bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of cone beam computed tomography on the choice of endodontic diagnosis
Authors: Mota de Almeida F. J. , Knutsson K. , Flygare L. 
Published: July 2014

AbstractAimTo determine whether the outcome of cone beam computed tomography (CBCT) examinations performed in accordance with the European Commission guidelines in a clinical setting has an impact on choosing diagnoses in endodontics.MethodologyA prospective observational study was conducted. Fifty‐three consecutive patients (81 teeth) from two different endodontic specialist clinics in Sweden were followed. After performing a thorough clinical examination (based on the history, clinical findings, and diagnostic tests such as intra‐oral radiography), the examiner wrote down a preliminary diagnosis before CBCT examination. After the CBCT examination, a new diagnosis was made by the same examiner. Both the pre‐ and the post‐CBCT examination diagnoses were plotted according to patients and teeth. The CBCT examinations were performed using similar equipment and protocols that were standardized amongst the clinics.ResultsThe diagnoses were changed for at least one tooth in 22 patients (41%); overall, the diagnoses were changed for 28 teeth (35%).ConclusionCBCT has a substantial impact on diagnostic thinking in endodontics when used in accordance with the European Commission guidelines.
Azathioprine as a therapeutic alternative for refractory chronic urticaria
Authors: Tal Yuval , Toker Ori , Agmon‐Levin Nancy , Shalit Meir 
Published: July 2014

AbstractBackgroundChronic urticaria (CU) affects up to 1% of the general population. Its impact on quality of life is immense, and patients might require multiple drugs to control symptoms. The main therapeutic challenge in the treatment of CU is to maintain symptomatic control while minimizing the use of glucocorticosteroids and their plethora of side effects.MethodsTwo patients with severe, refractory CU after treatment failure with various drugs, including high‐dose cyclosporine, were administered azathioprine.ResultsIn both patients, the treatment with azathioprine resulted in a significant clinical improvement, enabling steroid withdrawal.ConclusionAzathioprine should be considered as a therapeutic option for chronic, steroid‐dependent urticaria, refractory to other treatments.
The first skin cancer screening day at the Italian parliament: a Euromelanoma initiative
Authors: Suppa Mariano , Neri Luca , Bianchi Luca , Capizzi Rodolfo , Carbone Angelo , Catricalà Caterina , Chimenti Sergio , Fargnoli Maria Concetta , Fossati Barbara , Frascione Pasquale , Peris Ketty 
Published: July 2014

AbstractBackgroundThe effort to decrease incidence/mortality of skin cancer should target not only the general public but also politicians and decision makers, to create a proper health policy. We report the results of the first Skin Cancer Screening Day at the Italian Parliament, organized to draw politicians’ attention on skin cancer.MethodsA questionnaire was used to collect data on participants’ characteristics and suspected skin cancers.ResultsWe screened 70 members of parliament (61.4% males, median age 54 years). Overall skin cancer suspicion rate was 14.5%. Suspicion rate, detection rate, and positive predictive values for melanoma were respectively 1.6, 1.6, and 100%, and for basal cell carcinoma 6.5, 1.6, and 25%. Highly educated, <54‐year‐old females reported sun‐seeking behaviors.ConclusionsThe considerable suspicion rate produced by this screening is justified by the particular demographics of the study population. Italian members of parliament display sun‐seeking behaviors similar to those previously described in the general public. Increasing politicians’ attention on skin cancer is vital for sufficient resources to be allocated to prevention strategies. Expert medical groups and politicians should cooperate to create a proper, integrated policy on skin cancer.
Assessment of immature platelet fraction and immature reticulocyte fraction as predictors of engraftment after hematopoietic stem cell transplantation
Authors: Morkis I. V. C. , Farias M. G. , Rigoni L. D. C. , Scotti L. , Gregianin L. J. , Daudt L. E. , Silla L. M. da R. , Paz A. A. 
Published: July 2014

SummaryIntroductionEngraftment is a critical milestone of the hematopoietic stem cell transplantation (HSCT) process. The immature platelet fraction (IPF) and immature reticulocyte fraction (IRF) are considered early indicators of bone marrow recovery. The objective of this study was to assess these parameters as predictors of HSCT engraftment.MethodsNeutrophil and platelet engraftment were defined as the first of three consecutive days with an absolute neutrophil count >0.5 × 109/L or platelet count >20 × 109/L, respectively. The IRF cutoff was 12%. Two IPF cutoffs were used: >6.2% and >10%.ResultsThe study sample comprised 44 patients, of whom 24 had undergone autologous HSCT and 20 had undergone allogeneic HSCT. Absolute neutrophil counts >0.5 × 109/L were preceded by IRF >12% in 86% of patients (38 of 44). Platelet counts >20 × 109/L were preceded by an IPF >6.2% in 90% of patients (37 of 41) and by an IPF >10% in 63% of patients (26 of 41).ConclusionThe results show that IRF and IPF are engraftment predictors. Peak in IPF was observed before rise in platelet count, while IRF rises before absolute neutrophil count (ANC) and persists increased. This indicates that IRF and IPF can be considered as new tools for hematopoietic assessment after HSCT.
Risk factors for chronic pelvic pain: hospital‐based case–control study from Turkey
Authors: Gokyildiz Sule , Beji Nezihe K , Avcibay Burcu , Ozgunen Fatma T 
Published: July 2014

ABSTRACTChronic pelvic pain (CPP) is a complicated condition that can have a large impact on life. The aetiology of CPP is often unclear and the origin appears to be multifactorial. This study aims to identify risk factors associated with CPP complaint in women. The study is a descriptive case–control study in nature. The study was conducted in one university and one state hospital. Women with CPP (n = 134) composed the case group while those who consulted to the polyclinics with other problems formed the control group (n = 383). The data were collected through a questionnaire which was prepared in light of the related literature and the ‘Pelvic Pain Assessment Form’ developed by the International Pelvic Pain Society. Women in the case and control groups were found to have similar socio‐demographical features. This study has detected that CPP is associated with factors such as having a relative with recurrent pelvic pain complaint, having cancer or CPP history, having pain during menstruation, feeling of fullness in the abdominal region and stool consistency, recurrent urinary tract infections, having a diagnosed woman's disease (ovarian cyst, genital tract infection, prolapsus and menstrual irregularity), having had an abdominal operation, taking vaginal showers after sexual intercourse or for any other reason, falling down from height or having an accident that caused back damage, experiencing a sad event during childhood, being exposed to physical violence or forced to sexual intercourse. In Conclusion, this study has found that reproduction, urinary, gastrointestinal, musculoskeletal systems and psychological factors affect women with chronic pelvic pain.
Factors influencing cardiometabolic monitoring practices in an adult community mental health service
Authors: Millar Freyja , Sands Natisha , Elsom Stephen 
Published: July 2014

AbstractPeople with serious mental illness are reported to live up to 25 years less than the general population. Cardiovascular disease and diabetes risk factors, as well as mental health, treatment, lifestyle, service provision, and socioeconomic factors, all contribute to this health inequity. Cardiometabolic monitoring (CMM) is one strategy used to attend to some cardiometabolic risk factors. The present study aimed to explore factors that influence decisions to undertake CMM in an Australian adult community mental health service. A CMM audit tool was designed to capture demographic, clinical, and care‐provision factors. A 6‐month retrospective file audit from the total population of consumers of an adult community mental health service was undertaken, where no existing CMM guidelines or practices were in place. The study findings confirmed a higher prevalence of cardiometabolic disorders in the study population compared to the general population. Complete CMM occurred in 24% of the study population (n = 94). No consumer demographic, socioeconomic, or clinical characteristics, or care‐provision factors, were found to be predictors of complete CMM. The random manner in which CMM was observed to occur in the study highlights the need for standardized CMM guidelines and capacity‐building strategies to improve current CMM practices.
Examining the use of telehealth in community nursing: identifying the factors affecting frontline staff acceptance and telehealth adoption
Authors: Taylor Johanna , Coates Elizabeth , Brewster Liz , Mountain Gail , Wessels Bridgette , Hawley Mark S. 
Published: July 2014

AbstractAimsTo examine frontline staff acceptance of telehealth and identify barriers to and enablers of successful adoption of remote monitoring for patients with Chronic Obstructive Pulmonary Disease and Chronic Heart Failure.BackgroundThe use of telehealth in the UK has not developed at the pace and scale anticipated by policy. Many existing studies report frontline staff acceptance as a key barrier, however data are limited and there is little evidence of the adoption of telehealth in routine practice.DesignCase studies of four community health services in England that use telehealth to monitor patients with Chronic Obstructive Pulmonary Disease and Chronic Heart Failure.MethodsThematic analysis of qualitative interviews with 84 nursing and other frontline staff; and 21 managers and key stakeholders; data collected May 2012–June 2013.FindingsStaff attitudes ranged from resistance to enthusiasm, with varied opinions about the motives for investing in telehealth and the potential impact on nursing roles. Having reliable and flexible technology and dedicated resources for telehealth work were identified as essential in helping to overcome early barriers to acceptance, along with appropriate staff training and a partnership approach to implementation. Early successes were also important, encouraging staff to use telehealth and facilitating clinical learning and increased adoption.ConclusionsThe mainstreaming of telehealth hinges on clinical ‘buy‐in’. Where barriers to successful implementation exist, clinicians can lose faith in using technology to perform tasks traditionally delivered in person. Addressing barriers is therefore crucial if clinicians are to adopt telehealth into routine practice.
Obesity Does Not Increase Complication Rate of Percutaneous Epicardial Access
Authors: WAN SIU‐HIN , KILLU AMMAR M. , HODGE DAVID O. , PACKER DOUGLAS L. , MULPURU SIVA , ASIRVATHAM SAMUEL J. , MUNGER THOMAS M. , FRIEDMAN PAUL A. 
Published: July 2014

Epicardial Access and ObesityIntroductionPercutaneous epicardial access for ablative therapies is an increasingly common technique utilized for refractory ventricular arrhythmias. There are, however few known data on obesity and complication rates associated with this procedure.Methods and ResultsWe retrospectively reviewed the charts of subjects undergoing epicardial access at Mayo Clinic between January 2004 and June 2013. Baseline clinical and echocardiographic data were collected for each subject, who was then classified into body mass index (BMI) categories as underweight, normal weight, overweight, and obese based on a BMI of <18.5, 18.5–24.99, 25–29.99, and ≥30, respectively. Events and complications were recorded, and procedural and clinical success rates were determined.There was no statistically significant difference in access approach, procedural or clinical outcomes, or complications among the BMI categories. Note that 95.1%, 91.7%, and 93.1% derived procedural success among the normal weight, overweight, and obese categories, respectively (P value = 0.81). Similarly, there was no difference in clinical outcomes with success rates of 68.3%, 66.7%, and 75.9% between the respective groups (P value = 0.54). At 5 years, there was a trend toward increased mortality among obese individuals (28.8%) compared to normal weight (8.8%) and overweight (9.8%) patients (P value = 0.139).ConclusionPercutaneous epicardial access, mapping, and ablation can be performed in obese individuals with similar outcomes to those of lower weight category. Obesity should not preclude the use of percutaneous epicardial access when clinically indicated.
Striatal serotonin 2C receptors decrease nigrostriatal dopamine release by increasing GABA‐A receptor tone in the substantia nigra
Authors: Burke Mary V. , Nocjar Christine , Sonneborn Alex J. , McCreary Andrew C. , Pehek Elizabeth A. 
Published: July 2014

AbstractDrugs acting at the serotonin‐2C (5‐HT2C) receptor subtype have shown promise as therapeutics in multiple syndromes including obesity, depression, and Parkinson's disease. While it is established that 5‐HT2C receptor stimulation inhibits DA release, the neural circuits and the localization of the relevant 5‐HT2C receptors remain unknown. This study used dual‐probe in vivo microdialysis to investigate the relative contributions of 5‐HT2C receptors localized in the rat substantia nigra (SN) and caudate‐putamen (CP) in the control of nigrostriatal DA release. Systemic administration (3.0 mg/kg) of the 5‐HT2C receptor selective agonist Ro 60‐0175 [(αS)‐6‐Chloro‐5‐fluoro‐α‐methyl‐1H‐indole‐1‐ethanamine fumarate] decreased, whereas intrastriatal infusions of the selective 5‐HT2C antagonist SB 242084 [6‐Chloro‐2,3‐dihydro‐5‐methyl‐N‐[6‐[(2‐methyl‐3‐pyridinyl)oxy]‐3‐pyridinyl]‐1H‐indole‐1‐carboxyamide; 1.0 μM] increased, basal DA in the CP. Depending on the site within the SN pars reticulata (SNpr), infusions of SB 242084 had more modest but significant effects. Moreover, infusions of the GABA‐A receptor agonist muscimol (10 μM) into the SNpr completely reversed the increases in striatal DA release produced by intrastriatal infusions of SB 242084. These findings suggest a role for 5‐HT2C receptors regulating striatal DA release that is highly localized. 5‐HT2C receptors localized in the striatum may represent a primary site of action that is mediated by the actions on GABAergic activity in the SN.
imageDopamine (DA) neurons in the substantia nigra pars compacta (SNpc) project to the caudate‐putamen (CP; striatum). This circuitry is implicated in numerous pathologies including Parkinson's disease. Using in vivo microdialysis, we demonstrated that blockade of serotonin (5‐HT) 2C receptors in the CP increased nigrostriatal DA release. Infusions of a GABA‐A agonist into the substantia nigra pars reticulata (SNpr) blocked this increase. This work indicates that striatal serotonin 2C receptors regulate GABAergic tone in the SNpr, which in turn regulates nigrostriatal DA release.
The effect of a non‐surgical orthopaedic physician on wait times to see a paediatric orthopaedic surgeon
Authors: Bowman Matthew , Mackey Anna , Wilson Nichola , Stott Ngaire Susan 
Published: July 2014

AimsHigh referral volumes to paediatric orthopaedic surgeons create long clinic waiting lists. The use of extended scope roles for doctors and health professionals is one strategy to address these wait times. We completed a 6‐month trial of a non‐surgical paediatric orthopaedic physician role (NSP) to help manage non‐urgent referrals to our service from local general practitioners (GPs).MethodsFor a 6‐month period, the majority of non‐urgent GP referrals were assessed by a US‐trained NSP. Wait times were compared between this period and the same time period in the previous year. Family and referrer satisfaction was determined through postal surveys.ResultsOver the trial period, the NSP saw a total of 155 new patient referrals, which represented 49% of all non‐urgent GP referrals for the period. Before the trial, only 75% of non‐urgent referrals were seen within 131 days (19 weeks) with 10% waiting more than 215 days (31 weeks). By the end of the trial, 75% of referrals were seen within 55 days (8 weeks) and 90% within 61 days (9 weeks). The most common outcome was discharge with management advice. 12% of patients were referred on to an orthopaedic surgeon but only 1% went on to a surgical wait list. Families and referrers reported high levels of satisfaction and only three patients discharged by the NSP were referred back for orthopaedic surgeon review.ConclusionThe NSP role was effective at reducing clinic wait times for patients with non‐urgent paediatric orthopaedic conditions, while maintaining family and referrer satisfaction.
Beneficial effects of melatonin on bovine oocytes maturation: a mechanistic approach
Authors: Tian XiuZhi , Wang Feng , He ChangJiu , Zhang Lu , Tan DunXian , Reiter Russel J. , Xu Jing , Ji PengYun , Liu GuoShi 
Published: July 2014

AbstractThis study was performed to investigate the effect of melatonin on bovine oocyte maturation and subsequent embryonic development in vitro. The endogenous melatonin concentration in bovine follicular fluid is approximately 10−11 m. To examine the potential beneficial effects of melatonin on bovine oocyte maturation in vitro, germinal vesicle (GV) oocytes were incubated with different concentrations of melatonin (10−11, 10−9, 10−7, 10−5, 10−3 m). Melatonin supplementation at suitable concentrations significantly promoted oocyte maturation. The development of embryos and the mean cell number/blastocyst produced after in vitro fertilization were remarkably improved. The most effective melatonin concentrations obtained from the studies ranged from 10−9 to 10−7 m. The expression of melatonin receptor MT1 and MT2 genes was identified in cumulus cells, granulosa cells, and oocytes using reverse transcription PCR, immunofluorescence, and Western blot. The mechanistic studies show that the beneficial effects of melatonin on bovine oocyte maturation are mediated via melatonin membrane receptors as the melatonin receptor agonist (IIK7) promotes this effect while the melatonin receptor antagonist (luzindole) blocks this action. Mechanistic explorations revealed that melatonin supplementation during bovine oocyte maturation significantly up‐regulated the expressions of oocyte maturation‐associated genes (GDF9, MARF1, and DNMT1a) and cumulus cells expansion‐related gene (PTX3, HAS1/2) and that LHR1/2, EGFR are involved in signal transduction and epigenetic reprogramming. The results obtained from the studies provide new information regarding the mechanisms by which melatonin promotes bovine oocyte maturation in vitro and provide an important reference for in vitro embryo production of bovine and the human‐assisted reproductive technology.
Black and white with some shades of grey: the diverse responses of inducible metabolic pathways inEscherichia coli
Authors: Rao Christopher V. , Koirala Santosh 
Published: July 2014

SummaryThe metabolic pathways for many sugars are inducible. This process has been extensively studied in the case ofEscherichia colilactose metabolism. It has long been known that gratuitous induction of thelacoperon with non‐metabolizable lactose analogues generates an all‐or‐nothing response, where some cells express thelacgenes at a maximal rate and others not at all. However, the response to lactose itself is graded, where all cells express thelacgenes in proportion to lactose concentrations. The mechanisms generating these distinct behaviours in lactose metabolism have been a topic of many studies. Despite this large body of work, little is known about how other pathways respond to their cognate sugars. An article ofMolecular Microbiologyinvestigated the response of eight metabolic pathways inE. colito their cognate sugars at single‐cell resolution. The authors demonstrate that these pathways exhibit diverse responses, ranging from graded to all‐or‐nothing responses and combinations thereof. Remarkably, they were able to interpret these responses using a simple mathematical model and identify the mechanisms likely giving rise to each.
Somali Piracy Negotiations: Resolving the Paradoxes of Extortionate Transactions
Authors: Donohue William A. , Pugh Franziska , Sabrie Sharmaake 
Published: July 2014

AbstractThis article examines the negotiation process within piracy hijackings that occur around Somalia. Access was provided to two Somali pirates who were interviewed about their roles: a financier and a navigator. This article views these hostage negotiations as extortionate transactions, which requires negotiators to confront five paradoxes in the course of forging an outcome. The interviews with the two pirates reveal how the pirates and the ship owners who do the negotiations manage these paradoxes in the settling on a ransom. The interviews reveal how the hijackings are organized and financed, how the negotiations are organized logistically, how the ransoms are paid, and what happens when negotiations reach sticking points. The article concludes with a discussion of how the negotiations are shaped by the paradoxes as each side crafts its position.
Multidisciplinary care improves clinical outcome and reduces medical costs for pre‐end‐stage renal disease in Taiwan
Authors: Chen Yue‐Ren , Yang Yu , Wang Shu‐Chuan , Chou Wen‐Yu , Chiu Ping‐Fang , Lin Ching‐Yuang , Tsai Wen‐Chen , Chang Jer‐Ming , Chen Tzen‐Wen , Ferng Shyang‐Hwa , Lin Chun‐Liang 
Published: July 2014

AbstractAimMultidisciplinary care (MDC) for patients with chronic kidney disease (CKD) may help to optimize disease care and improve clinical outcomes. Our study aimed to evaluate the effectiveness of pre‐end‐stage renal disease (ESRD) patients under MDC and usual care in Taiwan.MethodIn this 3‐year retrospective observational study, we recruited 822 ESRD subjects, aged 18 years and older, initiating maintenance dialysis more than 3 months from five cooperating hospitals. The MDC (n = 391) group was cared for by a nephrologists‐based team and the usual care group (n = 431) was cared for by sub‐specialists or nephrologists alone more than 90 days before dialysis initiation. Patient characteristics, dialysis modality, hospital utilization, hospitalization at dialysis initiation, mortality and medical cost were evaluated. Medical costs were further divided into in‐hospital, emergency services and outpatient visits.ResultsThe MDC group had a better prevalence in peritoneal dialysis (PD) selection, less temporary catheter use, a lower hospitalization rate at dialysis initiation and 15% reduction in the risk of hospitalization (P < 0.05). After adjusting for gender, age and Charlson Comorbidity Index score, there were lower in‐hospital and higher outpatient costs in the MDC group during 3 months before dialysis initiation (P < 0.05). In contrast, medical costs (NT$ 146 038 vs 79 022) and hospitalization days (22.4 vs 15.5 days) at dialysis initiation were higher in the usual care group. Estimated medical costs during 3 months before dialysis till dialysis initiation, the MDC group yielded a reduction of NT$ 59 251 for each patient (P < 0.001). Patient mortality was not significantly different.ConclusionMultidisciplinary care intervention for pre‐ESRD patients could not only significantly improve the quality of disease care and clinical outcome, but also reduce medical costs.