bluuebunny/crossref_metadata_2025_split huggingface dataset:
Advanced restorative dentistry – a problem for the elderly? An ethical dilemma
Authors: Murray CG 
Published: March 2015

AbstractThe type of dental restorations taken into old age may have an adverse effect on the quality of life of the elderly. Root caries and dry mouth increase in prevalence with age and may precipitate the breakdown of remaining natural and restored teeth. At present the availability of dental personnel and facilities in residential aged care facilities (RACFs) is limited, often non‐existent, and the elderly living at home may be unable to easily gain access to dental care. Thus, the provision of appropriate and timely dental treatment may not occur, resulting in prolonged pain and suffering. It is important that, as our elderly population increasingly retain natural teeth into advanced old age, appropriate funds are made available to ensure their dental health is maintained. A lack of early intervention to arrest dental disease may result in life‐threatening medical consequences in the elderly, such as ventilator assisted pneumonia or the need for a general anaesthetic and possible associated medical risks. Significant local disease, such as osteonecrosis, may also result from a lack of appropriate dental intervention. The necessity to remove questionable teeth prior to irradiation for neoplastic disease or bisphosphonate prescription for neoplastic disease or severe osteoporosis emphasizes the need for regular dental care.In contrast, extensive dental restorative treatment for younger people may have benefits, such as optimal dental aesthetics and oral function, but in older individuals careful consideration should be given to select the most appropriate treatment modality so that adverse situations can be avoided or their resolution simplified should they occur later when the individual is compromised or in a RACF. This may mean the use of conservative dental restorative materials and an avoidance of complex restorative options which may be difficult for the individual or RACF staff to maintain. Some years after receipt of their complex restorations they may be unable to cope with the operative demands and financial burden of resolving their deteriorating dental situation and so complex implant‐born structures and precision removable prostheses should probably be avoided for those individuals contemplating entering a care situation. Therefore, the timing of the provision of complex dentistry poses an ethical dilemma.
Social implications and workforce issues in the oral health of an ageing population
Authors: Wright FAC 
Published: March 2015

AbstractA functional and socially acceptable level of oral health is an integral part of healthy ageing! More teeth, more sophisticated dental technology and increasing co‐morbidities of an ageing Australian society will have significant impacts on oral health professionals and their capacities to work within expanded teams of health, education and social organizations. Society is adapting its perspective on the social role of older citizens; replacing its perception of the elderly as an economic social burden, to one of senior citizens as being a respected and active source of social and economic benefit.Maintaining general and oral health for older Australians will bring into sharp focus the need for recognizing and managing not only the biological markers associated with ageing and frailty, but also the potential mediators on health outcomes associated with changing health and social behaviours. Increasing social capital of older Australians through national policy initiatives such as the Living Longer Living Better reforms, and greater involvement of allied health and carers’ organizations in oral health education and health promotion will set a new scene for the roles of dental professionals. Issues of equity will drive the service delivery agenda, and a socio‐cultural shift to ‘consumer‐directed’ health outcomes will shape the range of services, quality of care and support required by an older Australian population. Formal education and training modules for aged care workers, allied health practitioners and geriatricians will develop. The challenge for the dental profession is the coordination and integration of these changes into new models of dental and general health care.
MicroRNA-155 may be involved in the pathogenesis of atopic dermatitis by modulating the differentiation and function of T helper type 17 (Th17) cells
Authors: Ma L , Xue H-B , Wang F , Shu C-M , Zhang J-H 
Published: March 2015

SummaryOur aims were to identify the differential expression of microRNA (miR)-155, as well as to explore the possible regulatory effects of miR-155 on the differentiation and function of T helper type 17 (Th17) cells in atopic dermatitis (AD). The Th17 cell percentage and expression levels of miR-155, retinoic acid-related orphan receptor (ROR)γt, interleukin (IL)-17 and suppressor of cytokine signalling-1 (SOCS1) in peripheral CD4+ T cells, plasma and skin specimens were detected and compared in AD patients and healthy subjects. A miR-155 mimic and an inhibitor were transfected separately into AD CD4+ T cells to confirm the in-vivo data. The Th17 cell percentage, miR-155 expression, RORγt mRNA expression, IL-17 mRNA expression and plasma concentration were increased significantly in AD patients compared with healthy subjects. Conversely, SOCS1 mRNA expression and plasma concentration were decreased significantly. Similar results were detected in cultured CD4+ T cells transfected with the miR-155 mimic compared with a miR-155 inhibitor or a negative control. Additionally, there was a sequential decrease in miR-155 expression, as well as RORγt and IL-17 mRNA expression, but an increase in SOCS1 mRNA expression, from AD lesional skin and perilesional skin to normal skin. Positive correlations were found between miR-155 expression and AD severity, Th17 cell percentage, RORγt mRNA expression and IL-17 mRNA expression and plasma concentration, while negative correlations were observed between miR-155 expression and SOCS1 mRNA expression and plasma concentration in AD peripheral circulation and skin lesions. In conclusion, miR-155 is over-expressed and may be involved in AD pathogenesis by modulating the differentiation and function of Th17 cells.
The most frequent cause of 90‐day unplanned hospital readmission following colorectal cancer resection is chemotherapy complications
Authors: Ang C. W. , Seretis C. , Wanigasooriya K. , Mahadik Y. , Singh J. , Chapman M. A. S. 
Published: March 2015

AbstractAimNHS England deems 90‐day readmission rates as a marker of quality of care. The causes of readmission have not been previously reported in the UK. The aim of this study was to examine the factors associated with 90‐day readmission following colorectal cancer surgery at a hospital trust with a catchment population 1.2 million.MethodA retrospective review was performed of all patients undergoing resection for colorectal cancer between January 2012 and December 2013. Unplanned readmission was defined as an emergency admission to the trust for any cause within 90 days of surgery. Readmission analyses were restricted to patients discharged from hospital within 28 days of resection.ResultsA total of 570 patients underwent surgery, of whom 522 were discharged within 28 days and are included for readmission analysis. The readmission rate was 24.3% (127 patients with a total of 163 episodes of hospital readmissions) within 90 days following surgery. The most frequent cause for readmission was complications related to adjuvant chemotherapy (18.4%) followed by wound‐related complications (14.1%). Most patients presenting with wound‐related complications were admitted within 60 days and patients with chemotherapy‐related complications after 61 days; 13/127 (10.2%) patients who were readmitted underwent emergency surgery, and one patient died following readmission. Multivariate analysis demonstrated that comorbidity was the only independent risk factor.ConclusionNinety‐day readmissions include a high number of readmissions secondary to chemotherapy‐related complications, whereas most surgical‐related readmission present within 60 days.
Early vs late tracheostomy in critically ill patients: a systematic review and meta‐analysis
Authors: Meng Liang , Wang Chunmei , Li Jianxin , Zhang Jian 
Published: March 2015

AbstractBackground and AimsThis study aims to compare the outcomes of early tracheostomy (ET) (≤10 days after translaryngeal intubation) with late tracheostomy (LT) (>10 days after translaryngeal intubation) in critically ill patients with prolonged mechanical ventilation (MV).MethodsWe searched PubMed, EMBASE and the Cochrane Library from inception to April 2014. We included all randomized controlled trials (RCTs), which compared ET with LT in critically ill patients. There was no language restriction. Two authors extracted data and conducted a quality assessment. Meta‐analyses using the fixed‐effects or random‐effects model were conducted for mortality, incidence of ventilator‐associated pneumonia (VAP), duration of MV and sedation, length of intensive care unit (ICU) stay.ResultsWe enrolled 9 studies, in which a total of 2040 patients were randomized to either ET group (N = 1018) or LT group (N = 1022). ET might reduce the duration of sedation [weighted mean difference (WMD) = −5.99 days; 95% confidence intervals (CI) = −11.41 to −0.57 days; P = 0.03]. ET did not significantly alter the mortality [relative risk (RR) = 0.88; 95% CI = 0.76–1.00; P = 0.06], incidence of VAP (RR = 0.84; 95% CI = 0.66–1.08; P = 0.17), duration of MV (WMD = −4.46 days; 95% CI = −12.61 to 3.69 days; P = 0.28) and length of ICU stay (WMD = −7.57 days; 95% CI = −15.42 to 0.29 days; P = 0.06).ConclusionsOur meta‐analysis suggested that ET might be able to reduce the duration of sedation but did not significantly alter the mortality, incidence of VAP, duration of MV and length of ICU stay.
Correlation between the Wells score and the Quanadli index in patients with pulmonary embolism
Authors: Obradović Dušanka , Joveš Biljana , Pena Karan Slobodanka , Stefanović Srdjan , Ivanov Igor , Vukoja Marija 
Published: March 2015

AbstractBackground and AimsDetermining clinical probability of pulmonary embolism (PE) with Wells scoring system is the first step towards diagnosis of PE. Definitive diagnosis of PE is confirmed by computed tomography pulmonary angiography (CTPA).MethodsThis was a prospective study on 80 patients referred to the Institute for Pulmonary Diseases of Vojvodina with suspected PE between April 2010 and August 2012. Clinical probability of PE was determined according to the Wells and modified Wells scoring system. CTPA was performed in 60 patients. The degree of pulmonary vascular obstruction was quantified by the Qanadli index.ResultsLow clinical probability of PE was present in one patient (1.6%), moderate in 43 (71.6%) and high in 16 (26.6%) patients. PE was confirmed in 50 (83.3%) patients. There were 21 patients (42%) whose Quanadli index was <25%, 18 (36%) between 25%–50%, while Quanadli index was ≥50 in 11 patients (22%). When compared to CTPA findings, modified Wells scoring system showed 90% sensitivity [95% confidence interval (CI) 78.2%–96.6%], and 20% specificity (95% CI 3.11%–55.6%), positive predictive value (PPV) 84.9% (95% CI 72.4%–93.2%) and negative predictive value (NPV) 28.6% (95% CI 4.5%–70.7%). There was weak positive correlation between Wells score and Quanadli index (r = 0.14; P = 0.29), without statistical significance. Wells score was significantly higher in haemodynamically unstable than in haemodynamically stable patients (6.8 vs 5.6, P = 0.014). There was no statistically significant difference between the values of Quanadli index in these two groups (31.33% vs 26.64%, P = 0.062).ConclusionModified Wells criteria have high sensitivity but low specificity in PE diagnostics. The Wells score does not correlate well with the Quanadli index.
Clinical outcomes of adult inpatients treated with continuous subcutaneous insulin infusion for diabetes mellitus: a systematic review
Authors: Anstey J. , Yassaee A. , Solomon A. 
Published: March 2015

AbstractAimsTo provide a systematic review of the current evidence concerning the diabetes‐related outcomes of patients provided with continuous subcutaneous insulin infusion for treating diabetes mellitus while a hospital inpatient.MethodsRelevant publications were obtained from MEDLINE and EMBASE databases concerning hospital inpatients with diabetes being treated with continuous subcutaneous insulin infusion. Studies were assessed independently by two reviewers, and data on the following outcomes were extracted: inpatient mortality; clinical complications, e.g. diabetic ketoacidosis; hyperglycaemia; hypoglycaemia; length of hospital stay; mean bedside glucose level; and glucose level on discharge. Obstetric cases were examined separately to look at maternal and neonatal glycaemic outcomes.ResultsA total of 11 studies met the required criteria and were analysed in detail, 5 of which were predominantly obstetric. No significant complications were reported, with no incidences of death, ketoacidosis or severe hypoglycaemia. Length of hospital stay appeared to be shorter in those patients who remained on continuous subcutaneous insulin infusion, while data on mild hyperglycaemia and hypoglycaemia were inconclusive.ConclusionsThere are limited data available to form a significant conclusion about the safety of continuous subcutaneous insulin infusion continuation in hospital; however, its use can be justified with the presence of a specialized inpatient diabetes team for advice and support and an alternative treatment regime (e.g. subcutaneous basal bolus) should be accessible if the need were to arise.
Reduction of hypoglycaemic events with a behavioural intervention: a randomized clinical trial for paediatric patients with Type 1 diabetes mellitus
Authors: Gee B. T. , Nansel T. R. , Liu A. 
Published: March 2015

AbstractAimsTo determine if a low‐intensity, clinic‐integrated behavioural intervention reduced the incidence of hypoglycaemic events in children with Type 1 diabetes.MethodsA total of 390 families with children with Type 1 diabetes were enrolled in a 2‐year, randomized clinical trial of a behavioural intervention. The intervention was designed to improve diabetes management practices by targeting the family's diabetes problem‐solving skills. Hypoglycaemic events were categorized in two groups: those treated by oral ingestion and those treated by parenteral therapy. Events were self‐reported by participants at each clinic visit, which occurred approximately every 3–4 months. Analyses included two‐sample t‐tests, the mean cumulative function test, and the Cox proportional hazards model for recurrent events to compare the incidence between groups.ResultsAcross the entire 2‐year study period, the incidence of hypoglycaemic events treated by oral ingestion of glucose‐rich foods and events requiring parenteral therapy did not significantly differ between study conditions; however, during the second year of participant enrolment, the incidence of events treated by oral ingestion in the intervention group was 13.6 per 100 person‐years compared with 27.3 per 100 patient‐years in the control group (P = 0.02). The hazard ratio of these events during the second year was 0.49 (95% CI 0.27–0.90; P = 0.02).ConclusionsOur findings suggest the need for a long‐term (> 1 year) focus on the implementation of interventions targeting diabetes management in young people. Behavioural interventions targeting problem‐solving skills could be considered as practical, non‐pharmacological strategies to reduce hypoglycaemia in adolescents with Type 1 diabetes.
Challenges in diagnosing infection in the diabetic foot
Authors: Glaudemans A. W. J. M. , Uçkay I. , Lipsky B. A. 
Published: March 2015

AbstractDiagnosing the presence of infection in the foot of a patient with diabetes can sometimes be a difficult task. Because open wounds are always colonized with microorganisms, most agree that infection should be diagnosed by the presence of systemic or local signs of inflammation. Determining whether or not infection is present in bone can be especially difficult. Diagnosis begins with a history and physical examination in which both classic and ‘secondary’ findings suggesting invasion of microorganisms or a host response are sought. Serological tests may be helpful, especially measurement of the erythrocyte sedimentation rate in osteomyelitis, but all (including bone biomarkers and procalcitonin) are relatively non‐specific. Cultures of properly obtained soft tissue and bone specimens can diagnose and define the causative pathogens in diabetic foot infections. Newer molecular microbial techniques, which may not only identify more organisms but also virulence factors and antibiotic resistance, look very promising. Imaging tests generally begin with plain X‐rays; when these are inconclusive or when more detail of bone or soft tissue abnormalities is required, more advanced studies are needed. Among these, magnetic resonance imaging is generally superior to standard radionuclide studies, but newer hybrid imaging techniques (single‐photon emission computed tomography/computed tomography, positron emission tomography/computed tomography and positron emission tomography/magnetic resonance imaging) look to be useful techniques, and new radiopharmaceuticals are on the horizon. In some cases, ultrasonography, photographic and thermographic methods may also be diagnostically useful. Improved methods developed and tested over the past decade have clearly increased our accuracy in diagnosing diabetic foot infections.
Use of a Baerveldt gonioimplant for secondary glaucoma in a horse
Authors: Wilson R. , Dees D. D. , Wagner L. , Monheit B. E. , O'Gan D. 
Published: March 2015

SummaryThis case report describes the surgical placement of a Baerveldt glaucoma shunt in the right eye of a 14‐year‐old Arabian gelding. The glaucomatous right eye was refractory to aggressive medical and repeated surgical therapies yet maintained functional vision. Despite the need for intensive post operative management and continued daily topical therapy, shunt placement surgery was successful at maintaining normotension and vision for a period of 402 days. This is the first report of long‐term successful glaucoma filtration surgery in this species. Further studies are warranted to evaluate long‐term success of glaucoma shunt placement in equine glaucoma cases.
Numerical investigation of compliance equations used in the R‐curve testing for clamped SE(T) specimens
Authors: Huang Y. , Zhou W. 
Published: March 2015

AbstractThree‐dimensional finite element analysis of clamped single‐edge tension specimen is performed to examine the accuracy of the crack‐mouth opening displacement compliance equations reported in the literature. The analysis covered both plane‐sided and side‐grooved specimens with a wide range of specimen configurations including nine relative crack lengths (a/W) ranging from 0.1 to 0.9 and seven relative thicknesses (B/W) ranging from 0.25 to 4. Based on the finite element analysis results, the crack length/compliance modification factors (ρ(a/W)andρ(BCE)) are developed to improve the accuracy of the compliance equations. The results of this study can improve the accuracy of the experimentally determinedJ‐Rand CTOD–Rcurves using the single‐specimen technique and single‐edge tension specimens.
The Implementation of High‐Leverage Teaching Practices: From the University Classroom to the Field Site
Authors: Davin Kristin J. , Troyan Francis J. 
Published: March 2015

AbstractIn response to the ACTFL's Research Priorities Initiative, the present study used a multiple case study design to examine teacher candidates' ability to implement two high‐leverage teaching practices: increasing interaction and target language comprehensibility and questioning to build and assess student understanding. Candidates implemented these practices in K–12 foreign language classrooms following a practice‐based methodology course. Findings revealed that candidates could more easily translate some aspects of practice to the field site than others. Generally, teacher candidates scored better on aspects of practice for which they were able to plan and practice than on those that required them to vary from their lesson plans or make in‐the‐moment decisions. Teacher candidates struggled the most with aspects of practice that involved sustaining meaningful interaction with students.
Comparative analysis of artisanal and recreational fisheries for Dentex dentex in a Marine Protected Area
Authors: Marengo M. , Culioli J.‐M. , Santoni M.‐C. , Marchand B. , Durieux E. D. H. 
Published: March 2015

AbstractThe common dentex, Dentex dentex (L.), is an iconic marine coastal fish in the Mediterranean Sea. This study was performed in the Bonifacio Strait Natural Reserve (BSNR), (NW Mediterranean Sea). The aims were to: (1) evaluate temporal variation of the artisanal fishing of common dentex (2000–2012); (2) compare and quantify catch rates, fishing techniques and catch composition for artisanal and recreational fisheries, and determine the influence of management measures by both activities; and (3) estimate the production of both artisanal and recreational fisheries. Fishery data were collected from different artisanal fishing surveys (onboard fishing vessels and landings) and recreational fishing surveys (roving). The gears with the highest rates of exploitation were longline (3554 g per 100 hooks) and Trolling (351 g boat−1 h−1 ±SE), respectively, for artisanal and recreational fishing. This study showed that catches by both activities were quantitatively higher in partially protected areas than outside them. Production estimations suggest that the recreational fishery contributes significantly to fishing mortality and that it can magnify the negative effects of artisanal fisheries. Specific measures are needed for the sustainable fishery management of common dentex.