bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of the Use of a Force Diagram in the Management of Temporomandibular Joint Sounds: A Prospective Cross-sectional Study
Authors: Saueressig Nilton Sodi , Saueressig Hickert Aline Cristina , Keller de Andrade Gilberto , Bittencourt Hélio Radke , Basso Délcio , Saueressig Nilton Gustavo 
Published: May 2019

Abstract

Context
Occlusal splints are widely used in clinical practice as a noninvasive treatment for patients with temporomandibular disorders (TMDs) and for reduction of TMD-related symptoms. A force diagram allows a health care professional to evaluate the interactions of loads caused by muscular effort, which are sensed by the teeth and the temporomandibular joint during the protrusive movement of the mandible.

Objective
To evaluate the efficacy of occlusal splints combined with occlusal adjustment (OA) based on a force diagram in the management of joint sounds (clicking and crepitation).

Methods
Patients were examined clinically and administered a questionnaire for the diagnosis of TMD and orofacial pain. Patients were then assigned to 1 of 2 splint therapies: (1) an anterior bite plane of the front-plateau type (FP) or (2) a maxillary muscle relaxation appliance (MRA), both combined with OA based on a force diagram performed at 6 visits, with an interval of 24 to 48 hours between each visit. To measure the effects of treatment, at each of the 6 visits, patients also rated the severity of their TMD-related symptoms on a visual analog scale. Data were dichotomized into presence and absence of symptoms and compared using the McNemar test.

Results
A total of 199 patients were included in the study. At baseline, 38 patients (19.1%) had crepitation and 161 (80.9%) had clicking. A total of 150 patients were treated with FP+OA, with a statistically significant reduction in the number of patients reporting clicking (42.6%, P<.001) and crepitation (42.9%, P<.001). Among patients treated with MRA+OA (n=49), there was a statistically significant reduction in the number of patients reporting clicking (50%, P<.001). All 3 patients with crepitation in the MRA+OA group reported total remission (P>.05).

Conclusion
The 2 treatment strategies, FP+OA and MRA+OA, improved both clicking and crepitation. Both strategies prioritize the concept of mutually protected occlusion, in which all jaw and temporomandibular joint movements must synchronize, which may be conveniently done using the force diagram.
Assessment of Knowledge and Practice about Self Expressed Breast Milk among Saudi Mothers in Jazan Region, KSA, 2016
Authors: Qutah Karimah Mohammad , Alsaleem Safar A. , Najmi Abdullah Ahmed , Zabbani Muteb Bawwah 
Published: May 2019

Aim: To assess mother's knowledge and attitude regarding self-expressed milk in Jazan, Saudi Arabia.
Methodology: Study Area: An observational and cross sectional study done in Obstetric Department (Well Baby and immunization Clinics) in King Fahd Central Hospital (KFCH), Jazan, Saudi Arabia and in six PHCCs in Jazan (randomly selected) from December 2016 - March 2017. Pregnant women who delivered babies before and post-partum women in Obstetric departments, Obstetric outpatient clinic, mother’s in well baby, and immunization clinics in mentioned areas were included in the study. Stratified multistage sampling techniques were used. N = 499 Saudi mothers calculated according to survey system with confidence level % 95. The questionnaire was self-administering questionnaire (in Arabic language). All data processed via Statistical Package for the Social Sciences (SPSS) version 19. Shapiro-Wilk test. Kruskal-Wallis test used to see the association between level of knowledge and practice with demographic variables that contains more than 2 variables. Mann-Whitney test and Spearman correlation were used.
Results: Total of 499 mothers was participating aged 30±7 years with mean number of kids 2.98 ± 2. Mothers heard about self-expressed breast milks accounts 73.5% and 236 mothers of them were practice it. Both level of knowledge and practice accuracy were inadequate. Around one third of mothers heard about it from social media. More than third of the women practice it because of work related issues. The higher the educational level was the higher knowledge (p<0.001). Age and number of kids, has no statistically significant effect on the knowledge level (P = 0.417, 0.285). Working mothers have higher knowledge level than house wife and students (p<0.001), nurses especially who toke breast feeding teaching have higher knowledge level than physicians then teachers (p<0.001). Mothers who toke their knowledge from breast feeding courses have the highest knowledge level followed by medical stuffs other than physicians followed by social media and internet websites then physicians then mothers and last are friends (p<0.001). Mothers with more accurate practice were more knowledgeable than mothers with less accurate practices (p<0.001).
Conclusion: Mothers knowledge and practice regarding self-expressed breast milk needed to be improved in order to give the babies better chance for exclusive breast feeding. Breast feeding courses for mothers give better results in term of accuracy of mother’s knowledge and practice of expressed breast milk.
Relationship between Observed Seismicity and Water Level Fluctuations in Polyphyto Dam Area (North Greece)
Authors: Pavlou Kyriaki 
Published: May 2019

The spatial-temporal seismicity in Aliakmona river area is presented for the period 1974-2010 (NW Greece). This study area, which was classified as low seismicity, presents a particular interest due to the unexpected strong earthquake of Ms=6.6 which occurred between the cities of Kozani–Grevena, at a distance of 18 km from the southern edge of Polyphyto lake in 1995. According to [1], seismic hazard changes have been identified SE of the Polyphyto dam after the impoundment of the lakes. In this study, we examined the possible correlation between the impoundment and the water level fluctuations due to the three artificial lakes which are established in the region and the observed seismicity using data from the catalogues of the National Observatory of Athens (NOA) (see details for seismological data on Mc, RMS, etc. in [2,3]). For the latter purpose, spatial and temporal distribution maps were developed as well as correlation diagrams between water level variations in respect to monthly seismicity for distances 10 Km, 20 Km, 30 Km, 40 Km and 50 Km around the artificial lakes using the ESRI ArcMap 10 software. A remarkable change is observed in seismic activity in the vicinity of reservoirs for the period commencing 10 years prior to the first filling in comparison with the period 10 years after. This increased seismicity is correlated to the daily rate of water level fluctuations (dh/dt) for the period 1984-2010 reveals the presence of mainly shallow seismic activity with focal depths of 0-5 km in a high percentage (67%). This protracted seismicity which is mainly located in the SW area of Polyphyto lake, has characteristics of the second type of induced seismicity according to Talwani [4], and seems to be controlled by the water level fluctuations of Polyphyto reservoir due to the mechanism of pore pressure diffusion.
Association of Lupus Nephritis With Coronary Artery Disease by ISN/RPS Classification: Results From a Large Real‐world Lupus Population
Authors: Sun Enid Y. , Alvarez Carolina , Sheikh Saira Z. 
Published: May 2019

ObjectivePatients with systemic lupus erythematosus (SLE) are at an increased risk for developing coronary artery disease (CAD). Several studies suggest that the presence of lupus nephritis (LN) is independently associated with CAD. The purpose of our study was to assess whether the presence of LN is independently associated with CAD in our patient population and whether this association varies by class of LN.MethodsA retrospective cross‐sectional analysis was performed using medical records of patients 18 years and older with SLE at University of North Carolina Hospitals from April 4, 2014, to December 31, 2017. Subjects were identified using International Classification of Diseases, Ninth Revision (ICD‐9) and International Classification of Diseases, 10th Revision (ICD‐10) codes specific for SLE. LN class was defined by International Society of Nephrology/Renal Pathology Society (ISN/RPS) classification. CAD was the outcome of interest. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs).ResultsOur sample consisted of 3732 patients with SLE, of whom 598 (16%) had LN and 537 (14%) had CAD. When adjusting for demographics and factors associated with CAD and LN, the odds of having CAD were significantly higher for patients with SLE and LN compared with patients without LN (OR 1.47; 95% CI 1.07‐2.02; P = 0.017). Controlling for these factors, class III LN (OR 1.98; 95% CI 0.95‐4.12; P = 0.069) and class III/V LN (OR 2.23; 95% CI 1.09‐4.62; P = 0.028) were very strongly associated with CAD in subjects with LN compared with subjects without LN.ConclusionWe confirm the observations of previous studies that LN is significantly associated with CAD. Our study is the first to show the association between CAD and specific classes of LN.
One‐Step Synthesis of W2C@N,P‐C Nanocatalysts for Efficient Hydrogen Electrooxidation across the Whole pH Range
Authors: Xiong Bingyan , Zhao Wenbin , Chen Lisong , Shi Jianlin 
Published: May 2019

AbstractHighly active and low‐cost non‐noble metal electrocatalysts for hydrogen oxidation reaction (HOR) are crucial for the large‐scale applications of fuel cells, which, unfortunately, are rarely documented up to now. Here, a facile one‐step strategy to fabricate W2C nanoparticles (≈3 nm) encased in N, P‐doped few layer carbon materials (W2C@N,P‐C, WNPC) as an efficient non‐noble metal HOR electrocatalyst simply by calcining the mixture of recrystallized phosphotungstic acid and dicyandiamide is reported. The obtained WNPC catalyst shows extraordinarily high HOR activities (1.03/0.91/0.84 mA cm−2 at 0.05 V vs reversible hydrogen electrode in 0.1 m HClO4/0.1 m KOH/0.1 m neutral phosphate buffered saline electrolytes, respectively), excellent durability during accelerated degradation tests for 10 000 cycles, and outstanding CO tolerance. These high performances are attributed to the uniform structure of WNPC, and more essentially, the synergistic effect among N, P, and C species which elevates the reducibility of WNPC, favoring the generation of abundant HOR active sites.
Base Metal Catalysis in Directed C(sp3)−H Functionalisation
Authors: St John‐Campbell Sahra , Bull James A. 
Published: May 2019

AbstractDirected C(sp3)−H functionalisation has made enormous progress in recent years, but has largely been restricted to catalysis using noble metals, particularly palladium. However, since 2013, there have been prominent advances that exploit the reactivity of abundant first row transition metals for a multitude of new bond formations. The use of base metal catalysis for C−H functionalisation can provide huge advantages in terms of cost and sustainability compared to methods using noble metals. This review covers all examples, to the end 2018, of auxiliary‐assisted, base metal‐catalysed C(sp3)−H functionalisation reactions. Successful examples are reported for Fe, Co, Ni and Cu catalysis with monodentate or bidentate directing groups for C−N, C−O, C−S and C−C bond forming reactions. This review aims to highlight the current state of this field and potential for expansion and so scope and limitations are highlighted. Notably, examples to date have required sterically activated α‐disubstituted substrates, particularly propanamide derivatives with bidentate directing groups, such as 8‐aminoquinoline amides. Monodentate quinoline and thioamide directing groups have also been used with Co catalysis for C−N and C−C bond formations. Mechanistic details are provided to outline the nature of the proposed organometallic intermediates and potential reaction pathways. We hope this review will stimulate further developments in this growing and important field.magnified image
Multisystem afflictions in former National Football League players
Authors: Morris Timothy P. , McCracken Caitlin , Baggish Aaron , Weisskopf Marc , Zafonte Ross , Taylor Herman A. , Nadler Lee M. , Speizer Frank E. , Pascual‐Leone Alvaro 
Published: May 2019

AbstractBackgroundThe long‐term health consequences of participation in American style football (ASF) are not well understood.MethodsWe conducted a retrospective cohort study of men who had played in the NFL after 1960. Participants were studied using a standardized self‐administered questionnaire designed to determine both the exposure history to ASF and the prevalence of chronic pain, sleep apnea, cardiometabolic disease, and neurocognitive impairment. Logistic regression and negative binomial regression models were used to assess associations between age, ethnicity, body‐mass index during professional football career, field position, and football career duration with individual and multiple afflictions.ResultsIn this cohort of former NFL players (n = 3745), approximately one quarter of the eligible former players (27%) reported two or more medical afflictions (chronic pain, cardiometabolic disease, sleep apnea, or neurocognitive impairment). Career duration was significantly associated with an increase in the number of comorbidities. Age, race, and body‐mass index were associated with all affliction categories, other than neurocognitive impairment, which was similarly prevalent in middle‐aged players and older players. Earlier age when first playing the sport was protective against cardiometabolic affliction.ConclusionsFormer NFL players report significant combinations of cross‐system afflictions. Future work will be required to determine mechanistic underpinnings. However, attention to the whole player, rather than specific organ systems seems critical to improve long‐term health outcomes in former ASF professional athletes.
Induction of brain‐infiltrating T‐bet–expressing B cells in multiple sclerosis
Authors: van Langelaar Jamie , Rijvers Liza , Janssen Malou , Wierenga‐Wolf Annet F. , Melief Marie‐José , Siepman Theodora A. , de Vries Helga E. , Unger Peter‐Paul A. , van Ham S. Marieke , Hintzen Rogier Q. , van Luijn Marvin M. 
Published: May 2019

ObjectiveResults from anti‐CD20 therapies demonstrate that B‐ and T‐cell interaction is a major driver of multiple sclerosis (MS). The local presence of B‐cell follicle‐like structures and oligoclonal bands in MS patients indicates that certain B cells infiltrate the central nervous system (CNS) to mediate pathology. Which peripheral triggers underlie the development of CNS‐infiltrating B cells is not fully understood.MethodsEx vivo flow cytometry was used to assess chemokine receptor profiles of B cells in blood, cerebrospinal fluid, meningeal, and brain tissues of MS patients (n = 10). Similar analyses were performed for distinct memory subsets in the blood of untreated and natalizumab‐treated MS patients (n = 38). To assess T‐bet(CXCR3)+ B‐cell differentiation, we cultured B cells from MS patients (n = 21) and healthy individuals (n = 34) under T helper 1‐ and TLR9‐inducing conditions. Their CNS transmigration capacity was confirmed using brain endothelial monolayers.ResultsCXC chemokine receptor 3 (CXCR3)‐expressing B cells were enriched in different CNS compartments of MS patients. Treatment with the clinically effective drug natalizumab prevented the recruitment of CXCR3high IgG1+ subsets, corresponding to their increased ability to cross CNS barriers in vitro. Blocking of interferon‐γ (IFNγ) reduced the transmigration potential and antigen‐presenting function of these cells. IFNγ‐induced B cells from MS patients showed increased T‐bet expression and plasmablast development. Additional TLR9 triggering further upregulated T‐bet and CXCR3, and was essential for IgG1 switching.InterpretationThis study demonstrates that T‐bethigh IgG1+ B cells are triggered by IFNγ and TLR9 signals, likely contributing to enhanced CXCR3‐mediated recruitment and local reactivity in the CNS of MS patients. ANN NEUROL 2019;86:264–278
Production of Conjugated Linoleic Acid by Microwave‐Assisted and Ultrasound‐Assisted Alkali Isomerization: Effects of Microwave Power and Ultrasound Amplitude
Authors: Alaşalvar Hamza , Erinç Hakan , Salur Fatma , Özbey Ayşe 
Published: May 2019

AbstractConjugated linoleic acid (CLA) is commercially produced by alkali isomerization of linoleic acid (LNA). However, this method constitutes a relatively high content of undesirable CLA isomers. In present study, microwave‐assisted and ultrasound‐assisted alkali isomerization techniques were applied for production of CLA as an alternative to traditional alkali isomerization. This study was aimed to evaluate the isomerization degree of LNA, by using various process conditions such as microwave power, ultrasound amplitude, and their reaction times. The best conditions for LNA isomerization were a microwave power of 700 W and a reaction time of 6 h for microwave‐assisted alkali isomerization and an ultrasound amplitude of 100% and a reaction time of 6 h for ultrasound‐assisted alkali isomerization. Under determined conditions, microwave‐assisted alkali isomerization (97.21%) resulted in a higher isomerization degree compared to ultrasound‐assisted alkali isomerization (76.98%) while the content of undesirable CLA isomers in ultrasound‐assisted alkali isomerization (0.62%) was lower than that of microwave‐assisted alkali isomerization (1.87%). This study showed that application of the both techniques resulted in equal amounts of desirable CLA isomers. The content of desirable CLA isomers was 47.09% cis‐9, trans‐11 and 48.25% trans‐10, cis‐12 for microwave‐assisted alkali isomerization and 36.34% cis‐9, trans‐11 and 40.02% trans‐10, cis‐12 for ultrasound‐assisted alkali isomerization.
Guideline Implementation: Sterilization
Authors: Link Terri 
Published: May 2019

ABSTRACTEnsuring that reusable surgical instruments and medical devices have been sterilized is an important factor in preventing surgical site infections. The sterilization method for a particular device is based on the device design, material, packaging, compatibility with the sterilant, load limitations, and safety requirements. Perioperative team members must review the manufacturer's instructions for cleaning, packaging, and sterilizing the device to determine the correct sterilization process. The AORN “Guideline for sterilization” provides guidance for processing reusable medical devices for use in perioperative and procedural settings. This article elaborates on key takeaways from the guideline, including processing a device based on the intended use of the item, protecting sterile items during transport, reprocessing by immediate‐use steam sterilization when certain conditions can be met, and educating personnel who perform sterile processing activities. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures.
Inadvertent Perioperative Hypothermia Risks and Postoperative Complications: A Retrospective Study
Authors: Akers J. Luke , Dupnick Amanda C. , Hillman Elisa L. , Bauer Andrew G. , Kinker Lauren M. , Hagedorn Wonder Amy 
Published: May 2019

ABSTRACTInadvertent perioperative hypothermia is a widely known patient condition that is associated with postoperative complications. This retrospective comparative study of 298 surgical patients was conducted at a single hospital site in the midwestern United States. Our aims were to describe risk factors and outcomes associated with perioperative hypothermia. We compared the type and frequency of patient factors, clinical factors, and postoperative complications during the inpatient stay of the sample patients to determine whether there were factors or complications associated with perioperative hypothermia. Significant factors associated with the occurrence of perioperative hypothermia included older age and type of surgery. Hypothermia in patients was associated with a higher rate of postoperative complications when compared with normothermic patients. Nurses and perioperative leaders should understand the risk factors and complications associated with perioperative hypothermia to collaboratively develop and test evidence‐based initiatives, improve care, and promote optimal patient outcomes.
The Effect of Radiofrequency Technology on Time Spent Searching for Surgical Sponges and Associated Costs
Authors: Steelman Victoria M. , Schaapveld Ann G. , Storm Hillary E. , Perkhounkova Yelena , Shane Dan M. 
Published: May 2019

ABSTRACTRetained surgical items (eg, sponges, instruments) remain the most frequently reported sentinel events. The primary strategy for preventing retained sponges is the sponge count. Reconciling sponge counts is time consuming and can extend the duration of operative and other invasive procedures. The primary objective of this observational study was to evaluate the effect of a radiofrequency (RF) surgical‐sponge detection system on time spent searching for surgical sponges. The study included 27,637 procedures during nine months before and after implementing an RF surgical‐sponge detection system. After implementation of the system, time spent searching for sponges was reduced by 79.58%, the percentage of unreconciled counts was reduced by 71.28%, and time spent using radiography to rule out a retained sponge was reduced by 46.31%. This resulted in a reduction of costs. These findings should be used as part of a comprehensive cost analysis of alternative methods when evaluating RF sponge detection technology.
Extracellular Vesicles and Cell–Cell Communication in the Cornea
Authors: Zieske James D. , Hutcheon Audrey E. K. , Guo Xiaoqing 
Published: May 2019

ABSTRACTOne question that has intrigued cell biologists for many years is, “How do cells interact to influence one another's activity?” The discovery of extracellular vesicles (EVs) and the fact that they carry cargo, which directs cells to undergo changes in morphology and gene expression, has revolutionized this field of research. Little is known regarding the role of EVs in the cornea; however, we have demonstrated that EVs isolated from corneal epithelial cells direct corneal keratocytes to initiate fibrosis. Intriguingly, our data suggest that EVs do not penetrate epithelial basement membrane (BM), perhaps providing a mechanism explaining the importance of BM in the lack of scarring in scrape wounds. Since over 100‐million people worldwide suffer from visual impairment as a result of corneal scarring, the role of EVs may be vital to understanding the mechanisms of wound repair. Therefore, we investigated EVs in ex vivo and in vivo‐like three‐dimensional cultures of human corneal cells using transmission electron microscopy. Some of the major findings were all three major cell types (epithelial, fibroblast, and endothelial cells) appear to release EVs, EVs can be identified using TEM, and EVs appeared to be involved in cell–cell communication. Interestingly, while our previous publication suggests that EVs do not penetrate the epithelial BM, it appears that EVs penetrate the much thicker endothelial BM (Descemet's membrane). These findings indicate the huge potential of EV research in the cornea and wound healing, and suggest that during homeostasis the endothelium and stromal cells are in communication. Anat Rec, 2019. © 2019 The Authors. The Anatomical Record published by Wiley Periodicals, Inc. on behalf of American Association of Anatomists.