Removal of fractured endodontic instruments using an Nd:YAG laser.

OBJECTIVE Fractured endodontic instruments inhibit optimal cleaning and filling of dental root canals, which may result in a less favorable prognosis for the tooth. Several techniques are available to remove fractured instruments; however, healthy tooth substance often must be destroyed in the process. This study was intended to evaluate Nd:YAG laser treatment as a method to remove fractured stainless steel instruments without destroying healthy tooth substance. METHOD AND MATERIALS Stainless steel endodontic instruments were fractured in 33 unprocessed root canals of mandibular central and lateral incisors and premolars in vitro. A brass tube charged with solder was placed at the coronal end of the fractured instrument and laser energy was used to melt the solder, connecting the fractured instrument with the brass tube. The success rates of connecting and removal of fractured instruments from the root channel were recorded for each case. RESULTS Connecting was achieved in every case in which more than 1.5 mm of the fractured instrument was tangible (22 out of 22). In cases where less than 1.5 mm was tangible, the rate for successful connection decreased to 4 out of 11 (36.4%). Fractured endodontic instruments were removed successfully in 17 out of 22 cases (77.3%) in which more than 1.5 mm was tangible. If less than 1.5 mm was tangible, the removal success rate decreased to 3 out of 11 cases (27.3%). CONCLUSION Our data support Nd:YAG laser-mediated connecting of a brass tube to a fractured endodontic instrument as a feasible and tissue conserving removal approach when more than 1.5 mm of the instrument is tangible.

The Jew as a patriot : a plea for the removal of the civil disabilities of the Jews in the Transvaal

by Joseph Herman Hertz

The York Medal, or the supposed Jewish medal, found in New York, on the removal of Layer Thorpe old bridge und postern, in the year 1829

deciphered by L. Loewe

A Biofilm Pocket Model to Evaluate Different Non-Surgical Periodontal Treatment Modalities in Terms of Biofilm Removal and Reformation, Surface Alterations and Attachment of Periodontal Ligament Fibroblasts.

BACKGROUND AND AIM There is a lack of suitable in vitro models to evaluate various treatment modalities intending to remove subgingival bacterial biofilm. Consequently, the aims of this in vitro-study were: a) to establish a pocket model enabling mechanical removal of biofilm and b) to evaluate repeated non-surgical periodontal treatment with respect to biofilm removal and reformation, surface alterations, tooth hard-substance-loss, and attachment of periodontal ligament (PDL) fibroblasts. MATERIAL AND METHODS Standardized human dentin specimens were colonized by multi-species biofilms for 3.5 days and subsequently placed into artificially created pockets. Non-surgical periodontal treatment was performed as follows: a) hand-instrumentation with curettes (CUR), b) ultrasonication (US), c) subgingival air-polishing using erythritol (EAP) and d) subgingival air-polishing using erythritol combined with chlorhexidine digluconate (EAP-CHX). The reduction and recolonization of bacterial counts, surface roughness (Ra and Rz), the caused tooth substance-loss (thickness) as well as the attachment of PDL fibroblasts were evaluated and statistically analyzed by means of ANOVA with Post-Hoc LSD. RESULTS After 5 treatments, bacterial reduction in biofilms was highest when applying EAP-CHX (4 log10). The lowest reduction was found after CUR (2 log10). Additionally, substance-loss was the highest when using CUR (128±40 µm) in comparison with US (14±12 µm), EAP (6±7 µm) and EAP-CHX (11±10) µm). Surface was roughened when using CUR and US. Surfaces exposed to US and to EAP attracted the highest numbers of PDL fibroblasts. CONCLUSION The established biofilm model simulating a periodontal pocket combined with interchangeable placements of test specimens with multi-species biofilms enables the evaluation of different non-surgical treatment modalities on biofilm removal and surface alterations. Compared to hand instrumentation the application of ultrasonication and of air-polishing with erythritol prevents from substance-loss and results in a smooth surface with nearly no residual biofilm that promotes the reattachment of PDL fibroblasts.

Genomics of Divergence along a Continuum of Parapatric Population Differentiation

The patterns of genomic divergence during ecological speciation are shaped by a combination of evolutionary forces. Processes such as genetic drift, local reduction of gene flow around genes causing reproductive isolation, hitchhiking around selected variants, variation in recombination and mutation rates are all factors that can contribute to the heterogeneity of genomic divergence. On the basis of 60 fully sequenced three-spined stickleback genomes, we explore these different mechanisms explaining the heterogeneity of genomic divergence across five parapatric lake and river population pairs varying in their degree of genetic differentiation. We find that divergent regions of the genome are mostly specific for each population pair, while their size and abundance are not correlated with the extent of genome-wide population differentiation. In each pair-wise comparison, an analysis of allele frequency spectra reveals that 25–55% of the divergent regions are consistent with a local restriction of gene flow. Another large proportion of divergent regions (38–75%) appears to be mainly shaped by hitchhiking effects around positively selected variants. We provide empirical evidence that alternative mechanisms determining the evolution of genomic patterns of divergence are not mutually exclusive, but rather act in concert to shape the genome during population differentiation, a first necessary step towards ecological speciation.

Clitics, affixes, and wordhood in Garifuna (Arawak): A multidimensional continuum of morphosyntactic boundness

Recent research on wordhood and morphosyntactic boundness suggests that the domains word and clitic do not lend themselves to cross-linguistic categorization but must be defined language specifically. In most languages, it is necessary to define word on two separate levels, the phonological word (p-word) and the grammatical word (g-word), and to describe mismatches between the two. This paper defines those domains for Garifuna, an Arawak language spoken in Honduras, Central America. Garifuna has auxiliary and classifier constructions which make up two p-words, and only one g-word. P-words made up of more than one g-word involve second position enclitics, word scope clitics, and proclitic connectives and prepositions. Garifuna clitics are typically unstressed, able to attach to hosts of any word class and able to string together into clusters. Enclitics are used to express tense-aspect, modality, and adverbial meanings, among others. In other languages, clitic clusters tend to display a fixed order; Garifuna clitic order seems quite free, although certain orders are preferred. Also, contrary to cross-linguistic tendencies, proclitic connectives can act as hosts for enclitic clusters, contradicting the commonly used definition of clitics as phonologically weak elements that need to attach to a host to form a p-word; such clitic-only p-words are problematic for traditional definitions of clitics.

Continuum damage interactions between tension and compression in osteonal bone

Skeletal diseases such as osteoporosis impose a severe socio-economic burden to ageing societies. Decreasing mechanical competence causes a rise in bone fracture incidence and mortality especially after the age of 65 y. The mechanisms of how bone damage is accumulated under different loading modes and its impact on bone strength are unclear. We hypothesise that damage accumulated in one loading mode increases the fracture risk in another. This study aimed at identifying continuum damage interactions between tensile and compressive loading modes. We propose and identify the material constants of a novel piecewise 1D constitutive model capable of describing the mechanical response of bone in combined tensile and compressive loading histories. We performed several sets of loading–reloading experiments to compute stiffness, plastic strains, and stress-strain curves. For tensile overloading, a stiffness reduction (damage) of 60% at 0.65% accumulated plastic strain was detectable as stiffness reduction of 20% under compression. For compressive overloading, 60% damage at 0.75% plastic strain was detectable as a stiffness reduction of 50% in tension. Plastic strain at ultimate stress was the same in tension and compression. Compression showed softening and tension exponential hardening in the post-yield regime. The hardening behaviour in compression is unaffected by a previous overload in tension but the hardening behaviour in tension is affected by a previous overload in compression as tensile reloading strength is significantly reduced. This paper demonstrates how damage accumulated under one loading mode affects the mechanical behaviour in another loading mode. To explain this and to illustrate a possible implementation we proposed a theoretical model. Including such loading mode dependent damage and plasticity behaviour in finite element models will help to improve fracture risk analysis of whole bones and bone implant structures.

A New Approach for Automatic Removal of Movement Artifacts in Near-Infrared Spectroscopy Time Series by Means of Acceleration Data

Abstract: Near-infrared spectroscopy (NIRS) enables the non-invasive measurement of changes in hemodynamics and oxygenation in tissue. Changes in light-coupling due to movement of the subject can cause movement artifacts (MAs) in the recorded signals. Several methods have been developed so far that facilitate the detection and reduction of MAs in the data. However, due to fixed parameter values (e.g., global threshold) none of these methods are perfectly suitable for long-term (i.e., hours) recordings or were not time-effective when applied to large datasets. We aimed to overcome these limitations by automation, i.e., data adaptive thresholding specifically designed for long-term measurements, and by introducing a stable long-term signal reconstruction. Our new technique (“acceleration-based movement artifact reduction algorithm”, AMARA) is based on combining two methods: the “movement artifact reduction algorithm” (MARA, Scholkmann et al. Phys. Meas. 2010, 31, 649–662), and the “accelerometer-based motion artifact removal” (ABAMAR, Virtanen et al. J. Biomed. Opt. 2011, 16, 087005). We describe AMARA in detail and report about successful validation of the algorithm using empirical NIRS data, measured over the prefrontal cortex in adolescents during sleep. In addition, we compared the performance of AMARA to that of MARA and ABAMAR based on validation data.

Prognostic Relevance of Palliative Primary Tumor Removal in 37,793 Metastatic Colorectal Cancer Patients: A Population-Based, Propensity Score-Adjusted Trend Analysis

OBJECTIVE To assess whether palliative primary tumor resection in colorectal cancer patients with incurable stage IV disease is associated with improved survival. BACKGROUND There is a heated debate regarding whether or not an asymptomatic primary tumor should be removed in patients with incurable stage IV colorectal disease. METHODS Stage IV colorectal cancer patients were identified in the Surveillance, Epidemiology, and End Results database between 1998 and 2009. Patients undergoing surgery to metastatic sites were excluded. Overall survival and cancer-specific survival were compared between patients with and without palliative primary tumor resection using risk-adjusted Cox proportional hazard regression models and stratified propensity score methods. RESULTS Overall, 37,793 stage IV colorectal cancer patients were identified. Of those, 23,004 (60.9%) underwent palliative primary tumor resection. The rate of patients undergoing palliative primary cancer resection decreased from 68.4% in 1998 to 50.7% in 2009 (P < 0.001). In Cox regression analysis after propensity score matching primary cancer resection was associated with a significantly improved overall survival [hazard ratio (HR) of death = 0.40, 95% confidence interval (CI) = 0.39-0.42, P < 0.001] and cancer-specific survival (HR of death = 0.39, 95% CI = 0.38-0.40, P < 0.001). The benefit of palliative primary cancer resection persisted during the time period 1998 to 2009 with HRs equal to or less than 0.47 for both overall and cancer-specific survival. CONCLUSIONS On the basis of this population-based cohort of stage IV colorectal cancer patients, palliative primary tumor resection was associated with improved overall and cancer-specific survival. Therefore, the dogma that an asymptomatic primary tumor never should be resected in patients with unresectable colorectal cancer metastases must be questioned.

Evidence for a perception memory continuum: an EEG study in a healthy population

In line with current memory theories of a perception-memory continuum along the ventral visual pathway, there is evidence that the specific profile of enhanced memory in special populations (e.g. synaesthesia) is based on increased perceptual sensitivity. The main goal of this study was to test in a more general population, if increased perceptual sensitivity is indeed associated with enhanced memory performance. We measured ERPs in response to simple perceptual stimuli biasing either the ventral or the dorsal route and established if perceptual sensitivity in response to ventrally (but not dorsally) processed stimuli is associated with visual short term memory performance in a change detection task. Preliminary results confirm the hypothesis and strengthen the assumption of a perceptual-memory-continuum.

El problema del continuum y sus implicancias en la teoría leibniziana de la sustancia

El problema del contínuum juega un papel decisivo en el desarrollo de la metafísica leibniciana de madurez. En los 70, dicho problema asomaba en sus intentos de explicar la naturaleza de la materia y la unión alma-cuerpo desde una perspectiva geométrico-mecanicista. Más tarde, la cuestión reaparece en la discusión con Arnauld sobre la unidad sustancial. Al hacer de la unidad real el criterio definitorio de la sustancia, Leibniz expulsa lo continuo al ámbito de lo ideal. Con este paso, su sistema se encamina hacia una ontología monadológica y hacia un esquema metafísico articulado en tres niveles (real, fenoménico e ideal).

El problema del continuum y sus implicancias en la teoría leibniziana de la sustancia

El problema del contínuum juega un papel decisivo en el desarrollo de la metafísica leibniciana de madurez. En los 70, dicho problema asomaba en sus intentos de explicar la naturaleza de la materia y la unión alma-cuerpo desde una perspectiva geométrico-mecanicista. Más tarde, la cuestión reaparece en la discusión con Arnauld sobre la unidad sustancial. Al hacer de la unidad real el criterio definitorio de la sustancia, Leibniz expulsa lo continuo al ámbito de lo ideal. Con este paso, su sistema se encamina hacia una ontología monadológica y hacia un esquema metafísico articulado en tres niveles (real, fenoménico e ideal).

El problema del continuum y sus implicancias en la teoría leibniziana de la sustancia

El problema del contínuum juega un papel decisivo en el desarrollo de la metafísica leibniciana de madurez. En los 70, dicho problema asomaba en sus intentos de explicar la naturaleza de la materia y la unión alma-cuerpo desde una perspectiva geométrico-mecanicista. Más tarde, la cuestión reaparece en la discusión con Arnauld sobre la unidad sustancial. Al hacer de la unidad real el criterio definitorio de la sustancia, Leibniz expulsa lo continuo al ámbito de lo ideal. Con este paso, su sistema se encamina hacia una ontología monadológica y hacia un esquema metafísico articulado en tres niveles (real, fenoménico e ideal).