bluuebunny/crossref_metadata_2025_split huggingface dataset:
Enhancing Nursing Students’ Understanding of Poverty Through Simulation
Authors: Patterson Nena , Hulton Linda J. 
Published: December 2011

AbstractObjectivesThe purposes of this study were (a) to describe the implementation of a poverty simulation, (b) to evaluate its use on nursing students’ attitudes about poverty, and (c) to offer lessons learned.Design and SampleUsing a mixed‐method design, a convenience sample of senior undergraduate nursing students (n = 43) from a public university in a mid‐Atlantic state participated in a poverty simulation experience. Students assumed the roles of real‐life families and were given limited amounts of resources to survive in a simulated community. This simulation took place during a community health practicum clinical day.MeasuresThe short form of Attitudes about Poverty and Poor Populations Scale (APPPS) was adapted for this evaluation. This 21‐item scale includes factors of personal deficiency, stigma, and structural perspective, which measures a range of diverse attitudes toward poverty and poor people.ResultsThe results of this evaluation demonstrated that nursing students viewed the poverty simulation as an effective teaching strategy and actively participated. In particular, nursing students’ scores on the factor of stigma of poverty demonstrated statistically significant changes.ConclusionWith proper planning, organization, and reflection, a poverty simulation experience can be a positive impetus for lifelong learning and civic engagement.
Long‐term follow‐up of febrile infection–related epilepsy syndrome
Authors: Howell Katherine B. , Katanyuwong Kamornwan , Mackay Mark T. , Bailey Catherine A. , Scheffer Ingrid E. , Freeman Jeremy L. , Berkovic Samuel F. , Harvey A. Simon 
Published: December 2011

SummaryPurpose:  Febrile infection–related epilepsy syndrome (FIRES) is an increasingly recognized epileptic syndrome that presents with multifocal refractory status epilepticus in previously normal children and evolves into a chronic, refractory, focal epilepsy with associated cognitive and behavioral difficulties. Herein we describe the features of the chronic epilepsy and critically review evidence for the etiology of this syndrome.Methods:  Seven patients with FIRES were studied. The duration of follow‐up in six survivors was 5–17 years. Clinical, electroencephalography (EEG), neuroimaging, and other investigative findings during the acute and chronic phases were reviewed.Key Findings:  These previously normal children presented with a febrile illness and status epilepticus that was refractory to antiepileptic medications in all children, to immunotherapies (including immunoglobulin, corticosteroids, plasma exchange, and rituximab) in four, and to acute vagus nerve stimulation in one. Markers of cerebral inflammation were few and response to antiepileptic and immunomodulatory therapies was poor. Evolution to chronic epilepsy occurred without a silent period. Seizure characteristics in the chronic phase were strikingly stereotyped and similar to the acute phase, with head and eye version, unilateral facial jerking, asymmetric tonic posturing, and unilateral limb jerking in all patients. Electrographic ictal onset was lateralized in all recorded seizures, unilateral in one patient, and independent bilateral in three. Seizures were refractory to multiple antiepileptic medications in all patients and partly responsive to chronic vagus nerve stimulation in two patients. Moderate to severe intellectual impairment was noted in four patients, and borderline intellectual abilities were noted in two. Magnetic resonance imaging (MRI) in the chronic phase was normal in three patients and showed mild diffuse cortical atrophy and/or mild hippocampal atrophy or sclerosis in three.Significance:  The similar perirolandic and perisylvian features of acute and chronic seizures, the lack of a silent period, the absence of evidence of cerebral inflammation, and the poor response to immunotherapies suggest FIRES is best conceptualized as a chronic epilepsy with explosive onset, not a remote‐symptomatic epilepsy with an acute inflammatory antecedent.
Revising the “Rule of Three” for inferring seizure freedom
Authors: Brandon Westover M. , Cormier Justine , Bianchi Matt T. , Shafi Mouhsin , Kilbride Ronan , Cole Andrew J. , Cash Sydney S. 
Published: December 2011

SummaryPurpose:  How long after starting a new medication must a patient go without seizures before they can be regarded as seizure‐free? A recent International League Against Epilepsy (ILAE) task force proposed using a “Rule of Three” as an operational definition of seizure freedom, according to which a patient should be considered seizure‐free following an intervention after a period without seizures has elapsed equal to three times the longest preintervention interseizure interval over the previous year. This rule was motivated in large part by statistical considerations advanced in a classic 1983 paper by Hanley and Lippman‐Hand. However, strict adherence to the statistical logic of this rule generally requires waiting much longer than recommended by the ILAE task force. Therefore, we set out to determine whether an alternative approach to the Rule of Three might be possible, and under what conditions the rule may be expected to hold or would need to be extended.Methods:  Probabilistic modeling and application of Bayes’ rule.Key Findings:  We find that an alternative approach to the problem of inferring seizure freedom supports using the Rule of Three in the way proposed by the ILAE in many cases, particularly in evaluating responses to a first trial of antiseizure medication, and to favorably‐selected epilepsy surgical candidates. In cases where the a priori odds of success are less favorable, our analysis requires longer seizure‐free observation periods before declaring seizure freedom, up to six times the average preintervention interseizure interval. The key to our approach is to take into account not only the time elapsed without seizures but also empirical data regarding the a priori probability of achieving seizure freedom conferred by a particular intervention.Significance:  In many cases it may be reasonable to consider a patient seizure‐free after they have gone without seizures for a period equal to three times the preintervention interseizure interval, as proposed on pragmatic grounds in a recent ILAE position paper, although in other commonly encountered cases a waiting time up to six times this interval is required. In this work we have provided a coherent theoretical basis for modified criterion for seizure freedom, which we call the “Rule of Three‐To‐Six.”
Penumbra region excitability is not enhanced acutely after cerebral ischemia in the in vitro isolated guinea pig brain
Authors: Breschi Gian Luca , Mastropietro Alfonso , Zucca Ileana , Librizzi Laura , de Curtis Marco 
Published: December 2011

SummaryPurpose: Early seizures are a frequent consequence of stroke. The main goal of the present study is to verify whether anoxic ischemia per se is able to induce early changes in excitability that may be a prelude to the generation of seizures and, ultimately, to epileptogenesis. Excitability changes in the very acute postischemic phase are here analyzed in a new model of ischemia developed in the isolated guinea pig brain preparation.Methods: Permanent bilateral occlusion of the anterior cerebral arteries (ACAs) was performed in the isolated guinea pig brain maintained in vitro by arterial perfusion. Magnetic resonance imaging and immunohistochemistry were utilized to identify the penumbra and core regions induced by ACA occlusion (ACAo). Slow potentials and evoked responses recorded in olfactory cortices were utilized to evaluate excitability changes in the acute phase after ischemia.Key Findings: ACAo induces a core area located in the shell of the nucleus accumbens and a region of penumbra in the underlying olfactory cortices, where characteristic slow potential shifts, but no reduction of diffusion tensor magnetic resonance (MR) signal and microtubule associated protein 2 (MAP‐2) immunostaining (typical of ischemic core) was observed. Recording of responses evoked by low‐ and high‐frequency stimulations of the lateral olfactory tract showed no excitability changes in the early hours that follow ischemia in the olfactory cortical areas supplied by ACAs.Significance: The absence of early hyperexcitability changes in an isolated whole brain model of ischemia, strongly suggests that brain anoxia per se does not contribute to the generation of early seizures. These findings support the view that blood‐borne events (such as hemorrhage and inflammation) may play a major role in early postischemic seizures.
Reduction and Fixation of Cranial Cervical Fracture/Luxations using Screws and Polymethylmethacrylate (PMMA) Cement: A Distraction Technique Applied to the Base of the Skull in Thirteen Dogs
Authors: Pike Fred S. , Kumar M. S. A. , Boudrieau Randy J. 
Published: December 2011

ObjectiveTo (1) describe a surgical distraction technique for C1‐2 cervical fractures/luxations or atlantoaxial (AA) subluxations using the base of the skull (basion of the foramen magnum) and either C2‐3 or C3‐4 for the purchase points of intraoperative axial distraction and (2) report outcome in 13 dogs.Study DesignRetrospective case series.AnimalsDogs (n = 13).Materials and MethodsMedical records (September 1995–December 2005) of dogs with fracture/luxation of the cervical spine, or AA subluxations, were reviewed. Only dogs that had intraoperative linear distraction using the base of the skull as a purchase point for a self‐retaining retractor were included. Signalment, presenting neurologic deficits, fracture location, and concurrent injury were recorded. Both short‐term in‐hospital follow‐up, including healing and any complications, and long‐term telephone follow‐up were obtained.ResultsRealignment of the spinal vertebrae, reestablishing the normal properties of the spinal canal, was achieved after distraction in all dogs. Screws and small pins incorporated into polymethylmethacrylate cement were used to span the fracture ventrally and achieve rigid internal fixation. Eight dogs had a complete neurologic recovery, 2 dogs had slight residual ataxia, 2 dogs died, and 1 dog was lost to follow‐up. Healing was good (mean, 7.5 weeks) or excellent (mean, 5.1 months) based on in‐hospital follow‐up (mean, 5.1 months). On final telephone follow‐up (mean, 7.7 years), no dogs were reported to have had any associated problems or additional surgery.ConclusionsThis surgical distraction technique was a reliable, relatively simple method to obtain reduction of fracture/luxations of C1‐2 to re‐align the spinal canal. Mortality in this series appears lower than that previously reported and supports surgical management of these injuries.
Effect of a Locking Triple Pelvic Osteotomy Plate on Screw Loosening in 26 Dogs
Authors: Rose Scott A. , Peck Jeffrey N. , Tano Cheryl A. , Uddin Nizam , de Haan Jacek J. 
Published: December 2011

ObjectiveTo evaluate the complication rate of the double (DPO) and triple pelvic osteotomy (TPO) procedure (unilateral and bilateral) with a locking purpose‐specific plate.Study designRetrospective case seriesAnimalsDogs (n = 26; 38 hips)MaterialsMedical records (January 2007–January 2011) of dogs that had unilateral or bilateral DPO or TPO were evaluated. Signalment, age, body weight, estimated preoperative subluxation and reduction angles, lameness, and complications were evaluated. Follow‐up radiographs were evaluated for implant loosening or failure, femoral head coverage (FCH), pelvic dimensions, and radiographic evidence of healing.ResultsScrew loosening occurred in 1 of 266 (0.4%) screws placed and in 1 of 38 hips (2.6%). The rate of screw loosening was significantly lower than previously reported. Only 1 hip (2.6%) developed a major complication. Minor complications involving implants occurred in 2 hips (5.3%). Three to 5 locking screws were used per plate. There was a significant increase in FCH and Norberg angle (NA) compared with preoperative values. No clinically significant change in pelvic canal dimensions measured at 3 locations was identified.ConclusionLocking 7‐hole TPO plates with 3–5 locking screws resulted in a lower rate of major and minor implant associated complications than the reported complication rate for conventional 6‐hole plates. En bloc pullout of the caudal aspect of the plate is an infrequent but repeatable complication associated with the locking TPO implant.
Er3+ Diffusion into MgO (5 mol%)‐Doped LiNbO3 Crystal Under Li‐Poor Atmosphere
Authors: Zhang De‐Long , Xu Shi‐Yu , Hua Ping‐Rang , Yu Dao‐Yin , Pun Edwin Yue‐Bun 
Published: December 2011

Under Li‐poor atmosphere, local Er3+ diffusion into highly MgO‐doped LiNbO3 (LN) crystal has been investigated. Three Z‐cut 5 mol% (in growth melt) MgO‐doped LN substrates locally coated with 44–60 nm thick Er‐metal films underwent the respective Li‐poor vapor transport equilibration (VTE) treatment at 1060°C, 1100°C, and 1130°C for the same 90 h duration. After the VTE, the reductions of Li2O content at the Er‐free and Er3+‐doped parts of the surface of the three samples, determined from the measured birefringence, have a similar value of 1.0 ± 0.1, 2.0 ± 0.1, and 2.3 ± 0.1 mol%, respectively. Secondary ion mass spectrometry was used to study the Er3+ diffusion properties and the VTE effect on Mg2+ profile. From the measured Er3+ profiles, characteristic diffusion parameters such as 1/e diffusion depth, diffusivity, diffusion constant, activation energy, surface concentration, solubility, solubility constant, and heat of solution are determined. A comparison with the related results previously reported allows to conclude that heavy MgO‐doping results in substantial decrease of both the diffusivity and solubility, and under the same diffusion temperature the diffusivity and solubility increase by as much as one order of magnitude and two times, respectively, as the diffusion atmosphere goes from the traditional argon to the Li‐poor atmosphere. The Mg2+ profiles reveal that the VTE may induce MgO diffusion and hence an inhomogeneous profile in the Er3+‐diffused layer. This undesired effect is strong for the 1130°C VTE temperature whereas is relatively much weak for 1060°C. It is tentatively explained in terms of the Er3+ diffusion and Li‐poor VTE mechanisms.
Significant association of deficiency of hemoglobin, iron and vitamin B12, high homocysteine level, and gastric parietal cell antibody positivity with atrophic glossitis
Authors: Sun Andy , Lin Hung‐Pin , Wang Yi‐Ping , Chiang Chun‐Pin 
Published: December 2011

J Oral Pathol Med (2012) 41: 500–504Background:  Atrophic glossitis (AG) is considered to be a marker of nutritional deficiency. In this study, we evaluated whether there was an intimate association of the deficiency of hemoglobin, iron, vitamin B12 or folic acid, high blood homocysteine level, and serum gastric parietal cell antibody (GPCA) positivity with AG.Methods:  The blood hemoglobin, iron, vitamin B12, folic acid, and homocysteine concentrations and the serum GPCA level in 176 AG patients were measured and compared with the corresponding levels in 176 age‐ and sex‐matched healthy control subjects.Results:  We found that 39 (22.2%), 47 (26.7%), 13 (7.4%), and 3 (1.7%) AG patients had deficiencies of Hb (men < 13 g/dl, women < 12 g/dl), iron (<60 μg/dl), vitamin B12 (<200 pg/ml), and folic acid (<4 ng/ml), respectively. Moreover, 38 (21.6%) AG patients had abnormally high blood homocysteine level, and 47 (26.7%) AG patients had serum GPCA positivity. AG patients had a significantly higher frequency of Hb, iron, or vitamin B12 deficiency, of abnormally elevated blood homocysteine level, or of serum GPCA positivity than healthy control subjects (all P‐values = 0.000). However, no significant difference in frequency of folic acid deficiency was found between AG patients and healthy control subjects.Conclusion:  We conclude that there is a significant association of deficiency of hemoglobin, iron and vitamin B12, abnormally high blood homocysteine level, and serum GPCA positivity with AG.
Extent and severity of chronic periodontitis in chronic kidney disease patients
Authors: Brito F. , Almeida S. , Figueredo C. M. S. , Bregman R. , Suassuna J. H. R. , Fischer R. G. 
Published: December 2011

Brito F, Almeida S, Figueredo CMS, Bregman R, Suassuna JHR, Fischer RG. Extent and severity of chronic periodontitis in chronic kidney disease patients. J Periodont Res 2012; 47: 426–430. © 2011 John Wiley & Sons A/SBackground and Objectve:  Chronic inflammatory diseases have been investigated as a possible source of inflammation in chronic kidney disease patients; however, there is a shortage of information about the prevalence of periodontitis in such individuals. Therefore, the aim of this cross‐sectional study was to determine the extent and severity of periodontitis in chronic kidney disease patients undergoing the following three different treatment modalities: predialysis; continuous ambulatory peritoneal dialysis (CAPD); and hemodialysis (HD); and to compare the findings with those from systemically healthy individuals.Material and Methods:  Forty CAPD patients (mean age 52 ± 12 years), 40 HD patients (mean age 50 ± 10 years), 51 predialysis patients (mean age 54 ± 11 years) and 67 healthy individuals (mean age 50 ± 7 years) were examined. The periodontal examination included probing pocket depth, clinical attachment loss, bleeding on probing and presence of plaque. Patients with at least four sites with clinical attachment loss ≥ 6 mm were considered to have severe chronic periodontitis, and those with at least 30% of sites with clinical attachment loss ≥ 4 mm were considered to have generalized chronic periodontitis.Results:  Predialysis and HD patients had significantly more sites with clinical attachment loss ≥ 6 mm than healthy individuals. The CAPD patients had similar periodontal condition to healthy subjects. There were significantly more cases of severe chronic periodontitis in predialysis and HD patients.Conclusion:  Predialysis and HD are associated with a higher prevalence of severe periodontitis compared with healthy individuals and CAPD patients.
Treatment Concept with CAD/CAM‐Fabricated High‐Density Polymer Temporary Restorations
Authors: GÜTH JAN‐FREDERIK , ALMEIDA E SILVA JÚNIO S. , RAMBERGER MARC , BEUER FLORIAN , EDELHOFF DANIEL 
Published: December 2011

ABSTRACTTooth wear in younger patients is perceived worldwide as an increasing problem. Its etiology is multifactorial (erosion, abrasion, attrition), and its treatment is challenging for the dental practitioner specifically when a great loss of the vertical dimension of occlusion has occurred.The aim of this article is to present a treatment approach for complex cases with high loss of tooth structure using computer‐aided design/computer‐aided manufacturing (CAD/CAM)‐fabricated temporary high‐density polymer restorations without any preparations.New manufacturing technologies and innovative materials such as high‐density polymers offer good possibilities for restorations during the pretreatment period. This is especially important in circumstances requiring massive corrections of color, form, or position. Pretreatment periods are indispensable in refining important factors such as lip‐position dynamics as well as the correct position of the smile line, which cannot be adequately assessed in the dental laboratory. In the presented case report, CAD/CAM‐fabricated non‐preparation restorations were adhesively placed on the worn dentition without any further loss of tooth structure.Such an approach provides the opportunity to “test‐drive” the new restoration design in terms of function, phonetics, and esthetics, thus improving the predictability of the definitive restorations design. If any change in the design is required, it can be cost‐effectively achieved through simple modification or replacement of the restorations.CLINICAL SIGNIFICANCEThe prolonged pretreatment phase using CAD/CAM‐fabricated high‐density polymer temporaries can help the practitioner turn challenging treatments into more predictable ones with respect to function and esthetics.(J Esthet Restor Dent ••:••–••, 2011)
A systematic review of structured compared with non‐structured breastfeeding programmes to support the initiation and duration of exclusive and any breastfeeding in acute and primary health care settings
Authors: Beake Sarah , Pellowe Carol , Dykes Fiona , Schmied Virginia , Bick Debra 
Published: December 2011

AbstractPolicies and guidelines have recommended that structured programmes to support breastfeeding should be introduced. The objective of this review was to consider the evidence of outcomes of structured compared with non‐structured breastfeeding programmes in acute maternity care settings to support initiation and duration of exclusive breastfeeding. Quantitative and qualitative studies were considered. Primary outcomes of interest were initiation of breastfeeding and duration of exclusive breastfeeding. Studies that only considered community‐based interventions were excluded. An extensive search of literature published in 1992–2010 was undertaken using identified key words and index terms. Methodological quality was assessed using checklists developed by the Joanna Briggs Institute. Two independent reviewers conducted critical appraisal and data extraction; 26 articles were included. Because of clinical and methodological heterogeneity of study designs, it was not possible to combine studies or individual outcomes in meta‐analyses. Most studies found a statistically significant improvement in breastfeeding initiation following introduction of a structured breastfeeding programme, although effect sizes varied. The impact on the duration of exclusive breastfeeding and duration of any breastfeeding to 6 months was also evident, although not all studies found statistically significant differences. Despite poor overall study quality, structured programmes compared with standard care positively influence the initiation and duration of exclusive breastfeeding and any breastfeeding. In health care settings with low breastfeeding initiation and duration rates, structured programmes may have a greater benefit. Few studies controlled for any potential confounding factors, and the impact of bias has to be considered.
OPTIMIZATION OF GLUTEN PEAK TESTER: A STATISTICAL APPROACH
Authors: CHANDI GURPREET KAUR , SEETHARAMAN KOUSHIK 
Published: December 2011

ABSTRACTResponse surface methodology was applied to develop a standard method for gluten peak tester. Four variables – flour weight, temperature, solvent and rpm – were varied as per the center composite design, and the responses – torque and peak maximum time – were analyzed. Flour–solvent interaction was observed to be the most significant factor impacting the peak torque for whole meal and hard wheat flours while flour (g) and rpm were the most significant for soft wheat flour and insignificant for whole meal flour. The setting 8.5 g flour, 9.5 g solvent (0.5 M CaCl2), 34C temperature and 1,900 rpm was obtained as the standard setting applicable to whole meal as well as refined flours from soft and hard wheats.PRACTICAL APPLICATIONSGluten quality is an important criterion to predict flour performance in cereal processing industry. The gluten peak tester has been recently introduced as a sensitive and rapid way of testing wheat gluten quality. The current research was designed to optimize the gluten peak tester to work with wheat varieties with a wide range of protein contents so as to lay a baseline for method development to assess gluten quality of different wheat varieties/lines within a short time span with minimum sample requirements which is very critical for the breeding industry.