bluuebunny/crossref_metadata_2025 huggingface dataset:
Flow into a hole in relation to laser drilling: influence of coating thickness
Authors: Zaman Shuja Shahzada , Yilbas Bekir
Published: May 2014

Purpose

– In laser drilling applications, hole wall remains almost the melting temperature of the substrate material and the thermodynamic pressure developed at high temperature molten surface vicinity influences the heat transfer rates and the skin friction at the surface of the hole wall. This effect becomes complicated for the holes drilled in coated substrates. In this case, melting temperatures of the coating and base materials are different, which in turn modifies the flow field in the hole due to jet impingement. Consequently, investigation of the heat transfer rates from the hole wall surfaces and the skin friction at the hole surface becomes essential. The paper aims to discuss these issues.

Design/methodology/approach

– Numerical solution for jet impingement onto a hole with high wall temperature is introduced. Heat transfer rates and skin friction from the hole wall is predicted. The numerical model is validated with the experimental data reported in the open literature.

Findings

– The Nusselt number attains high values across the coating thickness and it drops sharply at the interface between the coating and the base material in the hole. Since fluid temperature in the vicinity of the substrate surface is higher than that of the wall temperature, heat transfer occurs from the fluid to the substrate material while modifying the Nusselt number along the hole wall. This results in discontinuity in the Nusselt variation across the coating-base material interface. The Raighly line effect enhances the flow acceleration toward the hole exit while increasing the rate of fluid strain. Consequently, skin friction increases toward the hole exit. The influence of average jet velocity on the Nusselt number and the skin friction is significant.

Research limitations/implications

– The findings are very useful to analyze the flow field in the hole at different wall temperature. In the simulations hole diameter is fixed in line with the practical applications. However, it may be changed to examine the influence of hole diameter on the flow field and heat transfer. However, this extension be more toward academic study than the practical significance.

Practical implications

– The complete modeling of turbulent flow jet flow impinging onto a hole is introduced and boundary conditions are well defined for the numerical solutions. The method of handing the physical problem will be useful for those working in the area of heat transfer and fluid flow. In addition, the importance of heat transfer rates and skin friction at the hole wall is established, which will benefit the practical engineers and the academicians working in the specific area of laser machining.

Social implications

– The findings are useful for those working to improve the laser technology in the machining area.

Originality/value

– The work presented is original and never being published anywhere else. The findings are reported in detail such that academicians and engineers are expected to benefit from this original contribution.
Physician associate: new role within mental health teams
Authors: Gill Kaybinder , Kauser Sabina , Khattack Kalsum , Hynes Fiona
Published: May 2014

Purpose

– The purpose of this paper is to outline the role of a new healthcare professional, the physician associate (PA), within the developing National Health Service (NHS), particularly within the specialty of psychiatry.

Design/methodology/approach

– The authors reviewed the available literature from the UK and the USA on the history and development of PAs, particularly within the UK. The paper focuses on PA training and the role of the PA, specialities in which PAs are employed in the UK and an insight into the role of PAs within psychiatry. This paper also drew upon research and viewpoints of the effectiveness and benefits of employing a PA, along with current misconceptions and limitations of the role.

Findings

– The initial influx of PAs into the NHS at a time of medical staffing crisis was found to be effective and successful in improving service provision and helping provide continuity of care for patients. Where PAs have been employed they have helped to relieve some of the strain by being a consistent member of the medical team and performing many of the duties of junior doctors. However they are still unable to prescribe and order radiological investigations, but this will come in time as the PA profession push for statutory registration.

Originality/value

– This paper is one of the first in the UK that gives an overview of the key roles of the PA within the liaison, forensic and community subspecialties of psychiatry.
International work and leadership in UK general practice
Authors: Young Peter , Smith Chris , Pettigrew Luisa , Seo Ha-Neul , Blane David
Published: May 2014

Purpose

– The purpose of this paper is to present an exploration of the leadership competencies developed by UK GPs through having undertaken international work and the ability to transfer these competencies back to the UK.

Design/methodology/approach

– The approach taken is a cross-sectional survey.

Findings

– A total of 439 UK-based, ranging from GP specialty trainees to retired GPs who had worked overseas, responded to an online survey of UK general practice and international work. Doctors were asked to report competency development through international work using the domains of the Medical Leadership Competency Framework (MLCF). The most common competencies developed, to a “moderate or significant” degree, related to “personal qualities” (89 per cent) and “working in teams” (87 per cent). To a lesser extent Doctors developed competencies in “setting direction” (60 per cent), “managing services” (59 per cent), and “service improvement” (56 per cent), and found these competencies harder to transfer back to the UK. A common reason for limited transfer of competency was the lack of leadership opportunities for Doctors when returning to UK locum roles. Overseas posts were more common in low/middle income countries, and these Doctors reported a greater range of leadership roles, including in health policy, management and teaching, compared to high-income countries. Most doctors felt that they were able to develop their clinical skills overseas whilst relatively few Doctors performed research, especially in high-income countries.

Originality/value

– To the authors' knowledge this is the first cross-sectional survey exploring the international work of UK GPs and leadership development using the MLCF domains.
Effects of Pitavastatin on the Expression of VCAM‐1 and its Target Gene miR‐126 in Cultured Human Umbilical Vein Endothelial Cells
Authors: Xu Qinglu , Luan Tianzhu , Fu Songbin , Yang Jian , Jiang Chao , Xia Fangfang
Published: May 2014

Objectives

Reducing the expression of endothelial cell adhesion molecules is conducive to the decrease of inflammation‐induced vascular complications. In this study, we observed pitavastatin on expression of vascular cell adhesion molecule‐1 (VCAM‐1) and its influence on VCAM‐1's target gene miR‐126 in endothelial cells. The purpose of this study is to explore the mechanism of pitavastatin in prevention and treatment of atherosclerosis.

Methods

HUVEC were cultured in M1640 and passages 2–5 were used in experiments. The cells were randomly divided into three groups, control, TNF‐α and pitavastatin group. Cells of TNF‐α group were co‐incubated with different concentrations (10, 20, 30 μg/L) of TNF‐α for 24 h. Cells of pitavastatin group were firstly coincubated with (0.01, 0.1, 1 μmol/L) pitavastatin, respectively, for 1 h, then coincubated with 30 μg/L TNF‐α for 24 h. VCAM‐1 and miR‐126 mRNA were detected by RT‐PCR, and Western blotting was used to detect protein expression of VCAM‐1.

Results

Both detection methods have showed that TNF‐α stimulation significantly increased the mRNA and protein expression of VCAM‐1 in a dose‐dependent manner, and miR‐126 mRNA expression exhibited a decreasing trend. The increase of VCAM‐1 mRNA and protein expression induced by TNF‐α was inhibited by pitavastatin in a dose‐dependent manner, too. However, there were no differences of the expression of miR‐126 among three groups.

Conclusions

These effects may explain the ability of pitavastatin to reduce the progression of atherosclerosis. The findings further suggest that inhibitory effect of pitavastatin on VCAM‐1 is not related to miR‐126 but depends on other ways.
Routine pre‐operative focused ultrasonography by anesthesiologists in patients undergoing urgent surgical procedures
Authors: BØTKER M. T. , VANG M. L. , GRØFTE T. , SLOTH E. , FREDERIKSEN C. A.
Published: May 2014

Background

Unexpected cardiopulmonary complications are well described during surgery and anesthesia. Pre‐operative evaluation by focused cardiopulmonary ultrasonography may prevent such mishaps. The aim of this study was to determine the frequency of unexpected cardiopulmonary pathology with focused ultrasonography in patients undergoing urgent surgical procedures.

Methods

We performed pre‐operative focused cardiopulmonary ultrasonography in patients aged 18 years or above undergoing urgent surgical procedures at pre‐defined study days. Known and unexpected cardiopulmonary pathology was recorded, and subsequent changes in the anesthesia technique or supportive actions were registered.

Results

A total of 112 patients scheduled for urgent surgical procedures were included. Their mean age (standard deviation) was 62 (21) years. Of these patients, 24% were American Society of Anesthesiologists (ASA) class 1, 39% were ASA class 2, 32% were ASA class 3, and 4% were ASA class 4. Unexpected cardiopulmonary pathology was disclosed in 27% [95% confidence interval (CI) 19–36] of the patients and led to a change in anesthesia technique or supportive actions in 43% (95% CI 25–63) of these. Unexpected pathology leading to changes in anesthesia technique or supportive actions was only disclosed in a group of patients above the age of 60 years and/or in ASA class ≥ 3.

Conclusion

Focused cardiopulmonary ultrasonography disclosed unexpected pathology in patients undergoing urgent surgical procedures and induced changes in the anesthesia technique or supportive actions. Pre‐operative focused ultrasonography seems feasible in patients above 60 year and/or with physical limitations but not in young, healthy individuals.
Circulating Cytokines and Alarmins Associated with Placental Inflammation in High‐Risk Pregnancies
Authors: Girard Sylvie , Heazell Alexander E. P. , Derricott Hayley , Allan Stuart M. , Sibley Colin P. , Abrahams Vikki M. , Jones Rebecca L.
Published: May 2014

Problem

Inflammation during pregnancy has devastating consequences for the placenta and fetus. These events are incompletely understood, thereby hampering screening and treatment.

Method of study

The inflammatory profile of villous tissue was studied in pregnancies at high‐risk of placental dysfunction and compared to uncomplicated pregnancies. The systemic inflammatory profile was assessed in matched maternal serum samples in cases of reduced fetal movements (RFM).

Results

Placentas from RFM pregnancies had a unique inflammatory profile characterized by increased interleukin (IL)‐1 receptor antagonist and decreased IL‐10 expression, concomitant with increased numbers of placental macrophages. This aberrant cytokine profile was evident in maternal serum in RFM, as were increased levels of alarmins (uric acid, HMGB1, cell‐free fetal DNA).

Conclusion

This distinct inflammatory profile at the maternal‐fetal interface, mirrored in maternal serum, could represent biomarkers of placental inflammation and could offer novel therapeutic options to protect the placenta and fetus from an adverse maternal environment.
Improving Development Ownership Among Vulnerable People: Challenges of NGOs’ Community Empowerment Projects in Bangladesh
Authors: Islam M. Rezaul
Published: May 2014

This paper exposed the major challenges that the non‐governmental organizations (NGOs) face in improving development ownership among vulnerable people in community empowerment projects in Bangladesh. The finding, based on a qualitative research approach, used multi‐method data collection procedures. Data were collected from two NGOs, Proshika and Practical Action Bangladesh (PAB), working with two vulnerable communities—blacksmiths and goldsmiths. The results showed that NGOs faced a number of challenges, including lack of understanding about the local context, initiatives to localize global development tools, developing partnership, and space for local people in the development processes. The paper argued that, without securing development ownership, the NGOs’ activities toward community empowerment of vulnerable people would not be possible. The findings of the paper would be valuable guidelines for policy makers, development practitioners, NGO workers, and academicians.
Approximal caries increment in adolescents in a low caries prevalence area in Sweden after a 3.5‐year school‐based fluoride varnish programme with Bifluorid 12 and Duraphat
Authors: Bergström Eva‐Karin , Birkhed Dowen , Granlund Christina , Moberg Sköld Ulla
Published: May 2014

Objectives

To evaluate approximal caries increment among 12‐ to 16‐year‐olds in a low caries prevalence area in Sweden after a 3.5‐year school‐based fluoride (F) varnish programme with Bifluorid 12 and Duraphat.

Methods

The design was a RCT study with 1365 adolescents, divided into following four groups: Group 1 Bifluorid 12 two applications/year; Group 2 Duraphat two applications/year; Group 3 Bifluorid 12 four applications/year and Group 4 no F varnish at school. 1143 children (84%) completed the study. Approximal caries was registered on bitewing radiographs.

Results

There were no statistically significant differences in caries prevalence among the groups either at baseline or after 3.5 years . The caries increment for Group 1 was 1.34 ± 2.99 (mean ± SD), 1.24 ± 2.84 for Group 2, 1.07 ± 2.66 for Group 3 and 1.25 ± 2.75 for Group 4, with no statically significant differences either between Bifluorid 12 and Duraphat with the same frequency of F varnish applications or between the F groups and the control group.

Conclusions

In an area with low caries prevalence in Sweden, the supplementary caries‐preventive effect of school‐based F varnish applications, to regular use of F toothpaste at home and to regular caries prevention given at the Public Dental Clinics, appears to be nonsignificant regarding approximal caries increment.
Pleuroscopy in ‘Idiopathic’ eosinophilic pleural effusions
Authors: Archontogeorgis Kostas , Anevlavis Stavros , Zarogoulidis Paul , Jain Ajay , Karpathiou Georgia , Giatromanolaki Alexandra , Sivridis Efthimios , Bouros Demosthenes , Froudarakis Marios E.
Published: May 2014

Background

Idiopathic eosinophilic pleural effusions (IEPEs) comprise the eosinophilic pleural effusions for which a specific aetiology cannot be established. There are no reports investigating IEPE on the basis of a systematically applied pleuroscopy approach and entailing an appropriate patient follow‐up till the final outcome is established; existing series rather combine clinical and thoracocentesis criteria to establish the idiopathic character of the diagnosis.

Objectives

The aim of our study was to assess the clinical outcome of patients with IEPE, who underwent a systematic diagnostic approach by pleuroscopy.

Methods

We studied 10 patients with IEPE among 175 consecutive patients who underwent pleuroscopy for undiagnosed pleural effusion. Pleural biopsies were obtained from observed lesions. All patients were followed up by means of clinical examination and imaging.

Results

The diagnosis of IEPE was established in 10 patients (median age was 50.5 years, range 35–91). Macroscopic examination of the pleura showed diffuse thickening with pleural plaques in eight patients, consistent with diffuse pleural eosinophilic inflammation histologically proven. In two patients, macroscopic examination showed scattered nodules associated with non‐caseating granulomas histologically. In all 10 patients, a specific aetiology could not be established. Follow‐up was available for all patients ranging from 24–102 months (median 60 months). No patient received a specific treatment during the follow‐up period. No relapse of a pleural effusion was documented during this period.

Conclusion

Pleuroscopy is mandatory in diagnosing IEPE. Negative histology and a long follow‐up showed a benign course. These findings suggest that we should call these effusions ‘indeterminate’.
Tracheobronchopathia osteochondroplastica: a review of the literature
Authors: Ulasli Sevinc Sarinc , Kupeli Elif
Published: May 2014

Background

Tracheobronchopathia osteochondroplastica (TBPOCP) is an uncommon benign condition affecting the lumen of tracheobronchial tree and characterized by abnormal chondrification and ossification. TBPOCP is more frequent than it has been reported, as it can be asymptomatic or present with non‐specific respiratory symptoms.

Aims

In this article, we provide a review of the English literature on the condition and discuss its clinical features, general principles, diagnostic approaches and current treatment recommendations for TBPOCP.

Methods

We searched for all papers indexed in Science Citation Index and Science Citation Index – Expanded by using Thomson Reuters Web of Knowledge Web of Science software.

Results

We reviewed a total of 72 scientific publications.

Conclusion

In order to highlight, diagnosis, treatment and treatment outcomes of TBPOCP, further review articles and large case series about this orphan disease are needed.
Effect of oral nutritional supplementation on wound healing in diabetic foot ulcers: a prospective randomized controlled trial
Authors: Armstrong D. G. , Hanft J. R. , Driver V. R. , Smith A. P. S. , Lazaro‐Martinez J. L. , Reyzelman A. M. , Furst G. J. , Vayser D. J. , Cervantes H. L. , Snyder R. J. , Moore M. F. , May P. E. , Nelson J. L. , Baggs G. E. , Voss A. C. ,   the Diabetic Foot Nutrition Study Group
Published: May 2014

Aims

Among people with diabetes, 10–25% will experience a foot ulcer. Research has shown that supplementation with arginine, glutamine and β‐hydroxy‐β‐methylbutyrate may improve wound repair. This study tested whether such supplementation would improve healing of foot ulcers in persons with diabetes.

Methods

Along with standard of care, 270 subjects received, in a double‐blinded fashion, (twice per day) either arginine, glutamine and β‐hydroxy‐β‐methylbutyrate or a control drink for 16 weeks. The proportion of subjects with total wound closure and time to complete healing was assessed. In a post‐hoc analysis, the interaction of serum albumin or limb perfusion, as measured by ankle–brachial index, and supplementation on healing was investigated.

Results

Overall, there were no group differences in wound closure or time to wound healing at week 16. However, in subjects with an albumin level of ≤ 40 g/l and/or an ankle–brachial index of < 1.0, a significantly greater proportion of subjects in the arginine, glutamine and β‐hydroxy‐β‐methylbutyrate group healed at week 16 compared with control subjects (P = 0.03 and 0.008, respectively). Those with low albumin or decreased limb perfusion in the supplementation group were 1.70 (95% CI 1.04–2.79) and 1.66 (95% CI 1.15–2.38) times more likely to heal.

Conclusions

While no differences in healing were identified with supplementation in non‐ischaemic patients or those with normal albumin, addition of arginine, glutamine and β‐hydroxy‐β‐methylbutyrate as an adjunct to standard of care may improve healing of diabetic foot ulcers in patients with risk of poor limb perfusion and/or low albumin levels. Further investigation involving arginine, glutamine and β‐hydroxy‐β‐methylbutyrate in these high‐risk subgroups might prove clinically valuable.
Gay and Lesbian Couples in Italy: Comparisons with Heterosexual Couples
Authors: Antonelli Paolo , Dèttore Davide , Lasagni Irene , Snyder Douglas K. , Balderrama‐Durbin Christina
Published: May 2014

Assessing couple relationships across diverse languages and cultures has important implications for both clinical intervention and prevention. This is especially true for nontraditional relationships potentially subject to various expressions of negative societal evaluation or bias. Few empirically validated measures of relationship functioning have been developed for cross‐cultural applications, and none have been examined for their psychometric sufficiency for evaluating same‐sex couples across different languages and cultures. The current study examined the psychometric properties of an Italian translation of the Marital Satisfaction Inventory – Revised (MSI‐R), a 150‐item 13‐scale measure of couple relationship functioning, for its use in assessing the intimate relationships of gay and lesbian couples in Italy. Results for these couples were compared to data from heterosexual married and unmarried cohabiting couples from the same geographical region, as well as to previously published data for gay, lesbian, and unmarried heterosexual couples from the United States. Findings suggest that, despite unique societal pressures confronting Italian same‐sex couples, these relationships appear resilient and fare well both overall and in specific domains of functioning compared to heterosexual couples both in Italy and the United States.
Enhancing tree belt productivity through capture of short‐slope runoff water
Authors: Bennett Richard G. , Mendham Daniel , Ogden Gary , Bartle John
Published: May 2014

A selection of multi‐stemmed, drought‐tolerant mallee eucalypts, planted in belt form and integrated with crops in dryland agricultural areas of Australia, may be able to produce biomass as a commercially attractive feedstock for biofuel production. This study aimed to determine if small (40–50 cm high) bunds along mallee belts could trap otherwise underutilized surface water runoff within paddocks, thereby increasing water available to the mallee trees and their growth rates. An experiment was established in 5 year‐old Eucalyptus polybractea (RT Baker) mallee belts near the town of Narrogin in the central wheatbelt area of Western Australia. Bunds led to significant (12%) increases in biomass accumulation after about 2 years and 35% increases at around 3 years. Bunds also led to significant increases in predawn leaf water potential and significant decreases in soil water deficit within 12 months, which persisted for the remainder of the 39 month trial. We suggest that the increase in biomass accumulation was largely due to increased water availability, but that increased nutrient supply from run‐on and trapping of organic residues may have also had some effect on bunded plots, despite our attempts to mitigate this effect by experimentally adding nutrients to all treatments. Results show that installing bunds along mallee belts would be a cost‐effective investment at sites where within‐paddock runoff is likely (i.e. gently sloping and with a loamy sand or heavier soil texture). Installation costs should be offset by improved biomass production within a few years and ongoing improvements in growth over the long term.
Barriers, biases, and beliefs about arteriovenous fistula placement in children: A survey of the International Pediatric Fistula First Initiative (IPFFI) within the Midwest Pediatric Nephrology Consortium (MWPNC)
Authors: Chand Deepa H. , Geary Denis , Patel Hiren , Greenbaum Larry A. , Nailescu Corina , Brier Michael E. , Valentini Rudolph P.
Published: May 2014

There has been recent emphasis on increased arteriovenous fistula (AVF) use and decreased central venous catheter use in hemodialysis (HD) patients. The International Pediatric Fistula First Initiative was founded via collaborative effort with the Midwest Pediatric Nephrology Consortium to alert nephrologists, surgeons, and dialysis staff to consider fistulae as the best access in pediatric HD patients. A multidisciplinary educational DVD outlining expectations and strategies to increase AVF placement and usage in children was created. Participants were administered a survey previewing and postviewing to identify barriers to placement and usage of AVF in children. A total of 52 surveys were subdivided as either “dialysis staff” or “proceduralist” at five centers. Thirty‐three percent of respondents were unaware if their practice was following published guidelines. Sixty‐five percent of respondents stated they referred to a dedicated vascular access surgeon at their respective institutions. Methods used to monitor AVF function included physical exam, venous pressure monitoring, and ultrasound dilution. Vascular access was placed within 3 months in only 35% of patients. Interdisciplinary communication problems between surgeons, interventional radiologists, and nephrologists were identified as a major barrier. Lack of AVF usage was often due to maturation failure. Routine access rounds did not occur in any centers. Regarding monitoring, 74% of the respondents use physical exam, 26% use venous pressure monitoring, and 9% use ultrasound dilution. Ninety‐three percent of dialysis staff stated they would change practice patterns following the intervention; however, 12% of surgeons stated they would alter practice patterns. To our knowledge, this is the first report to identify barriers to placement of AVF in children from the perspectives of multidisciplinary team members including pediatric nephrologists, surgeons, interventional radiologists, and multidisciplinary dialysis staff.
Effects of root surface debridement using Er:YAG Laser versus ultrasonic scaling – a SEM study
Authors: Miremadi SR , Cosyn J , Schaubroeck D , Lang NP , De Moor RJG , De Bruyn H
Published: May 2014

Objective

Despite promising results of Er:YAG laser in periodontal debridement, to date there is no consensus about the ideal settings for clinical use. This experimental clinical trial aimed to determine the effects of debridement using Er:YAG laser and to compare with ultrasonic treatment.

Materials and methods

Sixty‐four teeth were divided into two in vivo and in vitro subgroups. Each tooth received ultrasonic treatment on one side and Er:YAG laser debridement at either 60, 100, 160 or 250 mJ pulse−1 and at 10 Hz on the other side on a random basis. All samples were morphologically analyzed afterwards under scanning electron microscope for surface changes and dentinal tubules exposure. Treatment duration (d) was also recorded.

Results

Laser debridement produced an irregular, rough and flaky surface free of carbonization or meltdown while ultrasound produced a relatively smoother surface. The number of exposed dentinal tubules (n) followed an energy‐dependent trend. The number of exposed tubules among the in vivo laser groups was n 60 mJ = n 100 mJ < n 160 mJ < n 250 mJ (P < 0.001). Also 160 and 250 mJ lasers led to significantly more dentinal exposure than ultrasound under in vivo condition. Within the in vitro laser groups, dentinal tubules exposure was n 60 mJ < n 100 mJ < n 160 mJ < n 250 mJ (P ≤ 0.0015). Furthermore, in vitro laser treatments at 100, 160 and 250 mJ led to significantly more dentinal denudation than ultrasound. Treatment duration (d) for the in vivo groups was d 60 mJ > d 100 mJ > d Ultrasound = d 160 mJ > d 250 mJ (P ≤ 0.046), while for the in vitro groups it was d 60 mJ > d 100 mJ = d Ultrasound = d 160 mJ >d 250 mJ (P ≤ 0.046).

Conclusions

Due to excessive treatment duration and surface damage, Er:YAG laser debridement at 60 and 250 mJ pulse−1, respectively, is not appropriate for clinical use. Although laser debridement at 100 and 160 mJ pulse−1 seems more suitable for clinical application, compared to ultrasound the former is more time‐consuming and the latter is more aggressive. Using a feedback device or lower pulse energies are recommended when using laser in closed field.
Gingival abrasion and recession in manual and oscillating–rotating power brush users
Authors: Rosema NAM , Adam R , Grender JM , Van der Sluijs E , Supranoto SC , Van der Weijden GA
Published: May 2014

Objective

To assess gingival recession (GR) in manual and power toothbrush users and evaluate the relationship between GR and gingival abrasion scores (GA).

Methods

This was an observational (cross‐sectional), single‐centre, examiner‐blind study involving a single‐brushing exercise, with 181 young adult participants: 90 manual brush users and 91 oscillating–rotating power brush users. Participants were assessed for GR and GA as primary response variables. Secondary response variables were the level of gingival inflammation, plaque score reduction and brushing duration. Pearson correlation was used to describe the relationship between number of recession sites and number of abrasions. Prebrushing (baseline) and post‐brushing GA and plaque scores were assessed and differences analysed using paired tests. Two‐sample t‐test was used to analyse group differences; ancova was used for analyses of post‐brushing changes with baseline as covariate.

Results

Overall, 97.8% of the study population had at least one site of ≥1 mm of gingival recession. For the manual group, this percentage was 98.9%, and for the power group, this percentage was 96.7% (P = 0.621). Post‐brushing, the power group showed a significantly smaller GA increase than the manual group (P = 0.004); however, there was no significant correlation between number of recession sites and number of abrasions for either group (P ≥ 0.327).

Conclusions

Little gingival recession was observed in either toothbrush user group; the observed GR levels were comparable. Lower post‐brushing gingival abrasion levels were seen in the power group. There was no correlation between gingival abrasion as a result of brushing and the observed gingival recession following use of either toothbrush.
Electrochemical‐induced dissolution of nickel–titanium endodontic instruments with different designs
Authors: Ormiga F. , Aboud L. R. L. , Gomes J. A. C. P.
Published: May 2014

Aim

To compare the active dissolution process of K3, ProTaper and Mtwo NiTi endodontic rotary instruments in chloride and fluoride containing solutions.

Methods

Anodic polarization of K3 size 20, 0.06 taper, ProTaper size F1 and MTwo size 20, 0.06 taper instruments was performed, and anova (P < 0.05) was used to compare the weight loss, the time of dissolution and the electrical charge generated by the groups of instruments. Fragments of the instruments were polarized in simulated root canals to evaluate the dissolution process. After the tests, a size 10 K‐file was used to verify whether the fragment could be bypassed. Radiographic analysis of the simulated canals was used before and after the tests to verify fragment dissolution.

Results

A progressive consumption of the instruments was observed. K3 and ProTaper instruments had significantly greater weight loss than Mtwo instruments after 30 min of polarization. K3 instruments had the highest values of total electrical charge, and MTwo instruments the lowest (P < 0.05). After 60 min, the anodic polarization of instrument fragments in simulated root canals resulted in their partial dissolution.

Conclusion

The anodic polarization of K3, ProTaper and MTwo instruments resulted in their progressive consumption with increasing polarization time. Sixty minutes anodic polarization of the various NiTi instrument fragments in simulated root canals resulted in their partial dissolution.
Assessment of dentinal tubule invasion capacity of Enterococcus faecalis under stress conditions ex vivo
Authors: Ran S. , Wang J. , Jiang W. , Zhu C. , Liang J.
Published: May 2014

Aim

To investigate the dentinal tubule invasion capacity of Enterococcus faecalis under alkaline and energy starvation stress conditions.

Methodology

The root canals from human single‐rooted teeth (n = 40) were infected with E. faecalis under alkaline (pH 9, 10, 11 and 12) and energy starvation (no glucose, 0.05% glucose and 0.15% glucose) stress conditions. The root canals were prepared in a standard manner and treated to remove the smear layer before incubation. After 4 weeks of cultivation, the roots were split vertically into two halves: one half was processed for biofilm formation analysis using a scanning electron microscope; the other half was stained with fluorescent DNA‐binding reagents, washed thoroughly and sectioned (100 μm thick), and the depth of tubule invasion by the microorganism was examined by confocal laser‐scanning microscopy. The extent of dentine tubule invasion was analysed statistically.

Results

The E. faecalis strain resulted in biofilm formation and dentine tubules invasion under all of the stress conditions, except for pH 11 and 12 conditions. However, the tubule penetration distance was markedly reduced in these stress conditions (P < 0.01) compared with in tryptic soy broth (TSB) or pH 7 medium. The invasion depth in the middle root dentine was significantly higher than in the apical sections in TSB and energy starvation medium (P < 0.01).

Conclusions

Ex vivo E. faecalis formed biofilms and colonized dentine under alkaline and glucose starvation stress conditions, but its ability to invade dentine tubules was significantly decreased.
Corpulence is the crucial factor: Association of testosterone and/or obesity with prostate cancer stage
Authors: Jentzmik Florian , Schnoeller Thomas J , Cronauer Marcus V , Steinestel Julie , Steffens Sandra , Zengerling Friedemann , Al Ghazal Andreas , Schrader Mark G , Steinestel Konrad , Schrader Andres J
Published: May 2014

Objectives

To evaluate whether low testosterone levels or obesity, or both, are directly associated with tumor stage/grade in patients with clinically localized prostate cancer.

Methods

Preoperative androgen serum levels (total and free testosterone), sex hormone‐binding globulin, body mass index and waist circumference were assessed in 510 consecutive European Caucasian men treated with radical prostatectomy. Hormone levels and body mass index/waist circumference were correlated with patient‐ and tumor‐specific characteristics using multivariable logistic regression analysis.

Results

Even though we confirmed an inverse correlation between bodyweight and testosterone levels, only overweight – but not low testosterone – was associated with advanced disease and poor differentiation of prostate cancer. Using multivariate analyses, both body mass index ≥30 kg/m2 and waist circumference >110 cm were associated with high‐grade disease (Gleason score ≥8). A waist circumference >110 cm also correlated significantly with lymph node metastasis.

Conclusions

This is the first study showing that obesity, but not low serum testosterone levels, is significantly associated with high grade and metastatic disease in men diagnosed with clinically localized prostate cancer. The present findings suggest that low androgen levels at diagnosis, which used to be held responsible for the development of aggressive prostate cancer, is only an epiphenomenon of obesity rather than the cause of prostate cancer development and/or progression.
Patient perception of wound photography
Authors: Wang Sheila C , Anderson John AE , Jones Duncan VB , Evans Robyn
Published: May 2014

The objectives of this study were to provide an assessment of photographic documentation of the wound from the patients' perspective and to evaluate whether this could improve patients' understanding of and involvement in their wound care. Our results revealed that most patients visiting the wound care clinic have difficult‐to‐see wounds (86%). Only 20% of patients monitor their wounds and instead rely on clinic or nurse visits to track the healing progress. There was a significant association between patients' ability to see their wound and their subsequent memory of the wound's appearance. This was especially true for patients who had recently begun visiting the wound care clinic. This relationship was not present in patients who had visited the clinic for 3  or more years. Patients reported that the inability to see their wounds resulted in feeling a loss of autonomy. The majority of patients reported that photographing their wounds would help them to track the wound progress (81%) and would afford them more involvement in their own care (58%). This study provides a current representation of wound photography from the patients' perspective and reveals that it can motivate patients to become more involved in the management of their wounds – particularly for patients with difficult‐to‐see wounds.
VAC therapy to promote wound healing after surgical revascularisation for critical lower limb ischaemia
Authors: De Caridi Giovanni , Massara Mafalda , Greco Michele , Pipitò Narayana , Spinelli Francesco , Grande Raffaele , Butrico Lucia , de Franciscis Stefano , Serra Raffaele
Published: May 2014

Vacuum‐assisted closure (VAC) therapy is a new emerging non‐invasive system in wound care, which speeds up wound healing by causing vacuum, improving tissue perfusion and suctioning the exudates, and facilitating the removal of bacteria from the wound. The application of sub‐atmospheric pressure on the lesions seems to alter the cytoskeleton of the cells on the wound bed, triggering a cascade of intracellular signals that increase the rate of cell division and subsequent formation of granulation tissue. The aim of this study is to analyse the results of VAC therapy used as an adjuvant therapy for the treatment of foot wounds in patients affected by critical limb ischaemia (CLI) (Rutherford 6 class) after distal surgical revascularisation, to promote and accelerate the healing of ulcers. Twenty‐nine patients (20 males, 9 females; mean age 68·4) affected by CLI of Rutherford 6 class, after surgical revascularisation of the lower limb, underwent VAC therapy in order to speed up wound healing. Complete wound healing was achieved in 19 patients (65·51%), in an average period of 45·4 ± 25·6 days. VAC therapy is a valid aid, after surgical revascularisation, to achieve rapid healing of foot lesions in patients with CLI.
Neuropsychology and brain morphology in Klinefelter syndrome – the impact of genetics
Authors: Skakkebæk A. , Bojesen A. , Kristensen M. K. , Cohen A. , Hougaard D. M. , Hertz J. M. , Fedder J. , Laurberg P. , Wallentin M. , Østergaard J. R. , Pedersen A. D. , Gravholt C. H.
Published: May 2014

Klinefelter syndrome (KS, 47,XXY) is associated with increased psychiatric morbidity and cognitive disabilities, although the neuropsychological phenotype shows great variability. Androgen receptor polymorphism (CAG repeat length), skewed X‐chromosome inactivation and parent‐of‐origin of the extra X‐chromosome have been suggested to influence cognitive function and psychological traits. These issues have not been clarified for KS patients. We studied X‐chromosome inactivation pattern, CAG repeat length and parent‐of‐origin in relation to educational and cohabitation status, personality and autism traits, psychological distress, cognitive function and brain volumes in 73 KS patients and 73 controls. Grey matter (GM) volume of left insula was significantly decreased in KS patients with skewed X‐inactivation (z = 5.78) and we observed a borderline significant difference in global brain matter volume where KS patients with skewed X‐chromosome inactivation tended to have smaller brains. Skewed X‐inactivation, CAG repeat length and parent‐of‐origin were not correlated with educational and marital status, personality traits, autism traits, and psychological distress, prevalence of depression and anxiety or cognitive function. Interestingly our results regarding brain volumes indicate that X‐inactivation has an influence on GM volume in left insula and might also be related to global GM volume, indicating a possible effect of X‐linked genes on the development of GM volume in KS patient. Skewed X‐inactivation, CAG repeat length and parent‐of‐origin have no impact on the neuropsychological phenotype in KS (http://www.clinicaltrials.gov (Clinical trial NCT00999310)).
BRDT gene sequence in human testicular pathologies and the implication of its single nucleotide polymorphism (rs3088232) on fertility
Authors: Barda S. , Yogev L. , Paz G. , Yavetz H. , Lehavi O. , Hauser R. , Doniger T. , Breitbart H. , Kleiman S. E.
Published: May 2014

Bromodomain testis‐specific (BRDT) protein is essential for the normal process of spermatogenesis. Mutant mice that expressed truncated BRDT had impaired testicular histology with severely reduced sperm concentration and abnormal sperm morphology, while a model of knockout Brdt mice with no BRDT protein had complete meiotic arrest. A BRDT single nucleotide polymorphism (SNP) (rs3088232) was reported as being associated with infertility in men. We assessed testicular specimens of 276 azoospermic men who underwent testicular sperm extraction to search for specimens that showed spermatogenic impairments similar to those of mutant BRDT mice. Ten similar specimens were selected for BRDT gene sequencing and they revealed three NCBI‐reported SNPs (rs10783071, rs3088232 and rs10747493) variously distributed among them. Bioinformatics analysis predicted that they would not affect protein activity. Further assessment of rs3088232 frequency in a large group of non‐obstructive azoospermia men and fertile controls demonstrated no significant difference between them (27.2 and 21.7% respectively; p = 0.122, Fisher's exact test). We conclude that the testicular impairments observed in the 10 specimens were not a consequence of BRDT gene mutation. The association between BRDT rs3088232 and infertility that had been reported in other studies was not supported.
Conceptualizations of dignity at the end of life: exploring theoretical and cultural congruence with dignity therapy
Authors: Li Hui‐Ching , Richardson Alison , Speck Peter , Armes Jo
Published: May 2014

Aim

To explore the conceptualization of patients' dignity in the context of end‐of‐life care in Taiwan.

Background

Dignity therapy – a novel nurse‐delivered psychotherapeutic intervention – has been demonstrated to have potential to alleviate terminal patients' psycho‐existential distress in western countries. In Taiwan, over half of end‐of‐life patients experience psychological‐spiritual suffering and dignity therapy might be helpful in improving this situation. Hence, a preliminary study to clarify Taiwanese conceptualizations of ‘dignity’ was conducted prior to planning a feasibility study to gauge the potential cultural fit of an intervention of this type.

Design

Qualitative exploration.

Methods

Nine people with terminal cancer and ten health professionals were recruited from palliative care services in 2008. In‐depth interviews were audiotaped and transcribed verbatim. A hermeneutic approach was employed to analyse and interpret data.

Findings

Being a valuable person is the core meaning of patients' dignity and this comprised intrinsic characteristics and extrinsic factors. Intrinsic characteristics of dignity encompassed living a moral life, having peace of mind and a sense of existence involving the perception of resignation to God's will. Extrinsic factors that influenced patients' dignity included illness‐related distress, care delivery and the perception of being loved. A dynamic relationship between these elements determined the state of patients' dignity.

Conclusion

The concept of dignity is culturally bound and understood differently in the Chinese and Western context; such differences should be considered when planning and delivering care. Modifications should be made to dignity therapy to ensure it is culturally congruent with Taiwanese patients' beliefs.
Dimensions of manic symptoms in youth: psychosocial impairment and cognitive performance in the IMAGEN sample
Authors: Stringaris Argyris , Castellanos‐Ryan Natalie , Banaschewski Tobias , Barker Gareth J. , Bokde Arun L. , Bromberg Uli , Büchel Christian , Fauth‐Bühler Mira , Flor Herta , Frouin Vincent , Gallinat Juergen , Garavan Hugh , Gowland Penny , Heinz Andreas , Itterman Bernd , Lawrence Claire , Nees Frauke , Paillere‐Martinot Marie‐Laure , Paus Tomas , Pausova Zdenka , Rietschel Marcella , Smolka Michael N. , Schumann Gunter , Goodman Robert , Conrod Patricia ,   the Imagen Consortium
Published: May 2014

Background

It has been reported that mania may be associated with superior cognitive performance. In this study, we test the hypothesis that manic symptoms in youth separate along two correlated dimensions and that a symptom constellation of high energy and cheerfulness is associated with superior cognitive performance.

Method

We studied 1755 participants of the IMAGEN study, of average age 14.4 years (SD = 0.43), 50.7% girls. Manic symptoms were assessed using the Development and Wellbeing Assessment by interviewing parents and young people. Cognition was assessed using the Wechsler Intelligence Scale For Children (WISC‐IV) and a response inhibition task.

Results

Manic symptoms in youth formed two correlated dimensions: one termed exuberance, characterized by high energy and cheerfulness and one of undercontrol with distractibility, irritability and risk‐taking behavior. Only the undercontrol, but not the exuberant dimension, was independently associated with measures of psychosocial impairment. In multivariate regression models, the exuberant, but not the undercontrolled, dimension was positively and significantly associated with verbal IQ by both parent‐ and self‐report; conversely, the undercontrolled, but not the exuberant, dimension was associated with poor performance in a response inhibition task.

Conclusions

Our findings suggest that manic symptoms in youth may form dimensions with distinct correlates. The results are in keeping with previous findings about superior performance associated with mania. Further research is required to study etiological differences between these symptom dimensions and their implications for clinical practice.
Morphological and Molecular Characterisation of Notosolenus urceolatus Larsen and Patterson 1990, a Member of an Understudied Deep‐branching Euglenid Group (Petalomonads)
Authors: Lee Won Je , Simpson Alastair G. B.
Published: May 2014

Petalomonads are particularly important for understanding the early evolution of euglenids, but are arguably the least studied major group within this taxon. We have established a culture of the biflagellate petalomonad Notosolenus urceolatus, and conducted electron microscopy observations and molecular phylogenetic analysis. Notosolenus urceolatus has eight pellicular strips bordered by grooves and underlain by close‐set microtubules. There are ventral and dorsal Golgi bodies. Mitochondria apparently contain fibrous inclusions, as in Petalomonas cantuscygni. A previously undocumented type of large, globular extrusome is present instead of the tubular extrusomes characteristic of Euglenozoa. The feeding apparatus lacks rods and vanes, and is partly supported by an “MTR”. The flagella have complex transition zones that are extremely elongated but unswollen. Only the emergent portion of the anterior flagellum has an organised paraxonemal rod, and also has very fine mastigonemes. The basal bodies are offset and lack connecting fibres. 18S rRNA gene phylogenies show that N. urceolatus is closely related to Petalomonas sphagnophila and P. cantuscygni, not Notosolenus ostium, confirming that current generic assignments based on the number of emergent flagella are phylogenetically unreliable, and making it difficult to infer whether features shared by N. urceolatus and P. cantuscygni (for example) are general for petalomonads.
Molecular characterization and expression of cyp19a gene in Carassius auratus
Authors: Chen X. W. , Jiang S. , Gu Y. F. , Shi Z. Y.
Published: May 2014

A cyp19a gene that contains nine exons and eight introns was identified from Carassius auratus and was mainly expressed in the ovary. The cyp19a mRNA level after hatching was initially low, but began to increase from 25 days after hatching. A number of cis‐acting elements, such as the oestrogen receptor, steroidogenic factor 1 and SOX‐5 recognition sites, were found in the promoter of the cyp19 gene, which possesses a promoter function confirmed by a recombination green fluorescent protein checking system in vitro.