bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patients’ Knowledge of Risk Factors for Dental Disease. A Pilot Service Evaluation in a General Dental Practice
Authors: Aggarwal Vishal R , Javidi Hanieh , Joughin Amy , Crawford Fiona IJ , Sharif Mohammad O 
Published: October 2010

The major dental diseases, including erosion, caries and periodontal disease, are preventable, and the Department of Health has produced guidelines in a ‘Prevention Toolkit’ to aid prevention of these diseases in primary care. Aim To investigate patients’ knowledge of the key themes in the Prevention Toolkit and to compare their knowledge of the different dental diseases. Methods Patients attending a general dental practice in North West England were asked to complete a questionnaire while they waited to see their dentist. The questionnaire had been piloted for readability, relevance of questions, and ease of use. It included nine true/false questions on key prevention messages. Data from the respondents were used to assess whether there were differences in knowledge by age or gender and between the types of dental diseases. Results were analysed using chi-square tests. Results 105 patients completed the questionnaire. Of the 420 questions relating to periodontal diseases, 322 (77%) were answered correctly and 196 (47%) of the 420 questions on caries were answered correctly; however, only 32 (31%) of the 105 questions relating to erosion were answered correctly. There were significantly lower levels of knowledge of caries ( P<0.01) compared with periodontal diseases. Worryingly, 47 (45%) of 105 respondents stated incorrectly that brushing teeth immediately after consuming a ‘fizzy’ drink would protect the teeth. Conclusion The results of this pilot service evaluation indicate that in the practice concerned, more needs to be done to promote disease prevention at the primary care level. The current questionnaire could form a valuable tool to audit and reinforce patients’ knowledge, although it needs further development and validation. Longitudinal evaluation of the questionnaire, linking it with disease outcome measures, has the potential to indicate whether change in knowledge translates into behavioural change.
Testing the predictors of boredom at school: Development and validation of the precursors to boredom scales
Authors: Daschmann Elena C. , Goetz Thomas , Stupnisky Robert H. 
Published: October 2010

Background. Boredom has been found to be an important emotion for students' learning processes and achievement outcomes; however, the precursors of this emotion remain largely unexplored. Aim. In the current study, scales assessing the precursors to boredom in academic achievement settings were developed and tested. Sample. Participants were 1,380 grade 5–10 students in mathematics classes. Method. The Precursors to Boredom Scales were tested for structural and convergent validity with multi‐level confirmatory factor analyses (ML‐CFA), and differences in the perception of the precursors of boredom due to gender were investigated. Results. The first ML‐CFA found support for the structural validity of the Precursors to Boredom Scales. In a second ML‐CFA, the newly developed boredom scales showed good convergent validity with several key aspects of instructional quality. Finally, the results supported previous research that found no gender differences in academic self‐concept and interest. Conclusion. The precursors contained in our scales are empirically separable. Implications of the current findings for research on boredom among students are discussed.
Cytomegalovirus infection after kidney transplantation, susceptibility to CMV-infection in association with HLA-genotype — Doctoral dissertation summary
Authors: Varga Marina 
Published: October 2010

Abstract
Cytomegalovirus infection is a major infectious complication of transplant recipients, causing significant morbidity and mortality. It is possible to treat this infection effectively only if we know the direct and indirect effects of it, if we take the risk-factors into account, and use sensitive and reliable diagnostic methods for early establishment of diagnosis. In order to avoid severe CMV-infection, it is possible to administer prophylactic therapy. For prophylaxis planning it is important to know the CMV-seroprevalence of Hungarian population and its characteristics. Our results have shown that the seroprevalence of Hungarian population is high: 86%. The primary CMV-infection in Hungary occurs in childhood or in early adulthood, till age of 20 years the seroprevalence is 72%. CMV-seronegative recipients should be transplanted using organs of seronegative donors, however, the chance obtaining the graft from a CMV-seronegative donor was shown to be 2% only. Since such seromatching is rear, we have to know that the constellation of negative recipient and positive donor is the highest risk-factor for developing severe primary CMV-infection. While investigating data of 147 CMV-seronegative recipients from high-risk group it has been established that CMV-infection prophylaxis is essential for high risk patients in the early post-transplant period of 3 months, the administration of any of investigated prophylactic protocols is advantageous in comparing with prophylaxis free management of those patients (P=0.006). The study has also proven that monoprophylaxis with ganciclovir or valganciclovir is the most effective and cost-effective procedure as compared to other protocols (P=0.006). It is important to take into consideration that in prophylactic groups the “late-onset” CMV-infection occurred often (25.4%), and that there were no signs of seroconversion after the primary CMV-infection in 14% of the patients. For the first time it has been found and proven that the female sex is a risk factor for CMV-infection (P=0.0006). Genetic variability influences susceptibility to infectious diseases and HLA-molecules are critical for viral antigen uptaking, processing and presenting. Our data of 129 of high-risk patients suggest that recipients positive for HLA-DQ3 are more susceptible to CMV-infection than a comparable group of patients negative for this HLA-type. This result was not due to rejection and/or treatment for rejection and was not influenced by induction therapy or number of HLA-mismatches. The multivariate Cox Regression analysis has shown that HLA-DQ3 positivity is an independent predictor of primary CMV-infection in CMV-seronegative recipients with seropositive donor grafts (P=0.001). The cognition of HLA-DQ3 is useful in the prediction of acute CMV-infection in high-risk patients, and should influence the planning of the patients' management.
Preconditioning is a method that may reduce the negative side-effect of pneumoperitoneum
Authors: Jávor Szaniszló Z. , Shanava K. , Hocsák E. , Kürthy M. , Lantos J. , Borsiczky B. , Takács I. , Horváth Sz. , Balatonyi B. , Ferencz S. , Ferencz A. , Rőth E. , Wéber Gy. 
Published: October 2010

AbstractIncreased intra-abdominal pressure during laparoscopy leads to hypoxia due to reduced blood flow. Aim of our study was to investigate whether preconditioning can reduce this negative effect of the pneumoperitoneum. Fifty female Wistar rats were used, divided into 5 groups. I: Sham operation (Sham), II: conventional pneumoperitoneum (PP), III: transvaginal pneumoperitoneum (TV), IV: preconditioning for 2.5 minutes in two cycles (Pre 2.5), V: preconditioning for 5 minutes (Pre 5). Malondialdehyde (MDA), reduced glutathione (GSH), sulfhydrylgroup (SH-) concentrations, superoxide-dismutase (SOD) and mieloperoxidase (MPO) activity, and anti-apoptotic pathway marker p-AKT level and inflammatory cytokine TNF-α were measured. SOD activity and GSH concentration were decreased in PP and TV groups comparing to Sham and preconditioning groups. MPO activity was decreased also in PP and TV groups comparing to the Sham group but in the preconditioning groups it has remained high. MDA concentration in plasma was increased in PP and TV groups comparing to Sham and preconditioning groups. There was no difference in the case of blood MDA and SH-concentrations between groups. Anti-apoptotic pathway marker p-AKT level was decreased in the TV group comparing to the sham and preconditioning groups. TNF-α level was increased in TV and preconditioning groups compared to the sham group. According to the results preconditioning can reduce negative effects of pneumoperitoneum.
Successful urinary tract reconstruction following ureteral necrosis in kidney transplant patient
Authors: Piros László , Deák P. Á. , Dallos G. , Máthé Zs. , Doros A. 
Published: October 2010

Abstract
Ureteric complications following renal transplantation are well known to cause significant morbidity and compromised graft survival. The necrosis of a major part of the ureter could be a highly detrimental situation, and hardly solvable complication, that poses great challenges. Herein we are presenting a case report to introduce a possible surgical solution following repeated ineffective radiological interventions, in a patient with ureteric necrosis that appeared 3 months after cadaveric kidney transplantation. We transplanted the right kidney to the right iliac fossa performing end-to-side vascular anastomoses and end-to-side uretero-ureterostomy. His clinical course was uneventful during 3 months, when he presented a mild borderline acute cellular rejection together with dilatation of the pyelon. Percutaneous nephrostomy was performed by interventional radiologist. During further radiologic interventions the stenosis was not permeable. We finally made up our minds for surgical solution. We found a totally necrotized graftureter. During a second operation we performed a right nephrectomy, transsecting the pyelon. After mobilization of the transplanted kidney approaching and identifying the pyelon, a large pyelopyelar anastomosis was performed with stenting. The postoperative follow-up showed excellent urine flow from the kidney to the bladder, then the TRD was removed. Surgery had to be considered only if minimally invasive procedures are infeasible or ineffective. A regimen of reconstructive methods are well-known, but all cases have to be evaluated individually. If the native kidneys can be removed, their pyelons and entire ureters should be used for reconstruction.
Spatial and Temporal Variability in Atka Mackerel Female Maturity at Length and Age
Authors: Cooper Daniel W. , McDermott Susanne F. , Ianelli James N. 
Published: October 2010

Abstract
Spatial and temporal variability in maturity at length and maturity at age was examined for female Atka mackerel Pleurogrammus monopterygius in the eastern and central Aleutian Islands of Alaska. Postovulatory follicles (POFs) were evaluated as a potential character to distinguish spent mature fish from immature fish. We estimated that POFs remain in the ovaries for approximately 1 month after spawning, therefore allowing us to include some collections of recently spent fish for maturity estimates. Maturity-at-length data varied significantly among geographic areas and years, whereas maturity-at-age data failed to indicate differences. These results are probably attributable to different growth rates between the areas. An age-based model was developed to account for differences in year-class strengths, and modeling results showed that length at maturity could vary by as much as 4 cm over time because of variable recruitment. Maturity in Atka mackerel seems to be determined more by age than by somatic body size.
South Asian Ethnicity as a Risk Factor for Major Adverse Cardiovascular Events after Renal Transplantation
Authors: Prasad G. V. Ramesh , Vangala Sai K. , Silver Samuel A. , Wong Steven C.W. , Huang Michael , Rapi Lindita , Nash Michelle M. , Zaltzman Jeffrey S. 
Published: October 2010

Summary

Background and objectives
South Asians (SAs) comprise 25% of all Canadian visible minorities. SAs constitute a group at high risk for cardiovascular disease in the general population, but the risk in SA kidney transplant recipients has never been studied.

Design, setting, participants, & measurements
In a cohort study of 864 kidney recipients transplanted from 1998 to 2007 and followed to June 2009, we identified risk factors including ethnicity associated with major cardiac events (MACEs, a composite of nonfatal myocardial infarction, coronary intervention, and cardiac death) within and beyond 3 months after transplant. Kaplan-Meier methodology and multivariate Cox regression analysis were used to determine risk factors for MACEs.

Results
There was no difference among SAs (n = 139), whites (n = 550), blacks (n = 65), or East Asians (n = 110) in baseline risk, including pre-existing cardiac disease. Post-transplant MACE rate in SAs was 4.4/100 patient-years compared with 1.31, 1.16, and 1.61/100 patient-years in whites, blacks, and East Asians, respectively (P < 0.0001 versus each). SA ethnicity independently predicted MACEs along with age, male gender, diabetes, systolic BP, and prior cardiac disease. SAs also experienced more MACEs within 3 months after transplant compared with whites (P < 0.0001), blacks (P = 0.04), and East Asians (P = 0.006). However, graft and patient survival was similar to other groups.

Conclusions
SA ethnicity is an independent risk factor for post-transplant cardiac events. Further study of this high-risk group is warranted.
Total en bloc spondylectomy for lung cancer metastasis to the spine
Authors: Murakami Hideki , Kawahara Norio , Demura Satoru , Kato Satoshi , Yoshioka Katsuhito , Tomita Katsuro 
Published: October 2010

Object
The prognosis in patients with a distant spinal metastasis from the lung is dismal. The role of radical surgery in such cases has been questioned because of the excessive morbidity, blood loss, and operative time as well as the tumor's extreme malignancy. The purpose of this study was to evaluate the surgical results and the prognosis associated with radical surgery for lung cancer metastasis to the spine in carefully selected patients and to clarify whether there is an indication for radical surgery such as total en bloc spondylectomy (TES) in lung cancer metastasis.

Methods
The author performed a retrospective review of patients with lung cancer spinal metastasis treated by TES during a 10-year period. Total en bloc spondylectomy for lung cancer metastasis to the spine was performed in 6 patients without visceral or other bony metastases. Outcome measures were prognostic score, mean survival time, and perioperative complications. The histological type was adenocarcinoma in all 6 cases. In 4 cases the surgical strategy prognostic score was 5. In the other 2 cases the score was 6 because there were skip metastases to adjacent vertebra. In the 2 cases with adjacent vertebral metastasis, the adjacent vertebra was excised en bloc together.

Results
The mean estimated blood loss was 1076 ml and the mean operative time was 7 hours 20 minutes. Perioperative complications were found in 2 cases. One was deep infection after CSF leakage, and the other was paralysis due to postoperative hematoma. At the end of follow-up period, 4 of 6 patients are still living after a mean of 46.3 months (range 36–62 months). In the other 2 cases, 1 patient died of a heart attack and the other of mediastinitis due to surgical site infection by methicillin-resistant Staphylococcus aureus. In this series, local recurrence was not found.

Conclusions
Total en bloc spondylectomy has been shown to be associated with excessive morbidity, blood loss, and operative time; however, the procedure is becoming less invasive. The authors conclude that TES is appropriate in selected cases with controllable primary lung cancer, localized spinal metastasis, and no visceral metastasis. In such patients, improvement in the prognosis can be expected after TES. However, even in selected cases and with skilled surgical technique, the complication rate remains high. Total en bloc spondylectomy should be performed after a thorough discussion of the risks and benefits.
Intrathecal endoscopy to enhance the diagnosis of tethered cord syndrome
Authors: Woods Kamal R. M. , Colohan Austin R. T. , Yamada Shokei , Yamada Shoko M. , Won Daniel J. 
Published: October 2010

Object
Tethered cord syndrome (TCS) is being diagnosed in an increasing number of adults and late teens. Before referral to neurosurgeons, however, the majority of patients in this group suffers back and leg pain for a long period without a definitive diagnosis. The diagnostic difficulty derives from 2 factors: the signs and symptoms are subtle and easily overlooked, and the combination of an elongated cord and a thickened filum is lacking in 65% of patients. When a patient presents with signs and symptoms typical for TCS but demonstrates no elongated cord or thickened filum on MR imaging, one must search for a more reliable finding to establish a diagnosis of TCS. Based on the authors' earlier surgical experiences, posterior displacement of the terminal filum is consistently found at surgery in all patients with TCS. In previous publications they interpreted this finding as the lower cord and filum traveling along the concave side of the lumbosacral spinal canal to minimize cord tension. In the present prospective study, the authors attempt to confirm posterior displacement of the filum terminale by using intrathecal endoscopy prior to wide exposure of the spinal cord and filum. Further, the stretch test was applied to the terminal filum to evaluate its elasticity.

Methods
Sixty-eight patients with signs and symptoms as well as MR imaging studies indicative of TCS underwent endoscopic examination of the filum and cauda equina. After lumbar or sacral laminectomy, a flexible endoscope was inserted through a small dural and arachnoid incision into the subarachnoid space. The filum and cauda equina fibers were identified. Once the dura mater and arachnoid were opened widely, a stretch test was done to confirm filum inelasticity. In 3 patients, percutaneous endoscopy was also performed before open surgery to determine its applicability as compared with the open method.

Results
On inserting the endoscope into the intrathecal space, the filum was immediately identified medioposterior to the cauda equina fibers in all 68 patients. The stretch test revealed a lack of filum elasticity in all patients. Preoperative percutaneous endoscopy was equally effective in identifying the position of the filum.

Conclusions
Currently, endoscopic identification of the posteriorly displaced filum, which was confirmed at open surgery, is the essential diagnostic study for TCS or the tethered spinal cord. Furthermore, the stretch test of the filum proves its inelasticity, and filum sectioning leads to ascension and relaxation of the caudal spinal cord. These results can be linked to the impaired oxidative metabolism of the lumbosacral cord under excessive tension and to the metabolic and neurological improvements seen after filum sectioning.
The effects of human umbilical cord blood transplantation in rats with experimentally induced spinal cord injury
Authors: Kaner Tuncay , Karadag Tolga , Cirak Bayram , Erken Haydar Ali , Karabulut Aysun , Kiroglu Yilmaz , Akkaya Semih , Acar Feridun , Coskun Erdal , Genc Osman , Colakoglu Nagihan 
Published: October 2010

ObjectEven though there have been many efforts to recover neuronal dysfunction following spinal cord injuries, there are limitations to the treatment of these injuries. The purpose of this laboratory investigation was to determine the clinical and neurophysiological effects of human umbilical cord blood (HUCB) transplantation in a rat hemisection model of spinal cord injury.MethodsIn this study, experimental hemisection of the thoracic spinal cord was performed in rats. The rats were divided into 4 groups (6 rats in each group). One group of rats (Group 1) underwent thoracic laminectomy only. Rats in Group 2 underwent laminectomy and right hemisection of the thoracic spinal cord. Rats in Group 3 underwent right hemisection and implantation of freshly obtained HUCB on Day 0 postinjury. Rats in Group 4 underwent hemisection and implantation of freshly obtained HUCB on Day 4 postinjury. Clinical evaluations of rat motor function included the following: neurological examination, Rotarod performance, and inclined plane tests. Rats also underwent reflex evaluation.ResultsThe neurological examinations revealed that the frequency of plegic rats was 70.8% at the beginning of the study across all 4 groups; this value decreased to 20.8% by the end of the study. The percentage of rats with a normal examination increased from 25% to 50%. The results of Rotarod performance and 8-week inclined plane performance tests showed statistical significance (p < 0.05) in an overall group comparison across all time points. At the end of the 8 weeks, a statistically significant difference was found in the inclined plane test results between rats in Groups 1 and 2. There were no statistically significant differences between Groups 1, 3, and 4 (p < 0.05). When the reflex responses of the hemisectioned sides were compared, statistically significant differences were detected between groups (p < 0.05). All groups were significantly different with regard to the right-side reflex response score (p < 0.05). Spinal cord preparations of rats in all groups were examined for histopathological changes.ConclusionsHuman umbilical cord blood is stem cell rich and easily available, and it carries less risk of inducing a graft-versus-host reaction in the recipient. Human umbilical cord blood serum is also noted to contain stem cell–promoting factors, which is why cell isolation was not used in this study. Freshly obtained cord blood was also used because storage of cord blood has been reported to have some negative effects on stem cells. Transplantation of freshly obtained HUCB into the hemisectioned spinal cord experimental model demonstrated clinical and neurophysiological improvement.
Paraspinal-approach transforaminal lumbar interbody fusion for the treatment of lumbar foraminal stenosis
Authors: Fujibayashi Shunsuke , Neo Masashi , Takemoto Mitsuru , Ota Masato , Nakamura Takashi 
Published: October 2010

ObjectForaminal stenosis is a common cause of lumbar radicular symptoms. Recognition of the dynamic pathology, as well as the static anatomical changes, is important to achieving successful surgical outcomes. Excessive facet and anulus removal leads to subsequent disc space narrowing and/or segmental instability, which can cause poor results after decompressive surgery. The objective of this study was to evaluate the efficacy of the paraspinalapproach transforaminal lumbar interbody fusion (TLIF) in the treatment of lumbar foraminal stenosis.MethodsTwenty levels of lumbar foraminal stenosis in 16 patients were treated using an instrumented paraspinal-approach TLIF. There were 12 single-level and 4 two-level cases. Pathologies included foraminal stenosis at 13 levels and lateral disc herniation with disc space narrowing at 7.ResultsIn all patients, preoperative radicular symptoms and mechanical low-back pain were resolved immediately after the operation and leg weakness improved gradually. The recovery rate using the Japanese Orthopaedic Association score was 89.1%. Bony union was achieved within 6 months after the operation in all cases. Postoperative MR imaging showed minimal changes in the paraspinal muscles in the single-level cases.ConclusionsThe paraspinal-approach TLIF is a minimally invasive, safe, and secure procedure for treating lumbar foraminal lesions. Direct visualization and decompression for the foraminal lesion, distraction of the collapsed disc space, and stabilization of the unstable segments can be achieved simultaneously through the paraspinal approach, which produces successful clinical and radiological results.