bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adolescent endometriosis in the Waikato region of New Zealand – A comparative cohort study with a mean follow‐up time of 2.6 years
Authors: ROMAN Jose D 
Published: April 2010

Study objective:  To describe our experience with laparoscopic excision of endometriosis on an adolescent population and to compare it with a non‐adolescent population treated during the same period.Design:  Comparative cohort study of patients with endometriosis treated consecutively between July 2003 and January 2009 with a follow‐up between six months and six years.Setting:  Braemar Hospital, Hamilton, New Zealand.Results:  We treated 20 adolescents. Ninety‐five per cent (19/20) of adolescents were using pain relief other than Paracetamol, in contrast to only 59% (84/143) of non‐adolescents. Thirty per cent (6/20) of adolescents had a first‐degree relative with endometriosis, in contrast to 8% (11/143) of non‐adolescents. Endometriosis was found to be stage I in 40% (8/20) of patients, stage II in 45% (9/20) of patients, stage III in 5% (1/20) of patients and stage IV in 10% (2/20) of patients. The main type of endometriotic lesion in the adolescent was an atypical red vascular lesion, which was present in 60% (12/20) of adolescents; but it was present in only 20% (29/143) of non‐adolescents. There were no intra‐operative complications. Minor postoperative complications included one case of urinary tract infection and one case of port infection. The operative complications that developed when treating the non‐adolescent group are presented for comparison. Pain scores recorded at follow‐up revealed a significant reduction in dysmenorrhoea and pelvic pain and there was a positive effect on the quality of life of adolescents as measured by the EQ‐5D questionnaire tool.Conclusion:  Adolescents with endometriosis use significantly more pain relief than non‐adolescents to control symptoms. They have a higher rate of a first degree relative with the disease and they present with more atypical endometriotic lesions when compared with an adult population with endometriosis. All the stages of disease are present in the adolescent, including stages III and IV. The laparoscopic excision of endometriosis has a positive effect on the relief of pain symptoms and on the improvement in quality of life in the adolescent.
Blood Glucose Control in the Intensive Care Unit: Benefits and Risks
Authors: Gunst Jan , Van den Berghe Greet 
Published: April 2010

AbstractAbnormal blood glucose levels are common during critical illness and are associated with outcomes that correspond to a J‐shaped curve, the lowest risk associated with normoglycemia. Three proof‐of‐concept randomized‐controlled‐trials performed in the surgical, medical, and pediatric intensive care units of the Leuven University Hospital in Belgium demonstrated that maintaining strict age‐adjusted normal fasting levels of glycemia (80–110 mg/dl in adults, 70–100 mg/dl in children, 50–80 mg/dl in infants) with intensive insulin therapy reduced morbidity and mortality as compared with tolerating stress hyperglycemia as a potentially beneficial response. Recently, concern has risen about the safety of this intervention, as a multicenter adult study reported an, as yet unexplained, increased mortality with targeting normoglycemia as compared with an intermediate blood glucose level of around 140 mg/dl. This apparent contradiction may be explained by several methodological differences among studies, comprising, among others, different glucose target ranges in the control groups, different feeding policies, and variable accuracy of tools used for glucose measurement and insulin infusion. Hence, efficacy and safety of intensive insulin therapy may be affected by patient‐related and ICU setting‐related variables. Therefore, no single optimal blood glucose target range for ICU patients can be advocated. It appears safe not to embark on targeting “age‐normal” levels in intensive care units (ICUs) that are not equipped to accurately and frequently measure blood glucose, and have not acquired extensive experience with intravenous insulin administration using a customized guideline. A simple fallback position could be to control blood glucose levels as close to normal as possible without evoking unacceptable blood glucose fluctuations, hypoglycemia, and hypokalemia.
ASDIN: Percutaneous Retrieval of an Intravascular Fluency Stent‐Graft Using a Rigid Alligator Forceps: Case Report
Authors: Alomari Ahmad I. 
Published: April 2010

AbstractThe author reports a case of a successful retrieval of a stent‐graft in a young patient with a femoral dialysis graft. The stent‐graft was used to treat a resistant occluded segment of the arterial limb of the graft. However, the stent‐graft was inadvertently deployed partially into the superficial femoral artery. The stent‐graft was successfully retrieved utilizing a rigid alligator forceps. The resulting dissection/thrombosis of the artery was managed successfully with transcatheter thrombolysis and the function of the dialysis graft was restored.
A Quality Improvement Model for Optimizing Care of the Diabetic End‐Stage Renal Disease Patient
Authors: Mahnensmith Rex L. , Zorzanello Mary , Hsu Yueh‐Han , Williams Mark E. 
Published: April 2010

AbstractPersons with diabetes mellitus whose kidney disease progresses to end‐stage requiring dialysis have poorer outcomes compared to nondiabetic patients who commence maintenance dialysis. In the diabetic patient without renal failure, sustained strict glycemic, lipid, and blood pressure (BP) control can retard or thwart diabetic complications such as retinopathy, neuropathy, coronary disease, and peripheral vascular disease. Achieving these outcomes requires multidisciplinary collaborative care. Best care of the diabetic person requires a dedicated clinician who knows the patient well, who closely follows the course of clinical problems, who provides frequent assessments and interventions, and who also directs care to other agencies, clinics, and specialized clinicians who provide expert focused evaluations and interventions aimed at specific clinical concerns. Diabetic patients who reach end‐stage renal disease (ESRD) have even greater clinical need of a dedicated principal care clinician than the diabetic patient who has minimal or moderate kidney disease. The diabetic patient with ESRD exhibits greater fluctuations in glucose and BP due to dialysis‐related diet patterns and fluid balances and has more active cardiovascular problems due to the combined influences of calcium, phosphorus, and lipid imbalances. These problems warrant exceptional care that includes frequent surveillance and monitoring with timely interventions if patient outcomes are to be improved. We present here a quality improvement model for optimizing care of the diabetic dialysis patient that relies on a dedicated practitioner who can evaluate and intervene on the multiple variables within and beyond the dialysis clinic that impact the patient’s health. We present three detailed clinical care pathways that the dedicated clinician can follow. We believe that patient outcomes can be improved with this approach that provides customized problem‐focused care, collaborates with the dialysis‐provider team, and extends and directs diabetic self‐care, home‐care, and specialized clinical care in the challenging areas of cardiac and peripheral vascular disease, glycemic control, lipid control, infection prevention, and BP management.
The Influence of Operational Protocol on the Fluid Dynamics in the 12 cc Penn State Pulsatile Pediatric Ventricular Assist Device: The Effect of End‐Diastolic Delay
Authors: Cooper Benjamin T. , Roszelle Breigh N. , Long Tobias C. , Deutsch Steven , Manning Keefe B. 
Published: April 2010

AbstractThe success of adult ventricular assist devices (VADs), coupled with the high transplant waiting list mortality of infants (40%) has prompted Penn State to develop a pediatric version of the clinically successful adult device. Although the primary use of this device will be bridge‐to‐transplant, there has been sufficient clinical data to demonstrate the efficacy of VADs in a bridge‐to‐recovery setting. However, removing the patient from the device, a process known as weaning, demands operation of the device at a lower beat rate and concomitant increased risk for thromboembolism. Previous studies have shown that the interrelated flow characteristics necessary for the prevention of thrombosis in a pulsatile VAD are a strong inlet jet, a late diastolic recirculating flow, and a wall shear rate greater than 500/s. In an effort to develop a strong inlet jet and rotational flow pattern at a lower beat and flow rate, we have compressed diastole by altering the end‐diastolic delay time (EDD). Particle image velocimetry was used to compare the flow fields and wall shear rates in the chamber of the 12 cc Penn State pulsatile pediatric VAD operated at 50 beats per minute using EDDs of 10, 50, and 100 ms. Although we expected the 100 ms EDD to have the best wall shear profiles, we found that the 50 ms EDD condition was superior to both the 10 and 100 EDD conditions, due to a longer sustained inlet jet.
Quantitative Analysis of Human Platelet Adhesions Under a Small‐Scale Flow Device
Authors: Furukawa Katsuko S. , Nakamura Keigo , Onimura Yuji , Uchida Masaki , Ito Atsuo , Yamane Takashi , Tamaki Tamotsu , Ushida Takashi , Tateishi Tetsuya 
Published: April 2010

AbstractTo realize real‐time evaluation of human platelet adhesions onto material surfaces with small volumes of human platelet suspensions, we developed an apparatus consisting of a modified cone and plate‐type viscometer, combined with an upright epi‐fluorescence microscope. The apparatus allowed real‐time evaluation of platelet–material interactions and the initial event of thrombus formation, using small platelet suspension volumes (7.5 µL) under shear flow conditions. To study the dynamic behavior of platelet–material interaction, we chose five representative opaque and transparent materials: acrylate resin (AC), polytetrafluoroethylene (PTFE), polyvynylchrolide (PVC), glass, and a monolayer of human normal umbilical cord vein endothelial cells (EC) on glass under shear flow conditions. The values of adhesiveness of human platelets to the test materials in descending order were as follows: AC > PTFE > PVC > glass > human EC. Under this new small‐scale flow system, we could obtain highly reproducible data, which were comparable with results from a previously developed large‐scale flow system. Therefore, the newly developed cone and plate‐type rheometer is a useful instrument for testing and screening materials, and allows precise quantitative evaluation of human platelet adhesion.
The Characterization of Contractile and Myoelectric Activities in Paralyzed Tibialis Anterior Post Electrically Elicited Muscle Fatigue
Authors: Yu Nan‐Ying , Chang Shao‐Hsia 
Published: April 2010

AbstractThis study aimed to understand the myoelectric and mechanical characteristics of muscle recovering from electrically elicited fatigue. A modified Burke fatigue protocol was delivered to activate the tibialis anterior of 13 spinal cord injured subjects for 4 min. Before and after the fatigue protocol, a series of pulse trains was delivered to induce three twitches and a fused contraction at 0, 1, 3, and 5 min and then followed every 5 min for 60 min. The recovery processes of the ankle dorsiflexion torque and the evoked electromyography (EMG) parameters were analyzed and characterized by a first‐order exponential equation. The recovery process was found to be faster in regard to tetanic muscle contraction. Factors relating to low‐frequency fatigue, postfatigue potentiation, and the quickly normalized relaxation rate were taken into account for the discussion of this result. During the recovery process, the disassociation was found not only between twitch and tetanic contractions but also between mechanical and myoelectric activities. After the complete normalization of EMG parameters from about 15 min post fatigue, the tetanic force recovered incompletely to an asymptotic level.
Experimental Investigation of Pulsatility Effect on the Deformability and Hemolysis of Blood Cells
Authors: Kang Yang Jun , Kim Myoung Gon , Son Kuk Hui , Lim Choon Hak , Son Ho Sung , Yoon Sang Youl , Kwon Hyuk Sang , Yang Sung 
Published: April 2010

AbstractIn this study, we investigated the differences between pulsatile cardiopulmonary bypass (CPB) procedure and nonpulsatile CPB procedure in terms of their effects on hemolysis and deformability of red blood cells (RBCs) under various shear stress conditions. In order to research the effects on hemolysis and deformability, four parameters—free hemoglobin (fHb) concentration, normalized index of hemolysis (NIH), deformability index (DI) of RBCs, and elongation index of RBCs—have been deeply investigated. For these investigations, two randomly assigned adult mongrel dog groups—nonpulsatile group (NP, n = 6) and pulsatile group (P, n = 6)—were examined. According to our results, both types of perfusion did not show any statistical differences in terms of the concentrations of fHb as well as NIH. In addition, there were no significant differences in RBC deformability between perfusion types within an operation time of 3 h. Therefore, our studies suggest that pulsatile perfusion has no significant difference from nonpulsatile perfusion in terms of hemolysis and deformability of RBCs.
“A Transcript of Actual Life”: Headache in the Novels of Jane Austen
Authors: Larner Andrew J. 
Published: April 2010

(Headache 2010;50:692‐695)References to headache in the novels of Jane Austen have been examined. Nine characters, all female, suffer headache at one time or another, often in association with emotionally stressful situations. As an authorial device, headache may have served Jane Austen as a culturally sanctioned form of bodily expression.
Communications skills in dental education: a systematic research review
Authors: Carey J. A. , Madill A. , Manogue M. 
Published: April 2010

AbstractCommunication is an essential element of the relationship between patient and dentist. Dental schools are required to ensure that undergraduates are adequately trained in communication skills yet little evidence exists to suggest what constitutes appropriate training and how competency can be assessed. This review aimed to explore the scope and quality of evidence relating to communication skills training for dental students. Eleven papers fitted the inclusion criteria. The review found extensive use amongst studies of didactic learning and clinical role‐play using simulated patients. Reported assessment methods focus mainly on observer evaluation of student interactions at consultation. Patient involvement in training appears to be minimal. This review recommends that several areas of methodology be addressed in future studies, the scope of research extended to include intra‐operative communication, and that the role of real patients in the development of communication skills be active rather than passive.
Clinical teaching in restorative dentistry and the variation between students’ and supervisors’ perceptions of its effectiveness
Authors: Polyzois I. , McLouglin J. , Kelly A. , Claffey N. 
Published: April 2010

AbstractObjectives:  To investigate if there was an agreement between the students and supervisors on the quality of clinical teaching in Restorative Dentistry in the Dublin Dental School and Hospital and to identify differences on how effective clinical teaching is perceived between three academic years. In addition it aimed to identify the existence of any similarities between students’ and supervisors’ perceptions of specific teaching behaviours that are most and least helpful in learning.Materials and methods:  An anonymous questionnaire based on the above objectives was distributed to three cohorts of undergraduate students and three cohorts of clinical supervisors. The response rate was 94% for the first, 94% for the second and 63% for the third student cohort. Twenty‐one (21) out of the 36 supervisors returned the questionnaire. Basic analysis of the clinical questionnaire was carried out in order to find the distributions of the variables between the groups. These distributions were compared using a non‐parametric analysis (Kruskal–Wallis). The degree of association was measured by the Pearson’s chi‐square values.Results:  Students from all 3 years reported to be neither very satisfied nor very dissatisfied with their clinical teaching with a few statistically significant differences across the 3 years. The supervisors on the other hand, replied with a great deal of similarity across the 3 years. Furthermore, supervisors gave a high degree of straight line responses and generally felt very good about the level of clinical teaching. There was a high degree of variability in what the supervisors thought was important but also a high degree of similarity in what they thought wasn’t helpful. It was exactly the opposite for the students.Conclusions:  There is a limited agreement between students and staff on the effectiveness of clinical teaching and the way effectiveness is perceived between students and clinical supervisors as well as between senior and more junior students. Overall though students and supervisors rated the clinical teaching favourably but indicated several areas of concern.
Comparison of dental education and professional development between mainland China and North America
Authors: Wu Z.Y. , Zhang Z.Y. , Jiang X.Q. , Guo L. 
Published: April 2010

AbstractDifferent educational and professional developments within the dental field create different sets of missions, norms, and practices regarding dental diseases and their appropriate treatment. This review has addressed differences in dental education and professional development between mainland China and North America. Many factors influence the choice of model and it is very difficult to predict which model will become predominant. However, there is growing sentiment that the independent faculty model in North America is logical and superior to the model, which ‘integrates’ dental and medical education in mainland China.Many North America dental schools place a high priority on preclinical and clinical training in the curriculum in order to expose students to patient oral health needs and systemic dental problems much earlier than in mainland China. North America dental schools promote and embrace students self‐learning skills by the use of PBL, CRL, and TRAD education methodologies and new e‐based technologies and approaches whereby students learn rather than are taught. In mainland China, the traditional lecture‐based format is still employed in the majority of dental schools; however, strategies to enhance students self‐learning skills is increasingly utilised in most well‐known Chinese dental schools.The Chinese dental education model, which treats dentistry as a sub‐specialty of medicine, has brought about fundamental differences, with the dentist functioning essentially as a stomatologist. For example, China has built up a large oral and maxillofacial surgery society, and craniofacial surgery is performed to a much broader extent by Chinese dentists than by most North American counterparts.In North America, dentists engage in full‐time work, attend continuing training/education programmes, belong to an association, gain legal status, and construct a code of ethics emphasising the quality of care delivered to the public. Currently, continuing dental education in North America is available through a variety of venues involving licensing authorities, universities and private programmes. The concept of professional development in mainland China is relatively new and is still considered primarily in the context of promotion or achieving a higher professional title. Mandatory continuing dental professional education requirements do not guarantee the competence of members of the profession. Today, the Chinese government and society place increasing emphasis upon the accountability of self‐regulating professions.Rather than attempting to summarise the current scope of dental education and professional development between mainland China and North America, this paper hopes to enhance mutual understanding, and promote greater academic exchanges in dental education.
Attitudes of Irish dental graduates to vocational training
Authors: McKenna G. , Burke F. , O’Sullivan K. 
Published: April 2010

AbstractIntroduction:  Vocational training (VT) is a mandatory 12 month period for UK dental graduates after graduation. Graduates of Irish Dental Schools are eligible to enter the general dental service in Ireland or obtain an NHS performers list number in the UK immediately after qualification. Reports would suggest that some graduates of Irish Dental Schools are choosing to take part in VT in the UK and find the experience beneficial. This study aimed to record the uptake of VT amongst recent graduates from University College Cork and to document their experiences. It was designed to compare the attitudes and experiences of graduates of Irish Dental Schools who undertook VT compared with those who entered the general dental service.Method:  A self‐completion questionnaire was distributed by e‐mail to dental graduates from University College Cork who had graduated 2001–2007. Responses were returned by e‐mail or post.Results:  The response rate was 68.9%. There has been an increase in the numbers of graduates taking part in VT each year since 2004. 92.5% of Vocational Dental Practitioners (VDPs) found their experience beneficial as they received a guaranteed source of income, had a supportive peer network and worked in a positive learning environment. However, some felt that they earned a lower income than their associate colleagues, others found the pace of practice slow and that the duration of the training period was excessive. Eighty‐five per cent of VDPs would choose the same position again after graduation as compared with 61.8% of associates (P < 0.001). Ninety per cent of VDPs would advise current undergraduates to take part in VT as compared with 51% of associates (P < 0.001). A larger proportion of VDPs had taken part in postgraduate studies but there was no significant difference between the two groups.Conclusions

Larger proportions of recent graduates are undertaking vocational training
The majority of VDPs and associates find their initial employment position beneficial
VDPs benefit from a guaranteed source of income, a supportive peer network and a positive learning environment
Some associates suffered from a lack of support, feeling isolated and overwhelmed with patients
The majority of previous VDPs and associates would recommend VT to current undergraduates
Almost 40% of associates would now choose to take part in VT if given the opportunity.
Integration of medicine and basic science in dentistry: the role of oral and maxillofacial surgery in the pre‐doctoral dental curriculum
Authors: Dennis Matthew J. 
Published: April 2010

AbstractIt is the premise of this paper that the need for medical and basic science instruction in dentistry will increase over time. However, student and faculty appreciation of the relevance and significance of medicine and basic science to clinical dentistry has been elusive, largely due to difficulties linking biomedical science instruction and clinical dental instruction. The scope of traditional procedure based oral surgery instruction can be expanded in an attempt to bridge the medical science‐clinical gap. Topics such as health status evaluation, medical risk assessment, and a variety of other biomedical issues can be presented to students in a way which imparts specific dental meaning to basic medical science in real‐life clinical situations. Using didactic and chair side instruction in an oral surgery clinical environment, students are confronted with the need to understand these issues and how they relate to the patients they encounter who present for dental care.