CAD/CAM fabrication accuracy of long- vs. short-span implant-supported FDPs

OBJECTIVE To compare the precision of fit of long-span vs. short-span implant-supported screw-retained fixed dental prostheses (FDPs) made from computer-aided-design/computer-aided-manufactured (CAD/CAM) titanium and veneered with ceramic. The null hypothesis was that there is no difference in the vertical microgap between long-span and short-span FDPs. MATERIALS AND METHODS CAD/CAM titanium frameworks for an implant-supported maxillary FDP on implants with a flat platform were fabricated on one single master cast. Group A consisted of six 10-unit FDPs connected to six implants (FDI positions 15, 13, 11, 21, 23, 25) and group B of six 5-unit FDPs (three implants, FDI positions 21, 23, 25). The CAD/CAM system from Biodenta Swiss AG (Berneck, Switzerland) was used for digitizing (laser scanner) the master cast and anatomical CAD of each framework separately. The frameworks were milled (CAM) from a titanium grade V monobloc and veneered with porcelain. Median vertical distance between implant and FDP platforms from the non-tightened implants (one-screw test on implant 25) was calculated from mesial, buccal, and distal scanning electron microscope measurements. RESULTS All measurements showed values <40 μm. Total median vertical microgaps were 23 μm (range 2-38 μm) for group A and 7 μm (4-24 μm) for group B. The difference between the groups was statistically significant at implant 21 (P = 0.002; 97.5% CI -27.3 to -4.9) and insignificant at implant 23 (P = 0.093; -3.9 to 1.0). CONCLUSIONS CAD/CAM fabrication including laboratory scanning and porcelain firing was highly precise and reproducible for all long- and short-span FDPs. While all FDPs showed clinically acceptable values, the short-span FDPs were statistically more precise at the 5-unit span distance.

Detecting the signature of natural selection with microsatellites

Natural selection is one of the major factors in the evolution of all organisms. Detecting the signature of natural selection has been a central theme in evolutionary genetics. With the availability of microsatellite data, it is of interest to study how natural selection can be detected with microsatellites. ^ The overall aim of this research is to detect signatures of natural selection with data on genetic variation at microsatellite loci. The null hypothesis to be tested is the neutral mutation theory of molecular evolution, which states that different alleles at a locus have equivalent effects on fitness. Currently used tests of this hypothesis based on data on genetic polymorphism in natural populations presume that mutations at the loci follow the infinite allele/site models (IAM, ISM), in the sense that at each site at most only one mutation event is recorded, and each mutation leads to an allele not seen before in the population. Microsatellite loci, which are abundant in the genome, do not obey these mutation models, since the new alleles at such loci can be created either by contraction or expansion of tandem repeat sizes of core motifs. Since the current genome map is mainly composed of microsatellite loci and this class of loci is still most commonly studied in the context of human genome diversity, this research explores how the current test procedures for testing the neutral mutation hypothesis should be modified to take into account a generalized model of forward-backward stepwise mutations. In addition, recent literature also suggested that past demographic history of populations, presence of population substructure, and varying rates of mutations across loci all have confounding effects for detecting signatures of natural selection. ^ The effects of the stepwise mutation model and other confounding factors on detecting signature of natural selection are the main results of the research. ^

Efficient Unit Root Tests of real Exchange Rates in the Post-Bretton Woods Era

We apply the efficient unit-roots tests of Elliott, Rothenberg, and Stock (1996), and Elliott (1998) to twenty-one real exchange rates using monthly data of the G-7 countries from the post-Bretton Woods floating exchange rate period. Our results indicate that, for eighteen out of the twenty-one real exchange rates, the null hypothesis of a unit root can be rejected at the 10% significance level or better using the Elliot et al (1996) DF-GLS test. The unit-root null hypothesis is also rejected for one additional real exchange rate when we allow for one endogenously determined break in the time series of the real exchange rate as in Perron (1997). In all, we find favorable evidence to support long-run purchasing power parity in nineteen out of twenty-one real exchange rates. Second, we find no strong evidence to suggest that the use of non-U.S. dollar-based real exchange rates tend to produce more favorable result for long-run PPP than the use of U.S. dollar-based real exchange rates as Lothian (1998) has concluded.

Non-Parametric Tests of Real Exchange rates in the Post-Bretton Woods Era

This paper examines the mean-reverting property of real exchange rates. Earlier studies have generally not been able to reject the null hypothesis of a unit-root in real exchange rates, especially for the post-Bretton Woods floating period. The results imply that long-run purchasing power parity does not hold. More recent studies, especially those using panel unit-root tests, have found more favorable results, however. But, Karlsson and Löthgren (2000) and others have recently pointed out several potential pitfalls of panel unit-root tests. Thus, the panel unit-root test results are suggestive, but they are far from conclusive. Moreover, consistent individual country time series evidence that supports long-run purchasing power parity continues to be scarce. In this paper, we test for long memory using Lo's (1991) modified rescaled range test, and the rescaled variance test of Giraitis, Kokoszka, Leipus, and Teyssière (2003). Our testing procedure provides a non-parametric alternative to the parametric tests commonly used in this literature. Our data set consists of monthly observations from April 1973 to April 2001 of the G-7 countries in the OECD. Our two tests find conflicting results when we use U.S. dollar real exchange rates. However, when non-U.S. dollar real exchange rates are used, we find only two cases out of fifteen where the null hypothesis of an unit-root with short-term dependence can be rejected in favor of the alternative hypothesis of long-term dependence using the modified rescaled range test, and only one case when using the rescaled variance test. Our results therefore provide a contrast to the recent favorable panel unit-root test results.

Effect of maternal weight status on the relationship between prenatal smoking and infant birth weight

The purpose of this study was to assess the effect of maternal pre-pregnancy weight status on the relationship between prenatal smoking and infant birth weight (IBW). Prenatal cigarette smoking and maternal weight exert opposing effects on IBW; smoking decreases birth weight while maternal pre-pregnancy weight is positively correlated with birth weight. As such, mutual effect modification may be sufficiently significant to alter the independent effects of these two birth weight correlates. Finding of such an effect has implications of prenatal smoking cessation education. Perception of risk is an important determinant of smoking cessation, and reduced or low birth weight (LBW) as a smoking-associated risk predominates prenatal smoking counseling and education. In a population such as the US, where obesity is becoming epidemic, particularly among minority and low-income groups, perception of risk may be lowered should increased maternal size attenuate the effect of smoking. Previous studies have not found a significant interaction effect of prenatal smoking and maternal pre-pregnancy weight on IBW; however, use of self-reported smoking status may have biased findings. Reliability of self-reported smoking status reported in the literature is variable, with deception rates ranging from a low of 5% to as high as 16%. This study, using data from a prenatal smoking cessation project, in which smoking status was validated by saliva cotinine, was an opportunity to assess effect modification of smoking and maternal weight using biochemically determined smoking status in lieu of self report. Stratified by saliva cotinine, 151 women from a prenatal smoking cessation cohort, who were 18 years and older and had full-term, singleton births, were included in this study. The effect of smoking in terms of mean birth weight across three levels of maternal pre-pregnancy weight was assessed by general linear modeling procedures, adjusting for other known correlates of IBW. Effect modification was marginally significant, p = .104, but only with control for differential effects among racial/ethnic groups. A smaller than planned sample of nonsmokers, or women who quit smoking during the pregnancy, prohibited rejection of the null hypothesis of no difference in the effect of smoking across levels of pre-pregnancy weight. ^

Mathematical and empirical examinations of some epidemiological procedures

In epidemiology literature, it is often required to investigate the relationships between means where the levels of experiment are actually monotone sets forming a partition on the range of sampling values. With this need, the analysis of these group means is generally performed using classical analysis of variance (ANOVA). However, this method has never been challenged. In this dissertation, we will formulate and present our examination of its validity. First, the classical assumptions of normality and constant variance are not always true. Second, under the null hypothesis of equal means, the test statistic for the classical ANOVA technique is still valid. Third, when the hypothesis of equal means is rejected, the classical analysis techniques for hypotheses of contrasts are not valid. Fourth, under the alternative hypothesis, we can show that the monotone property of levels leads to the conclusion that the means are monotone. Fifth, we propose an appropriate method for handing the data in this situation. ^

Assessment of US Air Force student pilots with intermittent monofixation syndrome on a non-stereoptic dependent flight maneuver in pilot training

The United States Air Force School of Aerospace Medicine (USAFSAM) and Aeromedical Consult Service (ACS) have developed waiver criteria for pilots with subtle substandard depth perception. This is to allow United States Air Force (USAF) pilots with mild depth perception deficiency to continue flying duties while limiting the risk to flight safety and ensuring the availability of costly human resources. From 1999 to 2005, 166 aviators were given waivers for intermittent monofixation syndrome (IMFS). Of these, 96 were student pilots who performed slightly worse at stereoptic dependent flight maneuvers than student pilots (8,907) with normal depth perception (Lowry, 2006).^ This study's purpose is to evaluate the performance of the extended-trail maneuver, a non-stereoptic dependent flying maneuver, as executed by a cohort of 12 United States Air Force student pilots with intermittent monofixation syndrome versus the cohort of 100 student pilots with normal depth perception. These subjects are extracted from the cohorts examined by Lowry (2006) and the null hypothesis predicts no statistical difference in the performance of the non-stereoptic dependant flight maneuver extended-trail between student pilots with intermittent monofixation syndrome and those without the condition. ^

Relationship between parental feeding practices and weight status in a lower socioeconomic pre-school population

High prevalence of overweight and obesity among preschool children in the low income population is consistently documented in research with one of every seven low-income, preschool-aged children classified as obese. Parental feeding practices have the potential to be contributing factors to the obesity epidemic. However, the impact of parental feeding practices on obesity in preschool age children has not been well explored. The purpose of this study was to determine relationships between the parental feeding practices of using dessert, sweets or candy as a reward for finishing foods, restricting dessert if the child does not finish their plate at dinner, asking the child to consume everything on their plate at dinner, and having family dinners to obesity in low income, preschool age children.^ A cross-sectional secondary data analysis was completed using the STATA 11 statistical software. Descriptive statistics were completed to summarize demographic and BMI data of participants, as well as parental feeding behavior variables. Pearson’s correlation was implemented to determine a correlation between parental feeding behavior variables and BMI z scores. Predictive relationships between the variables were explored through multivariable linear regression analysis. Regression analyses were also completed factoring in the confounders of gender, age, and ethnicity.^ Results revealed (1) no significant correlations or predictive trends between the use of rewards, forced consumption, or family dinner and BMI in low income preschool age children, and (2) a significant negative correlation and predictive trend between restriction of desserts and BMI in low income preschool age children. Since the analysis supported the null hypothesis for the practices of reward use, forced consumption, and family dinner, these practices are not considered risk factors for obese level BMIs. The inverse association found for practice of restriction and BMI suggests it is unnecessary to discourage parents from using restriction. Limitations of the study included the sample size, reliability of the answers provided on the Healthy Home Survey by participant guardians, and generalizability of the sample to the larger population.^

Seasonal aspects of leukemia

An investigation of (a) month/season-of-birth as a risk factor and (b) month/season-of-treatment initation as a prognostic factor in acute lymphoblastic leukemia (ALL) in children, 0-15 years of age, was conducted. The study population used was that of the Surveillance, Epidemiology, and End Results (SEER) program of the National Cancer Institute and included children diagnosed and treated for ALL from 1973-1986. Two separate sets of analyses using different exclusion criteria led to similar results. Specifically, the inability to reject the null hypothesis of no significant difference in the variation of monthly/seasonal incidence rates among children residing within the 10 SEER sites using either cosinor analysis or one-way analysis of variance. No association was established between month/season of treatment initiation and survival in ALL among children using either Kaplan-Meier or cosinor analysis. In separate Kaplan-Meier analyses, age, gender, and treatment type were each found to be significant univariate prognostic factors for survival, however. ^

THE RELATIONSHIP BETWEEN ATTITUDE ASSESSMENT/ROLE PERCEPTION AND THE FINANCIAL PERFORMANCE OF HOSPITAL DEPARTMENT MANAGERS

Much of the current healthcare financial literature addresses the concern of government officials, the public, and healthcare providers regarding the need for control of health care costs. The literature suggests that attitudes of hospital department managers toward their role in financial management affects their ability to effect favorable financial results.^ There were several objectives of the dissertation: (1) To identify whether or not there exists a relationship between the attitude/role perception of hospital managers and the financial performance of their departments. (2) To compile a descriptive survey data base of key factors identified in the financial literature from individual hospitals. (3) To compile a brief descriptive survey of hospital managers' financial management background and training (both formal and informal). (4) To conduct an attitude assessment/role perception survey regarding the importance or relevance of a suggested financial management role set (i.e., issues discussed in the current literature) as viewed by the selected hospital managers and their matched administrators. (5) To propose plausible theoretical models and statistical tests of seven proposed hypotheses.^ The statistical results of a variety of methods generally suggested, for the sample population, that the null hypothesis should not be rejected concerning the relationships between a department manager's financial attitudes and role perceptions and the resultant financial performance.^ The fact that the results of this study did not suggest that there was a significant relationship which existed between role perception and financial performance does not necessarily indicate that the theories supporting such a relationship in literature are false, not that such a relationship does not exist. Several alternative theories were postulated to explain the apparent lack of statistical relationship, and suggestions for refinement and/or improvement of further research were discussed. ^

Change in permeation rates of acids and bases through limited use protective fabrics after repeated wash cycles

The primary objective of this study was to determine if there is a change in permeation rates when limited use protective fabrics undergo repeated exposure and wash cycles. The null hypothesis of this study was that no substantial change in permeation takes place after the test material is subjected to repeated contact with a strong acid or base and has undergone repeated wash cycles. ^ The materials tested were DuPont Tychem® CPF 3 and CPF 4 fabrics. The challenge chemicals in this study were ninety-eight percent sulfuric acid and fifty percent sodium hydroxide. Permeation testing was conducted utilizing ASTM designation F739-99a Standard Test Method for Resistance of Protective Clothing Materials to Permeation by Liquids or Gases Under Conditions of Continuous Contact. ^ In this study, no change in permeation rates of either challenge chemical was detected for CPF 3 or CPF 4 limited use protective fabrics after repeated exposure and wash cycles. Certain unexposed areas of the fabric suffered structural degradation unrelated to exposure and which may be due to multiple washings.^

The cost of insuring the uninsured in the U.S.

Objectives: This study included two overarching objectives. Through a systematic review of the literature published between 1990 and 2012, the first objective aimed to assess whether insuring the uninsured would result in higher costs compared to insuring the currently insured. Studies that quantified the actual costs associated with insuring the uninsured in the U.S. were included. Based upon 2009 data from the Medical Expenditure Panel Survey (MEPS), the second objective aimed to assess and compare the self-reported health of populations with four different insurance statuses. The second part of this study involved a secondary data analysis of both currently insured and currently uninsured individuals who participated in the MEPS in 2009. The null hypothesis was that there were no differences across the four categories of health insurance status for self-reported health status and healthcare service use. The alternative hypothesis was that were differences across the four categories of health insurance status for self-reported health status and healthcare service use. Methods: For the systematic review, three databases were searched using search terms to identify studies that actually quantified the cost of insuring the uninsured. Thirteen studies were selected, discussed, and summarized in tables. For the secondary data analysis of MEPS data, this study compared four categories of health insurance status: (1) currently uninsured persons who will become eligible for Medicaid under the Patient Protection and Affordable Care Act (PPACA) healthcare reforms in 2014; (2) currently uninsured persons who will be required to buy private insurance through the PPACA health insurance exchanges in 2014; (3) persons currently insured under Medicaid or SCHIP; and (4) persons currently insured with private insurance. The four categories were compared on the basis of demographic information, health status information, and health conditions with relatively high prevalence. Chi-square tests were run to determine if there were differences between the four groups in regard to health insurance status and health status. With some exceptions, the two currently insured groups had worse self-reported health status compared to the two currently uninsured groups. Results: The thirteen studies that met the inclusion criteria for the systematic review included: (1) three cost studies from 1993, 1995, and 1997; (2) four cost studies from 2001, 2003, and 2004; (3) one study of disabilities and one study of immigrants; (4) two state specific studies of uninsured status; and (5) two current studies of healthcare reform. Of the thirteen studies reviewed, four directly addressed the study question about whether insuring the uninsured was more or less expensive than insuring the currently insured. All four of the studies provided support for the study finding that the cost of insuring the uninsured would generally not be higher than insuring those already insured. One study indicated that the cost of insuring the uninsured would be less expensive than insuring the population currently covered by Medicaid, but more expensive to insure than the populations of those covered by employer-sponsored insurance and non-group private insurance. While the nine other studies included in the systematic review discussed the costs associated with insuring the uninsured population, they did not directly compare the costs of insuring the uninsured population with the costs associated with insuring the currently insured population. For the MEPS secondary data analysis, the results of the chi-square tests indicated that there were differences in the distribution of disease status by health insurance status. As anticipated, with some exceptions, the uninsured reported lower rates of disease and healthcare service use. However, for the variable attention deficit disorder, the uninsured reported higher disease rates than the two insured groups. Additionally, for the variables high blood pressure, high cholesterol, and joint pain, the currently insured under Medicaid or SCHIP group reported a lower rate of disease than the two currently insured groups. This result may be due to the lower mean age of the currently insured under Medicaid or SCHIP group. Conclusion: Based on this study, with some exceptions, the costs for insuring the uninsured should not exceed healthcare-related costs for insuring the currently uninsured. The results of the systematic review indicated that the U.S. is already paying some of the costs associated with insuring the uninsured. PPACA will expand health insurance coverage to millions of Americans who are currently uninsured, as the individual mandate and insurance market reforms will require. Because many of the currently uninsured are relatively healthy young persons, the costs associated with expanding insurance coverage to the uninsured are anticipated to be relatively modest. However, for the purposes of construing these results, it is important to note that once individuals obtain insurance, it is anticipated that they will use more healthcare services, which will increase costs. (Abstract shortened by UMI.)^

Learning kinds for students of technical high school : An analysis from the David Ausubel's theory

This article presents the findings of a field research, not experimental, observational, correlating, basic, of mixed data, micro sociologic, leading to a study of surveys.The object of study is to find learning kinds, and the unit of analysis were 529 high school students between 16 and 21 years old. Its purpose is to understand the impact of learning by rote, guided, self learned and meaningful learning and its achievement degree besides the learning outcomes of differentiated curriculum based on David Ausubel's thoughts, associated with different economic specialties (MINEDUC, 1998) where the population of the study is trained. To collect data, the test TADA - DO2 was used, this test has a reliability index of 0.911 according to Cronbach. From the hits it can be stated from the null hypothesis that there is a significant association (a = 0,05) between the learning kinds and the learning expected of differentiated training plan for both, male and female. It is complex to state that the training of the middle-level technicians leads to a successful employment.

Learning kinds for students of technical high school : An analysis from the David Ausubel's theory

This article presents the findings of a field research, not experimental, observational, correlating, basic, of mixed data, micro sociologic, leading to a study of surveys.The object of study is to find learning kinds, and the unit of analysis were 529 high school students between 16 and 21 years old. Its purpose is to understand the impact of learning by rote, guided, self learned and meaningful learning and its achievement degree besides the learning outcomes of differentiated curriculum based on David Ausubel's thoughts, associated with different economic specialties (MINEDUC, 1998) where the population of the study is trained. To collect data, the test TADA - DO2 was used, this test has a reliability index of 0.911 according to Cronbach. From the hits it can be stated from the null hypothesis that there is a significant association (a = 0,05) between the learning kinds and the learning expected of differentiated training plan for both, male and female. It is complex to state that the training of the middle-level technicians leads to a successful employment.

Learning kinds for students of technical high school : An analysis from the David Ausubel's theory

This article presents the findings of a field research, not experimental, observational, correlating, basic, of mixed data, micro sociologic, leading to a study of surveys.The object of study is to find learning kinds, and the unit of analysis were 529 high school students between 16 and 21 years old. Its purpose is to understand the impact of learning by rote, guided, self learned and meaningful learning and its achievement degree besides the learning outcomes of differentiated curriculum based on David Ausubel's thoughts, associated with different economic specialties (MINEDUC, 1998) where the population of the study is trained. To collect data, the test TADA - DO2 was used, this test has a reliability index of 0.911 according to Cronbach. From the hits it can be stated from the null hypothesis that there is a significant association (a = 0,05) between the learning kinds and the learning expected of differentiated training plan for both, male and female. It is complex to state that the training of the middle-level technicians leads to a successful employment.