bluuebunny/crossref_metadata_2025_split huggingface dataset:
Shortage of dentists in Outer Regional and Remote areas and long public dental waiting lists: Changes over the past decade
Authors: Dudko Yevgeni , Kruger Estie , Tennant Marc 
Published: June 2018

AbstractObjectiveThe shortage of dentists in Outer Regional and Remote areas of Australia and long public dental waiting lists have been the subject of media attention over the last decade. A number of state and federal initiatives were introduced over the years to address these problems. This study aims to gauge whether the waiting lists and shortage of dentists in Outer Regional and Remote areas have seen a positive change over the last decade.DesignThis evaluation study analysed and compared the number of dentists full‐time equivalent per 100 000 population, eligible population and waiting list size (New South Wales and Queensland) at various points in time over the last decade.SettingNational.ParticipantsData were extracted from practitioner registry reports.Main outcome measuresNumber of dentists practising in Outer Regional and Remote areas of Australia and number of people on the public dental waiting list (New South Wales and Queensland).ResultsThere was a significant improvement in the number of dentists practising in Outer Regional and Remote areas of Australia. The public dental waiting lists in New South Wales and Queensland (as of September 2016) were found to have surpassed their pre National Partnership Agreement levels in 2012. The growth of public dental waiting lists exceeded the growth of the eligible population by a significant margin.ConclusionThe dentist‐to‐population ratios in Outer Regional and Remote areas have seen a significant improvement. The reduction in the number of people on the public dental waiting list was significant, but brief.
Functional significance and risk factors for lymphocele formation after renal transplantation
Authors: Heer Munish K. , Clark David , Trevillian Paul R. , Sprott Philip , Palazzi Kerrin , Hibberd Adrian D. 
Published: June 2018

BackgroundLymphocele development following renal transplantation is a significant adverse event. It may cause acute graft dysfunction or venous obstruction. There are no consistent risk factors reported in literature. Perioperative fluid balance may lead to increased lymphocele formation and has never been studied. We aimed to analyse incidence and risk factors for lymphocele formation. We hypothesized that overhydration in perioperative period is a risk factor.MethodsWe analysed 250 consecutive renal transplant recipients from 2006 to 2014. All recipients had undergone protocol screening by computerized tomography and ultrasound scan at 3 months post‐transplant. We analysed risk factors for lymphocele formation. Comparisons between lymphocele and no‐lymphocele groups were made with binary logistic regression analyses. Renal function was compared between treated, untreated and no‐lymphocele groups with linear regression analyses.ResultsThirty‐one of 250 (12.4%) transplant recipients developed lymphocele. Fourteen of 31 (45.4%) recipients required intervention due to symptoms (venous obstruction being the most common). Surgical drainage was done in all symptomatic patients (11 laparoscopic and three open). Two of 11 (18%) recipients had recurrence after laparoscopic drainage. There were no significant differences in risk factors between the lymphocele and no‐lymphocele groups. Renal function was comparable between no‐lymphocele and treated lymphocele groups. Untreated lymphocele group trended towards better graft function at 1 year (P = 0.051).ConclusionPost‐transplant lymphocele developed one in eight transplant recipients and tended to occur in those with good renal function. Around half of the recipients with lymphocele required intervention with good recovery of long‐term renal function. No risk factor for lymphocele development was established.
Increased risk of open‐angle glaucoma among patients with diabetes mellitus: a 10‐year follow‐up nationwide cohort study
Authors: Rim Tyler Hyungtaek , Lee Sang Yeop , Bae Hyoung Won , Seong Gong Je , Kim Sung Soo , Kim Chan Yun 
Published: June 2018

AbstractPurposeTo evaluate the risk of open‐angle glaucoma among patients with diabetes.MethodsThis retrospective propensity score‐matched cohort study included patients with diabetes and a matched comparison group from the Korean National Health Insurance Service National Health Screening Cohort, which includes approximately 500 000 adults aged ≥40 years. Nondiabetes group was matched to diabetes group in a 1:1 ratio using a propensity score based on age, sex, comorbidities, antihypertensive medication use and medical care visits. Each group was followed from January 1, 2004 to either the date of developing open‐angle glaucoma or the date of last follow‐up in 2013.ResultsIncidence of open‐angle glaucoma was 20.0/10 000 person‐years in diabetes group (n = 58 358) and 17.0/10 000 person‐years in nondiabetes group (n = 58 358). Age‐ and sex‐ adjusted hazard ratio (HR) was 1.19 (95% confidence interval [CI], 1.09–1.30). In the subgroup analyses, diabetes was associated with an increased risk of open‐angle glaucoma in both younger and older age groups (HR = 1.20 for those aged 40–59 years and HR = 1.18 for those aged 60–79 years) and in both sexes (men, HR = 1.13; women, HR = 1.27).ConclusionPatients diagnosed with diabetes were more likely to develop open‐angle glaucoma compared with patients without diabetes.
Early central line‐associated blood stream infections in children with cancer pose a risk for premature catheter removal
Authors: Moell Jacob , Svenningsson Anna , Af Sandeberg Margareta , Larsson Magnus , Heyman Mats , Harila‐Saari Arja , Nilsson Anna 
Published: June 2018

AbstractAimThis study examined the clinical characteristics of central line‐associated blood stream infections occurring within 30 days after insertion versus later infections in paediatric cancer patients and the subsequent risk for premature catheter removal.MethodsThis was a retrospective study of children aged 0–18 years who were diagnosed with cancer from 2013 to 2014 at the Astrid Lindgren Children Hospital, Sweden. Clinical and microbiology data for each patient were collected for 365 days after the central venous catheter (CVC) was inserted.ResultsDuring the study period, 154 children received a CVC. The overall incidence of central line associated blood stream infections was 2.0 per 1000 catheter days. A total of 108 infectious episodes were identified in 44/154 (29%) patients. Of those, 15/44 children (29%) had an early infection within 30 days and alpha‐haemolytic Streptococci and coagulase‐negative Staphylococci dominated. Children with early infections were more likely to have a haematological malignancy and to need premature removal of the CVC due to repeated infections.ConclusionWe observed a high prevalence of early CVC associated blood stream infection mainly in patients with haematological malignancies. Our study highlights the importance of preventive measures in reducing infections in paediatric cancer patients.
Long‐term adverse effects of paracetamol – a review
Authors: McCrae J. C. , Morrison E. E. , MacIntyre I. M. , Dear J. W. , Webb D. J. 
Published: June 2018

Paracetamol (acetaminophen) is the most commonly used drug in the world, with a long record of use in acute and chronic pain. In recent years, the benefits of paracetamol use in chronic conditions has been questioned, notably in the areas of osteoarthritis and lower back pain. Over the same period, concerns over the long‐term adverse effects of paracetamol use have increased, initially in the field of hypertension, but more recently in other areas as well. The evidence base for the adverse effects of chronic paracetamol use consists of many cohort and observational studies, with few randomized controlled trials, many of which contradict each other, so these studies must be interpreted with caution. Nevertheless, there are some areas where the evidence for harm is more robust, and if a clinician is starting paracetamol with the expectation of chronic use it might be advisable to discuss these side effects with patients beforehand. In particular, an increased risk of gastrointestinal bleeding and a small (~4 mmHg) increase in systolic blood pressure are adverse effects for which the evidence is particularly strong, and which show a degree of dose dependence. As our estimation of the benefits decreases, an accurate assessment of the harms is ever more important. The present review summarizes the current evidence on the harms associated with chronic paracetamol use, focusing on cardiovascular disease, asthma and renal injury, and the effects of in utero exposure.
Gastrointestinal bleeding risk of selective serotonin reuptake inhibitors by level of kidney function: A population‐based cohort study
Authors: Iwagami Masao , Tomlinson Laurie A. , Mansfield Kathryn E. , Douglas Ian J. , Smeeth Liam , Nitsch Dorothea 
Published: June 2018

AimTo estimate the risk of gastrointestinal (GI) bleeding associated with serotonin reuptake inhibitors (SSRIs) by level of kidney function.MethodsWe conducted a cohort study using the Clinical Practice Research Datalink linked to Hospital Episode Statistics. We identified patients with chronic kidney disease (CKD; estimated glomerular filtration rate <60 ml min–1 1.73 m–2 for ≥3 months), and a comparison group of patients without it. Patients with CKD were further classified as stage 3a (eGFR 45–59 ml min–1 1.73 m–2), 3b (30–44 ml min–1 1.73 m–2) and 4/5 (<30 ml min–1 1.73 m–2). We excluded prevalent SSRI users at cohort entry. Exposure was time‐dependent SSRI prescription and outcome was first hospitalization for GI bleeding. We estimated adjusted rate ratio (aRR) and rate difference (aRD) of GI bleeding comparing periods with and without SSRI prescription at each level of kidney function.ResultsThe aRRs and aRDs were: (i) no CKD (n = 202 121) aRR: 1.66 (95%CI 1.37–2.01), aRD: 2.0/1000 person–years (5.5 vs. 3.5/1000 person–years in period with and without SSRIs); (ii) CKD stage 3a (n = 153 316) aRR: 1.86 (1.62–2.15), aRD: 4.2/1000 person–years (8.3 vs. 4.1/1000 person–years); (iii) CKD stage 3b (n = 46 482) aRR: 1.61 (1.27–2.04), aRD: 4.8/1000 person–years (9.9 vs. 5.1/1000 person–years); and (iv) CKD stage 4/5 (n = 11 197) aRR: 1.84 (1.14–2.96), aRD: 7.9/1000 person–years (15.3 vs. 7.4/1000 person–years). While there was no evidence of increase in the aRR (P = 0.922), there was strong evidence that the aRD increased as kidney function deteriorated (P = 0.001).ConclusionsWhile the relative risk was constant, the excess risk of GI bleeding associated with SSRIs markedly increased among patients with decreased kidney function.
Enhanced taxane uptake into bladder tissues following co‐administration with either mitomycin C, doxorubicin or gemcitabine: association to exfoliation processes
Authors: Pandey Rakhi , Jackson John K. , Liggins Richard , Mugabe Clement , Burt Helen M. 
Published: June 2018

ObjectiveTo investigate the effect of three anticancer drugs (mitomycin c (MMC), doxorubicin or gemcitabine) on bladder wall morphology and the uptake of paclitaxel or docetaxel following coadministration. The primary objective of this study was to measure the uptake of MMC, doxorubicin or gemcitabine with or without exposure of the tissue to amine terminated cationic nanoparticles (CNPs) and to investigate any possible exfoliation effects of the three drugs on intact bladder tissue. The secondary objective was to investigate the uptake of taxane drugs (docetaxel, DTX) and paclitaxel, (PTX) from surfactant micelle formulations in the presence of MMC, doxorubicin or gemcitabine.Materials and MethodsSections of fresh pig bladder tissue were incubated in Franz diffusion cells with the urothelial side exposed to solutions of doxorubicin, MMC and gemcitabine containing radioactive drug for 90 min. Some tissue samples were simultaneously exposed to each of the three drugs in combination with the surfactant micelle formulations of PTX (Taxol) or DTX (Taxotere). Tissue sections were then cryostat sectioned for drug quantitation by liquid scintillation counting or fixed for scanning electron microscopy and haematoxylin and eosin staining.ResultsAll three drugs caused exfoliation of the urothelial layer of bladder tissues. Drug uptake studies showed that all three drugs effectively penetrated the lamina propria through to the muscular layer over a 2‐h incubation and these levels were unaffected by pre‐treatment with CNPs. The uptake levels of the taxane drugs PTX and DTX were significantly enhanced following simultaneous treatment of bladders with MMC, doxorubicin or gemcitabine.ConclusionThe exfoliation effects of MMC, doxorubicin and gemcitabine allow for good tissue penetration of these drugs with no additional effect from CNP treatment of bladders. The observed exfoliation effect of these amine‐containing drugs probably arises from a cationic interaction with the mucus and urothelium cell layer in a manner similar to that previously reported for CNPs. These studies suggest that the lack of long‐term clinical efficacy of these drugs may not arise from poor intravesical drug penetration but may result from a rapid diffusion of the drugs into the deeper vascularised muscular region with rapid drug clearance. The enhanced uptake of PTX or DTX following co‐administration with MMC, doxorubicin or gemcitabine probably arises from the removal of the urothelial barrier by exfoliation allowing for improved taxane partitioning into superficial layers. These effects may allow for dual drug intravesical strategies offering greatly improved taxane uptake and potential additive drug effects for improved efficacy.
Insect outbreaks alter nutrient dynamics in a southern African savanna: patchy defoliation ofColophospermum mopanesavanna byImbrasia belinalarvae
Authors: de Swardt Donovan B. , Wigley‐Coetsee Corli , O'Connor Timothy G. 
Published: June 2018

AbstractInvertebrate herbivore outbreaks have important impacts on system biogeochemical cycling, but these effects have been poorly documented in African savanna ecosystems. In semi‐arid African savannas, outbreaks of the lepidopteranImbrasia belina(mopane worm) affect discrete patches of the dominantColophospermum mopanetrees; larvae may completely defoliate trees for up to six weeks during each of the early and late growing seasons. We studied the impact of mopane worm outbreaks on the availability of nitrogen (N), phosphorus (P), and potassium (K) within mopane savanna by quantifying major nutrient pools in defoliated and non‐defoliated savanna patches, including leaves, leaf litter, worm frass, and the soil beneath trees. Within an outbreak area, approximately 44 percent of trees were infested, supporting ~29,000 worms/ha, leading to ~640 kg/ha dry weight frass deposition at 1.4 g of frass/day‐individual (fourth or fifth instar), compared with an average 1645 kg/ha dry weight of leaf on trees most of which should be deposited by litterfall at the end of the growing season. Frass had twofold higher P, 10 percent higher K, but equivalent N content than litter. Taking frass and litter deposition together, the N, P, and K contents added due to the outbreak event at our study site were 0.88, 5.8, and 2.8 times those measured in non‐outbreak patches, a pattern which was reflected in the nutrient contents of soil surfaces beneath defoliated trees. Invertebrate herbivory appears to be an important driver for mopane savanna but has been largely neglected.
Dental health aides in Alaska: A qualitative assessment to improve paediatric oral health in remote rural villages
Authors: Senturia Kirsten , Fiset Louis , Hort Kim , Huebner Colleen , Mallott Elizabeth , Milgrom Peter , Nelson Lonnie , Parrish Canada , Cunha‐Cruz Joana 
Published: June 2018

AbstractObjectiveIsolated villages in Alaska face disparities in oral health and access to care. Dental health aides such as the primary dental health aide (PDHA) and the dental health therapist (DHAT) fill a critical role for providing dental care in Alaska. Our objective was to describe strengths and barriers to paediatric dental care for children living in remote Alaska villages from the perspectives of the community and the health care system.MethodsThis qualitative study collected data through semi‐structured key informant interviews with community members (n = 19) and healthcare workers (n = 19) and focus groups with patients (n = 31 adolescents and 16 caregivers of children under 12 years) living in or providing health care to 3 remote villages in Alaska. Using an inductively developed codebook and a narrative approach, 3 researchers independently read and thematically analysed the transcripts.ResultsTwo themes emerged: (i) PDHAs and DHATs are perceived as sustainable and strongly positioned to meet the unique dental needs of the rural communities; (ii) PDHAs and DHATs face barriers that limit their effectiveness, and their distinct roles require clarification and administrative support.ConclusionsDental health aides, both PDHAs and DHATs, are well accepted in Alaska villages. An innate understanding of cultural norms and continuity of care are key elements driving village satisfaction. The potential exists administratively to strengthen the model with the implementation of clinical and office‐system strategies to increase efficiency of the dental team. Culturally adapted implementation strategies will be critical to the successful expansion of new workforce models that are addressing health disparities.
Self‐control and dental caries among elementary school children in Japan
Authors: Matsuyama Yusuke , Fujiwara Takeo , Ochi Manami , Isumi Aya , Kato Tsuguhiko 
Published: June 2018

AbstractObjectivesChildren's self‐control is associated with various behaviour‐related health problems in childhood and later in life. However, studies on self‐control and dental caries, strongly associated with toothbrushing or drinking and eating behaviour, are limited. We investigated the association between self‐control and the number of decayed or filled primary teeth (dft) among first‐grade children (6‐7 years old) in Japan and evaluated the mediation effect of oral health behaviour on this association.MethodsA cross‐sectional study of all first‐grade elementary school children and their caregivers in Adachi ward (Tokyo) was conducted in 2015. Clinically determined dft status among children and caregiver‐administered questionnaires on self‐control was linked (n = 4291; valid response rate = 80.1%). Self‐control was assessed by the following single question: “in the last month, was your child able to give up on things they want or do things that they do not like to do for better future outcomes?” Poisson regression analysis was conducted adjusting for age in months, sex, parental educational attainment and household income. Mediation analysis was performed to evaluate the mediation effects of toothbrushing frequency, frequency of drinking sugar‐sweetened beverages and snack‐eating habits on the association.ResultsLower self‐control was associated with higher dft after adjusting for all covariates (mean ratio = 1.09; 95% CI: 1.06, 1.12). Toothbrushing frequency, frequency of drinking sugar‐sweetened beverages and snack‐eating habits mediated 18.1%, 36.1% and 38.3% of the association between self‐control and dft, respectively.ConclusionsStrengthening children's self‐control might decrease their dental caries by improving their oral health behaviour.
Scottish Bowel Screening Programme colonoscopy quality – scope for improvement?
Authors: Quyn A. J. , Fraser C. G. , Stanners G. , Carey F. A. , Rees C. J. , Moores B. , Steele R. J. 
Published: June 2018

AbstractAimThe delivery of the Scottish Bowel Screening Programme (SBoSP) is rooted in the provision of a high quality, effective and participant‐centred service. Safe and effective colonoscopy forms an integral part of the process. Additional accreditation as part of a multi‐faceted programme for participating colonoscopists, as in England, does not exist in Scotland. This study aimed to describe the quality of colonoscopy in the SBoSP and compare this to the English national screening standards.MethodsData were collected from the SBoSP between 2007 and 2014. End‐points for analysis were caecal intubation, cancer, polyp and adenoma detection, and complications. Overall results were compared with 2012 published English national standards for screening and outcomes from 2006 to 2009.ResultsDuring the study period 53 332 participants attended for colonoscopy. The colonoscopy completion rate was 95.6% overall. The mean cancer detection rate was 7.1%, the polyp detection rate was 45.7% and the adenoma detection rate was 35.5%. The overall complication rate was 0.47%.ConclusionColonoscopy quality in the SBoSP has exceeded the standard set for screening colonoscopy in England, despite not adopting a multi‐faceted programme for screening colonoscopy. However, the overall adenoma detection rate in Scotland was 9.1% lower than that in England which has implications for colonoscopy quality and may have an impact on cancer prevention rates, a key aim of the SBoSP.
Acute effect of wearing compression stockings on lower leg swelling and muscle stiffness in healthy young women
Authors: Sugahara Ikumi , Doi Misaki , Nakayama Rinko , Sasaki Kazushige 
Published: June 2018

SummaryCompression stockings are known to be effective in reducing peripheral oedema or leg swelling by increasing tissue pressure and venous blood flow. While previous studies on compression stockings have focused on its prolonged, preventive effect on leg swelling, the aim of this study was to investigate an acute effect of wearing compression stockings on lower leg swelling and muscle stiffness. Twenty healthy women aged 18–23 years participated in the experiment conducted in the evening, in which they wore below‐knee graduated compression stockings and rested in a seated position for 30 min. Before and after the application of stockings, maximum calf circumference, volume, extracellular water resistance (RECW) and muscle stiffness of the right lower leg were determined by tape measure, water displacement volumetry, segmental bioelectrical impedance spectroscopy and ultrasound shear‐wave elastography, respectively. The maximum calf circumference and the reciprocal of RECW (an index of extracellular fluid volume) significantly decreased after the application of stockings, whereas the total lower leg volume and the stiffness (shear modulus) of the medial gastrocnemius muscle tended to decrease. These changes, except for that in the medial gastrocnemius muscle stiffness, were opposite to those from morning to evening studied in the subgroup of participants (n = 8). However, partial correlation analysis failed to detect significant associations among these changes. These results suggest that even for a short period of application, compression stockings have some positive effects against lower leg swelling.
“We Are Not Starving:” Challenging Genetically Modified Seeds and Development in Ghana
Authors: Rock Joeva 
Published: June 2018

AbstractIn the last decade, the number of African countries researching and growing genetically modified seeds (GMOs) has increased fourfold. These efforts are backed by an international consortium of donors who broker agreements between biotechnology companies and African state scientists to lease genetic material for use. Given the involvement of African scientists, proponents argue that these projects are homegrown and necessary to feed the African continent. However, in Ghana, where GM cowpea and rice are currently under field trial, both Ghanaian scientists and anti‐GMO activists are unsatisfied with donor‐constructed realities. Instead, these unlikely bedfellows challenge the discourses that circulate through international development circuits by pointing to a history of both colonial exploitation and sovereign dreams. By doing so, Ghanaian scientists and activists articulate alternative visions for a food sovereign, postcolonial future.