Browse publications by year: 2017

  1. Ali N, Tretiakov A, Whiddett D, Hunter I
    Int J Med Inform, 2017 01;97:331-340.
    PMID: 27919392 DOI: 10.1016/j.ijmedinf.2016.11.004
    PURPOSE: To deliver high-quality healthcare doctors need to access, interpret, and share appropriate and localised medical knowledge. Information technology is widely used to facilitate the management of this knowledge in healthcare organisations. The purpose of this study is to develop a knowledge management systems success model for healthcare organisations.

    METHOD: A model was formulated by extending an existing generic knowledge management systems success model by including organisational and system factors relevant to healthcare. It was tested by using data obtained from 263 doctors working within two district health boards in New Zealand.

    RESULTS: Of the system factors, knowledge content quality was found to be particularly important for knowledge management systems success. Of the organisational factors, leadership was the most important, and more important than incentives.

    CONCLUSION: Leadership promoted knowledge management systems success primarily by positively affecting knowledge content quality. Leadership also promoted knowledge management use for retrieval, which should lead to the use of that better quality knowledge by the doctors, ultimately resulting in better outcomes for patients.

    MeSH terms: Delivery of Health Care/organization & administration*; Humans; Leadership*; New Zealand; Physicians; Quality of Health Care*; Knowledge Management*
  2. Guivarc'h M, Ordioni U, Ahmed HM, Cohen S, Catherine JH, Bukiet F
    J Endod, 2017 Jan;43(1):16-24.
    PMID: 27986099 DOI: 10.1016/j.joen.2016.09.023
    INTRODUCTION: Sodium hypochlorite (NaOCl) extrusion beyond the apex, also known as "a hypochlorite accident," is a well-known complication that seldom occurs during root canal therapy. These "accidents" have been the subject of several case reports published over the years. Until now, no publication has addressed the global synthesis of the general and clinical data related to NaOCl extrusion. The main purpose of this article was to conduct a systematic review of previously published case reports to identify, synthesize, and present a critical analysis of the available data. A second purpose was to propose a standardized presentation of reporting data concerning NaOCl extrusions to refine and develop guidelines that should be used in further case report series.

    METHODS: A review of clinical cases reporting NaOCl accidents was conducted in June 2016 using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist; it combined an electronic search of the PubMed database and an extensive manual search.

    RESULTS: Forty full-text articles corresponding to 52 case reports published between 1974 and 2015 were selected. Four main categories of data were highlighted: general and clinical information, clinical signs and symptoms of NaOCl extrusions, management of NaOCl extrusions, and healing and prognosis. Overall, up to now, clinical cases were reported in a very unsystematic manner, and some relevant information was missing.

    CONCLUSIONS: A better understanding of the potential causes, management, and prognosis of NaOCl accidents requires a standardization of reported data; this study proposes a template that can fulfill this objective.

    MeSH terms: Humans; Root Canal Irrigants/adverse effects*; Sodium Hypochlorite/adverse effects*; Root Canal Preparation/adverse effects*
  3. Tan M, Aghaei F, Wang Y, Zheng B
    Phys Med Biol, 2017 01 21;62(2):358-376.
    PMID: 27997380 DOI: 10.1088/1361-6560/aa5081
    The purpose of this study is to evaluate a new method to improve performance of computer-aided detection (CAD) schemes of screening mammograms with two approaches. In the first approach, we developed a new case based CAD scheme using a set of optimally selected global mammographic density, texture, spiculation, and structural similarity features computed from all four full-field digital mammography images of the craniocaudal (CC) and mediolateral oblique (MLO) views by using a modified fast and accurate sequential floating forward selection feature selection algorithm. Selected features were then applied to a 'scoring fusion' artificial neural network classification scheme to produce a final case based risk score. In the second approach, we combined the case based risk score with the conventional lesion based scores of a conventional lesion based CAD scheme using a new adaptive cueing method that is integrated with the case based risk scores. We evaluated our methods using a ten-fold cross-validation scheme on 924 cases (476 cancer and 448 recalled or negative), whereby each case had all four images from the CC and MLO views. The area under the receiver operating characteristic curve was AUC  =  0.793  ±  0.015 and the odds ratio monotonically increased from 1 to 37.21 as CAD-generated case based detection scores increased. Using the new adaptive cueing method, the region based and case based sensitivities of the conventional CAD scheme at a false positive rate of 0.71 per image increased by 2.4% and 0.8%, respectively. The study demonstrated that supplementary information can be derived by computing global mammographic density image features to improve CAD-cueing performance on the suspicious mammographic lesions.
    MeSH terms: Algorithms*; Breast Neoplasms/diagnosis*; Female; Humans; Mammography/methods*; Radiographic Image Interpretation, Computer-Assisted/methods*; ROC Curve; Neural Networks (Computer); Early Detection of Cancer; Breast Density
  4. Zou D, Goh KL
    J Gastroenterol Hepatol, 2017 Jun;32(6):1152-1159.
    PMID: 28024166 DOI: 10.1111/jgh.13712
    Both proton pump inhibitors (PPIs) and clopidogrel are widely prescribed in the Asia-Pacific population. PPIs are the mainstay therapeutic agents for prophylaxis against aspirin gastropathy and for acid-related disorders including gastroesophageal reflux disease. They are also co-prescribed with oral anticoagulant agents and with dual-antiplatelet therapy for the treatment and prevention of gastrointestinal bleeding. Clopidogrel belongs to the drug class of thienopyridines and is currently the most widely prescribed oral anticoagulant agent either alone or in combination with aspirin. Platelet inhibition by clopidogrel is prone to significant inter-individual variability and is believed to be affected by several factors such as genetics and drug-drug interactions. Since it was first reported in 2009, the potential for drug-drug interactions between PPIs and clopidogrel has remained headline news, and its significance in clinical practice is the subject of an ongoing debate. For East Asian patients in particular, the clinical relevance of the interaction between PPIs and clopidogrel remains unclear because of conflicting data, as well as underrepresentation of East Asian subjects in landmark trials. Increased CYP2C19 genetic polymorphisms in individuals from Asia-Pacific countries only fuel the confusion. Recent studies in East Asian cohorts suggests that the potential of PPIs to attenuate the efficacy of clopidogrel could be minimized by the use of newer PPIs with weaker affinity for the CYP2C19 isoenzyme, namely, pantoprazole, dexlansoprazole, and rabeprazole. This review aims to help clinicians choose the most appropriate PPI for co-prescription with clopidogrel in patients from Asia-Pacific countries.
    MeSH terms: Anticoagulants/administration & dosage; Aspirin/administration & dosage; Aspirin/adverse effects; Drug Interactions; Drug Therapy, Combination; Far East; Gastroesophageal Reflux/drug therapy; Gastroesophageal Reflux/prevention & control; Gastrointestinal Hemorrhage/drug therapy; Gastrointestinal Hemorrhage/prevention & control; Humans; Isoenzymes; Platelet Aggregation Inhibitors/administration & dosage; Polymorphism, Genetic; Ticlopidine/administration & dosage; Ticlopidine/analogs & derivatives*; Asian Continental Ancestry Group/genetics; 2-Pyridinylmethylsulfinylbenzimidazoles; Proton Pump Inhibitors/administration & dosage*; Dexlansoprazole; Rabeprazole; Cytochrome P-450 CYP2C19/genetics
  5. Foo CY, Reidpath DD, Sivasampu S
    Eval Health Prof, 2017 Jan 01.
    PMID: 29179560 DOI: 10.1177/0163278717713569
    In any survey where some of the invited participants fail to respond estimates may be biased. The literature on survey nonresponse is substantial, and the intellectual focus has typically been on the nonresponse of individuals. An important yet less scrutinized area in the analysis of nonresponse is in organizational surveys, particularly surveys of health-care organizations. This study used data from the 2010 National Healthcare Establishment and Workforce Survey in Malaysia to examine the relationship between a set of measurable hospital attributes and their probability of survey response and the relationship between this probability and the differences in survey estimates. We found that readily measurable hospital characteristics such as size and geographical location are useful predictors of survey response likelihood. Larger hospitals and hospitals located in less developed geographical regions responded more favorably than their counterparts. We have also illustrated that the resulting response pattern affected some key survey estimates. These findings have the potential to extend our understanding of nonresponse to organization surveys in the health-care sector, potentially allow for the prediction of nonresponse, and help researchers to identify profiles of "reluctant responders" before a survey commences, so that additional engagement strategies may be used.
  6. Dadrasnia A, Azirun MS, Ismail SB
    BMC Biotechnol, 2017 Nov 28;17(1):85.
    PMID: 29179747 DOI: 10.1186/s12896-017-0395-9
    BACKGROUND: When the unavoidable waste generation is considered as damaging to our environment, it becomes crucial to develop a sustainable technology to remediate the pollutant source towards an environmental protection and safety. The development of a bioengineering technology for highly efficient pollutant removal is this regard. Given the high ammonia nitrogen content and chemical oxygen demand of landfill leachate, Bacillus salmalaya strain 139SI, a novel resident strain microbe that can survive in high ammonia nitrogen concentrations, was investigated for the bioremoval of ammonia nitrogen from landfill leachate. The treatability of landfill leachate was evaluated under different treatment parameters, such as temperature, inoculum dosage, and pH.

    RESULTS: Results demonstrated that bioaugmentation with the novel strain can potentially improve the biodegradability of landfill leachate. B. salmalaya strain 139SI showed high potential to enhance biological treatment given its maximum NH3-N and COD removal efficiencies. The response surface plot pattern indicated that within 11 days and under optimum conditions (10% v/v inoculant, pH 6, and 35 °C), B. salmalaya strain139SI removed 78% of ammonia nitrogen. At the end of the study, biological and chemical oxygen demands remarkably decreased by 88% and 91.4%, respectively. Scanning electron microscopy images revealed that ammonia ions covered the cell surface of B. salmalaya strain139SI.

    CONCLUSIONS: Therefore, novel resistant Bacillus salmalaya strain139SI significantly reduces the chemical oxygen demand and NH3-N content of landfill leachate. Leachate treatment by B. salmalaya strain 139SI within 11 days.

    MeSH terms: Ammonia/analysis*; Ammonia/metabolism; Ammonia/chemistry; Bacillus/metabolism*; Biodegradation, Environmental*; Hydrogen-Ion Concentration; Nitrogen/metabolism; Oxygen/analysis; Oxygen/metabolism; Temperature; Water Pollutants, Chemical/analysis*; Water Pollutants, Chemical/metabolism; Water Pollutants, Chemical/chemistry; Biological Oxygen Demand Analysis*
  7. Loong TH, Soon NC, Nik Mahmud NRK, Naidu J, Rani RA, Abdul Hamid N, et al.
    Biomed Rep, 2017 Nov;7(5):460-468.
    PMID: 29181158 DOI: 10.3892/br.2017.985
    There is a lack of non-invasive screening modalities to diagnose chronic atrophic gastritis (CAG) and intestinal metaplasia (IM). Thus, the aim of the present study was to determine the sensitivity and specificity of serum pepsinogen I (PGI), PGI:II, the PGI:II ratio and gastrin-17 (G-17) in diagnosing CAG and IM, and the correlations between these serum biomarkers and pre-malignant gastric lesions. A cross-sectional study of 72 patients (82% of the calculated sample size) who underwent oesophageal-gastro-duodenoscopy for dyspepsia was performed in the present study. The mean age of the participants was 56.2±16.2 years. Serum PGI:I, PGI:II, G-17 and Helicobacter pylori antibody levels were measured by enzyme-linked immunosorbent assay. Median levels of PGI:I, PGI:II, the PGI:II ratio and G-17 for were 129.9 µg/l, 10.3 µg/l, 14.7 and 4.4 pmol/l, respectively. Subjects with corpus CAG/IM exhibited a significantly lower PGI:II ratio (7.2) compared with the control group (15.7; P<0.001). Histological CAG and IM correlated well with the serum PGI:II ratio (r=-0.417; P<0.001). The cut-off value of the PGI:II ratio of ≤10.0 demonstrated high sensitivity (83.3%), specificity (77.9%) and area under the receiver operating characteristic curve of 0.902 in detecting the two conditions. However, the sensitivity was particularly low at a ratio of ≤3.0. The serum PGI:II ratio is a sensitive and specific marker to diagnose corpus CAG/IM, but at a high cut-off value. This ratio may potentially be used as an outpatient, non-invasive biomarker for detecting corpus CAG/IM.
    MeSH terms: Adult; Aged; Cross-Sectional Studies; Duodenoscopy; Dyspepsia; Enzyme-Linked Immunosorbent Assay; Gastrins; Gastritis, Atrophic; Humans; Metaplasia; Middle Aged; Outpatients; ROC Curve; Sensitivity and Specificity; Helicobacter pylori; Sample Size; Pepsinogen A; Control Groups
  8. Othman M, Ariff AB, Wasoh H, Kapri MR, Halim M
    AMB Express, 2017 Nov 27;7(1):215.
    PMID: 29181600 DOI: 10.1186/s13568-017-0519-6
    Lactic acid bacteria are industrially important microorganisms recognized for fermentative ability mostly in their probiotic benefits as well as lactic acid production for various applications. Fermentation conditions such as concentration of initial glucose in the culture, concentration of lactic acid accumulated in the culture, types of pH control strategy, types of aeration mode and different agitation speed had influenced the cultivation performance of batch fermentation of Pediococcus acidilactici. The maximum viable cell concentration obtained in constant fed-batch fermentation at a feeding rate of 0.015 L/h was 6.1 times higher with 1.6 times reduction in lactic acid accumulation compared to batch fermentation. Anion exchange resin, IRA 67 was found to have the highest selectivity towards lactic acid compared to other components studied. Fed-batch fermentation of P. acidilactici coupled with lactic acid removal system using IRA 67 resin showed 55.5 and 9.1 times of improvement in maximum viable cell concentration compared to fermentation without resin for batch and fed-batch mode respectively. The improvement of the P. acidilactici growth in the constant fed-batch fermentation indicated the use of minimal and simple process control equipment is an effective approach for reducing by-product inhibition. Further improvement in the cultivation performance of P. acidilactici in fed-bath fermentation with in situ addition of anion-exchange resin significantly helped to enhance the growth of P. acidilactici by reducing the inhibitory effect of lactic acid and thus increasing probiotic production.
  9. Soe HJ, Khan AM, Manikam R, Samudi Raju C, Vanhoutte P, Sekaran SD
    J Gen Virol, 2017 Dec;98(12):2993-3007.
    PMID: 29182510 DOI: 10.1099/jgv.0.000981
    Plasma leakage is the main pathophysiological feature in severe dengue, resulting from altered vascular barrier function associated with an inappropriate immune response triggered upon infection. The present study investigated functional changes using an electric cell-substrate impedance sensing system in four (brain, dermal, pulmonary and retinal) human microvascular endothelial cell (MEC) lines infected with purified dengue virus, followed by assessment of cytokine profiles and the expression of inter-endothelial junctional proteins. Modelling of changes in electrical impedance suggests that vascular leakage in dengue-infected MECs is mostly due to the modulation of cell-to-cell interactions, while this loss of vascular barrier function observed in the infected MECs varied between cell lines and DENV serotypes. High levels of inflammatory cytokines (IL-6 and TNF-α), chemokines (CXCL1, CXCL5, CXCL11, CX3CL1, CCL2 and CCL20) and adhesion molecules (VCAM-1) were differentially produced in the four infected MECs. Further, the tight junctional protein, ZO-1, was down-regulated in both the DENV-1-infected brain and pulmonary MECs, while claudin-1, PECAM-1 and VE-cadherin were differentially expressed in these two MECs after infection. Non-purified virus stock was also studied to investigate the impact of virus stock purity on dengue-specific immune responses, and the results suggest that virus stock propagated through cell culture may include factors that mask or alter the DENV-specific immune responses of the MECs. The findings of the present study show that high DENV load differentially modulates human microvascular endothelial barrier function and disrupts the function of inter-endothelial junctional proteins during early infection with organ-specific cytokine production.
    MeSH terms: Brain/cytology; Brain/immunology; Brain/virology; Cell Line; Dengue Virus/genetics; Dengue Virus/growth & development; Dengue Virus/immunology; Endothelium, Vascular/cytology; Endothelium, Vascular/immunology; Endothelium, Vascular/virology*; Gene Expression Regulation; Humans; Lung/cytology; Lung/immunology; Lung/virology; Organ Specificity; Permeability; Retina/cytology; Retina/immunology; Retina/virology; Tumor Necrosis Factor-alpha/genetics; Tumor Necrosis Factor-alpha/immunology; Signal Transduction; Antigens, CD/genetics; Antigens, CD/immunology; Cadherins/genetics; Cadherins/immunology; Interleukin-6/genetics; Interleukin-6/immunology; Electric Impedance; Chemokine CCL2/genetics; Chemokine CCL2/immunology; Vascular Cell Adhesion Molecule-1/genetics; Vascular Cell Adhesion Molecule-1/immunology; Antigens, CD31/genetics; Antigens, CD31/immunology; Viral Load/immunology*; Chemokines, CXC/genetics; Chemokines, CXC/immunology; Dermis/cytology; Dermis/immunology; Dermis/virology; Endothelial Cells/cytology; Endothelial Cells/immunology; Endothelial Cells/virology*; Virus Internalization; Chemokine CCL20/genetics; Chemokine CCL20/immunology; Chemokine CX3CL1/genetics; Chemokine CX3CL1/immunology; Host-Pathogen Interactions*; Claudin-1/genetics; Claudin-1/immunology; Zonula Occludens-1 Protein/genetics; Zonula Occludens-1 Protein/immunology
  10. Chapagai, M. K., Wan Rosli ,W. I., Wan Manan, W. M., Jalil, R. A., Karrila, T., Pinkaew, S.
    MyJurnal
    Consumption of brown rice is increasing on account of higher nutritional components such as
    vitamins, minerals, fibres and antioxidants than white rice. However, the effect of domestic
    cooking methods on nutritional attributes of brown rice is not well-characterized. Hence, this
    study aimed to investigate the effect of cooking methods; pressure cooker (PC) and rice cooker
    (RC) on physicochemical, nutritional and sensory properties of brown rice from five different
    varieties: Sungyod (SY), Chiang (CH), and Lepnok (LP) of Thai and long grain LS1 and LS2 of
    Malaysian origin. Peak viscosity (PV) and final viscosity (FV) among uncooked samples were
    significantly different except for LS1 and LS2. Between cooking methods, protein content (8.17
    – 10.14%) was significantly different (p < 0.05) except in SY, LS1 and LS2 varieties whereas fat
    (1.74 – 2.71%) and ash content (1.15 – 1.46%) showed significant difference (p < 0.05) only
    in LP and SY varieties. Loss of iron was significantly higher in RC method than PC method
    but zinc and thiamine was insignificant. The LS1 and LS2 cooked in PC was significantly
    softer (p < 0.05) than cooked in RC. Hardness of PC cooked rice was correlated with PV (r
    = –0.965), breakdown viscosity (r = –0.973), setback viscosity (r = –0.944) at p < 0.01 and
    pasting temperature (r = 0.89, p < 0.05) of uncooked brown rice flours. Overall, PC was found
    better over RC in terms of cooking time, textural properties, nutrients and sensory attributes.
  11. Glazier PS
    Hum Mov Sci, 2017 Dec;56(Pt A):139-156.
    PMID: 26725372 DOI: 10.1016/j.humov.2015.08.001
    Sports performance is generally considered to be governed by a range of interacting physiological, biomechanical, and psychological variables, amongst others. Despite sports performance being multi-factorial, however, the majority of performance-oriented sports science research has predominantly been monodisciplinary in nature, presumably due, at least in part, to the lack of a unifying theoretical framework required to integrate the various subdisciplines of sports science. In this target article, I propose a Grand Unified Theory (GUT) of sports performance-and, by elaboration, sports science-based around the constraints framework introduced originally by Newell (1986). A central tenet of this GUT is that, at both the intra- and inter-individual levels of analysis, patterns of coordination and control, which directly determine the performance outcome, emerge from the confluence of interacting organismic, environmental, and task constraints via the formation and self-organisation of coordinative structures. It is suggested that this GUT could be used to: foster interdisciplinary research collaborations; break down the silos that have developed in sports science and restore greater disciplinary balance to the field; promote a more holistic understanding of sports performance across all levels of analysis; increase explanatory power of applied research work; provide stronger rationale for data collection and variable selection; and direct the development of integrated performance monitoring technologies. This GUT could also provide a scientifically rigorous basis for integrating the subdisciplines of sports science in applied sports science support programmes adopted by high-performance agencies and national governing bodies for various individual and team sports.
    MeSH terms: Self-Control/psychology*; Competitive Behavior/physiology; Goals; Humans; Research; Sports/physiology*; Sports/psychology; Muscle Fatigue/physiology; Athletic Performance/physiology*; Athletic Performance/psychology
  12. Mohammadi F, Momtaz YA, Motalebi SA, Boosepasi S
    Rev Recent Clin Trials, 2017;12(3):182-186.
    PMID: 28530532 DOI: 10.2174/1574887112666170522142315
    BACKGROUND: There are limited scientific investigations on cognitive remediation in elderly patients with schizophrenia. The present study was aimed to examine the efficacy of cognitive remediation therapy on social skills in institutionalized elderly patients with schizophrenia.

    METHODS: The study employed a randomized clinical trial. A total of 60 institutionalized elderly patients with schizophrenia from Razi Psychiatric Hospital, Tehran were selected and randomly allocated into two equal groups (control and intervention). The intervention group attended to cognitive remediation therapy for 8 weeks. The Evaluation of Living Skills Scale for psychiatric patients was used for data collection. The Chi Square, independent and paired t-tests using SPSS, version 22, were employed to analyze the data.

    RESULTS: The mean age of 60 elderly patients participated in the study was 65.25 ± 4.19 years. No significant differences were found between two groups at baseline. However, independent t-tests showed significant differences between the intervention and the control group in social skills after implementation of intervention. Additionally, the results of paired t-tests revealed significant improvements in intervention group on communication skills (t=5.50, p<0.001), behavioral problems with others (t=5.44, p<0.001), and self-care (t=4.70, p<0.001). No significant differences were observed from pretest to post test in control group.

    CONCLUSION: The results of the present study may support the efficacy of cognitive remediation therapy on social skills of elderly patients with schizophrenia.
    MeSH terms: Age Factors; Aged; Female; Humans; Iran/epidemiology; Male; Middle Aged; Schizophrenia/epidemiology; Schizophrenia/therapy*; Self Care; Cognitive Therapy/methods*; Prevalence; Treatment Outcome; Social Skills*; Cognitive Remediation/methods*
  13. Balasopoulou A, Mooy FM, Baker DJ, Mitropoulou C, Skoufas E, Bulgiba A, et al.
    OMICS, 2017 12;21(12):733-740.
    PMID: 29173101 DOI: 10.1089/omi.2017.0136
    Precision medicine, genomic and diagnostic services are no longer limited to developed countries. This broadening in geography of biomarker applications and omics diagnostics also demands empirical study of implementation, diagnostic testing, and counseling practices in the field. For example, the Malaysian population has large ethnic diversity and high prevalence of genetic disorders such as hemoglobinopathies and metabolic disorders. Increased morbidity and mortality from such diseases have a direct impact on society and health system sustainability and for this, decision-making becomes of outmost importance. We report here on our findings on the landscape of genomic testing and genetic counseling services in Malaysia. We first defined the framework of all Malaysian stakeholders that offer genomics services and next, we identified the related information gaps, as depicted through the service providers' online websites. Our research framework revealed that there is a very diverse spectrum of genomics services in Malaysia, in which wet- and dry-laboratory services integrate. Moreover, we identify the current gaps and possible remedies to improve the quality of genomic and predictive analytics, not to mention considerations to ensure robust ethics and responsible innovation. To our knowledge, this is the first such study to be performed for a Southeast Asian country. Our genomics and precision medicine services mapping strategy presented in this study may serve as a model for field assessment at regional, national, and international levels as precision medicine is expanding globally and new governance challenges and opportunities continue to emerge for smart implementation science.
    MeSH terms: Genetic Counseling/statistics & numerical data; Genetic Testing/statistics & numerical data; Humans; Malaysia; Public Health/statistics & numerical data; Genomics/statistics & numerical data; Precision Medicine/statistics & numerical data*
  14. Ulhaq A, Esmail Z, Kamaruddin A, Meadows S, Daus J, Vitale M, et al.
    Am J Orthod Dentofacial Orthop, 2017 Dec;152(6):744-752.
    PMID: 29173854 DOI: 10.1016/j.ajodo.2017.07.014
    INTRODUCTION: The objective of this 4-arm parallel study was to evaluate the alignment efficiency and esthetic performance of 4 coated nickel-titanium archwires over an 8-week period.

    METHODS: Patients in the permanent dentition requiring maxillary and mandibular fixed orthodontic treatment with a preadjusted edgewise appliance were eligible for inclusion. Patients attending 4 hospital departments (United Kingdom and Italy) were randomly allocated to 1 of 4 treatment interventions: (1) BioCosmetic (Forestadent, Pforzheim, Germany), 0.017 in; (2) Titanol (Forestadent), 0.016 in; (3) TP Aesthetic (TP Orthodontics, La Porte, Ind), 0.014 in; and (4) Tooth Tone (Ortho Organizers, Calsbad, Calif) 0.016 in. Block randomization with block sizes of 4 and 8 was used to ensure an allocation ratio of 1:1:1:1. The primary outcome was alignment efficiency determined by the reduction in Little's irregularity index (mm). Secondary outcomes were color change using the Commission Internationale de L'Eclairage L*a*b* system and percentage of coating loss. Blinding was only applicable to outcome assessment of alignment efficiency. Regression models with Sidak's multiple comparison of means were used to analyze the data.

    RESULTS: One hundred fifty patients (300 dental arches) were allocated to the treatment interventions, including 61 male and 89 female subjects with a mean age of 16.60 years. The average duration of follow-up was 63.65 days. Baseline characteristics for the archwire groups were similar. One patient was lost to follow-up. Five percent (n = 15) of the archwires fractured: BioCosmetic, 5.3% (n = 4); Titanol, 6.8% (n = 5); TP Aesthetic, 5.3% (n = 4); and Tooth Tone, 2.7% (n = 2). We analyzed 283 dental arches for alignment efficiency. There was no statistically significant difference for mean reduction in irregularity between the archwire groups (P = 0.627): BioCosmetic (n = 71), 3.86 mm (95% CI, 3.31-4.41); Titanol (n = 69), 4.51 mm (95% CI, 4.00-5.02); TP Aesthetic (n = 71), 4.13 mm (95% CI, 3.49-4.78); and Tooth Tone (n = 72), 4.21 mm (95% CI, 3.89-4.46). There was a statistically significant difference between archwire groups for color change (P = 0.001) and percentage of coating loss (P = 0.001), with BioCosmetic performing best in both parameters.

    CONCLUSIONS: There was no difference between the archwires for alignment efficiency. BioCosmetic performed statistically significantly better than did the other groups for both color change and coating loss.

    REGISTRATION: This trial was registered with the East Midlands NHS Research Ethics Committee (12/EM/0190).

    PROTOCOL: The protocol was not published before trial commencement.

    MeSH terms: Adolescent; Adult; Child; Esthetics, Dental*; Female; Humans; Male; Middle Aged; Nickel*; Orthodontic Wires*; Titanium*; Orthodontic Appliance Design; Treatment Outcome; Young Adult
  15. Jong WL, Ung NM, Vannyat A, Rosenfeld AB, Wong JHD
    Phys Med, 2017 Oct;42:39-46.
    PMID: 29173919 DOI: 10.1016/j.ejmp.2017.08.011
    Challenges in treating lung tumours are related to the respiratory-induced tumour motion and the accuracy of dose calculation in charged particle disequilibrium condition. The dosimetric characteristics near the interface of lung and Perspex media in a moving phantom during respiratory-gated and non-gated radiotherapy were investigated using Gafchromic EBT2 and the MOSkin detector. The MOSkin detectors showed good agreement with the EBT2 films during static and gated radiotherapy. In static radiotherapy, the penumbral widths were found to be 3.66mm and 7.22mm in Perspex and lung media, respectively. In non-gated (moving) radiotherapy with 40mm respiratory amplitude, dose smearing effect was observed and the penumbral widths were increased to 28.81mm and 26.40mm, respectively. This has been reduced to 6.85mm and 9.81mm, respectively, in gated radiotherapy with 25% gating window. There were still some dose discrepancies as compared to static radiotherapy due to the residual motion. This should be taken into account in the margin generation for the target tumour.
    MeSH terms: Humans; Lung/physiopathology; Lung/radiation effects*; Lung Neoplasms/physiopathology; Lung Neoplasms/radiotherapy; Models, Biological; Motion*; Radiometry/instrumentation; Radiotherapy/instrumentation; Radiotherapy/methods*; Radiotherapy Dosage*; Respiration*; Phantoms, Imaging
  16. Nazir SR, Hassali MA, Saleem F, Bashir S, Aljadhey H
    Pak J Pharm Sci, 2017 Nov;30(6):2159-2165.
    PMID: 29175785
    Patient adherence with a therapeutic regimen predicts successful treatment and reduces the severity of negative complications. The purpose of this work was to find the relationship between general Health Related Quality of Life (HRQoL) and compliance to the treatment among type 2 diabetes mellitus patients (T2DM) in Sargodha, Pakistan. The research was planned as a cross-sectional survey. T2DM patients attending a tertiary care institute in Sargodha, Pakistan were targeted for the study. The Urdu version of the Morisky Medication Adherence Scale (MMAS-Urdu) and EuroQol Quality of Life Scale were employed to evaluate adherence to treatment regimen and HRQoL correspondingly. Descriptive statistics were used for the elaboration of socio-demographic characteristics. The Spearman rank order test was employed to determine the relationship between medicine adherence and HRQoL. P<0.05 was considered statistically significant. A total of 392 patients were selected for the survey. Most participants were males (n=222, 56.6%) with 5.58±4.09 years of history of T2DM. Majority of respondents (n=137, 34.9%) were categorized in age group of 51 to 60 years with mean age of 50.77±9.671 years. The present study highlighted that individuals with type 2 diabetes mellitus had decreased HRQoL (0.4715±0.3360) and poor medication adherence (4.44±1.8). Significant, yet weak positive correlations were observed between medication adherence and HRQoL (r=0.217 and 0.136 for EQ-5D and EQVAS respectively). Although the association between adherence to therapeutic regimen and HRQoL in the present study cohort was significant, it was rated as weak, hence failed in producing an overall impression on quality of life. The study highlights the need of identifying other individual factors affecting HRQoL among T2DM patients in Pakistan.
    MeSH terms: Adult; Aged; Cross-Sectional Studies; Diabetes Mellitus, Type 2/diagnosis; Diabetes Mellitus, Type 2/drug therapy*; Diabetes Mellitus, Type 2/epidemiology; Diabetes Mellitus, Type 2/psychology; Female; Health Status; Humans; Hypoglycemic Agents/therapeutic use*; Male; Middle Aged; Pakistan/epidemiology; Quality of Life*; Prevalence; Treatment Outcome; Health Care Surveys; Medication Adherence*
  17. Ng FL, Phang SM, Periasamy V, Yunus K, Fisher AC
    Sci Rep, 2017 Nov 24;7(1):16237.
    PMID: 29176639 DOI: 10.1038/s41598-017-16530-y
    We report for the first time a photosynthetically active algae immobilized in alginate gel within a fuel cell design for generation of bioelectricity. The algal-alginate biofilm was utilized within a biophotovoltaics (BPV) device developed for direct bioelectricity generation from photosynthesis. A peak power output of 0.289 mWm-2 with an increase of 18% in power output compared to conventional suspension culture BPV device was observed. The increase in maximum power density was correlated to the maximum relative electron transport rate (rETRm). The semi-dry type of photosynthetically active biofilm proposed in this work may offer significantly improved performances in terms of fuel cell design, bioelectricity generation, oxygen production and CO2 reduction.
  18. Lim CP, Md-Redzuan A, Lai YK, Borhanuddin B, Cheah FC
    Ann Acad Med Singap, 2017 10;46(10):395-398.
    PMID: 29177368
    MeSH terms: Anemia/drug therapy*; Dose-Response Relationship, Drug*; Erythropoietin/administration & dosage*; Female; Humans; Male; Premature Birth/blood*
  19. Yahya N, Kamarudin SK, Karim NA, Masdar MS, Loh KS
    Nanoscale Res Lett, 2017 Nov 25;12(1):605.
    PMID: 29177577 DOI: 10.1186/s11671-017-2360-x
    This study presents a novel anodic PdAu/VGCNF catalyst for electro-oxidation in a glycerol fuel cell. The reaction conditions are critical issues affecting the glycerol electro-oxidation performance. This study presents the effects of catalyst loading, temperature, and electrolyte concentration. The glycerol oxidation performance of the PdAu/VGCNF catalyst on the anode side is tested via cyclic voltammetry with a 3 mm2 active area. The morphology and physical properties of the catalyst are examined using X-ray diffraction (XRD), field emission scanning electron microscopy (SEM) and energy dispersive X-ray (EDX) spectroscopy. Then, optimization is carried out using the response surface method with central composite experimental design. The current density is experimentally obtained as a response variable from a set of experimental laboratory tests. The catalyst loading, temperature, and NaOH concentration are taken as independent parameters, which were evaluated previously in the screening experiments. The highest current density of 158.34 mAcm-2 is obtained under the optimal conditions of 3.0 M NaOH concentration, 60 °C temperature and 12 wt.% catalyst loading. These results prove that PdAu-VGCNF is a potential anodic catalyst for glycerol fuel cells.
  20. Alarami N, Sulaiman E, Al-Haddad A
    Am J Dent, 2017 Aug;30(4):197-200.
    PMID: 29178701
    PURPOSE: To evaluate fracture resistance and failure mode of endodontically-treated mandibular molars restored with different intra-radicular techniques.

    METHODS: 75 human mandibular molars were randomly divided into five equal groups. Teeth were standardized, endodontically-treated and restored according the assigned group as follows: amalgam core only, prefabricated titanium post in the distal canal and amalgam core, composite core only; fiber post in the distal canal and composite core. One group of untreated sound teeth was used as a control. Non-precious metal crowns were fabricated and cemented on the prepared specimens with Rely X U200 resin cement. All specimens were subjected to a compressive load at crosshead speed 0.5 mm/minute, 25° to the long axis of the tooth. Failure loads and modes were recorded.

    RESULTS: Mean failure loads among the groups were significantly different (P= 0.035). Post-hoc multiple pair-wise comparisons revealed the amalgam core and composite core groups produced significantly lower fracture resistance than the control group (P= 0.041 and P= 0.025, respectively) and no significant differences among the different intra-radicular techniques (P> 0.05). The composite core with fiber post and amalgam core with titanium posts showed the highest percentage of favorable failures (67%) and non-favorable failures (87%) respectively.

    CLINICAL SIGNIFICANCE: The composite core with fiber post is the most appropriate intraradicular restoration in cases of severely compromised molars.

    MeSH terms: Composite Resins; Dental Stress Analysis; Humans; Molar; Post and Core Technique*; Tooth Fractures/prevention & control*; Dental Restoration Failure*; Tooth, Nonvital*
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