Resonance Frequency Analysis (RFA) during early healing

Objectives: - to monitor resonance frequency analysis (RFA) in relation to the jawbone characteristics during the early phases of healing and incorporation of Straumann® dental implants with an SLA surface. Material and methods: 17 Straumann 4.1mm implants (10mm) and 7 Straumann 4.8mm implants (10mm) were installed and ISQ determined at baseline and after 1, 2, 3, 4, 5, 6, 8 and 12 weeks. Central bone cores were analyzed from the 4.1mm implants using micro CT for bone volume density (BVD) and bone trabecular connectivity (BTC). Results: Pocket probing depths ranged between 2-4mm and bleeding on probing between 5-20%. At baseline, BVD varied between 24 and 65% and BTC between 4.9 and 25.4 for the 4.1mm implants. Baseline ISQ varied between 55 and 74 with a mean of 61.4. No significant correlations were found between BVD or BTC and ISQ Values. For the 4.8mm diameter implants baseline ISQ values ranged from 57 – 70 with a mean of 63.3. Over the healing period ISQ values increased at 1 week and decreased after 2-3 weeks. After 4 weeks ISQ values, again increased slightly, no significant differences were noted over time. One implant (4.1mm) lost stability at 3 weeks. Its ISQ value had dropped from 68 to 45. However the latter value was determined after the clinical diagnosis of instability. Conclusion: ISQ values of 57 – 70 represented homeostasis and implant stability. However no predictive value for loosing implant stability can be attributed to RFA since decease occurred after the fact.

Tooth loss over five years

Objectives: To assess the ability to predict tooth loss on the basis of clinical and radiographic parameters. Methods: Clinical and radiographic data from a five year prospective cohort were studied to identify cause of progressive tooth loss in older subjects. Results: 363 subjects with a baseline mean age of 67.1 years (S.D. + 4.7, range : 60-75), and 51.4% women were studied including 59.5% never smokers, and 33.0% current smokers. At baseline the subjects had, on average, 22.4 teeth (S.D. + 6.4). Self-assessed tooth loss risk was identified by 16.0 % of subjects while 34% of subjects lost teeth. Tooth loss due to caries was found in 24.7% (178 teeth), periodontitis in 15.4% (133 teeth), peri-apical lesions 5.9% (32 teeth), combined periodontal/peri-apical in 3.4% (18 teeth), and teeth irrational to treat in 7.5% (58 teeth) of the subjects. 122 of the extracted teeth (34%) should have been possible to save but were extracted. At year five severe caries, periodontitis, peri-apical lesions, periodontal/peri-apical, irrational to treat were found in 6.3%, 7.2%, 2.6%, 4.6%, and 1.2% of subjects, respectively. Signs of osteoporosis increased by 11.2 % (Klemetti index). Linear regression analysis failed to include smoking habits as being explanatory. Explanatory factors were researcher prediction of extraction needs, subject self assessment of risk and change in ostoporosis status (r2 = 0.39, ANOVA, F=22.6, p< 0.001). Conclusions: Caries and periodontitis are primary causes for extraction. Progressive osteoporosis is associated with tooth loss. Radiographs, and subjects self-assessment of risk for tooth loss are robust predictors.

Infection at titanium implants with or without clinical inflammation

Objectives: The aims of the present study were (1)to assess the microbiota at implants in function diagnosed as having either peri-implantitis, or mucositis, or being clinically without symptoms of inflammation, (2) to identify explanatory factors to implant status. Material and Methods: Clinical and microbiological data were collected from 138 subjects (mean age: 62.3 ± 14.9) with 524 implants in function for an average of 10.8 years (S.D. +1.5). The checkerboard DNA-DNA hybridization method was used to identify 40 bacterial species. Results: Subjects had poor oral hygiene with a mean % plaque score 53.2 ± 24.4. In 36% of cases periodontitis was reported as the cause for implant therapy. Mucositis was diagnosed in 61.6% and per-implantitis in 15.9% of all cases. Edentulous subjects had at implants with peri-implantitis significantly higher bacterial loads for Streptococcus sanguis (p<0.01), Fusobacterium nucleatum sp. nucleatum (p<0.02), and Leptothrichia buccalis (p<0.05) than did dentate implant subjects. Dentate subjects had higher bacterial loads of Porphyromonas gingivalis (p<0.02). The levels of Fusobacterium nucleatum sp.vincentii and Capnocytophaga ochracea were explanatory to mucositis. Only a history of periodontitis as cause of tooth loss and smoking were explanatory to peri-implantitis. The microbiota was not affect by supportive care patterns. Conclusions: Presence or absence of teeth partly explains the implant microbiota. A past history of periodontitis and smoking are associated with peri-implantitis. The microbiota at implants with mucositis, or peri-implantitis is similar to that of teeth. Supportive periodontal and implant therapy fails to have an impact on implant microbiota and does not prevent mucositis and peri-implantitis.

Immunodetection of bone-related proteins in microcalcifications of human dental pulp

Objective: Root canal obliterations may pose esthetic and clinical problems or may even be a risk factor for tooth survival. Microcalcifications in the pulp can be so extensive that the entire root canal system becomes obliterated. Since bone sialoprotein (BSP) and osteopontin (OPN) are involved in both physiological and pathological mineralization processes, our hypothesis was that these two bone-related noncollagenous proteins are present in microcalcifications of the pulp. The purpose of this study was, therefore, to characterize the nature of microcalcifications in the pulp of aged human teeth. Methods: From a large collection of human teeth, 10 were found to exhibit pulpal microcalcifications. The teeth were extracted for periodontal reasons from 39-60 year old patients. After fixation in aldehydes and decalcification, teeth were processed for embedding in LR White resin for analysis in the light and transmission electron microscope. For the detection of BSP and OPN, post-embedding high resolution immunocytochemistry was applied. Results: The microcalcifications were round or elongated, occasionally coalescing, and intensely stained with toluidine blue. Collagen fibrils were found in most but not all microcalcifications. All microcalcifications were immunoreactive for both antibodies and showed an identical labeling pattern. Gold particle labeling was extensively found throughout the interfibrillar ground substance of the microcalcifications, whereas the dentin matrix lacked immunolabeling. Conclusion: BSP and OPN appear to be major matrix constituents of pulp microcalcifications and may thus, like in other mineralized tissues, be involved in their mineralization process.

Microhardness and marginal adaptation of pre-warmed composites

Objectives: The aim of this study was to examine the effect of pre-warmed composite on the microhardness and marginal adaptation. Methods: Ninety six identical class II cavities were prepared in extracted human molars and filled/cured in three 2 mm increments using a metal matrix. Two composites (Tetric Evo Ceram (IvoclarVivadent) and ELS(Saremco)) were cured with a LED curing unit (Bluephase (IvoclarVivadent)) using curing cycles of 20 and 40 seconds. The composite was used at room temperature or pre-warmed at 54.5ºC (Calset(AdDent)). Twelve teeth were filled for every composite-curing time-composite temperature combination. The teeth were thermocycled (1000 cycles at 5º and 55ºC) and then stored at 37° C for seven days . Dye penetration (basic fuchsine 5% for 8 hours) was measured using a score scale. Knoop microhardness was determined 100, 200, 500, 1000, 1500, 2500, 3500, 4500 and 5500µm from the occlusal surface at a distance of 150 and 1000µm from the metal matrix. The total degree of polymerization of a composite specimen was determined by calculating the area under the hardness curve. Results: Statistical analyses showed no difference in marginal adaptation (p>0.05). Hardness values at 150µm from the matrix were lower than those at 1000µm. There was an increase of the microhardness at the top of each increment and decrease towards the bottom of each increment. Longer curing times resulted in harder composite samples. Multiple linear regression showed that only the curing time (p<0.001) and composite material (p<0.001) had a significant association with the degree of polymerization. The degree of polymerization was not influenced by pre-warming the composite at a temperature of 54.5ºC (p=4.86). Conclusion: Polymerization time can not be reduced by pre-warming the composite on a temperature of 54.5ºC. The marginal adaptation is not compromised by pre-warming the composite.

The EU Policy on Institutional Multilingualism: Between Principles and Practicality

This article brings to light several inconsistencies within the narrative of the EU policy on institutional multilingualism. The EU has invoked fundamental EU principles of democracy, equality and transparent government, to publically bolster the need for its institutions to communicate and operate in the languages of its citizens. However, these principles do not allow for the pragmatic and budgetary arguments that the EU uses to justify the in reality limited number of official and de facto working languages of its institutions. The article argues that this disagreement could be resolved if the narrative of the EU's language policy would include the objective that all European citizens master any of the languages that the EU institutions use. In that light, the article recommends that further research is done into the question whether the EU should accept or even encourage the spontaneous development of English as a de facto pan-European lingua franca.

A Targeted Survey for Scrapie in Jos Plateau State, Nigeria

Scrapie, a disease of sheep and goats with a progressive course and fatal outcome, has not been identified in Nigeria. Anecdotal scrapie reports by livestock workers abound. Livestock diseases like scrapie form huddles in livestock economics of countries. For 8 months we surveyed for scrapie targeting emergency/casualty slaughter sheep and goats in Jos, Nigeria. We clinically examined 510 sheep and 608 goats of local breeds, aged from 12 months to 5 years. In total 31 (5.10%) goats and no sheep were clinically suspicious for scrapie. Caudal brainstem tissues of suspect animals collected postmortem were analyzed for the disease specific form of the prion protein, PrPSc, using Bio-Rad’s TeSeE ELISA rapid test kit. No sample was positive for scrapie. Fluorescent antibody test for rabies and H&E staining on samples were carried out for differential diagnosis. These showed no pathological lesions indicative for neurological disease. While our findings do not exclude the presence of scrapie in Jos, we demonstrate that targeted sampling of small ruminants for neuroinfectious disease is feasible in developing countries, pointing to the possibility of implementing such a monitoring scheme in Nigeria to prevent economic losses in small ruminant livestock as scrapie caveats from endemic countries have shown.

Surface Roughness and Microhardness of Two Recent CAD/CAM-Materials After Storage

Objectives: To investigate surface roughness and microhardness of two recent resin-ceramic materials for computer-aided design/computer-aided manufacturing (CAD/CAM) after polishing with three polishing systems. Surface roughness and microhardness were measured immediately after polishing and after six months storage including monthly artificial toothbrushing. Methods: Sixty specimens of Lava Ultimate (3M ESPE) and 60 specimens of VITA ENAMIC (VITA Zahnfabrik) were roughened in a standardized manner and polished with one of three polishing systems (n=20/group): Sof-Lex XT discs (SOFLEX; three-step (medium-superfine); 3M ESPE), VITA Polishing Set Clinical (VITA; two-step; VITA Zahnfabrik), or KENDA Unicus (KENDA; one-step; KENDA Dental). Surface roughness (Ra; μm) was measured with a profilometer and microhardness (Vickers; VHN) with a surface hardness indentation device. Ra and VHN were measured immediately after polishing and after six months storage (tap water, 37°C) including monthly artificial toothbrushing (500 cycles/month, toothpaste RDA ~70). Ra- and VHN-values were analysed with nonparametric ANOVA followed by Wilcoxon rank sum tests (α=0.05). Results: For Lava Ultimate, Ra (mean [standard deviation] before/after storage) remained the same when polished with SOFLEX (0.18 [0.09]/0.19 [0.10]; p=0.18), increased significantly with VITA (1.10 [0.44]/1.27 [0.39]; p=0.0001), and decreased significantly with KENDA (0.35 [0.07]/0.33 [0.08]; p=0.03). VHN (mean [standard deviation] before/after storage) decreased significantly regardless of polishing system (SOFLEX: 134.1 [5.6]/116.4 [3.6], VITA: 138.2 [10.5]/115.4 [5.9], KENDA: 135.1 [6.2]/116.7 [6.3]; all p<0.0001). For VITA ENAMIC, Ra (mean [standard deviation] before/after storage) increased significantly when polished with SOFLEX (0.37 [0.18]/0.41 [0.14]; p=0.01) and remained the same with VITA (1.32 [0.37]/1.31 [0.40]; p=0.58) and with KENDA (0.81 [0.35]/0.78 [0.32]; p=0.21). VHN (mean [standard deviation] before/after storage) remained the same regardless of polishing system (SOFLEX: 284.9 [24.6]/282.4 [31.8], VITA: 284.6 [28.5]/276.4 [25.8], KENDA: 292.6 [26.9]/282.9 [24.3]; p=0.42-1.00). Conclusion: Surface roughness and microhardness of Lava Ultimate was more affected by storage and artificial toothbrushing than was VITA ENAMIC.

High prevalence but limited evidence in complementary and alternative medicine: guidelines for future research

The use of complementary and alternative Medicine (CAM) has increased over the past two decades in Europe. Nonetheless, research investigating the evidence to support its use remains limited. The CAMbrella project funded by the European Commission aimed to develop a strategic research agenda starting by systematically evaluating the state of CAM in the EU. CAMbrella involved 9 work packages covering issues such as the definition of CAM; its legal status, provision and use in the EU; and a synthesis of international research perspectives. Based on the work package reports, we developed a strategic and methodologically robust research roadmap based on expert workshops, a systematic Delphi-based process and a final consensus conference. The CAMbrella project suggests six core areas for research to examine the potential contribution of CAM to the health care challenges faced by the EU. These areas include evaluating the prevalence of CAM use in Europe; the EU cititzens’ needs and attitudes regarding CAM; the safety of CAM; the comparative effectiveness of CAM; the effects of meaning and context on CAM outcomes; and different models for integrating CAM into existing health care systems. CAM research should use methods generally accepted in the evaluation of health services, including comparative effectiveness studies and mixed-methods designs. A research strategy is urgently needed, ideally led by a European CAM coordinating research office dedicated to fostering systematic communication between EU governments, the public, charitable and industry funders, researchers and other stakeholders. A European Centre for CAM should also be established to monitor and further a coordinated research strategy with sufficient funds to commission and promote high quality, independent research focusing on the public’s health needs and pan-European collaboration. There is a disparity between highly prevalent use of CAM in Europe and solid knowledge about it. A strategic approach on CAM research should be established to investigate the identified gaps of knowledge and to address upcoming health care challenges.

Childhood cancer survivor cohorts in Europe.

With the advent of multimodality therapy, the overall five-year survival rate from childhood cancer has improved considerably now exceeding 80% in developed European countries. This growing cohort of survivors, with many years of life ahead of them, has raised the necessity for knowledge concerning the risks of adverse long-term sequelae of the life-saving treatments in order to provide optimal screening and care and to identify and provide adequate interventions. Childhood cancer survivor cohorts in Europe. Considerable advantages exist to study late effects in individuals treated for childhood cancer in a European context, including the complementary advantages of large population-based cancer registries and the unrivalled opportunities to study lifetime risks, together with rich and detailed hospital-based cohorts which fill many of the gaps left by the large-scale population-based studies, such as sparse treatment information. Several large national cohorts have been established within Europe to study late effects in individuals treated for childhood cancer including the Nordic Adult Life after Childhood Cancer in Scandinavia study (ALiCCS), the British Childhood Cancer Survivor Study (BCCSS), the Dutch Childhood Oncology Group (DCOG) LATER study, and the Swiss Childhood Cancer Survivor Study (SCCSS). Furthermore, there are other large cohorts, which may eventually become national in scope including the French Childhood Cancer Survivor Study (FCCSS), the French Childhood Cancer Survivor Study for Leukaemia (LEA), and the Italian Study on off-therapy Childhood Cancer Survivors (OTR). In recent years significant steps have been taken to extend these national studies into a larger pan-European context through the establishment of two large consortia - PanCareSurFup and PanCareLIFE. The purpose of this paper is to present an overview of the current large, national and pan-European studies of late effects after childhood cancer. This overview will highlight the strong cooperation across Europe, in particular the EU-funded collaborative research projects PanCareSurFup and PanCareLIFE. Overall goal. The overall goal of these large cohort studies is to provide every European childhood cancer survivor with better care and better long-term health so that they reach their full potential, and to the degree possible, enjoy the same quality of life and opportunities as their peers.

Continental-Scale Footprint of Balancing and Positive Selection in a Small Rodent (Microtus arvalis)

Genetic adaptation to different environmental conditions is expected to lead to large differences between populations at selected loci, thus providing a signature of positive selection. Whereas balancing selection can maintain polymorphisms over long evolutionary periods and even geographic scale, thus leads to low levels of divergence between populations at selected loci. However, little is known about the relative importance of these two selective forces in shaping genomic diversity, partly due to difficulties in recognizing balancing selection in species showing low levels of differentiation. Here we address this problem by studying genomic diversity in the European common vole (Microtus arvalis) presenting high levels of differentiation between populations (average FST = 0.31). We studied 3,839 Amplified Fragment Length Polymorphism (AFLP) markers genotyped in 444 individuals from 21 populations distributed across the European continent and hence over different environmental conditions. Our statistical approach to detect markers under selection is based on a Bayesian method specifically developed for AFLP markers, which treats AFLPs as a nearly codominant marker system, and therefore has increased power to detect selection. The high number of screened populations allowed us to detect the signature of balancing selection across a large geographic area. We detected 33 markers potentially under balancing selection, hence strong evidence of stabilizing selection in 21 populations across Europe. However, our analyses identified four-times more markers (138) being under positive selection, and geographical patterns suggest that some of these markers are probably associated with alpine regions, which seem to have environmental conditions that favour adaptation. We conclude that despite favourable conditions in this study for the detection of balancing selection, this evolutionary force seems to play a relatively minor role in shaping the genomic diversity of the common vole, which is more influenced by positive selection and neutral processes like drift and demographic history.

Contribution of APOBEC3G/F Activity to the Development of Low-Abundance Drug-Resistant HIV-1 variants.

Plasma drug-resistant minority HIV-1 variants (DRMV) increase the risk of virological failure to first-line NNRTI antiretroviral therapy (ART). The origin of DRMVs in ART-naive patients, however, remains unclear. In a large pan-European case-control study investigating the clinical relevance of pre-existing DRMVs using 454 pyrosequencing, the six most prevalent plasma DRMVs detected corresponded to G-to-A nucleotide mutations (V90I, V106I, V108I, E138K, M184I and M230I). Here, we evaluated if such DRMVs could have emerged from APOBEC3G/F activity. Out of 236 ART-naïve evaluated subjects, APOBEC3G/F hypermutation signatures were detected in plasma viruses of 14 (5.9%) individuals. Samples with minority E138K, M184I, and M230I mutations, but not those with V90I, V106I, or V108I were significantly associated with APOBEC3G/F activity (Fisher's p<0.005), defined as presence of >0.5% of sample sequences with an APOBEC3G/F signature. Mutations E138K, M184I and M230I co-occurred in the same sequence as APOBEC3G/F signatures in 3/9 (33%), 5/11 (45%) and 4/8 (50%) of samples, respectively; such linkage was not found for V90I, V106I or V108I. In-frame STOP codons were observed in 1.5% of all clonal sequences; 14.8% of them co-occurred with APOBEC3G/F signatures. APOBEC3G/F-associated E138K, M184I and M230I appeared within clonal sequences containing in-frame STOP codons in 2/3 (66%), 5/5 (100%) and 4/4 (100%) of the samples. In a reanalysis of the parent case-control study, presence of APOBEC3G/F signatures was not associated with virological failure. In conclusion, the contribution of APOBEC3G/F editing to the development of DRMVs is very limited and does not affect the efficacy of NNRTI ART.

Displaced Stories: The Interplay of Telling and Being in the Face of Displacement

Throughout the last decades, narrative approaches have become quintessential tools for understanding crisis and displacement. While a focus on individual stories allows for a deep look into the particularity of being-displaced, it simultaneously runs the risk of romanticising the outcome (the life story) of what is indeed the product of a rather complex process (the telling of the life story). In this paper I will discuss a change of perspectives: Rather than laying the focus on life stories as texts, I will suggest to shift the attention towards the existential dynamics of storytelling. By zooming in on my longstanding collaboration with a Somali woman in Melbourne, Australia, I will map out the interplay of telling and being that marked this process. Focusing on one particular storytelling moment, I will suggest the importance of appreciating the intersubjective force of storytelling. Rather than melting the set of stories into a coherent “life story”, I will look at the storytelling moment in its lived messiness. In doing so, I will sketch out its potential to shed light both on the teller’s hopes, imaginations and ambitions, and on the reality of being part of a wider world that often contradicts and shatters these hopes.

Biotic homogenization can decrease landscape-scale forest multifunctionality

Many experiments have shown that local biodiversity loss impairs the ability of ecosystems to maintain multiple ecosystem functions at high levels (multifunctionality). In contrast, the role of biodiversity in driving ecosystem multifunctionality at landscape scales remains unresolved. We used a comprehensive pan-European dataset, including 16 ecosystem functions measured in 209 forest plots across six European countries, and performed simulations to investigate how local plot-scale richness of tree species (α-diversity) and their turnover between plots (β-diversity) are related to landscape-scale multifunctionality. After accounting for variation in environmental conditions, we found that relationships between α-diversity and landscape-scale multifunctionality varied from positive to negative depending on the multifunctionality metric used. In contrast, when significant, relationships between β-diversity and landscape-scale multifunctionality were always positive, because a high spatial turnover in species composition was closely related to a high spatial turnover in functions that were supported at high levels. Our findings have major implications for forest management and indicate that biotic homogenization can have previously unrecognized and negative consequences for large-scale ecosystem multifunctionality.