bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of preoperative patient education on prevention of postoperative complications after major visceral surgery: study protocol for a randomized controlled trial (PEDUCAT trial)
Authors: Fink Christine , Diener Markus K , Bruckner Thomas , Müller Gisela , Paulsen Lisa , Keller Monika , Büchler Markus W , Knebel Phillip
Published: August 2013

Background

In line with the growing number of surgical procedures being performed worldwide, postoperative complications are also increasing proportionately. Prevention of these postoperative complications is a high medical priority. Preoperative education of patients, including provision of preparatory information about the correct behavior after surgery, could improve the postoperative outcome, but the evidence for this is inconclusive. The aim of the PEDUCAT trial is to evaluate the feasibility and the impact of preoperative patient education on postoperative morbidity, mortality and quality of life in patients scheduled for elective major visceral surgery.

Methods/design

PEDUCAT is designed as a cluster-randomized controlled pilot study. The experimental group will visit a standardized preoperative seminar to learn how best to behave after surgery in addition to being given a standard information brochure, whereas the control group will only receive the information brochure. Outcome measures such as postoperative morbidity, postoperative pain, postoperative anxiety and depression, patient satisfaction, quality of life, length of hospital stay and postoperative mortality will be evaluated. Statistical analysis will be based on the intention-to-treat population. Analysis of covariance will be applied for the intervention group comparison, adjusting for age, center and quality of life before surgery. This is a pilot study to show the feasibility of the concept. Nevertheless, the planned sample size of n = 204 is large enough to show an effect with power of 90% and a significance level of 5%.

Trial registration

German Clinical Trial Register number: DRKS00004226.
Increasing the metabolic capacity of Escherichia coli for hydrogen production through heterologous expression of the Ralstonia eutropha SH operon
Authors: Ghosh Dipankar , Bisaillon Ariane , Hallenbeck Patrick C
Published: August 2013

Background

Fermentative hydrogen production is an attractive means for the sustainable production of this future energy carrier but is hampered by low yields. One possible solution is to create, using metabolic engineering, strains which can bypass the normal metabolic limits to substrate conversion to hydrogen. Escherichia coli can degrade a variety of sugars to hydrogen but can only convert electrons available at the pyruvate node to hydrogen, and is unable to use the electrons available in NADH generated during glycolysis.

Results

Here, the heterologous expression of the soluble [NiFe] hydrogenase from Ralstonia eutropha H16 (the SH hydrogenase) was used to demonstrate the introduction of a pathway capable of deriving substantial hydrogen from the NADH generated by fermentation. Successful expression was demonstrated by in vitro assay of enzyme activity. Moreover, expression of SH restored anaerobic growth on glucose to adhE strains, normally blocked for growth due to the inability to re-oxidize NADH. Measurement of in vivo hydrogen production showed that several metabolically engineered strains were capable of using the SH hydrogenase to derive 2 mol H2 per mol of glucose consumed, close to the theoretical maximum.

Conclusion

Previous introduction of heterologous [NiFe] hydrogenase in E. coli led to NAD(P)H dependent activity, but hydrogen production levels were very low. Here we have shown for the first time substantial in vivo hydrogen production by a heterologously expressed [NiFe] hydrogenase, the soluble NAD-dependent H2ase of R. eutropha (SH hydrogenase). This hydrogenase was able to couple metabolically generated NADH to hydrogen production, thus rescuing an alcohol dehydrogenase (adhE) mutant. This enlarges the range of metabolism available for hydrogen production, thus potentially opening the door to the creation of greatly improved hydrogen production. Strategies for further increasing yields should revolve around making additional NADH available.
Provision of foot health services for people with rheumatoid arthritis in New South Wales: a web‐based survey of local podiatrists
Authors: Hendry Gordon J , Gibson Kathryn A , Pile Kevin , Taylor Luke , du Toit Verona , Burns Joshua , Rome Keith
Published: August 2013

Background

It is unclear if podiatric foot care for people with rheumatoid arthritis (RA) in New South Wales (NSW) meets current clinical recommendations. The objective of this study was to survey podiatrists' perceptions of the nature of podiatric foot care provision for people who have RA in NSW.

Methods

An anonymous, cross‐sectional survey with a web‐based questionnaire was conducted. The survey questionnaire was developed according to clinical experience and current foot care recommendations. State registered podiatrists practising in the state of NSW were invited to participate. The survey link was distributed initially via email to members of the Australian Podiatry Association (NSW), and distributed further through snowballing techniques using professional networks. Data was analysed to assess significant associations between adherence to clinical practice guidelines, and private/public podiatry practices.

Results

86 podiatrists participated in the survey (78% from private practice, 22% from public practice). Respondents largely did not adhere to formal guidelines to manage their patients (88%). Only one respondent offered a dedicated service for patients with RA. Respondents indicated that the primary mode of accessing podiatry was by self‐referral (68%). Significant variation was observed regarding access to disease and foot specific assessments and treatment strategies. Assessment methods such as administration of patient reported outcome measures, vascular and neurological assessments were not conducted by all respondents. Similarly, routine foot care strategies such as prescription of foot orthoses, foot health advice and footwear were not employed by all respondents.

Conclusions

The results identified issues in foot care provision which should be explored through further research. Foot care provision in NSW does not appear to meet the current recommended standards for the management of foot problems in people who have RA. Improvements to foot care could be undertaken in terms of providing better access to examination techniques and treatment strategies that are recommended by evidence based treatment paradigms.
Management of diabetes mellitus and associated cardiovascular risk factors in Brazil – the Brazilian study on the practice of diabetes care
Authors: Braga Juarez R , Avezum Alvaro , Ferreira Sandra RG , Forti Adriana
Published: August 2013

Background

The Brazilian Study on the Practice of Diabetes Care main objective was to provide an epidemiological profile of individuals with type 1 and 2 diabetes mellitus (DM) in Brazil, concerning therapy and adherence to international guidelines in the medical practice.

Methods

This observational, cross-sectional, multicenter study collected and analyzed data from individuals with type 1 and 2 DM attending public or private clinics in Brazil. Each investigator included the first 10 patients with type 2 DM who visited his/her office, and the first 5 patients with type 1 DM.

Results

A total of 1,358 patients were analyzed; 375 (27.6%) had type 1 and 983 (72.4%) had type 2 DM. Most individuals were women, Caucasian, and private health care users. High prevalence rates of hypertension, dyslipidemia and central obesity were observed, particularly in type 2 DM. Only 7.3% and 5.1% of the individuals with types 1 and 2 DM, respectively, had optimal control of blood pressure, plasma glucose and lipids. The absence of hypertension and female sex were associated with better control of type 1 DM and other cardiovascular risk factors. In type 2 DM, older age was also associated with better control.

Conclusions

Female sex, older age, and absence of hypertension were associated with better metabolic control. An optimal control of plasma glucose and other cardiovascular risk factors are obtained only in a minority of individuals with diabetes. Local numbers, compared to those from other countries are worse.
Disassembly-driven Turn-on Sensing of Enzyme Activity by Substrate-based Fluorescent Nanoprobe
Authors: Takaoka Yousuke , Fukuyama Yoshiaki , Matsuo Kazuya , Hamachi Itaru
Published: August 2013

Herein, we report a novel signal-amplifiable self-assembling fluorescent nanoprobe for turn-on detection of specific enzyme activity. This probe employed a substrate of matrix metalloproteinase 2 (MMP2) together with a self-assembling unit, and showed a detection limit of less than 830 pM, which is 84-fold lower than that of our previous ligand-tethered fluorescent nanoprobes. Using this new probe, we succeeded in monitoring the specific activity of secreted MMP even in the conditioned media of tumor cells.
Optical coatings for energy-efficient fenestration: principles, products and prospects
Authors: Granqvist Claes G.
Published: August 2013

Buildings use as much as 40% of the world’s total primary energy. This huge energy consumption is mainly tied to poor designs and entrenched practices for buildings’ envelopes. One major road toward more energy efficient buildings is to employ design principles that are in harmony with the radiation in our natural surroundings. Glass coatings with spectral selectivity can lead to windows and glass facades with good thermal insulation and capability to transmit mainly visible light or, alternatively, across the full solar spectrum. Chromogenic glazings, especially if based on electrochromism, can regulate the inflow of visible light and solar energy between widely separated limits and achieve further energy efficiency. The new fenestration technologies are able to improve indoor comfort.
Increased B-type natriuretic peptide levels in early-onset versus late-onset preeclampsia
Authors: Szabó Gábor , Molvarec Attila , Nagy Bálint , Rigó Jr. János
Published: August 2013

We compared B-type natriuretic peptide (BNP) levels, clinical and laboratory findings in early-onset preeclampsia (EOP), late-onset preeclampsia (LOP) and healthy pregnant groups.

We studied 40 healthy pregnant and 40 preeclamptic patients. Preeclamptics were divided in two groups, the EOP group (n=20) and LOP group (n=20), according to gestational age at the onset of disease. The distinction criterion for early- vs. late-onset was set as week 34 of gestation. The concentration of the BNP levels was measured by a sandwich fluorescence immunoassay. For statistical analysis of the clinical and laboratory findings non-parametric methods were applied.

BNP levels were higher in EOP [61.35 (36.95–93.25) pg/mL] and LOP patients [32.4 (19.15–39.2) pg/mL] than in healthy pregnant women [10.05 (6.08–16.03) pg/mL] (both p<0.001). Furthermore, EOPs had significantly higher BNP levels as compared to LOP patients (p<0.001). A BNP cut-off <24.5 pg/mL had a negative-predictive value of 85.1% excluding preeclampsia. There was a significant inverse correlation between plasma BNP levels of EOP patients and sodium (p<0.05) and total protein concentrations (p<0.05). In the EOP group, a significant positive correlation was observed between plasma levels of BNP and hematocrit (p<0.05), serum potassium (p<0.05), urea (p<0.05) and 24-h proteinuria (p<0.05).

BNP levels were significantly higher in EOP than in LOP patients. The cut-off value <24.5 pg/mL seems to be a powerful discriminative indicator excluding preeclampsia. The amount of proteinuria and total protein levels correlate with the elevation of the BNP levels. In EOP the extent of proteinuria is higher than in the LOP.
Recent Advances of Spout-Fluid Bed: A Review of Fundamentals and Applications
Authors: Shao Yingjuan , Liu Xuejiao , Zhong Wenqi , Jin B.-S. , Zhang Mingyao
Published: August 2013

The spout-fluid bed (SFB) is a very successful synthesis of the spouting and fluidization. The hydrodynamics of SFB are more complex than both fluidized beds and spouted beds. Up-to-date information on the fundamentals and applications of SFBs has been briefly presented, based on the limited work reported, in the new spouted bed book edited by Norman Epstein and John R. Grace (Spouted and spout-fluid beds: fundamentals and applications, 2011). In the past three years, nearly 30 papers have been published in international journals. They reported interesting studies on hydrodynamic characteristics, numerical simulations and new applications of SFBs. This article reviews the major research and development on SFB from the year 2010 and recommends further research topics. This review is intended not only as an important supplement to the SFB chapter of the spouted bed book but also helpful guidance for future research.
Dual form of Generalized Variational Principles for Piezoelectricity
Authors: Song Hai-Yan , Liu Zong-Min , Huang Yong-Hu
Published: August 2013

Because of electromechanical coupled properties and anisotropy of piezoelectric materials, it is quite a challenge to obtain analytical solution and numerical solution. In the paper, the dual form of the generalized VPs for piezoelectricity are established using the variational integral method and form the Hamilton symplectic dual system for piezoelectricity. These then provide the theoretical foundation of the finite element method for piezoelectricity.
Exponential Stabilization and Synchronization of Complex-variable Chaotic Systems via Intermittent Control
Authors: Wu Zhaoyan
Published: August 2013

In this paper, exponential stabilization and synchronization of complex-variable chaotic system are investigated. Periodically intermittent controllers are designed and applied to achieve the stabilization and synchronization. Based on the differential inequality method and the analysis technique, several simple and useful synchronization criteria are derived. Simulated examples are provided to verify the effectiveness of the proposed method.
Size Effect Analysis in Laminated Composite Structure using General Bilinear Fit
Authors: Mohammed Y. , Hassan Mohamed K. , Abu El-Ainin H. , Hashem A. M.
Published: August 2013

A bilinear cohesive law analyzes the in-plane nominal strength of Quasi-brittle material containing a single hole in which damage around the open hole is represented by a line crack loaded on its faces. This analysis of quasi-brittle structures has been done by taking into account the geometry and length of fracture processing zone and the shape of the cohesive law. The nominal strength based on size effect is analyzed for similarly shape specimen geometry. Simple design tables for the bilinear cohesive law have been developed respect to the specimen types offering a very useful for engineering designers.
Complex Dynamics in Non-linear Real Estate Models
Authors: Gkana Amalia , Zachilas Loukas , Arvanitidis Paschalis
Published: August 2013

In the present paper we study the complex dynamics of non-linear cobweb models of real estate markets in discrete time. Our model incorporates two sub-markets, land and housing, interacting with each other. We start by outlining the basic model, which assumes that land prices determine housing supply. This provides the foundations for the development of the more refined and complicated models that follow. These explore the dynamics of the real estate system, when land supply is affected by housing prices. Two forms of this relation are examined: linear and quotient, in order to investigate the dynamics of the system and the qualities and behaviour of the solutions. Stability analysis is obtained in order to investigate the stability properties of the fixed points. Various numerical simulation tools are used in order to study the complex dynamics of the systems. Finally, a global bifurcation occurring in the nonlinear case (quotient) is investigated, which changes the asymptotic behaviour of the system leading from a situation of bistability (cycle of period 2) to chaotic behaviour.
Mutual masking in the cochlea by bone conduction stimulation and by soft tissue conduction stimulation in an animal model
Authors: Adelman Cahtia , Sohmer Haim , Perez Ronen
Published: August 2013

Background: Soft tissue conduction (STC) is a recently described mode of auditory stimulation in which vibrations induced by a clinical bone vibrator applied to soft tissue sites on the head, neck, and thorax of human subjects reach the cochlea and elicit auditory sensation. In humans, STC stimulation interacts with air conduction stimulation and with bone conduction (BC) stimulation in several ways, e.g., mutual masking.

Methods: This study investigated whether mutual masking between STC and BC stimulation can be demonstrated in an experimental animal. In fat sand rats, auditory nerve and brainstem evoked response to BC stimulation was recorded in the presence of noise masking presented by STC and vice versa.

Results: STC successfully masked BC, and BC also masked STC responses.

Conclusions: Mutual masking, now demonstrated in animals, paves the way for animal experiments to clarify the pathway between the STC stimulation sites and the cochlea.
Results of second cochlear implant with long inter-implant delay
Authors: Jbarah Rema , Geal-Dor Miriam , Rich Shanit , Adler Miriam , Yehezkely Michal Kaufmann
Published: August 2013

Background: Implantation at a young age enables exposure to language and speech during the critical age for language acquisition. Long duration of auditory deprivation may lead to less optimal results.

Methods: A retrospective review of cases was performed. A young girl with congenital bilateral profound sensorineural hearing loss received her first cochlear implant on the right side at the age of 2½ years and successfully developed good speech and language. At the age of 10 years, explantation had to be performed, and as reimplantation could not be done on the same side, the implantation was done on the left ear, which had never received auditory stimulation. Two age-matched girls with bilateral sequential implantation, in whom the second sound-deprived ear was implanted after a long duration, were studied as well.

Results: A year after implantation, in two of the cases there was very good speech perception, even in noise. In one case, the second ear never attained the ability to understand speech.

Conclusions: These results can be explained in light of recent findings that early unilateral stimulation can result in bilateral representation in the auditory cortex.
Engaging Black Males on Their Own Terms: What Schools Can Learn from Black Males Who Produce Hip-Hop
Authors: Irby Decoteau J. , Petchauer Emery , Kirkland David
Published: August 2013

Education scholars and practitioners have much to learn about engagement and motivation of Black males by directing their inquiries to more organic sites of hip-hop cultural production outside of schools. One such site is the hip-hop’s informal labor economy where Black males engage in earning money through hip-hop cultural production. Labor practices include a myriad of activities such as beat making, promoting shows, teaching dance classes, managing studios and recording sessions, artist development, visual art, and other modes of hip-hop cultural production. Through exploring the decision-making process of Black males that opt to participate in informal labor in lieu of formal labor, we examine what it is that compels their engagement and motivation efforts in hip-hop production. We find that participating in hip-hop cultural production gives Black males: (1) the autonomy to control their own image and maintain their individuality and (2) a sense of worth and belonging to something positive. From these findings, we discuss the need for schools to model themselves after such fields where Black males demonstrate high levels of engagement, motivation, and mastery.
Applying systemic functional linguistics in healthcare contexts
Authors: Matthiessen Christian M. I. M.
Published: August 2013

This paper is concerned with research on healthcare communication that draws on Halliday's systemic functional linguistics (SFL). Section 1 introduces Halliday's notion of appliable linguistics, with SFL as a particular manifestation. Section 2 deals with instances of healthcare communication in the form of medical consultations, and shows how they can be illuminated through SF text analysis. Section 3 relates medical consultations to institutions of healthcare along two dimensions, stratification and instantiation; and it suggests that institutions can be analyzed as aggregates of situation types. Section 4 considers the field of activity within healthcare contexts, suggesting how texts in situation types characterized by different fields complement one another. Section 5 adds tenor considerations in the form of the institutional healthcare roles across fields. Section 6 explores patient journeys through hospitals as sequences of situation types. Section 7 asks how risks and failures inherent in patient journeys can be interpreted, and then analyzed and addressed, in terms of the orders of systems in a hospital. Section 8 continues this systemic analysis, applying them to patients, and Section 9 extends the analysis to healthcare systems, as semo-technical systems. Section 10 shows how relationship-centered healthcare can be interpreted in terms of SFL.
Interlingual re-instantiation – a new systemic functional perspective on translation
Authors: Farias de Souza Ladjane Maria
Published: August 2013

From a systemic functional perspective, translation has been dealt with mostly by means of the hierarchy of realization and has been modeled against parameters of difference between language systems – equivalence and shift. Such a concern with equivalence between language systems reflects the primary focus of research on the supporting language theory itself. As recent developments in systemic functional linguistics have shifted focus from system to uses and users, proposing three complementary hierarchies – realization, instantiation, and individuation – a more comprehensive perspective on translation has been enabled, which includes the systems, uses, and users involved. In tune with recent developments in translation studies, it views translation as a negotiation of meanings (including the notion of “equivalence”) between users via a specific use – the translated text. This article introduces this new model, its foundations, proposed concepts, and suggested methodology, as well as a glimpse of the model at work.
Systemic functional linguistics, corpus linguistics, and the ideology of science
Authors: Hunston Susan
Published: August 2013

This paper considers the relationship between research using systemic functional linguistics and research of the kind referred to as corpus linguistics, specifically in a study of ideology in a popular science text. The paper argues that ideas in SFL and corpus linguistics may be regarded as parallel (register), divergent (grammar and phraseology), and complementary (lexis and taxonomy). Following a review of research in these areas, the paper presents a case study of evaluation of status in a popular science book (
Hallidayan systemic-functional semiotics and the analysis of the moving audiovisual image
Authors: Bateman John A.
Published: August 2013

Although linguistically inflected semiotic approaches to film were pursued in the 1960s and 1970s, they have since been almost universally rejected within film studies and film theory even though film is precisely the kind of intentionally produced communicative artifact for which one would have expected semiotics to have much to offer. Traditionally, forms of semiotics modeled on linguistics have offered some of the most finely articulated accounts available but, so far, this has not been shown convincingly for film. This paper argues that the semiotics of the 1960s and 1970s was just too undeveloped to deal with entities as complex as film. In contrast, the multidimensional account of verbal semiotic systems articulated within Hallidayan systemic-functional semiotics over the past forty years is now dissolving many of the original problems and provides renewed impetus for the semiotic analysis of film, reinstating much expanded notions of
Multimodal digital semiotics: the interaction of language with other resources
Authors: O'Halloran Kay L. , E Marissa K. L. , Podlasov Alexey , Tan Sabine
Published: August 2013

A “multimodal digital semiotics” approach, involving the development and use of interactive digital media technology, mathematical techniques of analysis and scientific visualization for modeling and analyzing multimodal phenomena, is demonstrated through the analysis of an interview between a climate scientist and a climate denialist on Fox News. Prototype software for multimodal analysis and network visualizations are used in combination with Allen's interval algebra to model multimodal semantic data and identify significant patterns based on temporal relationships between different semiotic choices. The resulting semantic patterns reveal combinations of semiotic choices that were drawn upon by the different speakers during the interview, accounting for how the climate denialist emerges as the dominant and convincing interviewee. Such an approach combines the objectivity of mathematical modeling and scientific visualization with the interpretive power of Halliday's systemic theory.
Hyperglycaemia-induced chemoresistance of prostate cancer cells due to IGFBP2
Authors: Biernacka K M , Uzoh C C , Zeng L , Persad R A , Bahl A , Gillatt D , Perks C M , Holly J M P
Published: August 2013

Clinically relevant prostate cancer (PCa) is more frequent in Westernised societies and increasingly men have co-morbidities associated with a Western lifestyle, primarily diabetes, characterised by hyperinsulinaemia and hyperglycaemia. IGFs and their binding proteins (IGFBPs) are important mediators of the effects of nutrition on growth and play a key role in the development of PCa. We used DU145, PC3 and LNCaP PCa cell lines to examine how hyperglycaemia altered their response to docetaxel. Trypan Blue dye-exclusion assay was used to determine the percentage of cell death. Protein abundance was determined using western immunoblotting. Levels of IGFBP2 were measured using an ELISA.IGFBP2gene silencing was achieved using siRNA technology. DNA methylation was assessed using combined bisulphide restriction analysis. Acetylation status of histones H3 and H4 associated withIGFBP2gene was assessed using chromatin immunoprecipitation assay. Hyperglycaemia reduced docetaxel-induced apoptosis by 40% for DU145 cells and by 88% for LNCaP cells. This reduced cell death was mediated by a glucose-induced up-regulation of IGFBP2, as silencing IGFBP2 negated the survival effect of high glucose. Glucose increased IGFBP2 via increasing the acetylation of histones associated with theIGFBP2gene promoter. This finding could have important implications in relation to therapeutic strategies as epigenetic modulation could be reversible.
Survey of quality of life of rheumatoid arthritis patients admitted to rehabilitation centres in Hungary
Authors: Sallai Julianna Rozália , Hunka Aniella , Héjj Gábor , †Ratkó István , Ortutay Judit , Márkus Ilona , Ormos Gábor , Ujfalussy Andor , Szekeres László , Insperger Antal , Varjú Tibor , Bálint Géza
Published: August 2013

Introduction: There are limited data about the quality of life of rheumatoid arthritis patients admitted to rehabilitation centres in Hungary. Aim: The aim of the authors was to assess demographic data, social status, health related quality of life, and needs for assistance and disease-related information of 239 rheumatoid arthritis patients (169 women and 7 men) admitted to four rehabilitation centres in Hungary. Method: For the assessment of demographic, social and other data the authors developed questionnaires. The health related quality of life was evaluated using the validated Short Form 36 questionnaire. Results: The authors found that rheumatoid arthritis patients require in-patient rehabilitation relatively early in their disease course. 80.4% of the patients were over 50 years of age, and their social status was low as compared to the average of the Hungarian population. The health related quality of life of patients was significantly lower than that of the average population, but it was similar to the quality of life of patients with osteoarthritis, osteoporosis and low back pain. Among domains of the quality of life, the scores for physical function and pain were the lowest. The most common accompanying diseases included hypertension and osteoporosis. In case of knee and hip surgeries, postoperative rehabilitation was performed in due time. Patients were not satisfied with disease-related information and education given by health care providers. Conclusions: There is poor quality of life of rheumatoid arthritis patients admitted to rehabilitation centres in Hungary. More efforts should be done to provide disease-related information and education for patients. Orv. Hetil., 2013, 154, 1381–1388.
Useful tests to assess the clinical usefulness of new prognostic markers: the example of heart failure
Authors: Jenei Zsigmond Máté , Prohászka Zoltán
Published: August 2013

Introduction: Identification of risk factors is one of the most frequent questions in medical research currently. Several reports showed “significant” and “independent” prognostic factors in a variety of human conditions, however, those were not tested about predictive information in addition to standard risk markers. Recently novel statistical approaches (reclassification) have been developed to test the performance and usefulness of new risk factors and prognostic markers. There are several established methods to test the prognostic models. Aim: The aim of this work was to present the application of these novel statistical approaches by re-analyzing previously reported results of the authors. Method: The authors analyzed the prognostic role of two markers: red cell distribution width and heat shock protein 70 in patients with heart failure. Using Cox regression analyses the authors have reported previously that both markers are independent predictors. In the present study they re-analyzed the role of red cell distribution width and heat shock protein 70 by reclassification tests. Results: Incorporating red cell distribution width to the reference model the authors found a significant improvement in discrimination . However, the reclassification analysis provided ambiguous results with heat shock protein 70. Conclusions: Interpretation of results on new prognostic factors has to be done carefully, and appropriate reclassification approaches may help to confirm clinical usefulness only. Orv. Hetil., 2013, 154, 1374–1380.
Comparison of Silorane and Methacrylate-Based Composites on the Polymerization Heat Generated with Different Light-Curing Units and Dentin Thicknesses
Authors: Guiraldo Ricardo Danil , Consani Simonides , Consani Rafael Leonardo Xediek , Berger Sandrine Bittencourt , Correr Americo Bortolazzo , Sinhoreti Mario Alexandre Coelho , Correr-Sobrinho Lourenco
Published: August 2013

This study evaluated the temperature variation in the pulp chamber during photoactivation of two restorative composite resins (Filtek P90 silorane-based composite and Heliomolar methacrylate-based composite) with either a quartz-tungsten-halogen (QTH) or light-emitting diodes (LED) light-curing unit (LCU) and using dentin thicknesses (0.5 and 1.0 mm). Standardized cavities (2x2x2 mm) were prepared in 80 bovine incisors, which were randomly assigned to 8 groups according to the photoactivation method and dentin thickness. Filtek P90 and Heliomolar (both in shade A3) were used with their respective adhesive systems (P90 self-etch primer / P90 adhesive bond and Excite adhesive). All experiments were carried out in a controlled environment (37°C). The temperature variations (°C) were recorded using a digital thermometer attached to a K-type thermocouple. The results were analyzed statistically by ANOVA and Tukey's test (α=0.05). For composite/dentin thickness interaction, temperature increase was significantly higher in 0.5 mm dentin thickness (40.07°C) compared with 1.0 mm dentin thickness (39.61°C) for Filtek P90. For composite/LCU interaction, the temperature increase was significantly higher for Filtek P90 (39.21°C - QTH and 40.47°C - LED) compared with Heliomolar (38.40°C - QTH and 39.30°C - LED). The silorane-based composite promoted higher temperature increase in the pulp chamber than the methacrylate-based composite.
Effect of Sodium Trimetaphosphate on Hydroxyapatite Solubility: An In Vitro Study
Authors: Souza Jose Antonio Santos , Amaral Jackeline Gallo do , Moraes Joao Carlos Silos , Sassaki Kikue Takebayashi , Delbem Alberto Carlos Botazzo
Published: August 2013

This study evaluated the effect of different concentrations of sodium trimetaphosphate (TMP) with and without fluoride (F) on the concentration of calcium (Ca), phosphorus (P) and F in hydroxyapatite (HA). Synthetic HA powder (0.15 g) was suspended (n=6) in solutions (75 mL) of TMP at 0%, 0.1%, 0.2%, 0.4%, 0.6%, 0.8%, 1.0%, 2.0%, 4.0%, 6.0%, 8.0% and 10% concentrations in the presence and absence of 100 ppm F and subjected to a pH-cycling process. The precipitates were filtrated, dried at 70° C for 24 h and ground onto a fine powder. The concentrations of F (KOH (CaF2) and HCl (FA) soluble), Ca (Arsenazo III), and P (molybdate method) in HA were determined. The Ca P, and Ca/P ratio data were subjected to Tukey's test and the F data were subjected to Student-Newman-Keuls test (p<0.05). The addition of TMP to the samples reduced F deposition to 98% (p<0.001). The groups containing 100 ppm F and 0.4% or 0.6% TMP exhibited a higher Ca concentration than the group containing only 100 ppm F (p<0.05). Furthermore, the HA treated with 0.2% and 0.4% TMP and 100 ppm F showed a higher Ca/P ratio than the other groups (p<0.001). In conclusion, TMP at 0.2%, 0.4% and 0.6% concentrations combined with F seemed to be able to precipitate HA with low solubility. However, especially at high concentrations, TMP interferes with F deposition on HA.
Tumor-Infiltrating Macrophage and Microvessel Density in Oral Squamous Cell Carcinoma
Authors: Boas Deise Souza Vilas , Takiya Christina Maeda , Gurgel Clarissa Araujo Silva , Cabral Marcia Grillo , Santos Jean Nunes dos
Published: August 2013

Tumor-associated macrophages (TAM) are the main cellular component in stroma of many tumors and participate in tumor angiogenesis. The aim of present study was to compare the microvascular density (MVD) and infiltrating macrophage density (IMD) in oral squamous cell carcinomas (OSCCs) with different histological grades. A histomorphometric analysis was performed after immunohistochemistry using antibodies such as von-Willebrand factor and CD68. A significant difference in MVD was found between well and moderately differentiated OSCCs (p<0.05). TAM were largely present in all studied tumors and the IMD was not different among OSCCs with different histological grades (p=0.381). Significant correlation between MVD and IMD was not observed (p=0.870). In conclusion, these results suggest that TAM and angiogenesis have an influence at different histological grades of OSCC. However, the lack of correlation between MVD and IMD could suggest that angiogenesis does not depend on the number of macrophages present in OSCC, but their predominant phenotype. Further studies involving distinct phenotypes of macrophages should be done to better understand the influence of TAM on the tumor angiogenesis.
In Vitro Enamel Remineralization by Low-Fluoride Toothpaste with Calcium Citrate and Sodium Trimetaphosphate
Authors: Hirata Edo , Danelon Marcelle , Freire Isabelle Rodrigues , Delbem Alberto Carlos Botazzo
Published: August 2013

The objective of this study was to evaluate in vitro the effect of a low fluoride toothpaste (450 µgF/g, NaF) combined with calcium citrate (Cacit) and sodium trimetaphosphate (TMP) on enamel remineralization. Bovine enamel blocks had the enamel surface polished sequentially to determine the surface hardness. After production of artificial carious lesions, the blocks selected by their surface hardness were submitted to remineralization pH cycling and daily treatment with dentifrice suspensions (diluted in deionized water or artificial saliva): placebo, 275, 450, 550 and 1,100 µgF/g and commercial dentifrice (positive control, 1,100 µgF/g). Finally, the surface and cross-section hardness was determined for calculating the change of surface hardness (%SH) and mineral content (%∆Z). Fluoride in enamel was also determined. The data from %SH, %∆Z and fluoride were subjected to two-way analysis of variance followed by Student-Newman-Keuls's test (p<0.05). The mineral gain (%SH and %∆Z) was higher for toothpastes diluted in saliva (p<0.05), except for the 450 µgF/g dentifrice with Cacit/TMP (p>0.05). The 450 Cacit/TMP toothpaste and the positive control showed similar results (p>0.05) when diluted in water. A dose-response was observed between fluoride concentration in toothpastes and fluoride present in enamel, regardless of dilution. It was concluded that it is possible to enhance the remineralization capacity of low F concentration toothpaste by of organic (Cacit) and inorganic (TMP) compounds with affinity to hydroxyapatite.
Effect of Sealant Application and Thermal Cycling on Bond Strength of Tissue Conditioners to Acrylic Resin
Authors: Sampaio Francisca Neta Cruz Soares , Pinto Jose Renato Ribeiro , Turssi Cecilia Pedroso , Basting Roberta Tarkany
Published: August 2013

The aim of this study was to evaluate the effect of sealer application and thermal cycling on the bond strength between tissue conditioners and acrylic resin, and to observe the type of bond failure. Two hundred eighty-eight specimens (10x16x3 mm) were made of an acrylic resin (Lucitone 500, Dentsply) using a metal muffle. Specimens were divided into four groups according to the tissue conditioner (Coe-Comfort, GC or Dentusoft, Densell) used and whether or not a sealer (Eversoft Soft Liner Sealer, Myerson) was applied. Each of the four groups was subdivided into other six subgroups (n=12) to undergo thermocycling for 45, 90, 135, 180 or 210 cycles with a dwell time of 60 s, or to be left non thermocycled (control). Tensile bond strength was measured in a universal testing machine at a crosshead speed of 5 mm/min. Sealant application had no effect on the tensile bond strength of the relined acrylic resin, regardless of the tissue conditioner used (Coe-Comfort: p=0.306 and Dentusoft: p=0.1501). The number of thermal cycles had a significant effect on the tensile bond strength of the relined acrylic resin (Coe-Comfort: p=0.002 and Dentusoft: p<0.001). Both tissue conditioners presented similar bond strength to acrylic resin. For both tissue conditioners, sealer coatings had no influence on bond strength, while different numbers of thermal cycles affected that mechanical property.
Influence of Endodontic Sealer Composition and Time of Fiber Post Cementation on Sealer Adhesiveness to Bovine Root Dentin
Authors: Rosa Ricardo Abreu da , Barreto Mirela Sangoi , Moraes Rafael do Amaral , Broch Juliana , Bier Carlos Alexandre Souza , So Marcus Vinicius Reis , Kaizer Osvaldo Bazzan , Valandro Luiz Felipe
Published: August 2013

This study aimed to assess the influence of the type of endodontic sealer (salicylate resin-based sealer vs. two endodontic sealers) and the time of fiber post cementation after root filling on the post adhesion to bovine root dentin. Sixty bovine roots were assigned to six groups (n=10), considering an experimental design with two factors (factorial 3x2): endodontic sealer factor in three levels [epoxy resin-based sealer (AH Plus), eugenol-based sealer (Endofill), and salicylate resin-based sealer plus mineral trioxide aggregate - MTA (MTA Fillapex)] and time for post cementation factor in two levels (immediate post cementation or 15 days after root canal filling). After post cementation, 2-mm-thick slices were produced and submitted to push-out test. The failure modes were analyzed under a 40× stereomicroscope and scored as: adhesive at cement/dentin interface; adhesive at cement/post interface; cement cohesive; post cohesive; dentin cohesive; or mixed. Data were analyzed using two-way ANOVA and Tukey's post-hoc tests (α=0.05). When the fiber posts were cemented immediately after the root canal filling, the bond strengths were similar, independent of the endodontic sealer type. However, after 15 days, the epoxy resin-based sealer presented higher bond strength than the other sealers (p<0.05). Comparison between each sealer in different experimental times did not reveal any differences. The main failure type was adhesive at dentin/cement interface (89.4%). The time elapsed between the root canal filling and post cementation has no influence on post/root dentin adhesion. On the contrary, the type of endodontic sealer can influence the adhesion between fiber posts and root dentin.
Effect of Carbamide Peroxide Bleaching Gel on Composite Resin Flexural Strength and Microhardness
Authors: Hatanaka Gabriel Rodrigues , Abi-Rached Filipe de Oliveira , Almeida-Junior Antonio Alves de , Cruz Carlos Alberto dos Santos
Published: August 2013

This study investigated the effect of 16% carbamide peroxide (Whiteness Perfect/FGM) on the Vickers microhardness and flexural strength of the restorative composites Filtek Z100 (hybrid), Filtek Z350 (nanofill), Brilliant (micro-hybrid) and Opallis (micro-hybrid). Disc-shaped (4x2 mm; n=5) and bar-shaped (12x2x1 mm; n=10) specimens of each restorative material were randomly divided into 2 groups: (G1) 16 weeks stored in distilled water; (G2) 16 weeks stored in distilled water, with 16% carbamide peroxide application during 6 h per day for the last 4 weeks. The mechanical properties were evaluated using a Vickers microhardness tester and a mechanical testing machine. Data were analyzed by two-way ANOVA and Tukey's (HSD) post-hoc test (α=0.05). Filtek Z100 presented the highest microhardness value, followed by Filtek Z350 and finally by Brilliant and Opallis (p=0.00). Filtek Z100 and Brilliant exhibited the highest flexural strength value, followed by Filtek Z350 and Opallis (p=0.00). Bleaching treatment decreased significantly microhardness of Brilliant and Opallis (p=0.00). The flexural strength of all studied materials was not affected by the home bleaching (p=0.28).
Tenascin and Fibronectin Expression after Pulp Capping with Different Hemostatic Agents: A Preliminary Study
Authors: Baldissera Elaine Zanchin , Silva Adriana Fernandes da , Gomes Ana Paula Neutzling , Etges Adriana , Botero Tatiana , Demarco Flavio Fernando , Tarquinio Sandra Beatriz Chaves
Published: August 2013

This study investigated the expression of extracellular matrix glycoproteins tenascin (TN) and fibronectin (FN) in pulp repair after capping with calcium hydroxide (CH), following different hemostasis protocols. Class I cavities with a pulp exposure were prepared in 42 human third molars scheduled for extraction. Different hemostatic agents (0.9% saline solution, 5.25% sodium hypochlorite and 2% chlorhexidine digluconate) were used and pulps were capped with CH cement. After 7, 30 or 90 days, teeth were extracted, formalin-fixed, and prepared for immunohistochemical technique. Hemostatic agents did not influence the expression of TN and FN. Both glycoproteins were found in the entire the pulp tissue and around collagen fibers, but were absent in the mineralized tissues. In the predentin, TN showed positive immunostaining and FN had a variable expression. Within 7 days post-treatment, a slightly more pronounced immunostaining on the pulp exposure site was observed. Within 30 days, TN and FN demonstrated a positive expression around the dentin barrier and at 90 days, a thin and linear expression of TN and FN was delimitating the reparative dentin. In conclusion, hemostatic agents did not influence TN and FN expression. Immunostaining for TN and FN was seen in different regions and periods, demonstrating their role in pulp repair.
Treatment of Intrabony Defects with Anorganic Bone Matrix/P-15 or Guided Tissue Regeneration in Patients with Aggressive Periodontitis
Authors: Queiroz Adriana C. , Nobrega Priscila Brasil da , Oliveira Fabiola S. , Novaes Jr. Arthur B. , Taba Jr. Mario , Palioto Daniela B. , Grisi Marcio F. M. , Souza Sergio L. S.
Published: August 2013

Intrabony periodontal defects present a particular treatment problem, especially in patients with generalized aggressive periodontitis (G-AgP). Regenerative procedures have been indicated for this clinical situation. The aim of this study was to compare treatment outcomes of intrabony periodontal defects with either anorganic bone matrix/cell binding peptide (ABM/P-15) or guided tissue regeneration (GTR) in patients with G-AgP. Fifteen patients, with two intrabony defects ≥3 mm deep, were selected. Patients were randomly allocated to be treated with ABM/P-15 or GTR. At baseline and at 3 and 6 months after surgery, clinical and radiographic parameters and IL-1β and IL-6 gingival fluid concentrations were recorded. There was a significant probing pocket depth reduction (p<0.001) for both groups (2.27 ± 0.96 mm for ABM/P-15 group and 2.57 ± 1.06 mm for GTR group). Clinical attachment level gain (1.87 ± 0.94 mm for ABM/P-15 group and 2.09 ± 0.88 mm for GTR group) was also observed. There were no statistically significant differences in clinical parameters between the groups. The radiographic bone fill was more expressive in ABM/P-15 group (2.49 mm) than in GTR group (0.73 mm). In subtraction radiographs, the areas representing gain in density were 93.16% of the baseline defect for ABM/P-15 group versus 62.03% in GRT group. There were no statistically significant differences in inter-group and intra-group comparisons with regards to IL-1β and IL-6 quantification. Treatment of intrabony periodontal defects in patients with G-AgP with ABM/P-15 and GTR improved significantly the clinical outcomes. The use of ABM/P-15 promoted a better radiographic bone fill.
Impact of Experimental Nano-HAP Pastes on Bovine Enamel and Dentin Submitted to a pH Cycling Model
Authors: Comar Livia P. , Souza Beatriz M. , Gracindo Luiz Fernando , Buzalaf Marilia A. R. , Magalhaes Ana Carolina
Published: August 2013

This in vitro study evaluated the preventive potential of experimental pastes containing 10% and 20% hydroxyapatite nanoparticles (Nano-HAP), with or without fluoride, on dental demineralization. Bovine enamel (n=15) and root dentin (n=15) specimens were divided into 9 groups according to their surface hardness: control (without treatment), 20 Nanop paste (20% HAP), 20 Nanop paste plus (20% HAP + 0.2% NaF), 10 Nanop paste (10% HAP), 10 Nanop paste plus (10% HAP + 0.2% NaF), placebo paste (without fluoride and HAP), fluoride paste (0.2% NaF), MI paste (CPP-ACP, casein phosphopeptide-amorphous calcium phosphate), and MI paste plus (CPP-ACP + 0.2% NaF). Both MI pastes were included as commercial control products containing calcium phosphate. The specimens were treated with the pastes twice a day (1 min), before and after demineralization. The specimens were subjected to a pH-cycling model (demineralization–6-8 h/ remineralization-16-18 h a day) for 7 days. The dental subsurface demineralization was analyzed using cross-sectional hardness (kgf/mm 2 , depth 10-220 µm). Data were tested using repeated-measures two-way ANOVA and Bonferroni's test (p<0.05). The only treatment able to reduce the loss of enamel and dentin subsurface hardness was fluoride paste (0.2% NaF), which differed significantly from the control at 30- and 50-µm depth (p<0.0001). The other treatments were not different from each other or compared with the control. The experimental Nanop pastes, regardless of the addition of fluoride, were unable to reduce dental demineralization in vitro.