bluuebunny/crossref_metadata_2025 huggingface dataset:
A Qualitative Study of Barriers to the Implementation of a Rheumatoid Arthritis Guideline Among Generalist and Specialist Physical Therapists
Authors: van Bodegom-Vos Leti , Verhoef John , Dickmann Margot , Kleijn Marjon , van Vliet Ingrid , Hurkmans Emalie , van der Wees Philip , Vliet Vlieland Thea
Published: June 2012

Background

Although the increasing complexity and expansion of the body of knowledge in physical therapy have led to specialized practice areas to provide better patient care, the impact of specialization on guideline implementation has been scarcely studied.

Objectives

The objective of this study was to identify the similarities and differences in barriers to the implementation of a Dutch rheumatoid arthritis (RA) guideline by generalist and specialist physical therapists.

Design

This observational study consisted of 4 focus group interviews in which 24 physical therapists (13 generalist and 11 specialist physical therapists) participated.

Methods

Physical therapists were asked to discuss barriers to the implementation of the RA guideline. Data were analyzed qualitatively using a directed approach to content analysis. Both the interviews and the interview analysis were informed by a previously developed conceptual framework.

Results

Besides a number of similarities (eg, lack of time), the present study showed important, although subtle, differences in barriers to the implementation of the RA guideline between generalist physical therapists and specialist physical therapists. Generalist physical therapists more frequently reported difficulties in interpreting the guideline (cognitive barriers) and had less favorable opinions about the guideline (affective barriers) than specialist physical therapists. Specialist physical therapists were hampered by external barriers that are outside the scope of generalist physical therapists, such as a lack of agreement about the roles and responsibilities of medical professionals involved in the care of the same patient.

Conclusions

The identified differences in barriers to the implementation of the RA guideline indicated that the effectiveness of implementation strategies could be improved by tailoring them to the level of specialization of physical therapists. However, it is expected that tailoring implementation strategies to barriers that hamper both generalist and specialist physical therapists will have a larger effect on the implementation of the RA guideline.
Illness Causation and Interpretation in a Newar Town
Authors: Subedi Madhusudan
Published: June 2012

One of the core concerns of medical anthropology is to explore how people in different cultures and social groups explain the causes of ill health, the type of treatment they believe in, and to whom they turn if they do become ill. This article focuses on the understanding of illness causation by the Newars in Kirtipur and their concern about biological and socio-cultural aspects of healthy behavior, and particularly with the ways in which they have been coping in everyday life. The basic method of data collection for this study was formal and informal discussions with the elderly Newar males and females, followed by discussions with youths to explore the variations in their perceptions. The findings show that the understanding of illness etiology is multi-causal. The individual, natural, social, and supernatural causes are not mutually exclusive but are usually linked together in a particular case. In any specific case of illness, moreover, people’s explanatory model varies in how they explain its etiology.DOI: http://dx.doi.org/10.3126/dsaj.v5i0.6358 Dhaulagiri Journal of Sociology and Anthropology Vol. 5, 2011: 101-120
Journal Review: Dhaulagiri Journal of Sociology and Anthropology Vol. IV.
Authors: Pokharel Binod
Published: June 2012

No abstract available.DOI: http://dx.doi.org/10.3126/dsaj.v5i0.6368 Dhaulagiri Journal of Sociology and Anthropology Vol. 5, 2011: 263-72
A Life between Geography and History
Authors: Harris Cole
Published: June 2012

Abstract:

Asked to write about my scholarly career, I do as bid. I briefly explain how I became a historical geographer and what I take to be the particular interests and opportunities of this small field tucked between geography and history. I describe the different intellectual climates in which my work has been situated, a brazen, law-seeking positivism in the sixties and later an almost equally brazen cultural theory, and my response to them. I identify my broad research interests – social and cultural change as Europeans migrated to new settings overseas; Canada as a historical geographical construction; the territorial dispossession of Native peoples by settler colonial societies – and my principal observations thereon. Finally, I look back on an enjoyable and rather spoiled academic life, muse about academic pressures that my generation hardly faced, and insist on the continuing value of work situated between geography and history.
Comparative effectiveness review of treatment options for pituitary microadenomas in acromegaly
Authors: Marko Nicholas F. , LaSota Emily , Hamrahian Amir H. , Weil Robert J.
Published: June 2012

Object

Acromegaly, a syndrome of excess growth hormone (GH) secretion typically caused by a GH-secreting pituitary adenoma, reduces life expectancy by approximately 10 years when left untreated. Treatment of acromegaly involves combinations of one or more discrete therapeutic modalities to achieve biochemical control. Unfortunately, data capable of informing decisions among alternate management strategies are presently lacking.

Methods

The authors performed a comparative effectiveness research (CER) review integrating efficacy, cost, and quality of life (QOL) analysis for treatment strategies comprising various combinations of surgery, radiotherapy, stereotactic radiosurgery, and pharmacotherapy in patients with acromegaly caused by a pituitary microadenoma. A management decision tree was used to identify 5 treatment strategies, each with up to 4 potential treatment steps. Efficacy was assessed using recent literature reports of biochemical control rates for each modality. Cost estimations were derived from wholesale drug prices and from the Healthcare Cost and Utility Project. Quality of life data were obtained from studies utilizing the Acromegaly Quality of Life Questionnaire.

Results

Individual treatment modalities were analyzed and ranked in each of 3 domains: highest rate of success, lowest cost, and highest QOL, and these scores were combined to facilitate comparison of overall effectiveness of each of the management strategies. These aggregate effectiveness scores were used to compare the 5 strategies from the decision tree, and a novel strategy was also proposed.

Conclusions

The choice of management strategy must be individualized for each patient with acromegaly. This CER analysis provides a comprehensive framework to inform clinical decisions among alternate management strategies in patients with GH-secreting pituitary microadenomas.
Seizure-free and neuropsychological outcomes after temporal lobectomy with amygdalohippocampectomy in pediatric patients with hippocampal sclerosis
Authors: Vadera Sumeet , Kshettry Varun R. , Klaas Patricia , Bingaman William
Published: June 2012

Object

Temporal lobe epilepsy is an uncommon clinical syndrome in the pediatric population. The most common underlying pathologies include low-grade gliomas, cortical dysplasia, and, less commonly, hippocampal sclerosis (HS). There is a paucity of data on neuropsychological and seizure-free outcomes in these patients after temporal lobectomy. In this study, the authors reviewed their seizure-free and neuropsychological outcomes after temporal lobectomy for pediatric HS.

Methods

The authors retrospectively reviewed the medical records of pediatric patients with HS who underwent anterior temporal lobectomy and amygdalohippocampectomy between 1998 and 2011 at the Cleveland Clinic. Results of neuropsychological assessment before and after surgery and seizure-free outcome at last follow-up were obtained.

Results

Forty-five patients met the inclusion criteria. Thirty-four (76%) patients had pathology of HS alone and 10 (22%) had HS and cortical dysplasia. The mean duration of follow-up was 60.2 months. Eighty-four percent of patients had postoperative Engel Class I or II outcomes. Neuropsychological outcomes remained unchanged or minimally improved postoperatively.

Conclusions

Seizure-free outcomes in pediatric HS are similar to historical rates in adult HS. Neuropsychological assessments remain stable after temporal lobectomy. Standard temporal lobectomy should be considered in pediatric patients with medically intractable epilepsy secondary to HS.
La psychanalyse, la réflexivité et l'enfant
Authors: Ody Michel
Published: June 2012

Résumé À première vue, la notion de réflexivité, déjà utilisée dans de multiples champs de la connaissance, paraît superflue pour son utilisation en psychanalyse. Dans un second temps, sa confrontation avec les notions et concepts psychanalytiques montre en fait son utilité. L’auteur part d’une analogie discutée par lui il y a une quinzaine d’années à propos de la notion d’ insight , et en particulier chez l’enfant. Cette analogie vaut ici pour le trajet qu’elle opère à partir de celui processuel du devenir conscient freudien. La réflexivité, à son tour, élargit la question de l’ insight , de par sa connotation de retour, à celle du double retournement, dont les textes freudiens qui en traitent montrent que ce double retournement est le soubassement pulsionnel à la réflexivité, tant du côté des pulsions érotiques que des pulsions du moi. L’élargissement du travail analytique aux situations non névrotiques montre bien que les deux faces de la réflexivité, celle pulsionnelle érotique, celle avant tout narcissique pour sa face « miroir », sont impliquées. La reprise d’une analyse d’enfant tente d’illustrer ces propos.
Réflexivité et parole de séance : des mots pour se voir
Authors: Birot Élisabeth
Published: June 2012

Résumé Le processus réflexif est ici abordé sous l’angle de la défaillance de la fonction spéculaire de l’objet et de son transfert sur la parole de séance. Le lien établi entre réflexivité et pare-excitation place l’activité perceptive au centre du processus, tandis que la référence au modèle freudien du double retournement pulsionnel le réfère à la dimension primaire et secondaire des autoérotismes.
Bion, la rêverie, la contenance et le rôle de la barrière de contact
Authors: Bronstein Catalina , Hacker Anne-Lise
Published: June 2012

Résumé L’auteure explore la relation entre la capacité de penser et de réfléchir et les notions bioniennes de contenance maternelle et de lien K. La notion de contenance désigne la capacité de la mère de recevoir des identifications projectives de son petit enfant, de s’en servir comme communication et de les renvoyer sous une forme modifiée. Chez le petit enfant, cette fonction contribue au développement d’une barrière de contact, une structure perméable, mais qui sépare également le conscient et l’inconscient, permettant ainsi un passage sélectif d’éléments de l’un à l’autre. C’est sur ce fondement que s’établit une capacité de penser et de réfléchir. Les attaques contre le lien K peuvent amener à des états d’esprit – K (moins K), l’activité de penser sur le self et la curiosité à l’égard de celui-ci étant alors remplacées par des attaques contre l’activité de la pensée et l’évacuation d’éléments bêta. L’auteure suggère que cela peut également amener le patient à être bouleversé par des expériences sensorielles. Un exemple clinique illustre ces notions.
Germes de concepts psychanalytiques fondamentaux
Authors: Grubrich-Simitis Ilse , Lortholary Bernard
Published: June 2012

Résumé Premier tome de l’édition intégrale des Brautbriefe , les lettres échangées entre Sigmund Freud et Martha Bernays pendant leurs fiançailles entre 1882 et 1886 ont été publiées l’an dernier dans l’édition originale allemande. Il s’agit de la correspondance de Freud la plus importante et la plus intime, dont seulement une petite sélection était jusqu’alors dans le domaine public. Ilse Grubrich-Simitis est coéditrice de ce document concernant la préhistoire de la psychanalyse, qui comprendra pour finir cinq volumes au total. Le XLVII e  congrès de l’ api , qui s’est tenu à Mexico au début du mois d’août 2011, était consacré au thème : « Exploration des concepts fondamentaux : Sexualité, Rêves, Inconscient ». Dans la première partie de sa conférence d’ouverture, Ilse Grubrich-Simitis montre que ces premières lettres, y compris celles écrites par Martha, contiennent déjà les germes de concepts psychanalytiques fondamentaux ainsi que ceux de la méthode psychanalytique. Dans la seconde partie de sa conférence, deux portraits surgissent dans la lumière : Martha Bernays occupe le devant de la scène pour la première fois, tandis qu’apparaît une image fascinante, originale et complexe du jeune Freud.
Mechanical behaviour of alkali-activated blast furnace slag-activated metakaolin blended pastes. Statistical study
Authors: Higuera I. , Varga C. , Palomo J. G. , Gil-Maroto A. , Vázquez T. , Puertas F.
Published: June 2012

The study and development of alternative, more ecoefficient binders than portland cement are attracting a good deal of scientific and technological interest. Binders obtained from the chemical interaction between calcium silico-aluminous materials and highly alkaline solutions are one of several types of such possible cements. The present paper discusses the mechanical behaviour and mineralogical composition of blended pastes made from NaOH-activated vitreous blast furnace slag and metakaolin. The aim of the study was to determine how parameters such as the slag/metakaolin ratio, activating solution concentration and curing temperature affect strength development in these binders. A statistical study was conducted to establish the impact of each variable and model strength behaviour in these alkaline cements. The conclusion drawn is that activator concentration and the slag/metakaolin ratio are both determinant parameters.
Constructive Aspects of the Artificial Stone Veneer (arcosita "Butsems") of the South Façade of the Spanish Senate Palace
Authors: Bustamante R. , Monjo J. , Sánchez de Rojas M. I.
Published: June 2012

The South façade of the Senate of Spain (Marina Square, Madrid) has undergone transformations since it was the old Convent-College of the Augustinians (1581-1601). According to photographical and historical documentation, by 1951 the coating was fully repaired and all its compositional and ornamental elements were dismantled. The reconstruction was carried out using cladding with an artificial stone (polished “arcosita Butsems”) made with a low content of portlandite, according to the XRD and FTIR tests performed. This paper covers the taking of samples, the testing and analysis of the materials, and a brief description of the pathological processes suffered as a result of the manufacture and installation of the cladding.
Determination of the stress-strain curve in specimens of Scots pine for numerical simulation of defect free beams
Authors: Baño V. , Argüelles-Bustillo R. , Regueira R. , Guaita M.
Published: June 2012

The objective of this paper is to develop a twodimensional numerical model to simulate the response of Scots pine (Pinus sylvestris L.) defect free timber members in order to predict the behaviour of these members when subjected to external forces. For this purpose, data of the mechanical properties of Scots pine were obtained by performing experimental tests on specimens. We determined the stresses and deformations of timber beams in the elastic-plastic and plastic phases. In addition, we developed a finite element software that considered the orthotropic nature of timber, the non-linearity of the compression-reduction branch and the differing moduli of elasticity in tension and compression for Scots pine beams free from defects. The software developed simulates an experimental four point bending test according to UNE-EN 408 Standard.
Pinturas en el arte megalítico atlántico: Barnenez
Authors: Bueno Ramírez Primitiva , De Balbín Behrmann Rodrigo , Laporte Luc , Gouezin Philippe , Barroso Bermejo Rosa , Hernanz Gismero Antonio , Gavira-Vallejo José M. , Iriarte Cela Mercedes
Published: June 2012

La técnica ha venido estableciéndose en el arte megalítico europeo como una categoría cultural. Solo la Península Ibérica disponía de dólmenes pintados. Pero algunos datos dispersos en el resto del continente, junto con los análisis que se aportan procedentes de la cámara H del túmulo de Barnenez, certifican que la pintura formó parte de los programas gráfi cos de los más clásicos conjuntos atlánticos, como es el bretón. Se abre un panorama muy enriquecedor de nuevas lecturas para un arte megalítico europeo en el que habrá de contemplarse la metodología pertinente para la detección de pinturas y su interpretación en los discursos funerarios.
El uso de trillos durante la Edad del Cobre en la Meseta española. Análisis traceológico de una colección de denticulados de sílex procedentes del ‘recinto de fosos’ de El Casetón de la Era (Villalba de los Alcores, Valladolid)
Authors: Gibaja Juan Francisco , Crespo Manuel , Delibes Germán , Fernández Julio , Fraile Cristina , Herrán José Ignacio , Palomo Antoni , Rodríguez José Antonio
Published: June 2012

La presencia de grandes piezas líticas talladas bifacialmente es una constante en los contextos de la Edad del Cobre en el interior de la Península Ibérica. El brillo apreciable a simple vista en su filo denticulado ha sido atribuido a su uso como hoz. El estudio que ahora presentamos contradice parcialmente esta propuesta, ya que la mayor parte de las piezas halladas en el yacimiento de El Casetón de la Era (Villalba de los Alcores, Valladolid) no eran hoces sino elementos de trillo. Estamos ante las evidencias más antiguas de su uso en la Península Ibérica. Este tipo de piezas tienen cierta semejanza con las encontradas en el Próximo Oriente durante la Edad del Bronce.
Aproximación a la discapacidad en una población de la cultura de El Argar
Authors: Roca María G. , Jiménez-Brobeil Sylvia , Al Oumaoui Ihab , Tristán Juan M. , Molina Fernando
Published: June 2012

La discapacidad, entendida como la consideración de una persona con invalidez por parte de su comunidad, constituye un nuevo campo de investigación en Ar queología y Antropología Física. Aquí se investiga este concepto en el marco de la cultura de El Argar. Se han estudiado más de 200 esqueletos procedentes de yacimientos de la provincia de Granada (Castellón Alto, Fuente Amarga, Cuesta del Negro, Terrera del Reloj y Cerro de la Encina) entre los cuales cuatro muestran señales de invalidez: un hombre y una mujer que debieron haber requerido ayuda para caminar y dos varones con luxaciones de hombro. Los cuatro individuos fueron enterrados según los rituales de la cultura argárica, bajo sus propias viviendas, lo que indica que no fueron rechazados socialmente. Sin embargo, no se puede profundizar sobre la concepción de la discapacidad en esta cultura puesto que los datos arqueológicos y biológicos son muy limitados.
The IL-2 Diphtheria Toxin Fusion Protein Denileukin Diftitox Modulates the Onset of Diabetes in Female Nonobese Diabetic Animals in a Time-Dependent Manner and Breaks Tolerance in Male Nonobese Diabetic Animals
Authors: Zinser Elisabeth , Rössner Susanne , Littmann Leonie , Pangratz Nadine , Schuler Gerold , Steinkasserer Alexander
Published: June 2012

Denileukin diftitox, also known as DAB389IL-2 or Ontak, is a fusion protein toxin consisting of the full-length sequence of the IL-2 protein and as toxophore the truncated diphtheria toxin. As a consequence, it delivers the toxic agent to CD25-bearing cells, whereby CD25 represents the high-affinity α-subunit of the IL-2 receptor. Initially it was developed for the treatment of patients with cutaneous T cell lymphoma. Meanwhile, denileukin diftitox is also used as an adjuvant in other tumor therapies and neoplastic disorders. In this study, to our knowledge we report for the first time that denileukin diftitox has also dramatic effects regarding the pathology of type 1 diabetes using the NOD mouse model. Repeated injections of denileukin diftitox into female NOD mice at 12 wk of age led to a clear acceleration of disease onset, whereas injection at 7 wk of age did not. Using male NOD mice, which are much less susceptible to diabetes, we demonstrate that the injection of denileukin diftitox leads to a dramatic development of type 1 diabetes within days after injection, thereby obviously breaking pre-existing tolerance mechanisms. This is accompanied by an increased IFN-γ production of autoreactive splenic cells and a decreased presence of regulatory CD4+CD25+Foxp3+ T cells. In contrast, transfer of CD4+CD25+Foxp3+ T cells could correct the defect after denileukin diftitox treatment. Furthermore, whereas IFN-γ production was increased in the pancreata of treated animals, insulin expression was strongly reduced. These finding should be considered when denileukin diftitox is used for the treatment of patients suffering from tumors and/or autoimmune disorders.
Redundant and Nonredundant Functions of ATM and H2AX in αβ T-Lineage Lymphocytes
Authors: Yin Bu , Lee Baeck-Seung , Yang-Iott Katherine S. , Sleckman Barry P. , Bassing Craig H.
Published: June 2012

The ataxia telangiectasia mutated (ATM) kinase and H2AX histone tumor suppressor proteins are each critical for maintenance of cellular genomic stability and suppression of lymphomas harboring clonal translocations. ATM is the predominant kinase that phosphorylates H2AX in chromatin around DNA double-strand breaks, including along lymphocyte Ag receptor loci cleaved during V(D)J recombination. However, combined germline inactivation of Atm and H2ax in mice causes early embryonic lethality associated with substantial cellular genomic instability, indicating that ATM and H2AX exhibit nonredundant functions in embryonic cells. To evaluate potential nonredundant roles of ATM and H2AX in somatic cells, we generated and analyzed Atm-deficient mice with conditional deletion of H2ax in αβ T-lineage lymphocytes. Combined Atm/H2ax inactivation starting in early-stage CD4–/CD8– thymocytes resulted in lower numbers of later-stage CD4+/CD8+ thymocytes, but led to no discernible V(D)J recombination defect in G1 phase cells beyond that observed in Atm-deficient cells. H2ax deletion in Atm-deficient thymocytes also did not affect the incidence or mortality of mice from thymic lymphomas with clonal chromosome 14 (TCRα/δ) translocations. Yet, in vitro-stimulated Atm/H2ax-deficient splenic αβ T cells exhibited a higher frequency of genomic instability, including radial chromosome translocations and TCRβ translocations, compared with cells lacking Atm or H2ax. Collectively, our data demonstrate that both redundant and nonredundant functions of ATM and H2AX are required for normal recombination of TCR loci, proliferative expansion of developing thymocytes, and maintenance of genomic stability in cycling αβ T-lineage cells.
Epigenetic Silencing of Cd8 Genes by ThPOK-Mediated Deacetylation during CD4 T Cell Differentiation
Authors: Rui Jinxiu , Liu Haifeng , Zhu Xiaoyan , Cui Yu , Liu Xiaolong
Published: June 2012

Intrathymic CD4/CD8 differentiation is a process that establishes the mutually exclusive expression profiles of the CD4 and CD8 T cell lineage. The RUNX3-mediated silencing of CD4 in CD8 lineage cells has been well documented; however, it is unclear how CD8 is silenced during CD4 lineage differentiation. In this study, we report that, by directly binding the CD8 locus, ThPOK works as a negative regulator that mediates the deacetylation of Cd8 genes and repositions the CD8 alleles close to heterochromatin during the development of the CD4 lineage. The ectopic expression of ThPOK resulted in increased recruitment of histone deacetylases at Cd8 loci; the enhanced deacetylation of Cd8 genes eventually led to impaired Cd8 transcription. In the absence of ThPOK, the enhanced acetylation and transcription of Cd8 genes were observed. The results of these studies showed that Cd8 loci are the direct targets of ThPOK, and, more importantly, they provide new insights into CD8 silencing during CD4 lineage commitment.
Childhood poisoning in Warri, Niger Delta, Nigeria: A ten year retrospective study
Authors: Ugwu Gilbert I.M. , Okperi Blessing O. , Ugwu Eunice N. , Okolugbo Nekwu E.
Published: June 2012

Background: Childhood poisoning is a common but avoidable problem in developing countries such as Nigeria. Objectives: To determine the pattern of childhood poisoning in the Warri Niger Delta Region of Nigeria.Method: The case notes of all the children seen at Central Hospital Warri, the reference base for the region and GN Children Clinic the pioneer children’s hospital in the region. This is a review of cases over a ten year period, from 2000 to 2009. The information obtained was analysed.Results: A total of 156 children aged 0–16 years diagnosed with poisoning were seen at the central hospital in Warri and at the GN Children’s Clinic which is also in Warri over a 10 year period from 2000 to 2009 under review. The male to female ratio is 2:1, and 75% of the children were aged 5 years or less. Most of the patients were from the low socio-economic class. Most of the poisoning was unintentional and occurred through ingestion (97.6%). Kerosene was the major substance leading to poisoning (56.6%). Alcohol ranked second in the study. Poisoning from drugs was the third most common source of poisoning and in that category most of the indices were in the highest income group. Most of the patients presented with mild symptoms and the mortality rate was 7%.Conclusion: Kerosine was found to be the most common source of poisoning. Most of the poisoning was unintensional and deaths cause by this form of poisoning can be prevented with proper health education and effective enactment of laws that will reduce the incidence of childhood poisoning.
Severe Pulmonary Hypertension: The Role of Metabolic and Endocrine Disorders
Authors: Bogaard Harm J. , Husseini Aysar Al , Farkas Laszlo , Farkas Daniela , Gomez‐Arroyo Jose , Abbate Antonio , Voelkel Norbert F.
Published: June 2012

Pulmonary arterial hypertension (PAH) is a multi‐factorial condition and the underlying pulmonary vascular disease is shaped by the combined action of genetic, epigenetic and immune‐related factors. Whether and how gender, obesity and the metabolic syndrome modify PAH and associated right heart failure is under intense investigation. Estrogens may enhance the process of pulmonary angioproliferation, but may also protect the right ventricle under pressure. Obesity may affect the pulmonary circulation via interactions with inflammatory cells and mediators, or via alterations in endocrine signaling. Obesity is a major risk factor for pulmonary hypertension in patients with elevated pulmonary venous pressure and preserved LV ejection fraction. Given the overlap between PAH and autoimmune diseases, hypothyroidism in patients with PAH is commonly considered a consequence of an autoimmune thyroiditis. In the clinical setting of hyperthyroidism, severe pulmonary hypertension may develop due to a hyperdynamic circulation, but a more complex situation presents itself when hyperthyroidism is associated with PAH. We recently showed in a relevant animal model of severe PAH that thyroid hormone, via its endothelial cell‐proliferative action, can be permissive and drive angioproliferation. Signaling via the integrin αvβ3 and FGF receptors may participate in the formation of the lung vascular lesions in this model of PAH. Whether thyroid hormones in euthyroid PAH patients play a pathobiologically important role is unknown‐ as we also do not know whether the commonly diagnosed hypothyroidism in patients with severe PAH is cardioprotective. This brief review highlights some recent insights into the role of metabolic and endocrine disorders in PAH.
Mesenchymal Stem Cell‐Mediated Reversal of Bronchopulmonary Dysplasia and Associated Pulmonary Hypertension
Authors: Hansmann Georg , Fernandez‐Gonzalez Angeles , Aslam Muhammad , Vitali Sally H. , Martin Thomas , Mitsialis S. Alex , Kourembanas Stella
Published: June 2012

Clinical trials have failed to demonstrate an effective preventative or therapeutic strategy for bronchopulmonary dysplasia (BPD), a multifactorial chronic lung disease in preterm infants frequently complicated by pulmonary hypertension (PH). Mesenchymal stem cells (MSCs) and their secreted components have been shown to prevent BPD and pulmonary fibrosis in rodent models. We hypothesized that treatment with conditioned media (CM) from cultured mouse bone marrow‐derived MSCs could reverse hyperoxia‐induced BPD and PH. Newborn mice were exposed to hyperoxia (FiO2=0.75) for two weeks, were then treated with one intravenous dose of CM from either MSCs or primary mouse lung fibroblasts (MLFs), and placed in room air for two to four weeks. Histological analysis of lungs harvested at four weeks of age was performed to determine the degree of alveolar injury, blood vessel number, and vascular remodeling. At age six weeks, pulmonary artery pressure (PA acceleration time) and right ventricular hypertrophy (RVH; RV wall thickness) were assessed by echocardiography, and pulmonary function tests were conducted. When compared to MLF‐CM, a single dose of MSC‐CM‐treatment (1) reversed the hyperoxia‐induced parenchymal fibrosis and peripheral PA devascularization (pruning), (2) partially reversed alveolar injury, (3) normalized lung function (airway resistance, dynamic lung compliance), (4) fully reversed the moderate PH and RVH, and (5) attenuated peripheral PA muscularization associated with hyperoxia‐induced BPD. Reversal of key features of hyperoxia‐induced BPD and its long‐term adverse effects on lung function can be achieved by a single intravenous dose of MSC‐CM, thereby pointing toward a new therapeutic intervention for chronic lung diseases.
Furegrelate, a Thromboxane Synthase Inhibitor, Blunts the Development of Pulmonary Arterial Hypertension in Neonatal Piglets
Authors: Hirenallur‐S Dinesh K. , Detweiler Neil D. , Haworth Steven T. , Leming Jeaninne T. , Gordon John B. , Rusch Nancy J.
Published: June 2012

The development of pulmonary arterial hypertension (PAH) in pediatric patients has been linked to the production of the arachidonic acid metabolite, thromboxane A2 (TxA2). The present study evaluated the therapeutic effect of furegrelate sodium, a thromboxane synthase inhibitor, on the development of PAH in a neonatal piglet model. Three‐day‐old piglets were exposed to 21 days of normoxia (N; 21% FIO2) or chronic hypoxia (CH; 10% FIO2). A third group of piglets received the oral TxA2 synthase inhibitor, furegrelate (3 mg/kg, 2 or 3 times daily) at the induction of CH. In vivo hemodynamics confirmed a 2.55‐fold increase of the pulmonary vascular resistance index (PVRI) in CH piglets (104±7 WU) compared to N piglets (40±2 WU). The CH piglets treated twice daily with furegrelate failed to show improved PVRI, but furegrelate three times daily lowered the elevated PVRI in CH piglets by 34% to 69±5 WU and ameliorated the development of right ventricular hypertrophy. Microfocal X‐ray computed tomography (CT) scanning was used to estimate the diameter‐independent distensibility term, α (% change in diameter per Torr). Pulmonary arterial distensibility in isolated lungs of CH piglets (α=1.0±0.1% per Torr) was lower than that of N piglets (α=1.5±0.1% per Torr) indicative of vascular remodeling. Arterial distensibility was partially restored in furegrelate‐treated CH piglets (α =1.2±0.1% per Torr) and microscopic evidence showing muscularization of small pulmonary arteries also was less prominent in these animals. Finally, isolated lungs of furegrelate‐treated piglets showed lower basal and vasodilator‐induced transpulmonary pressures compared to CH animals. These findings suggest that pharmacological inhibition of TxA2 synthase activity by furegrelate blunts the development of hypoxia‐induced PAH in an established neonatal piglet model primarily by preserving the structural integrity of the pulmonary vasculature.
Activation of the Unfolded Protein Response is Associated with Pulmonary Hypertension
Authors: Yeager Michael E. , Reddy Monica B. , Nguyen Cecilia M. , Colvin Kelley L. , Ivy D. Dunbar , Stenmark Kurt R.
Published: June 2012

Pulmonary hypertension remains an important cause of morbidity and mortality. Although there is currently no cure, descriptions of defective intracellular trafficking and protein misfolding in vascular cell models of pulmonary hypertension have been recently reported. We tested the hypothesis that activation of the unfolded protein response (UPR) would be associated with the development of severe PH. We investigated activation of the UPR in archival tissues from patients with severe PH, and in the monocrotaline‐induced rat model of severe PH. We tested the ability of a pharmacologic agent capable of modulating the UPR to prevent and reverse pulmonary hypertension. We found evidence of an active UPR in archival tissue from humans with PH, but not in control lungs. Similarly, monocrotaline‐treated rats demonstrated a significant difference in expression of each of the major arms of the UPR compared to controls. Interestingly, the UPR preceded the appearance of macrophages and the development of lung vascular remodeling in the rats. Treatment of monocrotaline rats with salubrinal, a modulator of the PERK arm of the UPR, attenuated PH and was associated with a decrease in lung macrophages. In culture, pulmonary artery smooth muscle cells with UPR induction produced IL‐6 and CCL‐2/MCP‐1, and stimulated macrophage migration. These effects were abolished by pretreatment of cells with salubrinal. These data support the hypothesis that the UPR may play a role in the pathogenesis of inflammatory vascular remodeling and PH. As such, understanding the functional contributions of the UPR in the setting of PH may have important therapeutic implications.
Reactive Hyperplastic Lesions of the Gingiva: A Retrospective Study of 260 Cases
Authors: Ramu Sangeetha , Rodrigues Charlotte
Published: June 2012

Objectives

The purpose of the study was to analyze the frequency and distribution of gingival lesions in MR Ambedkar Dental College, Bengaluru.

Materials and methods

The material included the biopsies of all localized reactive hyperplastic lesions (LRHL) of the gingiva stored in the department's database (1995-2011). The lesions were analyzed according to their location and the patient's age and gender. The findings were compared with other published studies on reactive lesions.

Results

A total of 260 reactive lesion biopsies were accessed. focal fibrous hyperplasia (FFH) was the most common (38.5%), followed by pyogenic granuloma (PG) (34.6%), peripheral ossifying fibroma (POF) (17.7%) and peripheral giant cell granuloma (PGCG) (9.2%). The mean age of the patients was 33 years, with a range varying from 9 to 80 years. The LRHL occurred more commonly in females except focal fibrous hyperplasia, which showed male predilection. PG and POF were more common in the maxilla and FFH as well as PGCG were more common in the mandible.

Conclusion

This study indicates some differences in age and gender distribution as well as in location between the different lesions. The results of this study differ from those of other studies and the data presented here can be used as a guide for further multicenter studies.

How to cite this article

Ramu S, Rodrigues C. Reactive Hyperplastic Lesions of the Gingiva: A Retrospective Study of 260 Cases. World J Dent 2012;3(2):126-130.
Effectiveness of Silorane-based Composite as a Repair Filling for Dimethacrylate- or Silorane-based Composite Restorations
Authors: Barcellos Daphne Câmara , Pucci Cesar Rogério , Torres Carlos Rocha Gomes , de Paiva Gonçalves Sergio Eduardo , Pleffken Patricia Rondon , Pagani Clovis
Published: June 2012

Objective

This study aimed to evaluate the suitability of one specific silorane-based composite for the application as a repair material for different substrates.

Materials and methods

Truncated cones of composites fabricated and thermocycled for 6000 cycles to serve as a substrate were made of two commercially available dimethacrylate-based composites (DBC) (Filtek Supreme and Clearfil APX) and one silorane-based composite (SBC) (Filtek P90). The surface of the specimens was treated with air-abraded using Al2O3-particles of 50 µm size. A Teflon device was used to fabricate inverted truncated cones of repair composite over the surface-treated top of each original truncated cone. DBC and SBC were used as repair materials and bonded to the specimens using either a dimethacrylate-based (single bond 2) or a phosphate-methacrylate-based (adhesive belongs to the silorane) adhesives. The specimens were stored in distilled water at 37°C for 7 days and stressed to failure under tension. The data were analyzed with one-way ANOVA and Tukey tests at 5%.

Results

Bonding DBC as a repair material to a DBC substrate using the dimethacrylate-based adhesive produced the highest bond strength. Bonding DBC as repair material using the phosphate-methacrylate-based adhesive or SBC as repair material using the dimethacrylate-based adhesive produced lower bond strength, regardless the brand and of the chemical formulation of the aged substrate.

Conclusion

In order to obtain high bond strength, there is need to match adhesive and repair material, regardless the brand and of the chemical formulation of the substrate.

How to cite this article

Barcellos DC, Pleffken PR, Pucci CR, Pagani C, Gonçalves SEP, Torres CRG. Effectiveness of Silorane-based Composite as a Repair Filling for Dimethacrylate- or Silorane-based Composite Restorations. World J Dent 2012;3(2):161-65.
Bioactive Glass: A Material for the Future
Authors: Imran Zonera
Published: June 2012

Bioactive glasses are novel dental materials that are different from conventional glasses and are used in dentistry. Bioactive glasses are composed of calcium and phosphate which are present in a proportion that is similar to the bone hydroxyapatite. These glasses bond to the tissue and are biocompatible. They have a wide range of medical and dental applications and are currently used as bone grafts, scaffolds and coating material for dental implants. This article reviews various properties of bioactive glasses and their applications and also reviews the changes that can be made in their composition according to a desired application.

How to cite this article

Farooq I, Imran Z, Farooq U, Leghari A, Ali H. Bioactive Glass: A Material for the Future. World J Dent 2012;3(2):199-201.
Management of Oral Pain
Authors: Pickett Frieda A
Published: June 2012

Pain is the leading reason for individuals to seek dental care and understanding factors in pain response assists in pain management. Some dental services, including those involving tooth preparation, can result in postprocedure discomfort leading to a recommendation for analgesic therapy following treatment. Analgesia is defined as pain relief by inhibiting specific pain pathways and drugs to relieve pain are analgesics. Over the counter agents are efficacious agents for most dental pain with ibuprofen and acetaminophen commonly recommended. Considerations for analgesic recommendations, based on the medical history, scientific evidence of efficacy, and patient preferences are discussed.

How to cite this article

Pickett FA. Management of Oral Pain. World J Dent 2012;3(2):207-212.
Lagrangian coherent structures in tropical cyclone intensification
Authors: Rutherford B. , Dangelmayr G. , Montgomery M. T.
Published: June 2012

Abstract. Recent work has suggested that tropical cyclones intensify via a pathway of rotating deep moist convection in the presence of enhanced fluxes of moisture from the ocean. The rotating deep convective structures possessing enhanced cyclonic vorticity within their cores have been dubbed Vortical Hot Towers (VHTs). In general, the interaction between VHTs and the system-scale vortex, as well as the corresponding evolution of equivalent potential temperature (θe) that modulates the VHT activity, is a complex problem in moist helical turbulence. To better understand the structural aspects of the three-dimensional intensification process, a Lagrangian perspective is explored that focuses on the coherent structures seen in the flow field associated with VHTs and their vortical remnants, as well as the evolution and localized stirring of θe. Recently developed finite-time Lagrangian methods are limited in the three-dimensional turbulence and shear associated with the VHTs. In this paper, new Lagrangian techniques developed for three-dimensional velocity fields are summarized and we apply these techniques to study VHT and θe phenomenology in a high-resolution numerical tropical cyclone simulation. The usefulness of these methods is demonstrated by an analysis of particle trajectories. We find that VHTs create a locally turbulent mixing environment. However, associated with the VHTs are hyperbolic structures that span between adjacent VHTs or adjacent vortical remnants and represent coherent finite-time transport barriers in the flow field. Although the azimuthally-averaged inflow is responsible for the inward advection of boundary layer θe, attracting Lagrangian coherent structures are coincident with pools of high boundary layer θe. Extensions of boundary layer coherent structures grow above the boundary layer during episodes of convection and remain with the convective vortices. These hyperbolic structures form initially as boundaries between VHTs. As vorticity aggregates into a ring-like eyewall feature, the Lagrangian boundaries merge into a ring outside of the region of maximal vorticity.
Impact of relative humidity and particles size distribution on aerosol light extinction in urban area of Guangzhou
Authors: Lin Z. J. , Tao J. , Chai F. H. , Fan S. J. , Yue J. H. , Zhu L. H.
Published: June 2012

Abstract. In urban area of Guangzhou, an experiment was conducted at the monitoring site of SCIES in order to recognize the impact of relative humidity (RH) and particles size distribution on aerosol light extinction during 2009 to 2010. Water-soluble ions and OC/EC in daily PM2.5 samples was determined by the Dionex ion chromatography and the DIR model 2001 carbon analyzer, respectively; particles size distribution was measured by TSI 3321 APS; and total light scattering coefficient was measured by TSI 3565 Nephelometer. Inorganic salts that constitute PM2.5 were recognized under an assumption of the electrical charge neutrality, while chemical components as POM, EC and water content were determined by means of hygroscopic growth calculation and chemical mass closure. As a result, (NH4)2SO4, NaNO3, POM, EC and water content were found to be the major components. By the Mie Model, light scattering and absorption coefficient of PM0.5–2.5 were estimated on the basis of the chemical composition of PM2.5 and the size distribution of number concentration of PM0.5–2.5. This estimation was evaluated by results from Nephelometer measurement and proved to have high accuracy. With the knowledge of hygroscopic growth of some inorganic salts, it was realized that optical properties of PM2.5 greatly depended on relative humidity, while light extinction was enhanced averagely 1.23, 1.38 and 1.75 times at 70%, 80% and 90% RH, respectively. Moreover, light extinction coefficient of PM0.5–2.5 increased averagely 1.24 to 1.28 times during wet days while merely 1.04 times in dry days. Furthermore, combined results from Nephelometer, the knowledge of relation between EC and aerosol light absorption and the Mie Model estimation, size distribution of total light extinction coefficient was determined. PM1 contributed averagely 76%, 85%, 94% and 93% to light extinction in spring, summer, autumn and winter, respectively, while the contributions from PM2.5 were 94% at least.
Soil CO2, CH4, and N2O fluxes from an afforested lowland raised peatbog in Scotland: implications for drainage and restoration
Authors: Yamulki S. , Anderson R. , Peace A. , Morison J. I. L.
Published: June 2012

Abstract. The effect of tree (lodgepole pine) planting with and without intensive drainage on soil greenhouse gas fluxes was assessed after 45 yr at a raised peatbog in West Flanders Moss, central Scotland. Fluxes of CO2, CH4 and N2O from the soil were monitored over a 2-yr period every 2 to 4 weeks using the static opaque chamber method in a randomised experimental block trial with the following treatments: drained and planted (DP), undrained and planted (uDP), undrained and unplanted (uDuP), and for reference also from an adjoining near pristine area of bog at East Flanders Moss (n-pris). There was a strong seasonal pattern in both CO2 and CH4 effluxes which were significantly higher in late spring and summer months, reflecting seasonal temperature changes. Effluxes of N2O were low and no significant differences were observed between the treatments. Annual CH4 emissions increased with the proximity of the water table to the soil surface across treatments in the order: DP < uDP < uDuP < n-pris with mean annual effluxes over the 2-yr monitoring period of 1.5, 6.4, 77.0 and 226.3 kg CH4 ha−1 yr−1, respectively. For CO2, effluxes increased in the order uDP < DP< n-pris < uDuP, with mean annual effluxes of 12.3, 16.6, 18.2 and 25.5 t CO2 ha−1 yr−1, respectively. CO2 effluxes dominated the calculated global warming potential (GWP) of the net fluxes for each treatment (76–98%), and only in the n-pris site was CH4 a substantial contribution (23%). Based on soil effluxes only, the near pristine (n-pris) peatbog had 43% higher net GWP compared with the DP treatment because of high CH4 effluxes and the DP treatment had 33% higher GWP compared with the uDP because drainage increased CO2 effluxes. Restoration is likely to increase CH4 emissions, but reduce CO2 effluxes. Including estimates of CO2 uptake by vegetation from similar peatbog sites suggests that the total GWP of restored peatbog would be about half that of the peatbog covered by woodland.