Temporomandibular disorders/myoarthropathy of the masticatory system. Costs of dental treatment and reimbursement by Swiss federal insurance agencies according to the Health Care Benefits Ordinance (KLV)

The goal of the study was to calculate the direct costs of therapy for patients with MAP. This retrospective study included 242 MAP patients treated at the Department of Prosthodontics of the University of Bern between 2003 and 2006. The following parameters were collected from the clinical charts: chief complaint, diagnosis, treatment modalities, total costs, costs of the dental technician, number of appointments, average cost per appointment, length of treatment, and services reimbursed by health insurance agencies. The average age of the patients was 40.4 ± 17.3 years (76.4% women, 23.6% men). The chief complaint was pain in 91.3% of the cases, TMJ noises (61.2%) or limitation of mandibular mobility (53.3%). Tendomyopathy (22.3%), disc displacement (22.4%), or a combination of the two (37.6%) were more often diagnosed than arthropathy alone (7.4%). Furthermore, 10.3% of the MAP patients had another primary diagnosis (tumor, trauma, etc.). Patients were treated with counseling and exercises (36.0%), physiotherapy (23.6%), or occlusal splints (32.6%). The cost of treatment reached 644 Swiss francs for four appointments spread over an average of 21 weeks. In the great majority of cases, patients can be treated with inexpensive modalities. 99.9% of the MAP cases submitted to the insurance agencies were reimbursed by them, in accordance with Article 17d1-3 of the Swiss Health Care Benefits Ordinance (KLV) and Article 25 of the Federal Health Insurance Act (KVG). The costs of treatment performed by dentists remain modest. The more time-consuming services, such as providing information, counseling and instructions, are poorly remunerated. This aspect should be re-evaluated in a future revision of the tariff schedule.

Site-Specific Expression of Gelatinolytic Activity during Morphogenesis of the Secondary Palate in the Mouse Embryo

Morphogenesis of the secondary palate in mammalian embryos involves two major events: first, reorientation of the two vertically oriented palatal shelves into a horizontal position above the tongue, and second, fusion of the two shelves at the midline. Genetic evidence in humans and mice indicates the involvement of matrix metalloproteinases (MMPs). As MMP expression patterns might differ from sites of activity, we used a recently developed highly sensitive in situ zymography technique to map gelatinolytic MMP activity in the developing mouse palate. At embryonic day 14.5 (E14.5), we detected strong gelatinolytic activity around the lateral epithelial folds of the nasopharyngeal cavity, which is generated as a consequence of palatal shelf elevation. Activity was concentrated in the basement membrane of the epithelial fold but extended into the adjacent mesenchyme, and increased in intensity with lateral outgrowth of the cavity at E15.5. Gelatinolytic activity at this site was not the consequence of epithelial fold formation, as it was also observed in Bmp7-deficient embryos where shelf elevation is delayed. In this case, gelatinolytic activity appeared in vertical shelves at the exact position where the epithelial fold will form during elevation. Mmp2 and Mmp14 (MT1-MMP), but not Mmp9 and Mmp13, mRNAs were expressed in the mesenchyme around the epithelial folds of the elevated palatal shelves; this was confirmed by immunostaining for MMP-2 and MT1-MMP. Weak gelatinolytic activity was also found at the midline of E14.5 palatal shelves, which increased during fusion at E15.5. Whereas MMPs have been implicated in palatal fusion before, this is the first report showing that gelatinases might contribute to tissue remodeling during early stages of palatal shelf elevation and formation of the nasopharynx.

The Clearing Storm: A Re-Assessment of the Climate for Collaboration between Academic and Student Affairs

There is increasing recognition among those in higher education that it is no longer adequate to train students in a specific field or industry. Instead, the push is more towards producing well-rounded students. In order to do so, all of a university’s resources must come together and the climate on campus must be one that supportscollaboration. This report is a re-examination of the climate for collaboration on the campus of a private liberal arts university in the Mid-Atlantic region of the United States. It is a follow up to a similar investigation conducted on the same campus by Victor Arcelus(2008) five years earlier. In the interim, the university had re-configured its organizational structure, combining separate academic and student affairs divisions into a single unit overseen by the Provost. Additionally, the university had experienced turnover in several key leadership positions, including those of the President and the chief academic and student affairs officers. The purpose of this investigation, therefore, was to gauge the immediate impact of these changes on conditions for collaboration, which when present, advance student learning and development. Through interviews with six men and women, information was collected on the perceived climate for collaboration between academic and student affairs personnel.Analysis of the interview transcripts revealed that, depending on the position of the interviewee within the university, conditions on campus were seen as either improved or largely unchanged as a result of the transition in leadership and the structural merger of the two divisions.

Dielectric map of the Martian northern hemisphere and the nature of plain filling materials

[1] A number of observations suggest that an extended ocean once covered a significant part of the Martian northern hemisphere. By probing the physical properties of the subsurface to unprecedented depth, the MARSIS/Mars Express provides new geophysical evidences for the former existence of a Late Hesperian ocean. The Vastitas Borealis formation, located inside a putative shoreline of the ancient ocean, has a low dielectric constant compared with that of typical volcanic materials. We show that the measured value is only consistent with low-density sedimentary deposits, massive deposits of ground-ice, or a combination of the two. In contrast, radar observations indicate a distribution of shallow ground ice in equilibrium with the atmosphere in the south polar region. We conclude that the northern plains are filled with remnants of a late Hesperian ocean, fed by water and sediments from the outflow channels about 3 Gy ago.

Late-onset manifestation of antenatal Bartter syndrome as a result of residual function of the mutated renal Na+-K+-2Cl- co-transporter

Genetic defects of the Na+-K+-2Cl- (NKCC2) sodium potassium chloride co-transporter result in severe, prenatal-onset renal salt wasting accompanied by polyhydramnios, prematurity, and life-threatening hypovolemia of the neonate (antenatal Bartter syndrome or hyperprostaglandin E syndrome). Herein are described two brothers who presented with hyperuricemia, mild metabolic alkalosis, low serum potassium levels, and bilateral medullary nephrocalcinosis at the ages of 13 and 15 yr. Impaired function of sodium chloride reabsorption along the thick ascending limb of Henle's loop was deduced from a reduced increase in diuresis and urinary chloride excretion upon application of furosemide. Molecular genetic analysis revealed that the brothers were compound heterozygotes for mutations in the SLC12A1 gene coding for the NKCC2 co-transporter. Functional analysis of the mutated rat NKCC2 protein by tracer-flux assays after heterologous expression in Xenopus oocytes revealed significant residual transport activity of the NKCC2 p.F177Y mutant construct in contrast to no activity of the NKCC2-D918fs frameshift mutant construct. However, coexpression of the two mutants was not significantly different from that of NKCC2-F177Y alone or wild type. Membrane expression of NKCC2-F177Y as determined by luminometric surface quantification was not significantly different from wild-type protein, pointing to an intrinsic partial transport defect caused by the p.F177Y mutation. The partial function of NKCC2-F177Y, which is not negatively affected by NKCC2-D918fs, therefore explains a mild and late-onset phenotype and for the first time establishes a mild phenotype-associated SLC12A1 gene mutation.

Keratinocyte transcriptional regulation of the human c-Myc promoter occurs via a novel Lef/Tcf binding element distinct from neoplastic cells

The proto-oncogene c-Myc is involved in early neoplastic transformations. Two consensus Lef/Tcf binding elements (TBE) were found to be prerequisite for transcriptional transactivation by the armadillo proteins beta-catenin and plakoglobin (PG) together with Tcf4 in human neoplastic cells. In epidermal keratinocytes, c-Myc was reported to be repressed by Lef-1 and PG. Using reporter gene assays, here we demonstrate that deletion of the two consensus TBE fails to abrogate transcriptional regulation by Lef-1/PG in wildtype and beta-catenin-/- keratinocytes, while it reduces transcription in pre-neoplastic PG-/- keratinocytes. We identified a TBE sequence variant downstream of the major transcriptional initiation site that binds Lef-1 in vitro and in vivo, and its mutation compromised transcriptional regulation by Lef-1/PG. Collectively, this study demonstrates that the two consensus TBE's reported in neoplastic cells are dispensable for c-Myc regulation in normal keratinocytes, which instead use a novel TBE sequence variant. This unprecedented finding may have important implications for armadillo target genes involved in carcinogenesis.

Synchronisation of the EDML and EDC ice cores for the last 52 kyr by volcanic signature matching

A common time scale for the EPICA ice cores from Dome C (EDC) and Dronning Maud Land (EDML) has been established. Since the EDML core was not drilled on a dome, the development of the EDML1 time scale for the EPICA ice core drilled in Dronning Maud Land was based on the creation of a detailed stratigraphic link between EDML and EDC, which was dated by a simpler 1D ice-flow model. The synchronisation between the two EPICA ice cores was done through the identification of several common volcanic signatures. This paper describes the rigorous method, using the signature of volcanic sulfate, which was employed for the last 52 kyr of the record. We estimated the discrepancies between the modelled EDC and EDML glaciological age scales during the studied period, by evaluating the ratio R of the apparent duration of temporal intervals between pairs of isochrones. On average R ranges between 0.8 and 1.2 corresponding to an uncertainty of up to 20% in the estimate of the time duration in at least one of the two ice cores. Significant deviations of R up to 1.4–1.5 are observed between 18 and 28 kyr before present (BP), where present is defined as 1950. At this stage our approach does not allow us unequivocally to find out which of the models is affected by errors, but assuming that the thinning function at both sites and accumulation history at Dome C (which was drilled on a dome) are correct, this anomaly can be ascribed to a complex spatial accumulation variability (which may be different in the past compared to the present day) upstream of the EDML core.

Comparative acute effects of the calcium channel blockers tiapamil, nisoldipine, and nifedipine on blood pressure and some regulatory factors in normal and hypertensive subjects

To clarify the pharmacological profile of the two new calcium channel blockers tiapamil and nisoldipine in humans, their acute effects as compared with those of the reference agent nifedipine were assessed in 10 normal subjects and 10 patients with essential hypertension. Blood pressure (BP), heart rate (HR), plasma and urinary catecholamine, sodium and potassium, plasma renin and aldosterone levels, and urinary prostaglandin E2 and F2 excretion rates were determined before and up to 4 or 5 h (urine values) after intravenous injection of placebo (20 ml 0.9% NaCl), tiapamil 1 mg/kg body weight, nisoldipine 6 micrograms/kg, or nifedipine 15 micrograms/kg. The four studies were performed at weekly intervals according to Latin square design. All three calcium channel blockers significantly (p less than 0.05 or lower) lowered BP and distinctly increased sodium excretion in hypertensive patients, but had only little influence on these parameters in normal subjects. HR was increased in both groups. Changes in BP and HR were maximal at 5 min and largely dissipated 3 h after drug injection. Effects on BP and HR, as well as concomitant mild increases in plasma norepinephrine and renin levels that occurred in both groups, tended to be more pronounced (about double) following nisoldipine than following tiapamil or nifedipine at the dosages given. Plasma aldosterone, epinephrine levels, and prostaglandin excretion rates were not consistently modified. These findings demonstrate that tiapamil and nisoldipine possess distinct antihypertensive properties in humans. Different chronotropic and renin-activating effects of different calcium channel blockers may be determined, at least in part, by a different influence on sympathetic activity.(ABSTRACT TRUNCATED AT 250 WORDS)

Human intestinal maltase-glucoamylase: crystal structure of the N-terminal catalytic subunit and basis of inhibition and substrate specificity

Human maltase-glucoamylase (MGAM) is one of the two enzymes responsible for catalyzing the last glucose-releasing step in starch digestion. MGAM is anchored to the small-intestinal brush-border epithelial cells and contains two homologous glycosyl hydrolase family 31 catalytic subunits: an N-terminal subunit (NtMGAM) found near the membrane-bound end and a C-terminal luminal subunit (CtMGAM). In this study, we report the crystal structure of the human NtMGAM subunit in its apo form (to 2.0 A) and in complex with acarbose (to 1.9 A). Structural analysis of the NtMGAM-acarbose complex reveals that acarbose is bound to the NtMGAM active site primarily through side-chain interactions with its acarvosine unit, and almost no interactions are made with its glycone rings. These observations, along with results from kinetic studies, suggest that the NtMGAM active site contains two primary sugar subsites and that NtMGAM and CtMGAM differ in their substrate specificities despite their structural relationship. Additional sequence analysis of the CtMGAM subunit suggests several features that could explain the higher affinity of the CtMGAM subunit for longer maltose oligosaccharides. The results provide a structural basis for the complementary roles of these glycosyl hydrolase family 31 subunits in the bioprocessing of complex starch structures into glucose.

Comparison of the effects of inquiry-based cooperative learning and demonstrations in science education

The reported research project involved studying how teaching science using demonstrations, inquiry-based cooperative learning groups, or a combination of the two methods affected sixth grade students’ understanding of air pressure and density. Three different groups of students were each taught the two units using different teaching methods. Group one learned about the topics through both demonstrations and inquirybased cooperative learning, whereas group two only viewed demonstrations, and group three only participated in inquiry-based learning in cooperative learning groups. The study was designed to answer the following two questions: 1. Which teaching strategy works best for supporting student understanding of air pressure and density: demonstrations, inquirybased labs in cooperative learning groups, or a combination of the two? 2. And what effect does the time spent engaging in a particular learning experience (demonstrations or labs) have on student learning? Overall, the data did not provide sufficient evidence that one method of learning was more effective than the others. The results also suggested that spending more time on a unit does not necessarily equate to a better understanding of the concepts by the students. Implications for science instruction are discussed.

Spatial and Temporal Evolution of the Volcanics and Sediments of the Kenya Rift

New volumetric and mass flux estimates have been calculated for the Kenya Rift. Spatial and temporal histories for volcanic eruptions, lacustrine deposition, and hominin fossil sites are presented, aided by the compilation of a new digital geologic map. Distribution of volcanism over time indicates several periods of southward expansion followed by relative positional stasis. Volcanism occurs throughout the activated rift length, with no obvious abandonment as the rift system migrated. The main exception is a period of volcanic concentration around 10 Ma, when activity was constrained within 2° of the equator. Volumes derived from seismic data indicate a total volume of c. 310,000 km3 (2.47 x 1010 kg/yr ), which is significantly more than the map-derived volumes found here or published previously. Map-based estimates are likely affected by a bias against recognizing small volume events in the older record. Such events are, however, the main driver of erupted volume over the last 5 Ma. A technique developed here to counter this bias results in convergence of the two volume estimation techniques. Relative erupted composition over time is variable. Overall, the erupted material has a mafic to silicic ratio of 0.9:1. Basalts are distinctly more common in the Turkana region, which previously experienced Mesozoic rifting. Despite the near equal ratio of mafic to silicic products, the Kenya Rift otherwise fits the definition of a SLIP. It is proposed that the compositions would better fit the published definition if the Turkana region was not twice-rifted. Lacustrine sedimentation post-dates initial volcanism by about 5 million years, and follows the same volcanic trends, showing south and eastward migration over time. This sedimentation delay is likely related to timing of fault displacements. Evidence of hominin habitation is distinctly abundant in the northern and southern sections of the Kenya Rift, but there is an observed gap in the equatorial rift between 4 and 0.5 million years ago. After 0.5 Ma, sites appear to progress towards the equator. The pattern and timing of hominid site distributions suggests that the equatorial gap in habitation may be the result of active volcanic avoidance.

The Effect of the Fe2: Fe3 Ratio upon the Current Efficiency in the Electrolysis of a Copper Sulfate Solution Containing Iron Sulfate

In the treatment of copper ores by hydro-electro-metallurgical methods, not only is copper deposited, but other metals are also dissolved. In practice it has been found* that iron, under certain conditions, causes the copper to deposit on the cathode as a nonadherent precipitate and also that the iron in solution causes a great decrease in current efficiency, es­pecially when the electrolysis is conducted by operating with a higher current density at the cathode than at the anode. The present investigation deals with the effects of the two valences of iron on the current efficiency and endeavors to determine whether or not there is a ratio of the two at which point the efficiency becomes zero or approaches it.

An Investigation Into the Adaption of the Induction Furnace for Determining the Equilibrim Diagram of the System Cu2S-FeS

This investigation was started in an effort to find an accurate and efficient method of determining the freezing points of ferrous and cuprous sulphides, mixtures of the two substances, and from this to establish the liquidus line of the equilibrium dia­gram.

Human-environment interactions in pre-Columbian Amazonia: The case of the Llanos de Moxos, Bolivia

The reconstruction of past environmental and historical events is much needed in Amazonia, a region at the centre of heated debates about the extent of pre-Columbian human disturbance of the natural ecosystems. Important aspects of this debate are to establish to what extent the rise of social complexity was influenced by the local geo-ecology; and what productive strategies were adopted in order to sustain these societies. The Llanos de Moxos (LM), in the Bolivian Amazon, is a vast floodplain made up of a variety of geo-ecological sub regions that host many different types of pre-Columbian earthworks. Therefore, it offers an excellent opportunity to compare different kinds of archaeological landscapes and their relationship to different pre-Columbian cultures and environmental settings. This paper analyses the links between pre-Columbian earthworks and the local geo-ecology in two regions of the LM: 1) the platform field region (PFR) in the north of Santa Ana de Yacuma, where the highest concentration of raised fields has been documented, and 2) the monumental mounds region (MMR) south and east of Trinidad, where >100 pre-Columbian monumental mounds are found. The study draws from remote sensing and GIS analysis, field work in the Bolivian lowlands, and laboratory analysis. Differences in the way people transformed the landscape in the PFR and MMR seem to respond to differences in the local geo-ecology of the two sites. The results also suggest that environmental conditions exerted an important, though not exclusive, control over the levels of social complexity that were reached in different areas of the LM.

Comparing the validity and output of the GT1M and GT3X accelerometer in 5- to 9-year-old children

The purpose of this study was to compare the validity and output of the biaxial ActiGraph GT1M and the triaxial GT3X (ActiGraph, LLC, Pensacola, FL, USA)accelerometer in 5- to 9-year-old children. Thirty-two children wore the two monitors while their energy expenditure was measured with indirect calorimetry. They performed four locomotor and four play activities in an exercise laboratory and were further measured during 12 minutes of a sports lesson. Validity evidence in relation to indirect calorimetry was examined with linear regression equations applied to the laboratory data. During the sports lessons predicted energy expenditure according to the regression equations was compared to measured energy expenditure with the Wilcoxon-signed rank test and the Spearman correlation. To compare the output, agreement between counts of the two monitors during the laboratory activities was assessed with Bland-Altman plots. The evidence of validity was similar for both monitors. Agreement between the output of the two monitors was good for vertical counts (mean bias = −14 ± 22 counts) but not for horizontal counts (−17 ± 32 counts). The current results indicate that the two accelerometer models are able to estimate energy expenditure of a range of physical activities equally well in young children. However, they show output differences for movement in the horizontal direction.