bluuebunny/crossref_metadata_2025 huggingface dataset:
Perioperative outcomes of robot‐assisted nephroureterectomy for upper urinary tract urothelial carcinoma: a multi‐institutional series
Authors: Pugh Joseph , Parekattil Sijo , Willis Daniel , Stifelman Michael , Hemal Ashok , Su Li‐Ming
Published: July 2013

Objective

To review a multi‐institutional series of robot‐assisted nephroureterectomy (RANU) for management of upper urinary tract urothelial carcinoma (UUTUC) with respect to technique and perioperative outcomes.

Patients and Methods

Between May 2007 and July 2011, 43 RANU were performed at three institutions for UUTUC with review of perioperative outcomes.

A three‐ or four‐armed robotic technique was used in all cases based on surgeon preference and the entirety of all procedures was performed using the robot‐assisted technique.

Single and two robot‐docking techniques are described.

Results

The mean (range) operating time was 247 (128–390) min, blood loss was 131 (10–500) mL and the median (range) length of stay was 3 (2–87) days.

Pathology was pTa in nine patients, pT1 in 14 patients, pT2 in three patients, pT3 in 15 patients and pT4 in two patients.

Lymph node dissection was performed in 22 patients (51%) with a mean (range) lymph node count of 11 (4–23).

There were six postoperative complications: bleeding requiring a blood transfusion (grade II), splenic bleeding (grade IV), two cases of pneumonia (grade II) and two cases of rhabdomyolysis (grades II and IV).

Nine recurrences (six bladder, two within the retroperitoneum and one in the contralateral collecting system) have been found to date on routine surveillance with a mean follow‐up of 9 months.

Conclusions

RANU is a feasible alternative to laparoscopic and open techniques.

Particular steps of the operation including sutured closure of the cystotomy and regional lymphadenectomy are facilitated with the use of robot‐assisted surgery.

Long‐term outcomes are necessary to assess the relative efficacy of these approaches to more established techniques; however, early perioperative outcomes appear promising.
Supporting communication for parents with intellectual impairments: communication facilitation in social work led parenting meetings
Authors: Matthews Alison , Stansfield Jois
Published: July 2013

Accessible summary

Parents who have a learning disability have to go to meetings with professionals such as social workers and lawyers.

Professionals do not always use easy words

If someone helps professionals and parents to listen to each other, it is easier to understand what they are saying

Listening and understanding is important for parents in meetings

People with intellectual impairments are recognised as having communication difficulties and even people with mild intellectual impairments can be challenged by complex language and limited literacy. The focus of this paper is parents who have learning disabilities, outlining a novel approach to support them in stressful case conference situations. Parents with intellectual impairments are frequently the subject of multiple interventions, case conferences and legal proceedings which challenge their communicative capacity. Case conferences often involve professionals with little or no experience of learning disability, including social workers and lawyers. The language in these case conferences can have complex sentence structure, low frequency legal vocabulary and difficult concepts, which are challenging for learning disabled parents to follow. The Communication Facilitator role is a recently developed approach to supporting parents in case conferences, aimed at enabling LD parents to understand and contribute to the proceedings. This paper reports the motivation and practical issues in developing the role, and the use of Communication Facilitator in child protection meetings where there are high stakes for not understanding, resulting in the potential removal of children from the parental home.
A snapshot of the Late Jurassic Western Tethys seafloor composition and morphology provided by the geochemistry of pelitic sediments (Corsica, Central Alps and Northern Apennines)
Authors: Bracciali L. , Pandolfi L. , Rocchi S.
Published: July 2013

The chemical composition of fine‐grained siliciclastic sediments is a powerful tool in provenance studies, either as a complement to other whole rock/single grain methods, or as a stand‐alone method when other techniques are not applicable, and particularly in those cases where the coarser sediment fractions are not available or the regional‐scale geologic framework is lost due major successive tectonic events. A comprehensive geochemical investigation of pelites from the post‐rift deposits of the Ligurian‐Piedmont ocean (sampled in tectonic units of the Alpine‐Apennine orogen: Balagne Nappe, Corsica; Tuscan Nappe and Internal Ligurian units, Northern Apennines; Err‐Platta units, Central Alps) has identified for the first time a major mafic‐ultramafic input immediately following rifting. Key trace element ratios (e.g. LaN/YbN < 10; avg. Eu/Eu* = 0.73 ± 0.06, 1SD; Th/(Cr + Ni + V) < 0.03) show that the pelitic siliciclastic layers intercalated in the Radiolarite Formation (the first post‐rift deposits) are systematically enriched in a mafic‐ultramafic source component compared with the younger post rift sediments (Calpionella Limestone and Palombini Shale). Such a peculiar chemical fingerprint is interpreted as the result of erosion and distribution across the whole basin (even to continental domains) of intraoceanic ophiolitic debris by turbidity and bottom currents sweeping the sea floor at the time of deposition of the Radiolarite Formation. Exhumed mantle and gabbroic‐basaltic rocks exposed at the morphologically articulated seafloor of the slow‐spreading Ligurian‐Piedmont ocean were available to erosion during the whole time‐span of the deposition of the Radiolarite Formation, whilst they became progressivey subordinate as a source as the basin floor was progressively covered by the siliciclastic input from the developing passive continental margins.
Amyloid precursor protein in human breast cancer: An androgen‐induced gene associated with cell proliferation
Authors: Takagi Kiyoshi , Ito Shigehiro , Miyazaki Toshiaki , Miki Yasuhiro , Shibahara Yukiko , Ishida Takanori , Watanabe Mika , Inoue Satoshi , Sasano Hironobu , Suzuki Takashi
Published: July 2013

Amyloid precursor protein (APP) is a transmembrane protein that is highly expressed in brain tissue. Recently, APP has been implicated in some human malignancies, and its regulation by androgens has also been demonstrated. Such findings suggest the importance of APP in hormone‐dependent breast carcinoma, but APP has not yet been examined in breast carcinoma tissues. Therefore, in this study, we examined the biological and clinical significance of APP in breast carcinoma using immunohistochemistry and in vitro studies. APP immunoreactivity was detected in 57 out of 117 (49%) breast carcinoma tissues examined, and it was positively associated with androgen receptor (AR) expression. APP immunoreactivity was also significantly associated with Ki‐67 LI and increased risk of recurrence in the estrogen receptor (ER)‐positive cases, and was an independent prognostic factor in these patients. Subsequent in vitro experiments demonstrated that APP mRNA expression was significantly induced by biologically active androgen dihydrotestosterone in both a dose‐dependent and a time‐dependent manner in MCF‐7 breast carcinoma cells, which was potently suppressed by an AR blocker hydroxyflutamide. Moreover, cell proliferation activity of MCF‐7 and MDA‐MB‐231 cells was significantly associated with their APP expression level. These findings suggest that APP is an androgen‐induced gene that promotes proliferation activity of breast carcinoma cells. Moreover, APP immunohistochemical status is considered a potent prognostic factor in ER‐positive breast cancer patients.
Identification of anaerobic threshold by analysis of heart rate variability during discontinuous dynamic and resistance exercise protocols in healthy older men
Authors: Simões Rodrigo Polaquini , Castello‐Simões Viviane , Mendes Renata Gonçalves , Archiza Bruno , dos Santos Daniel Augusto , Bonjorno José Carlos , de Oliveira Claudio Ricardo , Catai Aparecida Maria , Arena Ross , Borghi‐Silva Audrey
Published: July 2013

The purposes of this study were to determine anaerobic threshold (AT) during discontinuous dynamic and resistive exercise protocols by analysing of heart rate variability (HRV) and blood lactate (BL) in healthy elderly subjects and compare the cardiovascular, metabolic and autonomic variables obtained from these two forms of exercise. Fourteen elderly (70 ± 4 years) apparently healthy males underwent the following tests: (i) incremental ramp test on cycle ergometer, (ii) one repetition maximum (1RM) leg press at 45°, (iii) a discontinuous exercise test on a cycle ergometer (DET‐C) protocol and (iv) a resistance exercise leg press (DET‐L) protocol. Heart rate, blood pressure and BL were obtained during each increment of exercise intensity. No significant differences (P>0·05) were found between methods of AT determination (BL and HRV) nor the relative intensity corresponding to AT (30% of maximum intensity) between the types of exercise (DET‐C and DET‐L). Furthermore, no significant differences (P>0·05) were found between the DET‐C and DET‐L in relation to HRV, however, the DET‐L provided higher values of systolic blood pressure and BL (P<0·05) from the intensity corresponding to AT. We conclude that HRV was effective in determination of AT, and the parasympathetic modulation responses obtained during dynamic and resistive exercise protocols were similar when compared at the same relative intensity. However, DET‐L resulted in higher values of blood pressure and BL at workloads beyond AT.
The importance of wild plant species as potential inoculum reservoirs of white root rot disease
Authors: Takemoto S. , Nakamura H. , Tabata M.
Published: July 2013

Rosellinia necatrix is a soilborne plant pathogenic fungus belonging to the phylum Ascomycota. The fungus is distributed widely in temperate zones and often causes huge economic losses on numerous crop plants. To determine the potential for wild plants to serve as inoculum reservoirs of white root rot disease, eight woody and two herbaceous plant species belonging to nine families were inoculated with two R. necatrix isolates. The species used were Actinidia polygama, Broussonetia kazinoki, Camellia sinensis, Castanea crenata, Hydrangea serrata, Magnolia obovata, Pteridium aquilinum, Petasites japonicus, Quercus serrata and Rosa multiflora, all common flora in the cool temperate forests of Japan. The mortality of plants varied between species, independent of the effect of fungal isolates. Although some of the plants survived fungal infection, all plant species tested were more or less susceptible, having rotting lesions on the inner bark and cortex. For the woody plants, most of the mycelial strands in the diseased tissues became plumose mycelia, growing compressed between the outer and inner barks. However, mycelia found in diseased tissues of the two herbaceous plants were not in the form of plumose mycelia. All plant species harboured mycelial strands on the surface of their root systems and underground main stem, and the amount of the mycelial strands did not correlate with the mortality of the plants. Even if plants exhibited no external symptoms, some of them harboured abundant mycelial strands. In conclusion, wild plants can serve as alternative host plants for R. necatrix and function as persistent inoculum reservoirs, irrespective of their apparent health status. Thus, assessments of such latent host plants must be considered in the course of managing white root rot.
Effects of ecological restoration‐induced land‐use change and improved management on grassland net primary productivity in the Shiyanghe River Basin, north‐west China
Authors: Zhou W. , Li J. L. , Mu S. J. , Gang C. C. , Sun Z. G.
Published: July 2013

To address severe grassland degradation, the Chinese government implemented national restoration programmes, which in turn drove a research focus towards assessment of the environmental effectiveness of such initiatives. In this study, net primary productivity (NPP) was used as an indicator for assessing the impacts of land use and cover change (LUCC), improved land‐use management and climate change on the grassland ecosystem of the Shiyanghe River Basin. NPP was calculated on the basis of the Carnegie–Ames–Stanford Approach model, which is driven by a Moderate Resolution Imaging Spectroradiometer (MODIS) normalized difference vegetation index and meteorological data. The LUCC data for 2001 and 2009 were derived from MODIS land‐cover data. During the study period, the net increase in grassland development was 5105·5 km2, with 80·4% of the newly developed grasslands attributed to desert‐to‐grassland conversion. The total NPP of grasslands in 2009 increased by 659·62 Gg C compared with that in 2001. The contributions of human activity and climate change to total NPP increase were 133 and −33% respectively. Land conversion and improved management measures directly increased grassland NPP. These factors are dominant positive driving forces, whereas warm and dry climates impose adverse effects on grassland restoration in the study site.
Understanding delusion in dementia: A review
Authors: Cipriani Gabriele , Danti Sabrina , Vedovello Marcella , Nuti Angelo , Lucetti Claudio
Published: July 2013

Alzheimer's disease and other dementia are associated with cognitive and functional impairment, as well as neuropsychiatric sequelae, including psychotic features. Research has largely concentrated on the study of cognitive decline, but the associated behavioral and neuropsychiatric symptoms are of equal importance in the clinical profile of the disease. Delusions are common, disabling and persistent in the course of dementia. The purpose of the present review was to examine the phenomenon of delusion in people with dementia. We searched the electronic databases for original research and review articles using the search terms “delusion, dementia, Alzheimer's disease, frontotemporal dementia, vascular dementia and Lewy body disease”. Various types of explanations have been proposed regarding the etiology of delusional belief in dementia, and cerebral correlates are considered. Pharmacological and non‐pharmacological treatments are analyzed. Geriatr Gerontol Int 2014; 14: 32–39.
Relationship between tissue hydroxyl radical and oxidatively modified macromolecule levels
Authors: Sasaki Toru , Mogi Sho‐Ichi , Kaneko Takao , Kojima Haruka , Katoh Shinsuke , Sano Akira , Kojima Shuji
Published: July 2013

Aims

The relationship between hydroxyl radical (·OH) and oxidatively modified macromolecule formations was examined in tissues from young and aged mice.

Methods

To determine the ·OH generation in tissues in vivo using the hydroxylation trapping reaction of ·OH into salicylic acid (SA), analytical conditions for dihydroxybenzoic acid (DHBA) and SA determination, and optimum dosages of SA for administration and time‐points of tissue sampling were determined. 2, 3‐DHBA levels in tissues from young mice and age‐related changes were determined with the oxidatively modified macromolecules.

Results

2, 3‐DHBA, a hydroxylation compound of SA, is considered to be suitable for determination of ·OH levels in tissues. Tissue levels of 2, 3‐DHBA expressed as a molar ratio to SA, was comparable among tissues, and was in accordance with 8‐oxo‐2′‐deoxyguanosine (8‐oxodG) and carbonylated proteins. In the aging process, 2, 3‐DHBA levels in the brain and heart increased in the biphasic pattern in accordance with the 8‐oxodG and thiobarbituric acid reactive substances (TBARS) levels, whereas levels of carbonylated proteins were not changed with age.

Conclusions

An in vivo method for ·OH measurement using hydroxylation of SA was optimized. However, as a limitation, 2, 3‐DHBA, as well as other oxidative stress markers, could be affected by various in vivo factors. The accordance was seen among 2, 3‐DHBA, 8‐oxodG and carbonylated protein levels in tissues from young mice. The tissue levels of 2, 3‐DHBA increased in accordance with the 8‐oxodG and TBARS during the aging process. Geriatr Gerontol Int 2014; 14: 498–507.
Frailty Index in Europeans: Association with determinants of health
Authors: Romero‐Ortuno Roman
Published: July 2013

Aim

The Frailty Index (FI) summarizes differences in health status within individuals, and the determinants of health drive that variability. The aim of the present study was to investigate the influence of education, income, smoking, alcohol intake and parental longevity on the FI variability in subjects of the same chronological age group.

Methods

Analyses were based on a 40‐item FI based on the first wave of the Survey of Health, Aging and Retirement in Europe (SHARE, http://www.share‐project.org/), including 29 905 participants aged ≥50 years from 12 countries. For each sex, the sample was divided into age categories (50s, 60s, 70s, 80s and ≥90), and FI quartiles within age categories were calculated. Multivariate ordinal regressions were computed to assess the relative contribution of the health determinants on the FI quartiles in each age group.

Results

In women, the most significant multivariate predictors were years of education (odds ratios [OR] around 0.9), and difficulties making ends meet (OR between 1.8 and 2.1). In men, the most significant multivariate predictors were years of education (OR around 0.9), difficulties making ends meet (OR between 1.6 and 2.1), mother's age at death (OR under 1), and father's age at death (OR under 1).

Conclusions

Consistently with the literature, education and income explained, in both sexes, cross‐sectional variability in FI in subjects of the same chronological age group. The influence of parental longevity seemed to be greater in men, which mirrors previous studies showing that genetic factors might have a higher impact on longevity in men. Geriatr Gerontol Int 2014; 14: 420–429.
Information‐seeking trends of medical professionals and students from middle‐income countries: a focus on the Philippines
Authors: Gavino Alex I. , Ho Beverly Lorraine C. , Wee Pura Angela A. , Marcelo Alvin B. , Fontelo Paul
Published: July 2013

Background

Increased emphasis has been given to the practice of evidence‐based medicine (EBM) worldwide. Access to quality health information is essential to the practice of EBM in developing countries.

Objectives

To understand the information needs and sources of information of physicians from low‐ and middle‐income countries (LMICs).

Methods

Medical doctors and students participated in an 18‐question online or paper study.

Results

Of the 156 respondents from six LMICs, 146 (94%) came from the Philippines. Eighty‐eight per cent encountered at least one clinical question daily, while 58% were very likely to search for answers. A basic mobile phone was the most used device at home (94%) and at work (82%). More than half had Internet connectivity at home (62%) and just under half at work (46%). In decreasing order, short messaging services (SMS), email, instant messaging and multimedia messaging services (MMS) were the most commonly used messaging tools at home and at work. The primary source for medication questions was a formulary, but for diagnostic dilemmas, colleagues were consulted first. PubMed use was high for therapy and management questions.

Conclusion

The use of health information from the Internet through mobile devices may be increasing. Access to health information was higher at home than at work. These results may be useful when planning resources for healthcare givers in resource‐poor settings.
Efficacy of straight versus angled interdental brushes on interproximal tooth cleaning: a randomized controlled trial
Authors: Jordan RA , Hong HM , Lucaciu A , Zimmer S
Published: July 2013

Background

To investigate interproximal biofilm reduction with an angled interdental brush as compared to a straight interdental brush (standard control) in a clinical, single‐centre, single‐blind, controlled, parallel‐group trial.

Methods

Recruitment and examinations of the subjects were performed at the Witten/Herdecke University School of Dental Medicine. 128 volunteers, aged 20–65 years, were recruited and stratified according to sex and age. Two groups with 64 subjects each used either straight (standard control) or angled (test group) handgripped interdental toothbrushes of the same bristle stiffness. After a 12‐day home‐care habituation period, participants received a professional tooth cleaning followed by a 48‐h plaque regrowth period. At the intervention appointment, plaque was recorded with a fluorescent revelator and soft tissue damage was noted (T0). Interdental brushing was performed by the participant for 2 min, and clinical parameters were recorded again (T1).

The primary efficacy end point was the difference in modified Proximal Plaque Index (mPPI) after brushing compared to baseline. Secondary efficacy end points were mPPI differences in subgroups (anterior vs. posterior teeth; vestibular vs. oral tooth surfaces). Safety end point was the Danser gingival abrasion index (DI).

Results

mPPI showed lower scores after brushing within all (sub)groups (P < 0.01). mPPI brushing efficacy (ΔT0 − T1) in subjects using straight interdental brushes was significantly higher as compared to angled interdental brushes (P < 0.0001). Straight interdental brushes were significantly more effective in posterior teeth, when used from vestibular and from oral tooth surfaces (P < 0.0001, P < 0.01 and P < 0.0001, respectively). No significant differences were found between the groups in anterior teeth and concerning soft tissue damage.

Conclusions

Straight interdental brushes may better remove plaque interproximally when compared to angled interdental brushes.
Influence of rotational speed on the cyclic fatigue of Mtwo instruments
Authors: Pedullà E. , Plotino G. , Grande N. M. , Scibilia M. , Pappalardo A. , Malagnino V. A. , Rapisarda E.
Published: July 2013

Aim

To evaluate the effect of rotational speed on cyclic fatigue of Mtwo nickel–titanium files.

Methodology

A total of 120 new Mtwo rotary instruments sizes 10, 0.04 taper; 15, 0.05 taper; 20, 0.05 taper; and 25, 0.06 taper were randomly divided into three groups on the basis of the rotational speed used to shape nine standardized simulated canals: group A = 350 rpm; group B = 250 rpm; group C = 150 rpm. Each group consisted of 40 instruments, 10 for every size. The average preparation time (in seconds) and the average correlated numbers of cycles to instrument (NCI) the nine standardized canals were recorded for each file. The resistance to cyclic fatigue was determined by counting numbers of cycles to failure (NCF) with a rotational speed of 300 rpm in a 60° curve with a 5‐mm radius. Data were analysed by two‐way anova.

Results

Preparation time was significantly longer at 150 rpm than at 250 or 350 rpm. The average number of cycles needed for each file to instrument nine standardized canals was significantly higher at 350 and 250 rpm, than at 150 rpm. There were no significant differences in the NCF (P > 0.05) between A, B and C groups for instruments of the same size.

Conclusions

Speed did not affect the cyclic fatigue of Mtwo instruments with the same size and taper. Preparation time was shorter at 350 or 250 rpm rather than at 150 rpm. However, there was no significant difference between 350 and 250 rpm rotational speed, neither in the preparation time of simulated canals nor in the resistance to fatigue fracture.
Use of Electrophoretic Impregnation and Vacuum Bagging to Impregnate SiC Powder into SiC Fiber Preforms
Authors: Binner Jon , Vaidhyanathan Bala , Jaglin David , Needham Sarah
Published: July 2013

Techniques based on vacuum bagging (VB) and electrophoretic impregnation (EPI) have been investigated for the impregnation of SiC powder into layered Nicalon SiC fabric preforms. The aim was to produce preimpregnated samples for subsequent chemical vapor infiltration (CVI) with reduced intertow porosity that arises from the construction of the fabric layers while leaving unblocked the intratow porosity that is so indispensable for a successful infiltration. Because the goal was simply to learn about the ability to impregnate the samples, no interphase coating was applied to the fibers as would normally be used when producing SiCf/SiC composites. While the VB process generally yielded much stronger preforms, depending on the pressure used and the powder particle size, it resulted in powder becoming located in the intratow rather than the intertow porosity. In contrast, provided an appropriate electrode arrangement was used, EPI offered the potential for a more controlled impregnation process with the powder primarily found in the intertow porosity; however, the preforms were very weak and delaminated easily. The combination of the two processes resulted in a very successful approach, with greater uniformity of particle infiltration and higher green strengths, while largely avoiding impregnating the intratow porosity.
A novel lobule rotation flap for the reconstruction of middle third auricular defects
Authors: Basu Indraneil , Way Benjamin , Al‐Basri Isam
Published: July 2013

Background

There are numerous techniques for the reconstruction of cutaneous defects of the pinna. Many of these distort the auricle, and several are challenging and time‐consuming to perform.

Methods

An illustrative case is presented to demonstrate a novel lobule rotational flap, which can be used to cover cutaneous defects of the middle third of the pinna.

Results

Postoperative photography illustrates that this simple one‐stage technique causes minimal anatomical distortion and allows the final scar to be concealed within the inner helical rim.

Conclusions

Small local flaps can be raised from the lobule to cover challenging defects of the middle third of the pinna. In selected patients, with abundant lobular tissue, this technique can be as effective as more complex reconstructive options.
Effects of imatinib mesylate on the spontaneous activity generated by the guinea‐pig prostate
Authors: Lam Michelle , Dey Anupa , Lang Richard J. , Exintaris Betty
Published: July 2013

What's known on the subject? and What does the study add?

Several studies have examined the functional role of tyrosine kinase receptors in the generation of spontaneous activity in various segments of the gastrointestinal and urogenital tracts through the application of its inhibitor, imatinib mesylate (Glivec®), but results are fairly inconsistent.

This is the first study detailing the effects of imatinib mesylate on the spontaneous activity in the young and ageing prostate gland. As spontaneous electrical activity underlies the spontaneous rhythmic prostatic contractions that occur at rest, elucidating the mechanisms involved in the regulation of the spontaneous electrical activity and the resultant phasic contractions could conceivably lead to the identification of better targets and the development of more specific therapeutic agents to treat prostate conditions.

Objective

To investigate the effect of imatinib mesylate, a tyrosine kinase receptor inhibitor, in the generation of spontaneous electrical and contractile activity in the young and ageing guinea‐pig prostate.

Materials and Methods

Standard tension and intracellular recording were used to measure spontaneous contractions and slow waves, respectively from the guinea‐pig prostate at varying concentrations of imatinib mesylate (1–50 μm).

Results

Imatinib mesylate (1–10 μm), did not significantly affect slow waves recorded in the prostate of both age groups but at 50 μm, the amplitude of slow waves from the ageing guinea‐pig prostate was significantly reduced (P < 0.05, n = 5).

In contrast, the amplitude of contractions across all concentrations in the young guinea‐pig prostate was reduced to between 35% and 41% of control, while the frequency was reduced to 15.7% at 1 μm (n = 7), 49.8% at 5 μm (n = 10), 46.2% at 10 μm (n = 7) and 53.1% at 50 μm (n = 5).

Similarly, imatinib mesylate attenuated the amplitude and slowed the frequency of contractions in ageing guinea‐pigs to 5.15% and 3.3% at 1 μm (n = 6); 21.1% and 20.8% at 5 μm (n = 8); 58.4% and 8.8% at 10 μm (n = 11); 72.7% and 60% at 50 μm (n = 5).

Conclusions

A significant reduction in contractions but persistence of slow waves suggests imatinib mesylate may affect the smooth muscle contractile mechanism.

Imatinib mesylate also significantly reduced contractions in the prostates of younger guinea pigs more than older ones, which is consistent with the notion that the younger guinea‐pig prostate is more reliant on the tyrosine‐dependent pacemaker ability of interstitial cells of Cajal‐like prostatic interstitial cells.
Cell‐mediated immune responses in oral disease: A review
Authors: LEHNER T.
Published: July 2013

Abstract. A review of cell‐mediated immunity in oral disease suggests that Gram‐negative bacteria, fungi, viruses and oral mucosa may give rise to 4 groups of immune responses. In gingival and periodontal disease (Group I), lymphocyte transformation is stimulated with dental plaque, Veillonella alcalescens, Fusobacterium fusiforme and Bacteroides melaninogenicus. Cytotoxicity against unrelated target cells and migration inhibition of macrophages also results from lymphocyte activation. The functions of lymphocytes are affected by serum factors which might prove to be antibodies or immune complexes. These data suggest that cell‐mediated immunity against a number of oral microorganisms may be involved in the pathogenesis of periodontal disease. Immunological studies in recurrent aphthous ulceration (Group II) suggest that oral epithelium or some antigenically cross‐reacting microorganism stimulates cell‐mediated and antibody responses. Autoimmune damage of oral mucosa, resulting in ulceration, can be accounted for by the immunological competence and cytotoxic potential of sensitized lymphocytes. Susceptibility to recurrent Herpes virus hominis type 1 infections (Group IIIA) may be accounted for by a selective and specific impairment of production of migration inhibitory factor and cytotoxicity in the presence of intact lymphocyte sensitization and antibody formation. Chronic muco‐cutaneous candidosis (Group IIIB) shows spectral immunodeficiencies with cell‐mediated and antibody defects which have been broadly related to the severity of clinical manifestations. Thus, in chronic oral hyperplastic candidosis the cellular immune defect may be limited to cytotoxicity, migration inhibition and sometimes impaired delayed hypersensitivity skin reaction to Candida albicans. Serum IgG and IgM antibodies are depressed also, but salivary IgA antibodies are raised and lymphocyte transformation is also intact. In the various histological stages of leukoplakia and in carcinoma (Group IV) there is a significant increase, mostly in lymphocytes and plasma cells. This is associated with a corresponding decrease in transformation of lymphocytes stimulated with autologous leukoplakic tissue. Cell‐mediated immune studies may show whether there is an impaired tumor surveillance in the leukoplakia‐carcinoma relationship.
Verrucous carcinoma of the mouth
Authors: JACOBSON SELWYN , SHEAR MERVYN
Published: July 2013

This paper describes a survey of 198 cases of oral verrucous carcinoma reported in the literature and a study of a further 15 personally‐observed cases. Elderly Caucasoid males are most frequently affected, although in the South African group there were 10 females and 5 males. The lesion, which classically has a verrucous surface, may be small or more extensive. The cheek mucosa and the alveolar mucosa/gingiva are the sites most commonly involved. Sometimes more than one area is affected in the same patient and the tumor may be associated with other lesions such as leukoplakia, pseudo‐epitheliomatous hyperplasia and frank carcinoma. The etiology is uncertain but tobacco usage in any form appears to be implicated. The tumor is locally invasive and 6 of our series of 15 recurred after surgical removal. It does not metastasize unless it undergoes anaplastic transformation, which it frequently does if treated with radiotherapy. The correct treatment is therefore wide surgical excision. Histologically, there is a typical abrupt margin. The tumor has surface papillary projections and infiltrating broad, blunt rete pegs which form a “pushing margin”. The epithelium is generally well‐differentiated but there may be a high mitotic index and there may be an appearance of epithelial atypia if the epithelium is inflamed. Keratin is usually present on the surface and in the crevices of the deep invaginations but may be absent from tumors involving non‐kcratinizing surfaces.
Changes in cell cycle characteristics in hamster cheek pouch epithelium during treatment with DMBA
Authors: THILAGARATNAM C. N. , MAIN J. H. P.
Published: July 2013

Abstract. Cell cycle characteristics were studied in hamster cheek pouch epithelium under normal conditions, in hyperplasia induced by topical DMBA treatment for 5 weeks, in pre‐neoplastic epithelium after 12 weeks of DMBA, and in DMBA induced squamous cell carcinoma. Vinblastine sulphate was used to measure mitotic rate, and the other cell cycle parameters were obtained from tritiated thymidine autoradiography, using the pulse chase method. Te was found to be reduced from the normal value of 163.9 hours to 90.8 hours in hyperplastic epithelium, 22.7 hours in pre‐neoplastic epithelium and 15.4 hours in carcinoma. All phases of the cell cycle were reduced in duration progressively during the stages of carcinoma induction, but the great reduction in Te was due chiefly to shortening of Tg1 by about 95 %.
Primate pulp response to an ultraviolet light cured restorative material
Authors: STANLEY H. R. , MYERS C. L. , HEYDE J. B. , CHAMBFRLAIN J.
Published: July 2013

Abstract. The present toxicity study investigated the pulpal response of an experimental u.v. light cured composite product as a Class V restorative material. Seventy‐eight Class V cavities were prepared on the buccofacial surfaces of cynomolgus monkeys using a high‐speed, air‐water spray cutting technique. The experimental product was compared to a self‐curing composite resin and a zinc oxide and eugenol formula. The animals were sacrificed at 3, 14 and 60 days.

All categories exhibited about the same minimal degree of pulpal response at the three‐day post‐operative interval. However, focal hemorrhage occurred in 80% of the u.v. light cured resin category. After 60 post‐operative days, the u.v. cured resin specimens presented persistent or increasing responses as compared to the specimens treated with either a self‐curing composite resin or zinc oxide and eugenol.

Should this u.v. light cured resin be used as a restorative material such as employed in this study, a calcium hydroxide liner is suggested in order to minimize the pulpal responses observed 60 days post‐operatively.
Studies in the recent new genus record Pseudostachyum (Poaceae: Bambusoideae) from Thailand: notes on its taxonomy, distribution and habitat
Authors: Teerawatananon Atchara , Sungkaew Sarawood , Marod Dokrak , Hodkinson Trevor R.
Published: July 2013

A taxonomic review of the genus Pseudostachyum Munro in Thailand is presented including a description of its morphology, geographic distribution and habitat. An illustrated description of the newly recorded species P. polymorphum Munro, discovered in Thailand, is provided and a doubtful species, P. wakha Brandis ex Camus, is reduced to a synonym of P. polymorphum.
Blood Pressure Control in a Hypertension Telemedicine Intervention: Does Distance to Primary Care Matter?
Authors: Bowen Michael E. , Bosworth Hayden B. , Roumie Christianne L.
Published: July 2013

Although telemedicine may help overcome geographic access barriers, it is unknown whether rural patients receive greater benefits. In a secondary analysis of 503 veterans participating in a hypertension telemedicine study, the authors hypothesized that patients with greater travel distances would have greater improvements in 18‐month systolic blood pressure (SBP). Patients were categorized by telemedicine exposure and travel distance to primary care, derived from zip codes. Comparisons were (1) usual care (UC), distance <30 miles (reference); (2) UC, distance ≥30 miles; (3) telemedicine, distance <30 miles; (4) telemedicine, distance ≥30 miles. Compared with patients receiving UC, distance <30 miles (intercept=127.7), no difference in 18‐month SBP was observed in patients receiving UC, distance ≥30 miles (0.13 mm Hg, 95% confidence interval [−6.6 to 6.8]); telemedicine, distance <30 miles (−1.1 mm Hg [−7.3 to 5.2]); telemedicine, distance ≥30 miles (−0.80 mm Hg [−6.6 to 5.1]). Although telemedicine may help overcome geographic access barriers, additional studies are needed to identify patients most likely to benefit.
The Malnutrition Screening Tool versus objective measures to detect malnutrition in hip fracture
Authors: Bell J. J. , Bauer J. D. , Capra S.
Published: July 2013

Background

The Malnutrition Screening Tool (MST) is the most commonly used screening tool in Australia. Poor screening tool sensitivity may lead to an under‐diagnosis of malnutrition, with potential patient and economic ramifications. The present study aimed to determine whether the MST or anthropometric parameters adequately detect malnutrition in patients who were admitted to a hip fracture unit.

Methods

Data were analysed for a prospective convenience sample (n = 100). MST screening was independently undertaken by nursing staff and a nutrition assistant. Mid upper arm circumference (MUAC) was measured by a trained nutrition assistant. Nutritional risk [MST score ≥ 2, body mass index (BMI) < 22 kg m–2, or MUAC < 25 cm] was compared with malnutrition diagnosed by accredited practicing dietitians using International Classification of Diseases version 10‐Australian Modification (ICD10‐AM) coding criteria.

Results

Malnutrition prevalence was 37.5% using ICD10‐AM criteria. Delirium, dementia or preadmission cognitive impairment was present in 65% of patients. The BMI as a nutrition risk screen was the most valid predictor of malnutrition (sensitivity 75%; specificity 93%; positive predictive value 73%; negative predictive value 84%). Nursing MST screening was the least valid (sensitivity 73%; specificity 55%; positive predictive value 50%; negative predictive value 77%). There was only fair agreement between nursing and nutrition assistant screening using the MST (κ = 0.28).

Conclusions

In this population with a high prevalence of delirium and dementia, further investigation is warranted into the performance of nutrition screening tools and anthropometric parameters such as BMI. All tools failed to predict a considerable number of patients with malnutrition. This may result in the under‐diagnosis and treatment of malnutrition, leading to case‐mix funding losses.
Low‐Income Women's Recommendations for Promoting Early Pregnancy Recognition
Authors: Ayoola Adejoke B. , Zandee Gail L.
Published: July 2013

Introduction

This study explored low‐income women's perspectives on how to promote early recognition of pregnancy as one strategy to address community residents’ concerns related to unintended pregnancy. Unintended pregnancy, which is more prevalent among low‐income women and minorities, has been associated with various adverse pregnancy outcomes.

Methods

This study used the ideological perspective of community‐based participatory research. Six focus groups were conducted in 3 low‐income, urban, medically underserved neighborhoods with ethnically diverse populations. Neighborhood women who were either pregnant or had experienced a pregnancy within 3 years were invited to participate in the study. A structured interview guide focused the discussion on how to promote early recognition of pregnancy within the existing context of unintended pregnancies in the neighborhoods. Focus‐group sessions were audiotaped, then transcribed verbatim; the data were analyzed using an open‐coding template approach assisted by QSR NVivo 8 software.

Results

Forty‐one women aged 18 to 44 years participated in the study. Thirty‐nine percent were African American, 24.4% were Hispanic/Latino, 19.5% were American Indians, and 17.1% were white. Three primary themes were identified: 1) women should know the menstrual/ovulation and pregnancy‐related changes that occur in their bodies; 2) women should be prepared to confirm their pregnancies early, as soon as they suspect they may be pregnant; and 3) both information and emotional support are needed for pregnancy‐related issues. “Knowing your body” was the strongest advice to promote early recognition of pregnancy.

Discussion

The participants in this study suggested that education about reproductive changes should be initiated during early adolescence and in the preconception period. Early testing and confirmation of pregnancy should also be promoted, especially for women who have unprotected intercourse. Local resources for information and emotional support during pregnancy should be accessible to women.
Information and Communication Technology: Students' Health Education in 1st‐ to 6th‐Grade South Korea Elementary Schools
Authors: Lee Eunjoo , Park Hyejin , Whyte James , Jeong Eunhoe
Published: July 2013

BACKGROUND

The purposes of this study were to (1) identify school nurses' awareness of information and communication technology (ICT) use in students' health education and (2) explore the barriers or reasons for the adoption of ICT in school nursing practice, while (3) presenting strategies to speed ICT diffusion and dissemination into practice.

METHODS

For data collection, 209 primary school nurses in K province of Korea were selected and e‐mailed the questionnaires. Collected data were analyzed as frequency, percentages, and chi‐square tests.

RESULTS

The major reasons to adopt ICT were increasing school nurses' confidence in providing health education and improving teaching methods using diverse multimedia. The major barriers to utilization of ICT were lack of time for preparation of educational materials, lack of software availability, and lack of computer skills of school nurses and students. Several strategies were suggested to speed the diffusion of ICT into students' health education, such as integrating a health education course into regular curriculum.

CONCLUSIONS

It is important to identify barriers and reasons for adoption of ICT in school nursing. In addition, strategies should be emphasized that result in more rapid diffusion of these technologies in school nursing practice.
Molecular cloning and functional analysis of serotonin N‐acetyltransferase from the cyanobacterium Synechocystis sp. PCC 6803
Authors: Byeon Yeong , Lee Kyungjin , Park Youn‐Il , Park Sangkyu , Back Kyoungwhan
Published: July 2013

Serotonin N‐acetyltransferase (SNAT) catalyzes conversion of serotonin into N‐acetylserotonin, which is a direct precursor for melatonin biosynthesis in all organisms. Molecular cloning of plant SNAT from rice led to a screening for SNAT homolog genes in other species. We identified a cyanobacterium SNAT‐like gene (cSNAT) that showed 56% amino acid homology with the rice SNAT. To confirm whether cSNAT encoded SNAT enzyme activity, we expressed cSNAT DNA in Escherichia coli and purified the cSNAT protein as a C‐terminal His‐tagged form. The purified cSNAT protein exhibited SNAT enzyme activities, transferring the acetyl group into either serotonin or tryptamine substrates. The optimum temperature was 55°C, but it was still highly active at 70°C, suggesting that cSNAT is a thermotolerant enzyme. The Km and Vmax were 823 μm and 1.6 nmol/min/mg protein, respectively. The cSNAT gene is highly conserved in all cyanobacterial taxa and seems to be an origin of SNAT in higher plants. The thermotolerance of cSNAT suggests that melatonin plays a role in the response to high‐temperature stress. Further analysis of this role of melatonin in higher plants is needed.
Distal Penile Shaft Reconstruction and Reinforcement: The “Double-Windsocks” Technique
Authors: Egydio Paulo H. , Kuehhas Franklin E.
Published: July 2013

Introduction

The management of penile prosthesis protrusion and the implantation of a prosthesis in fibrotic penile corporal bodies represents a challenging task even for experienced surgeons.

Aim

To demonstrate the long-term efficacy and safety of a new technique for distal shaft reconstruction and reinforcement in cases of penile prosthesis protrusion or cases of penile prosthesis implantation in corporal fibrosis.

Methods

Between August 2007 and August 2012, 69 patients underwent surgery for penile prosthesis protrusion (45 patients) or severe distal corporal fibrosis (24 patients). The mean age at the time of surgery was 56 years (range 38–69). All patients underwent distal shaft reconstruction using our technique, involving the creation of two neocorpora (“double windsocks”).

Main Outcome Measures

Functional outcome and patient satisfaction were evaluated with item numbers 1 and 7 of the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaire. Furthermore, clinical data concerning the early postoperative outcome were analyzed retrospectively.

Results

Mean follow-up time was 22.5 months (range 6–48). Based on answers to EDITS questionnaire item 1, 42 patients (60.9%) were very satisfied and 19 patients (27.5%) were somewhat satisfied with the outcome of the procedure. Furthermore, answers to the self-confidence domain question (EDITS item 7) revealed that 63 patients (91.3%) felt that the treatment had a positive effect with respect to their ability to engage in sexual activity.

No patient exhibited device extrusion, postoperative infection, or skin dehiscence, and glans sensation as well as orgasmic ability were also preserved in all cases. Neuropraxia was reported in five cases (3.4%) immediately after the operation. The recovery of orgasmic ability was delayed in 17 (24.6%) patients. All patients were able to perform sexual intercourse postoperatively.

Conclusion

The “double-windsocks” technique is an effective option for difficult cases of distal penile shaft reconstruction and reinforcement.
Time perception in narcolepsy in comparison to patients with Parkinson's disease and healthy controls—an exploratory study
Authors: Poryazova Rositsa , Mensen Armand , Bislimi Fatime , Huegli Gordana , Baumann Christian R. , Khatami Ramin
Published: July 2013

The striatum and the prefrontal cortex play an important role in cognitive time processing, and time perception depends on sustained attention. Narcolepsy patients are unable to maintain sustained attention, due probably to deficient hypocretin signalling. Impaired time perception has been found in Parkinson's disease (PD) and attributed to a dysfunctional dopaminergic striatal pacemaker. We aimed to assess time perception in patients with narcolepsy and PD and to compare the outcome to healthy control participants. Seventeen narcolepsy patients, 12 PD patients and 15 healthy controls performed a short time production task, where they had to produce an interval of 1, 2 or 5 s. The accuracy of time production differed significantly according to task target duration, and there was a trend towards a group difference with narcolepsy patients tending to overproduce all target durations. Absolute variability was significantly different between groups, with narcolepsy patients showing higher absolute variability in comparison to controls and PD patients. The analysis of the temporal course of time estimation showed more pronounced overproduction of each target duration at the end of each trial in narcolepsy patients, whereas performance was more or less stable in controls and PD patients. Overproduction and higher variability of all time durations in narcolepsy indicate impaired short interval timing in the seconds range, while the scalar property of timing was preserved. The time–course of accuracy and variability of time production within sessions indicate an attention‐related mechanism of impaired interval timing.