bluuebunny/crossref_metadata_2025_split huggingface dataset:
The efficacy of treatment of patients with severe constipation or recurrent pseudo‐obstruction with pyridostigmine
Authors: O’Dea C. J. , Brookes S. J. H. , Wattchow D. A. 
Published: March 2009

AbstractObjective  Disorders of colonic motility, such as severe constipation and pseudo‐obstruction, remain difficult to treat. The pathophysiology of these conditions is not completely understood, but previous studies suggest a deficiency of cholinergic innervation and an imbalance in autonomic regulation of colonic motor function as contributing factors. Therefore, increasing the availability of acetylcholine in the bowel wall with a cholinesterase inhibitor, such as pyridostigmine, may improve symptoms.Method  We studied thirteen patients with severe constipation (slow transit type) or recurrent pseudo‐obstruction. The six patients with slow transit constipation had mechanical obstruction and pelvic floor dysfunction excluded, and normal calibre colon and slow transit confirmed. These patients were offered pyridostigmine in an attempt to avoid surgery. The seven patients with pseudo‐obstruction had dilated bowel on imaging, and mechanical obstruction was excluded. These patients received pyridostigmine when symptoms recurred, despite previous treatments. Pyridostigmine was initiated at 10 mg b.i.d. and increased if required.Results  One of the six patients with slow transit constipation reported improvement of symptoms and had concurrently weaned anti‐psychotic medications. Pyridostigmine was ceased in the remaining five patients due to lack of efficacy and/or side effects. Four patients proceeded to surgery for refractory symptoms. All seven patients with pseudo‐obstruction had some improvement of symptoms with few side effects. Of these, two later had surgery for recurrent symptoms.Conclusion  In patients with slow transit constipation, treatment with pyridostigmine does not improve symptoms. However, it does improve symptoms in patients with recurrent pseudo‐obstruction with few side effects, offering an extra treatment option for these patients.
Randomized controlled trial comparing rubber band ligation with stapled haemorrhoidopexy for Grade II circumferential haemorrhoids: long‐term results
Authors: Shanmugam V. , Muthukumarasamy G. , Cook J. A. , Vale L. , Watson A. J. M. , Loudon M. A. 
Published: March 2009

AbstractObjective  An improved understanding of the pathophysiology of haemorrhoids has resulted in the introduction of new surgical techniques including stapled haemorrhoidopexy (SH). This randomized controlled trial compared the long‐term effectiveness of SH with rubber band ligation (RBL) in the treatment of grade II circumferential symptomatic haemorrhoids.Method  A consecutive cohort of patients was randomly allocated to either SH or RBL. Data on haemorrhoidal symptoms, Cleveland continence scores, sphincter assessment, SF‐36, EQ‐5D, HAD score and prior treatment history were assessed at enrolment and reassessed by long‐term postal questionnaire. The details were analysed using spssTM 12.0 from MicrosoftTM Access®.Results  Sixty patients were allocated by computer block randomization. Both groups were balanced for age, sex and symptoms. Recurrence favoured SH [3 vs 11; OR 0.18, 95% CI (0.03 to 0.86), P = 0.028] at 1 year and, at a mean of 40.67 (31–47) months [4 vs 12; OR 0.23, 95% CI (0.05, 0.95); P = 0.039]. SH patients experienced prolonged pain [Median (IQR) = 7 (5,7) vs 3 (1,7), P = 0.008] and took a longer time to return to work [6 (3,7) vs 3 (1,6) days, P = 0.018]. This was no significant difference in quality of life.Conclusion  Stapled haemorrhoidopexy achieved better disease control at 1 year without any major complication. This was sustained in the long‐term. Further studies with greater patient numbers are needed to confirm this study.
HOW EXPERIENCE CONFRONTS ETHICS
Authors: HOFFMASTER BARRY , HOOKER CLIFF 
Published: March 2009

ABSTRACTAnalytic moral philosophy's strong divide between empirical and normative restricts facts to providing information for the application of norms and does not allow them to confront or challenge norms. So any genuine attempt to incorporate experience and empirical research into bioethics – to give the empirical more than the status of mere ‘descriptive ethics’– must make a sharp break with the kind of analytic moral philosophy that has dominated contemporary bioethics. Examples from bioethics and science are used to illustrate the problems with the method of application that philosophically prevails in both domains and with the conception of rationality that underlies this method. Cues from how these problems can be handled in science then introduce summaries of richer, more productive naturalist and constructivist accounts of reason and normative knowledge. Liberated by a naturalist approach to ethics and an enlarged conception of rationality, empirical work can be recognized not just as essential to bioethics but also as contributing to normative knowledge.
‘NOBODY TOSSES A DWARF!’ THE RELATION BETWEEN THE EMPIRICAL AND THE NORMATIVE REEXAMINED
Authors: LEGET CARLO , BORRY PASCAL , DE VRIES RAYMOND 
Published: March 2009

ABSTRACTThis article discusses the relation between empirical and normative approaches in bioethics. The issue of dwarf tossing, while admittedly unusual, is chosen as a point of departure because it challenges the reader to look with fresh eyes upon several central bioethical themes, including human dignity, autonomy, and the protection of vulnerable people. After an overview of current approaches to the integration of empirical and normative ethics, we consider five ways that the empirical and normative can be brought together to speak to the problem of dwarf tossing: prescriptive applied ethics, theoretical ethics, critical applied ethics, particularist ethics and integrated empirical ethics. We defend a position of critical applied ethics that allows for a two‐way relation between empirical and normative theories. Against efforts fully to integrate the normative and the empirical into one synthesis, we propose that the two should stand in tension and relation to one another. The approach we endorse acknowledges that a social practice can and should be judged both by the gathering of empirical data and by normative ethics. Critical applied ethics uses a five stage process that includes: (a) determination of the problem, (b) description of the problem, (c) empirical study of effects and alternatives, (d) normative weighing and (e) evaluation of the effects of a decision. In each stage, we explore the perspective from both the empirical (sociological) and the normative ethical point of view. We conclude by applying our five‐stage critical applied ethics to the example of dwarf tossing.
Gingivomorphometry – esthetic evaluation of the crown–mucogingival complex: a new method for collection and measurement of standardized and reproducible data in oral photography
Authors: Weinländer Michael , Lekovic Vojislav , Spadijer‐Gostovic Sanja , Milicic Bilijana , Krennmair Gerald , Plenk Jr Hanns 
Published: March 2009

AbstractObjectives: A new method is introduced for the esthetic evaluation of the periimplant mucogingival complex through collection of standardized oral photographs and computer‐assisted measurement of reproducible data. Using this method, different soft tissue and crown parameters in the dentogingival complex can be measured and the esthetic outcome monitored.Material and methods: A photographic device for standardized oral photography and a standard protocol for the esthetic evaluation of the crown–mucogingival complex is presented, comprising six soft tissue parameters: (1) mesial and (2) distal papilla areas, (3) mesial and (4) distal papilla heights, (5) soft tissue–crown perimeter, and (6) gingival recession. In order to demonstrate the reproducibility of standardized oral photographs and the accuracy of the measurement of the six parameters, the data obtained in each of two such standardized clinical photographs, taken at 10–14 days intervals, of the anterior maxillary region from 10 patients with no apparent dental disease were compared. For the statistical analysis of the reproducibility of these dependent data the 95% confidence interval and the coefficients of variation were calculated from measurement means and ranges of each of the above parameters, pooled from all 10 patients.Results: Statistical analysis revealed high reproducibility with no significant differences between the range of mean values of all six parameter measurements on the first and second standardized oral photograph of the same patient, respectively.Conclusion: Gingivomorphometry on standardized oral photographs can be considered to be an accurate and reproducible method for the evaluation and measurement of different dentogingival and periimplant parameters.
Cost‐effectiveness modeling of dental implant vs. bridge
Authors: Bouchard P. , Renouard F. , Bourgeois D. , Fromentin O. , Jeanneret M.H. , Beresniak A. 
Published: March 2009

AbstractAims: We assess the cost‐effectiveness of dental implant first‐line strategy vs. fixed partial denture strategy in patients suffering from one single missing tooth.Materials and methods: The model used a simulation decision framework over a 20‐year period. Potential treatment switches can occur every 5 years. Transition probabilities come from literature, epidemiological reports or expert opinions. They have been programmed using specific distribution ranges to simulate the patients' and practice variability, and to take into account parameter uncertainty. Direct medical costs have been assessed according to a cost survey. Probabilistic sensitivity analyses were conducted using 5000 Monte‐Carlo simulations, generating confidence intervals of model outcomes.Results: We found that mean cost‐effectiveness of the bridge strategy is higher than the implant strategy.Conclusion: Implant as the first‐line strategy appears to be the ‘dominant’ strategy, considering the lower overall costs and the higher success rate.
Effect of a niobium‐containing titanium alloy on osteoblast behavior in culture
Authors: Shapira Lior , Klinger Avigdor , Tadir Anat , Wilensky Asaf , Halabi Amal 
Published: March 2009

AbstractBackground: The chemistry of titanium is a key factor in determining implant–tissue interactions. Reports that a vanadium‐based titanium alloy (Ti–6Al–4V) exhibits some cytotoxicity led to a search for an alternative.Aim: The aim of the present study was to investigate the behavior of human osteoblast‐like cells (Saos‐2) cultured on Ti–6Al–4V or Ti–6Al–7Nb disks with a rough or a machined surface.Results: In all four groups, the cells proliferated rapidly between days 1 and 3, and then plateaued. On day 1 of culture, the highest proliferation rate was of cells cultured on disks containing Nb with a machined surface. On day 7, there was no significant difference in cell density on all the tested surfaces. Alkaline phosphatase (ALP) activity was lower on the machined surfaces, regardless of the material used, suggesting that cells on rough surfaces exhibit a more mature phenotype. On day 3, cells cultured on rough disks made of Ti–6Al–7Nb showed the highest ALP activity; the lowest activity was observed on the machined Ti–6Al–4V surface. The highest level of osteocalcin (day 7) was found in the cells cultured on rough Ti–6Al–7Nb disks. Also, higher levels of transforming growth factor (TGFβ) were noted for cells cultured on the rough Ti–6Al–7Nb disks, suggesting that the Nb‐containing alloy supports more rapid maturation of the osteoblast.Conclusions: The results of the present study suggest that according to our cell culture preclinical model, Ti–6Al–7Nb may replace the Ti–6Al–4V alloy as an implant material.
Cumulative costs for the prosthetic reconstructions and maintenance in young adult patients with birth defects affecting the formation of teeth
Authors: Incici Erol , Matuliene Giedre , Hüsler Jürg , Salvi Giovanni E. , Pjetursson Bjarni , Brägger Urs 
Published: March 2009

AbstractObjectives: To assess retrospectively the cumulative costs for the long‐term oral rehabilitation of patients with birth defects affecting the development of teeth.Methods: Patients with birth defects who had received fixed reconstructions on teeth and/or implants ≥5 years ago were asked to participate in a comprehensive clinical, radiographic and economic evaluation.Results: From the 45 patients included, 18 were cases with a cleft lip and palate, five had amelogenesis/dentinogenesis imperfecta and 22 were cases with hypodontia/oligodontia. The initial costs for the first oral rehabilitation (before the age of 20) had been covered by the Swiss Insurance for Disability. The costs for the initial rehabilitation of the 45 cases amounted to 407,584 CHF (39% for laboratory fees). Linear regression analyses for the initial treatment costs per replaced tooth revealed the formula 731 CHF+(811 CHF × units) on teeth and 3369 CHF+(1183 CHF × units) for reconstructions on implants (P<.001). Fifty‐eight percent of the patients with tooth‐supported reconstructions remained free from failures/complications (median observation 15.7 years). Forty‐seven percent of the patients with implant‐supported reconstructions remained free from failures/complications (median observation 8 years). The long‐term cumulative treatment costs for implant cases, however, were not statistically significantly different compared with cases reconstructed with tooth‐supported fixed reconstructions. Twenty‐seven percent of the initial treatment costs were needed to cover supportive periodontal therapy as well as the treatment of technical/biological complications and failures.Conclusion: Insurance companies should accept to cover implant‐supported reconstructions because there is no need to prepare healthy teeth, fewer tooth units need to be replaced and the cumulative long‐term costs seem to be similar compared with cases restored on teeth.
Oral status among seniors in nine nursing homes in Styria, Austria
Authors: Gluhak Christine , Arnetzl Gerwin Vincent , Kirmeier Robert , Jakse Norbert , Arnetzl Gerwin 
Published: March 2009

doi:10.1111/j.1741‐2358.2009.00281.x

Oral status among seniors in nine nursing homes in Styria, Austria Objective:  To investigate the oral state in participants cared for in residences for senior citizens in Styria, Austria.Materials and methods:  Four hundred and nine participants in Styria from nine homes for senior citizens were examined employing parameters in accordance with those of Folstein’s Mini Mental Status (MMS), DMFT, basic periodontal examination, the modified oral hygiene index, pain experienced during the preceding year, the subjective and objective need for treatment, and also requirements involving surgical and prosthetic treatment. Furthermore, the habitual methods of maintaining oral hygiene were examined establishing by whom this was carried out – whether by the patient, the nurse, or by patient and nurse together.Results:  Four hundred and nine participants were examined, 48.3% were found to have retained on average 4.9 of their own teeth while 69% were fitted with dentures; however, 81% of the participants required prosthetic treatment. 28.9% of the participants had experienced acute dental pain during the preceding year and surgical treatment was found to be necessary in 47.7% of those with original teeth. Eighty‐four per cent of the participants showed acute inflammation of the periodontium while the state of oral hygiene, measured on a scale of 0–4, reached an average of 2.43. Oral hygiene was carried out by the nurses in only 7.46% of the cases which showed an average MMS measurement of 18.Conclusion:  The results compared with those reported in other recent surveys and our data show an urgent need in Austria to improve the standards in dental care for the hospitalised elderly. Regular dental checks, carried out in the actual home by a dental surgeon should be introduced, whilst the nursing staff should be made fully aware of the problems caused by insufficient oral care and receive regular support from specialised oral hygiene assistants. The results of this survey also suggest that nursing staff should be equipped with simple instruments in order to judge to the extent to which the patient is capable of carrying out oral care independently and then according to the results to supplement this with additional care.
Isolation and characterization of polymorphic microsatellites in the Potato Tuber Moth Tecia solanivora (Povolny, 1973) (Lepidoptera: Gelechiidae)
Authors: TORRES‐LEGUIZAMON M. , SOLIGNAC M. , VAUTRIN D. , CAPDEVIELLE‐DULAC C. , DUPAS S. , SILVAIN J.‐F. 
Published: March 2009

AbstractNine polymorphic microsatellite markers were isolated from Tecia solanivora, one of the most serious pests of potato tubers in Central and South America. As found in other studies of Lepidoptera, development of microsatellites is a difficult task: in our case, despite the large number of clones sequenced (796), of which 70 were unique, only nine loci were found to be both variable, and in Hardy–Weinberg equilibrium, No null alleles were detected. The loci were tested in three other co‐occurring Gelechiidae species, one of which was variable. These loci will be used to provide a greater understanding of the genetic changes occurring during the invasive process in this species.
The online Cough Clinic: developing guideline-based diagnosis and advice
Authors: Dettmar P. W. , Strugala V. , Fathi H. , Dettmar H. J. , Wright C. , Morice A. H. 
Published: March 2009

The aim of the present study was make chronic cough guidelines more practical and user friendly by developing an internet-based interactive diagnostic questionnaire for chronic cough.A prospective cohort study of chronic cough sufferers was conducted in the UK, following European Respiratory Society guidelines for the diagnosis and management of chronic cough. Depending on the response to 16 specific questions, the medical condition responsible for the patient's chronic cough was ascertained according to a predetermined diagnostic algorithm designed to differentiate the three common causes of chronic cough. Appropriate advice and treatment recommendations were then provided.8,546 adults with chronic cough completed the Cough Clinic diagnostic questionnaire. 46.1% were suggested to have reflux, 38.7% asthma and 15.2% rhinitis. Participants found the website easy to use (94%), the advice helpful (73%) and that it helped them to communicate with their general practitioner better (60%), and 62% reported taking the recommended treatment.The Cough Clinic, an internet-based diagnostic site for chronic cough, had a large uptake by chronic cough sufferers in the UK. Almost half were diagnosed as having reflux as the probable cause of their chronic cough. Internet diagnosis by expert algorithm provides a novel mechanism for patients to access guideline-recommended therapies and enhances dialogue between patients and physicians.
Evaluating noninvasive ventilation using a monitoring system coupled to a ventilator: a bench-to-bedside study
Authors: Rabec C. , Georges M. , Kabeya N. K. , Baudouin N. , Massin F. , Reybet-Degat O. , Camus P. 
Published: March 2009

Empirically determined noninvasive ventilation (NIV) settings may not achieve optimal ventilatory support. Some ventilators include monitoring modules to assess ventilatory quality. We conducted a bench-to-bedside study to assess the ventilatory quality of the VPAPTMIII-ResLinkTM(ResMed, North Ryde, Australia).We tested the accuracy of minute ventilation (MV) and leak calculations given by VPAPTMIII-ResLinkTMcompared to those measured by a bench model at varied leak levels and ventilator settings. We systematically assessed NIV efficacy using this system from 2003 to 2006. Ventilation was considered inadequate if leak (>24 L·min−1), continuous desaturation (>30% of the trace) or desaturation dips (>3%) were present.On the bench test, both methods were highly correlated (r = 0.947, p>0.0001 and r = 0.959, p<0.0001 for leak and MV, respectively). We performed 222 assessments in 169 patients (aged 66.42±16 yrs, 100 males). Abnormalities were detected on 147 (66%) out of 222 occasions. Leak was the most common abnormality (34.2%) followed by desaturation dips (23.8%). The most effective therapeutic solutions were a chin strap if leak was detected (61.2%) and expiratory positive airway pressure increase for desaturation dips (59.5%). In 15.7% of cases, when abnormalities persisted, a polygraphy was performed.The systematic use of this device enables NIV to be optimised, limiting the indication of sleep studies to complex cases.
Estrogen Receptor β Is Required for Optimal cAMP Production in Mouse Granulosa Cells
Authors: Deroo Bonnie J. , Rodriguez Karina F. , Couse John F. , Hamilton Katherine J. , Collins Jennifer B. , Grissom Sherry F. , Korach Kenneth S. 
Published: March 2009

AbstractGranulosa cells of preovulatory follicles differentiate in response to FSH, and this differentiation is augmented by estradiol. We have previously shown that FSH-mediated granulosa cell differentiation requires functional estrogen receptor-β (ERβ) by demonstrating that the granulosa cells of ERβ−/− FSH-treated mice are unable to maximally induce expression of the LH receptor (an indicator of granulosa cell differentiation) compared with ERβ+/+ controls. As a result, FSH-primed ERβ−/− granulosa cells exhibit a reduced response to a subsequent ovulatory dose of LH. In this study, we further characterized the attenuated response of ERβ−/− granulosa cells to stimulation by LH and FSH using isolated mouse granulosa cells and primary granulosa cell cultures. We observed a 50% reduction in cAMP levels in cultured ERβ−/− granulosa cells exposed to LH compared with ERβ+/+ controls. We also observed an attenuated genomic response in granulosa cells isolated from FSH-primed ERβ−/− mice compared with ERβ+/+ controls. Our data indicate that this attenuated response may result from inadequate levels of cAMP, because cAMP levels in cultured ERβ−/− granulosa cells exposed to forskolin were approximately 50% lower than in ERβ+/+ granulosa cells. Phosphorylation of cAMP regulatory element binding protein, an indicator of protein kinase A activity, was also reduced in FSH-treated ERβ−/− granulosa cells compared with ERβ+/+ controls. These are the first data to indicate that ERβ plays a role in the induction of the cAMP pathway in mouse granulosa cells and that disruption of proper ERβ signaling associated with this pathway may cause negative effects on ovulation and fertility.
Efficient calculation of the inertia terms in floating frame of reference formulations for flexible multibody dynamics
Authors: Lugrís U , Naya M A , Luaces A , Cuadrado J 
Published: March 2009

One of the characteristics of floating frame of reference (FFR) formulations for flexible multibody dynamics is the fact that the inertia terms are highly non-linear. At every time-step, both the mass matrix and the velocity-dependent forces vector must be updated, and this can become the most CPU intensive task. This work studies the efficiency of two different methods for performing this operation, when applied to both a formulation in absolute coordinates and another in relative coordinates. The first method calculates the inertia terms by projecting the finite element (FE) mass matrix into the generalized coordinates, by means of a variable projection matrix. The second one calculates the inertia shape integrals at a preprocessing stage and uses them for obtaining the inertia terms in a more efficient way, at the cost of a more involved implementation. Both methods have been tested when used in combination with either the FFR absolute or relative formulation, by simulating a vehicle with 12 flexible elements. The results show that the performance can be considerably increased by means of the preprocessing method, especially in the case of large FE models, whereas, for small models, the projection method can be more convenient due to its simplicity.