bluuebunny/crossref_metadata_2025_split huggingface dataset:
Facility‐Level Variation in Potentially Inappropriate Prescribing for Older Veterans
Authors: Gellad Walid F. , Good Chester B. , Amuan Megan E. , Marcum Zachary A. , Hanlon Joseph T. , Pugh Mary Jo V. 
Published: June 2012

ObjectivesTo describe facility‐level variation in two measures of potentially inappropriate prescribing prevalent in Veterans Affairs (VA) facilities—exposure to high‐risk medications in elderly adults (HRME) and drug–disease interactions (Rx‐DIS)—and to identify facility characteristics associated with high‐quality prescribing.DesignCross‐sectional.SettingVA Healthcare System.ParticipantsVeterans aged 65 and older with at least one inpatient or outpatient visit in 2005–2006 (N = 2,023,477; HRME exposure) and a subsample with a history of falls or hip fractures, dementia, or chronic renal failure (n = 305,059; Rx‐DIS exposure).MeasurementsIncident use of any HRME (iHRME) and incident Rx‐DIS (iRx‐DIS) and facility‐level rates and facility‐level predictors of iHRME and iRx‐DIS exposure, adjusting for differences in patient characteristics.ResultsOverall, 94,692 (4.7%) veterans had iHRME exposure. At the facility level, iHRME exposure ranged from 1.6% at the lowest facility to 12.8% at the highest (median 4.7%). In the subsample, 9,803 (3.2%) veterans had iRx‐DIS exposure, with a facility‐level range from 1.3% to 5.8% (median 3.2%). In adjusted analyses, veterans seen in facilities with formal geriatric education had lower odds of iHRME (odds ratio (OR) = 0.86, 95% confidence interval (CI) = 0.77–0.96) and iRx‐DIS (OR = 0.95, 95% CI = 0.88–1.01). Patients seen in facilities caring for fewer older veterans had greater odds of iHRME (OR = 1.54, 95% CI = 1.35–1.75) and iRx‐DIS exposure (OR = 1.22, 95% CI = 1.11–1.33).ConclusionSubstantial variation in the quality of prescribing for older adults exists across VA facilities, even after adjusting for patient characteristics. Higher‐quality prescribing is found in facilities caring for a larger number of older veterans and facilities with formal geriatric education.
The RPH Clasp Assembly: A Simple Alternative to Traditional Designs
Authors: Nazarova Elena , Taylor Thomas D. 
Published: June 2012

AbstractOne of the popular designs for the distal extension partial removable dental prosthesis is the RPI clasp assembly. A modification of the RPI clasp assembly is introduced. It incorporates a mesial rest (R), proximal plate (P), and a horizontal retentive arm (H—RPH). This clasp assembly provides benefits of the RPI clasp and can be used in clinical situations where the RPI clasp is contraindicated.
Influence of Implant Abutment Angulations and Two Types of Fibers on the Fracture Resistance of Ceramage Single Crowns
Authors: Ellakwa Ayman , Martin F. Elizabeth , Klineberg Iven 
Published: June 2012

AbstractPurpose: To assess the effect of three implant abutment angulations and two types of fibers on the fracture resistance of overlaying Ceramage single crowns.Materials and Methods: Three groups, coded A to C, with different implant abutment angulations (group A/0°, group B/15°, and group C/30° angulation) were restored with 45 overlay composite restorations; 15 Ceramage crowns for each angulation. Groups A, B, and C were further subdivided into three subgroups (n = 5) coded: 1, crowns without fiber reinforcement; 2, crowns with Connect polyethylene reinforcement; and 3, crowns with Interlig glass reinforcement. All crowns were constructed by one technician using the Ceramage System. The definitive restorations (before cementation) were stored in distilled water at mouth temperature (37°C) for 24 hours prior to testing. Before testing, the crowns were cemented using Temp Bond. The compressive load required to break each crown and the mode of failure were recorded. The speed of testing was 1 mm/min. The results were statistically analyzed by two‐way ANOVA (p < 0.05). The tested crowns were examined using a stereomicroscope at 40×, and selected crowns (five randomly selected from each group) were further examined by scanning electron microscopy (SEM) to reveal the composite–fiber interface.Results: Fracture resistance of single crowns was not affected (p > 0.05) by the different abutment angulations chosen (0°, 15°, 30°) or fiber reinforcement (Connect and Interlig fibers). Crowns in group A exhibited average loads to fracture (N) of A1 = 843.57 ± 168.20, A2 = 1389.20 ± 193.40, and A3 = 968.00 ± 387.53, which were not significantly different (p > 0.05) from those of groups B (B1 = 993.20 ± 327.19, B2 = 1471.00 ± 311.68, B3 = 1408.40 ± 295.07), or group C (C1 = 1326.80 ± 785.30, C2 = 1322.20 ± 285.33, C3 = 1348.40 ± 527.21). SEM images of the fractured crowns showed that the origin of the fracture appeared to be located at the occlusal surfaces of the crowns, and the crack propagation tended to extend from the occlusal surface towards the gingival margin.Conclusions: Implant abutment angulations of 0°, 15°, and 30° did not significantly (p > 0.05) influence the fracture resistance of overlaying Ceramage single crowns constructed with or without reinforcing fibers. The two types of fibers used for reinforcement (Connect and Interlig) had no effect (p > 0.05) on the fracture resistance of overlaying Ceramage single crowns.
Three‐Dimensional Finite Element Analysis of Custom‐Made Ceramic Dowel Made Using CAD/CAM Technology
Authors: Yousif Marghalani Thamer , Tharwat Hamed Mohamed , Abdelmageed Awad Mohamed , Hussein Naguib Ghada , Fouad Elragi Ahmed 
Published: June 2012

AbstractPurpose: This study compares the stress distribution in the structure of a loaded endodontically treated maxillary extracted canine restored with either custom‐made zirconia (Cercon) or cast gold dowel and core.Materials and Methods: Standard treatments were implemented to prepare the gutta‐percha‐filled root canal and dowel space. The tooth along with the dowel and core fabricated pattern resin were prepared to receive an all‐ceramic (Cercon) crown. An impression was made for the tooth preparation with the zirconia milled dowel and core in place to fabricate the Cercon crown using CAD/CAM. The restored canine was scanned, and from the scan two models were constructed with the surrounding ligament and bone. Three‐dimensional finite element elastic analysis was then carried out for the stress distribution within the different regions of the two models due to a concentrated force of 100 N applied at the mid‐lingual area. Analyses were made for three load angulations, vertical, buccolingual horizontal, and an in‐between oblique force at 45o. Each region of the models was assumed isotropic and homogeneous. The two restored canines with zirconia and gold were compared in terms of the resulting maximum tensile, compressive, and Von Mises stresses.Results: Generally, there were no significant differences in the maximum stresses in most regions for both models. Von Mises stresses for zirconia dowel and core was 8.966 MPa and for cast gold dowel and core was 8.752 MPa. The maximum tensile stress for zirconia dowel and core was 9.326 MPa, and for cast gold dowel and core was 8.166 MPa.Conclusions: The present work validates the use of CAD/CAM zirconia material for ceramic dowel and cores. Clinical implications: CAD/CAM Zirconia can be used for a custom‐made dowel and core in an esthetically demanding zone as an esthetic replacement for a metal cast dowel and core when restoring endodontically treated teeth.
An Alternative Approach in Fabrication of Fixed Complete Dentures Using a Duplicate Denture
Authors: Afshari Fatemeh S. , Hallas Matthew B. , Knoernschild Kent L. 
Published: June 2012

AbstractThe traditional prosthetic steps in the fabrication of a fixed complete denture after implant osseointegration include final impression, verification of implant positioning in the working cast, mounting of the working cast, and mock denture wax trial insertion prior to the laboratory fabrication of the metal substructure; however, in patient scenarios of immediate loading of implants, the interim conversion prosthesis can be used to advance from the final impression to the milling of the underlying framework in one appointment. Consistency in the initial wax trial insertion, radiographic guide, and intraoral positioning of the conversion prosthesis can result in a well‐designed definitive prosthesis in less time with the use of the existing duplicate complete denture.
A Comparative In Vitro Study of Two Denture Cleaning Techniques as an Effective Strategy for Inhibiting Candida albicans Biofilms on Denture Surfaces and Reducing Inflammation
Authors: Ramage Gordon , Zalewska Adriana , Cameron Donald A. , Sherry Leighann , Murray Colin , Finnegan Mary Beth , Loewy Zvi G. , Jagger Daryll C. 
Published: June 2012

AbstractPurpose: Candida albicans is the predominant oral yeast associated with denture‐induced stomatitis, and with an increasing population of denture wearers its incidence is increasing. Maintaining good oral and denture hygiene, through chemical and/or mechanical intervention, is essential to reducing this disease. The aim of this study, using a robust adherent C. albicans cell model system, was to evaluate and compare the efficacy of a novel denture cleanser to the efficacy of a commonly used dentifrice coupled with brushing.Materials and Methods: Four C. albicans strains isolated from individuals diagnosed as having denture‐induced stomatitis, were adhered to denture acrylic resin sections (1 cm2 by 1 mm thickness) and after 4 hours of growth, challenged daily sequentially for 4 days with a denture cleanser (Polident) or intermittently with denture cleanser (day 1), then dentifrice (Colgate Cavity Protection Toothpaste) and brushing (days 2 and 3) and denture cleanser (day 4). Colony forming units were evaluated for each treatment, as were the levels of regrowth. Scanning electron microscopy (SEM) was also performed. Microbial susceptibility testing and time‐kill studies were performed on biofilms. A coculture model was also used to assess interleukin‐8 (IL‐8) production from treated biofilms.Results: It was shown that sequential treatment with the denture cleanser killed and inhibited regrowth each day. Intermittent treatment showed that viable C. albicans biofilms were only retained rather than being dispersed, which could be visualized by SEM. Time‐kill studies demonstrated that the novel denture cleanser was highly active and killed quickly, unlike the dentifrice. IL‐8 was expressed in greater levels in 24‐hour biofilms than in 4‐hour biofilms, but treatment with denture cleanser reduced IL‐8 output.Conclusions: The data indicate that maintaining good oral health for denture wearers requires daily use of a denture cleanser rather than an alternating regimen. The inability of the denture cleanser to sterilize during intermittent treatments demonstrates the difficulty in controlling established biofilm. Moreover, the presence of mature biofilm may result in high levels of inflammation, but this can be controlled through denture cleansing.
Residual Thermal Stress Simulation in Three‐Dimensional Molar Crown Systems: A Finite Element Analysis
Authors: Bonfante Estevam A , Rafferty Brian T. , Silva Nelson R.F.A. , Hanan Jay C. , Rekow Elizabeth Dianne , Thompson Van P. , Coelho Paulo G. 
Published: June 2012

AbstractPurpose: To simulate coefficient of thermal expansion (CTE)‐generated stress fields in monolithic metal and ceramic crowns, and CTE mismatch stresses between metal, alumina, or zirconia cores and veneer layered crowns when cooled from high temperature processing.Materials and Methods: A 3D computer‐aided design model of a mandibular first molar crown was generated. Tooth preparation comprised reduction of proximal walls by 1.5 mm and of occlusal surfaces by 2.0 mm. Crown systems were monolithic (all‐porcelain, alumina, metal, or zirconia) or subdivided into a core (metallic, zirconia, or alumina) and a porcelain veneer layer. The model was thermally loaded from 900°C to 25°C. A finite element mesh of three nodes per edge and a first/last node interval ratio of 1 was used, resulting in approximately 60,000 elements for both solids. Regions and values of maximum principal stress at the core and veneer layers were determined through 3D graphs and software output.Results: The metal‐porcelain and zirconia‐porcelain systems showed compressive fields within the veneer cusp bulk, whereas alumina‐porcelain presented tensile fields. At the core/veneer interface, compressive fields were observed for the metal‐porcelain system, slightly tensile for the zirconia‐porcelain, and higher tensile stress magnitudes for the alumina‐porcelain. Increasingly compressive stresses were observed for the metal, alumina, zirconia, and all‐porcelain monolithic systems.Conclusions: Variations in residual thermal stress levels were observed between bilayered and single‐material systems due to the interaction between crown configuration and material properties.
Nanoparticle Loading Level and Properties of Experimental Hybrid Resin Luting Agents
Authors: Habekost Luciano V. , Camacho Guilherme B. , Lima Giana S. , Ogliari Fabrício A. , Cubas Glória B. , Moraes Rafael R. 
Published: June 2012

AbstractPurpose: This study investigated the influence of nanoparticle loading level on properties of experimental hybrid resin luting agents.Materials and Methods: Silanated 2‐μm barium borosilicate glass microparticles and 7‐nm silica nanoparticles were used. Five materials were obtained by loading a photocurable Bis‐GMA/TEGDMA co‐monomer with a total mass fraction of 60% inorganic fillers. The mass fraction of nanoparticles was set at 0% (control), 1% (G1), 2.5% (G2.5), 5% (G5), or 10% (G10). The properties evaluated were flexural strength (σ) and modulus (Ef), Knoop hardness number (KHN), and film thickness (FT). Dispersion/interaction of the particles with the resin phase was assessed by scanning electron microscopy (SEM). Data were submitted to statistical analysis (5%).Results: For σ, G1 > G2.5 = G5 = G10, and control > G10. For Ef, G2.5 > control = G1 > G5 > G10. For KHN, G5 = G10 > control = G1 = G2.5. For FT, G10 = G5 > control = G1, and G10 > G2.5. Incorporation of nanoparticles was associated with observation of clusters in the SEM analysis. The clusters were more frequent for higher nanoparticle loadings.Conclusion: Modest incorporation of nanoparticles may improve the properties of resin luting materials. Nanofiller mass fractions above 2.5% should, however, be avoided because they may be detrimental to the properties of the resin luting agents.
Prosthodontic Treatment and Medical Considerations for a Patient with Turner Syndrome: A Clinical Report
Authors: Nguyen Caroline T. , Hofstede Theresa M. 
Published: June 2012

AbstractThis clinical report describes a multidisciplinary approach in the rehabilitation of a 23‐year‐old Caucasian woman affected with Turner's syndrome and subsequently diagnosed with T4 Giant cell reparative granuloma of the right maxillary sinus. The surgical treatment included a maxillectomy and infratemporal fossa dissection followed by a free fibula palatal reconstruction, fibula bone graft of the orbital floor, dental implant placement, and prosthodontic rehabilitation. Prosthodontic planning and treatment considerations in an adult patient with Turner Syndrome are discussed.
Perinatal Outcomes and Satisfaction with Care in Women with High Body Mass Index
Authors: Hildingsson Ingegerd , Thomas Jan 
Published: June 2012

Introduction: The majority of studies on pregnant women with high body mass index (BMI) have focused on medical complications and birth outcome, rather than these women's encounters with health care providers. The aims were to identify the proportion of pregnant women with high BMIs (≥30); compare maternal characteristics and pregnancy and birth outcomes; and assess the experiences of prenatal, intrapartum, and postnatal care in women with high (≥30) and lower (<30) BMIs.Methods: Data were collected through questionnaires and antenatal records from 919 women recruited in mid‐pregnancy at 3 hospitals in the north of Sweden, with a follow‐up questionnaire 2 months after birth.Results: The prevalence of obesity was 15.2%. Women with high BMIs were more often aged 35 years or older and less likely to have a university education. They had more negative attitudes regarding being pregnant and reported more childbirth fear compared to women with lower BMIs, but they did not differ in regard to their feelings about the approaching birth or the first weeks with the newborn. They reported more pregnancy complications and had less continuity of caregiver. High BMI was associated with labor induction and emergency cesarean birth. No differences were found in birth complications; birth experience; or satisfaction with prenatal, intrapartum, or postnatal care.Discussion: The findings reveal that women who are obese have more complicated pregnancies and births but are generally satisfied with the care they receive. There are some differences in the way they experience care. Health care providers have a delicate task to provide sufficient information about health risks while still offering respect, encouragement, and support.
Patient Safety in Midwifery Care for Low‐Risk Women: Instrument Development
Authors: Martijn Lucie , Jacobs Annelies , Harmsen Mirjam , Maassen Irma , Wensing Michel 
Published: June 2012

Introduction: Few studies have examined the safety of midwife‐led care for low‐risk childbearing women. While most women have a low‐risk profile at the start of pregnancy, validated measures to detect patient safety risks for this population are needed. The increased interest of midwife‐led care for childbearing women to substitute for other models of care requires careful evaluation of safety aspects. In this study, we developed and tested an instrument for safety assessment of midwifery care.Methods: A structured approach was followed for instrument development. First, we reviewed the literature on patient safety in general and obstetric and midwifery care in particular. We identified 5 domains of patient risk: organization, communication, patient‐related risk factors, clinical management, and outcomes. We then developed a prototype to assess patient records and, in an iterative process, reviewed the prototype with the help of a review team of midwives and safety experts. The instrument was pilot tested for content validity, reliability, and feasibility.Results: Trained reviewers with clinical midwifery expertise applied the instrument. We were able to reduce the original 100‐item screening instrument to 32 items and applied the instrument to patient records in a reliable manner. With regard to the validity of the instrument, review of the literature and the validation procedure produced good content validity.Discussion: A valid and feasible instrument to assess patient safety in low‐risk childbearing women is now available and can be used for quantitative analyses of patient records and to identify unsafe situations. Identification and analysis of patient safety incidents required clinical judgment and consultation with the panel of safety experts. The instrument allows us to draw conclusions about safety and to recommend steps for specific, domain‐based improvements. Studies on the use of the instrument for improving patient safety are recommended.
Uremic pleuritis in chronic hemodialysis patients
Authors: Rashid‐Farokhi Farin , Pourdowlat Guitti , Nikoonia Mohammad‐Reza , Behzadnia Neda , Kahkouee Shahram , Nassiri Amir‐Ahmad , Masjedi Mohammad‐Reza 
Published: June 2012

AbstractChronic hemodialysis (HD) patients are predisposed to several complications associated with pleural effusion. In addition, uremia can directly cause pleuritis. However, there are inadequate data about pathogenesis and natural course of uremic pleuritis. In this study, 76 chronic HD patients with pleural effusion admitted to the Respiratory Center of Masih Daneshvari Hospital, in Tehran, Iran between June 2005 and May 2011 were evaluated to figure out the etiology of their pleural disease. Among these patients, patients with uremic pleuritis were identified and studied. The rate of uremic pleuritis was 23.7%. Other frequent etiologies of pleural effusion were parapneumonic effusion (23.7%), cardiac failure (19.7%), tuberculosis (6.6%), volume overload, malignancy, and unknown. In patients with uremic pleuritis, dyspnea was the most common symptom, followed by cough, weight loss, anorexia, chest pain, and fever. Compared to patients with parapneumonic effusion, patients with uremic effusion had a significantly higher rate of dyspnea and lower rate of cough and fever. Pleural fluid analysis showed that these patients had a significantly lower pleural to serum lactic dehydrogenase ratio, total pleural leukocytes, and polymorphonuclear count compared to patients with parapneumonic effusion. Improvement was achieved in 94.1% of patients with uremic pleuritis by continuation of HD, chest tube insertion or pleural decortication; an outcome better than the previous reports. Despite the association with an exudative effusion, inflammatory pleural reactions in patients with uremic pleuritis may not be as severe as infection‐induced effusions. Owing to the advancement in HD technology and other interventions, outcome of uremic pleuritis may be improved.
Receptivity toward Immigrants in Rural Pennsylvania: Perceptions of Adult English as Second Language Providers*
Authors: Prins Esther , Toso Blaire Willson 
Published: June 2012

AbstractThis article uses interview and questionnaire data to examine how adult English as a second language (ESL) providers in rural Pennsylvania perceive community receptivity toward immigrants and the factors they believe foster or hinder receptivity and immigrants' integration. ESL providers' depictions of local responses to immigrants ranged from welcoming to hostile. They identified four constellations of factors that influenced receptivity: national and local politics, the labor market and immigrant occupations, immigrants' ability to look or act like native‐born residents, and community institutions. This study reveals how differing contexts of reception are believed to influence immigrants' incorporation into rural communities. It also highlights the role of educators and educational institutions in creating a welcoming atmosphere that supports immigrants' socioeconomic well‐being.
Polarized Light Spectroscopy for Measurement of the Microvascular Response to Local Heating at Multiple Skin Sites
Authors: TESSELAAR ERIK , BERGKVIST MAX , SJÖBERG FOLKE , FARNEBO SIMON 
Published: June 2012

Please cite this paper as: Tesselaar E, Bergkvist M, Sjöberg F, Farnebo S. Polarized light spectroscopy for measurement of the microvascular response to local heating at multiple skin sites. Microcirculation 19: 705–713, 2012.AbstractObjective: To evaluate whether TiVi, a technique based on polarized light, could measure the change in RBC concentration during local heating in healthy volunteers.Methods: Using a custom‐made transparent heater, forearm skin was heated to 42 °C for 40 minutes while the change in RBC concentration was measured with TiVi. The perfusion response during local heating was measured at the same time with Laser Doppler flowmetry.Results: Mean RBC concentration increased (91 ± 34 vs. 51 ± 34 A.U. at baseline, p < 0.001). The spatial heterogeneity of the RBC concentration in the measured skin areas was 26 ± 6.4% at baseline, and 23 ± 4.6% after 40 minutes of heating. The mean RBC concentrations in two skin sites were highly correlated (0.98 at baseline and 0.96 after 40 minutes of heating). The change in RBC concentration was less than the change in perfusion, measured with LDF. Unlike with LDF, a neurally mediated peak was not observed with TiVi in most of the test subjects.Conclusions: TiVi is a valuable technique for measuring the microvascular response to local heating in the skin, and offers a high reproducibility for simultaneous measurements at different skin sites, provided carefully controlled experiments are ensured.