Primary prevention of peri-implantitis: managing peri-implant mucositis

AIMS Over the past decades, the placement of dental implants has become a routine procedure in the oral rehabilitation of fully and partially edentulous patients. However, the number of patients/implants affected by peri-implant diseases is increasing. As there are--in contrast to periodontitis--at present no established and predictable concepts for the treatment of peri-implantitis, primary prevention is of key importance. The management of peri-implant mucositis is considered as a preventive measure for the onset of peri-implantitis. Therefore, the remit of this working group was to assess the prevalence of peri-implant diseases, as well as risks for peri-implant mucositis and to evaluate measures for the management of peri-implant mucositis. METHODS Discussions were informed by four systematic reviews on the current epidemiology of peri-implant diseases, on potential risks contributing to the development of peri-implant mucositis, and on the effect of patient and of professionally administered measures to manage peri-implant mucositis. This consensus report is based on the outcomes of these systematic reviews and on the expert opinion of the participants. RESULTS Key findings included: (i) meta-analysis estimated a weighted mean prevalence for peri-implant mucositis of 43% (CI: 32-54%) and for peri-implantitis of 22% (CI: 14-30%); (ii) bleeding on probing is considered as key clinical measure to distinguish between peri-implant health and disease; (iii) lack of regular supportive therapy in patients with peri-implant mucositis was associated with increased risk for onset of peri-implantitis; (iv) whereas plaque accumulation has been established as aetiological factor, smoking was identified as modifiable patient-related and excess cement as local risk indicator for the development of peri-implant mucositis; (v) patient-administered mechanical plaque control (with manual or powered toothbrushes) has been shown to be an effective preventive measure; (vi) professional intervention comprising oral hygiene instructions and mechanical debridement revealed a reduction in clinical signs of inflammation; (vii) adjunctive measures (antiseptics, local and systemic antibiotics, air-abrasive devices) were not found to improve the efficacy of professionally administered plaque removal in reducing clinical signs of inflammation. CONCLUSIONS Consensus was reached on recommendations for patients with dental implants and oral health care professionals with regard to the efficacy of measures to manage peri-implant mucositis. It was particularly emphasized that implant placement and prosthetic reconstructions need to allow proper personal cleaning, diagnosis by probing and professional plaque removal.

Managing social policy under federalism: The challenges of hybrid funding and program delivery

This paper discusses generally the question of the level of government that should be used to administer different social policies. The chapter focuses on the Medicaid program, looking at recent state-level changes in health insurance for the poor and long-term care policy. Particular attention will be paid to the question of how states have used their new freedoms to outsource public insurance to the private sector and on the consequent differences in outcomes across states. Notably, this paper will be drawn from my forthcoming book “The American Myth of Markets in Social Policy” (Palgrave, MacMillan, November, 2015).

Managing Complications of Fillers: Rare and Not-So-Rare.

Fillers belong to the most frequently used beautifying products. They are generally well tolerated, but any one of them may occasionally produce adverse side effects. Adverse effects usually last as long as the filler is in the skin, which means that short-lived fillers have short-term side effects and permanent fillers may induce life-long adverse effects. The main goal is to prevent them, however, this is not always possible. Utmost care has to be given to the prevention of infections and the injection technique has to be perfect. Treatment of adverse effects is often with hyaluronidase or steroid injections and in some cases together with 5-fluorouracil plus allopurinol orally. Histological examination of biopsy specimens often helps to identify the responsible filler allowing a specific treatment to be adapted.

Efficiency in Managing the Environment and the Opportunity Cost of Pollution Abatement

Using the directional distance function we study a cross section of 110 countries to examine the efficiency of management of the tradeoffs between pollution and income. The DEA model is reformulated to permit 'reverse disposability' of the bad output. Further, we interpret the optimal solution of the multiplier form of the DEA model as an iso-inefficiency line. This permits us to measure the shadow cost of the bad output for a country that is in the interior, rather than on the frontier of the production possibilities set. We also compare the relative environmental performance of countries in terms of emission intensity adjusted for technical efficiency. Only 10% of the countries are found to be on the frontier. Also, there is considerable inter-country variation in the imputed opportunity cost of CO2 reduction. Further, differences in technical efficiency contribute substantially to differences in the observed levels of CO2 intensity.

Managing Moral Motivations

Firms confront three problems: (1) shirking (sub-optimal provision of effort), (2) smooth transfer of knowledge, and (3) eliciting new knowledge. The motivations possessed by firm members are four: (a) instrumental rationality (i.e., self-interest), (b) moral motivations and integrity, (c) intrinsic motivations, and (d) fairness motivations. The trick for the firm is to manage motivations in a way that solves its particular problems. The purpose of this paper is to provide the foundations for moral motivations and moral integrity, and to discuss the kinds of problems that they can and cannot solve, particularly in context of the complex motivational mix.

Real Options: A Tool for Managing Technical Risk in a Mine Plan

NPV is a static measure of project value which does not discriminate between levels of internal and external risk in project valuation. Due to current investment project?s characteristics, a much more complex model is needed: one that includes the value of flexibility and the different risk levels associated with variables subject to uncertainty (price, costs, exchange rates, grade and tonnage of the deposits, cut off grade, among many others). Few of these variables present any correlation or can be treated uniformly. In this context, Real Option Valuation (ROV) arose more than a decade ago, as a mainly theoretical model with the potential for simultaneous calculation of the risk associated with such variables. This paper reviews the literature regarding the application of Real Options Valuation in mining, noting the prior focus on external risks, and presents a case study where ROV is applied to quantify risk associated to mine planning.

Cloud Computing Service for Managing Large Medical Image Data-Sets Using Balanced Collaborative Agents

Managing large medical image collections is an increasingly demanding important issue in many hospitals and other medical settings. A huge amount of this information is daily generated, which requires robust and agile systems. In this paper we present a distributed multi-agent system capable of managing very large medical image datasets. In this approach, agents extract low-level information from images and store them in a data structure implemented in a relational database. The data structure can also store semantic information related to images and particular regions. A distinctive aspect of our work is that a single image can be divided so that the resultant sub-images can be stored and managed separately by different agents to improve performance in data accessing and processing. The system also offers the possibility of applying some region-based operations and filters on images, facilitating image classification. These operations can be performed directly on data structures in the database.

Managing Industrial Simulator Visual Databases Using Geographic Information Systems

Geographic Information Systems are developed to handle enormous volumes of data and are equipped with numerous functionalities intended to capture, store, edit, organise, process and analyse or represent the geographically referenced information. On the other hand, industrial simulators for driver training are real-time applications that require a virtual environment, either geospecific, geogeneric or a combination of the two, over which the simulation programs will be run. In the final instance, this environment constitutes a geographic location with its specific characteristics of geometry, appearance, functionality, topography, etc. The set of elements that enables the virtual simulation environment to be created and in which the simulator user can move, is usually called the Visual Database (VDB). The main idea behind the work being developed approaches a topic that is of major interest in the field of industrial training simulators, which is the problem of analysing, structuring and describing the virtual environments to be used in large driving simulators. This paper sets out a methodology that uses the capabilities and benefits of Geographic Information Systems for organising, optimising and managing the visual Database of the simulator and for generally enhancing the quality and performance of the simulator.

Managing software development information in global configuration management activities

Software Configuration Management (SCM) techniques have been considered the entry point to rigorous software engineering, where multiple organizations cooperate in a decentralized mode to save resources, ensure the quality of the diversity of software products, and manage corporate information to get a better return of investment. The incessant trend of Global Software Development (GSD) and the complexity of implementing a correct SCM solution grow not only because of the changing circumstances, but also because of the interactions and the forces related to GSD activities. This paper addresses the role SCM plays in the development of commercial products and systems, and introduces a SCM reference model to describe the relationships between the different technical, organizational, and product concerns any software development company should support in the global market.

An Internet of Things approach for managing smart services provided by wearable devices.

The Internet of Things (IoT) is growing at a fast pace with new devices getting connected all the time. A new emerging group of these devices are the wearable devices, and Wireless Sensor Networks are a good way to integrate them in the IoT concept and bring new experiences to the daily life activities. In this paper we present an everyday life application involving a WSN as the base of a novel context-awareness sports scenario where physiological parameters are measured and sent to the WSN by wearable devices. Applications with several hardware components introduce the problem of heterogeneity in the network. In order to integrate different hardware platforms and to introduce a service-oriented semantic middleware solution into a single application, we propose the use of an Enterprise Service Bus (ESB) as a bridge for guaranteeing interoperability and integration of the different environments, thus introducing a semantic added value needed in the world of IoT-based systems. This approach places all the data acquired (e.g., via Internet data access) at application developers disposal, opening the system to new user applications. The user can then access the data through a wide variety of devices (smartphones, tablets, computers) and Operating Systems (Android, iOS, Windows, Linux, etc.).

UBURYO: open source software for managing microcredits in education

One of the major problems in developing countries is minority access to higher education. Traditional scholarships usually focus on paying tuition fees for bringing brilliant students to developed countries (from where they seldom return). But local grants seldom target the more needy students. We propose a system of student loans to pay tuition fees in exchange for technical work. This appears to be a satisfactory and sustainable solution. We also provide UBURYO (a Kirundi word meaning opportunity). UBURYO is the free open source software, that we have developed, to manage this loan system in a simple, trustworthy, fair and efficient way.

Evaluation of an application for managing microcredits in education

One of the major problems in developing countries is minority access to higher education. Traditional scholarships usually focus on paying eventually tuition fees or bringing brilliant students to develop countries. Additionally, these systems used to be opaque and, consequently, a corruption source. We propose a system of student loans to pay tuition fees in exchange for work. We also provide UBURYO. It is the FOSS, that we have developed, to manage this loan system in a simple, trustworthy, fair and efficient way. We deployed the loan system in the University of Ngozi (UNG, Burundi). A shallow evaluation demonstrates that system sustainability is feasible.