bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevention of functional decline in older hospitalized patients: Nurses should play a key role in safe and adequate care
Authors: Hoogerduijn Jita G , Grobbee Diederick E , Schuurmans Marieke J 
Published: August 2013

This paper presents a discussion of knowledge and awareness regarding prevention of functional decline in older hospitalized patients.Functional decline is experienced by 30–60% of the older hospitalized patients, resulting in decreased independence and other adverse health outcomes.One literature study and four cohort studies (total n = 1628) were conducted to develop and validate an instrument to identify older hospitalized patients at risk for functional decline. An evidence‐based best practice was developed to improve the quality of care for older patients.This paper shows the relevance and the complexity of this problem and shows that patients at risk can be recognized by four simple questions.Due to their ability to observe and guide patients and their 24‐h patient supervision, nurses should play a key role in strategies to prevent functional decline. Nurses should assess the geriatric needs in patients at risk and based on these initiate and coordinate multi‐professional interventions. Given the growing number of older people in western society and the growing need for care, action to prevent functional decline cannot be withheld. Knowledge of the ageing process, implementation of an evidence‐based programme and a multidisciplinary approach is a basic ingredient to prevent functional decline.
Emphysematous pyelonephritis: Clinical characteristics and prognostic factors
Authors: Lu Yu‐Chuan , Chiang Bing‐Juin , Pong Yuan‐Hung , Chen Chung‐Hsin , Pu Yeong‐Shiau , Hsueh Po‐Ren , Huang Chao‐Yuan 
Published: August 2013

ObjectivesEmphysematous pyelonephritis is a severe necrotizing infection of the renal parenchyma and perirenal tissues that is caused by gas‐producing bacterial pathogens. The aim of the present study was to determine the clinical characteristics and prognostic factors of patients with emphysematous pyelonephritis.MethodsWe retrospectively analyzed the clinical and laboratory data, imaging findings, and outcomes of 32 patients with emphysematous pyelonephritis. Receiver operating characteristic curve analysis was carried out on variables that were significantly associated with patient mortality.ResultsThe overall survival rate was 87.5% (28/32). Escherichia coli (43.6%) was the most common organism cultured from urine and blood specimens. Hypoalbuminemia, shock as the presenting feature, bacteremia, need for hemodialysis and polymicrobial infection were significantly more common in cases resulting in death. The area under the receiver operating characteristic curve was 0.96. The cut‐off point determined by the maximum Youden index (0.93) for three of these five factors yielded a sensitivity of 1.00 and specificity of 0.93. Shock as an initial presentation (P = 0.039) and polymicrobial infection (P = 0.010) were significantly associated with poor outcome. There were no significant differences in the clinical or laboratory features of the patients who did or did not undergo nephrectomy.ConclusionHypoalbuminemia, shock as an initial presentation, bacteremia, indications for hemodialysis and polymicrobial infection represent prognostic factors for mortality in patients with emphysematous pyelonephritis. Patients presenting with more than two of these prognostic factors carry the highest risk of mortality, and they require timely diagnosis and aggressive management.
Assessment of permanent brachytherapy combined with androgen deprivation therapy in an intermediate‐risk prostate cancer group without a Gleason score of 4 + 3: A single Japanese institutional experience
Authors: Okihara Koji , Kobayashi Kana , Iwata Tsuyoshi , Naitoh Yasuyuki , Kamoi Kazumi , Kawauchi Akihiro , Yamada Kei , Miki Tsuneharu 
Published: August 2013

ObjectivesTo evaluate the outcome of low‐dose‐rate permanent brachytherapy combined with anti‐androgen deprivation therapy for intermediate‐risk prostate cancer excluding biopsy Gleason score 4 + 3.MethodsPatients included in the intermediate‐risk group were those presenting clinical stage T1c to T2c (by magnetic resonance imaging staging), Gleason score 3 + 4 or lower and/or prostate‐specific antigen less than 20 ng/mL, whereas those with clinical stage T1c to T2a, Gleason score 3 + 3 and prostate‐specific antigen less than 10 ng/mL represented the low‐risk group, and were used as controls. In the intermediate‐risk group, therapy with a luteinizing hormone‐releasing hormone analog was continued for at least 6 months before and after permanent brachytherapy.ResultsA total of 147 low‐risk group patients and 139 intermediate‐risk group patients were included in the study. The median follow up was 51 and 52 months for the intermediate‐risk group and low‐risk group, respectively. The 5‐year overall, cause‐specific and distant‐metastasis‐free survival rates in the low‐risk group and intermediate‐risk group were 97.6/99.2, 100/100 and 100/100%, respectively. The 5‐year biochemical disease‐free survival in these groups were 95.9 and 92.5%, respectively (P = 0.18). There was no sexual activity and desire for erection before treatment in 50%, and in 46% of the patients in the low‐risk group and intermediate‐risk group, respectively. Overall satisfaction score at 2 years after permanent brachytherapy significantly improved, compared with pretreatment (P = 0.0399).ConclusionsIn intermediate‐risk prostate cancer, excluding biopsy Gleason score 4 + 3, permanent brachytherapy combined with androgen deprivation therapy for 6 months or more represents an effective treatment option in Japanese patients, based on a favorable prognosis, adverse event profile and quality of life analysis.
Effect of DA‐8031, a novel oral compound for premature ejaculation, on male rat sexual behavior
Authors: Kang Kyung Koo , Sung Ji Hyun , Kim Soon Hoe , Lee Sukhyang 
Published: August 2013

ObjectivesDA‐8031 is a potent and selective serotonin transporter inhibitor developed for the treatment of premature ejaculation. The aim of the present study was to investigate the effects of DA‐8031 on male sexual behavior in a rat model.MethodsSexual behavior was examined after an acute oral administration of 10, 30 or 100 mg/kg of DA‐8031 in copulation studies with female rats. Pharmacokinetic parameters were calculated after oral administration of DA‐8031 at a dose level of 30 mg/kg.ResultsDA‐8031 treatment produced a dose‐dependent increase in ejaculation latency time and showed statistical significance at 30 and 100 mg/kg dosage levels compared with the vehicle (P < 0.05). In addition, DA‐8031 treatment reduced the mean number of ejaculations in a dose‐dependent manner. No changes in post‐ejaculatory interval, numbers of mounts, intromissions or ejaculations were observed at any dose. In pharmacokinetic study, the blood concentration of DA‐8031 peaked at 0.38 ± 0.14 h after oral administration, and then rapidly declined with a half‐life of 1.79 ± 0.32 h.ConclusionsTreatment with DA‐8031 delays the ejaculation latency time without affecting the initiation of mounting behavior or post‐ejaculatory interval in rats. Furthermore, DA‐8031 is rapidly absorbed and eliminated after oral administration in rats. These preclinical findings provide a clue for the clinical testing of DA‐8031 as an “on‐demand” agent for premature ejaculation.
Formative evaluation of the dietary assessment component of Children's and Adolescents' Nutrition Assessment and Advice on the Web (CANAA‐W)
Authors: Vereecken C. , Covents M. , Maes L. , Moyson T. 
Published: August 2013

AbstractBackgroundThe increased availability of computers and the efficiency and user‐acceptability of computer‐assisted questioning have increased the attractiveness of computer‐administered querying for large‐scale population nutrition research during the last decade. The Young Adolescents' Nutrition Assessment on Computer (YANA‐C), a computer‐based 24‐h dietary recall, was originally developed to collect dietary data among Belgian–Flemish adolescents. A web‐based version was created to collect parentally reported dietary data of preschoolers, called Young Children's Nutrition Assessment on the Web (YCNA‐W), which has been improved and adapted for use in young adolescents: Children and Adolescents' Nutrition Assessment and Advice on the Web (CANAA‐W). The present study describes recent developments and the formative evaluation of the dietary assessment component.MethodsA feasibility questionnaire was completed by 131 children [mean (SD) age: 11.3 (0.7) years] and 53 parents. Eight focus groups were held with children (n = 65) and three with parents (n = 17).ResultsChildren (C) and parents (P) found the instrument clear (C: 97%; P: 94%), comprehensible (C: 92%; P: 100%), attractive (C: 84%; P: 85%), fun (C: 93%; P: 83%) and easy to complete (C: 91%; P: 83%). There was ample explanation (C: 95%; P: 94%); the pictures were clear (C: 97%; P: 96%); and most respondents found the food items easy to find (C: 71%, P: 85%). The results helped to refine the lay out and structure of the instrument and the list of food items included.ConclusionsChildren and parents were enthusiastic. The major challenge will be to convince parents who are less interested in dietary intake and less computer literate to participate in this type of study. Children in this age group (11–12 years) should complete the instrument with assistance from an adult.
Melanoma in skin of color in Connecticut: an analysis of melanoma incidence and stage at diagnosis in non‐Hispanic blacks, non‐Hispanic whites, and Hispanics
Authors: Clairwood MariMeg , Ricketts Janelle , Grant‐Kels Jane , Gonsalves Lou 
Published: August 2013

AbstractBackgroundThe incidence of melanoma is increasing in Caucasians and in Hispanic subgroups in California and Florida. There is a paucity of information regarding melanoma incidence, stage at diagnosis, and other patient and tumor factors among minority subgroups in the northeast USA. This report examines melanoma in non‐Hispanic white, non‐Hispanic black, and Hispanic residents of Connecticut.MethodsTrends in age‐adjusted melanoma incidence rates (1992–2007) and the corresponding annual percentage changes in rates were calculated for Connecticut residents by race and Hispanic ethnicity. The racial/ethnic variation was evaluated for a number of patient and tumor characteristics: gender, age at diagnosis, marital status, anatomic site, histology, ulceration, Breslow thickness, and stage at diagnosis. Statistical significance at the 95% level was assessed using confidence intervals (95% CIs) and Pearson's chi‐squared tests.ResultsBetween 1992 and 2007, melanoma incidence increased by 4.1% per year in non‐Hispanic whites in Connecticut (95% CI 3.1–5.1%; P < 0.05). Melanoma incidence remained relatively stable for Hispanics and non‐Hispanic blacks over the same period. A significantly higher proportion of advanced (regional and distant) melanomas were diagnosed in non‐Hispanic blacks (19.1%) and Hispanics (17.1%) than in non‐Hispanic whites (8.7%) (P < 0.001).ConclusionsA significantly higher proportion of advanced melanomas were diagnosed in non‐Hispanic blacks and Hispanics than in non‐Hispanic whites. There is a growing need to educate patients and healthcare providers of the necessity for skin cancer surveillance regardless of the race of the patient.
Immunohistochemical analysis of FOXP3+ regulatory T cells in healthy human skin and autoimmune dermatoses
Authors: Terras Sarah , Gambichler Thilo , Moritz Rose K. C. , Altmeyer Peter , Lambert Jo 
Published: August 2013

AbstractBackgroundRegulatory T cells (Tregs) play an important role in autoimmune diseases. In skin, the presence of Tregs is thought to be mandatory for suppression of autoreactive T cells. Here, we assess the number of Tregs in skin of healthy subjects and patients with an autoimmune dermatosis.MethodsImmunohistochemical stainings for CD3 and FOXP3 on skin biopsies of healthy subjects and subjects with psoriasis, vitiligo, pemphigus vulgaris, bullous pemphigoid, and halo nevus to assess the number of T and regulatory T cells, respectively.ResultsLow numbers of CD3+ and FOXP3+ cells were seen in the skin of healthy controls (median = 0.5%). A significantly higher frequency of Tregs was seen in lesional skin of patients with psoriasis (median = 12.4%) and patients with bullous pemphigoid (median = 10.1%) as compared to controls. In vitiligo (median = 0.0%), pemphigus vulgaris (median = 5.2%), and halo nevi (median = 5.4%), no significant difference in number of FOXP3+ cells was observed when compared to controls.ConclusionsAs confirmed in the literature, few Tregs were seen in healthy skin. A high number of Tregs were present in lesional skin from patients with psoriasis and bullous pemphigoid. These results support the hypothesis that not a decrease in number but rather a decrease in function of Tregs would be at the basis of autoimmune skin diseases, which could result in unrestrained activation autoreactive T cells in skin of patients with autoimmune dermatoses.
Clinical and dermoscopic patterns of melanocytic nevi in Hispanic adolescents: a descriptive study
Authors: Sosa‐Seda Ivette M. , Valentín‐Nogueras Sheila , Figueroa Luz D. , Sánchez Jorge L. , Mercado Rogelio 
Published: August 2013

AbstractBackgroundMelanocytic nevi are well‐known, important precursors of melanoma among children and adults. The adolescence period is an important period for nevi formation and evolution. This study provides data of a longitudinal study of nevi in a Hispanic adolescent population.Materials and methodsA cross‐sectional survey and 1‐year prospective follow‐up study was performed on Hispanic students from grades 6 and 7 at a school in Caguas, Puerto Rico (n = 90). The survey was completed by the students and one of their parents. The backs of the children were clinically examined for melanocytic nevi using digital photography and dermoscopy. Follow‐up was conducted one year later.ResultsThe study cohort consisted of 53 (59%) boys and 37 (41%) girls, with an average age of 11.9 years (range 11–13 years). At the beginning of the study, 85% (n = 71/90) of the students presented with melanocytic nevi on their backs. After one year, new nevi were identified in 62% (n = 44/71), and there was a mean increase in nevus count of 1.8 (P < 0.001). A trend toward increased nevus count in lighter skin types was observed (P < 0.001). The predominant dermoscopic pattern was reticular (44%). The globular pattern was found most commonly in children with skin‐type II (100%), while the reticular pattern was the most common among skin‐types III (32%), IV (56%), and V (45%).ConclusionsThis study supports the utility of digital photography and dermoscopy for the evaluation of melanocytic nevi, providing evidence of the interrelationship between nevus count, dermoscopic pattern, and skin phenotype.
Biomechanical evaluation of the helica femoral implant system using traditional and modified techniques
Authors: Dosch Mark , Hayashi Kei , Garcia Tanya C. , Weeren Robert , Stover Susan M. 
Published: August 2013

AbstractObjectiveTo determine the effect of implant placement on proximal femoral axial bone strains, implant subsidence, implant motion, and failure mechanical properties of Helica implants.Study DesignIn vitro biomechanical study.Sample PopulationCadaveric canine femora (n = 8 pairs).MethodsFemora instrumented with strain gauges and kinematic markers were cyclically loaded in axial compression before (intact femora) and after implantation with a Helica prosthesis that engaged only cancellous bone (traditional technique) or cancellous bone and lateral cortex (modified technique) to evaluate bone strains, subsidence, and motion; femora were then loaded to failure to evaluate failure mechanical properties.ResultsAfter implantation, modified femoral prosthesis angle was 5% less than intact femora and 5.7% less than traditional implanted femora. Medial femoral bone strain was lower (P ≤ .05) for intact (−570 µstrain) than modified (−790), but not (P = .08) traditional (−700) implanted femora. High‐load implant subsidence was present but small (−0.087 mm) for the modified technique. Motion (traditional and modified) increased (P = .05) during cyclic loading (−0.17 and −0.328 mm) and failure (P = .04) (−2.121 and −3.390 mm); remaining yield and failure properties revealed no significant findings (P ≤ .05).ConclusionsThe modified technique resulted in a smaller neck angle and minimal subsidence. Bone strain was minimally altered so stress shielding may be less compared to findings with traditional implants. Motion detected during cyclic and failure testing may lead to implant loosening in vivo.
Optimal collusion with limited liability
Authors: Billette de Villemeur Etienne , Flochel Laurent , Versaevel Bruno 
Published: August 2013

AbstractCollusion sustainability depends on firms’ ability to impose sufficiently severe punishments in the event of deviation from the collusive rule. We extend results from the literature on optimal collusion by investigating the role of a limited liability constraint. We examine all situations in which either structural conditions, financial considerations, or institutional circumstances set a lower bound, possibly negative, to firms’ profits. For a large class of repeated games we show that, when the limited liability constraint binds, there exists an infinity of multi‐period punishment paths that permit firms to implement the optimal collusive strategy. The usual front‐loading scheme is only a specific case and an optimal punishment profile can take the form of a price asymmetric cycle. We characterize the situations in which a longer punishment does not perform as a perfect substitute for more immediate severity. In this case, the lowest discount factor that permits collusion is strictly higher than without the limited liability constraint, which hinders collusion.
A volumetric study of guided bone regeneration around titanium implants in the New Zealand white rabbit
Authors: Pal George L. , Stevenson Alastair , Klineberg Iven J. , Pearson Martin , Albrektsson Tomas , Johansson Carina 
Published: August 2013

AbstractPrevious studies have shown the ability for bone to grow under occlusive membranes. This study was undertaken to determine the time required for bone to form in the space created under the membrane and to determine the amount of bone that may be grown under the membrane. Thirty‐two New Zealand white rabbits were divided into three groups. A Brånemark implant, having a diameter of 3.75 mm with a length of 7 mm, was placed in each tibia and Gore‐Tex membrane was draped over the implant on the experimental side and tethered to the wound margin. Sixteen rabbits were sacrificed at six weeks, eight at twelve weeks, and eight at eighteen weeks. At six weeks the available space under the membrane was filled to 68 per cent, at twelve weeks it was 45 per cent, and at eighteen weeks 54 per cent. A comparison of bone height measurements on test and control sides showed a significant difference (p=0.0001) at the three time intervals. A comparison of grown bone volumes (test vs control) was also statistically significant (p=0.0001). The ability to grow bone under an occlusive membrane was confirmed but the long‐term survival rate and ability to support load needs to be investigated.
Purification and characterization of a putative fimbrial protein/receptor of Porphyromonas gingivalis
Authors: Dashper S. G. , O'Brien‐Simpson N. M. , Bhogal P. S. , Franzmann A. D. , Reynolds E. C. 
Published: August 2013

AbstractPorphyromonas gingivalis has been implicated as a major aetiological agent in certain forms of periodontal disease. P. gingivalis is a Gram‐negative, asaccharolytic bacterium that obtains energy from the fermentation of amino acids derived from the hydrolysis of host protein. Virulence factors of this bacterium include the capsule, fimbrial adhesins, cytotoxins and extracellular hydrolytic enzymes. A 43 kDa fimbrillin from P. gingivalis has been isolated and characterized. However, there is evidence that a second type of fimbria exists on the surface of P. gingivalis. A putative P. gingivalis fimbrial protein from a membrane preparation has been isolated and identified. This protein was shown to be reactive with sera from patients harbouring P. gingivalis. A 28 kDa protein fragment was purified by anion exchange, gel filtration and reversed‐phase chromatography. N‐terminal sequence analysis of the 28 kDa protein fragment revealed homology to the fimbrial precursor protein of Dichelobacter nodosus. A peptide corresponding to the N‐terminal 26 amino acyl residues of the 28 kDa protein fragment was synthesized and used to raise antibodies to the protein. Western blot analysis after SDS‐PAGE of a P. gingivalis membrane preparation using the antibodies raised to the synthetic peptide detected three proteins of 36, 41 and 67 kDa. When protease inhibitors were not included in the extraction procedure only the 36 and 41 kDa bands were detected. It would appear, therefore, that the intact protein has an Mr of 67 kDa and that the 28, 36 and 41 kDa bands represent protein fragments produced by endogenous proteolytic activity. Based on sequence homology, the 67 kDa protein is possibly a sub‐unit of a second P. gingivalis fimbrial type or a surface receptor.
Studies on fusobacteria associated with periodontal diseases
Authors: Rogers A. H. 
Published: August 2013

AbstractThe physiological and metabolic characteristics of representative isolates of the various subspecies of Fusobacterium nucleatum were investigated by growing them in continuous culture in chemically‐defined media. Behaving almost identically, these organisms were found to obtain energy from the fermentation of simple carbohydrates such as glucose or fructose or from the fermentation of certain amino acids, free or in the form of small peptides. The latter can be attacked by aminopeptidase activity which was shown to be essential for the growth of the organism in an environment lacking fermentable carbohydrate and free amino acids but replete with small peptides. This metabolic versatility may explain the presence of F nucleatum in both supra‐ and sub‐gingival dental plaque and why it is often found together with organisms such as Porphyromonas gingivalis which display powerful endopeptidase activities. Using the technique of allozyme electrophoresis, the current subspeciation of F. nucleatum was shown to be of doubtful validity and evidence, based upon physiological and metabolic properties, for differences in pathogenicity between isolates was not detected. While this organism is a member of various bacterial consortia associated with periodontal diseases, its contribution to the disease process remains unclear.
Enamel cracks. The role of enamel lamellae in caries initiation
Authors: Walker B. N. , Makinson O. F. , Peters M. C. R. B. 
Published: August 2013

AbstractLamellae or cracks are distributed throughout tooth enamel in both deciduous and permanent dentitions. While earlier authors postulated that lamellae may be pathways of entry for caries, no evidence was adduced and the theory appears to have been discounted. The present study seeks to show that, at least in some cases, lamellae are permeable to dyes, may be associated with caries initiated in the dentine, supporting the hypothesis of Hardwick and Manly of lamellae penetration by Streptococcus mutans and lactobacilli.The enamel lamellae are shown to be a permeable pathway allowing caries‐producing bacteria access to the dentine‐enamel junction. Caries can thus be established within the tooth without visible evidence at the surface.