bluuebunny/crossref_metadata_2025_split huggingface dataset:
Root cause analysis of delays to discharge for patients held for serial cardiac troponin levels
Authors: Owen Julian James , Worster Andrew , Waines Barbara Marie , Ward James , Kavsak Peter , Hill Stephen 
Published: July 2016

ABSTRACTObjective:Emergency department (ED) patients with symptoms of cardiac ischemia often require a second cardiac troponin (cTn) measurement to rule out non–ST elevation myocardial infarction. We measured the total turnaround time and the component event times following the ordering of the second cTn level to ED discharge to identify root causes of delays.Methods:We reviewed a random sample of ED discharges following a second normal cTn measurement and recorded associated event times. The central tendency of time intervals is reported as median and mean number of minutes with interquartile ranges (IQRs) and 95% confidence intervals, respectively.Results:From 9,656 eligible cases, we randomly selected 226 for data collection. The median number of minutes for each event are as follows: from ordering the second cTn measurement to the time of ED discharge was 90 minutes (IQR 65–120); for blood collection from the time the collection was ordered for was 0 minutes (IQR 212–0); from blood collection to the time the blood was transported to the laboratory was 9 minutes (IQR 2–19); laboratory process duration was 44 minutes (IQR 39–52); from when the results were available to the time the patient was discharged was 30 minutes (IQR 15–52).Conclusions:For ED patients discharged following two normal cTn levels, the laboratory processing time and time from the result being available to the time of ED discharge represent the longest modifiable time periods to reduce ED length of stay.
Computerized interpretation of the prehospital electrocardiogram: predictive value for ST segment elevation myocardial infarction and impact on on-scene time
Authors: de Champlain François , Boothroyd Lucy J. , Vadeboncoeur Alain , Huynh Thao , Nguyen Viviane , Eisenberg Mark J. , Joseph Lawrence , Boivin Jean-François , Segal Eli 
Published: July 2016

ABSTRACTIntroduction:Computerized interpretation of the prehospital electrocardiogram (ECG) is increasingly being used in the basic life support (BLS) ambulance setting to reduce delays to treatment for patients suspected of ST segment elevation myocardial infarction (STEMI).Objectives:To estimate 1) predictive values of computerized prehospital 12-lead ECG interpretation for STEMI and 2) additional on-scene time for 12-lead ECG acquisition.Methods:Over a 2-year period, 1,247 ECGs acquired by primary care paramedics for suspected STEMI were collected. ECGs were interpreted in real time by the GEMarquette 12SL ECG analysis program. Predictive values were estimated with a bayesian latent class model incorporating the computerized ECG interpretations, consensus ECG interpretations by study cardiologists, and hospital diagnosis. On-scene time was compared for ambulance-transported patients with (n 5 985) and without (n 5 5,056) prehospital ECGs who received prehospital aspirin and/or nitroglycerin.Results:The computer's positive and negative predictive values for STEMI were 74.0% (95% credible interval [CrI] 69.6–75.6) and 98.1% (95% CrI 97.8–98.4), respectively. The sensitivity and specificity were 69.2% (95% CrI 59.0–78.5) and 98.9% (95% CrI 98.1–99.4), respectively. Prehospital ECGs were associated with a mean increase in on-scene time of 5.9 minutes (95% confidence interval 5.5–6.3).Conclusions:The predictive values of the computerized prehospital ECG interpretation appear to be adequate for diversion programs that direct patients with a positive result to hospitals with angioplasty facilities. The estimated 26.0% chance that a positive interpretation is false is likely too high for activation of a catheterization laboratory from the field. Acquiring prehospital ECGs does not substantially increase on-scene time in the BLS setting.
Use of diagnostic imaging in the emergency department for cervical spine injuries in Kingston, Ontario
Authors: Pickett William , Kukaswadia Atif , Thompson Wendy , Frechette Mylene , McFaull Steven , Dowdall Hilary , Brison Robert J. 
Published: July 2016

ABSTRACTObjectives:This study assessed the use and clinical yield of diagnostic imaging (radiography, computed tomography, and medical resonance imaging) ordered to assist in the diagnosis of acute neck injuries presenting to emergency departments (EDs) in Kingston, Ontario, from 2002–2003 to 2009–2010.Methods:Acute neck injury cases were identified using records from the Kingston sites of the Canadian National Ambulatory Care Reporting System. Use of radiography was analyzed over time and related to proportions of cases diagnosed with clinically significant cervical spine injuries.Results:A total of 4,712 neck injury cases were identified. Proportions of cases referred for diagnostic imaging to the neck varied significantly over time, from 30.4% in 2002–2003 to 37.6% in 2009–2010 (ptrend= 0.02). The percentage of total cases that were positive for clinically significant cervical spine injury (“clinical yield”) also varied from a low of 5.8% in 2005–2006 to 9.2% in 2008–2009 (ptrend= 0.04), although the clinical yield of neck-imaged cases did not increase across the study years (ptrend= 0.23). Increased clinical yield was not observed in association with higher neck imaging rates whether that yield was expressed as a percentage of total cases positive for clinically significant injury (p= 0.29) or as a percentage of neck-imaged cases that were positive (p= 0.77).Conclusions:We observed increases in the use of diagnostic images over time, reflecting a need to reinforce an existing clinical decision rule for cervical spine radiography. Temporal increases in the clinical yield for total cases may suggest a changing case mix or more judicious use of advanced types of diagnostic imaging.
Point-of-care ultrasonography for the diagnosis of small bowel obstruction in the emergency department
Authors: Guttman Joshua , Stone Michael B. , Kimberly Heidi H. , Rempell Joshua S. 
Published: July 2016

AbstractSmall bowel obstruction (SBO) is a common cause of acute abdominal pain presenting to the emergency department (ED). Although the literature is limited, point-of-care ultrasonography (POCUS) has been found to have superior diagnostic accuracy for SBO compared to plain radiography; however, it is rarely used in North America for this. We present the case of a middle-aged man who presented with abdominal pain where POCUS by the emergency physician early in the hospital course expedited the diagnosis of SBO and led to earlier surgical consultation. The application of POCUS for SBO is easily learned and applied in the ED. POCUS for SBO may obviate the need for plain radiography and expedite patient care.
Evaluation of surface blood flow in intact and ruptured canine cruciate ligaments using laser Doppler flowmetry
Authors: Testuz Joakim , Howard Judith , Pozzi Antonio , Rytz Ulrich , Krudewig Christiane , Spreng David , Forterre Simone 
Published: July 2016

SummaryObjective: To evaluate the usefulness of laser Doppler flowmetry (LDF) to measure surface blood flow in canine cruciate ligaments, compare measurements in different sites of intact and partially ruptured canine cranial cruciate ligaments (CrCL) and intact caudal cruciate ligaments (CaCL), and investigate any association between surface blood flow in partially ruptured CrCL and synovitis or duration of clinical signs.Study design: Case-controlled clinical study.Animals: Sixteen dogs with partially ruptured CrCL and five dogs with intact CrCL.Methods: Blood cell flux (BCF) readings during three measurement cycles using LDF at two sites in each ligament (mid-substance and the distal portion of the CrCL, and mid-substance and the proximal portion of the CaCL) were recorded. Synovial changes were graded grossly and histologically using the Osteoarthritis Research Society International histopathology scoring system.Results: The within-run coefficients of variation (CV) for a single BCF measurement cycle were 12.2% and 12.7% in the ruptured and intact CrCL groups, respectively. The between-run CV for three measurement cycles was 20.8% and 14.8%, respectively. The intraclass correlation coefficient (ICC, absolute agreement) was 0.66 for a single measurement cycle and 0.86 for the average of three cycles.No difference in average BCF readings was found between any two sites in either group, but BCF readings in both CrCL sites were significantly higher in the ruptured CrCL group than the intact CrCL group. No associations between BCF and synovial grades or duration of lameness were identified.Conclusions: Laser Doppler flowmetry can be used to assess surface blood flow in intact and partially ruptured canine cruciate ligaments with acceptable precision. Using this method, surface blood flow appears greater in partially ruptured canine CrCL than intact CrCL. Further studies are required to determine if this is a sequela of trauma or synovitis.
Morphometric assessment of hip dysplasia in a cat treated by juvenile pubic symphysiodesis
Authors: Culvenor John , Bailey Craig , Lai Alen 
Published: July 2016

SummaryObjective: To quantitatively evaluate the change of the coxofemoral joints using computed tomography and distraction index in a cat with hip dysplasia treated by juvenile pubic symphysiodesis.Study Design: Case report.Animal: Eighteen-week-old female entire Maine Coon cat.Results: Juvenile pubic symphysiodesis resulted in changes in the distraction index, acetabular angle, dorsal acetabular rim angle, dorsal acetabular sector angle, and clinical improvement at the six month follow-up. No intra-operative or postoperative complications were recorded.Conclusions: Juvenile pubic symphysiodesis performed at 18 weeks of age resulted in improvement in hip joint conformation and hip laxity in a dysplastic cat.Clinical relevance: Juvenile pubic symphysiodesis may be a promising treatment for feline hip dysplasia and is a safe and technically simple procedure to perform. Further investigations are warranted.
Finite Volume Lattice Boltzmann Method for Nearly Incompressible Flows on Arbitrary Unstructured Meshes
Authors: Li Weidong , Luo Li-Shi 
Published: July 2016

AbstractA genuine finite volume method based on the lattice Boltzmann equation (LBE) for nearly incompressible flows is developed. The proposed finite volume lattice Boltzmann method (FV-LBM) is grid-transparent,i.e., it requires no knowledge of cell topology, thus it can be implemented on arbitrary unstructured meshes for effective and efficient treatment of complex geometries. Due to the linear advection term in the LBE, it is easy to construct multi-dimensional schemes. In addition, inviscid and viscous fluxes are computed in one step in the LBE, as opposed to in two separate steps for the traditional finite-volume discretization of the Navier-Stokes equations. Because of its conservation constraints, the collision term of the kinetic equation can be treated implicitly without linearization or any other approximation, thus the computational efficiency is enhanced. The collision with multiple-relaxation-time (MRT) model is used in the LBE. The developed FV-LBM is of second-order convergence. The proposed FV-LBM is validated with three test cases in two-dimensions: (a) the Poiseuille flow driven by a constant body force; (b) the Blasius boundary layer; and (c) the steady flow past a cylinder at the Reynolds numbers Re=10, 20, and 40. The results verify the designed accuracy and efficacy of the proposed FV-LBM.
On the Stability and CPU Time of the Implicit Runge-Kutta Schemes for Steady State Simulations
Authors: Du Yongle , Ekaterinaris John A. 
Published: July 2016

AbstractImplicit time integration schemes are popular because their relaxed stability constraints can result in better computational efficiency. For time-accurate unsteady simulations, it has been well recognized that the inherent dispersion and dissipation errors of implicit Runge-Kutta schemes will reduce the computational accuracy for large time steps. Yet for steady state simulations using the time-dependent governing equations, these errors are often overlooked because the intermediate solutions are of less interest. Based on the model equationdy/dt=(μ+iλ)yof scalar convection diffusion systems, this study examines the stability limits, dispersion and dissipation errors of four diagonally implicit Runge-Kutta-type schemes on the complex (μ+iλ)Δtplane. Through numerical experiments, it is shown that, as the time steps increase, the A-stable implicit schemes may not always have reduced CPU time and the computations may not always remain stable, due to the inherent dispersion and dissipation errors of the implicit Runge-Kutta schemes. The dissipation errors may decelerate the convergence rate, and the dispersion errors may cause large oscillations of the numerical solutions. These errors, especially those of high wavenumber components, grow at large time steps. They lead to difficulty in the convergence of the numerical computations, and result in increasing CPU time or even unstable computations as the time step increases. It is concluded that an optimal implicit time integration scheme for steady state simulations should have high dissipation and low dispersion.
The Effects of Functional Appliances on Female Patients with Skeletal Class II Malocclusion 6 Months after Menarche
Authors: Jouybari Ali AM , Arash Valiallah , Tavanafar Saeid , Khafri Soraya , Dehghan Zahra 
Published: July 2016

ABSTRACT

Aim
To investigate the skeletal, dental, and soft tissue changes in girls with class II division 1 malocclusion after growth spurt peak under the effect of activator appliance.

Materials and methods
In this clinical trial study, 15 female patients, with skeletal class II and mandibular growth deficiency and at least 5 mm overjet, were randomly selected 6 months after their menarche. The mean of their ages at the beginning was 12.33 ± 0.81 years, and in the end it was 13.73 ± 0.79 years; the mean duration of treatment was 12.2 ± 3.18 months. Lateral, cephalometric radiographs were taken from all the patients before and after the treatment. Data were analyzed with Statistical Package for the Social Sciences (SPSS) 20 using paired t-test.

Results
On an average, the ANB angle, the angle of the upper incisors with the S-N, facial convexity, and overjet decreased by 2.6° ± 0.9, 5.4° ± 0.8, 3.8° ± 3.4, and 5.6 ± 1.8 mm respectively. The SNB angle, the angle of the lower incisors with the N-B, the labiomental angle, the total length of the mandible, the lower anterior facial height, the lower lip distance, the first molar of the mandible, and the soft tissue pogonion to the vertical line from the S point increased by 2.8° ± 1.8, 3.4° ± 3, 14.7 ± 15, 3.7 ± 2.6, 2.1 ± 1.6, 6.3 ± 2.5, 4.4 ± 2.4, and 6 ± 3.3 mm respectively. All these figures were statistically significant (p = 0.000).

Conclusion
The functional appliance improved the dental–skeletal relations and the soft tissue profile of patients after growth spurt peak of puberty in a group of Iranian girls, whereas dental changes were more than skeletal ones.

Clinical significance
Functional appliances can be used for correction of skeletal class II malocclusion 6 months after menarche in girls.

How to cite this article
Jouybari AAM, Arash V, Tavanafar S, Khafri S, Dehghan Z. The Effects of Functional Appliances on Female Patients with Skeletal Class II Malocclusion 6 Months after Menarche. J Contemp Dent Pract 2016;17(4):286-293.
The Accuracy and Reproducibility of Linear Measurements Made on CBCT-derived Digital Models
Authors: Hajeer Mohammad Y , Maroua Ahmad L , Ajaj Mowaffak 
Published: July 2016

ABSTRACT

Objective
To evaluate the accuracy and reproducibility of linear measurements made on cone-beam computed tomography (CBCT)-derived digital models.

Materials and methods
A total of 25 patients (44% female, 18.7 ± 4 years) who had CBCT images for diagnostic purposes were included. Plaster models were obtained and digital models were extracted from CBCT scans. Seven linear measurements from predetermined landmarks were measured and analyzed on plaster models and the corresponding digital models. The measurements included arch length and width at different sites. Paired t test and Bland–Altman analysis were used to evaluate the accuracy of measurements on digital models compared to the plaster models. Also, intraclass correlation coefficients (ICCs) were used to evaluate the reproducibility of the measurements in order to assess the intraobserver reliability.

Results
The statistical analysis showed significant differences on 5 out of 14 variables, and the mean differences ranged from −0.48 to 0.51 mm. The Bland–Altman analysis revealed that the mean difference between variables was (0.14 ± 0.56) and (0.05 ± 0.96) mm and limits of agreement between the two methods ranged from −1.2 to 0.96 and from −1.8 to 1.9 mm in the maxilla and the mandible, respectively. The intraobserver reliability values were determined for all 14 variables of two types of models separately. The mean ICC value for the plaster models was 0.984 (0.924–0.999), while it was 0.946 for the CBCT models (range from 0.850 to 0.985).

Conclusion
Linear measurements obtained from the CBCTderived models appeared to have a high level of accuracy and reproducibility.

How to cite this article
Maroua AL, Ajaj M, Hajeer MY. The Accuracy and Reproducibility of Linear Measurements Made on CBCT-derived Digital Models. J Contemp Dent Pract 2016;17(4):294-299.
Peri-implant Diseases: What do We know and What do We need to know?
Authors: Danesh-Sani Seyed Amir 
Published: July 2016

How to cite this article
Danesh-Sani SA. Peri-implant Diseases: What do We know and What do We need to know?. J Contemp Dent Pract 2016;17(5):347-348.
Antibacterial Effect of New Bioceramic Pulp Capping Material on the Main Cariogenic Bacteria
Authors: Elshamy Fahiem MM , Elraih Husham , Gupta Iti , Idris Faisal AI 
Published: July 2016

ABSTRACT

Background
The purpose of this research was to assess the antibacterial activity of a new bioceramic pulp capping material (endosequence root repair material [ERRM]) against the main cariogenic bacteria: Salivary mutans streptococci (MS) and lactobacilli and compare the results with mineral trioxide aggregate (MTA) and calcium hydroxide (Dycal).

Materials and methods
The isolation of MS group bacteria and Lactobacillus (LB) spp. from stimulated saliva was performed with in-office caries risk test bacteria dip slide test. Endosequence root repair material, MTA (ProRoot MTA), and Dycal were used as pulp capping materials. Mutans Streptococci and LB were scattered on the agar dishes with a swab. The pulp capping materials under study were placed in the wells and prepared in the agar, immediately after mixing. The dishes were incubated for 24 hours at 37°C. The growth inhibition zones were recorded and compared for every material and bacterial strain. One-way analysis of variance test was done to compare the development of growth inhibition of selected bacteria against testing materials. Post hoc Tukey honest significant difference was conducted to compare each material group.

Results
All the three selected pulp capping materials were found to inhibit the bacteria LB and MS. The antibacterial activity of ERRM and ProRoot MTA was significantly better than the Dycal. Against MS, ERRM and MTA showed no statistically significant difference. Mineral trioxide aggregate showed significantly better inhibitory activity against LB.

Conclusion
Endosequence root repair material and MTA had superior antibacterial properties against the main cariogenic bacteria: MS and LB compared with Dycal.

Clinical significance
A pulp-capping agent having good antibacterial properties can have better success rate in maintaining the vitality of the tooth while treating deep carious lesions in patients.

How to cite this article
Elshamy FMM, Singh G, Elraih H, Gupta I, AI Idris F. Antibacterial Effect of New Bioceramic Pulp Capping Material on the Main Cariogenic Bacteria. J Contemp Dent Pract 2016;17(5):349-353.
Intricate Assessment and Evaluation of Dental Implants in Patients on Bisphosphonate Therapy: A Retrospective Analysis
Authors: Suvarna Suraj , Dutt Poonam , Misra Animesh , Usmani Nausheen , Suvarna Chandini 
Published: July 2016

ABSTRACT

Background
Osteonecrosis is one of the prevalent side effects of bisphosphonate (BP) therapy in oral cancer patients. In case of patients with various oncologic lesions, standard guidelines contraindicate the use of dental implants if the patients are on BP therapy. Literature also quotes studies that emphasize on the safety of dental implants in patients on BP therapy. Hence, this study aimed to retrospectively evaluate the clinical outcome of dental implants in patients on BP therapy.

Materials and methods
In this retrospective analysis, a total of 140 dental implants in 112 patients were included. Inclusion criteria included only those patients who were on or had history of BP therapy. Calculation of implant failure and survival rate was done.

Results
Ten cases of implant failure occurred, giving a success rate of above 92%, which was comparable to the results found in previous studies in patients who were not on BP therapy.

Conclusion
No significant risk of implant failure is seen in patients on BP therapy compared with other patients.

How to cite this article
Suvarna S, Dutt P, Misra A, Usmani N, Singh A, Suvarna C. Intricate Assessment and Evaluation of Dental Implants in Patients on Bisphosphonate Therapy: A Retrospective Analysis. J Contemp Dent Pract 2016;17(5):414-417.
Reconstruction of Post-burn Microstomia: Our Experience
Authors: Dhanraj Prema , Mahesh MS , Narayan Naveen 
Published: July 2016

ABSTRACT
Reconstruction of the post-burn contracture is a complex task in plastic surgery. A burn patient treated traditionally only by dressings develops scar with contracture involving the burned region. The lip is a part of the face that is frequently affected by burn injury. Post-burn scar sequelae in this area often result in cosmetic disfigurement and psychological upset in patients. Microstomia poses difficulty in airway intubation during anesthesia and contracture of the neck if present confounds difficulty. Reconstruction of post-burn oral commissure aims to restore both symmetry of the lips (esthetic) and full oral competence (functional). Frequently treated in our department, we present a case series of post-burn contracture of neck with microstomia whose neck extension and mouth opening both were restricted giving less option but more challenge for both anesthesiologists and plastic surgeons.

How to cite this article
Narayan N, Dhanraj P, Mahesh MS. Reconstruction of Post-burn Microstomia: Our Experience. J Health Sci Res 2015;6(1):5-7.
Esthetic Correction of Gummy Smile by Gingivectomy using Diode Laser
Authors: Shivaprasad BM , Rakesh MP , Prabhu Sandeep S 
Published: July 2016

ABSTRACT
A pleasant smile is considered a symbol of beauty and well being in the modern society periodontology extensively deals with soft tissue surgeries. However, pain, trauma, bleeding, postoperative edema and scarring are often associated with conventional methods of surgery which are problematic for both the patient and the clinician. Hence, to overcome these drawbacks, 940 nm diode laser was used to perform various periodontal surgical procedures. This case report highlights the use of diode laser to correct gummy smile for better shape, contour and gingival margin.

How to cite this article
Shivaprasad BM, Rakesh MP, Prabhu SS. Esthetic Correction of Gummy Smile by Gingivectomy using Diode Laser. J Health Sci Res 2015;6(1):17-21.