Implants versus short-span fixed bridges: survival, complications, patients' benefits. A systematic review on economic aspects

To systematically evaluate the existing evidence to answer the focused question: For a patient with a single tooth to be replaced, is the implant crown, based on economic considerations, preferred to a conventional fixed partial denture?

Epidemiological, social, diagnostic and economic evaluation of population screening for genital chlamydial infection

OBJECTIVES: To investigate epidemiological, social, diagnostic and economic aspects of chlamydia screening in non-genitourinary medicine settings. METHODS: Linked studies around a cross-sectional population-based survey of adult men and women invited to collect urine and (for women) vulvovaginal swab specimens at home and mail these to a laboratory for testing for Chlamydia trachomatis. Specimens were used in laboratory evaluations of an amplified enzyme immunoassay (PCE EIA) and two nucleic acid amplification tests [Cobas polymerase chain reaction (PCR), Becton Dickinson strand displacement amplification (SDA)]. Chlamydia-positive cases and two negative controls completed a risk factor questionnaire. Chlamydia-positive cases were invited into a randomised controlled trial of partner notification strategies. Samples of individuals testing negative completed psychological questionnaires before and after screening. In-depth interviews were conducted at all stages of screening. Chlamydia transmission and cost-effectiveness of screening were investigated in a transmission dynamic model. SETTING AND PARTICIPANTS: General population in the Bristol and Birmingham areas of England. In total, 19,773 women and men aged 16-39 years were randomly selected from 27 general practice lists. RESULTS: Screening invitations reached 73% (14,382/19,773). Uptake (4731 participants), weighted for sampling, was 39.5% (95% CI 37.7, 40.8%) in women and 29.5% (95% CI 28.0, 31.0%) in men aged 16-39 years. Chlamydia prevalence (219 positive results) in 16-24 year olds was 6.2% (95% CI 4.9, 7.8%) in women and 5.3% (95% CI 4.4, 6.3%) in men. The case-control study did not identify any additional factors that would help target screening. Screening did not adversely affect anxiety, depression or self-esteem. Participants welcomed the convenience and privacy of home-sampling. The relative sensitivity of PCR on male urine specimens was 100% (95% CI 89.1, 100%). The combined relative sensitivities of PCR and SDA using female urine and vulvovaginal swabs were 91.8% (86.1, 95.7, 134/146) and 97.3% (93.1, 99.2%, 142/146). A total of 140 people (74% of eligible) participated in the randomised trial. Compared with referral to a genitourinary medicine clinic, partner notification by practice nurses resulted in 12.4% (95% CI -3.7, 28.6%) more patients with at least one partner treated and 22.0% (95% CI 6.1, 37.8%) more patients with all partners treated. The health service and patients costs (2005 prices) of home-based postal chlamydia screening were 21.47 pounds (95% CI 19.91 pounds, 25.99) per screening invitation and 28.56 pounds (95% CI 22.10 pounds, 30.43) per accepted offer. Preliminary modelling found an incremental cost-effectiveness ratio (2003 prices) comparing screening men and women annually to no screening in the base case of 27,000 pounds/major outcome averted at 8 years. If estimated screening uptake and pelvic inflammatory disease incidence were increased, the cost-effectiveness ratio fell to 3700 pounds/major outcome averted. CONCLUSIONS: Proactive screening for chlamydia in women and men using home-collected specimens was feasible and acceptable. Chlamydia prevalence rates in men and women in the general population are similar. Nucleic acid amplification tests can be used on first-catch urine specimens and vulvovaginal swabs. The administrative costs of proactive screening were similar to those for opportunistic screening. Using empirical estimates of screening uptake and incidence of complications, screening was not cost-effective.

Applied Graph Theory in Computer Vision and Pattern Recognition

This book will serve as a foundation for a variety of useful applications of graph theory to computer vision, pattern recognition, and related areas. It covers a representative set of novel graph-theoretic methods for complex computer vision and pattern recognition tasks. The first part of the book presents the application of graph theory to low-level processing of digital images such as a new method for partitioning a given image into a hierarchy of homogeneous areas using graph pyramids, or a study of the relationship between graph theory and digital topology. Part II presents graph-theoretic learning algorithms for high-level computer vision and pattern recognition applications, including a survey of graph based methodologies for pattern recognition and computer vision, a presentation of a series of computationally efficient algorithms for testing graph isomorphism and related graph matching tasks in pattern recognition and a new graph distance measure to be used for solving graph matching problems. Finally, Part III provides detailed descriptions of several applications of graph-based methods to real-world pattern recognition tasks. It includes a critical review of the main graph-based and structural methods for fingerprint classification, a new method to visualize time series of graphs, and potential applications in computer network monitoring and abnormal event detection.

Efficacy of communication skills training courses in oncology: a systematic review and meta-analysis

Objective: Group training in communication skills [communication skills training (CST)] has become partly mandatory for oncology staff. However, so far, a comprehensive meta-analysis on the efficacy is lacking. Design: Included studies either compare the efficacy of a specific training with a control group or look at the additional effect of booster sessions on communication behaviour, attitudes or patient outcomes. Methods: Four electronic databases were searched up to July 2008 without language restriction, and reference lists of earlier reviews were screened. Effect sizes (ESs) were extracted and pooled in random effects meta-analyses. Results: We included 13 trials (three non-randomised), 10 with no specific intervention in the control group. Meta-analysis showed a moderate effect of CST on communication behaviour ES = 0.54. Three trials compared basic training courses with more extensive training courses and showed a small additional effect on communication skills ES = 0.37. Trials investigating participants' attitudes ES = 0.35 and patient outcomes ES = 0.13 (trend) confirmed this effect. Conclusions: Training health professionals by CST is a promising approach to change communication behaviour and attitudes. Patients might also benefit from specifically trained health professionals but strong studies are lacking. However, feasibility and economic aspects have to be kept in mind when considering providing a training of optimal length.

Dental erosion in children

Erosive tooth wear in children is a common condition. The overlapping of erosion with mechanical forces like attrition or abrasion is probably in deciduous teeth more pronounced than in permanent teeth. Early erosive damage to the permanent teeth may compromise the dentition for the entire lifetime and require extensive restorative procedures. Therefore, early diagnosis of the condition and adequate preventive measures are of importance. Knowledge of the etiological factors for erosive tooth wear is a prerequisite for such measures. In children and adolescents (like in adults) extrinsic and intrinsic factors or a combination of them are possible reasons for the condition. Such factors are frequent and extensive consumption of erosive foodstuffs and drinks, the intake of medicaments (asthma), gastro-esophageal reflux (a case history is discussed) or vomiting. But also behavioral factors like unusual eating and drinking habits, the consumption of designer drugs and socio-economic aspects are of importance.

Agroecosystem resilience and farmers’ perceptions of climate change impacts on cocoa farms in Alto Beni, Bolivia

Cocoa-based small-scale agriculture is the most important source of income for most farming families in the region of Alto Beni in the sub-humid foothills of the Andes. Cocoa is grown in cultivation systems of varying ecological complexity. The plantations are highly susceptible to climate change impacts. Local cocoa producers mention heat waves, droughts, floods and plant diseases as the main impacts affecting plants and working conditions, and they associate these impacts with global climate change. From a sustainable regional development point of view, cocoa farms need to become more resilient in order to cope with the climate change related effects that are putting cocoa-based livelihoods at risk. This study assesses agroecosystem resilience under three different cocoa cultivation systems (successional agroforestry, simple agroforestry and common practice monocultures). In a first step, farmers’ perceptions of climate change impacts were assessed and eight indicators of agroecological resilience were derived in a transdisciplinary process (focus groups and workshop) based on farmers’ and scientists’ knowledge. These indicators (soil organic matter, depth of Ah horizon, soil bulk density, tree species diversity, crop varieties diversity, ant species diversity, cocoa yields and infestation of cocoa trees with Moniliophthora perniciosa) were then surveyed on 15 cocoa farms and compared for the three different cultivation systems. Parts of the socio-economic aspects of resilience were covered by evaluating the role of cocoa cooperatives and organic certification in transitioning to more resilient cocoa farms (interviews with 15 cocoa farmers combined with five expert interviews). Agroecosystem resilience was higher under the two agroforestry systems than under common practice monoculture, especially under successional agroforestry. Both agroforestry systems achieved higher cocoa yields than common practice monoculture due to agroforestry farmers’ enhanced knowledge regarding cocoa cultivation. Knowledge sharing was promoted by local organizations facilitating organic certification. These organizations were thus found to enhance the social process of farmers’ integration into cooperatives and their reorientation toward organic principles and diversified agroforestry.

Erosive tooth wear in children.

Erosive tooth wear in children is a common condition. Besides the anatomical differences between deciduous and permanent teeth, additional histological differences may influence their susceptibility to dissolution. Considering laboratory studies alone, it is not clear whether deciduous teeth are more liable to erosive wear than permanent teeth. However, results from epidemiological studies imply that the primary dentition is less wear resistant than permanent teeth, possibly due to the overlapping of erosion with mechanical forces (like attrition or abrasion). Although low severity of tooth wear in children does not cause a significant impact on their quality of life, early erosive damage to their permanent teeth may compromise their dentition for their entire lifetime and require extensive restorative procedures. Therefore, early diagnosis of erosive wear and adequate preventive measures are important. Knowledge on the aetiological factors of erosive wear is a prerequisite for preventive strategies. Like in adults, extrinsic and intrinsic factors, or a combination of them, are possible reasons for erosive tooth wear in children and adolescents. Several factors directly related to erosive tooth wear in children are presently discussed, such as socio-economic aspects, gastroesophageal reflux or vomiting, and intake of some medicaments, as well as behavioural factors such as unusual eating and drinking habits. Additionally, frequent and excessive consumption of erosive foodstuffs and drinks are of importance.

Irrigation development in Eritrea: potentials and constraints: Proceedings of the workshop of AEAS and SLM Programme Eritrea

Development of irrigation, which is of crucial importance in Eritrea, is perceived by many as the main technique for improving the precarious food security situation in this Sahelian country in the Horn of Africa. The present publication presents the outcome of a nationwide workshop held in 2003, which brought together administrators, scientists, and members of public development agencies and NGOs. These workshop participants presented experiences, lessons learnt, and ideas about how to move forward in relation to development of irrigation in Eritrea. Specifically, the publication deals with the following broad themes, lessons learnt, and experiences in Eritrea: · spate irrigation systems and measurement of performance, as well as experience with modernisation of spate irrigation systems in Eritrea · small-scale irrigation systems and their potentials and pitfalls, including development of low-cost micro irrigation · climate and irrigation, including rainfall forecasts · socio-economic aspects of irrigation, including gender questions, institutional requirements, and irrigation and livelihoods The publication contains an extensive summary in the Tigrinya language, in order to facilitate access to the key findings by local non-English-speaking stakeholders in irrigation development.

A computer-aided diagnostic system to characterize CT focal liver lesions: design and optimization of a neural network classifier

In this paper, a computer-aided diagnostic (CAD) system for the classification of hepatic lesions from computed tomography (CT) images is presented. Regions of interest (ROIs) taken from nonenhanced CT images of normal liver, hepatic cysts, hemangiomas, and hepatocellular carcinomas have been used as input to the system. The proposed system consists of two modules: the feature extraction and the classification modules. The feature extraction module calculates the average gray level and 48 texture characteristics, which are derived from the spatial gray-level co-occurrence matrices, obtained from the ROIs. The classifier module consists of three sequentially placed feed-forward neural networks (NNs). The first NN classifies into normal or pathological liver regions. The pathological liver regions are characterized by the second NN as cyst or "other disease." The third NN classifies "other disease" into hemangioma or hepatocellular carcinoma. Three feature selection techniques have been applied to each individual NN: the sequential forward selection, the sequential floating forward selection, and a genetic algorithm for feature selection. The comparative study of the above dimensionality reduction methods shows that genetic algorithms result in lower dimension feature vectors and improved classification performance.

Real-World Energy Measurements of a Wireless Mesh Network

Over the past several years the topics of energy consumption and energy harvesting have gained significant importance as a means for improved operation of wireless sensor and mesh networks. Energy-awareness of operation is especially relevant for application scenarios from the domain of environmental monitoring in hard to access areas. In this work we reflect upon our experiences with a real-world deployment of a wireless mesh network. In particular, a comprehensive study on energy measurements collected over several weeks during the summer and the winter period in a network deployment in the Swiss Alps is presented. Energy performance is monitored and analysed for three system components, namely, mesh node, battery and solar panel module. Our findings cover a number of aspects of energy consumption, including the amount of load consumed by a mesh node, the amount of load harvested by a solar panel module, and the dependencies between these two. With our work we aim to shed some light on energy-aware network operation and to help both users and developers in the planning and deployment of a new wireless (mesh) network for environmental research.

A Routing Protocol Based on Energy and Link Quality for Internet of Things Applications

The Internet of Things (IoT) is attracting considerable attention from the universities, industries, citizens and governments for applications, such as healthcare, environmental monitoring and smart buildings. IoT enables network connectivity between smart devices at all times, everywhere, and about everything. In this context, Wireless Sensor Networks (WSNs) play an important role in increasing the ubiquity of networks with smart devices that are low-cost and easy to deploy. However, sensor nodes are restricted in terms of energy, processing and memory. Additionally, low-power radios are very sensitive to noise, interference and multipath distortions. In this context, this article proposes a routing protocol based on Routing by Energy and Link quality (REL) for IoT applications. To increase reliability and energy-efficiency, REL selects routes on the basis of a proposed end-to-end link quality estimator mechanism, residual energy and hop count. Furthermore, REL proposes an event-driven mechanism to provide load balancing and avoid the premature energy depletion of nodes/networks. Performance evaluations were carried out using simulation and testbed experiments to show the impact and benefits of REL in small and large-scale networks. The results show that REL increases the network lifetime and services availability, as well as the quality of service of IoT applications. It also provides an even distribution of scarce network resources and reduces the packet loss rate, compared with the performance of well-known protocols.

Mobile Cloud Networking: Mobile Network, Compute, and Storage as One Service On-Demand

The Future Communication Architecture for Mobile Cloud Services: Mobile Cloud Networking (MCN) is a EU FP7 Large-scale Integrating Project (IP) funded by the European Commission. MCN project was launched in November 2012 for the period of 36 month. In total top-tier 19 partners from industry and academia commit to jointly establish the vision of Mobile Cloud Networking, to develop a fully cloud-based mobile communication and application platform.