing secondary spread of Ac in melon nurseries by sub‐irrigation combined with a bactericidal spray at the cotyledon stage may provide an effective means for BFB control.
Fruit illumination stimulates cell division but has no detectable effect on fruit size in tomato (Solanum lycopersicum)
Authors: Okello Robert C.O. , Heuvelink Ep , de Visser Pieter H.B. , Lammers Michiel , de Maagd Ruud A. , Marcelis Leo F.M. , Struik Paul C.
Published: September 2014

Light affects plant growth through assimilate availability and signals regulating development. The effects of light on growth of tomato fruit were studied using cuvettes with light‐emitting diodes providing white, red or blue light to individual tomato trusses for different periods during daytime. Hypotheses tested were as follows: (1) light‐grown fruits have stronger assimilate sinks than dark‐grown fruits, and (2) responses depend on light treatment provided, and fruit development stage. Seven light treatments [dark, 12‐h white, 24‐h white, 24‐h red and 24‐h blue light, dark in the first 24 days after anthesis (DAA) followed by 24‐h white light until breaker stage, and its reverse] were applied. Observations were made between anthesis and breaker stage at fruit, cell and gene levels. Fruit size and carbohydrate content did not respond to light treatments while cell division was strongly stimulated at the expense of cell expansion by light. The effects of light on cell number and volume were independent of the combination of light color and intensity. Increased cell division and decreased cell volume when fruits were grown in the presence of light were not clearly corroborated by the expression pattern of promoters and inhibitors of cell division and expansion analyzed in this study, implying a strong effect of posttranscriptional regulation. Results suggest the existence of a complex homeostatic regulatory system for fruit growth in which reduced cell division is compensated by enhanced cell expansion.
Sarcocystosis in a Stillborn Lamb
Authors: Agerholm JS , Dubey JP
Published: September 2014

Contents

Confirmed congenital sarcocystosis has been reported extremely rarely in domestic ruminants. Sarcocystosis was diagnosed in a stillborn lamb with microscopic lesions predominantly in the central nervous system and placenta. Encephalitis was characterized by multiple foci of glial nodules some with central necrosis, perivascular cuffing and vascular occlusion, while placental lesions consisted of multifocal necroses, inflammation and mild calcification. Immature and mature schizonts were found in vascular endothelium of several organs. It is suggested that the protozoa were Sarcocystis tenella based on their morphology, location and as this is the most pathogenic Sarcocystis sp. parasitizing sheep.
The Induction of a Secondary Corpus Luteum on Day 12 Post‐Ovulation can Delay the Time of Luteolysis in High‐Producing Holstein Cows
Authors: Saint‐Dizier M , Legendre A‐C , Driancourt M‐A , Chastant‐Maillard S
Published: September 2014

Contents

Luteolysis before the time of maternal recognition of pregnancy is one cause of low fertility in high‐producing dairy cows. The objective of this study was to assess whether induction of a secondary corpus luteum (CL) late in the luteal phase would delay the time of luteolysis. Twenty high‐producing Holstein cows were synchronized to ovulation (Day 0) with the Ovsynch protocol and received hCG (1500 IU im) on Day 12. Corpora lutea formation (as evaluated by ultrasonography) and plasma P4 concentrations were monitored from Days 4 to 36. hCG treatment induced the formation of one secondary CL (CL2) in 11 of 20 cows (55%) from the dominant follicle (mean diameter: 14.2 ± 0.9 mm) of two‐wave (3/11) and three‐wave (8/11) cycles. The maximal diameter of the CL2 (23.3 ± 1.9 mm) was reached approximately 6 days after hCG treatment and was correlated with its structural lifespan (p < 0.01). Cows that formed a CL2 after hCG had higher mean plasma P4 concentrations on Day 14 (+4.5 ng/ml) and Day 18 (+3.0 ng/ml) compared with cows without CL2 (p < 0.05). The structural regression of CL2 begun approximately 8 days after that of the CL1, and the median time at which the first drop in circulating P4 levels occurred was later in cows that formed a CL2 than in those that did not (Day 26 vs Day 18; p < 0.01). Thus, the induction of a CL2 by hCG on Day 12 might reduce the risk of premature luteolysis in high‐producing dairy cows after insemination.
Relationships between ventilatory impairment, sleep hypoventilation and type 2 respiratory failure
Authors: Hillman David , Singh Bhajan , McArdle Nigel , Eastwood Peter
Published: September 2014

Conditions that increase load on respiratory muscles and/or reduce their capacity to cope with this load predispose to type 2 (hypercapnic) respiratory failure. In its milder forms, this imbalance between load and capacity may primarily manifest as sleep hypoventilation which, if untreated, can increase the likelihood of wakeful respiratory failure. Such problems are commonly seen in progressive respiratory neuromuscular disorders, morbid obesity and chronic obstructive pulmonary disease, either separately or together. Identifying patients at risk can be important in determining whether and when to intervene with treatments such as non‐invasive ventilatory assistance. Measurements of wakeful respiratory function are fundamental to this risk assessment. These issues are reviewed in this paper.
Differential injurious effects of ambient and traffic‐derived particulate matter on airway epithelial cells
Authors: Kumar Rakesh K. , Shadie Alexander M. , Bucknall Martin P. , Rutlidge Helen , Garthwaite Linda , Herbert Cristan , Halliburton Brendan , Parsons Kristy S. , Wark Peter A.B.
Published: September 2014

Background and objective

Exposure to airborne particulate matter (PM) may promote development of childhood asthma and trigger acute exacerbations of existing asthma via injury to airway epithelial cells (AEC).

Methods

We compared the response of AEC to ambient particulates with median aerodynamic diameters of <10 μm or <2.5 μm from the Sydney metropolitan region (Sydney PM10 or PM2.5), to traffic‐derived particulates from the exhaust stack of a motorway tunnel or to inert carbon black as a control.

Results

Sydney PM10 strongly stimulated messenger RNA expression and secretion of the pro‐inflammatory cytokines interleukin 6 (IL‐6) and chemokine (C‐X‐C motif) ligand 1 (CXCL1) by mouse tracheal AEC. In contrast, traffic‐derived particulates did not. Similarly, PM10 stimulated expression of IL6, IL8 and IL1B by human AEC. Mass spectrometric analysis showed that PM10 contained much higher levels of elements associated with dusts of geological origin. In contrast, tunnel soot contained much higher levels of various organic compounds, notably including long straight‐chain alkanes and diesel‐derived polycyclic aromatic hydrocarbons. Sydney PM2.5, as well as PM10 collected during a period including a major dust storm, both of which contained relatively lower levels of iron but similar levels of other crustal elements, did not stimulate expression or secretion of CXCL1 by mouse AEC.

Conclusions

Ambient PM10 is likely to be more important than traffic‐derived PM in causing injury to AEC leading to production of pro‐inflammatory cytokines. The injurious effects may be related to the presence of iron in the coarse fraction of airborne PM. These findings are likely to be relevant to the pathogenesis of asthma.
Optimal Insurance With Costly Internal Capital
Authors: Jaffee Dwight , Walden Johan
Published: September 2014

We introduce costly internal capital into a standard insurance model, in which a risk‐averse policyholder buys insurance from a risk‐neutral insurer with limited liability. The unique optimal contract and internal capital lead to a strictly positive probability for insurer default. Some risks are uninsurable in that the insurer chooses not to provide insurance against such risks. An increase in the cost of capital may lead to a higher optimal amount of internal capital. The results extend to multiple policyholders in a symmetric setting. Our extension of the classical model to include costly internal capital provides a fruitful approach to many real world insurance markets.
Risk Culture: What It Is and How It Affects an Insurer's Risk Management
Authors: Roeschmann Angela Zeier
Published: September 2014

This article conceptualizes risk culture and sheds light on the role it plays in insurers’ risk management frameworks. The article follows a cognitive, dynamic approach, arguing that risk culture is the product of organizational learning about what has or has not worked for it in the past. Within their local context, the members of a group learn which of the typically centrally prescribed formal risk management policies and procedures and which espoused risk philosophies actually work in practice in the sense of behavior that is formally or informally encouraged or discouraged, rewarded or punished. While the formal risk management framework defines which processes to use, which limits to obey, and which values to aspire to, it is the risk culture that defines which rules and norms are perceived to be rational and important. The insurance literature commonly argues, and practice suggests, that it is necessary to achieve consistency in order to effectively embed risk management. Nevertheless, inconsistent basic assumptions at the deepest level of risk culture are a likely feature of local subgroups. However, what is rational and efficient to one subgroup might be random and dangerous for the organization as a whole.
Insurance Rating Games: Strikes, Spares, and Bags
Authors: Ahlgrim Kevin C. , Jones James R.
Published: September 2014

Carefully designed classroom activities and games can be used to increase student engagement, motivation, and learning. This article describes two games that have been used with students of risk management and insurance to help highlight the intricacies of insurance pricing. These two games, bowling insurance and bags insurance, help students experience the challenging nature of premium determination in risk transfer contracts and also connect the various actions taken by insurers during the insurance transaction.
Improved methods for selective cryolipolysis results in subcutaneous fat layer reduction in a porcine model
Authors: Kwon T.‐R. , Yoo K. H. , Oh C. T. , Shin D. H. , Choi E. J. , Jung S. J. , Hong H. , Choi Y. S. , Kim B. J.
Published: September 2014

Background/aims

Cryolipolysis is a noninvasive method for the selective reduction of localized fat tissues. It has demonstrated efficacy in both clinical and preclinical trials; however, despite its popularity, its mechanisms of action and evaluation methods are not yet fully defined. The purpose of this study was to improved methods for cryolipolysis using a porcine model.

Methods

The abdomens of female PWG micro‐pigs were treated with a cooling device (CRYOLIPO II™), and we examined the treatment effects using photography, three‐dimensional photography, ultrasound, gross, and microscopic pathology, and serum lipid level analyses in order to determine the mechanism of action, efficacy, and safety of CRYOLIPO II™.

Results

CRYOLIPO II™ successfully reduced abdominal fat in our porcine model. Gross and microscopic histological results confirmed the noninvasive cold‐induced selective subcutaneous fat destruction, and showed increases in pre‐adipocyte differentiation and in the activation of lipid catabolism. In particular, we found that CRYOLIPO II™ may increase PPARδ (delta) levels in adipose tissue at 30–60 days post‐treatment.

Conclusion

Fat reduction by cryolipolysis was successfully achieved in our porcine model. Thus, our findings indicate that CRYOLIPO II™ may be a promising fat reduction device for body contouring and fat reduction in humans, and that cryolipolysis exerts its effects, at least partly, by targeting the PPARδ signaling pathway. These results show that both investigative and diagnostic potentials capacity.