bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patterns of dental service utilization following nontraumatic dental condition visits to the emergency department in Wisconsin Medicaid
Authors: Pajewski Nicholas M. , Okunseri Christopher 
Published: August 2012

AbstractObjectives: To examine patterns of dental service utilization for adult Medicaid enrollees in Wisconsin following nontraumatic dental condition (NTDC) visits to the emergency department (ED).Methods: This is a retrospective, observational study of claims for NTDC visits to the ED and dental service encounters from the Wisconsin Medicaid Evaluation and Decision Support database (2001‐2009). We used competing risk models to predict probabilities of returning to the ED versus obtaining follow‐up care from a dentist.Results: We observed a 43 percent increase in the rate of NTDC visits to the ED, with most of this increase occurring from 2001 to 2005. Within 30 days of an NTDC visit to the ED, ∼29.6 percent of enrollees will first visit a dentist office, while ∼9.9 percent will return to the ED. Young to middle‐aged adults (18 to <50 years) and enrollees living in counties with a lower supply of dental providers were more likely to return to the ED following a NTDC visit. Among the enrollees that first visited a dental office following an ED visit, 37.6 percent had an extraction performed at this visit.Conclusions: Almost one in five adult Medicaid enrollees will subsequently return to the ED following a previous NTDC visit. The provision of definitive care for these individuals appears to primarily consist of extractions.
Very low and low birth weight associated with maternal periodontitis
Authors: Guimarães Alessandra N. , Silva‐Mato Agustín , Siqueira Fernanda M. , Cyrino Renata M. , Cota Luís O. M. , Costa Fernando O. 
Published: August 2012

AbstractAimThe aim of this study was to evaluate the association of very low and low birth weight (VLBWandLBW) with maternal periodontitis.Material and MethodsOverall, 1206 women were examined at post‐partum and two alternative criteria for periodontitis definition were used: (1) four or more teeth with at least one site with probing depth (PD) ≥4 mm and clinical attachment loss (CAL) ≥3 mm; and (2) at least one site withPDandCAL≥4 mm. For each definition, two multivariate analyses were performed: (1) linear regression for birth weight; (2) ordinal logistic regression for birth weight, categorized as adequate (n = 1046),LBW(n = 145) andVLBW(n = 15).ResultsLinear regression showed that maternal periodontitis was associated with a decrease in mean birth weight (periodontitis definition 1:p = 0.027; periodontitis definition 2:p = 0.003). Ordinal logistic regression showed that maternal periodontitis was associated withLBWandVLBW[odds ratio (OR) = 2.0; 95% confidence interval (CI) 1.39–2.90, when considering periodontitis definition 2]; and withLBW(OR = 1.65; 95%CI1.15–2.36, when considering periodontitis definition 1).ConclusionMaternal periodontitis was associated with a decrease in mean birth weight, as well as withLBWandVLBW.
Melanocortin 3/4 receptors in paraventricular nucleus modulate sympathetic outflow and blood pressure
Authors: Li Peng , Cui Bai‐Ping , Zhang Ling‐Li , Sun Hai‐Jian , Liu Tong‐Yan , Zhu Guo‐Qing 
Published: August 2012

New findings
What is the central question of this study?The paraventricular nucleus (PVN) is important in regulating sympathetic activity and blood pressure. This study addresses whether activation of melanocortin 3/4 receptors in the PVN modulates sympathetic activity and blood pressure, and whether intracellular signalling involves the cAMP–protein kinase A pathway.
What is the main finding and its importance?Activation of melanocortin 3/4 receptors in the PVN increases sympathetic outflow and blood pressure via the cAMP–protein kinase A pathway. Melanocortin 3 receptors in the PVN exert a tonic excitatory effect on sympathetic activity. Melanocortin 3/4 receptors in the PVN are a putative therapeutic target to inhibit sympathetic activity.
Central melanocortin 3/4 receptors (MC3/4Rs) are known to regulate energy balance. Activation of MC3/4Rs causes a greater increase in the firing activity of the PVN neurons in obese Zucker rats than in lean Zucker rats. The present study was undertaken to determine the roles of MC3/4Rs in the hypothalamic paraventricular nucleus (PVN) in modulating the sympathetic activity and blood pressure and its downstream pathway. Renal sympathetic nerve activity (RSNA) and mean arterial pressure (MAP) were recorded in anaesthetized rats. Microinjection of the MC3/4R agonist melanotan II (MTII) into the PVN increased the RSNA and MAP. The MC3/4R antagonist agouti‐related peptide (AgRP) or SHU9119 decreased the RSNA and MAP, but the MC4R antagonist HS024 had no significant effect on the RSNA and MAP. The effects of MTII were abolished by pretreatment of the PVN with AgRP, SHU9119, the adenylate cyclase inhibitor SQ22536 or the protein kinase A inhibitor Rp‐cAMP, and substantially attenuated by HS024. Microinjection of SQ22536 alone into the PVN had no significant effect on the RSNA and MAP, but Rp‐cAMP caused significant decreases in the RSNA and MAP. Furthermore, MTII increased the cAMP level in the PVN. These results indicate that activation of MC3/4Rs in the PVN increases the sympathetic outflow and blood pressure via the cAMP–protein kinase A pathway. Melanocortin 3 receptors in the PVN may exert a tonic excitatory effect on sympathetic activity.
The Pre-NH
2
-Terminal Domain of the Herpes Simplex Virus 1 DNA Polymerase Catalytic Subunit Is Required for Efficient Viral Replication
Authors: Terrell Shariya L. , Coen Donald M. 
Published: August 2012

ABSTRACT

The catalytic subunit of herpes simplex virus 1 DNA polymerase (HSV-1 Pol) has been extensively studied; however, its full complement of functional domains has yet to be characterized. A crystal structure has revealed a previously uncharacterized pre-NH
2
-terminal domain (residues 1 to 140) within HSV-1 Pol. Due to the conservation of the pre-NH
2
-terminal domain within the herpesvirus Pol family and its location in the crystal structure, we hypothesized that this domain provides an important function during viral replication in the infected cell distinct from 5′-3′ polymerase activity. We identified three pre-NH
2
-terminal Pol mutants that exhibited 5′-3′ polymerase activity indistinguishable from that of wild-type Pol
in vitro
: deletion mutants PolΔN43 and PolΔN52 that lack the extreme N-terminal 42 and 51 residues, respectively, and mutant PolA
6
, in which a conserved motif at residues 44 to 49 was replaced with alanines. We constructed the corresponding
pol
mutant viruses and found that the
pol
ΔN43 mutant displayed replication kinetics similar to those of wild-type virus, while
pol
ΔN52 and
pol
A
6
mutant virus infection resulted in an 8-fold defect in viral yield compared to that achieved with wild type and their respective rescued derivative viruses. Additionally, both
pol
ΔN52 and
pol
A
6
viruses exhibited defects in viral DNA synthesis that correlated with the observed reduction in viral yield. These results strongly indicate that the conserved motif within the pre-NH
2
-terminal domain is important for viral DNA synthesis and production of infectious virus and indicate a functional role for this domain.
Visualizing Production of Beta Interferon by Astrocytes and Microglia in Brain of La Crosse Virus-Infected Mice
Authors: Kallfass Carsten , Ackerman Andreas , Lienenklaus Stefan , Weiss Siegfried , Heimrich Bernd , Staeheli Peter 
Published: August 2012

ABSTRACT

Beta interferon (IFN-β) is a major component of innate immunity in mammals, but information on the
in vivo
source of this cytokine after pathogen infection is still scarce. To identify the cell types responsible for IFN-β production during viral encephalitis, we used reporter mice that express firefly luciferase under the control of the IFN-β promoter and stained organ sections with luciferase-specific antibodies. Numerous luciferase-positive cells were detected in regions of La Crosse virus (LACV)-infected mouse brains that contained many infected cells. Double-staining experiments with cell-type-specific markers revealed that similar numbers of astrocytes and microglia of infected brains were luciferase positive, whereas virus-infected neurons rarely contained detectable levels of luciferase. Interestingly, if a mutant LACV unable of synthesizing the IFN-antagonistic factor NSs was used for challenge, the vast majority of the IFN-β-producing cells in infected brains were astrocytes rather than microglia. Similar conclusions were reached in a second series of experiments in which conditional reporter mice expressing the luciferase reporter gene solely in defined cell types were infected with wild-type or mutant LACV. Collectively, our data suggest that glial cells rather than infected neurons represent the major source of IFN-β in LACV-infected mouse brains. They further indicate that IFN-β synthesis in astrocytes and microglia is differentially affected by the viral IFN antagonist, presumably due to differences in LACV susceptibility of these two cell types.
Vitamin D in children with cystic fibrosis
Authors: Brodlie Malcolm , Orchard William A , Reeks Gordon A , Pattman Stewart , McCabe Helen , O'Brien Christopher J , Thomas Matthew F , Spencer David Anthony 
Published: August 2012

PurposeThe Cystic Fibrosis Trust in 2007 published a recommended target of 75-150 nmol/L for 25-hydroxyvitamin D (25-OHD). In 2008 we found that only 10% of pancreatic insufficient (PI) children met this target. An increase in supplementation was implemented and a repeat audit performed in 2010.MethodsPI children ≥1 year under sole-care in our regional centre were included. Vitamin D3 supplementation increased by >450% to either 3800 IU/day liquid or 800 IU daily plus 20,000 IU weekly tablets. In 2010 pancreatic sufficient (PS) children were also audited separately.ResultsThe median 25-OHD level increased from 51.5 nmol/L in 2008 (n=78, 10% >75 nmol/L) to 72 nmol/L in 2010 (n=72, 51% >75 nmol/L), p<0.0001. In PS children (n=15 in 2010) 87% had 25-OHD levels <75 nmol/L.ConclusionsA substantial increase in supplementation led to a significant increase in 25-OHD levels but around half still failed to reach the recommended target.
Prospective analysis of neutralising antibody titres in secondary non-responders under continuous treatment with a botulinumtoxin type A preparation free of complexing proteins—a single cohort 4-year follow-up study
Authors: Hefter Harald , Hartmann Christian , Kahlen Ulrike , Moll Marek , Bigalke Hans 
Published: August 2012

ObjectivesIn long-term botulinum neurotoxin treatment, loss of therapeutic efficacy may occur due to neutralising antibody formation. Preliminary results with incobotulinumtoxinA, a preparation free of complexing/accessory proteins, have indicated a low antigenicity. We hypothesised that continuous treatment with this botulinum neurotoxin preparation would not result in an increase in neutralising antibody titres (NABTs) in patients with pre-existing NABTs.DesignProspective, blinded cohort study.SettingSingle centre in Germany.ParticipantsThirty-seven cervical dystonia patients with NABTs and partial secondary non-responsiveness to their previous botulinum neurotoxin type A treatment.InterventionThree-monthly intramuscular injections of incobotulinumtoxinA with a constant dose of 200 MU per injection during the first year; thereafter up to 500 MU for the next 36 months.Outcome measuresPrimary outcome measure: number of patients in whom NABTs declined below the initial titre after 48 months of incobotulinumtoxinA treatment or in whom titres had become negative within the 48 months. Secondary outcome measure: steepness of changes in NABT. NABTs were determined by mouse hemidiaphragm assay. Findings were compared to long-term data from 24 cervical dystonia patients who had developed NABTs and in whom treatment had been discontinued.ResultsFollowing a transient increase in the first 24 months under incobotulinumtoxinA treatment in some patients, NABTs declined well below the initial titre in the majority of patients. Test assay results were negative in most of the patients followed for more than 36 months. NABTs seemed to decline into the negative detection range as rapidly under incobotulinumtoxinA treatment as after cessation of botulinum neurotoxin therapy.ConclusionsThe reduction of NABTs despite continuous treatment with incobotulinumtoxinA indicates low antigenicity of incobotulinumtoxinA. This might have implications on restrictions such as minimum injection intervals of ≥10 weeks currently in place for maintaining successful long-term application of botulinum neurotoxin.
Covert checks by standardised patients of general practitioners' delivery of new periodic health examinations: clustered cross-sectional study from a consumer organisation
Authors: Piribauer Franz , Thaler Kylie , Harris Mark F 
Published: August 2012

ObjectiveTo assess if data collected by a consumer organisation are valid for a health service research study on physicians' performance in preventive care. To report first results of the analysis of physicians performance like consultation time and guideline adherence in history taking.DesignSecondary data analysis of a clustered cross-sectional direct observation survey.SettingGeneral practitioners (GPs) in Vienna, Austria, visited unannounced by mystery shoppers (incognito standardised patients (ISPs)).Participants21 randomly selected GPs were visited by two different ISPs each. 40 observation protocols were realised.Main outcome measuresRobustness of sampling and data collection by the consumer organisation. GPs consultation and waiting times, guideline adherence in history taking.ResultsThe double stratified random sampling method was robust and representative for the private and contracted GPs mix of Vienna. The clinical scenarios presented by the ISPs were valid and believable, and no GP realised the ISPs were not genuine patients. The average consultation time was 46 min (95% CI 37 to 54 min). Waiting times differed more than consultation times between private and contracted GPs. No differences between private and contracted GPs in terms of adherence to the evidence-based guidelines regarding history taking including questions regarding alcohol use were found. According to the analysis, 20% of the GPs took a perfect history (95% CI 9% to 39%).ConclusionsThe analysis of secondary data collected by a consumer organisation was a valid method for drawing conclusions about GPs preventive practice. Initial results, like consultation times longer than anticipated, and the moderate quality of history taking encourage continuing the analysis on available clinical data.
Dyslipidaemia in HIV-1-infected patients receiving protease inhibitors after initial treatment with first-line-based non-nucleoside reverse transcriptase inhibitors: a cross-sectional study
Authors: Pefura Yone Eric Walter , Kengne André Pascal , Ashuntantang Gloria , Betyoumin Awa Foueudjeu , Ngogang Jeanne 
Published: August 2012

ObjectivesLipid abnormalities associated with antiretroviral therapy in people with HIV infection are more frequent with protease inhibitors (PI)-based regimens. Whether effects extend to patients receiving a PI subsequent to failure on non-nucleoside reverse-transcriptase inhibitors (NNRTI)-based regimen is still unknown. We investigated the effects of secondary treatment with a PI on the lipid profile in a group of patients with HIV infection in Cameroon.DesignThis was a cross-sectional study.SettingThis study was carried out at the registered centre for HIV treatment of the Yaounde Jamot Hospital in Cameroon.ParticipantsParticipants were consecutively recruited between November 2009 and January 2010. There were 138 HIV-1 patients on initial treatment with an NNRTI regimen and 66 HIV patients on secondary treatment with a PI for at least 12 months. Lipid abnormalities were based on the National Cholesterol Education Program, Adult Treatment Panel III criteria.Outcome measuresLevels of lipid parameters among patients on PI and NNRTI.ResultsMedian (IQR) levels (mg/dl), NNRTI-treated versus PI-treated patients were 185 (149–225) and 189 (147–244) for total cholesterol, 46 (27–66) and 42 (28–82) for high-density lipoprotein (HDL)-cholesterol, 121 (90–169) and 126.9 (71–176) for low-density lipoprotein (LDL)-cholesterol, 134 (98–174) and 138 (111–167) for triglycerides, and 4.3 (2.9–6.2) and 5.1 (2.6–7.9) for total/HDL-cholesterol ratio (all p>0.32). The most frequent lipid abnormality in the two groups was high LDL-cholesterol (46.4% (NNRTI) vs 54.5% (PI)). The occurrence of lipid abnormalities was similar in the two groups (all p>0.29).ConclusionsThe use of PI does not appear to deteriorate the lipid profile of HIV patients above and beyond abnormalities induced by an unsuccessful initial treatment with NNRTI. Monitoring of lipid profile during HIV treatment regardless of the regimens would improve timely detection and management of abnormalities, to mitigate related risks.
Evaluation of current Australian health service accreditation processes (ACCREDIT-CAP): protocol for a mixed-method research project
Authors: Hinchcliff Reece , Greenfield David , Moldovan Max , Pawsey Marjorie , Mumford Virginia , Westbrook Johanna Irene , Braithwaite Jeffrey 
Published: August 2012

IntroductionAccreditation programmes aim to improve the quality and safety of health services, and have been widely implemented. However, there is conflicting evidence regarding the outcomes of existing programmes. The Accreditation Collaborative for the Conduct of Research, Evaluation and Designated Investigations through Teamwork-Current Accreditation Processes (ACCREDIT-CAP) project is designed to address key gaps in the literature by evaluating the current processes of three accreditation programmes used across Australian acute, primary and aged care services.Methods and designThe project comprises three mixed-method studies involving documentary analyses, surveys, focus groups and individual interviews. Study samples will comprise stakeholders from across the Australian healthcare system: accreditation agencies; federal and state government departments; consumer advocates; professional colleges and associations; and staff of acute, primary and aged care services. Sample sizes have been determined to ensure results allow robust conclusions. Qualitative information will be thematically analysed, supported by the use of textual grouping software. Quantitative data will be subjected to a variety of analytical procedures, including descriptive and comparative statistics. The results are designed to inform health system policy and planning decisions in Australia and internationally.Ethics and disseminationThe project has been approved by the University of New South Wales Human Research Ethics Committee (approval number HREC 10274). Results will be reported to partner organisations, healthcare consumers and other stakeholders via peer-reviewed publications, conference and seminar presentations, and a publicly accessible website.
What effect does breastfeeding have on coeliac disease? A systematic review update
Authors: Henriksson Camilla , Boström Anne-Marie , Wiklund Ingela E 
Published: August 2012

ObjectiveTo update the evidence published in a previous systematic review and meta-analysis that compared the effect of breastfeeding on risk of coeliac disease (CD).Material and methodsA systematic review of observational studies published between 1966 and May 2004 on the subject was conducted in 2005. This update is a systematic review of observational studies published between June 2004 and April 2011. Pubmed, EMBASE and Cinahl were searched for published studies that examined the association between breastfeeding and CD.ResultsAfter duplicates were removed 90 citations were screened. Four observational studies were included in the review. Two of three studies which had examined the duration of breastfeeding and CD reported significant associations between longer duration of breastfeeding and later onset of CD (OR ranged from 0.18 to 0.665). Breastfeeding during the introduction of gluten to the infant was reported to have a protective effect in two studies.ConclusionsOur findings support previous published findings that breastfeeding seems to offer a protection against the development of CD in predisposed infants. Breastfeeding at time of gluten introduction is the most significant variable in reducing the risk. Timing of gluten introduction may also be a factor in the development of CD.
How to confidently teach EBM on foot: development and evaluation of a web-based e-learning course
Authors: Weberschock Tobias , Sorinola Olanrewaju , Thangaratinam Shakila , Oude Rengerink Katrien , Arvanitis Theodoros N , Khan Khalid S ,   EBM Unity Group*
Published: August 2012

BackgroundScarcity of well-trained clinical tutors is a key constraint in integrating teaching of evidence-based medicine (EBM) into clinical activities.ObjectivesWe developed a web-based educational course for clinical trainers to confidently teach EBM principles in everyday practice. Its e-learning modules defined the learning objectives and incorporated video clips of practical and effective EBM teaching methods for exploiting educational opportunities in six different clinical settings.MethodsWe evaluated the course with clinical tutors in different specialties across six European countries using a questionnaire to capture learning achievement against preset objectives.ResultsAmong 56 tutors, 47 participants (84%) improved their scores from baseline. The mean pre-course score was 69.2 (SD=10.4), which increased to 77.3 (SD=11.7) postcourse (p<0.0001). The effect size was moderate with a Cohen's d of 0.73.ConclusionsAn e-learning approach incorporating videos of applied EBM teaching and learning based on real clinical scenarios in the workplace can be useful in facilitating EBM teaching on foot. It can be integrated in the continuing professional development programmes for clinical trainers.
Supported liquid extraction offers improved sample preparation for aldosterone analysis by liquid chromatography tandem mass spectrometry
Authors: Van Der Gugten Jessica Grace , Crawford Matthew , Grant Russell P , Holmes Daniel T 
Published: August 2012

BackgroundTo evaluate the accuracy and precision of a method for serum aldosterone using supported liquid extraction (SLE) for sample preparation instead of the more conventional liquid-liquid extraction (LLE) approach.MethodsTwo independently developed SLE-based LC-MS/MS methods for serum aldosterone (sample volumes 250 μl and 300 μl respectively) were compared to a modification of a previously reported LLE approach (sample volume 500 μl) in two method comparisons (n=75 and n=97). SLE analyses were performed at two separate centres. Precision was evaluated at a single site using human pools in head-to-head comparison between SLE and LLE. All analyses were performed on the ABSCIEX API-5000 LC-MS/MS system.ResultsAt four increasing pool concentrations spanning 67-1060 pmol/l, total precision for SLE ranged from 6.8-4.1% compared with 11.1-4.3% for LLE. Differences did not reach statistical significance except at the lowest concentration where SLE was superior. Pasing Bablok regression comparisons were SLE=0.96×LLE-5.8 pmol/l (R2=0.985) and SLE=0.96×LLE-0.44 pmol/l (R2=0.969).ConclusionsFor analysis of serum aldosterone on the ABSCIEX API-5000, SLE affords a smaller sample volume while maintaining the accuracy and precision performance of LLE. By avoiding specimen vortexing, SLE also allows for greater automation in the sample preparation.