Current erosion indices--flawed or valid? Summary

The problem of erosive tooth wear appears increasingly to be encountered by clinicians and researchers. An adequate way of defining and recording erosive tooth wear is essential in order to assess the extent of this clinical phenomenon, both on an individual level and in the population, and for the adequate provision of preventive and therapeutic measures. Well-established erosion indices have been used in most of these studies, although in many cases modifications have been made to suit the different research aims. This use of different indices is one reason why it still cannot be claimed that there is enough current knowledge on this clinical phenomenon. This article summarises the proceedings of a workshop to discuss the topic of dental erosion indices. The result of the workshop is the proposal for a new scoring system (Basic Erosive Wear Examination, BEWE) designed for use both within the research field and for dental clinicians, with the aims of standardising assessment of erosion for international comparisons, raising awareness and providing guidelines for treatment of erosive tooth wear in dental practice.

Is virtuality close enough to reality? A comparison of the effectiveness of simulations with traditional laboratory activities in a high school biology class

Some schools do not have ideal access to laboratory space and supplies. Computer simulations of laboratory activities can be a cost-effective way of presenting experiences to students, but are those simulations as effective at supplementing content concepts? This study compared the use of traditional lab activities illustrating the principles of cell respiration and photosynthesis in an introductory high school biology class with virtual simulations of the same activities. Additionally student results were analyzed to assess if student conceptual understanding was affected by the complexity of the simulation. Although all student groups posted average gain increases between the pre and post-tests coupled with positive effect sizes, students who completed the wet lab version of the activity consistently outperformed the students who completed the virtual simulation of the same activity. There was no significant difference between the use of more or less complex simulations. Students also tended to rate the wet lab experience higher on a motivation and interest inventory.

Assessment of flow in perforating arteries during intracranial aneurysm surgery using intraoperative near-infrared indocyanine green videoangiography

OBJECTIVE: Perforating arteries are commonly involved during the surgical dissection and clipping of intracranial aneurysms. Occlusion of perforating arteries is responsible for ischemic infarction and poor outcome. The goal of this study is to describe the usefulness of near-infrared indocyanine green videoangiography (ICGA) for the intraoperative assessment of blood flow in perforating arteries that are visible in the surgical field during clipping of intracranial aneurysms. In addition, we analyzed the incidence of perforating vessels involved during the aneurysm surgery and the incidence of ischemic infarct caused by compromised small arteries. METHODS: Sixty patients with 64 aneurysms were surgically treated and prospectively included in this study. Intraoperative ICGA was performed using a surgical microscope (Carl Zeiss Co., Oberkochen, Germany) with integrated ICGA technology. The presence and involvement of perforating arteries were analyzed in the microsurgical field during surgical dissection and clip application. Assessment of vascular patency after clipping was also investigated. Only those small arteries that were not visible on preoperative digital subtraction angiography were considered for analysis. RESULTS: The ICGA was able to visualize flow in all patients in whom perforating vessels were found in the microscope field. Among 36 patients whose perforating vessels were visible on ICGA, 11 (30%) presented a close relation between the aneurysm and perforating arteries. In one (9%) of these 11 patients, ICGA showed occlusion of a P1 perforating artery after clip application, which led to immediate correction of the clip confirmed by immediate reestablishment of flow visible with ICGA without clinical consequences. Four patients (6.7%) presented with postoperative perforating artery infarct, three of whom had perforating arteries that were not visible or distant from the aneurysm. CONCLUSION: The involvement of perforating arteries during clip application for aneurysm occlusion is a usual finding. Intraoperative ICGA may provide visual information with regard to the patency of these small vessels.

Perceptions of water conditions and management in the Sonora River Basin, Sonora, Mexico

The effects of climate change are expected to be very severe in arid regions. The Sonora River Basin, in the northwestern state of Sonora, Mexico, is likely to be severely affected. Some of the anticipated effects include precipitation variability, intense storm events, higher overall temperatures, and less available water. In addition, population in Sonora, specifically the capital city of Hermosillo, is increasing at a 1.5% rate and current populations are near 700,000. With the reduction in water availability and an increase in population, Sonora, Mexico is expected to experience severe water resource issues in the near future. In anticipation of these changes, research is being conducted in an attempt to improve water management in the Sonora River Basin, located in the northwestern part of Sonora. This research involves participatory modeling techniques designed to increase water manager awareness of hydrological models and their use as integrative tools for water resource management. This study was conducted as preliminary research for the participatory modeling grant in order to gather useful information on the population being studied. This thesis presents research from thirty-four in-depth interviews with water managers, citizens, and agricultural producers in Sonora, Mexico. Data was collected on perceptions of water quantity and quality in the basin, thoughts on current water management practices, perceptions of climate change and its management, experience with, knowledge of, and trust in hydrological models as water management tools. Results showed that the majority of interviewees thought there was not enough water to satisfy their daily needs. Most respondents also agreed that the water available was of good quality, but that current management of water resources was ineffective. Nearly all interviewees were aware of climate change and thought it to be anthropogenic. May reported experiencing higher temperatures, precipitation changes, and higher water scarcity and attributed those fluctuations to climate change. 65% of interviewees were at least somewhat familiar with hydrological models, though only 28% had ever used them or their output. Even with model usage results being low, 100% of respondents believed hydrological models to be very useful water management tools. Understanding how water, climate change, and hydrological models are perceived by this population of people is essential to improving their water management practices in the face of climate change.

Residence near power lines and mortality from neurodegenerative diseases: longitudinal study of the Swiss population

The relation between residential magnetic field exposure from power lines and mortality from neurodegenerative conditions was analyzed among 4.7 million persons of the Swiss National Cohort (linking mortality and census data), covering the period 2000-2005. Cox proportional hazard models were used to analyze the relation of living in the proximity of 220-380 kV power lines and the risk of death from neurodegenerative diseases, with adjustment for a range of potential confounders. Overall, the adjusted hazard ratio for Alzheimer's disease in persons living within 50 m of a 220-380 kV power line was 1.24 (95% confidence interval (CI): 0.80, 1.92) compared with persons who lived at a distance of 600 m or more. There was a dose-response relation with respect to years of residence in the immediate vicinity of power lines and Alzheimer's disease: Persons living at least 5 years within 50 m had an adjusted hazard ratio of 1.51 (95% CI: 0.91, 2.51), increasing to 1.78 (95% CI: 1.07, 2.96) with at least 10 years and to 2.00 (95% CI: 1.21, 3.33) with at least 15 years. The pattern was similar for senile dementia. There was little evidence for an increased risk of amyotrophic lateral sclerosis, Parkinson's disease, or multiple sclerosis.

Driver Safety in Far-side and Far-oblique Crashes: A Study of Patrol Vehicles in the United States of America

The dissertation titled "Driver Safety in Far-side and Far-oblique Crashes" presents a novel approach to assessing vehicle cockpit safety by integrating Human Factors and Applied Mechanics. The methodology of this approach is aimed at improving safety in compact mobile workspaces such as patrol vehicle cockpits. A statistical analysis performed using Michigan state's traffic crash data to assess various contributing factors that affect the risk of severe driver injuries showed that the risk was greater for unrestrained drivers (OR=3.38, p<0.0001) and for incidents involving front and far-side crashes without seatbelts (OR=8.0 and 23.0 respectively, p<0.005). Statistics also showed that near-side and far-side crashes pose similar threat to driver injury severity. A Human Factor survey was conducted to assess various Human-Machine/Human-Computer Interaction aspects in patrol vehicle cockpits. Results showed that tasks requiring manual operation, especially the usage of laptop, would require more attention and potentially cause more distraction. A vehicle survey conducted to evaluate ergonomics-related issues revealed that some of the equipment was in airbag deployment zones. In addition, experiments were conducted to assess the effects on driver distraction caused by changing the position of in-car accessories. A driving simulator study was conducted to mimic HMI/HCI in a patrol vehicle cockpit (20 subjects, average driving experience = 5.35 years, s.d. = 1.8). It was found that the mounting locations of manual tasks did not result in a significant change in response times. Visual displays resulted in response times less than 1.5sec. It can also be concluded that the manual task was equally distracting regardless of mounting positions (average response time was 15 secs). Average speeds and lane deviations did not show any significant results. Data from 13 full-scale sled tests conducted to simulate far-side impacts at 70 PDOF and 40 PDOF was used to analyze head injuries and HIC/AIS values. It was found that accelerations generated by the vehicle deceleration alone were high enough to cause AIS 3 - AIS 6 injuries. Pretensioners could mitigated injuries only in 40 PDOF (oblique) impacts but are useless in 70 PDOF impacts. Seat belts were ineffective in protecting the driver's head from injuries. Head would come in contact with the laptop during a far-oblique (40 PDOF) crash and far-side door for an angle-type crash (70 PDOF). Finite Element analysis head-laptop impact interaction showed that the contact velocity was the most crucial factor in causing a severe (and potentially fatal) head injury. Results indicate that no equipment may be mounted in driver trajectory envelopes. A very narrow band of space is left in patrol vehicles for installation of manual-task equipment to be both safe and ergonomic. In case of a contact, the material stiffness and damping properties play a very significant role in determining the injury outcome. Future work may be done on improving the interiors' material properties to better absorb and dissipate kinetic energy of the head. The design of seat belts and pretensioners may also be seen as an essential aspect to be further improved.

The Presence of Asbestos-Contaminated Vermiculite Attic Insulation and/or Other Asbestos Containing Materials in Homes and the Potential for Living Space Contamination

Asbestos-contaminated vermiculite attic insulation (VAI) produced from a mine near Libby, Montana, may be present in millions of homes along with other commercial asbestos-containing materials (ACM). The primary goal of the research described here was to develop and test procedures that would allow for the safe and effective weatherization of low-income homes with asbestos. The presence of asbestos insulation was confirmed by bulk sampling of the suspect asbestos material. The homes were then tested for the presence of asbestos fibers in the living spaces. All 40 homes containing VAI revealed the presence of amphibole asbestos in bulk samples. Asbestos (primarily chrysotile) was confirmed in bulk samples of ACM collected from 18 homes. Amphibole asbestos was detected in the living space of 12 (26%) homes, while chrysotile asbestos was detected in the living space of 45 (98%) homes. These results suggest that asbestos sources in homes can contribute to living space contamination

Manganese Oxide Deposits Near Butte and Development Since 1942

The manganese minerals occur in the peripheral zone of the Butte district with quartz in veins, which at depth contain galena and sphalerite closely associated with silver-bearing minerals. The manganese oxides are all oxidation products formed by weathering of primary rhodochrosite or rhodonite.

Radiologische Diagnose des femoroazetabuläre Impingements [Radiological diagnosis of femoroacetabular impingement]

Femoroacetabular impingements (FAI) are due to an anatomical disproportion between the proximal femur and the acetabulum which causes premature wear of the joint surfaces. An operation is often necessary in order to relieve symptoms such as limited movement and pain as well as to prevent or slow down the degenerative process. The result is dependent on the preoperative status of the joint with poor results for advanced arthritis of the hip joint. This explains the necessity for an accurate diagnosis in order to recognize early stages of damage to the joint. The diagnosis of FAI includes clinical examination, X-ray examination and magnetic resonance imaging (MRI). The standard X-radiological examination for FAI is carried out using two X-ray images, an anterior-posterior view of the pelvis and a lateral view of the proximal femur, such as the cross-table lateral or Lauenstein projections. It is necessary that positioning criteria are adhered to in order to avoid distortion artifacts. MRI permits an examination of the pelvis on three levels and should also include radial planned sequences for improved representation of peripheral structures, such as the labrum and peripheral cartilage. The use of contrast medium for a direct MR arthrogram has proved to be advantageous particularly for representation of labrum damage. The data with respect to cartilage imaging are still unclear. Further developments in technology, such as biochemical-sensitive MRI applications, will be able to improve the diagnosis of the pelvis in the near future.

Respiratory distress syndrome in near-term babies after caesarean section

OBJECTIVE: Severe respiratory distress syndrome (RDS) caused by surfactant deficiency is described not only in preterm infants but also in (near-) term babies after caesarean section (CS), especially when carried out before the onset of labour. The aim of the present study was to document the severity of this theoretically avoidable entity in order to improve obstetric and perinatal care. PATIENTS: All neonates admitted to the paediatric intensive care unit of the University Hospital of Bern between 1988 and 2000 with RDS on the basis of hyaline membrane disease (HMD) needing mechanical ventilation (MV) after CS and with a birthweight > or = 2500 g were analysed. HMD was diagnosed when respiratory distress and the typical radiological signs were present. Patients were grouped into elective CS before onset of labour and before rupture of membranes (group 1, n = 34) and patients delivered by emergency CS or CS after onset of labour or rupture of membranes (group 2, n = 22). Analysed indices for severity of illness were duration of stay in intensive care unit and MV, ventilation mode, worst oxygenation index (OI), presence of pulmonary air leak, and systemic hypotension. RESULTS: Mean gestational age (GA) was 37 2/7 weeks in group 1 and 36 2/7 weeks in group 2; no patient had a GA of > or = 39 0/7 weeks. Duration of MV was 4.4 days in group 1 and 3.9 days in group 2. Thirteen patients (38%) of group 1 and 7 (32%) of group 2 had to be managed by rescue high-frequency ventilation. A total of 7 patients had an OI>40. Eight patients (24%) in group 1 and 4 (18%) in group 2 developed a pulmonary air leak. Fourteen neonates (41%) in group 1 had to be supported by catecholamines versus 5 (22%) in group 2. There was one death in group 1. CONCLUSION: Severe RDS on the basis of HMD can also occur in near-term babies after CS; even a fatal outcome can not be excluded. The severity of illness in elective CS without labour may be quite high and is comparable to newborns delivered by CS (after onset of labour and/or rupture of the membranes) who were 1 week younger. No case of HMD was found in our population when CS was carried out after completion of 39 post-menstrual weeks of gestation.

Modeling Calcium Concentration and Biochemical Reactions

Almost all regions of the brain receive one or more neuromodulatory inputs, and disrupting these inputs produces deficits in neuronal function. Neuromodulators act through intracellular second messenger pathways to influence the electrical properties of neurons, integration of synaptic inputs, spatio-temporal firing dynamics of neuronal networks, and, ultimately, systems behavior. Second messengers pathways consist of series of bimolecular reactions, enzymatic reactions, and diffusion. Calcium is the second messenger molecule with the most effectors, and thus is highly regulated by buffers, pumps and intracellular stores. Computational modeling provides an innovative, yet practical method to evaluate the spatial extent, time course and interaction among second messenger pathways, and the interaction of second messengers with neuron electrical properties. These processes occur both in compartments where the number of molecules are large enough to describe reactions deterministically (e.g. cell body), and in compartments where the number of molecules is small enough that reactions occur stochastically (e.g. spines). – In this tutorial, I explain how to develop models of second messenger pathways and calcium dynamics. The first part of the tutorial explains the equations used to model bimolecular reactions, enzyme reactions, calcium release channels, calcium pumps and diffusion. The second part explains some of the GENESIS, Kinetikit and Chemesis objects that implement the appropriate equations. In depth explanation of calcium and second messenger models is provided by reviewing code, both in XPP, Chemesis and Kinetikit, that implements simple models of calcium dynamics and second messenger cascades.

Transverse-momentum spectra of electroweak bosons near threshold at NNLO

We obtain the next-to-next-to-leading order corrections to transverse-momentum spectra of W, Z and Higgs bosons near the partonic threshold. In the threshold limit, the electroweak boson recoils against a low-mass jet and all radiation is either soft, or collinear to the jet or the beam directions. We extract the virtual corrections from known results for the relevant two-loop four-point amplitudes and combine them with the soft and collinear two-loop functions as defined in Soft-Collinear Effective Theory. We have implemented these results in a public code PeTeR and present numerical results for the threshold resummed cross section of W and Z bosons at next-to-next-to-next-to-leading logarithmic accuracy, matched to next-to-leading fixed-order perturbation theory. The two-loop corrections lead to a moderate increase in the cross section and reduce the scale uncertainty by about a factor of two. The corrections are significantly larger for Higgs production.

The long arm of time pressure at work: Cognitive failure and commuting near-accidents

This study tests whether cognitive failures mediate effects of work-related time pressure and time control on commuting accidents and near-accidents. Participants were 83 employees (56% female) who each commuted between their regular place of residence and place of work using vehicles. The Workplace Cognitive Failure Scale (WCFS) asked for the frequency of failure in memory function, failure in attention regulation, and failure in action execution. Time pressure and time control at work were assessed by the Instrument for Stress Oriented Task Analysis (ISTA). Commuting accidents in the last 12 months were reported by 10% of participants, and half of the sample reported commuting near-accidents in the last 4 weeks. Cognitive failure significantly mediated the influence of time pressure at work on near-accidents even when age, gender, neuroticism, conscientiousness, commuting duration, commuting distance, and time pressure during commuting were controlled for. Time control was negatively related to cognitive failure and neuroticism, but no association with commuting accidents or near-accidents was found. Time pressure at work is likely to increase cognitive load. Time pressure might, therefore, increase cognitive failures during work and also during commuting. Hence, time pressure at work can decrease commuting safety. The result suggests a reduction of time pressure at work should improve commuting safety.

Neoadjuvant chemoradiotherapy with or without panitumumab in patients with wild-type KRAS, locally advanced rectal cancer (LARC): a randomized, multicenter, phase II trial SAKK 41/07

BACKGROUND We conducted a randomized, phase II, multicenter study to evaluate the anti-epidermal growth factor receptor (EGFR) mAb panitumumab (P) in combination with chemoradiotherapy (CRT) with standard-dose capecitabine as neoadjuvant treatment for wild-type KRAS locally advanced rectal cancer (LARC). PATIENTS AND METHODS Patients with wild-type KRAS, T3-4 and/or N+ LARC were randomly assigned to receive CRT with or without P (6 mg/kg). The primary end-point was pathological near-complete or complete tumor response (pNC/CR), defined as grade 3 (pNCR) or 4 (pCR) histological regression by Dworak classification (DC). RESULTS Forty of 68 patients were randomly assigned to P + CRT and 28 to CRT. pNC/CR was achieved in 21 patients (53%) treated with P + CRT [95% confidence interval (CI) 36%-69%] versus 9 patients (32%) treated with CRT alone (95% CI: 16%-52%). pCR was achieved in 4 (10%) and 5 (18%) patients, and pNCR in 17 (43%) and 4 (14%) patients. In immunohistochemical analysis, most DC 3 cells were not apoptotic. The most common grade ≥3 toxic effects in the P + CRT/CRT arm were diarrhea (10%/6%) and anastomotic leakage (15%/4%). CONCLUSIONS The addition of panitumumab to neoadjuvant CRT in patients with KRAS wild-type LARC resulted in a high pNC/CR rate, mostly grade 3 DC. The results of both treatment arms exceeded prespecified thresholds. The addition of panitumumab increased toxicity.

Tree growth response along an elevational gradient: climate or genetics?

Environment and genetics combine to influence tree growth and should therefore be jointly considered when evaluating forest responses in a warming climate. Here, we combine dendroclimatology and population genetic approaches with the aim of attributing climatic influences on growth of European larch (Larix decidua) and Norway spruce (Picea abies). Increment cores and genomic DNA samples were collected from populations along a ~900-m elevational transect where the air temperature gradient encompasses a ~4 °C temperature difference. We found that low genetic differentiation among populations indicates gene flow is high, suggesting that migration rate is high enough to counteract the selective pressures of local environmental variation. We observed lower growth rates towards higher elevations and a transition from negative to positive correlations with growing season temperature upward along the elevational transect. With increasing elevation there was also a clear increase in the explained variance of growth due to summer temperatures. Comparisons between climate sensitivity patterns observed along this elevational transect with those from Larix and Picea sites distributed across the Alps reveal good agreement, and suggest that tree-ring width (TRW) variations are more climate-driven than genetics-driven at regional and larger scales. We conclude that elevational transects are an extremely valuable platform for understanding climatic-driven changes over time and can be especially powerful when working within an assessed genetic framework.