Removable Partial Dentures: Use of Rapid Prototyping

The CAD/CAM technology associated with rapid prototyping (RP) is already widely used in the fabrication of all-ceramic fixed prostheses and in the biomedical area; however, the use of this technology for the manufacture of metal frames for removable dentures is new. This work reports the results of a literature review conducted on the use of CAD/CAM and RP in the manufacture of removable partial dentures.

Impact of the availability of an influenza virus rapid antigen test on diagnostic decision making in a pediatric emergency department

OBJECTIVES: Fever is one of the most commonly seen symptoms in the pediatric emergency department. The objective of this study was to observe how the rapid testing for influenza virus impacts on the management of children with fever. METHODS: We performed a review of our pediatric emergency department records during the 2008/2009 annual influenza season. The BinaxNow Influenza A+B test was performed on patients with the following criteria: age 1.0 to 16.0 years, fever greater than 38.5 °C, fever of less than 96 hours' duration after the onset of clinical illness, clinical signs compatible with acute influenza, and nontoxic appearance. Additional laboratory tests were performed at the treating physician's discretion. RESULTS: The influenza rapid antigen test was performed in 192 children. One hundred nine (57%) were influenza positive, with the largest fraction (101 patients) positive for influenza A. The age distribution did not differ between children with negative and positive test results (mean, 5.3 vs. 5.1 years, not statistically significant). A larger number of diagnostic tests were performed in the group of influenza-negative patients. Twice as many complete blood counts, C-reactive protein determinations, lumbar punctures, and urinalyses were ordered in the latter group. CONCLUSIONS: Rapid diagnosis of influenza in the pediatric emergency department affects the management of febrile children as the confirmation of influenza virus infection decreases additional diagnostic tests ordered.

Accuracy of B-type natriuretic peptide tests to exclude congestive heart failure: systematic review of test accuracy studies

BACKGROUND: Congestive heart failure (CHF) is a major public health problem. The use of B-type natriuretic peptide (BNP) tests shows promising diagnostic accuracy. Herein, we summarize the evidence on the accuracy of BNP tests in the diagnosis of CHF and compare the performance of rapid enzyme-linked immunosorbent assay (ELISA) and standard radioimmunosorbent assay (RIA) tests. METHODS: We searched electronic databases and the reference lists of included studies, and we contacted experts. Data were extracted on the study population, the type of test used, and methods. Receiver operating characteristic (ROC) plots and summary ROC curves were produced and negative likelihood ratios pooled. Random-effect meta-analysis and metaregression were used to combine data and explore sources of between-study heterogeneity. RESULTS: Nineteen studies describing 22 patient populations (9 ELISA and 13 RIA) and 9093 patients were included. The diagnosis of CHF was verified by echocardiography, radionuclide scan, or echocardiography combined with clinical criteria. The pooled negative likelihood ratio overall from random-effect meta-analysis was 0.18 (95% confidence interval [CI], 0.13-0.23). It was lower for the ELISA test (0.12; 95% CI, 0.09-0.16) than for the RIA test (0.23; 95% CI, 0.16-0.32). For a pretest probability of 20%, which is typical for patients with suspected CHF in primary care, a negative result of the ELISA test would produce a posttest probability of 2.9%; a negative RIA test, a posttest probability of 5.4%. CONCLUSIONS: The use of BNP tests to rule out CHF in primary care settings could reduce demand for echocardiography. The advantages of rapid ELISA tests need to be balanced against their higher cost.

Postmortem angiography: review of former and current methods

OBJECTIVE: Postmortem investigations are becoming more and more sophisticated. CT and MRI are already being used in pathology and forensic medicine. In this context, the impact of postmortem angiography increases because of the rapid evaluation of organ-specific vascular patterns, vascular alteration under pathologic and physiologic conditions, and tissue changes induced by artificial and unnatural causes. CONCLUSION: In this article, the advantages and disadvantages of former and current techniques and contrast agents are reviewed.

Review of assessment, design, and mitigation of multiple hazards

Large parts of the world are subjected to one or more natural hazards, such as earthquakes, tsunamis, landslides, tropical storms (hurricanes, cyclones and typhoons), costal inundation and flooding. Virtually the entire world is at risk of man-made hazards. In recent decades, rapid population growth and economic development in hazard-prone areas have greatly increased the potential of multiple hazards to cause damage and destruction of buildings, bridges, power plants, and other infrastructure; thus posing a grave danger to the community and disruption of economic and societal activities. Although an individual hazard is significant in many parts of the United States (U.S.), in certain areas more than one hazard may pose a threat to the constructed environment. In such areas, structural design and construction practices should address multiple hazards in an integrated manner to achieve structural performance that is consistent with owner expectations and general societal objectives. The growing interest and importance of multiple-hazard engineering has been recognized recently. This has spurred the evolution of multiple-hazard risk-assessment frameworks and development of design approaches which have paved way for future research towards sustainable construction of new and improved structures and retrofitting of the existing structures. This report provides a review of literature and the current state of practice for assessment, design and mitigation of the impact of multiple hazards on structural infrastructure. It also presents an overview of future research needs related to multiple-hazard performance of constructed facilities.

Paediatric antiretroviral treatment programmes in sub-Saharan Africa: a review of published clinical studies

Knowledge of the experience and outcomes of current paediatric antiretroviral treatment (ART) programmes in sub-Saharan Africa can inform new programmes in the region as well as enhance existing ones. This is urgently needed to facilitate the scale-up of treatment, which is needed to address the burden of paediatric HIV cases on the continent. We reviewed the characteristics and outcomes of programmes with clinical paediatric ART studies published prior to 1 January 2008. The outcomes of the studies were comparable to similar ones from developed countries; however, the duration of follow-up was relatively limited in almost all the studies reviewed. One-year survival probability was between 84% and 91%, and considerable improvement in the clinical, immunologic and iral status of the paediatric patients was generally recorded. Loss to follow-up was less than 10% in all but two studies. Adherence to treatment was good and few adverse events were reported. This is despite the fact that many programmes were subject to enormous constraints in terms of health services, and despite widespread use of adult fixed-dose combinations for paediatric patients, including young infants. While the majority of children commencing ART were severely ill, most children were old (median age >5 years for almost all studies) with relatively few infants and young children (age <2 years) receiving treatment. This is in contrast to knowledge of rapid disease progression in the majority of HIV-infected infants and despite the World Health Organization’s recent recommendations to commence ART in all HIV-infected infants less than one year old. There is an urgent need to address barriers to ART for infants. Studies of the outcomes of programmes treating infants as well as those with longer-term follow-up are also needed.

Trends and Expertise Exchange within Rapid Manufacturing in Europe

Rapid Manufacturing (RM) umfasst den Begriff der direkten und wirtschaftlichen Bauteilherstellung des Serienprodukts aus 3D-Daten. Die Hauptvorteile sind u.a. das Wegfallen von Werkzeugen und eine Designfreiheit in der Produktentwicklung, die noch vor wenigen Jahren undenkbar war. Wenngleich heute eine Vielzahl von Werkstoffen im Kunststoff- und Metallbereich einsetzbar sind, konzentriert sich die Verbreitung des RM allerdings auf besondere Technologie- und Wirtschaftszweige, aufgrund mangelnder Erfahrungswerte, teilweise abweichender Werkstoffeigenschaften, fehlender Standards und ungeeigneter Testmethoden. In der Praxis sind Ingenieure und Techniker stark darauf bedacht, auf etablierte Abläufe und Standards zurückzugreifen. Es ist daher schwer einen geeigneten RM-Prozess aufzubauen, wo wichtige Eingangsgrößen meist unbekannt sind. In diesem Bericht wird beschrieben, welche Informationskanäle es innerhalb Europas zum Thema RM gibt und welche Hochschulen und Forschungszentren Aktivitäten aufweisen. Darüber hinaus werden Anwendungsfelder des RM aufgeführt, die über die bekannten Anwendungsfelder hinaus gehen. Dazu gehören Anwendungen im Bereich der Elektrotechnik, Raumfahrtinstrumentation und der Mode. Obwohl nicht alle Anwendungen des RM in diesem Bericht aufgeführt werden, sind einige Schlüsselinformationen im Bereich innovativer Anwendungen von RM enthalten.

The tectonometamorphic evolution of the Sesia–Dent Blanche nappes (internal Western Alps): review and synthesis

This study reviews and synthesizes the present knowledge on the Sesia–Dent Blanche nappes, the highest tectonic elements in the Western Alps (Switzerland and Italy), which comprise pieces of pre-Alpine basement and Mesozoic cover. All of the available data are integrated in a crustal-scale kinematic model with the aim to reconstruct the Alpine tectono-metamorphic evolution of the Sesia–Dent Blanche nappes. Although major uncertainties remain in the pre-Alpine geometry, the basement and cover sequences of the Sesia–Dent Blanche nappes are seen as part of a thinned continental crust derived from the Adriatic margin. The earliest stages of the Alpine evolution are interpreted as recording late Cretaceous subduction of the Adria-derived Sesia–Dent Blanche nappes below the South-Alpine domain. During this subduction, several sheets of crustal material were stacked and separated by shear zones that rework remnants of their Mesozoic cover. The recently described Roisan-Cignana Shear Zone of the Dent Blanche Tectonic System represents such a shear zone, indicating that the Sesia–Dent Blanche nappes represent a stack of several individual nappes. During the subsequent subduction of the Piemonte–Liguria Ocean large-scale folding of the nappe stack (including the Roisan-Cignana Shear Zone) took place under greenschist facies conditions, which indicates partial exhumation of the Dent Blanche Tectonic System. The entrance of the Briançonnais micro-continent within the subduction zone led to a drastic change in the deformation pattern of the Alpine belt, with rapid exhumation of the eclogite-facies ophiolite bearing units and thrust propagation towards the foreland. Slab breakoff probably was responsible for allowing partial melting in the mantle and Oligocene intrusions into the most internal parts of the Sesia–Dent Blanche nappes. Finally, indentation of the Adriatic plate into the orogenic wedge resulted in the formation of the Vanzone back-fold, which marks the end of the pervasive ductile deformation within the Sesia–Dent Blanche nappes during the earliest Miocene.

A systematic review and meta-analysis of diabetes disease management programs

Context. Despite the rapid growth of disease management programs, there are still questions about their efficacy and effectiveness for improving patient outcomes and their ability to reduce costs associated with chronic disease. ^ Objective. To determine the effectiveness of disease management programs on improving the results of HbA1c tests, lipid profiles and systolic blood pressure (SBP) readings among diabetics. These three quantitative measures are widely accepted methods of determining the quality of a patient's diabetes management and the potential for future complications. ^ Data Sources. MEDLINE and CINAHL were searched from 1950 to June 2008 using MeSH terms designed to capture all relevant studies. Scopus pearling and hand searching were also done. Only English language articles were selected. ^ Study Selection. Titles and abstracts for the 2347 articles were screened against predetermined inclusion and exclusion criteria, yielding 217 articles for full screening. After full article screening, 29 studies were selected for inclusion in the review. ^ Data Extraction. From the selected studies, data extraction included sample size, mean change over baseline, and standard deviation for each control and experimental arm. ^ Results. The pooled results show a mean HbA1c reduction of 0.64%, 95% CI (-0.83 to -0.44), mean SBP reduction of 7.39 mmHg (95% CI to -11.58 to -3.2), mean total cholesterol reduction of 5.74 mg/dL (95% CI, -10.01 to -1.43), and mean LDL cholesterol reduction of 3.74 mg/dL (95% CI, -8.34 to 0.87). Results for HbA1c, SBP and total cholesterol were statistically significant, while the results for LDL cholesterol were not. ^ Conclusions. The findings suggest that disease management programs utilizing five hallmarks of care can be effective at improving intermediate outcomes among diabetics. However, given the significant heterogeneity present, there may be fundamental differences with respect to study-specific interventions and populations that render them inappropriate for meta-analysis. ^

Multi-criteria selection of structural adhesives to bond ABS parts obtained by rapid prototyping

One of the most used methods in rapidprototyping is Fused Deposition Modeling (FDM), which provides components with a reasonable strength in plastic materials such as ABS and has a low environmental impact. However, the FDM process exhibits low levels of surface finishing, difficulty in getting complex and/or small geometries and low consistency in “slim” elements of the parts. Furthermore, “cantilever” elements need large material structures to be supported. The solution of these deficiencies requires a comprehensive review of the three-dimensional part design to enhance advantages and performances of FDM and reduce their constraints. As a key feature of this redesign a novel method of construction by assembling parts with structuraladhesive joints is proposed. These adhesive joints should be designed specifically to fit the plastic substrate and the FDM manufacturing technology. To achieve this, the most suitable structuraladhesiveselection is firstly required. Therefore, the present work analyzes five different families of adhesives (cyanoacrylate, polyurethane, epoxy, acrylic and silicone), and, by means of the application of technical multi-criteria decision analysis based on the analytic hierarchy process (AHP), to select the structuraladhesive that better conjugates mechanical benefits and adaptation to the FDM manufacturing process

A review of the potential of renewable energy sources for the State of Jammu and Kashmir (India)

The future economic development trajectory for India is likely to result in rapid and accelerated growth in energy demand, with expected shortages. Many of its current policies and strategies are aimed at the improvement and possible maximization of energy production from the renewable sector. It is also clear that while energy-conservation and energy-efficiency can make an important contribution in the national energy strategy, renewable energies will be essential to the solution and are likely to play an increasingly important role for the growth of grid power, providing energy access, reducing consumption of fossil fuels, and helping India pursue its low carbon progressive pathway. However, most of the states in India, like the northernmost State of Jammu and Kashmir (J&K), have experienced an energy crisis over a sustained period of time. As India intends to be one of the emerging powers of the 21st century, it has to embark upon with these pressing issues in a more sustainable manner and accordingly initiate various renewable energy projects within these states. This paper will provide a broad-spectrum view about the energy situation within J&K and will highlight the current policies along with future strategies for the optimal utilization of renewable energy resources.

Rapid prototyping for biomedical engineering: current capabilities and Challenges

A new set of manufacturing technologies has emerged in the past decades to address market requirements in a customized way and to provide support for research tasks that require prototypes. These new techniques and technologies are usually referred to as rapid prototyping and manufacturing technologies, and they allow prototypes to be produced in a wide range of materials with remarkable precision in a couple of hours. Although they have been rapidly incorporated into product development methodologies, they are still under development, and their applications in bioengineering are continuously evolving. Rapid prototyping and manufacturing technologies can be of assistance in every stage of the development process of novel biodevices, to address various problems that can arise in the devices' interactions with biological systems and the fact that the design decisions must be tested carefully. This review focuses on the main fields of application for rapid prototyping in biomedical engineering and health sciences, as well as on the most remarkable challenges and research trends.

Recovery of Disruptions in Rapid Transit Networks

This paper studies the disruption management problem of rapid transit rail networks. Besides optimizing the timetable and the rolling stock schedules, we explicitly deal with the effects of the disruption on the passenger demand. We propose a two-step approach that combines an integrated optimization model (for the timetable and rolling stock) with a model for the passengers’ behavior. We report our computational tests on realistic problem instances of the Spanish rail operator RENFE. The proposed approach is able to find solutions with a very good balance between various managerial goals within a few minutes. Se estudia la gestión de las incidencias en redes de metro y cercanías. Se optimizan los horarios y la asignación del material rodante, teniendo en cuenta el comportamiento de los pasajeros. Se reallizan pruebas en varias líneas de la red de cercanías de Madrid, con resultados satisfactorios.

Mealiness Detection in Agricultural Crops: Destructive and Nondestructive Tests: A Review

Mealiness is known as an important internal quality attribute of fruits/vegetables, which has significant influence on consumer purchasing decisions. Mealiness has been a topic of research interest over the past several decades. A number of destructive and nondestructive techniques are introduced for mealiness detection. Nondestructive methods are more interesting because they are rapid, noninvasive, and suitable for real-time purposes. In this review, the concept of mealiness is presented for potato, apple, and peach, followed by an in-depth discussion about applications of destructive and nondestructive techniques developed for mealiness detection. The results suggest the potential of electromagnetic-based techniques for nondestructive mealiness evaluation. Further investigations are in progress to find more appropriate nondestructive techniques as well as cost and performance.

The place of DPP-4 inhibitors in the treatment algorithm of diabetes type 2 : a systematic review of cost-effectiveness studies

Tese de mestrado, Epidemiologia, Universidade de Lisboa, Faculdade de Medicina, 2015