bluuebunny/crossref_metadata_2025 huggingface dataset:
Reflective folios for dental hygiene students: what do they tell us about a residential aged care student placement experience?
Authors: Wallace J. P. , Blinkhorn A. S. , Blinkhorn F. A.
Published: April 2013

Introduction

Community‐based education programmes provide students with an experiential learning opportunity in a real‐life context. The purpose of this study was to examine reflective journals to identify students' experiences and perceived learning during a 12‐week placement programme in residential aged care facilities (RACF) on the NSW Central Coast, Australia.

Methodology

All final year dental hygiene students from the University of Newcastle, Australia attended an aged care orientation workshop prior to commencing the RACF student placement programme. Throughout the placement, students were asked to record their educational experiences in reflective journals. Student reflections were based on the ‘Gibbs Reflective Cycle’, diarising experiences and feelings. Qualitative data was analysed using the constant comparative method and unitised to identify emergent themes.

Results

Sixty‐seven students completed reflective journals during the placement programme; emergent themes indicated students felt ill‐prepared for the placement programme despite attending the orientation workshop. They were apprehensive and nervous prior to commencement of the placement. The general consensus after week 6 was that the placement became a more positive experience where students began to feel comfortable in the RACF environment and residents, and staff started to respond more positively to their presence. Overall, they thought the placement was challenging and confronting, but had improved their skills and knowledge in care of older people and increased their confidence in working with other healthcare professionals.

Conclusion

The reflective journals provided students with the opportunity to record and reflect on their experience and perceived learning during the placement programme. Student reflections identified negative experiences at the commencement of the placement, suggesting a need for additional orientation prior to the RACF programme.
Nucleus accumbens GABAergic inhibition generates intense eating and fear that resists environmental retuning and needs no local dopamine
Authors: Richard Jocelyn M. , Plawecki Andrea M. , Berridge Kent C.
Published: April 2013

Intense fearful behavior and/or intense appetitive eating behavior can be generated by localized amino acid inhibitions along a rostrocaudal anatomical gradient within medial shell of nucleus accumbens of the rat. This can be produced by microinjections in medial shell of either the γ‐aminobutyric acid (GABA)A agonist muscimol (mimicking intrinsic GABAergic inputs) or the AMPA (α‐amino‐3‐hydroxy‐5‐methylisoxazole‐4‐propionic acid) antagonist DNQX (6,7‐dinitroquinoxaline‐2,3‐dione), disrupting corticolimbic glutamate inputs). At rostral sites in medial shell, each drug robustly stimulates appetitive eating and food intake, whereas at more caudal sites the same drugs instead produce increasingly fearful behaviors such as escape, distress vocalizations and defensive treading (an antipredator behavior rodents emit to snakes and scorpions). Previously we showed that intense motivated behaviors generated by glutamate blockade require local endogenous dopamine and can be modulated in valence by environmental ambience. Here we investigated whether GABAergic generation of intense appetitive and fearful motivations similarly depends on local dopamine signals, and whether the valence of motivations generated by GABAergic inhibition can also be retuned by changes in environmental ambience. We report that the answer to both questions is ‘no’. Eating and fear generated by GABAergic inhibition of accumbens shell does not need endogenous dopamine. Also, the appetitive/fearful valence generated by GABAergic muscimol microinjections resists environmental retuning and is determined almost purely by rostrocaudal anatomical placement. These results suggest that nucleus accumbens GABAergic release of fear and eating are relatively independent of modulatory dopamine signals, and more anatomically pre‐determined in valence balance than release of the same intense behaviors by glutamate disruptions.
Depression‐related behaviours displayed by female C57BL/6J mice during abstinence from chronic ethanol consumption are rescued by wheel‐running
Authors: Pang Terence Y. , Renoir Thibault , Du Xin , Lawrence Andrew J. , Hannan Anthony J.
Published: April 2013

Withdrawal from a chronic period of alcohol consumption is commonly associated with the manifestation of depression, potentially exerting a significant influence on treatment prospects and increasing the likelihood of relapse. Better therapeutic strategies need to be developed to assist with rehabilitation. Here, we report the detection of depression‐related behaviours in a mouse model of 6‐week free‐choice ethanol (10%, v/v) consumption followed by 2‐week abstinence. Mice abstinent from alcohol showed increased immobility time on the forced‐swim test, reduced saccharin consumption and increased latency to feed in the novelty‐suppressed feeding test. By comparison, there was no significant effect on anxiety‐related behaviours as determined by testing on the light–dark box and elevated plus maze. We found that the provision of running‐wheels through the duration of abstinence attenuated depressive behaviour in the forced‐swim and novelty‐suppressed feeding tests, and increased saccharin consumption. Given the link between withdrawal from addictive substances and depression, this model will be useful for the study of the pathophysiology underlying alcohol‐related depression. The findings of this study establish an interaction between physical activity and the development of behavioural changes following cessation of alcohol consumption that could have implications for the development of rehabilitative therapies.
What should men living with severe haemophilia need to know? The perspectives of Canadian haemophilia health care providers
Authors: Lane S. , Arnold E. , Webert K. E. , Chan A. , Walker I. , Heddle N. M.
Published: April 2013

Haemophilia is a complex disease to manage. Home‐based management of haemophilia has placed greater responsibility for disease management on individuals with haemophilia, heightening the individual's need for knowledge, particularly among individuals with severe haemophilia. The aim of this study was to identify and understand the knowledge needs and gaps of Canadian men with severe haemophilia from the perspectives of health care providers. A qualitative approach was undertaken. Data were collected using semi‐structured focus groups and interviews with health care providers from Haemophilia Treatment Centres (HTCs) across Canada; data were analysed using thematic analysis. Three focus groups and two interviews were conducted; 13 individuals participated in this study. Health care providers identified the following areas of knowledge required by men with severe haemophilia: disease pathology, causes and consequences of bleeds, bleed prevention, recognition, treatment, how and when to access support, activity selection and risk reduction, benefits of exercise, genetic inheritance patterns, impact on career selection, travel and ageing. Knowledge gaps and challenges to knowledge provision were highlighted. In addition, providers emphasized the influences of timing, rapport and context on readiness to receive and assimilate information and recommended tailoring education to the individual and creating a developmental curriculum and knowledge assessment tool. Provision and uptake of disease knowledge is essential to patient self‐management. To effectively receive, retain and assimilate information, individuals with severe haemophilia require the right information, from the right source, at the right time. Education should be tailored to the needs of the individual, provided throughout the lifespan.
Assessment of individual dose utilization vs. physician prescribing recommendations for recombinant activated factor VII (rFVIIa) in paediatric and adult patients with congenital haemophilia and alloantibody inhibitors (CHwI): the Dosing Observational Study in Hemophilia (DOSE)
Authors: Gruppo R. A. , Kessler C. M. , Neufeld E. J. , Cooper D. L.
Published: April 2013

Recent data from the Dosing Observational Study in Hemophilia diary study has described home treatment with recombinant activated factor VII (rFVIIa) in congenital haemophilia with inhibitors (CHwI). The current analysis compares prescribed and patient/caregiver‐reported rFVIIa administration in paediatric and adult CHwI patients in this study. Patients with ≥4 bleeding episodes within a 3‐month period prescribed rFVIIa as first‐line therapy for bleeding episodes were eligible. Patients/caregivers completed a diary for ≥90 days or until the patient experienced four bleeds. Initial, total and mean rFVIIa doses reported for each bleeding episode were calculated and compared with the physician‐prescribed doses. Of 52 enrolled patients (25 children; 27 adults), 39 (75%) completed the study. Children and adults had similar mean durations of bleeding episodes. Both patient groups were administered higher initial rFVIIa doses for joint bleeds than prescribed: median (range) 215.2 (74.1–400.0) mcg kg−1 vs. 200.0 (61.0–270.0) mcg kg−1 for children, and 231.3 (59.3–379.7) mcg kg−1 vs. 123.0 (81.0–289.0) mcg kg−1 for adults. The median infused dose for joint bleeds was higher in adults than children (175.2 vs. 148.0 mcg kg−1), but children received significantly more doses per joint bleed than adults (median 6.5 vs. 3.0). The median total dose per joint bleed was higher in children than adults (1248.7 vs. 441.6). For children and adults, both initial and additional doses administered for bleeds were higher than prescribed. Children received higher total doses per bleed due to an increased number of infusions per bleed.
Alliaceous Migraines
Authors: Roussos Alexander P. , Hirsch Alan R.
Published: April 2013

Objective

To report a migraineur with osmophobia and trigger to garlic and onion aroma.

Background

While odors serve as a trigger in 70% of migraineurs, alliaceous aromas have been described only rarely. Furthermore, nor has more than one type of alliaceous odor acted as a trigger in the same individual. Neither has migraine with aura been described as precipitated by such aromas. A patient experiencing migraines with aura, triggered almost exclusively by alliaceous aromas, is described.

Methods

Case study: 32‐year‐old woman; 5 years previously felt nasal pruritis upon eating a red onion dip. Shortly thereafter, the mere aroma of raw onions caused a sensation of her throat closing along with an associated panic attack. Over the intervening years, upon exposure to onions and garlic aroma she experienced a fortification spectra and visual entopia, followed by a bipareital, crushing level 10/10 headache, burning eyes and nose, lacrimation, perioral paresthesias, generalized pruritis, nausea, fatigue, sore throat, dysarthria, confusion, dyspnea, palpitations, presyncopal sensations, hand spasms, tongue soreness, neck pain, phonophobia, and photophobia. These would persist for 1 hour after leaving the aroma. She was unresponsive to medication and would wear a surgical mask when out. The patient also experienced chemosensory complaints: dysosmias every few months; phantosmias of food or cleaning products every month for a minute of level 5/10 intensity; pallinosmia of onion or garlic odor for 30 minutes after exposure; and metallic pallinugeusia after eating with metal utensils.

Results

Neurological exam normal except for bilateral positive Hoffman reflexes.

Chemosensory Testing

Quick Smell Identification Test 3/3 and Brief Smell Identification Test 12/12 were normal. Magnetic resonance imaging and computed tomography with and without contrast normal. Allergy skin test was positive for garlic and onion. Nose plug and counter stimulation with peppermint prevented the onset of headaches and associated symptoms.

Conclusion

This is the first report of migraines with aura triggered by more than one alliaceous compound in the same individual. Possible mechanisms include odor induced, emotional change, vasomotor instability, trigeminal‐induced neurogenic inflammation, and allergic response. In alliaceous and odor‐induced migraines, a trial of counter stimulation and nose plugs is warranted.
Interleukin‐17‐producing cell infiltration in the breast cancer tumour microenvironment is a poor prognostic factor
Authors: Chen Wen‐Chung , Lai Yu‐Hsuan , Chen Hung‐Yu , Guo How‐Ran , Su Ih‐Jen , Chen Helen H W
Published: April 2013

Aims

Interleukin‐17 (IL‐17) is a proinflammatory cytokine that is most prominently produced by T‐helper type 17 (Th17) cells, a distinct CD4+ T‐helper cell subset. The aim of this study was to investigate the level of IL‐17‐producing cells in the breast cancer tumour microenvironment and its prognostic role.

Methods and results

A total of 207 breast carcinoma specimens were assessed by IL‐17 immunohistochemistry, and the findings were correlated with clinicopathological parameters. We found that increased numbers of IL‐17‐producing cells were correlated with high histological grade, negative ER/PR status, and triple‐negative molecular subtypes segregated by immunoprofiles. However, they did not correlate with stage, tumour size, nodal status, HER2 status, or histological type. Patients with tumours with high numbers of IL‐17‐producing cells had shorter disease‐free survival (DFS) than patients with tumours with low numbers of IL‐17‐producing cells (P < 0.01). In multivariate analysis, high IL‐17 level [hazard ratio (HR) 2.24; 95% CI 1.06–4.75], advanced T stage (HR 2.73; 95% CI 1.30–5.73), positive HER2 status (HR 4.88; 95% CI 1.47–16.18) and triple‐negative subtype (HR 7.46; 95% CI 1.38–40.36) were significant prognostic factors for DFS.

Conclusions

Our results indicate that a high level of IL‐17‐producing cells in the breast cancer tumour microenvironment is a poor prognostic factor.
pPKC α regulates through integrin β 1 human gingival fibroblasts/Streptococcus mitis adhesion in response to HEMA
Authors: di Giacomo V. , Pacella S. , Rapino M. , Di Giulio M. , Zara S. , Pasquantonio G. , Cellini L. , Cataldi A.
Published: April 2013

Aim

To investigate in coculture of human gingival fibroblasts (HGFs) and Streptococcus mitis, the molecular mechanisms driving the response to 2‐hydroxyethyl methacrylate (HEMA) in terms of eukaryotic/prokaryotic cell adhesion, signal transduction and apoptosis.

Methodology

The clinical strain S. mitis DS12, cultured in Trypticase soy broth was added to HGFs, obtained from fragments of healthy marginal gingival tissue and cultured in DMEM, treated with 3 mmol L−1 2‐hydroxyethyl methacrylate (HEMA) for 48 h and processed for microscopic, western blotting and flow cytometric analyses.

Results

2‐hydroxyethyl methacrylate (HEMA) treatment increased the adhesion between S. mitis and HGFs, which seemed to be mediated by the PKC α/integrin β 1 signalling system, improved by the presence of saliva. It also reduced the viability and the adhesion of HGFs to polypropylene substrate in terms of procollagen I and MMP3 expression. The presence of saliva and S. mitis reduced the number of necrotic HGFs and upregulated the expression of both procollagen I and MMP3.

Conclusions

These results shed more light on the biological and molecular events occurring in vitro in a coculture model that mimics the environment of the oral cavity with HEMA treatment. The key role played by oral bacteria and saliva in preventing inflammatory and toxic processes that occur in vivo in human gingival fibroblasts upon the release of dental material monomers is confirmed.
Epithelioid angiomyolipoma of the kidney: Radiological imaging
Authors: Tsukada Jitsuro , Jinzaki Masahiro , Yao Masahiro , Nagashima Yoji , Mikami Shuji , Yashiro Hideki , Nozaki Miwako , Mizuno Ryuichi , Oya Mototsugu , Kuribayashi Sachio
Published: April 2013

Objectives

To review the imaging findings of renal epithelioid angiomyolipomas.

Methods

Eight patients treated at two institutions were pathologically diagnosed as having epithelioid angiomyolipoma. All of them underwent computed tomography, and four underwent magnetic resonance imaging. The tumor size, existence of fat, heterogeneity, computed tomography attenuation, degree of enhancement, enhancement pattern and magnetic resonance imaging signal intensity were evaluated.

Results

Intratumoral fat was not detected in any of the cases. On unenhanced computed tomography, the intratumoral attenuation was hyperattenuating in six of the seven patients who were examined using this modality. OnT2‐weighted images, the signal intensity of the solid component, cyst wall or septum was low in three of the four cases. Four of the eight cases were heterogeneous solid‐type accompanied by hemorrhage, necrosis or hyalinization. One homogeneous solid‐type lesion was large in size and was pathologically accompanied by neither hemorrhage nor necrosis. All three multilocular cystic types were pathologically accompanied by massive hemorrhage in the cystic component. One was accompanied by spontaneous perirenal hematoma.

Conclusions

The radiological appearance of most epithelioid angiomyolipomas has a tendency to be hyperattenuating on unenhanced computed tomography images, with low intensities onT2‐weighted images. They can be heterogeneously solid, homogeneously solid or a multilocular cystic lesion with massive hemorrhage.
Lipid profiles and persisting inflammation following critical illness in a Central Australian population: a prospective longitudinal observational study
Authors: Secombe P. J. , Brown A. , Kruger P. S. , Stewart P. C. H.
Published: April 2013

No published data exist following the changes in lipid profile during and after an episode of acute illness for the Australian Indigenous population. This paper presents data focusing on lipid profiles and inflammatory markers in a group of survivors of critical illness in Central Australia, prospectively recruited to a larger trial exploring the medium‐term sequelae of an intensive care unit admission. This data confirm that lipid profiles in acute illness are deranged, and that recovery may differ between indigenous and non‐indigenous populations.
Immune‐mediated cytopenias in human immunodeficiency virus: the first reported case of idiopathic aplastic anaemia successfully treated with immunosuppression
Authors: Hapgood G. , Hoy J. F. , Morrissey C. O. , Jane S. M.
Published: April 2013

Although isolated cytopenias are relatively common in human immunodeficiency virus (HIV), the incidence of aplastic anaemia is extremely rare. We report here the first case of a HIV‐infected patient who developed severe idiopathic aplastic anaemia, and who was safely and effectively treated with anti‐thymocyte globulin and cyclosporin. We briefly review immune‐mediated cytopenias in HIV, including their frequency, pathophysiology and management strategies.
Reading difficulties and attention‐deficit/hyperactivity behaviours: evidence of an early association in a nonclinical sample
Authors: Luoni Chiara , Balottin Umberto , Zaccagnino Maria , Brembilla Laura , Livetti Giulia , Termine Cristiano
Published: April 2013

Attention‐deficit/hyperactivity disorder (ADHD) often co‐occurs with reading disability. A cross‐sectional study in an Italian‐speaking, nonclinical sample was conducted in an attempt to document the existence of an early association between reading difficulties (RD) and ADHD behaviours. We recruited a sample of 369 children in their first year at primary school. Of the sample, 8.4% displayed RD; 7.0% had ADHD; 3.5% presented both RD and ADHD behaviours; 50% of the children with ADHD displayed RD; 41.9% of those with RD displayed ADHD behaviours. Low socioeconomic status was associated with a fourfold increased probability of displaying RD (odds ratio = 3.98), but not ADHD behaviours. In this nonclinical sample, we detected an early association between ADHD behaviours and RD. A key role in this association may be played by inattention symptoms, which occurred with significantly increased frequency also in the group presenting only RD.
Expert‐based drug lists to measure anticholinergic burden: similar names, different results
Authors: LERTXUNDI Unax , DOMINGO‐ECHABURU Saioa , HERNANDEZ Rafael , PERAL Javier , MEDRANO Juan
Published: April 2013

Background:  Scoring scales such as the Anticholinergic Drug Scale (ADS), the Anticholinergic Risk Scale (ARS), and the Anticholinergic Cognitive Burden Scale (ACB) provide an estimation of total anticholinergic burden. Not all the lists include the same drugs, and the points given for certain drugs differ among them. Whether these discrepancies present important differences in the estimation of anticholinergic burden for an individual patient is unknown. Therefore, the aim of this study is to assess agreement among the three scales.

Method:  Anticholinergic burden was measured with the three scales in 83 patients aged ≥65 years in a medium‐ and long‐stay psychiatric hospital. Subsequently, patients were categorized into three risk categories: low risk (0 points), medium risk (1–2 points) or high risk (3 or more points). The chance‐corrected measures of agreement for the different scores were determined with the k‐statistic (kappa).

Results:  Values for kappa were: 0.19 for Anticholinergic Risk Scale‐Anticholinergic Drug Scale, 0.21 for ACB‐Anticholinergic Drug Scale and 0.25 for Anticholinergic Risk Scale‐ACB. The mean anticholinergic burden measured with ACB was 3.28.

Conclusions:  There is poor agreement among the three scales. These lists cannot be directly applied to different settings in which drug availability differs substantially, and they require periodic updates. Anticholinergic burden in our setting (psychogeriatric inpatients) was particularly high.
Reduced memory in fat mass and obesity‐associated allele carriers among older adults with cardiovascular disease
Authors: ALOSCO Michael L. , BENITEZ Andreana , GUNSTAD John , SPITZNAGEL Mary Beth , MCCAFFERY Jeanne M. , MCGEARY John E. , POPPAS Athena , PAUL Robert H. , SWEET Lawrence H. , COHEN Ronald A.
Published: April 2013

Background:  Much attention has been paid to the prevalence and predisposition of the fat mass and obesity‐associated (FTO) gene to obesity, although only a few studies have characterized the extent to which this affects cognitive function. This study examined differences between risk allele carriers (i.e. FTO‐AC/AA) and non‐carriers (i.e. FTO‐CC) on indices of attention/executive function/psychomotor speed, memory, language, and visual‐spatial ability in a sample of older patients with cardiovascular disease.

Methods:  We recruited 120 older adults from an outpatient cardiology clinic who underwent blood draw and completed neuropsychological testing. Participants were classified into two groups: one for those who were homozygous for the non‐risk‐conferring allele (i.e. FTO‐CC) (n= 49) and the other for those who had at least one copy of the obesity risk‐conferring A allele (i.e. FTO‐AC/AA) (n= 71).

Results:  Mancova analyses adjusting for age and years of education revealed the FTO‐AC/AA group performed significantly worse on indices of memory (λ= 0.94, F(2, 115) = 3.58, P= 0.03, partial η2= 0.06). Follow‐up tests revealed a significant effect for the FTO‐AC/AA group, relative to the non‐carrier group, on encoding (i.e. California Verbal Learning Test Total Learning) and California Verbal Learning Test long‐delay free recall (P < 0.05). No such differences between FTO carriers and non‐carriers emerged on tests of attention/executive function/psychomotor speed, language, or visual‐spatial ability (P > 0.05 for all).

Conclusions:  These findings suggest that the FTO risk allele is associated with reduced memory performance, particularly on aspects of memory encoding and delayed recall. To elucidate underlying mechanisms, these findings will need to be replicated in larger samples that utilize neuroimaging.
Managing abnormal eating behaviours in frontotemporal lobar degeneration patients with topiramate
Authors: SHINAGAWA Shunichiro , TSUNO Norifumi , NAKAYAMA Kazuhiko
Published: April 2013

Abnormal eating behaviours are specific to frontotemporal lobar degeneration and increase caregiver burden. Topiramate, an anticonvulsant, suppresses cravings for alcohol and other substances and is a potential treatment for binge eating. However, there are few reports on topiramate efficacy for abnormal eating behaviours in frontotemporal lobar degeneration patients. We present three Japanese frontotemporal lobar degeneration patients with abnormal eating behaviours. Topiramate was effective, especially for compulsive eating, in cases with distinct lobar atrophy, but not for all abnormal eating behaviours.
Exploring the Issue of Employment for Adults with an Intellectual Disability in Ireland
Authors: McGlinchey Eimear , McCallion Philip , Burke Eilish , Carroll Rachel , McCarron Mary
Published: April 2013

Background

The benefits of being in employment are well documented; however, underemployment is a critical issue for people with intellectual disability (ID). Some individuals perceive themselves as being in employment when in fact they are attending a non‐work site such as a day service. The impact that this perception of employment has on other areas in life has not been investigated and research into this area could have implications for both policy makers and service providers.

Materials and Methods

The first wave of the intellectual disability Supplement to the Irish Longitudinal Study on Ageing (IDS‐TILDA) included a series of questions on employment that yielded data for a representative sample of 753 participants with intellectual disability aged 40 and over randomly selected from Ireland's National Intellectual Disability Database (NIDD).

Results and Discussion

Overall, 6.6% of the population were in real paid employment, 7.4% in perceived employment, 12% in sheltered employment and 73.5% were unemployed. Differences were identified between these two groups in relation to social activities, levels of depression and self‐rated health. Further investigation is needed into the area of perceived employment.
Air‐Water Temperature Relationships in the Trout Streams of Southeastern Minnesota's Carbonate‐Sandstone Landscape
Authors: Krider Lori A. , Magner Joseph A. , Perry Jim , Vondracek Bruce , Ferrington Leonard C.
Published: April 2013

Carbonate‐sandstone geology in southeastern Minnesota creates a heterogeneous landscape of springs, seeps, and sinkholes that supply groundwater into streams. Air temperatures are effective predictors of water temperature in surface‐water dominated streams. However, no published work investigates the relationship between air and water temperatures in groundwater‐fed streams (GWFS) across watersheds. We used simple linear regressions to examine weekly air‐water temperature relationships for 40 GWFS in southeastern Minnesota. A 40‐stream, composite linear regression model has a slope of 0.38, an intercept of 6.63, and R2 of 0.83. The regression models for GWFS have lower slopes and higher intercepts in comparison to surface‐water dominated streams. Regression models for streams with high R2 values offer promise for use as predictive tools for future climate conditions. Climate change is expected to alter the thermal regime of groundwater‐fed systems, but will do so at a slower rate than surface‐water dominated systems. A regression model of intercept vs. slope can be used to identify streams for which water temperatures are more meteorologically than groundwater controlled, and thus more vulnerable to climate change. Such relationships can be used to guide restoration vs. management strategies to protect trout streams.
A Semianalytical Solution for Residual Drawdown at a Finite Diameter Well in a Confined Aquifer
Authors: Yeh Hund‐Der , Wang Chih‐Tse
Published: April 2013

After the end of pumping the water level in the observation well starts to recover and the reduced drawdown during the recovery period is named as the residual drawdown. Traditional approaches in analyzing the data of residual drawdown for estimating the aquifer hydraulic parameters are mostly based on the application of superposition principle and Theis equation. In addition, the effect of wellbore storage is commonly ignored in the evaluation even if the test well has a finite diameter. In this article, we develop a mathematical model for describing the residual drawdown with considering the wellbore storage effect and the existing drawdown distribution produced by the pumping part of the test. The Laplace‐domain solution of the model is derived using the Laplace transform technique and the time‐domain result is inverted based on the Stehfest algorithm. This new solution shows that the residual drawdown associated with the boundary and initial conditions are related to the well drawdown and the aquifer drawdown, respectively. The well residual drawdown will be overestimated by the Theis residual drawdown solution in the early recovery part if neglecting the wellbore storage. On the other hand, the Theis residual drawdown solution can be used to approximate the present residual drawdown solution in the late recovery part of the test.
A mixed methods assessment of students' flow experiences during a mobile augmented reality science game
Authors: Bressler D.M. , Bodzin A.M.
Published: April 2013

Current studies have reported that secondary students are highly engaged while playing mobile augmented reality (AR) learning games. Some researchers have posited that players' engagement may indicate a flow experience, but no research results have confirmed this hypothesis with vision‐based AR learning games. This study investigated factors related to students' engagement – as characterized by flow theory – during a collaborative AR, forensic science mystery game using mobile devices. School Scene Investigators: The Case of the Stolen Score Sheets is a vision‐based AR game played inside the school environment with Quick Response codes. A mixed methods approach was employed with 68 urban middle school students. Data sources included pre‐ and post‐surveys, field observations and group interviews. Results showed that neither gender nor interest in science was an important predictor of variability in flow experience. Gaming attitude uniquely predicted 23% of the variance in flow experience. Student flow experience features included a flash of intensity, a sense of discovery and the desire for higher performance. The findings demonstrated a potential for mobile AR science games to increase science interest and help students learn collaboration skills. Implications for future research concerning mobile AR science games are discussed.
Treatment of Hypertension Among African Americans: The Jackson Heart Study
Authors: Harman Jane , Walker Evelyn R. , Charbonneau Vicki , Akylbekova Ermeg L. , Nelson Cheryl , Wyatt Sharon B.
Published: April 2013

Hypertension treatment regimens used by African American adults in the Jackson Heart Study were evaluated at the first two clinical examinations (2415 treated hypertensive persons at examination I [exam I], 2000–2004; 2577 at examination II [exam II], 2005–2008). Blood pressure (BP) was below 140/90 mm Hg for 66% and 70% of treated participants at exam I and exam II, respectively. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure treatment targets were met for 56% and 61% at exam I and exam II, respectively. Persons with diabetes or chronic kidney disease were less likely to have BP at target, as were men compared with women. Thiazide diuretics were the most commonly used antihypertensive medication, and persons taking a thiazide were more likely to have their BP controlled than persons not taking them; thiazides were used significantly less among men than women. Although calcium channel blockers are often considered to be effective monotherapy for African Americans, persons using calcium channel blocker monotherapy were significantly less likely to be at target BP than persons using thiazide monotherapy.
Telmisartan/Hydrochlorothiazide Combination Therapy for the Treatment of Hypertension: A Pooled Analysis in Older and Younger Patients
Authors: Kjeldsen Sverre E. , Schumacher Helmut , Neldam Steen , Guthrie Robert M.
Published: April 2013

Older patients frequently receive angiotensin II receptor blocker/diuretic combinations to control blood pressure (BP), although there have been relatively few trials specifically examining this patient population. A pooled analysis was performed of data from 7 randomized trials of telmisartan/hydrochlorothiazide combinations or telmisartan monotherapy in older (65 years and older) and younger (younger than 65 years) patients to better understand the response of older patients to a telmisartan/hydrochlorothiazide combination. Telmisartan doses were 40 mg and 80 mg (T40 and T80). Hydrochlorothiazide doses were 12.5 mg and 25 mg (H12.5 and H25). A total of 3654 patients were included and the mean treatment duration was approximately 8 weeks. BP reductions with telmisartan/hydrochlorothiazide combinations were broadly similar in older and younger patients. In older patients, mean BP reductions from baseline were −30.1/−19.0 mm Hg with the T80/H25 combination and −21.7/−13.0 mm Hg with T80 monotherapy. Tolerability was similar regardless of age, and the incidence of adverse events in both older and younger patients was similar to placebo. The telmisartan/hydrochlorothiazide combination, particularly high‐dose T80/H25, is effective and well tolerated in patients 65 years and older as well as in younger patients.
A New Freshwater Amoeba: Cochliopodium pentatrifurcatum n. sp. (Amoebozoa, Amorphea)
Authors: Tekle Yonas I. , Roger Anderson O. , Lecky Ariel F. , Kelly Samantha D.
Published: April 2013

Cochliopodium pentatrifurcatum n. sp. (ATCC© 30935TM) is described based on light microscopic morphology, fine structure, and molecular genetic evidence. Cochliopodium pentatrifurcatum n. sp. (length ~ 25 μm) is characterized by surface microscales (0.3 μm tall) containing a circular porous base (~ 0.6 μm diam.) with a thin peripheral rim. Five radially arranged feet, emanating from the base, support a short central column terminating apically as a funnel‐shaped collar (~ 0.5 μm diam.) composed of five radial, trifurcate rays extending from the center toward a thin peripheral rim. The central spine is 0.5–0.6 μm long. The comparative morphologies and combined molecular genetic evidence, SSU‐rDNA and COI, indicate that the new species falls in a clade sufficiently different from other species to suggest that it is a valid new species.
Unmet needs for visiting nurse services among older people after hospital discharge and related factors in Japan: Cross‐sectional survey
Authors: Nagata Satoko , Taguchi Atsuko , Naruse Takashi , Kuwahara Yuki , Murashima Sachiyo
Published: April 2013

Aim

Studies have suggested that some home care recipients have unmet needs for visiting nurse services. In particular, such needs are greater just after hospital discharge than at other times. Thus, there is concern that there exist unmet needs for visiting nurse services among patients after hospital discharge. The purpose of this study was to investigate the current situation of unmet needs for visiting nurse services among older patients discharged from acute hospitals.

Methods

This was a cross‐sectional correlation study. Participants were patients aged 65 years or over who had been discharged from the general units in all hospitals in four prefectures in Japan after a hospital stay of 14 days or more. Nursing staff gathered the patients' information and assessed unmet needs for visiting nurse services after discharge.

Results

There were 1594 eligible participants; 190 (11.9%) utilized visiting nurse services after discharge and 87 (5.4%) were judged to have no visiting nurse services despite a need for such services. Need for assistance in activities of daily living, presence of a respiratory disease, need for continued medical/nursing care after discharge, inadequate capacity for family caregiving, and implementation of discharge planning were related to use of, and need for, visiting nurse services.

Conclusion

After controlling for other factors, implementation of discharge planning determined the utilization of, and the need for, nursing care after discharge. Therefore, an adequate discharge planning screening system is necessary.
Neuroimaging of brain changes associated with cognitive impairment in Parkinson's disease
Authors: Christopher Leigh , Strafella Antonio P.
Published: April 2013

Cognitive impairment occurs frequently in Parkinson's disease (PD) and the concept of Mild Cognitive Impairment in PD (PD‐MCI) has recently emerged. Patients with mild impairment are at risk of developing dementia, and thus it is a topic of growing interest. Many previous studies have investigated the neural correlates of cognitive impairment, in particular executive dysfunction, in PD patients without dementia using neuroimaging techniques including structural MRI, functional MRI and PET imaging. These studies, which have provided a foundation for understanding which brain regions and neurotransmitter systems may be involved in executive dysfunction in PD, will be reviewed. Recent neuroimaging studies that have used specific criteria to classify patients as PD‐MCI, in the hopes of gaining further insight into the underlying neural mechanisms will also be discussed. In particular, this review will cover key findings involving structural MRI investigating grey and white matter changes, functional MRI to examine changes in neural activation and PET imaging to investigate metabolic and neurochemical changes that have led to an improved understanding of pathology associated with executive dysfunction in PD without dementia and PD‐MCI.
Product Market Threats, Payouts, and Financial Flexibility
Authors: HOBERG GERARD , PHILLIPS GORDON , PRABHALA NAGPURNANAND
Published: April 2013

We examine how product market threats influence firm payout policy and cash holdings. Using firms' product text descriptions, we develop new measures of competitive threats. Our primary measure, product market fluidity, captures changes in rival firms' products relative to the firm's products. We show that fluidity decreases firm propensity to make payouts via dividends or repurchases and increases the cash held by firms, especially for firms with less access to financial markets. These results are consistent with the hypothesis that firms' financial policies are significantly shaped by product market threats and dynamics.
Experience with a Novel Retrograde Wiring Technique for Coronary Chronic Total Occlusion
Authors: KIM MOO HYUN , YU LONG‐HAO , TANAKA HIROYUKI , MITSUDO KAZUAKI
Published: April 2013

Objectives

We report our evaluation of a novel retrograde wiring technique known as the Rendezvous method.

Background

Different strategies of retrograde approaches can be used to improve the success rate of recanalization of coronary chronic total occlusion (CTO). We previously introduced the Rendezvous technique as an alternative final step for a retrograde CTO procedure.

Methods

From July 2007 to May 2010, 20 CTO patients were treated in two medical centers using the Rendezvous method, which is an alternative to the conventional final externalization method to complete the retrograde CTO procedure. It involves crossing of the guidewire through the CTO segment using 2 microcatheters.

Results

The majority of the CTO sites were in the proximal right coronary artery (50.0%). Most of the lesions had mild to moderate calcification (95.0%) and revealed an abrupt stump with a side branch at the occlusion site. The lesion length of the occlusion was relatively long (median 27.6 mm; range of 7.1–87.3 mm). No adverse cardiac events occurred during hospitalization.

Conclusion

The Rendezvous method used during the retrograde approach can be performed as an alternative to the conventional “externalization method” after the guidewire and microcatheter have crossed the occluded proximal segment into the opposite guiding catheter. (J Interven Cardiol 2013;26:254–258)
Effect of Surface Modification on the Bond Strength between Zirconia and Resin Cement
Authors: Egilmez Ferhan , Ergun Gulfem , Cekic‐Nagas Isil , Vallittu Pekka K. , Ozcan Mutlu , Lassila Lippo V.J.
Published: April 2013

Purpose

This study aimed to evaluate the micro push‐out (μ‐PO) bond strength between zirconia and resin cement after addition of zirconia particles to increase the surface roughness.

Materials and Methods

Y‐TZP zirconia specimens in three experimental groups were subjected to Y‐TZP particle deposition via dipping into the milling residue suspension at different times prior to the sintering process. The dipping procedure was repeated twice for each specimen in group B, six times in group C, and ten times in group D. The specimens subjected to airborne‐particle abrasion (110 μm Al2O3, Rocatec Pre) acted as the control group (group A). All of the specimens were then bonded using adhesive resin cement (RelyX Ultimate). A μ‐PO test was used to determine the bond strength values. One‐way ANOVA at a 5% confidence level was performed for data analysis. Optical microscopy and scanning electron microscopy (SEM) were used to evaluate the failure modes and surface structure.

Results

Y‐TZP particle deposition did not have a significant effect on the bond strength of the resin cement to zirconia specimens when compared to the control (p = 0.141). Higher bond strength values were observed in groups C and D than in control. The surface layer presented blister‐like porosities with openings of various diameters ranging between 2 and 4 μm.

Conclusion

Y‐TZP particle deposition after dipping six and ten times did not improve the mean bond strength statistically but presented surface topography that may be favorable for increased micromechanical retention for adhesive resin cement.

Clinical Significance

Y‐TZP particle deposition may create a more retentive surface than airborne‐particle abrasion for adhesive bonding between zirconia surface and resin cement.
Comparison of Marginal Fidelity and Surface Roughness of Porcelain Veneers Fabricated by Refractory Die and Pressing Techniques
Authors: Jha Ritu , Jain Veena , Das Taposh K. , Shah Naseem , Pruthi Gunjan
Published: April 2013

Purpose

The aim of the present study was to compare the marginal fidelity and surface roughness of porcelain veneers fabricated by the refractory die and pressing techniques under in vivo conditions.

Materials and Methods

A total of 72 veneers were prepared for anterior teeth in 12 participants. Veneers on anterior teeth in the first and second quadrants were fabricated using refractory die (group I) and pressing techniques (group II), respectively. Surface roughness was evaluated using a profilometer in three areas (cervical, mesio‐incisal, disto‐incisal) for each veneer. Marginal adaptation of all the veneers (N = 36/group) was evaluated at each margin (cervical, incisal, mesial, and distal) at 7 days and at 3 months after cementation under a scanning electron microscope (SEM) at 200× magnification.

Results

The mean surface roughness of veneers in cervical, mesio‐incisal, and disto‐incisal areas was 0.41 ± 0.25, 0.33 ± 0.14, and 0.32 ± 0.14 μm, respectively, for group I; and 0.31 ± 0.11, 0.36 ± 0.18, and 0.29 ± 0.11 μm, respectively, for group II. Intra‐ and intergroup comparisons showed no statistically significant values for all areas (p > 0.05). In 144 margins evaluated for each group, a visible gap was present in 15 (10.4%) and 18 (12.5%) recordings at 7 days for groups I and II, respectively. They increased to 19 (13.1%) and 20 (13.8%) after 3 months. These gaps were further broken down into percent distribution of total recordings at the cervical, incisal, mesial, and distal margins. Intragroup comparison was made using the Cochrane test. The chi‐square test and Fisher's exact test were used for intergroup comparison of margins, revealing no statistical difference (p > 0.05)

Conclusion

Within the limitations of the study, the surface roughness and marginal fidelity of porcelain veneers fabricated by refractory die technique and pressing technique were comparable.
Orthodontic Treatment and Implant‐Prosthetic Rehabilitation of a Partially Edentulous Patient
Authors: Farret Milton MB , Farret Marcel Marchiori , Carlesso Jhosué , Carlesso Oscar
Published: April 2013

This article describes the treatment of a 61‐year‐old man who had a completely edentulous maxillary arch and partially edentulous mandibular arch. The patient was orthodontically treated to correct an anterior crossbite by distalization of the mandibular teeth using a removable prosthesis serving as an anchorage unit. Subsequently, the patient received two zygomatic implants, five conventional implants in the maxillary arch, and six conventional implants in the mandibular arch. By the end of treatment, the convexity of the facial profile improved, and esthetic and functional occlusion was established.
Reverse Activated Hyrax Pressure Appliance for Treatment of a Keloid Located at Auricula Helix
Authors: Yüzbaşıoğlu Emir
Published: April 2013

Keloids are considered aberrations of the wound healing process, and various treatment regimens are described depending on the morphology and size of the lesion. Compression therapy using custom‐made pressure clips or splints is widely used for the treatment of keloids. The most common complication of this therapy is ulceration due to excessive soft tissue pressure, resulting in delays and prolonged treatment time. This article describes the fabrication of a custom‐made pressure appliance for the treatment of a keloid located at the auricle helix. The pressure appliance can be modified to fit the auricle helix and covers the area needing pressure.
Plastic Damage Induced Fracture Behaviors of Dental Ceramic Layer Structures Subjected to Monotonic Load
Authors: Wang Raorao , Lu Chenglin , Arola Dwayne , Zhang Dongsheng
Published: April 2013

Purpose

The aim of this study was to compare failure modes and fracture strength of ceramic structures using a combination of experimental and numerical methods.

Materials and Methods

Twelve specimens with flat layer structures were fabricated from two types of ceramic systems (IPS e.max ceram/e.max press‐CP and Vita VM9/Lava zirconia‐VZ) and subjected to monotonic load to fracture with a tungsten carbide sphere. Digital image correlation (DIC) and fractography technology were used to analyze fracture behaviors of specimens. Numerical simulation was also applied to analyze the stress distribution in these two types of dental ceramics.

Results

Quasi‐plastic damage occurred beneath the indenter in porcelain in all cases. In general, the fracture strength of VZ specimens was greater than that of CP specimens. The crack initiation loads of VZ and CP were determined as 958 ± 50 N and 724 ± 36 N, respectively. Cracks were induced by plastic damage and were subsequently driven by tensile stress at the elastic/plastic boundary and extended downward toward to the veneer/core interface from the observation of DIC at the specimen surface. Cracks penetrated into e.max press core, which led to a serious bulk fracture in CP crowns, while in VZ specimens, cracks were deflected and extended along the porcelain/zirconia core interface without penetration into the zirconia core. The rupture loads for VZ and CP ceramics were determined as 1150 ± 170 N and 857 ± 66 N, respectively.

Conclusions

Quasi‐plastic deformation (damage) is responsible for crack initiation within porcelain in both types of crowns. Due to the intrinsic mechanical properties, the fracture behaviors of these two types of ceramics are different. The zirconia core with high strength and high elastic modulus has better resistance to fracture than the e.max core.