bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bedside Ocular Ultrasound for the Detection of Retinal Detachment in the Emergency Department
Authors: Yoonessi Roxana , Hussain Aliasgher , Jang Timothy B. 
Published: September 2010

ACADEMIC EMERGENCY MEDICINE 2010; 17:913–917 © 2010 by the Society for Academic Emergency MedicineAbstractObjectives:  Acute retinal detachments (RD) can be difficult to diagnose and may require emergent intervention. This study was designed to assess the performance of emergency department ocular ultrasound (EOUS) for the diagnosis of RD.Methods:  This was a prospective, observational study using a convenience sample of emergency department (ED) patients. Physicians performed EOUS for the diagnosis of RD prior to evaluation by an ophthalmologist. The criterion standard was the diagnosis of a RD by the ophthalmologist who was blinded to the results of EOUS.Results:  Fifteen physicians evaluated 48 patients with acute visual changes. Eighteen patients (38%) had RDs and all were correctly identified (true positives). Of the 30 patients (62%) without RD, 25 patients were correctly identified (true negatives), and five patients with vitreous hemorrhages were misidentified as having RDs (false positives). Therefore, the sensitivity and specificity of EOUS for RD were 100% (95% confidence interval [CI] = 78% to 100%) and 83% (95% CI = 65% to 94%), respectively.Conclusions:  Emergency department ocular ultrasound is sensitive for the diagnosis of RD and may have a role in excluding RD in patients presenting to the ED.
The Association Between Prehospital Endotracheal Intubation Attempts and Survival to Hospital Discharge Among Out‐of‐hospital Cardiac Arrest Patients
Authors: Studnek Jonathan R. , Thestrup Lars , Vandeventer Steve , Ward Steven R. , Staley Kevin , Garvey Lee , Blackwell Tom 
Published: September 2010

ACADEMIC EMERGENCY MEDICINE  2010; 17:918–925 © 2010 by the Society for Academic Emergency MedicineAbstractObjectives:  The benefit of prehospital endotracheal intubation (ETI) among individuals experiencing out‐of‐hospital cardiac arrest (OOHCA) has not been fully examined. The objective of this study was to determine if prehospital ETI attempts were associated with return of spontaneous circulation (ROSC) and survival to discharge among individuals experiencing OOHCA.Methods:  This retrospective study included individuals who experienced a medical cardiac arrest between July 2006 and December 2008 and had resuscitation efforts initiated by paramedics from Mecklenburg County, North Carolina. Outcome variables were prehospital ROSC and survival to hospital discharge, while the primary independent variable was the number of prehospital ETI attempts.Results:  There were 1,142 cardiac arrests included in the analytic data set. Prehospital ROSC occurred in 299 individuals (26.2%). When controlling for initial arrest rhythm and other confounding variables, individuals with no ETI attempted were 2.33 (95% confidence interval [CI] = 1.63 to 3.33) times more likely to have ROSC compared to those with one successful ETI attempt. Of the 299 individuals with prehospital ROSC, 118 (39.5%) were subsequently discharged alive from the hospital. Individuals having no ETI were 5.46 (95% CI = 3.36 to 8.90) times more likely to be discharged from the hospital alive compared to individuals with one successful ETI attempt.Conclusions:  Results from these analyses suggest a negative association between prehospital ETI attempts and survival from OOHCA. In this study, the individuals most likely to have prehospital ROSC and survival to hospital discharge were those who did not have a reported ETI attempt. Further comparative research should assess the potential causes of the demonstrated associations.
Sequential Analysis of Pretreatment Delays In Stroke Thrombolysis
Authors: Puolakka Tuukka , Väyrynen Taneli , Häppölä Olli , Soinne Lauri , Kuisma Markku , Lindsberg Perttu J. 
Published: September 2010

ACADEMIC EMERGENCY MEDICINE 2010; 17:965–969 © 2010 by the Society for Academic Emergency MedicineAbstractObjectives:  The aim was to determine if an intensive restructuring of the approach to acute stroke improved time to thrombolysis over a 3‐year study period and to determine whether delay modifications correlated with increased thrombolytic intervention or functional outcome.Methods:  The study examined the pretreatment process to define specific time intervals (delays) of interest in the acute management of 289 consecutive ischemic stroke patients who were transported by the emergency medical services (EMS) and received intravenous (IV) thrombolytic therapy in the emergency department (ED) of Helsinki University Central Hospital. Time interval changes of the 3‐year period and use of thrombolytics was measured. Functional outcome, measured with the modified Rankin Scale (mRS) at 3 months, was assessed with multivariable statistical analysis.Results:  During implementation of the restructuring program from 2003 to 2005, the median total time delay from symptom onset to drug administration dropped from 149 to 112 minutes (p < 0.0001). Prehospital delays did not change significantly during the study period. The median delay in calling an ambulance remained at 13 minutes, and the total median prehospital delay stayed at 71 minutes. In‐hospital delays decreased from 67 to 34 minutes (p < 0.0001). The median call delay was 25 minutes in patients with mild symptoms (National Institute of Health Stroke Scale [NIHSS] score < 7) and 8 minutes with severe symptoms (NIHSS > 15). In the multivariate model, stroke severity (odds ratio [OR] = 0.83, 95% confidence interval [CI] = 0.78 to 0.88, p < 0.0001), age (OR = 0.57, 95% CI = 0.42 to 0.77, p < 0.0001), and in‐hospital delay (OR = 0.47, 95% CI = 0.22 to 0.97, p = 0.04) were suggesting a good outcome.Conclusions:  Restructuring of the teamwork between the EMS personnel and the reorganized ED significantly reduced in‐hospital, but not prehospital, delays. The present data suggest that a decreased in‐hospital delay improves the accessibility of the benefits of thrombolysis.
From Model to Forecasting: A Multicenter Study in Emergency Departments
Authors: Wargon Mathias , Casalino Enrique , Guidet Bertrand 
Published: September 2010

ACADEMIC EMERGENCY MEDICINE 2010; 17:970–978 © 2010 by the Society for Academic Emergency MedicineAbstractObjectives:  This study investigated whether mathematical models using calendar variables could identify the determinants of emergency department (ED) census over time in geographically close EDs and assessed the performance of long‐term forecasts.Methods:  Daily visits in four EDs at academic hospitals in the Paris area were collected from 2004 to 2007. First, a general linear model (GLM) based on calendar variables was used to assess two consecutive periods of 2 years each to create and test the mathematical models. Second, 2007 ED attendance was forecasted, based on a training set of data from 2004 to 2006. These analyses were performed on data sets from each individual ED and in a virtual mega ED, grouping all of the visits. Models and forecast accuracy were evaluated by mean absolute percentage error (MAPE).Results:  The authors recorded 299,743 and 322,510 ED visits for the two periods, 2004–2005 and 2006–2007, respectively. The models accounted for up to 50% of the variations with a MAPE less than 10%. Visit patterns according to weekdays and holidays were different from one hospital to another, without seasonality. Influential factors changed over time within one ED, reducing the accuracy of forecasts. Forecasts led to a MAPE of 5.3% for the four EDs together and from 8.1% to 17.0% for each hospital.Conclusions:  Unexpectedly, in geographically close EDs over short periods of time, calendar determinants of attendance were different. In our setting, models and forecasts are more valuable to predict the combined ED attendance of several hospitals. In similar settings where resources are shared between facilities, these mathematical models could be a valuable tool to anticipate staff needs and site allocation.
Reducing Ambulance Response Times Using Geospatial–Time Analysis of Ambulance Deployment
Authors: Ong Marcus Eng Hock , Chiam Tut Fu , Ng Faith Suan Peng , Sultana Papia , Lim Swee Han , Leong Benjamin Sieu‐Hon , Ong Victor Yeok Kein , Ching Tan Elaine Ching , Tham Lai Peng , Yap Susan , Anantharaman V. ,   on behalf of the Cardiac Arrest Resuscitation Epidemiology (CARE) Study Group
Published: September 2010

ACADEMIC EMERGENCY MEDICINE 2010; 17:951–957 © 2010 by the Society for Academic Emergency MedicineAbstractObjectives:  This study aimed to determine if a deployment strategy based on geospatial–time analysis is able to reduce ambulance response times for out‐of‐hospital cardiac arrests (OOHCA) in an urban emergency medical services (EMS) system.Methods:  An observational prospective study examining geographic locations of all OOHCA in Singapore was conducted. Locations of cardiac arrests were spot‐mapped using a geographic information system (GIS). A progressive strategy of satellite ambulance deployment was implemented, increasing ambulance bases from 17 to 32 locations. Variation in ambulance deployment according to demand, based on time of day, was also implemented. The total number of ambulances and crews remained constant over the study period. The main outcome measure was ambulance response times.Results:  From October 1, 2001, to October 14, 2004, a total of 2,428 OOHCA patients were enrolled into the study. Mean ± SD age for arrests was 60.6 ± 19.3 years with 68.0% male. The overall return of spontaneous circulation (ROSC) rate was 17.2% and survival to discharge rate was 1.6%. Response time decreased significantly as the number of fire stations/fire posts increased (Pearson χ2 = 108.70, df = 48, p < 0.001). Response times for OOHCA decreased from a monthly median of 10.1 minutes at the beginning to 7.1 minutes at the end of the study. Similarly, the proportion of cases with response times < 8 minutes increased from 22.3% to 47.3% and < 11 minutes from 57.6% to 77.5% at the end of the study.Conclusions:  A simple, relatively low‐cost ambulance deployment strategy was associated with significantly reduced response times for OOHCA. Geospatial–time analysis can be a useful tool for EMS providers.
A Virtual Reality Simulation Curriculum for Intravenous Cannulation Training
Authors: Loukas Constantinos , Nikiteas Nikolaos , Kanakis Meletios , Moutsatsos Argyris , Leandros Emmanuel , Georgiou Evangelos 
Published: September 2010

AbstractObjectives:  Although virtual reality (VR) simulators play an important role in modern medical training, their efficacy is not often evaluated using learning curves. In this study, the learning curves of novice and intermediate users were elicited during a VR simulation–based curriculum for intravenous (IV) cannulation.Methods:  This was a prospective observational study of subjects undergoing training using a VR model of IV cannulation. Participants were divided into two groups: novices (third‐year medical students with no prior practical experience in IV catheterization) and intermediates (recent graduates with limited experience). Performance was measured with two endpoints: time to completion and errors committed. Errors were categorized as critical or noncritical. Learning curves (error score and time completion vs. session number) were analyzed using the Friedman’s test. Performance before and after training was compared using the Kruskal‐Wallis test. The Spearman rank correlation coefficient (rs) was used to determine the correlation between time completion and error score estimates. The number of attempts required to complete the training phase was also measured and compared between the two groups.Results:  Thirty subjects were enrolled: 17 in the novice group and 13 in the intermediate group. Learning curve plateaus of intermediates were reached in the sixth case scenario (session), whereas novices reached a plateau in the eighth session. Performance comparison of time to completion and errors showed significant improvement for both groups. Less time and fewer attempts were required by all trainees to complete a scenario while progressing through the curriculum. The overall number of IV cannulation attempts of novices was significantly higher than that of the intermediates throughout the course.Conclusions:  Significant learning curves for novice and intermediate students were demonstrated after following the VR simulation–based curriculum. Competencies acquired during this educational course may provide an important advantage for training prior to actual clinical practice.ACADEMIC EMERGENCY MEDICINE 2010; 17:1142–1145 © 2010 by the Society for Academic Emergency Medicine
A survey of undergraduate education in dental implantology in UK dental schools
Authors: Blum I. R. , O’Sullivan D. J. , Jagger D. C. 
Published: September 2010

AbstractThe aim of this study was to ascertain knowledge on current teaching of implant dentistry in the undergraduate curriculum of Dental Schools in the UK. Information on the teaching modalities, including year of introduction of implant dentistry into undergraduate curriculum, departments involved in teaching, format of teaching, use of adjunctive teaching aids, and types of implant systems used in undergraduate teaching was collected by means of a questionnaire, which was sent to all undergraduate dental schools in the UK. Based on a 100% response rate, the findings indicate that all dental schools in the UK reported that they included dental implantology in their undergraduate curriculum; however there were marked variations in the content and delivery of the teaching.
Dental nursing education and the introduction of technology‐assisted learning
Authors: Sheridan C. , Gorman T. , Claffey N. 
Published: September 2010

AbstractThe aim of this paper is to explore the profile of dental nursing students in the National Dental Nurse Training Programme of Ireland and their adjustment to a technology‐assisted learning environment. Evaluation by students of the course and their reactions to the course were analysed. Dental nurses must possess the skills and knowledge to proficiently function in the modern day dental surgery. The implementation of a dental nurse programme that is heavily reliant on technology has started to create a group of dental nurses equipped with basic skills to access and retrieve information over a lifetime. However, the transition to a technology‐assisted learning environment including online learning activities requires adaptation and expertise by educators and students alike. Careful evaluation and stakeholder feedback is imperative in the creation and maintaining of a quality programme. In conclusion, the students in this study responded well to the transition to a technology‐based learning environment. Furthermore, the findings of this study suggest that the use of an online environment is an effective and stimulating learning environment for the students of a dental nurse programme; however, familiarity skills and knowledge of information technology is a prerequisite for success.
Effect of fluoride and non‐fluoride salts of copper, silver and tin on the acidogenicity of dental plaque in vivo
Authors: OPPERMANN RUI VICENTE , JOHANSEN JAN ROLF 
Published: September 2010

Abstract –The aim of the present study was to assess the relative importance of the metal and fluoride components in the inhibiting effect on the acidogenicity of plaque exhibited by silver fluoride and copper fluoride. The effect of these salts was therefore compared with that of silver nitrate and copper sulfate. Four subjects with a 3‐day‐old .sucrose induced plaque received topical applications of the test agents. Plaque pH‐measurements, in the presence of sucrose, were performed prior to and at given time intervals after this application. No significant differences were observed in the inhibitory effect of 5 mm solutions of the copper and silver salts These salts were all more effective than stannous fluoride in the first 4 h following application. Sodium fluoride was the least effective. All metals tested were found to be retained in plaque. The inhibitory activity appears to be carried by the cations. Other properties than retention alone may explain the higher effectiveness observed for silver and copper.
Eugenol: liberation from dental materials and effect on human diploid fibroblast cells
Authors: LINDQVIST LENNART , OTTESKOG PER 
Published: September 2010

Abstract –The amount of eugenol (4‐allyl‐2‐methoxyphenol) released from four different dental materials immersed in phosphate buffer was measured by gas liquid chromatography. Maximal release of eugenol from zinc oxide‐eugenol cement (ZOE) and IRM® was attained within 5 h and corresponded to 5% and 4%, respectively, of the total amount of eugenol in each material. Both the rates and total amounts of eugenol released from Nobetec® and Opotow® were lower than for ZOE and IRM. Eugenol (0.67 mm) applied to growing cultures of human diploid fibroblasts reduced the number of cells recovered to a value which was 4%. of that found for control cultures which grew to form, monolayers. Confluent monolayers of 3H‐uridine labeled cell cultures which were incubated for 1 h in the presence of 4 mm eugenol lost approximately 100% of this cytoplasmic label, indicating total cell death.
Eight‐year mortality associated with dental occlusion and denture use in community‐dwelling elderly persons
Authors: Yoshida Mitsuyoshi , Morikawa Hidehiko , Yoshikawa Mineka , Tsuga Kazuhiro , Akagawa Yasumasa 
Published: September 2010

Objective:  To evaluate the influence of dental occlusion, with or without the use of dentures, on mortality in community‐dwelling elderly persons.Subjects:  A total of 1030 randomly selected healthy independent elderly aged 65 and over were surveyed in 1995. For the study reported here, subjects were classified into three groups according to the presence or absence of maxillo‐mandibular tooth contacts. Subjects with no maxillo‐mandibular tooth contacts were further subdivided into those with and without dentures.Methods:  Data on mortality were obtained from Kure City Council in September 2003. Cox regression models were used in analysing the risk for death with gender and age as covariates.Results:  Individuals whose teeth had contact in at least the bilateral premolar regions at baseline had 0.78 times (95% CI: 0.60–0.99) smaller risk for death during the succeeding 8 years than those who had no occlusion. Among those who had no occlusion with their own teeth, the risk for mortality among denture non‐users was 1.52 times (95% CI: 1.25–1.83) higher than the risk for denture users.Conclusion:  These results may support the view that, in the elderly, poor dental occlusion is associated with an increased risk for mortality and that, in the edentulous, the use of dentures is associated with a decreased risk for mortality.
A study of occlusion in elderly Japanese over 80 years with at least 20 teeth
Authors: Miyazaki Haruyo , Motegi Etsuko , Yatabe Kenichi , Yamaguchi Hideharu , Maki Yoshinobu 
Published: September 2010

Objectives:  The purpose of this study was to identify the occlusal status of elderly Japanese over 80 years with at least 20 teeth.Materials and methods:  The study enrolled 76 elderly Japanese (44 male, 32 female) with a mean age of 82 years and an average of 25.7 remaining teeth. The study consisted of intra‐oral examination, intra‐oral and facial photographs, radiographs and impressions for study casts.Results:  No gender difference was observed in age or number of remaining teeth. Anteroposterior occlusal relationship was characterised by maxillary protrusion in 67.6%, acceptable overjet in 31.0%, and anterior crossbite in 1.4%. Vertically, deep bite was noted in 33.8%, acceptable overbite in 64.8%, and open bite in 1.4%. Most of the subjects had either Angle class I (68.4%) or class II (25.7%) canine relationship. Only 3.9% of the subjects had upper anterior crowding. Lower anterior crowding was observed in 23.7%, but tended not to be severe.Conclusion:  These results indicate that Japanese who attained the goal of ‘8020’ have a relatively good occlusion.
Tooth loss, the wearing of dentures and associated factors in Sri Lankan older individuals
Authors: Pallegedara C. , Ekanayake L. 
Published: September 2010

Objective:  To determine tooth loss, wearing of dentures and associated factors in older individuals from Sri Lanka.Design:  A cross‐sectional survey where the data were collected by means of an oral examination and an interviewer administered questionnaire.Setting:  Negambo within the Gampaha district of Sri Lanka.Subjects:  A total of 630 subjects who were aged 60 years and above.Results:  Only 11 subjects had all 32 teeth and 17% were edentulous. Age, gender and level of income were significantly associated with the number of missing teeth. Of those with missing teeth, 22% wore dentures. Only 16% of the non‐denture wearers perceived a need for dentures. Among the non‐denture wearers who perceived a need for dentures, a majority had cited ‘cost’ as the main barrier for obtaining dentures. Logistic regression analysis revealed that age, gender, levels of income and education and missing teeth were significant predictors of wearing of dentures.Conclusions:  Knowledge of factors that influence tooth loss and wearing of dentures may have implications for oral health care planners in the provision and delivery of oral health services to the older individuals.
BchJ and BchM interact in a 1 : 1 ratio with the magnesium chelatase BchH subunit of Rhodobacter capsulatus
Authors: Sawicki Artur , Willows Robert D. 
Published: September 2010

Substrate channeling between the enzymatic steps in the (bacterio)chlorophyll biosynthetic pathway catalyzed by magnesium chelatase (BchI/ChlI, BchD/ChlD and BchH/ChlH subunits) and S‐adenosyl‐l‐methionine:magnesium‐protoporphyrin IX O‐methyltransferase (BchM/ChlM) has been suggested. This involves delivery of magnesium‐protoporphyrin IX from the BchH/ChlH subunit of magnesium chelatase to BchM/ChlM. Stimulation of BchM/ChlM activity by BchH/ChlH has previously been shown, and physical interaction of the two proteins has been demonstrated. In plants and cyanobacteria, there is an added layer of complexity, as Gun4 serves as a porphyrin (protoporphyrin IX and magnesium‐protoporphyrin IX) carrier, but this protein does not exist in anoxygenic photosynthetic bacteria. BchJ may play a similar role to Gun4 in Rhodobacter, as it has no currently assigned function in the established pathway. Purified recombinant Rhodobacter capsulatus BchJ and BchM were found to cause a shift in the equilibrium amount of Mg‐protoporphyrin IX formed in a magnesium chelatase assay. Analysis of this shift revealed that it was always in a 1 : 1 ratio with either of these proteins and the BchH subunit of the magnesium chelatase. The establishment of the new equilibrium was faster with BchM than with BchJ in a coupled magnesium chelatase assay. BchJ bound magnesium‐protoporphyrin IX or formed a ternary complex with BchH and magnesium‐protoporphyrin IX. These results suggest that BchJ may play a role as a general magnesium porphyrin carrier, similar to one of the roles of GUN4 in oxygenic organisms.Structured digital abstract
MINT‐7994803:bchI (uniprotkb:P26239), bchD (uniprotkb:P26175) and bchH (uniprotkb: P26162) physically interact (MI:0915) by cosedimentation in solution (MI:0028)
MINT‐7994743:bchJ (uniprotkb:P26169), bchI (uniprotkb:P26239), bchD (uniprotkb:P26175) and bchH (uniprotkb:P26162) physically interact (MI:0915) by cosedimentation in solution (MI:0028)
MINT‐7994762:bchM (uniprotkb:P26236), bchH (uniprotkb:P26162), bchD (uniprotkb: P26175) and bchI (uniprotkb:P26239) physically interact (MI:0915) by cosedimentation in solution (MI:0028)