bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of an intensified prevention program for 4th graders with increased caries risk using ICDAS
Authors: Winter Julia , Weber Kristina , Martin Katharina , Heinzel‐Gutenbrunner Monika , Pieper Klaus
Published: September 2015

Background

In order to investigate correlations between specific parameters and dental caries, it is useful to record incipient and dentine lesions.

Aim

The aim of this study was to evaluate the effect of a selective intensified preventive program (SIP) on oral health of fourth graders using ICDAS.

Design

A cohort study was performed. ICDAS and DMFT index were recorded. Prevention and social factors were collected with psychometric questionnaires. The test group and the control group were parallelized using sociodemographic variables.

Results

The participants in the fluoride varnish program in the test region showed a significantly lower caries experience than pupils in the control region. The bivariate analysis revealed that a migrant background had a negative impact on oral health whereas fissure sealants, use of fluoridated table salt, use of fluoride tablets, early start of toothbrushing and high social status exerted a positive influence on dental health. Stepwise backward logistic regression analysis confirmed that fissure sealants, a high social status and an early start of toothbrushing had a significant positive impact on dental health.

Conclusion

The results of our study suggest that a SIP impedes the primary occurrence of incipient lesions and the transition from incipient to advanced lesions.
Momentum Strategies and Investor Sentiment in the REIT Market
Authors: Hao Ying , Chu Hsiang‐Hui , Ko Kuan‐Cheng , Lin Lin
Published: September 2015

Comparing across three momentum measures, we empirically find that the 52‐week high strategy plays a dominant role in generating momentum profits in the Real Estate Investment Trust (REIT) market. The profitability of the 52‐week high strategy, however, varies with the state of investor sentiment. Specifically, we find that the 52‐week high momentum earns significantly positive returns following optimistic periods and significantly negative returns following pessimistic periods. Further evidence indicates that investor sentiment serves as a better predictive variable in explaining the REIT momentum than market states, business cycles, legislation changes, and monetary policy changes. Overall, our findings are in line with behavioral theories in explaining the REIT momentum.
Corporate Tax Changes under the UK Coalition Government (2010–15)
Authors: Miller Helen , Pope Thomas
Published: September 2015

Corporation tax was one of the most active policy areas under the coalition government in power in the UK from 2010 to 2015. In attempting to fulfil an aim to create ‘the most competitive corporate tax regime in the G20’, the government reduced the main rate by 8 percentage points, introduced a Patent Box and reformed the taxation of foreign income. The government also made changes to the tax base – notably, reducing the generosity of capital allowances for plant and machinery and temporarily increasing the generosity of the annual investment allowance – and took steps to reduce avoidance opportunities. This paper reviews the policy changes and sets out where they leave the UK corporate tax system.
School Spending in England 2010–15
Authors: Sibieta Luke
Published: September 2015

School spending in England has been relatively protected over the past five years, with day‐to‐day school spending per pupil rising by about 0.6 per cent in real terms. This contrasts with cuts to other areas of education spending and across other areas of government spending more generally. This real‐terms increase has been delivered by an increase in funding going to the most disadvantaged pupils via the pupil premium. (Other types of funding were frozen in cash terms per pupil.) One of the consequences of this reform is that funding is increasingly concentrated on schools catering for the highest proportions of pupils from disadvantaged backgrounds. This is in contrast to school systems in some other countries (for example, the US), where resources tend to be more highly correlated with local property values. Looking forward, rising pupil numbers, together with reforms that will increase the cost of employing staff, will contribute to increasing school costs over the coming years, with school spending needing to increase by at least 20 per cent in cash terms just to keep funding per pupil constant in real terms after accounting for expected cost increases for schools.
The Effect of the UK Coalition Government's Tax and Benefit Changes on Household Incomes and Work Incentives
Authors: Adam Stuart , Browne James , Elming William
Published: September 2015

The coalition government that was in office in the UK between May 2010 and May 2015 introduced a sizeable package of tax and benefit reforms to reduce the UK's large budget deficit. We use a microsimulation model that includes a broader range of policy measures than previous studies to estimate how these reforms affected both household incomes and work incentives. We find that lower‐income working‐age households and the very richest have lost the most, while working‐age households without children in the upper‐middle of the income distribution actually gained from these reforms. Some results of our analysis are, however, highly sensitive to the choice of ‘no reform’ baseline. This is particularly true of how much pensioners have gained or lost from the reforms, since this depends critically on whether the basic state pension is increased in line with earnings or prices in the ‘no reform’ scenario. When analysing the impact of these reforms on individuals’ work incentives, we find that the coalition's changes have slightly strengthened work incentives. The participation tax rate has, on average, been reduced by 3 percentage points, perhaps a less significant strengthening of incentives than might have been expected given the scale of the coalition's benefit cuts. However, this average effect disguises considerable variation across the population; indeed, the majority of workers have seen the incentive to increase their earnings weaken, not strengthen, as a result of the coalition's reforms.
Perennial ice and snow‐covered land as important ecosystems for birds and mammals
Authors: Rosvold Jørgen
Published: September 2015

Aim

To investigate the role of perennial ice and snow‐covered land in the environment of birds and mammals, and to what degree vertebrates are parts of terrestrial glacial ecosystems.

Location

Global.

Methods

The synthesis was based on a review of existing literature.

Results

The relationship between perennial ice and snow‐covered land and birds and mammals is generally poorly known and behaviours associated with such areas are likely underreported. Nevertheless, the review revealed that a relatively large range of species actively use and spend large amounts of time on ice covered land. Foraging or seeking relief from both climatic and different biotic factors are the main behaviours associated with these landscapes, but for some species they are also important areas for food caching, water, play and travel, and even as nesting grounds. In well‐used sites, birds and mammals are likely important contributors to the nutrient cycling of glacial ecosystems.

Main conclusions

Despite increased global temperatures and rapid glacial melting in recent years, perennial ice and snow‐covered landscapes have largely escaped management attention, likely due to them being viewed as inhospitable. It is, however, becoming increasingly clear that a large range of organisms inhabit and make use of the ice, and that these areas constitute high‐quality parts of their habitats. It is therefore essential that glacierized areas are properly described, classified and managed as threatened ecosystems.
Rapid Detection of Exogenous Adulterants and Species Discrimination for a Chinese Functional Tea (Banlangen) by Fourier‐Transform Near‐Infrared (FT‐NIR) Spectroscopy and Chemometrics
Authors: Xu Lu , Fu Xian‐Shu , Fu Hai‐Yan , She Yuan‐Bin
Published: September 2015

The practical adulterations of herbal tea are usually performed by adding some marker components together with adulterants, or some exogenous adulterants containing the marker components. It is difficult to detect such adulterations by the traditional analytical methods focused on a few marker components. Therefore, Fourier‐transform near‐infrared (FT‐NIR) spectroscopy was used to characterize the compositions and class models of authentic banlangen tea and to detect possible exogenous adulterants. Discrimination of two different species of banlangen tea was also performed using partial least squares discrimination analysis (PLSDA). The most accurate one‐class partial least squares (OCPLS) model was obtained with standard normal variate (SNV) transformation. SNV‐OCPLS could detect adulterations with 5% (w/w) or more dried apple skin in banlangen. For species discrimination, a total classification accuracy of 0.936 was achieved by SNV‐PLSDA. FT‐NIR spectrometry and chemometrics can provide a useful and alternative tool for rapid quality control of banlangen tea.

Practical Applications

FT‐NIR spectrometry and chemometrics can provide a useful and alternative tool for rapid quality control of banlangen tea.
Ageing in Rett syndrome
Authors: Cianfaglione R. , Clarke A. , Kerr M. , Hastings R. P. , Oliver C. , Felce D.
Published: September 2015

Background

The aim was to gain a UK national sample of people with Rett syndrome across the age range and (1) conduct a cross‐sectional comparison of age groups and (2) undertake a longitudinal follow‐up.

Methods

From 308 potential participants approached to take part, a sample of 91 girls and women was achieved (29.5%). Their ages ranged from 4 to 47 years, and 71 were known to have a mutation in the methyl‐CpG binding protein‐2 (MECP2) gene. Seventy‐two of the initial sample were followed up 16 months later, and 50 returned completed assessments (69.4%). Their ages ranged from 7 to 48 years, and 42 were MECP2 positive. Parental questionnaire measures of Rett syndrome specific characteristics, impulsivity, overactivity, mood, interest and pleasure, repetitive behaviour and self‐injury were administered.

Results

Adaptive behaviour and behavioural characteristics of Rett syndrome were similar across age groups and, where assessed, stable over time, as were repetitive behaviours generally and self‐injury. There was some suggestion of deterioration in health arising with ageing, principally contributed to by deteriorations in dental and gastro‐intestinal problems both with moderate effect sizes. Indicators of mood, interest and pleasure differed significantly across age groups. The total scale score significantly deteriorated over time, with a moderate effect size.

Conclusions

This study provides further evidence for the post‐regression stability that characterises Rett syndrome. Emergent low mood in Rett syndrome requires further research.
Cdk5 at crossroads of protein oligomerization in neurodegenerative diseases: facts and hypotheses
Authors: Wilkaniec Anna , Czapski Grzegorz A. , Adamczyk Agata
Published: September 2015

Cyclin‐dependent kinase 5 (Cdk5) is involved in proper neurodevelopment and brain function and serves as a switch between neuronal survival and death. Overactivation of Cdk5 is associated with many neurodegenerative disorders such as Alzheimer's or Parkinson's diseases. It is believed that in those diseases Cdk5 may be an important link between disease‐initiating factors and cell death effectors. A common hallmark of neurodegenerative disorders is incorrect folding of specific proteins, thus leading to their intra‐ and extracellular accumulation in the nervous system. Abnormal Cdk5 signaling contributes to dysfunction of individual proteins and has a substantial role in either direct or indirect interactions of proteins common to, and critical in, different neurodegenerative diseases. While the roles of Cdk5 in α‐synuclein (ASN) – tau or β‐amyloid peptide (Aβ) – tau interactions are well documented, its contribution to many other pertinent interactions, such as that of ASN with Aβ, or interactions of the Aβ – ASN – tau triad with prion proteins, did not get beyond plausible hypotheses and remains to be proven. Understanding of the exact position of Cdk5 in the deleterious feed‐forward loop critical for development and progression of neurodegenerative diseases may help designing successful therapeutic strategies of several fatal neurodegenerative diseases.

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Cyclin‐dependent kinase 5 (Cdk5) is associated with many neurodegenerative disorders such as Alzheimer's or Parkinson's diseases. It is believed that in those diseases Cdk5 may be an important factor involved in protein misfolding, toxicity and interaction. We suggest that Cdk5 may contribute to the vicious circle of neurotoxic events involved in the pathogenesis of different neurodegenerative diseases.
Regulation of neuronal pH by the metabotropic Zn2+‐sensing Gq‐coupled receptor, mZnR/GPR39
Authors: Ganay Thibault , Asraf Hila , Aizenman Elias , Bogdanovic Milos , Sekler Israel , Hershfinkel Michal
Published: September 2015

Synaptically released Zn2+ acts as a neurotransmitter, in part, by activating the postsynaptic metabotropic Zn2+‐sensing Gq protein‐coupled receptor (mZnR/GPR39). In previous work using epithelial cells, we described crosstalk between Zn2+ signaling and changes in intracellular pH and/or extracellular pH (pHe). As pH changes accompany neuronal activity under physiological and pathological conditions, we tested whether Zn2+ signaling is involved in regulation of neuronal pH. Here, we report that up‐regulation of a major H+ extrusion pathway, the Na+/H+ exchanger (NHE), is induced by mZnR/GPR39 activation in an extracellular‐regulated kinase 1/2‐dependent manner in hippocampal neurons in vitro. We also observed that changes in pHe can modulate neuronal mZnR/GPR39‐dependent signaling, resulting in reduced activity at pHe 8 or 6.5. Similarly, Zn2+‐dependent extracellular‐regulated kinase 1/2 phosphorylation and up‐regulation of NHE activity were absent at acidic pHe. Thus, our results suggest that when pHe is maintained within the physiological range, mZnR/GPR39 activation can up‐regulate NHE‐dependent recovery from intracellular acidification. During acidosis, as pHe drops, mZnR/GPR39‐dependent NHE activation is inhibited, thereby attenuating further H+ extrusion. This mechanism may serve to protect neurons from excessive decreases in pHe. Thus, mZnR/GPR39 signaling provides a homeostatic adaptive process for regulation of intracellular and extracellular pH changes in the brain.

image

We show that the postsynaptic metabotropic Zn2+‐sensing Gq protein‐coupled receptor (mZnR/GPR39) activation induces up‐regulation of a major neuronal H+ extrusion pathway, the Na+/H+ exchanger (NHE), thereby enhancing neuronal recovery from intracellular acidification. Changes in extracellular pH (pHe), however, modulate neuronal mZnR/GPR39‐dependent signaling, resulting in reduced activity at pHe 8 or 6.5. This mechanism may serve to protect neurons from excessive decreases in pHe during acidosis. Hence, mZnR/GPR39 signaling provides a homeostatic adaptive process for regulation of intracellular and extracellular pH changes in the brain.
Risk of extrapyramidal side effects comparing continuous vs. bolus intravenous metoclopramide administration: a systematic review and meta‐analysis of randomised controlled trials
Authors: Cavero‐Redondo Iván , Álvarez‐Bueno Celia , Pozuelo‐Carrascosa Diana P , Díez‐Fernández Ana , Notario‐Pacheco Blanca
Published: September 2015

Aims and objectives

To provide evidence about whether intravenous metoclopramide continuous infusion is associated with fewer extrapyramidal side effects than bolus infusion.

Background

Many studies have described the effects produced by the administration of metoclopramide, as a continuous intravenous infusion or intravenous bolus directly, but there is a lack of consensus about the best administration of this drug to minimise extrapyramidal side effects.

Design

A meta‐analysis was conducted.

Methods

The search data base was conducted in: Cochrane Library, PubMed, Web of Knowledge and Scopus, to collect randomised controlled trials examining the association between extrapyramidal side effects and intravenous metoclopramide continuous or bolus infusion. Meta‐analyses were conducted for the eligible randomised controlled trials by Comprehensive Meta‐Analysis. Risk difference and 95% CIs were calculated with the Cochran's Q‐statistic, and heterogeneity was assessed with the I2 test.

Results

Eleven randomised controlled trials were included. Meta‐analysis showed that continuous intravenous infusion of metoclopramide produced less extrapyramidal side effects (8%; 95% CI, 5–11%; p < 0·001; I2 = 65%). These improvements were particularly strong in studies scored ≥3 in the Jadad scale (12%; 95% CI, 3–24%; I2 = 0%), in emergency patients (12%; 95% CI, 2–25%; I2 = 0%), in patients who used concomitant drugs (9%; 95% CI, 5–12%; I2 = 80%) and when observation (8%; 95% CI, 5–14%; I2 = 69%) or analogue scale (7%; 95% CI, 1–13%; I2 = 64%) were used to quantify the number of extrapyramidal reactions in patients.

Conclusions

Compared with bolus administration, continuous intravenous infusion of metoclopramide reduces the appearance of extrapyramidal side effects.

Relevance to clinical practice

Continuous infusion is an effective intervention to reduce in patients discomfort caused by the extrapyramidal side effects of metoclopramide. Clinicians also reduce the time spent on alleviating these unwanted effects.
Nurses' experiences of hospitalised patients' sleep in Sweden: a qualitative study
Authors: Gellerstedt Linda , Medin Jörgen , Kumlin Maria , Rydell Karlsson Monica
Published: September 2015

Aims and objectives

The aim was to describe nurses' experiences of patients' sleep at an emergency hospital and their perceptions of sleep‐promoting interventions.

Background

Promotion of patients' sleep during hospital care is an important intervention for the nursing profession. To promote sleep and to initiate sleep‐promoting interventions, nurses need basic knowledge about sleep and its physiology. Therefore, it is of importance to explore and expand knowledge about how nurses experience patients′ sleep and how they perceive working with it while providing care.

Design

A qualitative descriptive design was used.

Methods

Data were collected from four focus groups and seven individual interviews. A total of twenty‐two registered nurses participated. Data were analysed using a qualitative content analysis.

Results

Nurses expressed a desire and an ambition to work in ways that promote patients' sleep during hospitalisation. Nurses reported that health care services and emergency hospitals were not organised according to patients' perspective and needs. Furthermore, they did not have opportunities to work effectively to promote sleep according to the patients' wishes. Several nurses stated that they did not have sufficient knowledge about sleep and that they did the best they could under prevailing circumstances. Nurses emphasised the importance of sleep for patients and that it was an area that should be given far greater priority.

Conclusions

The results indicate that nurses currently have insufficient knowledge about sleep and sleep‐promoting interventions. These aspects of nursing is based on personal experience and common sense rather than being evidence based. Furthermore, sleep as a nursing topic needs to be developed and given more focus in order for nurses to be able to deliver high quality care at emergency hospitals.

Relevance to clinical practice

Nurses require more knowledge and education to gain deeper understanding of sleep and to deliver evidence‐based, high quality care.
Patients in transition – improving hospital–home care collaboration through electronic messaging: providers’ perspectives
Authors: Melby Line , Brattheim Berit J , Hellesø Ragnhild
Published: September 2015

Aims and objectives

To explore how the use of electronic messages support hospital and community care nurses’ collaboration and communication concerning patients’ admittance to and discharges from hospitals.

Background

Nurses in hospitals and in community care play a crucial role in the transfer of patients between the home and the hospital. Several studies have shown that transition situations are challenging due to a lack of communication and information exchange. Information and communication technologies may support nurses’ work in these transition situations. An electronic message system was introduced in Norway to support patient transitions across the health care sector.

Design

A descriptive, qualitative interview study was conducted.

Methods

One hospital and three adjacent communities were included in the study. We conducted semi‐structured interviews with hospital nurses and community care nurses. In total, 41 persons were included in the study. The analysis stemmed from three main topics related to the aims of e‐messaging: efficiency, quality and safety. These were further divided into sub‐themes.

Results

All informants agreed that electronic messaging is more efficient, i.e. less time‐consuming than previous means of communication. The shift from predominantly oral communication to writing electronic messages has brought attention to the content of the information exchanged, thereby leading to more conscious communication. Electronic messaging enables improved information security, thereby enhancing patient safety, but this depends on nurses using the system as intended.

Conclusion

Nurses consider electronic messaging to be a useful tool for communication and collaboration in patient transitions.

Relevance to clinical practice

Patient transitions are demanding situations both for patients and for the nurses who facilitate the transitions. The introduction of information and communication technologies can support nurses’ work in the transition situations, and this is likely to benefit the patients.
‘Providing good and comfortable care by building a bond of trust’: nurses views regarding their role in patients' perception of safety in the Intensive Care Unit
Authors: Wassenaar Annelies , van den Boogaard Mark , van der Hooft Truus , Pickkers Peter , Schoonhoven Lisette
Published: September 2015

Aims and objectives

To describe and understand intensive care unit (ICU) nurses' views regarding their role in ICU patients' perception of safety.

Background

Feeling safe is an important issue for ICU patients. Not feeling safe may result in adverse effects including traumatic experiences, having nightmares and feeling depressed. Nursing care plays a major role in patients' perception of safety. However, it is unknown whether ICU nurses are aware of this role.

Design

A grounded theory approach following Corbin and Strauss.

Methods

A total of 13 participants were included in the study following maximum variation sampling, by selecting ICU nurses who differed in gender, age, work experience as registered ICU nurse, and were employed in different IC units. In‐depth interviews were performed using open‐ended questions guided by a topic list with broad question areas. Data collection and analysis were executed during an iterative process.

Results

The core category, building a bond of trust to provide good and comfortable care, arose from four main categories: explaining and informing ICU patients, using patients' family bond, ICU nurses' attitudes and expertise, and creating physical safety.

Conclusion

The ICU nurses stated that they were not explicitly aware of ICU patients' perception of safety, but that they strived to provide good and comfortable care, through building a bond of trust with their patients. According to the nurses, a bond of trust is essential for patients to feel safe in the ICU.

Relevance to clinical practice

The importance of feeling safe in ICU patients should be addressed within the education and clinical practice of ICU nurses, to ensure that they become aware of ICU patients' perception of safety.
The importance of molecular markers for diagnosis and selection of targeted treatments in patients with cancer
Authors: Tobin N. P. , Foukakis T. , De Petris L. , Bergh J.
Published: September 2015

The past 30 years have seen the introduction of a number of cancer therapies with the aim of restricting the growth and spread of primary and metastatic tumours. A shared commonality among these therapies is their targeting of various aspects of the cancer hallmarks, that is traits that are essential to successful tumour propagation and dissemination. The evolution of molecular‐scale technology has been central to the identification of new cancer targets, and it is not a coincidence that improved therapies have emerged at the same time as gene expression arrays and DNA sequencing have enhanced our understanding of cancer genetics. Modern tumour pathology is now viewed at the molecular level ranging from IHC biomarkers, to gene signature classifiers and gene mutations, all of which provide crucial information about which patients will respond to targeted therapy regimens. In this review, we briefly discuss the general types of targeted therapies used in a clinical setting and provide a short background on immunohistochemical, gene expression and DNA sequencing technologies, before focusing on three tumour types: breast, lung and colorectal cancers. For each of these cancer types, we provide a background to the disease along with an overview of the current standard therapies and then focus on the relevant targeted therapies and the pathways they inhibit. Finally, we highlight several strategies that are pivotal to the successful development of targeted anti‐cancer drugs.
Rehabilitation for patients with myalgic encephalomyelitis/chronic fatigue syndrome: time to extent the boundaries of this field
Authors: Nijs J. , Malfliet A.
Published: September 2015

Click here to view the Original Article by D. C. W. M. Vos‐Vromans et al.
Socioeconomic Status and Parenting Priorities: Child Independence and Obedience Around the World
Authors: Park Heejung , Lau Anna S.
Published: September 2015

This study investigates the extent to which both national and personal socioeconomic status shape national norms and parenting priorities concerning child socialization. Data came from the European Values Survey, the World Values Survey, and the World Bank Data Catalog, resulting in 227,431 parents from 90 nations across fives study waves (1981–2008). Child independence was more popular in nations with greater wealth and more highly educated populations; obedience was more popular in nations with less wealth and lower percentages of educated and urban populations. Personal socioeconomic status predicted individual parents' prioritization of child independence and obedience; higher social class predicted a greater likelihood of endorsing independence and not endorsing obedience. Time‐slope estimation across study waves revealed that parents' prioritization of independence and obedience may rise over time in developing nations. Results provide implications for education, practice, and policy on cultural variations in parenting.
Methylene Blue‐Mediated Photodynamic Inactivation Followed by Low‐Laser Therapy versus Miconazole Gel in the Treatment of Denture Stomatitis
Authors: Maciel Carolina Menezes , Piva Marta Rabello , Ribeiro Maria Amália Gonzaga , de Santana Santos Thiago , Ribeiro Cyntia Ferreira , Martins‐Filho Paulo Ricardo Saquete
Published: September 2015

Purpose

Photodynamic therapy (PDT) appears to be an effective method for the in vitro and in vivo inactivation of Candida spp., but no clinical trials in this context have yet been conducted. The aim of this study was to compare the effect of oral miconazole gel to PDT combined with low‐power laser (LPL) therapy in the treatment of denture stomatitis.

Materials and Methods

Forty participants with clinical and microbiological diagnoses of type II denture stomatitis were randomly allocated to two treatment groups (PDT and miconazole gel), each with 20 individuals. The PDT group was submitted to one session of methylene blue‐mediated PDT plus two sessions of low‐laser therapy twice a week for 15 days. The miconazole group was submitted to the drug four times a day for 15 days.

Results

Forty percent of the patients achieved clinical and microbiological resolution of denture stomatitis after methylene blue‐mediated photodynamic inactivation followed by low‐laser therapy. The cure rate associated with miconazole was 80% (p < 0.05). Fifteen days after the end of treatment, the recurrence rate was 25% in patients treated with PDT combined with LPL therapy and 12.5% in patients treated with miconazole.

Conclusion

Miconazole gel provides better results than a protocol combining methylene blue‐mediated PDT and LPL therapy in the treatment of type II denture stomatitis.
The Effect of Reading Aloud Exercises for Complete Denture Patients during the Functional Rehabilitation Period
Authors: Liu Lang , Ye Xiu‐hua , Li Jie‐yin , Liao Juan‐kun , Ye Jian‐tao
Published: September 2015

Purpose

The focus of this study was to evaluate the effect of reading aloud on masticatory performance and patient satisfaction of patients rehabilitated with conventional complete dentures for the first time.

Materials and Methods

Sixty‐two edentulous patients who received conventional complete denture treatment for the first time were randomly divided into two equal groups. After insertion of the dentures, patients in group I were asked to read a news report three times per day for 4 weeks, while those in group II did not read. The reading duration increased by 5 minutes per week, from 5 minutes in the first week to 20 minutes in the fourth week. The patients’ mouth opening during reading aloud was advised to gradually increase throughout the training project. Two and four weeks after insertion of the dentures, masticatory performance was assessed using the sieving method, and patient satisfaction was measured using a visual analogue scale, which combined the patient's perceptions in relation to comfort, esthetics, stability, ability to talk, and ability to chew.

Results

There were significant improvements in masticatory performance with reading aloud exercises after the insertion of complete dentures (p < 0.001) at the 2‐ and 4‐week follow‐up visits. Masticatory performance also showed significant improvement within each group in the follow‐up periods (p < 0.001). No significant differences were found between the two groups in patient satisfaction (p > 0.05) at 2 weeks, but at 4 weeks, patient satisfaction regarding stability, ability to talk, and ability to chew was significantly higher for group I (p < 0.001).

Conclusions

The results of this study suggest that reading aloud exercises significantly improved early masticatory performance and patient satisfaction for denture wearers who were treated with conventional complete dentures for the first time, and may be a useful clinical application for more effective denture treatment.
Clinical Evaluation and Patient Satisfaction of Single Zirconia‐Based and High‐Noble Alloy Porcelain‐Fused‐to‐Metal Crowns in the Esthetic Area: A Retrospective Cohort Study
Authors: Shi Jun‐Yu , Li Xin , Ni Jie , Zhu Zi‐Yuan
Published: September 2015

Purpose

The aim of this study was to assess clinical survival, complications, and patient satisfaction with single zirconia‐based crowns (ZC) or high‐noble alloy PFM crowns (HC) in esthetic areas.

Materials and Methods

The study was a retrospective cohort study with up to 3.8 years follow‐up (mean 2.5 years). Patients who met the inclusion criteria were reviewed. Survival rates, complications, satisfaction rates (color and form), and overall satisfaction (visual analogue scale, VAS) were evaluated by follow‐up examination. Chi‐square test (survival, complication, and satisfaction rate) and unpaired t‐test (overall satisfaction: VAS) were used to test the difference between the ZC and HC groups. Survival rates and complications were assessed both at subject‐level (patient as statistical unit) and at tooth‐level (tooth as statistical unit).

Results

One hundred and thirteen patients met the inclusion criteria; 95 patients (ZC: 45, HC: 50) with 132 crowns (ZC: 61, HC: 71) were enrolled in the study. The overall survival rate was 93.3% for ZC crowns and 96.0% for HC crowns at subject‐level and 93.4% for ZC crowns and 97.2% for HC crowns at tooth‐level (p = 0.56 and 0.30, respectively). Veneer chipping was the most frequently seen complication. One HC crown lost retention because of poor cementation. One patient in the ZC group showed progression of periodontal disease. No significant difference of complications was found between the two groups at subject‐level and tooth‐level (p = 0.37 and 0.34, respectively). The overall satisfaction (VAS) was 8.18 for ZC crowns and 8.46 for HC crowns (p = 0.34).

Conclusions

The results of the study showed that a high survival rate could be achieved in both ZC and HC groups. Chipping of the veneering porcelain was the most frequently seen event that led to short‐term (less than 3 years) failure and complications. The patients’ rating of ZC crowns was not superior to HC crowns. Well‐designed studies with high evidence level and large sample size are still needed to further explore the clinical success of ZC and HC crowns.
Restoration of the Occlusal Vertical Dimension with an Overlay Removable Partial Denture: A Clinical Report
Authors: Zanardi Piero Rocha , Santos Mayara Silva , Stegun Roberto Chaib , Sesma Newton , Costa Bruno , Laganá Dalva Cruz
Published: September 2015

The process of tooth loss throughout life associated with severe occlusal wear may pose a challenge in the rehabilitation of partially edentulous arches. In these cases, many therapeutic procedures are necessary because each tooth must be restored to obtain the correct anatomical contour and recover the occlusal vertical dimension (OVD). A removable partial denture (RPD) with occlusal/incisal coverage, also known as an overlay RPD, is an alternative treatment option with fewer interventions, and, consequently, lower cost. This clinical report reviews the principles involved in the clinical indication for an overlay RPD, as well as the necessary planning and execution, to discuss the feasibility and clinical effectiveness of this treatment, identifying the indications, advantages, and disadvantages of this procedure through the presentation of a clinical case. The overlay RPD can be an alternative treatment for special situations involving partially edentulous arches in patients who need reestablishment of the OVD and/or realignment of the occlusal plane, and it can be used as a temporary or definitive treatment. The main advantages of this type of treatment are its simplicity, reversibility, and relatively low cost; however, further studies are needed to ensure the efficacy of this treatment option.
Variation in Primary Care Service Patterns by Rural‐Urban Location
Authors: Weigel Paula A.M. , Ullrich Fred , Shane Dan M. , Mueller Keith J.
Published: September 2015

Background

Rural communities have disproportionately faced primary care shortages for decades in spite of policy efforts to prepare and attract primary care health professionals to practice in rural locales. Insight into how primary care physicians’ service patterns in rural areas differ from those in less rural places is important to better inform recruitment strategies that target primary care providers and rural communities.

Objectives

The purpose of this research is to describe how primary care physician service patterns vary by rural‐urban location for a large, privately insured population. We discuss implications of service pattern variation on policy efforts to attract primary care providers to underserved rural areas.

Methods

Claims data from fully insured commercial health insurance beneficiaries were used to develop service pattern profiles for primary care providers located in 1 of 4 types of rural‐urban areas in Iowa in 2009. The 4 area types are metropolitan, micropolitan, noncore area adjacent to a metro area, and noncore/nonadjacent rural area.

Results

There were differences in primary care physicians’ service patterns by rural‐urban area type. Physicians in nonmetropolitan areas provided relatively more care on a per physician basis than those in the metropolitan area type, as well as more surgery, maternity, emergency, and nursing facility services than metropolitan physicians.

Conclusion

Primary care physicians who value practicing a relatively diverse range of services may find locating in rural areas an appealing choice. Health systems and policy makers seeking to attract primary care physicians to rural areas can incorporate this reality into a recruitment strategy.
Changes in the Supply of US Rural Health Centers, 2000‐2011: Implications for Rural Minority Communities
Authors: Ko Michelle , Cummings Janet R. , Ponce Ninez A.
Published: September 2015

Purpose

Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) provide primary care in rural areas with a shortage of providers. This paper examines whether racial and ethnic minority composition was related to changes in the supply of RHCs and FQHCs in rural counties from 2000 to 2011.

Methods

We conducted a retrospective cohort study of rural counties using the Area Health Resource File 2012‐2013. We examined rural counties defined as non‐Core‐Based Statistical Areas, with complete data on county characteristics for the study period (N = 1,349). Logistic regression analyses estimated associations between percentage of minority residents, and net gains and losses of RHCs and FQHCs, adjusting for total population, percentage of elderly residents, infant mortality rate, poverty rate, and physician, hospital, and clinic supply. Model estimates were used to calculate the predicted probability of outcomes across a range of minority percentage, from the 10th (≤1.6%) to 90th (≥46%) percentile of rural counties.

Findings

In high‐minority counties, the predicted probability of a net gain in any type of clinic was 28.6% (95% CI: 21.3‐35.8), versus 46.4% (95% CI: 40.0‐52.8) for low‐minority counties. High‐minority counties were also more likely to experience a net decline in RHCs.

Conclusions

During a period of substantial growth in both programs, the percentage of minority residents was negatively associated with gaining new clinics of either type. Policy makers may need to consider targeting rural minority communities for additional primary care workforce support.
Electroencephalogram of Healthy Horses During Inhaled Anesthesia
Authors: Williams D.C. , Aleman M.R. , Brosnan R.J. , Fletcher D.J. , Holliday T.A. , Tharp B. , Kass P.H. , Steffey E.P. , LeCouteur R.A.
Published: September 2015

Background

Previous study of the diagnostic validity of electroencephalography (EEG) to detect abnormalities in equine cerebral cortical function relied on the administration of various drugs for sedation, induction, and maintenance of general anesthesia but used identical criteria to interpret recordings.

Objectives

To determine the effects of 2 inhalation anesthetics on the EEG of healthy horses.

Animals

Six healthy horses.

Methods

Prospective study. After the sole administration of one of either isoflurane or halothane at 1.2, 1.4, and 1.6 times the minimum alveolar concentration, EEG was recorded during controlled ventilation, spontaneous ventilation, and nerve stimulation.

Results

Burst suppression was observed with isoflurane, along with EEG events that resembled epileptiform discharges. Halothane results were variable between horses, with epileptiform‐like discharges and bursts of theta, alpha, and beta recorded intermittently. One horse died and 2 were euthanized as the result of anesthesia‐related complications.

Conclusions and Clinical Importance

The results of this study indicate that the effects of halothane and isoflurane on EEG activity in the normal horse can be quite variable, even when used in the absence of other drugs. It is recommended that equine EEG be performed without the use of these inhalation anesthetics and that general anesthesia be induced and maintained by other contemporary means.
Systematic Review of Brain Tumor Treatment in Dogs
Authors: Hu H. , Barker A. , Harcourt‐Brown T. , Jeffery N.
Published: September 2015

Intracranial neoplasia is commonly diagnosed in dogs and can be treated by a variety of methods, but formal comparisons of treatment efficacy are currently unavailable. This review was undertaken to summarize the current state of knowledge regarding outcome after the treatment of intracranial masses in dogs, with the aim of defining optimal recommendations for owners. This review summarizes data from 794 cases in 22 previously published reports and followsPRISMAguidelines for systematic review. APubmed search was used to identify suitable articles. These then were analyzed for quality and interstudy variability of inclusion and exclusion criteria and the outcome data extracted for summary in graphs and tables. There was a high degree of heterogeneity among studies with respect to inclusion and exclusion criteria, definition of survival periods, and cases lost to follow‐up making comparisons among modalities troublesome. There is a need for standardized design and reporting of outcomes of treatment for brain tumors in dogs. The available data do not support lomustine as an effective treatment, but also do not show a clear difference in outcome between radiotherapy and surgery for those cases in which the choice is available.
Factors associated with early growth in Egyptian infants: implications for addressing the dual burden of malnutrition
Authors: Kavle Justine A. , Flax Valerie L. , Abdelmegeid Ali , Salah Farouk , Hafez Seham , Ramzy Magda , Hamed Doaa , Saleh Gulsen , Galloway Rae
Published: September 2015

Optimal nutrition is critical to the attainment of healthy growth, human capital and sustainable development. In Egypt, infants and young children face overlapping forms of malnutrition, including micronutrient deficiencies, stunting and overweight. Yet, in this setting, little is known about the factors associated with growth during the first year of life. A rise in stunting in Lower Egypt from 2005 to 2008 prompted this implementation research study, which followed a longitudinal cohort of infants from birth to 1 year of age within the context of a USAID‐funded maternal and child health integrated programme. We sought to determine if growth patterns and factors related to early growth differed in Lower and Upper Egypt, and examined the relationship between weight loss and subsequent stunting at 12 months of age. Growth patterns revealed that length‐for‐age z‐score (LAZ) decreased and weight‐for‐length z‐score (WLZ) increased from 6 to 12 months of age in both regions. One‐quarter of infants were stunted and nearly one‐third were overweight by 12 months of age in lower Egypt. Minimum dietary diversity was significantly associated with WLZ in Lower Egypt (β = 0.22, P < 0.05), but not in Upper Egypt. Diarrhoea, fever and programme exposure were not associated with any growth outcome. Weight loss during any period was associated with a twofold likelihood of stunting at 12 months in Lower Egypt, but not Upper Egypt. In countries, like Egypt, facing the nutrition transition, infant and young child nutrition programmes need to address both stunting and overweight through improving dietary quality and reducing reliance on energy‐dense foods.
Azithromycin‐containing intermittent preventive treatment in pregnancy affects gestational weight gain, an important predictor of birthweight in Papua New Guinea – an exploratory analysis
Authors: Unger Holger W. , Wangnapi Regina A. , Ome‐Kaius Maria , Boeuf Philippe , Karl Stephan , Mueller Ivo , Rogerson Stephen J.
Published: September 2015

In Papua New Guinea, intermittent preventive treatment with sulphadoxine‐pyrimethamine and azithromycin (SPAZ‐IPTp) increased birthweight despite limited impact on malaria and sexually transmitted infections. To explore possible nutrition‐related mechanisms, we evaluated associations between gestational weight gain (GWG), enrolment body mass index (BMI) and mid‐upper arm circumference (MUAC), and birthweight. We investigated whether the increase in birthweight associated with SPAZ‐IPTp may partly be driven by a treatment effect on GWG. The mean GWG rate was 393 g/week (SD 250; n = 948). A 100 g/week increase in GWG was associated with a 14 g (95% CI 2.6, 25.4) increase in birthweight (P = 0.016). Enrolment BMI and MUAC also positively correlated with birthweight. SPAZ‐IPTp was associated with increased GWG [58 g/week (26, 900), P < 0.001, n = 948] and with increased birthweight [48 g, 95% CI (8, 880), P = 0.019] when all eligible women were considered (n = 1947). Inclusion of GWG reduced the birthweight coefficient associated with SPAZ‐IPTp by 18% from 44 to 36 g (n = 948), although SPAZ‐IPTp was not significantly associated with birthweight among women for whom GWG data were available (P = 0.13, n = 948). One month post‐partum, fewer women who had received SPAZ‐IPTp had a low post‐partum BMI (<18.5 kg m−2) [adjusted risk ratio: 0.55 (95% CI 0.36, 0.82), P = 0.004] and their babies had a reduced risk of wasting [risk ratio 0.39 (95% CI 0.21, 0.72), P = 0.003]. SPAZ‐IPTp increased GWG, which could explain its impact on birthweight and maternal post‐partum BMI. Future trials of SPAZ‐IPTp must incorporate detailed anthropometric evaluations to investigate mechanisms of effects on maternal and child health.
Evidence for altered cholesterol metabolism in Huntington's disease post mortem brain tissue
Authors: Kreilaus Fabian , Spiro Adena S. , McLean Catriona A. , Garner Brett , Jenner Andrew M.
Published: September 2015

Aims

Cholesterol plays an essential role in membrane structure and function, being especially important in the brain. Alteration of brain cholesterol synthesis and metabolism has been demonstrated in several Huntington's disease (HD) mouse and cell models; however, less is known about these alterations in human tissue. This study aimed to identify alterations to cholesterol synthetic and metabolic pathways in human HD brain tissue.

Methods

A broad range of cholesterol synthetic precursors, metabolites and oxidation products were measured by gas chromatography‐tandem mass spectrometry in five regions of human post mortem HD brain and compared with age‐ and sex‐matched control tissues. The level of enzymes that regulate cholesterol homeostasis, cholesterol 24‐hydroxylase and delta(24)‐sterol reductase were investigated by Western blotting and qPCR in putamen.

Results

The most significant changes were localized to the putamen, where a 60% decrease in 24(S)‐hydroxycholesterol, 30% increase in cholesterol and 100–200% increase in synthetic precursors (lathosterol, zymosterol and desmosterol) was detected. The enzymes cholesterol 24‐hydroxylase and delta(24)‐sterol reductase were also significantly decreased in HD putamen as compared with control tissues. Free radical‐generated cholesterol oxidation products 7‐keto cholesterol and 7β‐hydroxycholesterol were also increased by 50–70% in HD putamen.

Conclusion

Human HD brain has significantly decreased cholesterol metabolism and disrupted cholesterol homeostasis. Our data also indicate that lipid oxidative stress accompanies HD pathology.