Minimal intervention dentistry and older patients Part 1: Risk assessment and caries prevention

Ten million people in the UK today are aged over 65. The latest projections estimate that there will be 5 1/2 million more people aged 65 and older in the next 20 years. This projected pattern of population ageing will have profound consequences for dentistry. Minimal intervention dentistry (MID) is a modern evidence-based approach to caries management in dentate patients that uses the 'medical model' whereby disease is controlled by the 'oral physician'. This approach offers considerable benefits over conventional dentistry for older patients. It encourages patients to be responsible for their oral health through the provision of both knowledge and motivation. MID encompasses risk assessment for dental disease, early detection and control of disease processes, and minimally invasive treatment. 

Clinical Relevance: Risk assessment tools can aid the general dental practitioner and the patient to develop a suitable caries prevention programme for that individual and reduce the need for future operative intervention.

Losses of bioactive polyacetylenes during minimal processing of carrots

Vegetables of the Apiaceae plant family such as carrots, parsnip, celery and parsley,contain in minor quantities, a group of bioactive aliphatic C17-polyacetylenes (falcarinol,falcarindiol, falcarindiol-3- acetate). Recent studies have highlighted important biologicalfunctions in vitro and in vivo (animal studies) although the beneficial effect in humannutrition attributable to an increased in polyacetylenes diet are yet to be confirmed(Lund, 1990).Carrots not only contain relatively high polyacetylene content but also form a significantpart of many countries dietary habits. Carrots are also present in some ready-to-eat foodssuch as chilled freshly prepared salads, as part of the increasingly popular minimallyprocessed foods. Whereas the effect of conventional processing (boiling, vacuum processing) on the levels of polyacetylenes has been relatively well studied, the effect of minimal mechanical operations such as “peeling”, “mechanical cutting” and “chlorine washing” remains unknown.

Special condition wind power forecasting based on Gaussian process and similar historical data

Due to the variability of wind power, it is imperative to accurately and timely forecast the wind generation to enhance the flexibility and reliability of the operation and control of real-time power. Special events such as ramps, spikes are hard to predict with traditional methods using solely recently measured data. In this paper, a new Gaussian Process model with hybrid training data taken from both the local time and historic dataset is proposed and applied to make short-term predictions from 10 minutes to one hour ahead. A key idea is that the similar pattern data in history are properly selected and embedded in Gaussian Process model to make predictions. The results of the proposed algorithms are compared to those of standard Gaussian Process model and the persistence model. It is shown that the proposed method not only reduces magnitude error but also phase error.

Modelling of Organic Rankine Cycle for Waste Heat Recovery Process in Supercritical Condition

Organic Rankine Cycle (ORC) is the most commonly used method for recovering energy from small sources of heat. The investigation of the ORC in supercritical condition is a new research area as it has a potential to generate high power and thermal efficiency in a waste heat recovery system. This paper presents a steady state ORC model in supercritical condition and its simulations with a real engine’s exhaust data. The key component of ORC, evaporator, is modelled using finite volume method, modelling of all other components of the waste heat recovery system such as pump, expander and condenser are also presented. The aim of this paper is to investigate the effects of mass flow rate and evaporator outlet temperature on the efficiency of the waste heat recovery process. Additionally, the necessity of maintaining an optimum evaporator outlet temperature is also investigated. Simulation results show that modification of mass flow rate is the key to changing the operating temperature at the evaporator outlet.

Minimal residual disease detection in childhood acute lymphoblastic leukaemia patients at multiple time-points reveals high levels of concordance between molecular and immunophenotypic approaches

In this single centre study of childhood acute lymphoblastic leukaemia (ALL) patients treated on the Medical Research Council UKALL 97/99 protocols, it was determined that minimal residual disease (MRD) detected by real time quantitative polymerase chain reaction (RQ-PCR) and 3-colour flow cytometry (FC) displayed high levels of qualitative concordance when evaluated at multiple time-points during treatment (93.38%), and a combined use of both approaches allowed a multi time-point evaluation of MRD kinetics for 90% (53/59) of the initial cohort. At diagnosis, MRD markers with sensitivity of at least 0.01% were identified by RQ-PCR detection of fusion gene transcripts, IGH/TRG rearrangements, and FC. Using a combined RQ-PCR and FC approach, the evaluation of 367 follow-up BM samples revealed that the detection of MRD >1% at Day 15 (P = 0.04), >0.01% at the end of induction (P = 0.02), >0.01% at the end of consolidation (P = 0.01), >0.01% prior to the first delayed intensification (P = 0.01), and >0.1% prior to the second delayed intensification and continued maintenance (P = 0.001) were all associated with relapse and, based on early time-points (end of induction and consolidation) a significant log-rank trend (P = 0.0091) was noted between survival curves for patients stratified into high, intermediate and low-risk MRD groups.

Wilms' tumor gene 1 (WT1) expression in childhood acute lymphoblastic leukemia:a wide range of WT1 expression levels, its impact on prognosis and minimal residual disease monitoring

Wilms' tumor gene 1 (WT1) is overexpressed in the majority (70-90%) of acute leukemias and has been identified as an independent adverse prognostic factor, a convenient minimal residual disease (MRD) marker and potential therapeutic target in acute leukemia. We examined WT1 expression patterns in childhood acute lymphoblastic leukemia (ALL), where its clinical implication remains unclear. Using a real-time quantitative PCR designed according to Europe Against Cancer Program recommendations, we evaluated WT1 expression in 125 consecutively enrolled patients with childhood ALL (106 BCP-ALL, 19 T-ALL) and compared it with physiologic WT1 expression in normal and regenerating bone marrow (BM). In childhood B-cell precursor (BCP)-ALL, we detected a wide range of WT1 levels (5 logs) with a median WT1 expression close to that of normal BM. WT1 expression in childhood T-ALL was significantly higher than in BCP-ALL (P<0.001). Patients with MLL-AF4 translocation showed high WT1 overexpression (P<0.01) compared to patients with other or no chromosomal aberrations. Older children (> or =10 years) expressed higher WT1 levels than children under 10 years of age (P<0.001), while there was no difference in WT1 expression in patients with peripheral blood leukocyte count (WBC) > or =50 x 10(9)/l and lower. Analysis of relapsed cases (14/125) indicated that an abnormal increase or decrease in WT1 expression was associated with a significantly increased risk of relapse (P=0.0006), and this prognostic impact of WT1 was independent of other main risk factors (P=0.0012). In summary, our study suggests that WT1 expression in childhood ALL is very variable and much lower than in AML or adult ALL. WT1, thus, will not be a useful marker for MRD detection in childhood ALL, however, it does represent a potential independent risk factor in childhood ALL. Interestingly, a proportion of childhood ALL patients express WT1 at levels below the normal physiological BM WT1 expression, and this reduced WT1 expression appears to be associated with a higher risk of relapse.

Strength reduction of till under dynamic pore pressure condition

Cuttings in heavily overconsolidated clays are known to be susceptible to progressive deformation caused by creep and fatigue that usually begins at the toe of the slope. The progressive deformation leads to strength reduction with time at constant stress (or called softening) and could be accelerated by fluctuation of groundwater level associated with more extreme rainfall events predicted through climate change. The purpose of this paper is to assess the mechanism of progressive deformation due to creep and fatigue using element testing on samples of till. The samples were subjected to fully drained loading and the deviator stresses were held constant at various percentages of peak failure stress, while the pore water pressure was kept static or dynamic (fluctuating ±5 kPa) over a period of time. The results have shown that the samples experienced significant deformation even at a higher factor of safety (i.e. the failure deviator stress/deviator stress at which the pore water pressure was fluctuated) under pore water pressure dynamics.