bluuebunny/crossref_metadata_2025_split huggingface dataset:
Shared decision-making in medication management: Development of a training intervention
Authors: Stead Ute , Morant Nicola , Ramon Shulamit 
Published: August 2017

SummaryShared decision-making is a collaborative process in which clinicians and patients make treatment decisions together. Although it is considered essential to patient-centred care, the adoption of shared decision-making into routine clinical practice has been slow, and there is a need to increase implementation. This paper describes the development and delivery of a training intervention to promote shared decision-making in medication management in mental health as part of the Shared Involvement in Medication Management Education (ShIMME) project. Three stakeholder groups (service users, care coordinators and psychiatrists) received training in shared decision-making, and their feedback was evaluated. The programme was mostly well received, with all groups rating interaction with peers as the best aspect of the training. This small-scale pilot shows that it is feasible to deliver training in shared decision-making to several key stakeholders. Larger studies will be required to assess the effectiveness of such training.
Flexible assertive community treatment (FACT) model in specialist psychosis teams: An evaluation
Authors: Sood Loopinder , Owen Andy , Onyon Richard , Sharma Aarohi , Nigriello Jessica , Markham Dominic , Seabrook Hannah 
Published: August 2017

Aims and methodThe impact of flexible assertive community treatment (FACT) has been observed in people previously supported by assertive community treatment (ACT) teams, but its effect on those previously with a community mental health team (CMHT) has not been studied in the UK. An observational study was conducted of 380 people from 3 CMHTs and 95 people from an ACT team, all with a history of psychosis, following service reconfiguration to 3 FACT teams.ResultsPeople previously with a CMHT required less time in hospital when the FACT model was introduced. A smaller reduction was observed in people coming from the ACT team. Both groups required less crisis resolution home treatment (CRHT) team input.Clinical implicationsFACT may be a better model than standard CMHT care for people with a history of psychosis, as a result of reduced need for acute (CRHT and inpatient) services.
Falls in Scottish homicide: Lessons for homicide reduction in mental health patients
Authors: Crichton John H. M. 
Published: August 2017

SummaryThe sustained fall in Scottish homicide rates follows crime reduction measures informed by the epidemiology of suicide. The violence reduction unit targeted young men carrying knives in public. The restriction of weapons immediately to hand appears to have caused an absolute fall in homicide just as suicide reduction was observed following changes to domestic gas supply. Further homicide reduction may be accomplished in the domestic setting with targeted changes in kitchen knife design in home safety planning for high-risk households. Most commonly homicides involving those in recent contact with mental health services in the UK have domestic characteristics and similar safety planning may be targeted at those with mental disorder and a history of violence.
Hypertension and Type 2 Diabetes Are Associated With Decreased Inhibition of Dipeptidyl Peptidase-4 by Sitagliptin
Authors: Wilson Jessica R , Shuey Megan M , Brown Nancy J , Devin Jessica K 
Published: August 2017

Abstract

Context
Patients with diabetes often have comorbidities such as hypertension. It is not known how individual characteristics influence response to dipeptidyl peptidase-4 (DPP4) inhibitors.

Objective
We tested the hypothesis that individual characteristics, sitagliptin dose, and genetic variability in DPP4 influence DPP4 activity during sitagliptin.

Design and Setting
Post hoc analysis of clinical and laboratory data from individuals randomized to sitagliptin versus placebo in crossover studies.

Patients and Interventions
Sixty-five subjects [27 with type 2 diabetes mellitus (T2DM) and hypertension, 38 healthy controls] were randomized to 100 mg/d sitagliptin or 200 mg sitagliptin and matching placebo in double-blind, crossover fashion. Fasting blood was obtained at baseline and 60 to 180 minutes after sitagliptin or placebo.

Main Outcome Measure(s)
DPP4 activity and antigen during placebo and sitagliptin and DPP4 inhibition during sitagliptin.

Results
Sitagliptin 100 mg/d was less effective at inhibiting DPP4 activity in individuals with T2DM and hypertension than in healthy controls (P = 0.001, percent inhibition). In healthy controls, 100 mg/d sitagliptin was not as effective as single-dose 200 mg sitagliptin (P = 0.001, percent inhibition). DPP4 genotypes rs2909451 TT (P = 0.02) and rs759717 CC (P = 0.02) were associated with DPP4 activity during sitagliptin. In multivariable analyses, T2DM with hypertension, sitagliptin dose, age, systolic blood pressure, DPP4 activity during placebo, and rs2909451 genotype were significantly associated with DPP4 activity during sitagliptin.

Conclusions
Sitagliptin is less effective in inhibiting DPP4 in individuals with T2DM and hypertension than in healthy controls. Higher doses of DPP4 inhibitors may be required in patients with the metabolic syndrome.
Randomized Controlled Trial of the Clinical Efficacy of Multiport Versus Uniport Wire-Reinforced Flexible Catheters for Labor Epidural Analgesia
Authors: Philip John , Sharma Shiv K. , Sparks Timothy J. , Reisch Joan S. 
Published: August 2017

BACKGROUND:
The purpose of this prospective, randomized, controlled trial was to determine whether multiple ports improve the analgesic efficacy of wire-reinforced flexible catheters used for labor epidural analgesia (LEA).

METHODS:
Six hundred fifty laboring patients were randomized to receive epidural analgesia using either a multiport or uniport wire-reinforced flexible catheter. The primary outcome was analgesic success, defined as the incidence of adequate analgesia following the initial bolus given to initiate LEA. Secondary outcomes included the number of patients requiring clinician interventions during maintenance of LEA; anesthetic success, defined as the incidence of adequate anesthesia following the initial bolus given to establish surgical anesthesia for cesarean delivery; and maternal satisfaction with the overall quality of LEA.

RESULTS:
There was no significant difference in analgesic success at initiation of LEA between the uniport and the multiport wire-reinforced flexible catheter (93.6% vs 89.5%, respectively; difference of 4.1% [95% confidence interval, −0.4% to 8.5%]; P = .077). There was also no difference in the number of patients requiring clinician interventions during maintenance of LEA and in anesthetic success at the establishment of surgical anesthesia for cesarean delivery between the 2 catheter types.

CONCLUSIONS:
Multiple ports do not appear to improve the analgesic efficacy of wire-reinforced flexible catheters used for LEA.
Distinct roles of NFATc1 and NFATc4 in human primary myoblast differentiation and in the maintenance of reserve cells
Authors: Perroud Julie , Bernheim Laurent , Frieden Maud , Koenig Stephane 
Published: August 2017

ABSTRACT
Ca2+ signaling plays a key role during human myoblast differentiation. Among Ca2+-sensitive pathways, calcineurin is essential for myoblast differentiation and muscle regeneration. Nuclear factor of activated T-cell (NFAT) transcription factors are the major calcineurin targets. We investigated the expression and the role of each NFAT gene during human primary myoblast differentiation. We found that three NFAT isoforms are present, NFATc1, NFATc3 and NFATc4. Importantly, while their mRNA expression increases during differentiation, NFATc1 is more highly expressed in myotubes, whilst NFATc4 is specifically maintained in reserve cells. NFATc3 is present in both cell types, although no specific role during myoblast differentiation was observed. Knockdown of either NFATc1 or NFATc4 affects the differentiation process similarly, by decreasing the expression of late differentiation markers, but impairs myotube formation differently. Whereas NFATc1 knockdown strongly reduced the number and the surface area of myotubes, NFATc4 knockdown increased the surface area of myotubes and reduced the pool of reserve cells. We conclude that NFAT genes have specific roles in myotube formation and in the maintenance of the reserve cell pool during human postnatal myogenesis.
Multiple cis-acting signals, some weak by necessity, collectively direct robust transport of oskar mRNA to the oocyte
Authors: Ryu Young Hee , Kenny Andrew , Gim Youme , Snee Mark , Macdonald Paul M. 
Published: August 2017

ABSTRACT
Localization of mRNAs can involve multiple steps, each with its own cis-acting localization signals and transport factors. How is the transition between different steps orchestrated? We show that the initial step in localization of Drosophila oskar mRNA − transport from nurse cells to the oocyte − relies on multiple cis-acting signals. Some of these are binding sites for the translational control factor Bruno, suggesting that Bruno plays an additional role in mRNA transport. Although transport of oskar mRNA is essential and robust, the localization activity of individual transport signals is weak. Notably, increasing the strength of individual transport signals, or adding a strong transport signal, disrupts the later stages of oskar mRNA localization. We propose that the oskar transport signals are weak by necessity; their weakness facilitates transfer of the oskar mRNA from the oocyte transport machinery to the machinery for posterior localization.
The cholesterol ester cycle regulates signalling complexes and synapse damage caused by amyloid-β
Authors: West Ewan , Osborne Craig , Bate Clive 
Published: August 2017

ABSTRACT
Cholesterol is required for the formation and function of some signalling platforms. In synaptosomes, amyloid-β (Aβ) oligomers, the causative agent in Alzheimer's disease, bind to cellular prion proteins (PrPC) resulting in increased cholesterol concentrations, translocation of cytoplasmic phospholipase A2 (cPLA2, also known as PLA2G4A) to lipid rafts, and activation of cPLA2. The formation of Aβ-PrPC complexes is controlled by the cholesterol ester cycle. In this study, Aβ activated cholesterol ester hydrolases, which released cholesterol from stores of cholesterol esters and stabilised Aβ-PrPC complexes, resulting in activated cPLA2. Conversely, cholesterol esterification reduced cholesterol concentrations causing the dispersal of Aβ-PrPC complexes. In cultured neurons, the cholesterol ester cycle regulated Aβ-induced synapse damage; cholesterol ester hydrolase inhibitors protected neurons, while inhibition of cholesterol esterification significantly increased Aβ-induced synapse damage. An understanding of the molecular mechanisms involved in the dispersal of signalling complexes is important as failure to deactivate signalling pathways can lead to pathology. This study demonstrates that esterification of cholesterol is a key factor in the dispersal of Aβ-induced signalling platforms involved in the activation of cPLA2 and synapse degeneration.
You Pay Your Money and You Take Your Choice!
Authors: Carrotte Peter 
Published: August 2017

Third Molar Management: A Case for Routine Removal in Adolescent and Young Adult Orthodontic Patients. C. S. Beeman. Journal of Oral and Maxillofacial Surgery 1999; 57: 824-830. Third Molar Management: A Case Against Routine Removal in Adolescent and Young Adult Orthodontic Patients. E. P. Hicks. Journal of Oral and Maxillofacial Surgery 1999; 57: 831-836.
30 Years of Preventive Dentistry – and 30 Years into the Future
Authors: Murray John J. , Steele James G. 
Published: August 2017

Preventive dentistry has had a major impact on the prevalence of dental caries and, to a lesser extent, periodontal disease since the 1970s. It should continue to have a positive effect on the oral health of the community in the future. The factors behind improvements seen in oral health are many and varied but include changes in public health policy, technology and commercial decisions made in the industrial sector. As oral health has improved, and tooth retention increased, the focus of preventive dentistry has widened to include all population groups, increasingly including older adults, and to include a wider range of disorders. The major issues relevant to preventive dentistry which have occurred over the last 30 years are discussed. The authors will speculate on the impact that the prevention of oral disease might have over the next 30 years.
Management of Dental Patients on Warfarin Therapy in a Primary Care Setting
Authors: Chugani Vikram 
Published: August 2017

The surgical management of patients on anticoagulant therapy is often poorly understood in all fields of medicine (not just dentistry). Until now there has been no uniform approach to managing these patients and much of the advice routinely given by medical practitioners and haematologists has fallen behind the recent evidence. Many medical conditions from atrial fibrillation to prosthetic heart valves predispose patients to venous thrombosis and pulmonary embolism (Table 1). In order to prevent these complications, these patients are normally placed on an anticoagulant. By far the most common one in use is Warfarin, which is a derivative of 4 hydroxycoumarin.
The ‘Combination Syndrome’ Revisited
Authors: Lynch Christopher D. , Finbarr Allen P. 
Published: August 2017

The ‘combination syndrome’ may present a considerable clinical and technical challenge to the dental practitioner. This clinical scenario classically relates to changes found in the mouth following use of a maxillary complete denture that has opposed natural mandibular anterior teeth. While this condition was first recognized over 30 years ago, the associated difficulties still pervade the practice of prosthetic dentistry today. The purpose of this article is to describe treatment of two patients who exhibited clinical features of this condition, and review some of the relevant literature on this condition.
Providing a Numerical Measure of Oral Health – Can it be Done and How Accurate is it?
Authors: Delargy Siobhan 
Published: August 2017

An Index of Oral Health (OHX) was developed by Burke and Wilson1 in the mid 90s. Use of the index involves assessing patient comfort and satisfaction in addition to the assessment of caries, periodontal disease, toothwear, mucosa, occlusion and dentures, where appropriate. On completion of this structured examination, the clinician arrives at an overall oral health index (OHX) for the patient, which is expressed as a fraction of the maximum achievable score. The index was modified by Denplan UK by amending the calculations to produce the Oral Health Score (OHS). The Reproducibility of the OHX and OHS was tested at Birmingham Dental Hospital and School during 2001 and 2002 and was found to be satisfactory. The dentists' opinions on the OHX and OHS were assessed by means of questionnaires. Most of the dentists felt that both were easy to use.
An Overview of Bleaching Techniques: 3. In-Surgery or Power Bleaching
Authors: Sulieman M. 
Published: August 2017

The use of in-surgery bleaching techniques has increased recently within the profession following the introduction of various new systems. Many dentists and patients alike prefer the in-surgery procedures to lighten teeth as it takes the responsibility for the procedure firmly away from the patient to the dentist; a situation with which both sides may be more comfortable. This article will review various in-surgery or power bleaching procedures. In addition, it will detail the procedure involved and how and when to combine bleaching techniques.
Peripheral Ameloblastoma: A Case Report
Authors: Hayes Mairéad I , Prince Sharon E 
Published: August 2017

Peripheral ameloblastoma is an uncommon pathological variant of the more usual intraosseous central ameloblastoma. It most typically presents as a localized soft tissue mass occurring in the tooth-bearing areas of the jaws and is often provisionally diagnosed as an epulis. In this paper, a 43-year-old male presented with a three-year history of a painful, slowly enlarging gingival swelling. There was no evidence of bony involvement on radiographs but it was revealed histologically to be a peripheral ameloblastoma. Treatment was by wide local excision, including a bony margin, and primary closure. Long-term follow-up is imperative owing to possible recurrence and malignant potential.
Allergic Contact Stomatitis from Colophony
Authors: Sharma Paul R. 
Published: August 2017

Colophony isan ubiquitous contact sensitizer which may be present in dental materials, such as periodontal dressings, impression materials, cements, fix adhesives and varnishes. Exposure to a sensitizer in a hypersensitive person may initiate an allergic contact dermatitis/stomatitis. This usually occurs after direct skin/mucosa contact with the sensitizer. This paper reports the case of a colophony hypersensitive male who developed contact stomatitis after dental treatment with a colophony-containing product.
The Application of Photodynamic Therapy in the Head and Neck
Authors: Jerjes Waseem , Upile Tahwinder , Betz Christian S , El Maaytah Mohammed , Abbas Syedda , Wright Anthony , Hopper Colin 
Published: August 2017

Photodynamic therapy (PDT) is considered to be a minimally invasive treatment modality which shows great promise in premalignant and malignant conditions of the head and neck. This therapy can be applied before or after any of the conventional treatment modalities (ie surgery, radiotherapy or chemotherapy) and the treatment can be repeated as much as is needed at the same site. PDT uses photosensitizing drugs that are activated by exposure to light of a specific wavelength. Illumination of the suspected premalignant or malignant site by light at the activating wavelength results in cellular destruction by a non-free radical oxidative process. Most photosensitizers are administered systemically, although some can be applied topically in the treatment of skin cancer. Recent developments in photosensitizers and light delivery systems have substantially reduced treatment times and residual photosensitivity, while increasing the achievable depth of necrosis. Compared with standard approaches, PDT can achieve equivalent or greater efficacy in the treatment of premalignant and malignant lesions in the head and neck, with greatly reduced morbidity and disfigurement. The technique is simple, can commonly be carried out in outpatient clinics, and is highly acceptable to patients. It can be repeated to debulk large tumours progressively, and it can also be applied through interstitial light delivery to large solid tumours.
Dermatitis Artefacta of the Lip in an Adolescent
Authors: Collard MM , Hunter ML , Motley RJ , Lewis MAO 
Published: August 2017

Self-inflicted trauma is found in several patient groups including those with learning and developmental delay, the very young and those suffering from psychiatric disturbance. The diagnosis of artefactual disease can only be made when all possible organic disease has been excluded by specific investigations. The case presented is that of a 15-year-old girl complaining of persistent bleeding and crusting of her lips. Investigations provided no real information as to the cause of the allegedly spontaneous bleeding. The diagnosis of artefactual disease was finally decided upon and a referral to a child and adolescent psychiatrist made.
Current Methods of Shade Matching in Dentistry: A Review of the Supporting Literature
Authors: Stevenson Brian 
Published: August 2017

The difficulties of shade matching in dentistry are discussed and various suggestions are given to improve the process. Several authors have described shade-taking routines with the aim of improving shade-matching. These are summarized and a method for choosing the appropriate shade from the previous guidelines is given. The scientific principles and evidence-base behind the new technique are given. The problems and advantages of instrumental shade-taking devices are reviewed.
Implementing NICE Guidelines on Recall Intervals into General Practice
Authors: Akram Sarah , D'Cruz Len 
Published: August 2017

The NICE guidelines require practitioners to ensure that each patient has a specific recall interval based on an oral health needs assessment. There appears to be a hesitancy in the profession to move away from the ‘six-month recall’. In England and Wales, Primary Care Organizations (PCOs) monitor activity using quantitative data. One particular metric measures how many patients are seen by the practice within 3 months and also between 3 and 9 months from their last course of treatment. The purpose of this paper is to introduce a quick reference chart based on the NICE guidelines which, when used in combination with clinical judgement, can aid the clinician in selecting a tailored recall interval. This paper discusses the purpose and benefits for using the guidelines in relation to NHS contractual obligations.
The current status of 3d imaging in dental practice
Authors: McNamara C , House K , Davies Rebecca , Barker CS , Chawla O , Sandy JR , Ireland AJ 
Published: August 2017

This article aims to describe the current status of 3-dimensional (3D) imaging in dental practice. Advances in this field have made 3D imaging far more accessible in all dental fields. This paper describes methods of imaging dental hard and soft tissues and their clinical uses. In addition, the potential advantages and disadvantages of various systems are discussed, as well as expected future developments. Clinical Relevance: The potential uses of 3D images in dental practice are ever increasing. Imaging systems are now far more accessible for clinical decision-making and patient information.
Incidental finding of sialolithiasis in the sublingual gland: a diagnostic dilemma
Authors: Pace Clarence , Ward Sean 
Published: August 2017

This case describes a 35-year-old female who presented with an incidental finding of sublingual gland sialolithiasis. The clinical presentation, investigations and management as well as the pathology are described. This case highlights the diagnostic dilemma in determining the anatomical position of sialoliths on radiographs. Clinical Relevance: To highlight the importance of incidental findings on radiographs and to make clinicians aware that radio-opacities on lower occlusal radiographs do not necessarily imply submandibular sialoliths but, rarely, may be sublingual sialoliths. This may warrant further investigations.
Conservative treatment of periodontal recessions with class v-defects using gingiva-shaded composite – a systematic treatment concept
Authors: Günay Hüsamettin , Geurtsen Werner , Lührs Anne-Katrin 
Published: August 2017

Periodontal recessions can cause aesthetic and functional problems, especially in the anterior region or when combined with exposed crown margins. A combination of periodontal disease, recession with exposed root surface, hard-tissue defects and age emphasizes the need for treating these defects. If crown margins are exposed and surgical treatment is not possible, aesthetics and function can only be improved by replacement of the restoration. The restorative treatment option with a gingiva-shaded composite is especially valuable for dental fear patients or older patients with general or local risk factors, surgical contra-indications or Class III and IV recessions with questionable prognosis of surgery. The step-by-step-approach described in this article is an alternative, minimal-invasive treatment concept for cervical lesions in combination with all kinds of periodontal recessions, that is especially suitable for wedge-shaped defects next to exposed crown margins. Clinical Relevance: With this treatment concept, the reader should be able to use gingiva-shaded composite for different indications, such as exposed root surfaces or crown margins in combination with recessions.