Biomechanical and histologic evaluation of non-washed resorbable blasting media and alumina-blasted/acid-etched surfaces

Objectives: To compare the biomechanical fixation and histomorphometric parameters between two implant surfaces: non-washed resorbable blasting media (NWRBM) and alumina-blasted/acid-etched (AB/AE), in a dog model. Material and methods: The surface topography was assessed by scanning electron microscopy, optical interferometry and chemistry by X-ray photoelectron spectroscopy (XPS). Six beagle dogs of similar to 1.5 years of age were utilized and each animal received one implant of each surface per limb (distal radii sites). After a healing period of 3 weeks, the animals were euthanized and half of the implants were biomechanically tested (removal torque) and the other half was referred to nondecalcified histology processing. Histomorphometric analysis considered bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO). Following data normality check with the Kolmogorov-Smirnov test, statistical analysis was performed by paired t-tests at 95% level of significance. Results: Surface roughness parameters Sa (average surface roughness) and Sq (mean root square of the surface) were significantly lower for the NWRBM compared with AB/ AE. The XPS spectra revealed the presence of Ca and P in the NWRBM. While no significant differences were observed for both BIC and BAFO parameters (P>0.35 and P>0.11, respectively), a significantly higher level of torque was observed for the NWRBM group (P = 0.01). Bone morphology was similar between groups, which presented newly formed woven bone in proximity with the implant surfaces. Conclusion: A significant increase in early biomechanical fixation was observed for implants presenting the NWRBM surface.

Non-inflammatory destructive periodontal disease: a clinical, microbiological, immunological and genetic investigation

Periodontitis comprises a group of multifactorial diseases in which periodontopathogens accumulate in dental plaque and trigger host chronic inflammatory and immune responses against periodontal structures, which are determinant to the disease outcome. Although unusual cases of non-inflammatory destructive periodontal disease (NIDPD) are described, their pathogenesis remains unknown. A unique NIDPD case was investigated by clinical, microbiological, immunological and genetic tools. The patient, a non-smoking dental surgeon with excessive oral hygiene practice, presented a generalized bone resorption and tooth mobility, but not gingival inflammation or occlusion problems. No hematological, immunological or endocrine alterations were found. No periodontopathogens (A. actinomycetemcomitans, P. gingivalis, F. nucleatum and T. denticola) or viruses (HCMV, EBV-1 and HSV-1) were detected, along with levels of IL-1 beta and TNF-alpha in GCF compatible with healthy tissues. Conversely ALP, ACP and RANKL GCF levels were similar to diseased periodontal sites. Genetic investigation demonstrated that the patient carried some SNPs, as well HLA-DR4 (*0404) and HLA-B27 alleles, considered risk factors for bone loss. Then, a less vigorous and diminished frequency of toothbrushing was recommended to the patient, resulting in the arrest of alveolar bone loss, associated with the return of ALP, ACP and RANKL in GCF to normality levels. In conclusion, the unusual case presented here is compatible with the previous description of NIDPD, and the results that a possible combination of excessive force and frequency of mechanical stimulation with a potentially bone loss prone genotype could result in the alveolar bone loss seen in NIDPD.

Using sonic enhancement to augment non-visual tabular navigation

More information is now readily available to computer users than at any time in human history; however, much of this information is often inaccessible to people with blindness or low-vision, for whom information must be presented non-visually. Currently, screen readers are able to verbalize on-screen text using text-to-speech (TTS) synthesis; however, much of this vocalization is inadequate for browsing the Internet. An auditory interface that incorporates auditory-spatial orientation was created and tested. For information that can be structured as a two-dimensional table, links can be semantically grouped as cells in a row within an auditory table, which provides a consistent structure for auditory navigation. An auditory display prototype was tested.^ Sixteen legally blind subjects participated in this research study. Results demonstrated that stereo panning was an effective technique for audio-spatially orienting non-visual navigation in a five-row, six-column HTML table as compared to a centered, stationary synthesized voice. These results were based on measuring the time- to-target (TTT), or the amount of time elapsed from the first prompting to the selection of each tabular link. Preliminary analysis of the TTT values recorded during the experiment showed that the populations did not conform to the ANOVA requirements of normality and equality of variances. Therefore, the data were transformed using the natural logarithm. The repeated-measures two-factor ANOVA results show that the logarithmically-transformed TTTs were significantly affected by the tonal variation method, F(1,15) = 6.194, p= 0.025. Similarly, the results show that the logarithmically transformed TTTs were marginally affected by the stereo spatialization method, F(1,15) = 4.240, p=0.057. The results show that the logarithmically transformed TTTs were not significantly affected by the interaction of both methods, F(1,15) = 1.381, p=0.258. These results suggest that some confusion may be caused in the subject when employing both of these methods simultaneously. The significant effect of tonal variation indicates that the effect is actually increasing the average TTT. In other words, the presence of preceding tones increases task completion time on average. The marginally-significant effect of stereo spatialization decreases the average log(TTT) from 2.405 to 2.264.^

Correcting for bias when estimating the cost of hospital-acquired infection : an analysis of lower respiratory tract infections in non-surgical patients

Hospital acquired infections (HAI) are costly but many are avoidable. Evaluating prevention programmes requires data on their costs and benefits. Estimating the actual costs of HAI (a measure of the cost savings due to prevention) is difficult as HAI changes cost by extending patient length of stay, yet, length of stay is a major risk factor for HAI. This endogeneity bias can confound attempts to measure accurately the cost of HAI. We propose a two-stage instrumental variables estimation strategy that explicitly controls for the endogeneity between risk of HAI and length of stay. We find that a 10% reduction in ex ante risk of HAI results in an expected savings of £693 ($US 984).

A Petrov-Galerkin method for a singularly perturbed ordinary differential equation with non-smooth data

In this paper, a singularly perturbed ordinary differential equation with non-smooth data is considered. The numerical method is generated by means of a Petrov-Galerkin finite element method with the piecewise-exponential test function and the piecewise-linear trial function. At the discontinuous point of the coefficient, a special technique is used. The method is shown to be first-order accurate and singular perturbation parameter uniform convergence. Finally, numerical results are presented, which are in agreement with theoretical results.