Cost-Effectiveness Analysis for Surgical, Angioplasty, or Medical Therapeutics for Coronary Artery Disease 5-Year Follow-Up of Medicine, Angioplasty, or Surgery Study (MASS) II Trial

Background-The Second Medicine, Angioplasty, or Surgery Study (MASS II) included patients with multivessel coronary artery disease and normal systolic ventricular function. Patients underwent coronary artery bypass graft surgery (CABG, n = 203), percutaneous coronary intervention (PCI, n = 205), or medical treatment alone (MT, n = 203). This investigation compares the economic outcome at 5-year follow-up of the 3 therapeutic strategies. Methods and Results-We analyzed cumulative costs during a 5-year follow-up period. To analyze the cost-effectiveness, adjustment was made on the cumulative costs for average event-free time and angina-free proportion. Respectively, for event-free survival and event plus angina-free survival, MT presented 3.79 quality-adjusted life-years and 2.07 quality-adjusted life-years; PCI presented 3.59 and 2.77 quality-adjusted life-years; and CABG demonstrated 4.4 and 2.81 quality-adjusted life-years. The event-free costs were $9071.00 for MT; $19 967.00 for PCI; and $18 263.00 for CABG. The paired comparison of the event-free costs showed that there was a significant difference favoring MT versus PCI (P<0.01) and versus CABG (P<0.01) and CABG versus PCI (P<0.01). The event-free plus angina-free costs were $16 553.00, $25 831.00, and $24 614.00, respectively. The paired comparison of the event-free plus angina-free costs showed that there was a significant difference favoring MT versus PCI (P=0.04), and versus CABG (P<0.001); there was no difference between CABG and PCI (P>0.05). Conclusions-In the long-term economic analysis, for the prevention of a composite primary end point, MT was more cost effective than CABG, and CABG was more cost-effective than PCI.

The Role of Keratinized Mucosa in Peri-Implant Health

Objective: To evaluate the role of keratinized mucosa around dental implants, correlating with other clinical parameters related to the success of dental implants. Design: Cross-section. Setting: Institutional tertiary referral hospital. Patients: A total of 202 dental implants fixed in the cleft area of 109 patients with cleft lip and/or palate were evaluated. Interventions: The evaluated clinical parameters were probing depth and gingival and plaque indexes on the buccal surface (three sites). Main Outcome Measures: All clinical parameters were correlated with the width of keratinized mucosa around the implants. Results: The largest probing depths were detected when the width of keratinized mucosa was 2 mm or more, with a statistically significant difference between the means of the probing depth and keratinized mucosa width. Conclusion: Even though the present results suggest that peri-implant health can be observed in areas with keratinized mucosa width under 2 mm provided an adequate oral hygiene control is performed, longitudinal randomized studies are necessary to analyze the relationship between the width of keratinized mucosa and the health of peri-implant tissues.

Influence of the base and diluent methacrylate monomers on the polymerization stress and its determinants

The aim of this study was to evaluate the effect of the association between bisphenol-A diglycidyl dimethacrylate (BisGMA) or its ethoxylated version (BisEMA) with diluents derived from the ethylene glycol dimethacrylate (EGDMA), with increasing number of ethylene glycol units (1: EGDMA, 2: DEGDMA, 3: TEGDMA, or 4: TETGDMA), or trimethylol propane trimethacrylate (TMPTMA) or 1,10-decanediol dimethacrylate (D3MA) on polymerization stress, volumetric shrinkage, degree of conversion, maximum rate of polymerization (Rpmax), and elastic modulus of experimental composites. BisGMA containing formulations presented lower shrinkage and stress but higher modulus and Rpmax than those containing BisEMA. TMPTMA presented the lowest stress among all diluents, as a result of lower conversion. EGDMA, DEGDMA, TEGDMA, and TETGDMA presented similar polymerization stress which was higher than the stress presented by D3MA and TMPTMA. D3MA presented similar conversion when copolymerized with both base monomers. The other diluents presented higher conversion when associated with BisEMA. EGDMA showed similar shrinkage compared with DEGDMA and higher than the other diluents. The lower conversion achieved by TMPTMA did not jeopardize its elastic modulus, similar to the other diluents. Despite the similar conversion presented by D3MA in comparison with EGDMA and DEGDMA, its lower elastic modulus may limit its use. Rather than proposing new materials, this study provides a systematic evaluation of off the shelf monomers and their effects on stress development, as highlighted by the analysis of conversion, shrinkage and modulus, to aid the optimization of commercially available materials. (c) 2011 Wiley Periodicals, Inc. J Appl Polym Sci, 2012

The local environment of Co2+ ions intercalated in vanadium oxide/hexadecylamine nanotubes

Vanadium oxide nanotubes constitute promising materials for applications in nanoelectronics as cathode materials, in sensor technology and in catalysis. In this work we present a study on hybrid vanadium oxide/hexadecylamine multiwall nanotubes doped with Co ions using state of the art x-ray diffraction and absorption techniques, to address the issue of the dopant location within the nanotubes' structure. The x-ray absorption near-edge structure analysis shows that the Co ions in the nanotubes are in the 2+ oxidation state, while extended x-ray absorption fine structure spectroscopy reveals the local environment of the Co2+ ions. Results indicate that Co atoms are exchanged at the interface between the vanadium oxide's layers and the hexadecylamines, reducing the amount of amine chains and therefore the interlayer distance, but preserving the tubular shape. The findings in this work are important for describing Co2+ interaction with vanadium oxide nanotubes at the molecular level and will help to improve the understanding of their physicochemical behavior, which is desired in view of their promising applications.

Ionization of chlorophyll-c(2) in liquid methanol

The ionization of chlorophyll-c(2) in liquid methanol was investigated by a sequential quantum mechanical/Monte Carlo approach. Focus was placed on the determination of the first ionization energy of chlorophyll-c(2). The results show that the first vertical ionization energy (IE) is red-shifted by 0.47 +/- 0.24 eV relative to the gas-phase value. The red-shift of the chlorophyll-c(2) IE in the liquid phase can be explained by Mg center dot center dot center dot OH hydrogen bonding and long-ranged electrostatic interactions in solution. The ionization threshold for chlorophyll-c2 in liquid methanol is close to 6 eV. (C) 2012 Elsevier B.V. All rights reserved.

Gender Effect on Oral Volume Capacity

Studies have shown anatomical and functional differences between men and women with respect to the mouth, pharynx, upper esophageal sphincter, and esophagus. The aim of this investigation was to analyze the influence of gender, body mass index (BMI), age, and orofacial anthropometric measurements on the intraoral maximum volume capacity for liquid. The investigation included asymptomatic subjects, 56 females and 44 males, aged 19-53 years. The volunteers sucked water through a straw up to the maximum tolerated oral volume, which was greater in men (71.2 +/- A 15.0 ml) than in women (55.4 +/- A 13.4 ml). Age, BMI, height, and number of teeth had no influence on the intraoral tolerated volume. Anthropometric orofacial measurements were greater in men than in women. In individuals with height between 1.66 and 1.89 m, anthropometric orofacial measurements were greater in men than in women, and the tolerated intraoral volume was greater in men than in women. There was a positive correlation between orofacial measurements and intraoral maximum volume. In conclusion, men have the capacity to place a larger volume of water inside their mouth than women. This observation is associated with higher anthropometric orofacial measures, but not with age, number of teeth, height, or BMI.

Effect of contact and systemic insecticides on the sharpshooter Bucephalogonia xanthophis (Hemiptera: cicadellidae), a vector of Xylella fastidiosa in citrus

The knockdown and toxic effects of insecticides of different chemical groups and modes of action registered for citrus in Brazil were investigated for effective control of Bucephalogonia xanthophis, a sharpshooter vector of Xylella fastidiosa in citrus. The active ingredients dimethoate (1.2 mL/1.2L), imidacloprid (0.24 mL/1.2L) and lambda-cyhalothrin (0.24 mL/1.2L), as well as a control (water), were sprayed onto branches of potted-citrus nursery trees to evaluate the effect of residual contact. The insects were confined on sprayed branches by using sleeve cages, in groups of 10 per branch (5 branches/treatment). Lambdacyhalothrin showed a knockdown effect on B. xanthophis (>70% mortality within 2 h of exposure), and the residues were effective for approximately one wk. Imidacloprid, lambdacyhalothrin and dimethoate suppressed the vector populations for up to 3 wk after application, when the insects were exposed to sprayed plants for at least 24 h. In another experiment, 2 neonicotinoid insecticides (thiamethoxam and imidacloprid) were applied by soil drench to potted nursery trees, in order to study their systemic effect, i.e., mortality by ingestion on sharpshooter adults. Thiamethoxam and imidacloprid effectively controlled the vectors at all concentrations tested, when the insects were exposed to treated plants for 24 h (>80% mortality) or 48 h (near 100% mortality). The knockdown effect of thiamethoxam and lambda-cyhalothrin might be particularly important to prevent vector transmission of X. fastidiosa in citrus groves.

Biochemical and metabolic profiles of Trichoderma strains isolated from common bean crops in the Brazilian Cerrado, and potential antagonism against Sclerotinia sclerotiorum

Some species of Trichoderma have successfully been used in the commercial biological control of fungal pathogens, e.g., Sclerotinia sclerotiorum, an economically important pathogen of common beans (Phaseolus vulgaris L.). The objectives of the present study were (1) to provide molecular characterization of Trichoderma strains isolated from the Brazilian Cerrado; (2) to assess the metabolic profile of each strain by means of Biolog FF Microplates; and (3) to evaluate the ability of each strain to antagonize S. sclerotiorum via the production of cell wall-degrading enzymes (CWDEs), volatile antibiotics, and dual-culture tests. Among 21 isolates, we identified 42.86 % as Trichoderma asperellum, 33.33 % as Trichoderma harzianum, 14.29 % as Trichoderma tomentosum, 4.76 % as Trichoderma koningiopsis, and 4.76 % as Trichoderma erinaceum. Trichoderma asperellum showed the highest CWDE activity. However, no species secreted a specific group of CWDEs. Trichoderma asperellum 364/01, T. asperellum 483/02, and T. asperellum 356/02 exhibited high and medium specific activities for key enzymes in the mycoparasitic process, but a low capacity for antagonism. We observed no significant correlation between CWDE and antagonism, or between metabolic profile and antagonism. The diversity of Trichoderma species, and in particular of T. harzianum, was clearly reflected in their metabolic profiles. Our findings indicate that the selection of Trichoderma candidates for biological control should be based primarily on the environmental fitness of competitive isolates and the target pathogen. (C) 2012 The British Mycological Society. Published by Elsevier Ltd. All rights reserved.

Calculations of the spectral shifts and line profiles of alkaline earth atoms in liquid helium environment

Liquid configurations generated by Metropolis Monte Carlo simulations are used in time-dependent density functional theory calculations of the spectral line shifts and line profiles of the lowest lying excitation of the alkaline earth atoms, Be, Mg, Ca, Sr and Ba embedded in liquid helium. The results are in very good agreement with the available experimental data. Special attention is given to the calculated spectroscopic shift and the associated line broadening. The analysis specifies the inhomogeneous broadening of the three separate contributions due to the splitting of the s -> p transition of the alkaline earth atom in the liquid environment. (C) 2012 Elsevier B. V. All rights reserved.

Photoconduction action spectra of regio-regular poly(3-hexylthiopene):TiO2 diodes

The development of polymer-based photovoltaic devices brings the promise of low-cost and lightweight solar energy conversion systems. This technology requires new materials and device architectures with enhanced efficiency and lifetime, which depends on the understanding of charge-transport mechanisms. Organic films combined with electronegative nanoparticles may form systems with efficient dissociation of the photogenerated excitons, thus increasing the number of carriers to be collected by the electrodes. In this paper we investigate the steady-state photoconductive action spectra of devices formed by a bilayer of regio-regular poly(3-hexylthiophene) (RRP3HT) and TiO2 sandwiched between ITO and aluminum electrodes (ITO/TiO2:RRP3HT/Al). Photocurrents were measured for distinct bias voltages with illumination from either side of the device. Heterojunction structures were prepared by spin coating a RRP3HT film on an already deposited TiO2 layer on ITO. Symbatic and antibatic curves were obtained and a model for photocurrent action spectra was able to fit the symbatic responses. The quantum yield increased with the electric field, indicating that exciton dissociation is a field-assisted process as in an Onsager mechanism. Furthermore, the quantum yield was significantly higher when illumination was carried out through the ITO electrode onto which the TiO2 layer was deposited, as the highly electronegative TiO2 nanoparticles were efficient in exciton dissociation.

Correction of Class II malocclusion with Class II elastics: a systematic review

Introduction: The aim of this prospective clinical study was to investigate the cephalometric changes produced by bonded spurs associated with high-pull chincup therapy in children with Angle Class I malocclusion and anterior open bite. Methods: Thirty patients with an initial mean age of 8.14 years and a mean anterior open bite of 3.93 mm were treated with bonded spurs associated with chincup therapy for 12 months. An untreated control group of 30 subjects with an initial mean age of 8.36 years and a mean anterior open bite of 3.93 mm and the same malocclusion was followed for 12 months for comparison. Student t tests were used for intergroup comparisons. Results: The treated group demonstrated a significantly greater decrease of the gonial angle, and increase in overbite, palatal tipping of the maxillary incisors, and vertical dentoalveolar development of the maxillary and mandibular incisors compared with the control group. Conclusions: The association of bonded spurs with high-pull chincup therapy was efficient for the correction of the open bite in 86.7% of the patients, with a 5.23-mm (SD, 61.69) overbite increase.

Influence of intentional ankylosis of deciduous canines to reinforce the anchorage for maxillary protraction

Introduction: This retrospective cephalometric study analyzed the influence of intentional ankylosis of deciduous canines in patients with Class III malocclusion and anterior crossbite, in the deciduous and early mixed dentition stages, treated by orthopedic maxillary expansion followed by maxillary protraction. Methods: Lateral cephalograms of 40 patients were used, divided in 2 groups paired for age and gender. The Ankylosis Group was composed of 20 patients (10 boys and 10 girls) treated with induced ankylosis and presenting initial and final mean ages of 7 years 4 months and 8 years 3 months, respectively, with a mean period of maxillary protraction of 11 months. The Control Group comprised 20 patients (10 boys and 10 girls) treated without induced ankylosis, with initial and final mean ages of 7 years 8 months and 8 years 7 months, respectively, with a mean period of maxillary protraction of 11 months. Two-way analysis of variance and covariance analysis were applied to compare the initial and final cephalometric variables and the treatment changes between groups. Results: According to the results, the variables evidencing the significant treatment changes between groups confirmed that the intentional ankylosis enhanced the sagittal response of the apical bases (Pg-NPerp) and increased the facial convexity angles (NAP and ANB). Conclusions: The protocol involving intentional ankylosis of deciduous canines enhanced the sagittal response of the apical bases.

Micro-structural and compositional variations of hydrothermal epidote-group minerals from a peralkaline granite, Corupá Pluton, Graciosa Province, South Brazil, and their petrological implications

Epidote-group minerals, together with albite, quartz, fluorite, Al-poor and Fe-rich phyllosilicates, zircon, and minor oxides and sulphides, are typical hydrothermal phases in peralkaline alkali-feldspar granites from the Corupá Pluton, Graciosa Province, South Brazil. The epidote-group minerals occur as single crystals and as aggregates filling in rock interstices and miarolitic cavities. They display complex recurrent zoning patterns with an internal zone of ferriallanite-(Ce), followed by allanite-(Ce), then epidote-ferriepidote, and an external zone with allanite-(Ce), with sharp limits, as shown in BSE and X-ray images. REE patterns show decreasing fractionation degrees of LREE over HREE from ferriallanite to epidote. The most external allanite is enriched in MREE. LA-ICP-MS data indicate that ferriallanite is enriched (>10-fold) in Ti, Sr and Ga, and depleted in Mg, Rb, Th and Zr relative to the host granite. Allanite has lower Ga and Mn and higher Zr, Nb and U contents as compared to ferriallanite, while epidote is enriched in Sr, U and depleted in Pb, Zr, Hf, Ti and Ga. The formation of these minerals is related to the variable concentrations of HFSE, Ca, Al, Fe and F in fluids remaining from magmatic crystallization, in an oxidizing environment, close to the HM buffer. L-MREE were in part released by the alteration of chevkinite, their main primary repository in the host rocks.

Risk factors for swallowing dysfunction in stroke patients

CONTEXT: Stroke is a frequent cause of dysphagia. OBJECTIVE: To evaluate in a tertiary care hospital the prevalence of swallowing dysfunction in stroke patients, to analyze factors associated with the dysfunction and to relate swallowing dysfunction to mortality 3 months after the stroke. METHODS: Clinical evaluation of deglutition was performed in 212 consecutive patients with a medical and radiologic diagnosis of stroke. The occurrence of death was determined 3 months after the stroke. RESULTS: It was observed that 63% of the patients had swallowing dysfunction. The variables gender and specific location of the lesion were not associated with the presence or absence of swallowing dysfunction. The patients with swallowing dysfunction had more frequently a previous stroke, had a stroke in the left hemisphere, motor and/or sensitivity alterations, difficulty in oral comprehension, alteration of oral expression, alteration of the level of consciousness, complications such as fever and pneumonia, high indexes on the Rankin scale, and low indexes on the Barthel scale. These patients had a higher mortality rate. CONCLUSIONS: Swallowing evaluation should be done in all patients with stroke, since swallowing dysfunction is associated with complications and an increased risk of death.

Esophageal contractions, bolus transit and perception of transit after swallows of liquid and solid boluses in normal subjects

CONTEXT: Esophageal dysphagia is the sensation that the ingested material has a slow transit or blockage in its normal passage to the stomach. It is not always associated with motility or transit alterations. OBJECTIVES: To evaluate in normal volunteers the possibility of perception of bolus transit through the esophagus after swallows of liquid and solid boluses, the differences in esophageal contraction and transit with these boluses, and the association of transit perception with alteration of esophageal contraction and/or transit. METHODS: The investigation included 11 asymptomatic volunteers, 4 men and 7 women aged 19-58 years. The subjects were evaluated in the sitting position. They performed swallows of the same volume of liquid (isotonic drink) and solid (macaroni) boluses in a random order and in duplicate. After each swallow they were asked about the sensation of bolus passage through the esophagus. Contractions and transit were evaluated simultaneously by solid state manometry and impedance. RESULTS: Perception of bolus transit occurred only with the solid bolus. The amplitude and area under the curve of contractions were higher with swallows of the solid bolus than with swallows of the liquid bolus. The difference was more evident in swallows with no perception of transit (n = 12) than in swallows with perception (n = 10). The total bolus transit time was longer for the solid bolus than for the liquid bolus only with swallows followed by no perception of transit. CONCLUSION: The results suggest that the perception of esophageal transit may be the consequence of inadequate adaptation of esophageal transit and contraction to the characteristics of the swallowed bolus.