The lifetime direct cost of periodontal treatment:A case study from a norwegian specialist practice

Background: Successful periodontal treatment requires a commitment to regular lifelong maintenance and may be perceived by patients to be costly. This study calculates the total lifetime cost of periodontal treatment in the setting of a specialist periodontal practice and investigates the cost implications of choosing not to proceed with such treatment. Methods: Data from patients treated in a specialist practice in Norway were used to calculate the total lifetime cost of periodontal treatment that included baseline periodontal treatment, regular maintenance, retreatment, and replacing teeth lost during maintenance. Incremental costs for alternative strategies based on opting to forego periodontal treatment or maintenance and to replace any teeth lost with either bridgework or implants were calculated. Results: Patients who completed baseline periodontal treatment but did not have any additional maintenance or retreatment could replace only three teeth with bridgework or two teeth with implants before the cost of replacing additional teeth would exceed the cost of lifetime periodontal treatment. Patients who did not have any periodontal treatment could replace ≤4 teeth with bridgework or implants before a replacement strategy became more expensive. Conclusions: Within the limits of the assumptions made, periodontal treatment in a Norwegian specialist periodontal practice is cost-effective when compared to an approach that relies on opting to replace teeth lost as a result of progressive periodontitis with fixed restorations. In particular, patients who have initial comprehensive periodontal treatment but do not subsequently comply with maintenance could, on average, replace ≤3 teeth with bridgework or two teeth with implants before this approach would exceed the direct cost of lifetime periodontal treatment in the setting of the specialist practice studied. © 2012 American Academy of Periodontology.

Enhancement of ion generation in femtosecond ultraintense laser-foil interactions by defocusing

A simple method to enhance ion generation with femtosecond ultraintense lasers is demonstrated experimentally by defocusing laser beams on target surface. When the laser is optimally defocused, we find that the population of medium and low energy protons from ultra-thin foils is increased significantly while the proton cutoff energy is almost unchanged. In this way, the total proton yield can be enhanced by more than 1 order, even though the peak laser intensity drops. The depression of the amplified spontaneous emission (ASE) effect and the population increase of moderate-energy electrons are believed to be the main reasons for the effective enhancement. © 2012 American Institute of Physics.

Few-cycle driven relativistically oscillating plasma mirrors:A source of intense isolated attosecond pulses

The conditions required for the production of isolated attosecond pulses from relativistically oscillating mirrors (ROM) are investigated numerically and experimentally. In simulations, carrier-envelope-phase-stabilized three-cycle pulses are found to be sufficient to produce isolated attosecond pulses, while two-cycle pulses will predominantly lead to isolated attosecond pulses even in the absence of carrier-envelope stabilization. Using a state-of-the-art laser system delivering three-cycle pulses at multiple-terawatt level, we have generated higher harmonics up to 70 eV photon energy via the ROM mechanism. The observed spectra are in agreement with theoretical expectations and highlight the potential of few-cycle-driven ROM harmonics for intense isolated attosecond pulse generation for performing extreme ultraviolet-pump extreme ultraviolet-probe experiments. © 2012 American Physical Society.

Deep separation of benzene from cyclohexane by liquid extraction using ionic liquids as the solvent

Separation of benzene and cyclohexane is one of the most important and difficult processes in the petrochemical industry, especially for low benzene concentration. In this work, three ionic liquids (ILs), [Bmim][BF ₄], [Bpy][BF ₄], and [Bmim][SCN], were investigated as the solvent in the extraction of benzene from cyclohexane. The corresponding ternary liquid-liquid equilibria (LLE) were experimentally determined at T = 298.15 K and atmospheric pressure. The LLE data were correlated with the nonrandom two-liquid model, and the parameters were fitted. The separation capabilities of the ILs were evaluated in terms of the benzene distribution coefficient and solvent selectivity. The effect of the IL structure on the separation was explained based on a well-founded physical model, COSMO-RS. Finally, the extraction processes were defined, and the operation parameters were analyzed. It shows that the ILs studied are suitable solvents for the extractive separation of benzene and cyclohexane, and their separation efficiency can be generally ranked as [Bmim][BF ₄] > [Bpy][BF ₄] > [Bmim][SCN]. The extraction process for a feed with 15 mol % benzene was optimized. High product purity (cyclohexane 0.997) and high recovery efficiency (cyclohexane 96.9% and benzene 98.1%) can be reached. © 2012 American Chemical Society.

Board invited review:The importance of the gestation period for welfare of calves: Maternal stressors and difficult births

The prenatal period is of critical importance in defining how individuals respond to their environment throughout life. Stress experienced by pregnant females has been shown to have detrimental effects on offspring biology in humans and a variety of other species. It also is becoming increasingly apparent that prenatal events can have important consequences for the behavior, health, and productivity of offspring in farmed species. Pregnant cattle may experience many potentially important stressors, for instance, relating to their social environment, housing system and physical environment, interactions with humans and husbandry procedures, and their state of health. We examined the available literature to provide a review of the implications of prenatal stress for offspring welfare in cattle. The long-term effects of dystocia on cattle offspring also are reviewed. To ensure a transparent and repeatable selection process, a systematic review approach was adopted. The research literature clearly demonstrates that prenatal stress and difficult births in beef and dairy cattle both have implications for offspring welfare and performance. Common husbandry practices, such as transport, were shown to influence offspring biology and the importance of environmental variables, including thermal stress and drought, also were highlighted. Maternal disease during pregnancy was shown to negatively impact offspring welfare. Moreover, dystocia-affected calves suffer increased mortality and morbidity, decreased transfer of passive immunity, and important physiological and behavioral changes. This review also identified considerable gaps in our knowledge and understanding of the effects of prenatal stress in cattle. © 2012 American Society of Animal Science. All rights reserved.

Determinants and two-year change in anterior chamber angle width in a Chinese population

Objective: To study the population distribution and longitudinal changes in anterior chamber angle width and its determinants among Chinese adults. Design: Prospective cohort, population-based study. Participants: Persons aged 35 years or more residing in Guangzhou, China, who had not previously undergone incisional or laser eye surgery. Methods: In December 2008 and December 2010, all subjects underwent automated keratometry, and a random 50% sample had anterior segment optical coherence tomography with measurement of angle-opening distance at 500 μm (AOD500), angle recess area (ARA), iris thickness at 750 μm (IT750), iris curvature, pupil diameter, corneal thickness, anterior chamber width (ACW), lens vault (LV), and lens thickness (LT) and measurement of axial length (AL) and anterior chamber depth (ACD) by partial coherence laser interferometry. Main Outcome Measures: Baseline and 2-year change in AOD500 and ARA in the right eye. Results: A total of 745 subjects were present for full biometric testing in both 2008 and 2010 (mean age at baseline, 52.2 years; standard deviation [SD], 11.5 years; 53.7% were female). Test completion rates in 2010 varied from 77.3% (AOD500: 576/745) to 100% (AL). Mean AOD500 decreased from 0.25 mm (SD, 0.13 mm) in 2008 to 0.21 mm (SD, 13 mm) in 2010 (difference, -0.04; 95% confidence interval [CI], -0.05 to -0.03). The ARA decreased from 21.5±3.73 10^-2 mm² to 21.0±3.64 10 ^-2 mm² (difference, -0.46; 95% CI, -0.52 to -0.41). The decrease in both was most pronounced among younger subjects and those with baseline AOD500 in the widest quartile at baseline. The following baseline variables were significantly associated with a greater 2-year decrease in both AOD500 and ARA: deeper ACD, steeper iris curvature, smaller LV, greater ARA, and greater AOD500. By using simple regression models, we could explain 52% to 58% and 93% of variation in baseline AOD500 and ARA, respectively, but only 27% and 16% of variation in 2-year change in AOD500 and ARA, respectively. Conclusions: Younger persons and those with the least crowded anterior chambers at baseline have the largest 2-year decreases in AOD500 and ARA. The ability to predict change in angle width based on demographic and biometric factors is relatively poor, which may have implications for screening. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. © 2012 American Academy of Ophthalmology.

Effectiveness of a short message reminder in increasing compliance with pediatric cataract treatment:A randomized trial

Objective: Regular follow-up is essential to successful management of childhood cataract. We sought to assess whether a mobile phone short message service (SMS) for parents of children with cataract could improve follow-up adherence and the proportion of procedures performed in timely fashion. Design: Randomized, controlled trial. This trial is registered with ClinicalTrials.gov, NCT01417819. Participants: We included 258 parent-child pairs involved in the Childhood Cataract Program of the Chinese Ministry of Health. Methods: Participants were randomized (1:1) to a mobile phone SMS intervention or standard follow-up appointments. All participants were scheduled to attend <4 follow-up appointments according to the protocol. Parents in the intervention group received SMS automated reminders before scheduled appointments. The control group parents did not receive SMSs or any alternative reminder of scheduled appointments. Regular ocular examinations and analyses were performed by investigators masked to group allocation; however, study participants and the manager in charge of randomization and sending SMSs were not masked. Main Outcome Measures: Number of follow-up appointments attended, additional surgeries, laser treatments, changes in eyeglasses prescription, and occurrence of secondary ocular hypertension. Results: Among parent-child participants, 135 were randomly assigned to the SMS intervention and 123 to standard appointments. Attendance rates for the SMS group (first visit, 97.8%; second, 91.9%; third, 92.6%; fourth, 83%) were significantly higher than those for the control group (first visit, 87.8%; second, 69.9%; third, 56.9%; fourth, 33.3%). The increase in attendance rate for total number of follow-up visits with SMS reminders was 47.2% (relative risk [RR] for attendance, 1.47; 95% confidence interval [CI], 1.16-1.78; P = 0.003). The number needed to remind (NNR) to gain 1 additional visit by 1 child was 3 (95% CI, 1.8-4.2). A total of 247 clinical interventions were carried out in the SMS group and 134 in the control group (RR, 1.68; 95% CI, 1.37-1.99; P = 0.007). The NNR to result in 1 additional clinical intervention was 5 (95% CI, 3.5-6.5). Conclusions: The SMS reminders significantly improved follow-up adherence in pediatric cataract treatment. Using readily available mobile phone resources may be an effective and economic strategy to improve management of childhood cataract in China. Financial Disclosure(s): The authors have no proprietary or commercial interest in any of the materials discussed in this article. © 2012 American Academy of Ophthalmology.

The History of Arsaces, Prince of Betlis

Recounting the eventful travels of Selim, an intrepid young Arab who runs away from his parental home to learn about the world, The History of Arsaces, Prince of Betlis (1774) by the Co. Limerick-born Charles Johnston (c.1719–c.1800) is an inventive mixture of fictional genres and styles: romance, satire, sentimental narrative and oriental fantasy. The novel appeared at a politically charged moment, on the eve of the American revolutionary war and in the aftermath of the Bengal famine of 1769–70, world events that were linked by the nefarious operations of the ubiquitous East India Company. These momentous occurrences, polarising public opinion and stimulating Irish patriot sympathies in the mid-70s, provide the undercurrent to Johnston’s thoughtful examination of war, commerce, and empire through the lens of a fictional ‘history’. Enclosing a series of tales within tales, Johnston’s oriental romance offers its readers a remarkable concoction of Gulliver-inspired fantasy, political satire and moral reflection, played out within an expansive historical and geographical setting. As the Monthly Review, or, Literary Journal commented on its first appearance in 1774, The History of Arsaces provided ‘striking intimations, of the utmost national importance, with respect to over-grown empire, and colony connexions’.

Domestic Violence and the Inter-American Commission on Human Rights: Jessica Lenahan (Gonzales) v United States

On 21 July 2011 the Inter-American Commission on Human Rights issued its much awaited decision in the case of Jessica Lenahan (Gonzales) v United States. In a landmark decision the Commission found the United States of America to be in violation of the American Declaration of the Rights and Duties of Man 1948 due to the failure of the state to protect a victim of domestic violence and her children. This paper analyses the Lenahan decision and its significance for the United States. In particular, the substantial influence of the case law of the European Court of Human Rights on the Commission’s reasoning is examined.

Observations of enhanced extreme ultraviolet continua during an X-class solar flare using SDO/EVE.

Observations of extreme ultraviolet (EUV) emission from an X-class solar flare that occurred on 2011 February 15 at 01: 44 UT are presented, obtained using the EUV Variability Experiment (EVE) on board the Solar Dynamics Observatory. The complete EVE spectral range covers the free-bound continua of H I (Lyman continuum), He I, and He II, with recombination edges at 91.2, 50.4, and 22.8 nm, respectively. By fitting the wavelength ranges blueward of each recombination edge with an exponential function, light curves of each of the integrated continua were generated over the course of the flare, as was emission from the free-free continuum (6.5-37 nm). The He II 30.4 nm and Ly alpha 121.6 nm lines, and soft X-ray (SXR; 0.1-0.8 nm) emission from GOES are also included for comparison. Each free-bound continuum was found to have a rapid rise phase at the flare onset similar to that seen in the 25-50 keV light curves from RHESSI, suggesting that they were formed by recombination with free electrons in the chromosphere. However, the free-free emission exhibited a slower rise phase seen also in the SXR emission from GOES, implying a predominantly coronal origin. By integrating over the entire flare the total energy emitted via each process was determined. We find that the flare energy in the EVE spectral range amounts to at most a few percent of the total flare energy, but EVE gives us a first comprehensive look at these diagnostically important continuum components.

A novel Kazal-type trypsin inhibitor from the skin secretion of the Central American red-eyed leaf frog, Agalychnis callidryas.

The chemical complexity of the defensive skin secretion of the red-eyed leaf frog, (Agalychnis callidryas), has not been elucidated in detail. During a systematic study of the skin secretion peptidomes of phyllomedusine frogs, we discovered a novel Kazal-type protein with potent trypsin inhibitory activity (Ki = 1.9 nM) that displays the highest degree of structural similarity with Kazal proteins from bony fishes. The protein was located in reverse-phase HPLC fractions following a screen of such for trypsin inhibition and subsequent partial Edman degradation of the peak active fraction derived the sequence: ATKPR-QYIVL-PRILRPV-GT. The molecular mass of the major component in this fraction was established by MALDI-TOF MS as 5893.09 Da. This partial sequence (assuming blank cycles to be Cys residues) was used to design a degenerate primer pool that was employed successfully in RACE-PCR to clone homologous precursor-encoding cDNA that encoded a mature Kazal protein of 52 amino acid residues with a computed molecular mass of 5892.82 Da. The protein was named A. callidryas Kazal trypsin inhibitor (ACKTI). BLAST analysis revealed that ACKTI contained a canonical Kazal motif (C-x(7)-C-x(6)-Y-x(3)-C-x(2,3)-C). This novel amphibian skin Kazal trypsin inhibitor adds to the spectrum of trypsin inhibitors of Kunitz- and Bowman Birk-type reported from this amphibian source.

Time-Dependent Density Diagnostics of Solar Flare Plasmas Using SDO/EVE

Temporally resolved electron density measurements of solar flare plasmas are presented using data from the EUV Variability Experiment (EVE) on board the Solar Dynamics Observatory. The EVE spectral range contains emission lines formed between 104 and 107 K, including transitions from highly ionized iron (gsim10 MK). Using three density-sensitive Fe XXI ratios, peak electron densities of 1011.2-1012.1 cm–3 were found during four X-class flares. While previous measurements of densities at such high temperatures were made at only one point during a flaring event, EVE now allows the temporal evolution of these high-temperature densities to be determined at 10 s cadence. A comparison with GOES data revealed that the peak of the density time profiles for each line ratio correlated well with that of the emission measure time profile for each of the events studied.