Searching for keys to successful post-merger integration : a longitudinal case-study following a public sector merger

Unsuccessful mergers are unfortunately the rule rather than the exception. Therefore it is necessary to gain an enhanced understanding of mergers and post-merger integrations (PMI) as well as learning more about how mergers and PMIs of information systems (IS) and people can be facilitated. Studies on PMI of IS are scarce and public sector mergers are even less studied. There is nothing however to indicate that public sector mergers are any more successful than those in the private sector. This thesis covers five studies carried out between 2008 and 2011 in two organizations in higher education that merged in January 2010. The most recent study was carried out two years after the new university was established. The longitudinal case-study focused on the administrators and their opinions of the IS, the work situation and the merger in general. These issues were investigated before, during and after the merger. Both surveys and interviews were used to collect data, to which were added documents that both describe and guide the merger process; in this way we aimed at a triangulation of findings. Administrators were chosen as the focus of the study since public organizations are highly dependent on this staff category, forming the backbone of the organization and whose performance is a key success factor for the organization. Reliable and effective IS are also critical for maintaining a functional and effective organization, and this makes administrators highly dependent on their organizations’ IS for the ability to carry out their duties as intended. The case-study has confirmed the administrators’ dependency on IS that work well. A merger is likely to lead to changes in the IS and the routines associated with the administrators’ work. Hence it was especially interesting to study how the administrators viewed the merger and its consequences for IS and the work situation. The overall research objective is to find key issues for successful mergers and PMIs. The first explorative study in 2008 showed that the administrators were confident of their skills and knowledge of IS and had no fear of having to learn new IS due to the merger. Most administrators had an academic background and were not anxious about whether IS training would be given or not. Before the merger the administrators were positive and enthusiastic towards the merger and also to the changes that they expected. The studies carried out before the merger showed that these administrators were very satisfied with the information provided about the merger. This information was disseminated through various channels and even negative information and postponed decisions were quickly distributed. The study conflicts with the theories that have found that resistance to change is inevitable in a merger. Shortly after the merger the (third) study showed disappointment with the fact that fewer changes than expected had been implemented even if the changes that actually were carried out sometimes led to a more problematic work situation. This was seen to be more prominent for routine changes than IS changes. Still the administrators showed a clear willingness to change and to share their knowledge with new colleagues. This knowledge sharing (also tacit) worked well in the merger and the PMI. The majority reported that the most common way to learn to use new ISs and to apply new routines was by asking help from colleagues. They also needed to take responsibility for their own training and development. Five months after the merger (the fourth study) the administrators had become worried about the changes in communication strategy that had been implemented in the new university. This was perceived as being more anonymous. Furthermore, it was harder to get to know what was happening and to contact the new decision makers. The administrators found that decisions, and the authority to make decisions, had been moved to a higher administrative level than they were accustomed to. A directive management style is recommended in mergers in order to achieve a quick transition without distracting from the core business. A merger process may be tiresome and require considerable effort from the participants. In addition, not everyone can make their voice heard during a merger and consensus is not possible in every question. It is important to find out what is best for the new organization instead of simply claiming that the tried and tested methods of doing things should be implemented. A major problem turned out to be the lack of management continuity during the merger process. Especially problematic was the situation in the IS-department with many substitute managers during the whole merger process (even after the merger was carried out). This meant that no one was in charge of IS-issues and the PMI of IS. Moreover, the top managers were appointed very late in the process; in some cases after the merger was carried out. This led to missed opportunities for building trust and management credibility was heavily affected. The administrators felt neglected and that their competences and knowledge no longer counted. This, together with a reduced and altered information flow, led to rumours and distrust. Before the merger the administrators were convinced that their achievements contributed value to their organizations and that they worked effectively. After the merger they were less sure of their value contribution and effectiveness even if these factors were not totally discounted. The fifth study in November 2011 found that the administrators were still satisfied with their IS as they had been throughout the whole study. Furthermore, they believed that the IS department had done a good job despite challenging circumstances. Both the former organizations lacked IS strategies, which badly affected the IS strategizing during the merger and the PMI. IS strategies deal with issues like system ownership; namely who should pay and who is responsible for maintenance and system development, for organizing system training for new IS, and for effectively run IS even during changing circumstances (e.g. more users). A proactive approach is recommended for IS strategizing to work. This is particularly true during a merger and PMI for handling issues about what ISs should be adopted and implemented in the new organization, issues of integration and reengineering of IS-related processes. In the new university an ITstrategy had still not been decided 26 months after the new university was established. The study shows the importance of the decisive management of IS in a merger requiring that IS issues are addressed in the merger process and that IS decisions are made early. Moreover, the new management needs to be appointed early in order to work actively with the IS-strategizing. It is also necessary to build trust and to plan and make decisions about integration of IS and people.

The consensus sequence of FAMLF alternative splice variants is overexpressed in undifferentiated hematopoietic cells

The familial acute myeloid leukemia related factor gene (FAMLF) was previously identified from a familial AML subtractive cDNA library and shown to undergo alternative splicing. This study used real-time quantitative PCR to investigate the expression of the FAMLF alternative-splicing transcript consensus sequence (FAMLF-CS) in peripheral blood mononuclear cells (PBMCs) from 119 patients with de novo acute leukemia (AL) and 104 healthy controls, as well as in CD34+cells from 12 AL patients and 10 healthy donors. A 429-bp fragment from a novel splicing variant of FAMLF was obtained, and a 363-bp consensus sequence was targeted to quantify total FAMLF expression. Kruskal-Wallis, Nemenyi, Spearman's correlation, and Mann-Whitney U-tests were used to analyze the data. FAMLF-CS expression in PBMCs from AL patients and CD34+ cells from AL patients and controls was significantly higher than in control PBMCs (P<0.0001). Moreover,FAMLF-CS expression in PBMCs from the AML group was positively correlated with red blood cell count (rs=0.317, P=0.006), hemoglobin levels (rs=0.210, P=0.049), and percentage of peripheral blood blasts (rs=0.256, P=0.027), but inversely correlated with hemoglobin levels in the control group (rs=–0.391, P<0.0001). AML patients with high CD34+ expression showed significantly higherFAMLF-CS expression than those with low CD34+ expression (P=0.041). Our results showed thatFAMLF is highly expressed in both normal and malignant immature hematopoietic cells, but that expression is lower in normal mature PBMCs.

Influence of transcutaneous electrical stimulation on heterotopic ossification: an experimental study in Wistar rats

Heterotopic ossification (HO) is a metaplastic biological process in which there is newly formed bone in soft tissues, resulting in joint mobility deficit and pain. Different treatment modalities have been tried to prevent HO development, but there is no consensus on a therapeutic approach. Since electrical stimulation is a widely used resource in physiotherapy practice to stimulate joint mobility, with analgesic and anti-inflammatory effects, its usefulness for HO treatment was investigated. We aimed to identify the influence of electrical stimulation on induced HO in Wistar rats. Thirty-six male rats (350-390 g) were used, and all animals were anesthetized for blood sampling before HO induction, to quantify the serum alkaline phosphatase. HO induction was performed by bone marrow implantation in both quadriceps of the animals, which were then divided into 3 groups: control (CG), transcutaneous electrical nerve stimulation (TENS) group (TG), and functional electrical stimulation (FES) group (FG) with 12 rats each. All animals were anesthetized and electrically stimulated twice per week, for 35 days from induction day. After this period, another blood sample was collected and quadriceps muscles were bilaterally removed for histological and calcium analysis and the rats were killed. Calcium levels in muscles showed significantly lower results when comparing TG and FG (P<0.001) and between TG and CG (P<0.001). Qualitative histological analyses confirmed 100% HO in FG and CG, while in TG the HO was detected in 54.5% of the animals. The effects of the muscle contractions caused by FES increased HO, while anti-inflammatory effects of TENS reduced HO.

Facilitating corporate entrepreneurial behavior: A study of corporate entrepreneurial behavior in corporate banking

This study discusses the pronounced importance of corporate entrepreneurial behavior, CEB, facilitation and enablement as a key dimension in the rapidly changing business environment within companies. The research target is a large finance company in Finland, where regulations, compliance and processes restrict and refine extensively business approach. The purpose of this study is to foster the understanding of corporate entrepreneurial behavior and requirements and identify the supporters and inhibitors of facilitation of it. Furthermore, this study examines who should be driving the implementation and offer concrete outcome for the company to get the facilitation started and berth it as part of the organizational culture and values. The theoretical background is constructed from literature related to concept of corporate entrepreneurial behavior, factors supporting and hindering the facilitation based on previous studies and innovation management. Furthermore theoretical framework of middle managers entrepreneurial behavior in facilitation process was researched. Additionally top down and bottom up approach of conversational space building within the organization in order to foster innovation and involving mindset and behavior was in the core literature. The empirical research conducted for the study consists three parts; innovation audit questionnaire, semi-structured interviews and secondary data from previously made research within the case company. Questionnaire and interviews were targeted to eight middle managers within the company, the head of branch regions in corporate segment. The secondary data was collected from over 300 employees in the case company by an external company. Research results were analyzed mainly by themes and source division in adaption with the theoretical framework. The study finds that facilitation of CEB should be a strategic choice and requires strong management support and examples. Behavior should be involved with organizational culture, values, structures and processes. The companies´ willingness to take risks and encourage employees at all levels to participate and be involved by taking ownership and responsibility is in the core. CEB is found to be a key dimension in increasing employee satisfaction and engagement, competitive advantages and economic growth of companies. There is increased interest towards CEB in the case company but there is lack in the mutual consensus of it. CEB is not in the strategy although the mindset and support from management is in place. There is no concrete enablement and space for innovation and CEB although the platform would be receptive. Further research is needed to build shared vision of CEB and how to make it a part of the organizational culture and values in addition to building the conversational space.

Comprehensive school health : an ethnographic case study

The purpose of this ethnographic case study was to describe the characteristics of one school's Comprehensive School Health (CSH) initiative and to explore the experiences of school community members in order to gain an understanding of how one school embraced a Comprehensive School Health approach. An elementary school (grades Junior Kindergarten to six) in Burlington, Ontario was the research site for this study. Multiple methods of data collection (observations, document analysis, interviews) were used in keeping with the ethnographic and case study approach. The data were coded using both a deductive and then inductive process (Merriam, 1998). From a deductive perspective, the coding system and the subsequent identification of categories were based on a priori categories identified by using the elements of CSH based on the Comprehensive School Health Consensus Statement prepared by the Canadian Association of School Health and the research questions. Findings included the role that various school community members as well as the implementation of different programs and policies played in applying a CSH approach. The impact ofthe physical environment was described as well as successes and challenges related to the school's experience in implementing CSH. Three main themes emerged that characterized this school's experience. The first theme relates to the fundamental question about CSH which is the school community's understanding o/the concept. The second theme focused on positive school culture and the third and most diverse theme was that of capacity. Engaging in CSH is a complex and long-term undertaking involving both the school and greater community. Based on the experiences of this school's community members, recommendations address the different levels of influence on the health of children.

Study of cox1 trans-splicing in Diplonema papillatum mitochondria

Diplonema papillatum est un organisme unicellulaire qui vit dans l’océan. Son génome mitochondrial possède une caractéristique spéciale: tous les gènes sont brisés en de multiples fragments qui s’appellent modules. Chaque module est codé par un chromosome différent. L’expression d’un gène exige des épissages-en-trans qui assemblent un ARN messager complet à partir de tous les modules du gène. Nous avons précédemment montré que le gène cox1 est encodé dans neuf modules avec six Us non encodés entre le module 4 et le module 5 de l’ARN messager mature [1]. Nous n’avons identifié aucune séquence consensus connue de site d’épissage près des modules. Nous spéculons qu’un ARN guide (gRNA) a dirigé l’épissage-en-trans du gène cox1 par un mécanisme qui est semblable à l’édition d’ARN par l’insertion/la suppression des Us chez les kinétoplastides, le groupe sœur des diplonémides. Nous avons trouvé que les six Us sont ajoutés au bout 3’ de l’ARN d’une façon semblable à ceux ajoutés par le TUTase lors de l’édition de l’insertion des Us chez les kinétoplastides. Nous avons construit des profils de gRNA de l’épissage-en-trans avec les expressions régulières basé sur notre connaissance des gRNAs dans l’édition d’ARN chez les kinétoplastides. Selon la complémentarité partielle entre le gRNA et les deux modules adjacents, nous avons généré des amorces pour RT-PCR visant à détecter des séquences qui sont assorties à un des profils de gRNA. Une expérience pilote in vitro n’a pas permis de reconstituer l’épissage-en-trans des modules 3, 4, et 5, suggérant que nous devons améliorer nos techniques.

Innovation and Globalization Policy in Small Transition Countries ; Case study: Macedonia and Slovenia

Diese Arbeit befasst sich mit der Innovations- und Globalisierungspolitik in kleinen Transformationsländern am Beispiel Mazedoniens; diese wurde mit der Lage in Slowenien verglichen, einem Land von ungefähr gleicher Größe und mit gemeinsamer Vergangenheit als Teilrepublik der Jugoslawischen Föderation, aber mit einem wesentlich höheren ökonomischen Entwicklungsstand. Innovation wird dabei verstanden als „Herstellung, Anpassung und Ausnutzung von Neuerungen“, und sie wird durch das Umfeld, in dem sie stattfindet, beeinflusst. Anpassung und Ausnutzung sind gerade für kleine Transformationsländer von erheblicher Bedeutung, da ihre Fähigkeit zu Herstellung von Neuerungen sehr begrenzt sind. Die Rolle der Innovationspolitik besteht hierbei darin, institutionelle und organisationelle Regulierungen einzuführen, die ein günstiges Umfeld sowohl für Innovationen als auch für die Entwicklung eines nationalen Innovationssystems schaffen. Die Rolle der Politik besteht also nicht in der Innovation als solcher, sondern in der Herstellung der notwendigen Bedingungen für die Industrie und die Forschungseinrichtungen dahingehend zu schaffen, dass sie ihr Wissen, ihre Fertigkeiten und ihre praktischen Erfahrungen für innovative Tätigkeiten einsetzen können. Auf der einen Seite gibt es Institutionen und Organisationen, ohne die die Unternehmen rückständig und wenig leistungsstark wären (etwa das Patentamt oder Institutionen höherer Bildung), und auf der anderen Seite gibt es Institutionen und Organisationen, welche die Unternehmen dabei unterstützen, dass sie ihre Tätigkeit weiter unterstützen (z.B. durch Technologietransfer-Zentren und Netzwerke). Die Leistungen dieser Institutionen und Organisationen sind von großer Bedeutung für die nationalen Innovationssysteme und sollten ihrerseits durch Innovationspolitik unterstützt werden; dies bedeutet jedoch nicht, dass diese Leistungen vom Staat bereitgestellt werden, vielmehr sollte die Wirtschaftspolitik Möglichkeiten für die öffentlich/private oder sogar rein private Bereitstellung solcher Leistungen in Erwägung ziehen; dies würde nicht nur die Kosten für den Staat senken, sondern auch die Effizienz bei der Erstellung dieser Leistungen steigern. Die Arbeit kommt zu dem Schluss, dass das größte Problem der Innovationspolitik in Mazedonien darin besteht, dass es sie gar nicht gibt, und zwar nicht als Folge einer bewussten Entscheidung darüber. Tatsächlich müssen Ressourcen und Zeit für die Schaffung eines nationalen Innovationssystems eingesetzt werden mit Hilfe einer Politik, die sich auf die wesentlichen Umrisse konzentriert, wobei die Nachfrage nach Technologie im Unternehmensbereich gesteigert wird und das Wissen und das Informationsangebot restrukturiert wird. Dieses System muss offen sein, unter beständigem Verbesserungsdruck stehen und fähig sein, sich an Veränderungen anzupassen. Damit eine solche Politik erfolgreich ist, muss es einen Konsens darüber zwischen allen beteiligten Akteuren geben und darüber hinaus auch eine Kohärenz zwischen den verschiedenen politischen Institutionen. Das ist deswegen wichtig, weil der Innovationsprozess komplex ist und verschiedene Politikbereiche berührt. Ziel sollte die Schaffung eines Systems sein, das einerseits auf Autonomie und Kooperation aufbaut, andererseits aber auch Wettbewerb zwischen den beteiligten Institutionen und Organisationen fördert. Eine wichtige Bedingung für ein positives Investitionsklima im Bereich der Innovation ist die Erreichung von makroökonomischer Stabilität. Die gegenwärtige Situation ist gekennzeichnet durch Instabilität des Rechtswesens, durch Korruption und Probleme des Vertragsschutzes, die sowohl ausländische als auch inländische Akteure davon abhält, sich in wirtschaftlichen Aktivitäten in Mazedonien zu engagieren. Bei der Suche nach einem Ausweg aus diesen Problemen ist es wichtig für Mazedonien, von anderen Ländern wie Slowenien zu lernen, die ähnliche Probleme haben, aber auch schon Erfahrungen in der Problemlösung. Man muss dabei beachten, dass der Entwicklungsstand, das wirtschaftliche und das politische Umfeld in beiden Vergleichsländern sich erheblich unterscheiden, so dass die Lektionen, die Mazedonien von Slowenien lernen könnte, nicht direkt übertragen und kopiert werden können, sondern entsprechend angepasst werden müssen. Die vorliegende Arbeit liefert Einsichten in die Probleme der Innovationspolitik in Transformationsländern und liefert daher sowohl einen Anreiz als auch eine Quelle von Informationen für künftige Analysen der wirtschaftlichen Bedingungen und vor allem Innovationspolitik in Transformationsländern.

A study on resident landscape perception through landscape image

Aiming at consensus building in environmental management with democratic procedure, a communication tool for mutual understanding is profoundly needed. The main purpose of this research is the establishment of a practical methodology to understand vernacular meanings of the environment in terms of resident landscape perception as a precondition for environmental discussion.

Contribution from neuropsychology to the study of semantic memory

Semantic memory has been studied from various fields. The first models emerged from cognitive psychology from the hand of the division proposed by Tulving between semantic and episodic memory. Over the past thirty years there have been parallel developments in the fields of psycholinguistics, cognitive psychology and cognitive neuropsychology. The present work is to review the contributions that have emerged within the neuropsychology to the study of semantic memory and to present an updated overview of the points of consensus. First, it is defined the term "semantics" conceptually within the field of neuropsychology. Then, there is a dichotomy that passes through both psychological and neuropsychological models on semantic memory: the existence of modals versus amodal representations. Third, there are  developed the main theoretical models in neuropsychology that emerged in an attempt to explain categoryspecific semantic deficits. Finally, more robust contributions and points that still generate some discussion are reviewed.

The Acute Care Undergraduate TEaching (ACUTE) initiative: consensus development of core competencies in acute care for undergraduates in the United Kingdom

Background: The care of the acutely ill patient in hospital is often sub-optimal. Poor recognition of critical illness combined with a lack of knowledge, failure to appreciate the clinical urgency of a situation, a lack of supervision, failure to seek advice and poor communication have been identified as contributory factors. At present the training of medical students in these important skills is fragmented. The aim of this study was to use consensus techniques to identify the core competencies in the care of acutely ill or arrested adult patients that medical students should possess at the point of graduation. Design: Healthcare professionals were invited to contribute suggestions for competencies to a website as part of a modified Delphi survey. The competency proposals were grouped into themes and rated by a nominal group comprised of physicians, nurses and students from the UK. The nominal group rated the importance of each competency using a 5-point Likert scale. Results: A total of 359 healthcare professionals contributed 2,629 competency suggestions during the Delphi survey. These were reduced to 88 representative themes covering: airway and oxygenation; breathing and ventilation; circulation; confusion and coma; drugs, therapeutics and protocols; clinical examination; monitoring and investigations; team-working, organisation and communication; patient and societal needs; trauma; equipment; pre-hospital care; infection and inflammation. The nominal group identified 71 essential and 16 optional competencies which students should possess at the point of graduation. Conclusions: We propose these competencies form a core set for undergraduate training in resuscitation and acute care.

Effect of patient age on management decisions in breast cancer: consensus from a national consultation

This qualitative study investigated the attitudes, perceptions, and practices of breast cancer specialists with reference to the effect of patient age on management decisions in breast cancer, and attempted to identify national consensus on this issue. One hundred thirty-three relevant specialists, including 75 surgeons and 43 oncologists, participated in a virtual consultation using e-mailed questionnaires and open-ended discussion documents, culminating in the development of proposed consensus statements sent to participants for validation. A strong consensus was seen in favor of incorporating minimum standards of diagnostic services, treatment, and care for older patients with breast cancer into relevant national guidance, endorsed by professional bodies. Similarly, an overwhelming majority of participants agreed that simple, evidence-based protocols or guidelines on standardizing assessment of biological and chronological age should be produced by the National Institute for Health and Clinical Excellence and the Scottish Medicines Consortium, developed in collaboration with specialist oncogeriatricians, and endorsed by professional bodies. A further recommendation that all breast cancer patient treatment and diagnostic procedures be undertaken in light of up-to-date, relevant scientific data met with majority support. This study was successful in gauging national specialist opinion regarding the effect of patient age on management decisions in breast cancer in the U.K.

Developing consensus on hospital prescribing indicators of potential harms amenable to decision support

Aim: To develop a list of prescribing indicators specific for the hospital setting that would facilitate the prospective collection of high severity and/or high frequency prescribing errors, which are also amenable to electronic clinical decision support (CDS). Method: A three-stage consensus technique (electronic Delphi) was carried out with 20 expert pharmacists and physicians across England. Participants were asked to score prescribing errors using a 5-point Likert scale for their likelihood of occurrence and the severity of the most likely outcome. These were combined to produce risk scores, from which median scores were calculated for each indicator across the participants in the study. The degree of consensus between the participants was defined as the proportion that gave a risk score in the same category as the median. Indicators were included if a consensus of 80% or more was achieved. Results: A total of 80 prescribing errors were identified by consensus as being high or extreme risk. The most common drug classes named within the indicators were antibiotics (n=13), antidepressants (n=8), nonsteroidal anti-inflammatory drugs (n=6), and opioid analgesics (n=6).The most frequent error type identified as high or extreme risk were those classified as clinical contraindications (n=29/80). Conclusion: 80 high risk prescribing errors in the hospital setting have been identified by an expert panel. These indicators can serve as the basis for a standardised, validated tool for the collection of data in both paperbased and electronic prescribing processes, as well as to assess the impact of electronic decision support implementation or development.

Content validation for level of use of feature rich systems: a Delphi study of electronic medical records systems

Introduction. Feature usage is a pre-requisite to realising the benefits of investments in feature rich systems. We propose that conceptualising the dependent variable 'system use' as 'level of use' and specifying it as a formative construct has greater value for measuring the post-adoption use of feature rich systems. We then validate the content of the construct as a first step in developing a research instrument to measure it. The context of our study is the post-adoption use of electronic medical records (EMR) by primary care physicians. Method. Initially, a literature review of the empirical context defines the scope based on prior studies. Having identified core features from the literature, they are further refined with the help of experts in a consensus seeking process that follows the Delphi technique. Results.The methodology was successfully applied to EMRs, which were selected as an example of feature rich systems. A review of EMR usage and regulatory standards provided the feature input for the first round of the Delphi process. A panel of experts then reached consensus after four rounds, identifying ten task-based features that would be indicators of level of use. Conclusions. To study why some users deploy more advanced features than others, theories of post-adoption require a rich formative dependent variable that measures level of use. We have demonstrated that a context sensitive literature review followed by refinement through a consensus seeking process is a suitable methodology to validate the content of this dependent variable. This is the first step of instrument development prior to statistical confirmation with a larger sample.

Thyroid hormone can increase estrogen-mediated transcription from a consensus estrogen response element in neuroblastoma cells

Thyroid hormones (T) and estrogens (E) are nuclear receptor ligands with at least two molecular mechanisms of action: (i) relatively slow genomic effects, such as the regulation of transcription by cognate T receptors (TR) and E receptors (ER); and (ii) relatively rapid nongenomic effects, such as kinase activation and calcium release initiated at the membrane by putative membrane receptors. Genomic and nongenomic effects were thought to be disparate and independent. However, in a previous study using a two-pulse paradigm in neuroblastoma cells, we showed that E acting at the membrane could potentiate transcription from an E-driven reporter gene in the nucleus. Because both T and E can have important effects on mood and cognition, it is possible that the two hormones can act synergistically. In this study, we demonstrate that early actions of T via TRalpha1 and TRbeta1 can potentiate E-mediated transcription (genomic effects) from a consensus E response element (ERE)-driven reporter gene in transiently transfected neuroblastoma cells. Such potentiation was reduced by inhibition of mitogen-activated protein kinase. Using phosphomutants of ERalpha, we also show that probable mitogen-activated protein kinase phosphorylation sites on the ERalpha, the serines at position 167 and 118, are important in TRbeta1-mediated potentiation of ERalpha-induced transactivation. We suggest that crosstalk between T and E includes potential interactions through both nuclear and membrane-initiated molecular mechanisms of hormone signaling.

Influence of rhBMP-2 on bone formation and osseointegration in different implant systems after sinus-floor elevation. An in vivo study on sheep

Background Several studies have reported certain bone morphogenic proteins (BMPs) to have positive effects on bone generation Although some investigators have studied the effects of human recombinant BMP (rhBMP-2) in sinus augmentation in sheep, none of these studies looked at the placement of implants at the time of sinus augmentation Furthermore, no literature could be found to report on the impact that different implant systems, as well as the positioning of the implants had on bone formation if rhBMP-2 was utilized in sinus-lift procedures Purpose The aim of this study was to compare sinus augmentation with rhBMP-2 on a poly-D, L-lactic-co-glycolic acid gelatine (PLPG) sponge with sinus augmentation with autologous pelvic cancellous bone in the maxillary sinus during the placement of different dental Implants Materials and methods Nine adult female sheep were submitted to bilateral sinus-floor elevation In one side (test group) the sinus lift was performed with rhBMP-2 on a PLPG-sponge, while the contralateral side served as the control by using cancellous bone from the iliac crest Three different implants (Branemark (R), 31 (R) and Straumann (R)) were inserted either simultaneously with the sinus augmentation or as a two staged procedure 6 weeks later The animals were sacrificed at 6 and 12 weeks for histological and histomorphometrical evaluations during which bone-to-implant contact (BIC) and bone density (BD) were evaluated Results BD and BIC were significantly higher at 12 weeks in the test group if the Implants were placed at the time of the sinus lift (p < 0 05) No difference was observed between the different implant systems or positions Conclusions The use of rhBMP-2 with PLPG-sponge increased BIC as well as BD in the augmented sinuses if compared to autologous bone Different implant systems and positions of the implants had no effect on BIC or BD (C) 2010 European Association for Cranio-Maxillo-Facial Surgery