Resin composites: Modulus of elasticity and marginal quality

OBJECTIVE To investigate how the modulus of elasticity of resin composites influences marginal quality in restorations submitted to thermocyclic and mechanical loading. METHODS Charisma, Filtek Supreme XTE and Grandio were selected as they were found to possess different moduli of elasticity but quite similar polymerization contraction. MOD cavities (n=30) were prepared in extracted premolars, restored and then subjected to thermocyclic and mechanical loading. Marginal quality of the restorations before and after loading was analyzed on epoxy replicas under a scanning electron microscope. The percentage of gap-free margins and occurrence of paramarginal fractures were registered. Modulus of elasticity and polymerization contraction were analyzed with parametric and margins with nonparametric ANOVA and post hoc Tukey HSD or Wilcoxon rank-sum tests, respectively. The number of paramarginal fractures was analyzed with exact Fisher tests (α=0.05). RESULTS Grandio demonstrated significantly more gap-free enamel margins than Charisma and Filtek Supreme XTE, before and after loading (p<0.01), whereas there was no difference between Charisma and Filtek Supreme XTE (p>0.05). No significant effect of resin composite (p=0.81) on the quality of dentine margins was observed, before or after loading. Deterioration of all margins was evident after loading (p<0.0001). More paramarginal enamel fractures were observed after loading in teeth restored with Grandio when compared to Charisma (p=0.008). CONCLUSIONS The resin composite with the highest modulus of elasticity resulted in the highest number of gap-free enamel margins but with an increased incidence of paramarginal enamel fractures. CLINICAL SIGNIFICANCE The results from this study suggest that the marginal quality of restorations can be improved by the selection of a resin composite with modulus of elasticity close to that of dentine, although an increase in paramarginal enamel fractures can result as a consequence.

"Quasi ombra e figura de la verità". Poesia e pensiero in Torquato Tasso

"Pochi autori come il Tasso hanno suscitato interpretazioni tanto differenziate e, in molti casi, discordanti. Posto di volta in volta a chiusura di un'epoca, quella manieristica, o come anticipatore della successiva temperie barocca, egli pare aver scontato il prezzo di un'esemplarità sin troppo manifesta rispetto al proprio Zeitgeist, una stagione che vede, nella vulgata storiografica, la regola prevalere sull'afflato creativo. 'Era già critico prima di esser poeta', sentenziò il De Sanctis, che arrivava a circoscriverne pure l'esperienza biografica nel perimetro di un implacabile autodafé, definendolo 'più crudele inquisitore di sé che il tribunale dell'Inquisizione'. A ciò poi si aggiungeva l'estrinsecità della corte quale destinataria e quasi principio informativo del mondo tassiano, che sembrava legittimare, da Croce in avanti, tutta una serie di giudizi limitativi sulla sua poesia, orientati ad accentuarne la natura encomiastica, aneddotica, addirittura frivola. La critica più recente ha compiuto un'imponente e fondamentale opera di scavo all'interno della cultura tassiana, delle sue letture, della sua poetica, ma il tentativo di rettificare il profilo complessivo dell'autore mostra esiti ancora incerti. In risposta alla vecchia immagine di un Tasso sconfitto dalla cultura controriformistica e alla fine assoggettato alle sue leggi, se ne sono di recente aggiunte altre..." (Dall'introduzione)

Marginal lands or marginal people? Analysing key processes determining the outcomes of large-scale land acquisitions in Lao PDR and Cambodia

This chapter aims to overcome the gap existing between case study research, which typically provides qualitative and process-based insights, and national or global inventories that typically offer spatially explicit and quantitative analysis of broader patterns, and thus to present adequate evidence for policymaking regarding large-scale land acquisitions. Therefore, the chapter links spatial patterns of land acquisitions to underlying implementation processes of land allocation. Methodologically linking the described patterns and processes proved difficult, but we have identified indicators that could be added to inventories and monitoring systems to make linkage possible. Combining complementary approaches in this way may help to determine where policy space exists for more sustainable governance of land acquisitions, both geographically and with regard to processes of agrarian transitions. Our spatial analysis revealed two general patterns: (i) relatively large forestry-related acquisitions that target forested landscapes and often interfere with semi-subsistence farming systems; and (ii) smaller agriculture-related acquisitions that often target existing cropland and also interfere with semi-subsistence systems. Furthermore, our meta-analysis of land acquisition implementation processes shows that authoritarian, top-down processes dominate. Initially, the demands of powerful regional and domestic investors tend to override socio-ecological variables, local actors’ interests, and land governance mechanisms. As available land grows scarce, however, and local actors gain experience dealing with land acquisitions, it appears that land investments begin to fail or give way to more inclusive, bottom-up investment models.

Quantifying the improvement in sepsis diagnosis, documentation, and coding: the marginal causal effect of year of hospitalization on sepsis diagnosis.

PURPOSE To quantify the coinciding improvement in the clinical diagnosis of sepsis, its documentation in the electronic health records, and subsequent medical coding of sepsis for billing purposes in recent years. METHODS We examined 98,267 hospitalizations in 66,208 patients who met systemic inflammatory response syndrome criteria at a tertiary care center from 2008 to 2012. We used g-computation to estimate the causal effect of the year of hospitalization on receiving an International Classification of Diseases, Ninth Revision, Clinical Modification discharge diagnosis code for sepsis by estimating changes in the probability of getting diagnosed and coded for sepsis during the study period. RESULTS When adjusted for demographics, Charlson-Deyo comorbidity index, blood culture frequency per hospitalization, and intensive care unit admission, the causal risk difference for receiving a discharge code for sepsis per 100 hospitalizations with systemic inflammatory response syndrome, had the hospitalization occurred in 2012, was estimated to be 3.9% (95% confidence interval [CI], 3.8%-4.0%), 3.4% (95% CI, 3.3%-3.5%), 2.2% (95% CI, 2.1%-2.3%), and 0.9% (95% CI, 0.8%-1.1%) from 2008 to 2011, respectively. CONCLUSIONS Patients with similar characteristics and risk factors had a higher of probability of getting diagnosed, documented, and coded for sepsis in 2012 than in previous years, which contributed to an apparent increase in sepsis incidence.

The Marginal Impact of ENGOs in Different Types of Democratic Systems

Conventional wisdom suggests that environmental non-governmental organizations (ENGOs) play a major role in pushing states towards more ambitious environmental policies. However, demonstrating that this presumption is in fact true is rather difficult, because the same system structures of democracies that may create more opportunities for ENGO activities are also, on their own, conducive to better environmental policies. This leaves open the possibility that the additional (marginal) impact of ENGOs on policy making is smaller than presumed. In trying to disentangle these effects, this paper examines the influence of ENGOs contingent on key structural characteristics of democratic systems. We develop the argument that presidential systems with a plurality electoral rule per se tend to provide more environmental public goods, which induces a smaller marginal impact of ENGOs. Conversely, parliamentary systems with a proportional representation electoral rule are likely to provide fewer environmental public goods, which allows for a larger marginal impact of ENGOs. We find robust empirical support for these hypotheses in analyses that focus on the ratification behavior of 75 democracies vis-à-vis 250 international environmental agreements in 1973–2002.