bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dental health status of community‐dwelling older Singaporeans: findings from a nationally representative survey
Authors: Chiu Chi‐Tsun , Malhotra Rahul , Tan See Mieng , Lim Jane , Chan Angelique , Teoh Khim Hean , Gan Sapphire Tsering , Saito Yasuhiko 
Published: February 2016

ObjectivesTo assess the dental health status of older Singaporeans by age, gender and ethnicity.BackgroundPoor dental health in elders has been linked to a number of adverse health conditions and is often associated with an increased risk of mortality in older people.Materials and methodsData came from a nationally representative cross‐sectional 2009 survey of community‐dwelling Singaporeans aged 60 and over. The distribution of the number of natural teeth, chewing ability and the presence of dentures were assessed by age, gender and ethnicity (Chinese/Malay/Indian) using sampling weights.ResultsWith increasing age, there was a decrease in the average number of natural teeth, a decrease in the proportion of people with 20 or more natural teeth and with the strongest chewing ability, and an increase in the proportion that was edentulous or had dentures. Women, vs. men, had a lower average number of natural teeth (10.3 vs. 12.8), and they were more likely to be edentulous (37 vs. 24%) and to have dentures (73 vs. 63%). Across ethnic groups, Indians had the highest average number of natural teeth (17.0). However, among those who had dentures, Indians were the least likely to have the strongest chewing ability.ConclusionsThe findings demonstrated differences in dental health status by age, gender and ethnicity. They highlight the need for improvements in the dental health status of all older Singaporeans, especially older women. The data presented herein may serve as a baseline for policymakers to evaluate the impact of recent schemes launched by the Ministry of Health (Singapore) to subsidise dental treatment.
Comprehension of Japanese oral care‐related terms among caregivers and nurses, as assessed using a newly developed instrument
Authors: Shibata Satoko , Stegaroiu Roxana , Nakazawa Akari , Ohuchi Akitsugu 
Published: February 2016

Objectives(i) To assess comprehension of oral care‐related terms among caregivers and nurses working at long‐term care facilities, using a newly developed test; (ii) to analyse the effect of participant characteristics on their comprehension.BackgroundEffective mutual communication between dental professionals and caregivers/nurses is essential for providing information on daily oral care for institutionalised elders.MethodsA 36‐item word‐knowledge test in Japanese was developed to assess comprehension of oral care‐related terms. The test was administered to a convenience sample of 236 nursing staff (198 caregivers and 38 nurses) at six long‐term care facilities in Niigata City, Japan, and its reliability and validity were verified. Associations of participant characteristics with their responses were investigated by multiple regression analysis.ResultsMean percentage of correct responses (accuracy rate) for nursing staff was approximately 62% (highest for oral care products and lowest for prosthodontic terms). Test internal reliability was high (Cronbach's alpha >0.8). Concurrent validity (test ability to distinguish between characteristically different groups) was confirmed. Mean accuracy rate was significantly higher among nurses (78.5 ± 19.3%) than among caregivers (58.7 ± 22.8%), and among respondents with interest in oral care (64.2 ± 21.1%) than among those with no such interest (51.5 ± 28.9%).ConclusionThe word‐knowledge test was valid and reliable for nursing staff of six long‐term care facilities in Niigata City. Their comprehension was low for perioral and intraoral structures, related symptom and disease names, and prosthodontics terms related to oral care. Understanding of oral care‐related terms among the nursing staff was related to their occupation and interest in oral care.
Early plant community dynamics following overseeding for the rehabilitation of a Mediterranean silvopastoral system
Authors: Franca Antonello , Caredda Salvatore , Sanna Federico , Fava Francesco , Seddaiu Giovanna 
Published: February 2016

AbstractThe sowing of selected seeds is often applied as post‐fire rehabilitation practice in Mediterranean silvopastoral systems. Often, the topography of these silvopastoral systems is sloppy and irregular, requiring low input and easy pasture rehabilitation practices, such as no tillage, low seed and fertilizer rates. In this paper, we studied the vegetation changes over 4 years, after a low‐input overseeding (broadcasting) of non‐native pasture species, within a post‐fire rehabilitation program of a silvopastoral system in Sardinia (Italy). The main objective was to assess the effect of overseeding on the early plant community dynamics and on the relationship between topography, soil pH, and soil nitrogen content on the spatial and temporal dynamics of the grassland composition. Understorey vegetation was classified into nine “functional classes”, three corresponding to the oversown species (subclovers, burr medic and annual ryegrass) and six belonging to the native community, i.e. grasses, legumes, Cistus spp., spiny Carduaceae, spiny Rubus spp. and other forbs. The oversown species showed a rapid establishment, contributing from 30 up to 50% to the floristic composition of the oversown pasture. The overseeding reduced the abundance of post‐fire invasive shrubs and spiny forbs by up to about 70% compared to the unsown pasture. The spatial patterns of the functional classes were only weakly influenced by nitrogen content, with a higher impact on introduced species in the first 2 years after overseeding, while the topographic variables had a desultory influence over the 4 years. Overseeding proved to be effective for the rehabilitation and improvement of semiarid Mediterranean grasslands without substantially constraining the ecological succession of floristic composition towards the native vegetation.
Effects of ITPA polymorphism on decrease of hemoglobin during simeprevir, peg‐interferon, and ribavirin combination treatment for chronic hepatitis C
Authors: Morio Kei , Imamura Michio , Kawakami Yoshiiku , Morio Reona , Hatooka Masahiro , Kan Hiromi , Fujino Hatsue , Fukuhara Takayuki , Kobayashi Tomoki , Masaki Keiichi , Ono Atsushi , Nakahara Takashi , Urabe Ayako , Yokoyama Satoe , Nagaoki Yuko , Kawaoka Tomokazu , Hiraga Nobuhiko , Tsuge Masataka , Hiramatsu Akira , Hayes C Nelson , Aikata Hiroshi , Ochi Hidenori , Chayama Kazuaki ,   Hiroshima Liver Study Group
Published: February 2016

AimPolymorphisms in the ITPA gene influence anemia during peg‐interferon (PEG‐IFN) and ribavirin (RBV) therapy, but their effects during triple therapy with simeprevir, PEG‐IFN, and RBV are not sufficiently known.MethodsWe analyzed 212 patients with genotype 1 chronic hepatitis C, who were treated with simeprevir plus PEG‐IFN/RBV triple therapy, and assessed the effect of the ITPA polymorphism on hemoglobin levels and RBV dose reduction. ITPA (rs1127354) and IFNL4 (ss469415590) polymorphisms were genotyped using the Invader assay. A stepwise multivariate regression analysis was carried out to identify factors associated with outcome of the therapy.ResultsReduction of hemoglobin levels was similar between patients treated with simeprevir plus PEG‐IFN/RBV and those treated with PEG‐IFN/RBV therapy. In simeprevir plus PEG‐IFN/RBV‐treated patients, decreases in hemoglobin levels were faster and greater, and the cumulative proportion of patients with ribavirin dose reduction was significantly greater in ITPA genotype CC patients than in CA/AA patients. The total dose of simeprevir and PEG‐IFN was similar between ITPA genotype CC and CA/AA patients. In contrast, the total dose of RBV was lower in patients with the CC genotype. Multivariate analysis showed that the IFNL4 TT/TT genotype, but not the ITPA SNP genotype, treatment history (treatment‐naive or relapse during prior treatment), and treatment completion were significantly associated with outcome of therapy.ConclusionITPA polymorphism influences hemoglobin levels and incidence of RVB dose reduction during simeprevir triple therapy, indicating the importance of monitoring anemia during treatment, particularly for ITPA genotype CC patients.
Dysplasia in Barrett's oesophagus: p53 immunostaining is more reproducible than haematoxylin and eosin diagnosis and improves overall reliability, while grading is poorly reproducible
Authors: Kaye Philip V , Ilyas Mohammad , Soomro Irshad , Haider Syeda A , Atwal Gurprit , Menon Sindhu , Gill Shafiq , Richards Cathy , Harrison Rebecca , West Kevin , Ragunath Krish 
Published: February 2016

Aimsp53 immunostaining in Barrett's oesophagus (BO) has been shown to be predictive of progression, but data regarding its generalizability to routine practice are lacking. This study compared the reliability of p53 and dysplasia interpretation and grading.Methods and resultsSeventy‐two cases encompassing the full spectrum of BO were circulated to 10 pathologists from four institutions after a brief training session in p53 interpretation. Each pathologist classified cases on haematoxylin and eosin (H&E) alone using the Vienna classification and assessed the p53 staining using a qualitative system. Agreement was assessed using kappa statistics. For the four‐tier Vienna system, the average unweighted kappa was 0.30. Weighted kappa values varied from 0.27 to 0.69 with an average of 0.47. When grouped into definite dysplasia versus no definite dysplasia the average kappa was 0.55, but the kappa for low‐grade dysplasia (LGD) versus high‐grade dysplasia (HGD) was only 0.31. For p53, using the three recognized patterns, the unweighted kappa was 0.6 (confidence interval 0.58–0.63). When cases were evaluated with both H&E and p53 the average kappa was 0.61 for definite dysplasia versus the rest.Conclusionsp53 immunohistochemistry interpretation is more reliable than dysplasia diagnosis, even with limited training. As it is predictive of prognosis and improves diagnostic reproducibility, it is suitable for routine use by pathologists as an adjunct to dysplasia diagnosis. The distinction of LGD versus HGD was poor. This study supports simplifying dysplasia diagnosis into ‘present’, ‘indefinite’ or ‘absent’, and the use of p53 as an ancillary marker in difficult cases. This should help to prevent overdiagnosis of dysplasia and inappropriate treatment.
New insights on the origin of troctolites from the breakaway area of the Godzilla Megamullion (Parece Vela back‐arc basin): The role of melt‐mantle interaction on the composition of the lower crust
Authors: Sanfilippo Alessio , Dick Henry J. B. , Ohara Yasuhiko , Tiepolo Massimo 
Published: February 2016

AbstractThe troctolites and olivine‐gabbros from the Dive 6 K‐1147 represent the most primitive gabbroic rocks collected at the Godzilla Megamullion, a giant oceanic core complex formed at an extinct spreading segment of the Parece Vela back‐arc basin (Philippine Sea). Previous investigations have shown that these rocks have textural and major elements mineral compositions consistent with a formation through multistage interaction between mantle‐derived melts and a pre‐existing ultramafic matrix. New investigations on trace element mineral compositions basically agree with this hypothesis. Clinopyroxenes and plagioclase have incompatible element signatures similar to that of typical‐MORB. However, the clinopyroxenes show very high Cr contents (similar to those of mantle clinopyroxene) and rim having sharply higher Zr/REE ratios with respect to the core. These features are in contrast with an evolution constrained by fractional crystallization processes, and suggest that the clinopyroxene compositions are controlled by melt‐rock interaction processes. The plagioclase anorthite versus clinopyroxene Mg#[Mg/(Mg + FeTot)] correlation of the Dive 6 K‐1147 rocks shows a trend much steeper than those depicted by other oceanic gabbroic sections. Using a thermodynamic model, we show that this trend is reproducible by fractionation of melts assimilating 1 g of mantle peridotite per 1 °C of cooling. This model predicts the early crystallization of high Mg# clinopyroxene, consistent with our petrological observation. The melt‐peridotite interaction process produces Na‐rich melts causing the crystallization of plagioclase with low anorthite component, typically characterizing the evolved gabbros from Godzilla Megamullion.
Consumers as innovators in the electricity sector? Consumer perceptions on smart grid services
Authors: Heiskanen Eva , Matschoss Kaisa 
Published: February 2016

AbstractThis article assesses the possibilities of using consumer innovation in the electricity sector, which is slow‐moving, yet faced with huge challenges and opportunities to become “smart” and “low carbon.” We study the benefits of engaging innovative consumers (“lead users”) in product, service, and business innovation in terms of (a) the capacity of lead user‐consumers to innovate in the highly regulated electricity market, (b) the attractiveness of such lead‐user generated ideas for mainstream consumers, (c) the usefulness of lead‐user engagement for companies in the energy industry, and (d) the usefulness of lead user engagement for the necessary broader societal transition processes. We conclude that consumers can stimulate industry‐wide innovation even in challenging contexts like “smart” and “low‐carbon” solutions and the highly regulated energy industry. Lead user‐consumers can also articulate societal and social responsibility concerns that are relevant for the entire market.
Infants Use Statistical Sampling to Understand the Psychological World
Authors: Wellman Henry M. , Kushnir Tamar , Xu Fei , Brink Kimberly A. 
Published: February 2016

Preverbal infants engage in statistical and probabilistic inference to learn about their linguistic and physical worlds. Do they also employ probabilistic information to understand their social world? Do they infer underlying causal mechanisms from statistical data? Here, we show, with looking‐time methods, that 10‐month‐olds attend to statistical information to understand their social–psychological world and plausibly infer underlying causal mechanisms from violations of physical probabilities.
Integrating transition theory and bioecological theory: a theoretical perspective for nurses supporting the transition to adulthood for young people with medical complexity
Authors: Joly Elizabeth 
Published: February 2016

AbstractAimsTo present a discussion of a theoretical perspective developed through integrating Meleis' Transition Theory and Bronfenbrenner's Bioecological Theory of Human Development to inform nursing and advanced nursing practice supporting the transition to adulthood for young people with medical complexity.BackgroundTheoretical perspectives to inform nursing practice in supporting successful transition are limited, yet nurses frequently encounter young people with medical complexity during the transition to adulthood.DesignDiscussion paper.DataA literature search of CINAHL and Medline was conducted in 2014 and included articles from 2003–2014; informal discussions with families; the author's experiences in a transition program.Implications for NursingThe integrated theoretical perspective described in this paper can inform nurses and advanced practice nurses on contextual influences, program and intervention development across spheres of influence and outcomes for the transition to adulthood for young people with medical complexity. Young people and their families require effective reciprocal interactions with individuals and services across sectors to successfully transition to adulthood and become situated in the adult world. Intervention must also extend beyond the young person to include providers, services and health and social policy.ConclusionNurses can take a leadership role in supporting the transition to adulthood for young people with medical complexity through direct care, case management, education and research. It is integral that nurses holistically consider developmental processes, complexity and contextual conditions that promote positive outcomes during and beyond the transition to adulthood.
Selecting Against Disability: The Liberal Eugenic Challenge and the Argument from Cognitive Diversity
Authors: Gyngell Christopher , Douglas Thomas 
Published: February 2016

AbstractSelection against embryos that are predisposed to develop disabilities is one of the less controversial uses of embryo selection technologies (ESTs). Many bio‐conservatives argue that while the use of ESTs to select for non‐disease‐related traits, such as height and eye‐colour, should be banned, their use to avoid disease and disability should be permitted. Nevertheless, there remains significant opposition, particularly from the disability rights movement, to the use of ESTs to select against disability.In this article we examine whether and why the state could be justified in restricting the use of ESTs to select against disability. We first outline the challenge posed by proponents of ‘liberal eugenics’. Liberal eugenicists challenge those who defend restrictions on the use of ESTs to show why the use of these technologies would create a harm of the type and magnitude required to justify coercive measures. We argue that this challenge could be met by adverting to the risk of harms to future persons that would result from a loss of certain forms of cognitive diversity. We suggest that this risk establishes a pro tanto case for restricting selection against some disabilities, including dyslexia and Asperger's syndrome.
The Occurrence of Implantable Cardioverter Defibrillator Therapies After Generator Replacement in Patients Who No Longer Meet Primary Prevention Indications
Authors: KAWATA HIRO , HIRAI TAISHI , DOUKAS DEMETRIOS , HIRAI RIE , STEINBRUNNER JENNI , WILSON JOHN , NODA TAKASHI , HSU JONATHAN , KRUMMEN DAVID , FELD GREGORY , WILBER DAVID , SANTUCCI PETER , BIRGERSDOTTER‐GREEN ULRIKA 
Published: February 2016

The Occurrence of ICD Therapies After Generator ReplacementIntroductionAt the time of generator replacement, after ICD implantation for primary prevention, many patients may no longer meet implantation criteria. We investigated the occurrence of ICD therapy after generator replacement in patients initially implanted ICD for primary prevention.MethodsPatients from 3 hospitals undergoing ICD generator replacement, who were initially implanted for primary prevention, were retrospectively evaluated for occurrence of appropriate ICD therapy after generator replacement. Patients were categorized as to whether or not they had appropriate ICD therapy during their first battery life, and by their left ventricular ejection fraction (LVEF) before generator replacement.ResultsData from 168 patients were analyzed, with average follow‐up after generator replacement of 41.2 ± 26.5 months. Seventy‐six (45.2%) patients had ventricular arrhythmia episodes (>180 beats per minutes) and 63 (37.5%) received appropriate ICD therapy during the first battery life. Among 105 patients without ICD therapy before generator replacement, those with an LVEF ≤35% before ICD replacement had higher occurrence of ICD therapy after generator replacement than patients with an LVEF ≥36%. Patients who no longer met primary prevention ICD indications (no ICD therapy and LVEF ≥36% before generator replacement) showed a lower risk for ICD therapy after generator replacement (11.6% over 5‐year follow‐up).ConclusionsIn patients without ICD therapy before generator replacement, low LVEF (≤35%) contributed to future ICD therapy. In patients initially undergoing ICD implantation for primary prevention, history of ICD therapy during the first battery life and LVEF should be utilized for risk stratification at the time of generator replacement.
Organized Sources Are Spatially Conserved in Recurrent Compared to Pre‐Ablation Atrial Fibrillation: Further Evidence for Non‐Random Electrical Substrates
Authors: LALANI GAUTAM G. , COYSH THOMAS , BAYKANER TINA , ZAMAN JUNAID , HOPPER KENNETH , SCHRICKER AMIR A. , TRIKHA RISHI , CLOPTON PAUL , KRUMMEN DAVID E. , NARAYAN SANJIV M. 
Published: February 2016

Conserved Rotors in Recurrent AFIntroductionRecurrent atrial fibrillation (AF) after ablation is associated with reconnection of initially isolated pulmonary vein (PV) trigger sites. Substrates are often targeted in addition to PVI, but it is unclear how substrates progress over time. We studied if substrates in recurrent AF are conserved or have developed de novo from pre‐ablation AF.Methods and ResultsOf 137 patients undergoing Focal Impulse and Rotor Mapping (FIRM) at their index procedure for AF, 29 consecutive patients (60 ± 8 years, 79% persistent) recurred and were also mapped at repeat procedure (21 ± 20 months later) using carefully placed 64‐pole baskets and RhythmViewTM (Topera, Menlo Park, CA, USA) to identify AF sources and disorganized zones. Compared to index AF, recurrent AF had a longer cycle length (177 ± 21 vs. 167 ± 19 milliseconds, P = 0.01). All patients (100%) had 1 or more conserved AF rotors between procedures with surrounding disorganization. The number of sources was similar for recurrent AF post‐PVI versus index AF (3.2 ± 1.4 vs. 3.1 ± 1.0, P = 0.79), but was lower for recurrent AF after FIRM+PVI versus index AF (4.4 ± 1.4 vs. 2.9 ± 1.7, P = 0.03). Overall, 81% (61/75) of AF sources lay in conserved regions, while 19% (14/75) were detected de novo.ConclusionElectrical propagation patterns for recurrent AF after unsuccessful ablation are similar in individual patients to their index AF. These data support temporospatial stability of AF substrates over 1–2 years. Trials should determine the relative benefit of adding substrate mapping and ablation to PVI for recurrent AF.
Is the European Commission Really in Decline?
Authors: Nugent Neill , Rhinard Mark 
Published: February 2016

AbstractIn the academic debate on the relative powers and influence of the EU institutions, it has become common to suggest – especially in the case of advocates of the ‘new intergovernmentalism’ – that the European Commission is in decline. In this article we show that while in some limited respects this is indeed the case, the Commission's overall position in the EU system is not one of having become a weaker institutional actor. The extent of the losses of its powers and influence tends to be exaggerated, while in some aspects its powers and influence have actually been strengthened. We show this by focusing on three of the Commission's core functions – agenda‐setter, legislative actor and executive – all of which are widely portrayed as being in decline. We incorporate into our analysis both the formal and informal resources available to the Commission in exercising the functions.