bluuebunny/crossref_metadata_2025 huggingface dataset:
History and Experience: A Survey of Traditional Chinese Medicine Treatment for Alzheimer′s Disease
Authors: Liu Ping , Kong Mingwang , Yuan Shihe , Liu Junfeng , Wang Ping
Published: January 2014

Traditional Chinese medicine (TCM) is practiced in the Chinese health care system for more than 2,000 years. In recent years, herbal medicines, which are used to treat Alzheimer′s disease (AD) in China based on TCM or modern pharmacological theories have attracted considerable attention. In this paper, we discuss etiology and pathogenesis of AD, TCM therapy, and herbal extracts for the treatment of AD. There is evidence to suggest that TCM therapy may offer certain complementary cognitive benefits for the treatment of AD. Chinese herb may have advantages with multiple target regulation compared with the single‐target antagonist in view of TCM.
A New Technique to Compute Coupled Coincidence Points
Authors: Jain Manish , Gupta Neetu , Kumar Sanjay
Published: January 2014

We compute coupled coincidence points without assuming the condition of compatibility of the pair of maps and relaxing the continuity condition of both the maps. In fact, our technique improves the technique introduced by Sintunavarat et al. (2011) which was then used by Hussain et al. (2012) to obtain coupled coincidence points.
About Merging Threshold and Critical Flux Concepts into a Single One: The Boundary Flux
Authors: Stoller Marco , Ochando-Pulido Javier M.
Published: January 2014

In the last decades much effort was put in understanding fouling phenomena on membranes. One successful approach to describe fouling issues on membranes is the critical flux theory. The possibility to measure a maximum value of the permeate flux for a given system without incurring in fouling issues was a breakthrough in membrane process design. However, in many cases critical fluxes were found to be very low, lower than the economic feasibility of the process. The knowledge of the critical flux value must be therefore considered as a good starting point for process design. In the last years, a new concept was introduced, the threshold flux, which defines the maximum permeate flow rate characterized by a low constant fouling rate regime. This concept, more than the critical flux, is a new practical tool for membrane process designers. In this paper a brief review on critical and threshold flux will be reported and analyzed. And since the concepts share many common aspects, merged into a new concept, called the boundary flux, the validation will occur by the analysis of previously collected data by the authors, during the treatment of olive vegetation wastewater by ultrafiltration and nanofiltration membranes.
Articulated Arm Coordinate Measuring Machine Calibration by Laser Tracker Multilateration
Authors: Santolaria Jorge , Majarena Ana C. , Samper David , Brau Agustín , Velázquez Jesús
Published: January 2014

A new procedure for the calibration of an articulated arm coordinate measuring machine (AACMM) is presented in this paper. First, a self-calibration algorithm of four laser trackers (LTs) is developed. The spatial localization of a retroreflector target, placed in different positions within the workspace, is determined by means of a geometric multilateration system constructed from the four LTs. Next, a nonlinear optimization algorithm for the identification procedure of the AACMM is explained. An objective function based on Euclidean distances and standard deviations is developed. This function is obtained from the captured nominal data (given by the LTs used as a gauge instrument) and the data obtained by the AACMM and compares the measured and calculated coordinates of the target to obtain the identified model parameters that minimize this difference. Finally, results show that the procedure presented, using the measurements of the LTs as a gauge instrument, is very effective by improving the AACMM precision.
Nonlinear Dynamics of Controlled Synchronizations of Manipulator System
Authors: Han Qingkai , Zhang Hao , Liu Jinguo
Published: January 2014

The nonlinear dynamics of the manipulator system which is controlled to achieve the synchronization motions is investigated in the paper. Firstly, the control strategies and modeling approaches of the manipulator system are given, in which the synchronization goal is defined by both synchronization errors and its derivatives. The synchronization controllers applied on the manipulator system include neuron synchronization controller, improved OPCL synchronization controller, and MRAC‐PD synchronization controller. Then, an improved adaptive synchronized control strategy is proposed in order to estimate online the unknown structure parameters and state variables of the manipulator system and to realize the needed synchronous compensation. Furthermore, a robust adaptive synchronization controller is also researched to guarantee the dynamic stability of the system. Finally, the stability of motion synchronizations of the manipulator system possessing nonlinear component is discussed, together with the effect of control parameters and joint friction and others. Some typical motions such as motion bifurcations and the loss of synchronization of it are obtained and illustrated as periodic, multiperiodic, and/or chaotic motion patterns.
Quality of Tuberculosis Care in Private Health Facilities of Addis Ababa, Ethiopia
Authors: Gebrekidan Gezahegn , Tesfaye Gezahegn , Hambisa Mitiku Teshome , Deyessa Negussie
Published: January 2014

Ensuring provision of good quality tuberculosis (TB) care, especially in private for profit health facilities, is an important component of TB control strategy to reduce poor medical practice which results in multidrug resistant TB (MDR-TB). The aim of this study was to investigate quality of TB care in private health facilities of Addis Ababa. A facility based cross-sectional study was conducted based on Donabedian’s structure-process-outcome model of health care quality. Quality of care was determined by adherence to National TB Program guidelines, treatment success rate, and client satisfaction. Exit interview was conducted on 292 patients on the intensive phase of treatment and 384 patient records were reviewed in eight private health facilities. Initial diagnostic AFB test was done for 95.4% of pulmonary TB patients. Most important components of TB care recommended by national guidelines were delivered for a significant proportion of patients. Majority (75%) of the clients were found to be satisfied with each component of TB care. The treatment success rate was 90.9%. The quality of TB care was fairly good. However, only 77.7% of the patients were counseled for HIV testing. Strengthening HIV counseling and testing, tackling shortage of streptomycin and laboratory reagent at private TB clinic is crucial.
Gamma-Ray Attenuation to Evaluate Soil Porosity: An Analysis of Methods
Authors: Pires Luiz F. , Pereira André B.
Published: January 2014

Soil porosity (ϕ) is of a great deal for environmental studies due to the fact that water infiltrates and suffers redistribution in the soil pore space. Many physical and biochemical processes related to environmental quality occur in the soil porous system. Representative determinations ofϕare necessary due to the importance of this physical property in several fields of natural sciences. In the current work, two methods to evaluateϕwere analyzed by means of gamma-ray attenuation technique. The first method uses the soil attenuation approach through dry soil and saturated samples, whereas the second one utilizes the same approach but taking into account dry soil samples to assess soil bulk density and soil particle density to determineϕ. The results obtained point out a good correlation between both methods. However, whenϕis obtained through soil water content at saturation and a 4 mm collimator is used to collimate the gamma-ray beam the first method also shows good correlations with the traditional one.
Medical Students’ Experience of and Reaction to Stress: The Role of Depression and Anxiety
Authors: Saravanan Coumaravelou , Wilks Ray
Published: January 2014

Background. Medical school is recognized as a stressful environment that often has a negative effect on students’ academic performance, physical health, and psychosocial well-being. Previous studies have not identified differences between depressed and nondepressed and anxious and nonanxious medical students’ experiences of stress or their reactions to stressors. The present study aimed to identify the prevalence of depression and anxiety among a sample of 358 medical students attending a private university in Malaysia and to examine differences according to participants’ gender, year of study, and stage of training (preclinical and clinical). Additionally, this study examined the extent to which stress predicts depression and anxiety, differences between depressed and nondepressed medical students’ experiences of and reactions to stressors, and differences between anxious and nonanxious medical students’ experiences of and reactions to stressors.Methods. The Student Life Stress Inventory was used to measure stress and reaction to stressors and the Depression, Anxiety, and Stress Scale was used to measure depression and anxiety.Results. The results showed that 44% (n=158) of the students were anxious and 34.9% (n=125) were depressed. More female students exhibited anxiety compared to male students. Stress is a predictor for depression and anxiety. A significant difference was found between depressed and nondepressed and anxious and nonanxious students’ experience of stressors due to frustration, change, and their emotional reaction to stressors.Conclusion. Overall, depressed and anxious students were found to experience more stress and react differently to stressors compared to nondepressed and nonanxious students.
New Graduate Nurses’ Clinical Competence, Clinical Stress, and Intention to Leave: A Longitudinal Study in Taiwan
Authors: Cheng Ching-Yu , Tsai Hsiu-Min , Chang Chia-Hao , Liou Shwu-Ru
Published: January 2014

This longitudinal research study aimed to develop a pregraduation clinical training program for nursing students before graduation and evaluate its effect on students’ self-perceived clinical competence, clinical stress, and intention to leave current job. A sample of 198 students returned the questionnaires before and after the program. They were followed up at 3, 6, and 12 months after graduation. Results showed that posttest clinical competence was significantly higher than pretest competence, positively related to clinical competence at 3 and 12 months, and negatively related to clinical stress at 3 months. The clinical competence at 3 months was positively related to clinical competence at 6 and 12 months, and clinical competence at 6 months was related to intention to leave at 12 months. Intention to leave at 6 months was positively related to intention to leave at 3 and 12 months. Clinical stress at 3 months was positively related to clinical stress at 6 and 12 months, but not related to intention to leave at any time points. The training program improved students’ clinical competence. The stressful time that was correlated with new graduate nurses’ intention to leave their job was between the sixth and twelfth months after employment.
Synthesis and Characterization of One-Dimensional Porous (Zn,Cd)S/SiO2Composite Nanostructural Materials
Authors: Fu Xiuli , Ban Guijun , Li Dan , Chen Hanyuan , Peng Zhijian
Published: January 2014

One-dimensional (1D) porous (Zn,Cd)S/SiO2composite nanostructural materials were synthesized by thermal evaporation of ZnS and CdS mixture powder at 950°C. The nanomaterials were collected from silicon wafers which were coated with 10 nm thick gold and were set apart from the source about 10 cm away. The diameter of the as-prepared 1D porous composite nanostructures is in the range of 1–1.5 μm and their lengths are up to tens to hundreds of micrometers. The photoluminescence spectra measured at different temperatures of the prepared nanostructures display a similar broadband signature, which can be fitted by Gaussian function into three emission peaks centered at 477, 536, and 588 nm and attributed to band edge emission, neutral oxygen vacancies, and antisymmetric stretching of Si–O–Si and nonstoichiometric SiOx(1<x<2), respectively.
New Estimators and Guidelines for Better Use of Fetal Heart Rate Estimators with Doppler Ultrasound Devices
Authors: Voicu Iulian , Ménigot Sébastien , Kouamé Denis , Girault Jean-Marc
Published: January 2014

Characterizing fetal wellbeing with a Doppler ultrasound device requires computation of a score based on fetal parameters. In order to analyze the parameters derived from the fetal heart rate correctly, an accuracy of 0.25 beats per minute is needed. Simultaneously with the lowest false negative rate and the highest sensitivity, we investigated whether various Doppler techniques ensure this accuracy. We found that the accuracy was ensured if directional Doppler signals and autocorrelation estimation were used. Our best estimator provided sensitivity of 95.5%, corresponding to an improvement of 14% compared to the standard estimator.
Adaptive Backstepping Finite Time Attitude Control of Reentry RLV with Input Constraint
Authors: Wang Fang , Zong Qun , Tian Bailing
Published: January 2014

This paper presents the finite time attitude tracking control problem of reusable launch vehicle (RLV) in reentry phase under input constraint, model uncertainty, and external disturbance. A control‐oriented model of rotational dynamics is developed and used for controller design for the complex coupling of the translational and rotational dynamics. Firstly, fast terminal sliding mode control is incorporated into backstepping control to design controller considering model uncertainty and external disturbance. The “explosion of terms” problem inherent in backstepping control is eliminated by a robust second order filter. Secondly, the control problem in the presence of input constraint is further considered, and a constrained adaptive backstepping fast terminal sliding mode control scheme is developed. At the control design level, adaptive law is employed to estimate the unknown norm bound of lumped uncertainty with the reduction of computational burden. The Lyapunov‐based stability analysis of the closed‐loop system is carried out. The control performance is presented via the simulation of six‐degree‐of‐freedom (6‐DOF) model of RLV.
Chronic Ethanol Feeding Modulates Inflammatory Mediators, Activation of Nuclear Factor-κB, and Responsiveness to Endotoxin in Murine Kupffer Cells and Circulating Leukocytes
Authors: Maraslioglu Miriam , Oppermann Elsie , Blattner Carolin , Weber Roxane , Henrich Dirk , Jobin Christian , Schleucher Elke , Marzi Ingo , Lehnert Mark
Published: January 2014

Chronic ethanol abuse is known to increase susceptibility to infections after injury, in part, by modification of macrophage function. Several intracellular signalling mechanisms are involved in the initiation of inflammatory responses, including the nuclear factor-κB (NF-κB) pathway. In this study, we investigated the systemic and hepatic effect of chronic ethanol feeding onin vivoactivation of NF-κB in NF-κBEGFPreporter gene mice. Specifically, the study focused on Kupffer cell proinflammatory cytokines IL-6 and TNF-αand activation of NF-κB after chronic ethanol feeding followed byin vitrostimulation with lipopolysaccharide (LPS). We found that chronic ethanol upregulated NF-κB activation and increased hepatic and systemic proinflammatory cytokine levels. Similarly, LPS-stimulated IL-1βrelease from whole blood was significantly enhanced in ethanol-fed mice. However, LPS significantly increased IL-6 and TNF-αlevels. These results demonstrate that chronic ethanol feeding can improve the responsiveness of macrophage LPS-stimulated IL-6 and TNF-αproduction and indicate that this effect may result from ethanol-induced alterations in intracellular signalling through NF-κB. Furthermore, LPS and TNF-αstimulated the gene expression of different inflammatory mediators, in part, in a NF-κB-dependent manner.
Coverage Extension and Balancing the Transmitted Power of the Moving Relay Node at LTE-A Cellular Network
Authors: Aldhaibani Jaafar A. , Yahya Abid , Ahmad R. Badlishah
Published: January 2014

The poor capacity at cell boundaries is not enough to meet the growing demand and stringent design which required high capacity and throughput irrespective of user’s location in the cellular network. In this paper, we propose new schemes for an optimum fixed relay node (RN) placement in LTE-A cellular network to enhance throughput and coverage extension at cell edge region. The proposed approach mitigates interferences between all nodes and ensures optimum utilization with the optimization of transmitted power. Moreover, we proposed a new algorithm to balance the transmitted power of moving relay node (MR) over cell size and providing required SNR and throughput at the users inside vehicle along with reducing the transmitted power consumption by MR. The numerical analysis along with the simulation results indicates that an improvement in capacity for users is 40% increment at downlink transmission from cell capacity. Furthermore, the results revealed that there is saving nearly 75% from transmitted power in MR after using proposed balancing algorithm. ATDI simulator was used to verify the numerical results, which deals with real digital cartographic and standard formats for terrain.
Comparative Study of Multimodal Biometric Recognition by Fusion of Iris and Fingerprint
Authors: Benaliouche Houda , Touahria Mohamed
Published: January 2014

This research investigates the comparative performance from three different approaches for multimodal recognition of combined iris and fingerprints: classical sum rule, weighted sum rule, and fuzzy logic method. The scores from the different biometric traits of iris and fingerprint are fused at the matching score and the decision levels. The scores combination approach is used after normalization of both scores using the min-max rule. Our experimental results suggest that the fuzzy logic method for the matching scores combinations at the decision level is the best followed by the classical weighted sum rule and the classical sum rule in order. The performance evaluation of each method is reported in terms of matching time, error rates, and accuracy after doing exhaustive tests on the public CASIA-Iris databases V1 and V2 and the FVC 2004 fingerprint database. Experimental results prior to fusion and after fusion are presented followed by their comparison with related works in the current literature. The fusion by fuzzy logic decision mimics the human reasoning in a soft and simple way and gives enhanced results.
Interarm Difference in Blood Pressure: Reproducibility and Association with Peripheral Vascular Disease
Authors: Mehlsen Jesper , Wiinberg Niels
Published: January 2014

The present study aimed at examining the interarm difference in blood pressure and its use as an indicator of peripheral arterial disease (PAD). Data were included from consecutive patients referred from their general practitioner to our vascular laboratory for possible PAD aged 50 years or older without known cardiac disease, renal disease, or diabetes mellitus. 824 patients (453 women) with mean age of 72 years (range: 50–101) were included. 491 patients had a diagnosis of hypertension and peripheral arterial disease (PAD) was present in 386 patients. Systolic blood pressure was 143 ± 24 mmHg and 142 ± 24 mmHg on the right and left arm, respectively (P=0.015). The interarm difference was greater in patients with hypertension (P=0.002) and PAD (P<0.0005). 443 patients were measured on two separate occasions and the interarm difference for systolic blood pressure was reproducible for differences >20 mmHg. This study confirmed the presence of a systematic but clinically insignificant difference in systolic blood pressure between arms. The interarm difference was larger in hypertension and PAD. Consistent lateralisation is present for differences ≥20 mmHg and an interarm difference >25 mmHg is a reliable indicator of PAD in the legs.
Correction of Faulty Sensors in Phased Array Radars Using Symmetrical Sensor Failure Technique and Cultural Algorithm with Differential Evolution
Authors: Khan S. U. , Qureshi I. M. , Zaman F. , Shoaib B. , Naveed A. , Basit A.
Published: January 2014

Three issues regarding sensor failure at any position in the antenna array are discussed. We assume that sensor position is known. The issues include raise in sidelobe levels, displacement of nulls from their original positions, and diminishing of null depth. The required null depth is achieved by making the weight of symmetrical complement sensor passive. A hybrid method based on memetic computing algorithm is proposed. The hybrid method combines the cultural algorithm with differential evolution (CADE) which is used for the reduction of sidelobe levels and placement of nulls at their original positions. Fitness function is used to minimize the error between the desired and estimated beam patterns along with null constraints. Simulation results for various scenarios have been given to exhibit the validity and performance of the proposed algorithm.
Differences in Brain Transcriptomes of Closely Related Baikal Coregonid Species
Authors: Bychenko Oksana S. , Sukhanova Lyubov V. , Azhikina Tatyana L. , Skvortsov Timofey A. , Belomestnykh Tuyana V. , Sverdlov Eugene D.
Published: January 2014

The aim of this work was to get deeper insight into genetic factors involved in the adaptive divergence of closely related species, specifically two representatives of Baikal coregonids—Baikal whitefish (Coregonus baicalensisDybowski) and Baikal omul (Coregonus migratoriusGeorgi)—that diverged from a common ancestor as recently as 10–20 thousand years ago. Using the Serial Analysis of Gene Expression method, we obtained libraries of short representative cDNA sequences (tags) from the brains of Baikal whitefish and omul. A comparative analysis of the libraries revealed quantitative differences among ~4% tags of the fishes under study. Based on the similarity of these tags with cDNA of known organisms, we identified candidate genes taking part in adaptive divergence. The most important candidate genes related to the adaptation of Baikal whitefish and Baikal omul, identified in this work, belong to the genes of cell metabolism, nervous and immune systems, protein synthesis, and regulatory genes as well as to DTSsa4 Tc1-like transposons which are widespread among fishes.
The Consequences of Tongue Piercing on Oral and Periodontal Tissues
Authors: Plastargias Ioannis , Sakellari Dimitra
Published: January 2014

This paper is discussing the potential consequences that may arise by the implementation of piercing in the oral cavity and is also categorizing the consequences according to their extent and severity. Furthermore, this paper is reviewing some possible oral hygiene methods that can prove to be auxiliary in decreasing the potential complications arising from oral piercing. This literature review is based on articles published from 1985 to 2012.
Optimization of Agave tequilana Weber var. Azul Juice Spray Drying Process
Authors: Chávez-Rodríguez Alejandra , López-Muraira Irma G. , Goméz-Leyva Juan F. , Luna-Solano Guadalupe , Ortíz-Basurto Rosa I. , Andrade-González Isaac
Published: January 2014

In this work, the response surface methodology was employed to optimize the microencapsulation of Agave tequilana Weber var. azul juice with whey protein isolated using a spray drying technique. A Box-Behnken design was used to establish optimum spray drying conditions for Agave tequilana juice. The process was optimized to obtain maximum powder yield with the best solubility time, hygroscopicity, bulk density, water activity, and reducing sugars. The independent parameters for the spray drying process were outlet temperature of 70–80°C, atomizer speed of 20000–30000 rpm, and airflow of 0.20–0.23 m3 s−1. The best spray drying condition was at outlet temperature of 80°C, atomizer speed of 20000 rpm, and air flow rate of 0.23 m3 s−1 to obtain maximum powder yield (14.65%bm), minimum solubility time (352.8 s), maximum bulk density (560 kg m−3), minimum hygroscopicity (1.9×10-7 kgwater s−1), and minimum aw (0.39). The Agave tequilana powder may be considered as an interesting source of dietary fiber used as food additive in food and nutraceutical industries.
Daytime Sleepiness: Associations with Alcohol Use and Sleep Duration in Americans
Authors: Chakravorty Subhajit , Jackson Nicholas , Chaudhary Ninad , Kozak Philip J. , Perlis Michael L. , Shue Holly R. , Grandner Michael A.
Published: January 2014

The aim of the current analysis was to investigate the relationship of daytime sleepiness with alcohol consumption and sleep duration using a population sample of adult Americans. Data was analyzed from adult respondents of the National Health and Nutritional Examination Survey (NHANES) 2007-2008 (N=2919) using self-reported variables for sleepiness, sleep duration, and alcohol consumption (quantity and frequency of alcohol use). A heavy drinking episode was defined as the consumption of ≥5 standard alcoholic beverages in a day. Logistic regression models adjusted for sociodemographic variables and insomnia covariates were used to evaluate the relationship between daytime sleepiness and an interaction of alcohol consumption variables with sleep duration. The results showed that daytime sleepiness was reported by 15.07% of the subjects. In univariate analyses adjusted for covariates, an increased probability of daytime sleepiness was predicted by decreased log drinks per day [OR = 0.74 (95% CI, 0.58–0.95)], a decreased log drinking frequency [0.90 (95% CI, 0.83–0.98)], and lower sleep duration [OR = 0.75 (95% CI, 0.67–0.84)]. An interaction between decreased sleep duration and an increased log heavy drinking frequency predicted increased daytime sleepiness (P=0.004). Thus, the effect of sleep duration should be considered when evaluating the relationship between daytime sleepiness and heavy drinking.
Trace Elements Analysis in Drinking Water of Meghalaya by Using Graphite Furnace-Atomic Absorption Spectroscopy and in relation to Environmental and Health Issues
Authors: Dkhar Elarina N. , Dkhar Paul S. , Anal Jasha Momo H.
Published: January 2014

Determination of the certain major and trace elements was carried out in drinking water supply scheme in three districts of Meghalaya. This work aims to identify trends resulting in the deterioration of drinking water which is also a potential source of environmental contaminants. About 50 samples, each from one district, were collected both from the source and various tanks and tap. The elements determined are Li, Na, Cr, Mn, Fe, Co, Ni, Cu, Zn, As, Rb, Ag, Au, Pb, Cd, Se, Ca, K, and Mg. The pH is slightly lower than neutral pH of 7 while the turbidity is very high even after treatment. The concentrations of Ca and Mg are found to be deficient. The elements Cr, Fe, Co, Ni, Zn, Mo, and Pb decrease after treatment while Mn, Cu, and Cd increase slightly after treatment. Se concentration is found to be much higher than expected. The results were compared with the standard recommendation values for the quality of drinking water. This study provides a general indication of where water-quality constituent concentrations met or exceeded water-quality standards and the data presented in this report will be useful from public health point of view.
p16INK4a Impairs Homologous Recombination–Mediated DNA Repair in Human Papillomavirus–Positive Head and Neck Tumors
Authors: Dok Rüveyda , Kalev Peter , Van Limbergen Evert Jan , Asbagh Layka Abbasi , Vázquez Iria , Hauben Esther , Sablina Anna , Nuyts Sandra
Published: January 2014

The p16INK4a protein is a principal cyclin-dependent kinase inhibitor that decelerates the cell cycle. Abnormally high levels of p16INK4a are commonly observed in human papillomavirus (HPV)–positive head and neck squamous cell carcinomas (HNSCC). We and others found that p16INK4a overexpression is associated with improved therapy response and survival of patients with HNSCC treated with radiotherapy. However, the functional role of p16INK4a in HNSCC remains unexplored. Our results implicate p16INK4a in regulation of homologous recombination–mediated DNA damage response independently from its role in control of the cell cycle. We found that expression of p16INK4a dramatically affects radiation sensitivity of HNSCC cells. p16INK4a overexpression impairs the recruitment of RAD51 to the site of DNA damage in HPV-positive cells by downregulating of cyclin D1 protein expression. Consistent with the in vitro findings, immunostaining of HNSCC patient samples revealed that high levels p16INK4a expression significantly correlated with decreased cyclin D1 expression. In summary, these findings reveal an unexpected function of p16INK4a in homologous recombination–mediated DNA repair response and imply p16INK4a status as an independent marker to predict response of patients with HNSCC to radiotherapy. Cancer Res; 74(6); 1739–51. ©2014 AACR.
Childhood Oral Health and SES Predictors of Caries in 30-Year-Olds
Authors: Brennan D.S. , Spencer A.J.
Published: January 2014

Background/Aims: To assess whether childhood socio-economic status modifies the relationship between childhood caries and young adult oral health. Methods: In 1988-1989, a total of 7,673 South Australian children aged 13 years were sampled, with 4,604 children (60.0%) and 4,476 parents (58.3%) responding. In 2005-2006, 632 baseline study participants responded (43.0% of those traced and living in Adelaide). Results: Adjusted analyses showed significant interactions for card status by DMFT at age 13 for decayed, missing and filled teeth at age 30, but not for DMFT. Higher DMFT at age 13 was associated with more decayed teeth at age 30 for those with no health card, while there were similar numbers of decayed teeth for card holders regardless of their DMFT at age 13. While higher DMFT at age 13 was associated with more missing teeth at age 30 for card holders, there were similar numbers of missing teeth for those with no card regardless of their DMFT at age 13. The interaction for filled teeth showed that even though higher DMFT at age 13 was associated with more fillings at age 30 for both card holders and those with no card, this relationship was more pronounced for card holders. Conclusions: SES modified the relationship between child oral health and caries at age 30 years. Card holders at age 13 were worse off in terms of their oral health at age 30 controlling for childhood oral health, supporting social causation explanations for oral health inequalities.
Measuring Initial Enamel Erosion with Quantitative Light-Induced Fluorescence and Optical Coherence Tomography: An in vitro Validation Study
Authors: Chew H.P. , Zakian C.M. , Pretty I.A. , Ellwood R.P.
Published: January 2014

Background: Measurement of initial enamel erosion is currently limited to in vitro methods. Optical coherence tomography (OCT) and quantitative light-induced fluorescence (QLF) have been used clinically to study advanced erosion. Little is known about their potential on initial enamel erosion. Objectives: To evaluate the sensitivity of QLF and OCT in detecting initial dental erosion in vitro. Methods: 12 human incisors were embedded in resin except for a window on the buccal surface. Bonding agent was applied to half of the window, creating an exposed and non-exposed area. Baseline measurements were taken with QLF, OCT and surface microhardness. Samples were immersed in orange juice for 60 min and measurements taken stepwise every 10 min. QLF was used to compare the loss of fluorescence between the two areas. The OCT system, OCS1300SS (Thorlabs Ltd.), was used to record the intensity of backscattered light of both areas. Multiple linear regression and paired t test were used to compare the change of the outcome measures. Results: All 3 instruments demonstrated significant dose responses with the erosive challenge interval (p < 0.05) and a detection threshold of 10 min from baseline. Thereafter, surface microhardness demonstrated significant changes after every 10 min of erosion, QLF at 4 erosive intervals (20, 40, 50 and 60 min) while OCT at only 2 (50 and 60 min). Conclusion: It can be concluded that OCT and QLF were able to detect demineralization after 10 min of erosive challenge and could be used to monitor the progression of demineralization of initial enamel erosion in vitro.
Should Cavitation in Proximal Surfaces Be Reported in Cone Beam Computed Tomography Examination?
Authors: Sansare K. , Singh D. , Sontakke S. , Karjodkar F. , Saxena V. , Frydenberg M. , Wenzel A.
Published: January 2014

Aim: A clinical study was done to assess the clinical diagnostic accuracy of cone beam computed tomography (CBCT) in detecting proximal cavitated carious lesions in order to determine whether cavitation should be reported when a CBCT examination is available. Materials and Methods: 79 adjacent proximal surfaces without restorations in permanent teeth were examined. Patients suspected to have carious lesions after a visual clinical and a bitewing examination participated in a CBCT examination (Kodak 9000 3D, 5 × 3.7 cm field of view, voxel size 0.07 mm). Ethical approval and informed consent were obtained according to the Helsinki Declaration. Radiographic assessment recording lesions with or without cavitation was performed by two observers in bitewings and CBCT sections. Orthodontic separators were placed interdentally between two lesion-suspected surfaces. The separator was removed after 3 days and the surfaces recorded as cavitated (yes/no), i.e. validated clinically. Differences between the two radiographic modalities (sensitivity, specificity and overall accuracy) were estimated by analyzing the binary data in a generalized linear model. Results: For both observers, sensitivity was significantly higher for CBCT than for bitewings (average difference 33%, p < 0.001) while specificity was not significantly different between the methods (p = 0.19). The overall accuracy was also significantly higher for CBCT (p < 0.001). Conclusion: CBCT was more accurate in detecting cavitation in proximal surfaces than bitewing radiographs; therefore a CBCT examination performed for other clinical applications should also be assessed for proximal surface cavities in teeth without restorations, and when detected, this pathology must be part of the dentist's report.
Characteristics, Detection Methods and Treatment of Questionable Occlusal Carious Lesions: Findings from The National Dental Practice-Based Research Network
Authors: Makhija S.K. , Gilbert G.H. , Funkhouser E. , Bader J.D. , Gordan V.V. , Rindal D.B. , Pihlstrom D.J. , Qvist V. ,   for the National Dental PBRN Collaborative Group
Published: January 2014

Questionable occlusal carious lesions (QOC) can be defined as an occlusal tooth surface with no cavitation and no radiographic radiolucencies, but caries is suspected due to roughness, surface opacities or staining. An earlier analysis of data from this study indicates 1/3 of patients have a QOC. The objective of this report has been to quantify the characteristics of these common lesions, the diagnostic aids used and the treatment of QOC. A total of 82 dentist and hygienist practitioner-investigators from the USA and Denmark in the National Dental Practice-Based Research Network participated. When consenting patients presented with a QOC, information was recorded about the patient, tooth, lesion and treatments. A total of 2,603 QOC from 1,732 patients were analyzed. The lesions were usually associated with a fissure, on molars, and varied from yellow to black in color. Half presented with a chalky luster and had a rough surface when examined with an explorer. There was an association between color and luster: 10% were chalky-light, 47% were shiny-dark and 42% were mixtures. A higher proportion of chalky than of shiny lesions were light (22 vs. 9%; p < 0.001). Lesions light in color were less common in adults than in pediatric patients (9 vs. 32%; p < 0.001). Lesions that were chalky and light were more common among pediatric than among adult patients (22 vs. 6%; p < 0.001). This is the first study to investigate characteristics of QOC in routine clinical practice. Clinicians commonly face this diagnostic uncertainty. Determining the characteristics of these lesions is relevant when making diagnostic and treatment decisions.
Organic Causes of Erectile Dysfunction in Men Under 40
Authors: Ludwig Wesley , Phillips Michael
Published: January 2014

There are a significant number of men under 40 who experience erectile dysfunction (ED). In the past, the vast majority of cases were thought to be psychogenic in nature. Studies have identified organic etiologies in 15-72% of men with ED under 40. Organic etiologies include vascular, neurogenic, Peyronie's disease (PD), medication side effects and endocrinologic sources. Vascular causes are commonly due to focal arterial occlusive disease. Young men with multiple sclerosis, epilepsy and trauma in close proximity to the spinal cord are at increased risk of ED. It is estimated that 8% of men with PD are under 40, with 21% of these individuals experiencing ED. Medications causing ED include antidepressants, NSAIDs and finasteride (Propecia), antiepileptics and neuroleptics. Hormonal sources are uncommon in the young population, however possible etiologies include Klinefelter's syndrome, congenital hypogonadotropic hypogonadism, and acquired hypogonadotropic hypogonadism. The workup of young men with ED should include a thorough history and physical examination. The significant prevalence of vascular etiologies of ED in young men should prompt consideration of nocturnal penile tumescence testing and penile Doppler ultrasound. Treatment options that may improve ED include exercise and oral PDE-5 inhibitors.
The Prognostic Value of T1 Bladder Cancer Substaging: A Single Institution Retrospective Study
Authors: Soukup V. , Dušková J. , Pešl M. , Čapoun O. , Feherová Z. , Zámečník L. , Hanuš T. , Babjuk M.
Published: January 2014

Objective: To evaluate the prognostic value of the depth of lamina propria invasion in patients with T1 bladder cancer. Subjects and Methods: 200 patients were treated between the years 2002 and 2009. Tumours with depth of invasion above the muscularis mucosae level were categorised as pT1a and those with depth of invasion up to or beyond the muscularis mucosae as pT1b. Results: Categorisation for pT1a and pT1b was performed in 176 of 200 patients (88%). In 10 patients a muscle-invasive tumour was found in re-transurethral resection samples. 131 (79%) of 166 analysed patients had pT1a tumour and 35 (21%) had pT1b tumour. During the follow-up, in 101 (61%) patients the tumour had recurred and in 27 (16.3%) the tumour had progressed. Of all the investigated parameters, T1 substaging (p < 0.0001), grade (p = 0.0003) and the number of bacillus Calmette-Guérin instillations (p = 0.0490) were significant in predicting progression. The only significant factor for disease-specific survival was T1 substaging in univariable (p = 0.0008) and multivariable (hazard ratio 4.407) analysis. T1 substaging (p = 0.0149) and tumour multiplicity (p = 0.0448) have a statistically significant prognostic value with respect to overall survival. Conclusions: Deep invasion of the lamina propria is a significant adverse prognostic factor for tumour progression, disease-specific survival and overall survival.
Skin-to-Stone Distance Has No Impact on Outcomes of Percutaneous Nephrolithotomy
Authors: Gonulalan Umut , Akand Murat , Coban Gokcen , Cicek Tufan , Kosan Murat , Goktas Serdar , Ozkardes Hakan
Published: January 2014

Objective: Skin-to-stone distance (SSD) is a stronger factor than body mass index in predicting the success of shock wave lithotripsy. We aimed to evaluate the impact of SSD on outcomes of percutaneous nephrolithotomy (PCNL). Materials and Methods: The medical records of 1,280 patients who had undergone PCNL between April 2007 and February 2012 were evaluated retrospectively. 192 patients who had had preoperative non-contrasted computed tomography and single renal access were included the study. According to this median SSD value, patients were divided into two groups: group 1 (SSD ≤94 mm) (n = 92) and group 2 (SSD >94 mm) (n = 90). The groups were compared according to operative and postoperative parameters. Results: We found no significant differences between the two groups with regard to stone-free rate, operation time, fluoroscopy time, hospitalization time, visual analog score of pain, stone burden, transfusion rates and complication rates. On the other hand, the mean body mass index of group 1 was significantly lower than that of group 2 (p < 0.05). Conclusions: In this retrospective review of patients undergoing PCNL, we found that SSD has no impact on operative and postoperative outcomes. These results were in accordance with the safety of PCNL in obese patients.
Biannual Fluoride Varnish Applications and Caries Incidence in Preschoolers: A 24-month Follow-Up Randomized Placebo-Controlled Clinical Trial
Authors: Oliveira B.H. , Salazar M. , Carvalho D.M. , Falcão A. , Campos K. , Nadanovsky P.
Published: January 2014

Sound evidence on the effectiveness of fluoride varnishes (FV) to reduce caries incidence in preschool children is lacking. Objective: To assess whether the application of FV in preschool children at 6-month intervals decreases the incidence of caries and produces any adverse effects. Methods: A randomized, examiner- and patient-blind, placebo-controlled, parallel-group design, clinical trial, comprising 1- to 4-year-old children, 100 in each group (FV or placebo varnish, PV), was conducted in Rio de Janeiro, Brazil. Two trained pediatric dentists performed the clinical examinations (kappa = 0.85). Dental caries was recorded at the d2 (cavitated enamel) and d3 (dentine) levels using the International Caries Diagnosis and Assessment System. Results: At baseline, the mean age of the participants was 2.4 years (SD 0.9) and the mean d3mfs was 0.8 (SD 1.9). Most of the children brushed their teeth with fluoride toothpaste and consumed fluoridated tap water. After 24 months, 89 and 92 children of the test and the control groups were analyzed, respectively. A total of 32 (35.9%) children in the FV group and 43 (46.7%) in the PV group presented new dentine caries lesions (χ2 test; p = 0.14), showing relative and absolute risk reductions of 23% (95% CI: -9.5 to 45.9) and 11% (95% CI: -3.5 to 25.0). The mean caries increment differences between the test and control groups were -0.8 (95% CI: -2.0 to 0.4) at the d2 level and -0.7 (95% CI: -1.9 to 0.4) at the d3 level. Only 2 minor complaints regarding the intervention were reported. Conclusion: Although safe and well accepted, twice-yearly professional FV application, during 2 years, did not result in a significant decrease in caries incidence.
Skeletal Metastatic Carcinomas from the Roman Period (1st to 5th Century AD) in Hungary
Authors: Merczi Mónika , Marcsik Antónia , Bernert Zsolt , Józsa László , Buczkó Krisztina , Lassányi Gábor , Kelemen Márta H. , Zádori Péter , Vandulek Csaba , Biró Gergely , Hajdu Tamás , Molnár Erika
Published: January 2014

Objectives: According to paleopathological records, tumors have a great antiquity. The prevalence of cancer in ancient populations might have differed from that in modern humans because of substantial differences in environmental factors, life expectancy and the availability of treatment. This study presents 3 cases of probable skeletal metastatic carcinoma from the Roman period (1st-5th century AD) in Hungary, showing the development of bone metastases of cancer without chemo- and radiotherapy. Methods: All skeletons were subjected to a careful macroscopic investigation, which was extended by radiological, stereo- and scanning electron microscopic analyses. Results: In 1 case, the mixed nature and localization of the lesions, as well as the sex and age of the individual, suggested breast cancer as the primary focus. In the other 2 cases, based on the mostly osteoblastic nature and the localization of the lesions as well as on the sex and age of the individuals, the most probable diagnostic option is prostate carcinoma with skeletal metastases. Conclusions: In view of the scarcity of cancer metastases that have been diagnosed in archeological specimens in general, identification of all examples of cancer in antiquity represents an important contribution both to paleopathology and to modern medicine.
Phase I Study of Nedaplatin Prior to S-1 in Patients with Locally Advanced Head and Neck Squamous Cell Carcinoma
Authors: Sato Dai , Kogashiwa Yasunao , Tsukahara Kiyoaki , Yamauchi Koichi , Kohno Naoyuki
Published: January 2014

Background: We previously reported on the regimen of S-1 plus nedaplatin (NDP), with S-1 was administered orally for 14 days and NDP intravenously on day 8. The maximum tolerated dose (MTD) of NDP was determined to be 90 mg/m2. The main toxicities were neutropenia and thrombocytopenia. This result was tolerated, but we believe there is a more effective and tolerable regimen. Thus, we investigated the S-1 regimen administered orally for 14 days, and NDP intravenously on day 1 in patients with locally advanced head and neck squamous cell carcinoma. Patients and Methods: Oral administration of S-1 (days 1-14) and intravenous NDP (day 1) were tested for patients with advance head and neck cancer in a phase I setting. The dose of S-1 was fixed and the dose of NDP was escalated from 70 mg/m2, with an increase of 10 mg/m2 per step, to find the MTD. Results: A total of 15 patients were registered. The MTD of NDP was determined to be 100 mg/m2. The main toxicities were neutropenia and thrombocytopenia. The response rate (RR) was 57.1%. Conclusions: The recommended dose of NDP for a phase II study was determined to be 100 mg/m2. We concluded that our regimen was well tolerated and that the RR was acceptable.
Foreign Material in the Gastrointestinal Tract: Cocaine Packets
Authors: Turkel Kucukmetin Nurten , Gucyetmez Bulent , Poyraz Tuncer , Yildirim Sadik , Boztas Gungor , Tozun Nurdan
Published: January 2014

Smuggling drugs by swallowing or inserting into a body cavity is not only a serious and growing international crime, but can also lead to lethal medical complications. The most common cause of death in ‘body packers', people transporting drugs by ingesting a packet into the gastrointestinal tract, is acute drug toxicity from a ruptured packet. However, more than 30 years after the initial report of body packing, there is still no definitive treatment protocol for the management of this patient group. The treatment strategy is determined according to the particular condition of the patient and the clinical experience of the treatment center. Surgical intervention is also less common now, due to both the use of improved packaging materials among smugglers and a shift towards a more conservative medical approach. Herein, we report a case of toxicity from ingested packets of cocaine that leaked and, despite surgery, resulted in exitus of the patient.