Use of endovascular therapy for peripheral arterial lesions: an analysis of the national trauma data bank from 2007 to 2009

An endovascular approach is increasingly used for the treatment of peripheral arterial trauma (PAT), but evidence supporting this approach is lacking. The objective of our study was to assess outcomes for endovascular repair (ER) versus operative repair (OR) in PAT.

Oral lichen planus and malignant transformation: a retrospective follow-up study of clinical and histopathologic data

OBJECTIVE: Patients in the stomatology service of the Department of Oral Surgery and Stomatology who were clinically and histopathologically diagnosed with oral lichen planus (OLP) in the years 1995 to 2001 were examined for a possible malignant transformation of a previously biopsied OLP site. METHOD AND MATERIALS: For the 145 patients included, the recordings were searched for initial localization and type of OLP lesion, potential noxious agents, distribution between symptomatic and asymptomatic OLP types, and for a malignant transformation of a known OLP site during the follow-up period up to December 2003. RESULTS: The group comprised 47 men and 98 women with a mean age of 56.3 years. Of the 497 lesions, almost half were classified as reticular or papular, predominantly located on the buccal mucosa, gingiva, and borders of the tongue. Four patients did not adhere to their scheduled control visits and were dropped from the study. During the follow-up period 4 patients developed malignant transformation of OLP. In 3 of these cases, dysplasia was present at the initial diagnosis of OLP. This results in a malignant transformation rate of 2.84% among the remaining 141 patients; if the 3 patients with initial dysplasia are excluded, the rate drops to 0.71%. CONCLUSIONS: Until further knowledge is derived from large prospective studies, the data supporting or negating a potential malignant character of OLP lesions remains inconclusive. Special emphasis has to be directed toward unified inclusion and exclusion criteria regarding clinical and histologic findings and identifiable risk factors to allow the comparison of different studies.

An integrated approach for reconstructing surface models of the proximal femur from sparse input data for surgical navigation

A patient-specific surface model of the proximal femur plays an important role in planning and supporting various computer-assisted surgical procedures including total hip replacement, hip resurfacing, and osteotomy of the proximal femur. The common approach to derive 3D models of the proximal femur is to use imaging techniques such as computed tomography (CT) or magnetic resonance imaging (MRI). However, the high logistic effort, the extra radiation (CT-imaging), and the large quantity of data to be acquired and processed make them less functional. In this paper, we present an integrated approach using a multi-level point distribution model (ML-PDM) to reconstruct a patient-specific model of the proximal femur from intra-operatively available sparse data. Results of experiments performed on dry cadaveric bones using dozens of 3D points are presented, as well as experiments using a limited number of 2D X-ray images, which demonstrate promising accuracy of the present approach.

SUPPORTING LEARNING FOR NAVAJO STUDENTS THROUGH ETHNOMATHEMATICS

The purpose of this research was to address how culturally informed ethnomathematical methods of teaching can be utilized to support the learning of Navajo students in mathematics. The study was conducted over the course of four years on the Navajo Reservations at Tohatchi Middle School in Tohatchi New Mexico. The students involved in the study were all in 8th grade and were enrolled either in Algebra 1 or a Response to Intervention, RTI, class. The data collected came in the form of a student survey, student observation and student assessment. The teacher written survey, a math textbook word problem, and two original math textbook problems along with their rewritten version were the sources of these three studies. The first year of the study consisted of a math attitude survey and how Navajo students perceived math as a subject of interest. The students answered four questions pertaining to their thoughts about mathematics. The students’ responses were positive according to their written answers. The second year of the study involved the observation of how students worked through a math word problem as a group. This method tested how the students culturally interacted in order to solve a math problem. Their questions and reasoning to solve the problem were shared with peers and the teacher. The teacher supported the students in understanding and solving the problem by asking questions that kept the students focused on the goal of solving the problem. The students worked collaboratively and openly in order to complete the activity. During the iv study, the teacher was more able to notice the students’ deficiencies individually or as a group, therefore was able to support them in a more specific manner. The last study was conducted over a period of two different years. This study was used to determine how textbook bias in the form of its sentence structure or word choice affects the performance of students who are not culturally familiar with one or both. It was found that the students performed better and took less time on the rewritten problem than on the original problem. The data suggests that focusing on the culture, language and education of Navajo students can affect how the students learn and understand math.

A systematic review of the performance of ceramic and metal implant abutments supporting fixed implant reconstructions

OBJECTIVES: The objective of this systematic review was to assess the 5-year survival rates and incidences of complications associated with ceramic abutments and to compare them with those of metal abutments. METHODS: An electronic Medline search complemented by manual searching was conducted to identify randomized-controlled clinical trials, and prospective and retrospective studies providing information on ceramic and metal abutments with a mean follow-up time of at least 3 years. Patients had to have been examined clinically at the follow-up visit. Assessment of the identified studies and data abstraction was performed independently by three reviewers. Failure rates were analyzed using standard and random-effects Poisson regression models to obtain summary estimates of 5-year survival proportions. RESULTS: Twenty-nine clinical and 22 laboratory studies were selected from an initial yield of 7136 titles and data were extracted. The estimated 5-year survival rate of ceramic abutments was 99.1% [95% confidence interval (CI): 93.8-99.9%] and 97.4% (95% CI: 96-98.3%) for metal abutments. The estimated cumulative incidence of technical complications after 5 years was 6.9% (95% CI: 3.5-13.4%) for ceramic abutments and 15.9% (95% CI: 11.6-21.5%) for metal abutments. Abutment screw loosening was the most frequent technical problem, occurring at an estimated cumulative incidence after 5 years of 5.1% (95% CI: 3.3-7.7%). All-ceramic crowns supported by ceramic abutments exhibited similar annual fracture rates as metal-ceramic crowns supported by metal abutments. The cumulative incidence of biological complications after 5 years was estimated at 5.2% (95% CI: 0.4-52%) for ceramic and 7.7% (95% CI: 4.7-12.5%) for metal abutments. Esthetic complications tended to be more frequent at metal abutments. A meta-analysis of the laboratory data was impossible due to the non-standardized test methods of the studies included. CONCLUSION: The 5-year survival rates estimated from annual failure rates appeared to be similar for ceramic and metal abutments. The information included in this review did not provide evidence for differences of the technical and biological outcomes of ceramic and metal abutments. However, the information for ceramic abutments was limited in the number of studies and abutments analyzed as well as the accrued follow-up time. Standardized methods for the analysis of abutment strength are needed.

Status and Causal Pathway Assessments Supporting River Basin Management

The European Water Framework Directive (WFD) requires a status assessment of all water bodies. If that status is deteriorated, the WFD urges the identification of its potential causes in order to be able to suggest appropriate management measures. The instrument of investigative monitoring allows for such identification, provided that appropriate tools are available to link the observed effects to causative stressors, while unravelling confounding factors. In this chapter, the state of the art of status and causal pathway assessment is described for the major stressors responsible for the deterioration of European water bodies, i.e. toxicity, acidification, salinisation, eutrophication and oxygen depletion, parasites and pathogens, invasive alien species, hydromorphological degradation, changing water levels as well as sediments and suspended matter. For each stressor, an extensive description of the potential effects on the ecological status is given. Secondly, stressor-specific abiotic and biotic indicators are described that allow for a first indication of probable causes, based on the assessment of available monitoring data. Subsequently, more advanced tools for site-specific confirmation of stressors at hand are discussed. Finally, the local status assessments are put into the perspective of the risk for downstream stretches in order to be able to prioritise stressors and to be able to select appropriate measures for mitigation of the risks resulting from these stressors.

Systematic review of the survival rate and incidence of biologic, technical, and esthetic complications of single implant abutments supporting fixed prostheses

Purpose: To assess the 5-year survival rate and number of technical, biologic, and esthetic complications involving implant abutments. Materials and Methods: Electronic (Medline) and hand searches were performed to assess studies on metal and ceramic implant abutments. Relevant data from a previous review were included. Two reviewers independently extracted the data. Failure and complication rates were analyzed, and estimates of 5-year survival proportions were calculated from the relationship between event rate and survival function. Multivariable robust Poisson regression was used to compare abutment characteristics. Results: The search yielded 1,558 titles and 274 abstracts. Twenty-four studies were selected for data analysis. The survival rate for ceramic abutments was 97.5% (95% confidence interval [CI]): 89.6% to 99.4%) and 97.6% (95% CI: 96.2% to 98.5%) for metal abutments. The overall 5-year rate for technical complications was 11.8% (95% CI: 8.5% to 16.3%), 8.9% (95% CI: 4.3% to 17.7%) for ceramic and 12.0% (95% CI: 8.5% to 16.8%) for metal abutments. Biologic complications occurred with an overall rate of 6.4% (95% CI: 3.3% to 12.0%), 10.4% (95% CI: 1.9% to 46.7%) for ceramic, and 6.1% (95% CI: 3.1% to 12.0%) for metal abutments. Conclusions: The present meta-analysis on single-implant prostheses presents high survival rates of single implants, abutments, and prostheses after 5 years of function. No differences were found for the survival and failure rates of ceramic and metal abutments. No significant differences were found for technical, biologic, and esthetic complications of internally and externally connected abutments.

Self-supporting CVD diamond charge state conversion surfaces for high resolution imaging of low-energy neutral atoms in space plasmas

Two polycrystalline diamond surfaces, manufactured by chemical vapour deposition (CVD) technique, are investigated regarding their applicability as charge state conversion surfaces (CS) for use in a low energy neutral atom imaging instrument in space research. The capability of the surfaces for converting neutral atoms into negative ions via surface ionisation processes was measured for hydrogen and oxygen with particle energies in the range from 100 eV to 1 keV and for angles of incidence between 6 deg and 15 deg. We observed surface charging during the surface ionisation processes for one of the CVD samples due to low electrical conductivity of the material. Measurements on the other CVD diamond sample resulted in ionisation efficiencies of ~2 % for H and up to 12 % for O. Analysis of the angular scattering revealed very narrow and almost circular scattering distributions. Comparison of the results with the data of the CS of the IBEX-Lo sensor shows that CVD diamond has great potential as CS material for future space missions.

B, d11B, K and d18O data for altered oceanic crust at DSDP Sites 417/418

Samples of drilled oceanic crust, from DSDP Holes 417A, 417D and 418A and ODP Hole 735B, and oceanic crust from the Oman and Cyprus ophiolites, were analyzed for B contents and d11B. Composite samples from DSDP Holes 417A, 417D and 418A were used to represent the upper 550 m of altered oceanic crustal Layer 2A. Whole-rock samples from the Troodos ophiolite, Cyprus, and the Oman ophiolite were selected to represent crustal Layer 2B dikes. Composite samples from ODP Hole 735B were used to represent crustal Layer 3. The B content of the DSDP composites ranges from 7.2 ppm to 104 ppm and correlates with both d1818O and K, showing that it is a good indicator of the extent of low temperature alteration. The d11B of the DSDP composites varies between -2.5? and 5.4?. The B content of the samples from the Troodos ophiolite ranges from 2.4 ppm to 8.1 ppm; d11B varies from -0.9? to 7.8?. The B content of the Oman ophiolite samples ranges from 5.0 ppm to 11.1 ppm; d11B varies from -1.6? to 16.9?. The B content of the samples from ODP Hole 735B ranges from 1.1 ppm to 7.1 ppm; d11B varies from -4.3? to 24.9?. The general pattern displayed by these samples is one of greatest (and most variable) B enrichment at the top of the crust and least enrichment at the bottom of the section. All of these samples are enriched compared to unaltered MORB, which is believed to have a B content of approximately 0.5 ppm. The d11B values of deeper samples, from Layers 2B and 3, are more variable and generally higher than those from Layer 2A. Boron contents and d11B are not correlated. The data from the DSDP Site 417/418 composites indicate that the d11B of fluid circulating in the upper crust changes only slightly during alteration, increasing by an average of 5.1? with an accompanying decrease in B concentration of 7%. Low temperature alteration appears to be a water-dominated process resulting in minor modification of circulating seawater. A minimum water-rock ratio of 400 is calculated for these samples, implying a minimum low-temperature seawater flux through the upper oceanic crust of 3.4?10**14 l/y. The average B content of altered oceanic crust, as represented by these samples, is 5.2+/-1.7 ppm and the average d11B is 3.4+/-1.1?. This average isotopic composition is measurably different from the apparent average of oceanic sediments, supporting the idea that d11B could be useful for identifying the source(s) of B in island arcs.

(Supporting Information) Collection date and location of the analysed herbarium Corallina officinalis samples of the Natural History Museum (BM)

Suporting Information 1; Herbarium Corallina officinalis samples of the Natural History Museum (BM) analysed for the present study. Where the same NHM barcodes are provided for more than one sample, multiple samples were present under the same barcode in the herbarium. (-) indicates samples were not barcoded in the NHM (BM) system.

Part of the global DOC versus AOU (dissolved organic carbon/apparent oxygen utilization) data compilation, BATS

The contributions of total organic carbon and nitrogen to elemental cycling in the surface layer of the Sargasso Sea are evaluated using a 5-yr time-series data set (1994-1998). Surface-layer total organic carbon (TOC) and total organic nitrogen (TON) concentrations ranged from 60 to 70 µM C and 4 to 5.5 µM N seasonally, resulting in a mean C : N molar ratio of 14.4±2.2. The highest surface concentrations varied little during individual summer periods, indicating that net TOC production ceased during the highly oligotrophic summer season. Winter overturn and mixing of the water column were both the cause of concentration reductions and the trigger for net TOC production each year following nutrient entrainment and subsequent new production. The net production of TOC varied with the maximum in the winter mixed-layer depth (MLD), with greater mixing supporting the greatest net production of TOC. In winter 1995, the TOC stock increased by 1.4 mol C/m**2 in response to maximum mixing depths of 260 m. In subsequent years experiencing shallower maxima in MLD (<220 m), TOC stocks increased <0.7 mol C/m**2. Overturn of the water column served to export TOC to depth (>100 m), with the amount exported dependent on the depth of mixing (total export ranged from 0.4 to 1.4 mol C/m**2/yr). The exported TOC was comprised both of material resident in the surface layer during late summer (resident TOC) and material newly produced during the spring bloom period (fresh TOC). Export of resident TOC ranged from 0.5 to 0.8 mol C/m**2/yr, covarying with the maximum winter MLD. Export of fresh TOC varied from nil to 0.8 mol C/m**2/yr. Fresh TOC was exported only after a threshold maximum winter MLD of ~200 m was reached. In years with shallower mixing, fresh TOC export and net TOC production in the surface layer were greatly reduced. The decay rates of the exported TOC also covaried with maximum MLD. The year with deepest mixing resulted in the highest export and the highest decay rate (0.003 1/d) while shallow and low export resulted in low decay rates (0.0002 1/d), likely a consequence of the quality of material exported. The exported TOC supported oxygen utilization at dC : dO2 molar ratios ranging from 0.17 when TOC export was low to 0.47 when it was high. We estimate that exported TOC drove 15-41% of the annual oxygen utilization rates in the 100-400 m depth range. Finally, there was a lack of variability in the surface-layer TON signal during summer. The lack of a summer signal for net TON production suggests a small role for N2 fixation at the site. We hypothesize that if N2 fixation is responsible for elevated N : P ratios in the main thermocline of the Sargasso Sea, then the process must take place south of Bermuda and the signal transported north with the Gulf Stream system.

Part of the global DOC versus AOU (dissolved organic carbon/apparent oxygen utilization) data compilation, Southern Ocean

Recent evidence that dissolved organic carbon (DOC) is a significant component of the organic carbon flux below the photic layer of the ocean (1), together with verification of high respiration rates in the dark ocean (2), suggests that the downward flux of DOC may play a major role in supporting respiration there. Here we show, on the basis of examination of the relation between DOC and apparent oxygen utilization (AOU), that the DOC flux supports ~10% of the respiration in the dark ocean. The contribution of DOC to pelagic respiration below the surface mixed layer can be inferred from the relation between DOC and apparent oxygen utilization (AOU, µM O2), a variable quantifying the cumulative oxygen consumption since a water parcel was last in contact with the atmosphere. However, assessments of DOC/AOU relations have been limited to specific regions of the ocean (3, 4) and have not considered the global ocean. We assembled a large data set (N = 9824) of concurrent DOC and AOU observations collected in cruises conducted throughout the world's oceans (fig. S1, table S1) to examine the relative contribution of DOC to AOU and, therefore, respiration in the dark ocean. AOU increased from an average (±SE) 96.3 ± 2.0 µM at the base of the surface mixed layer (100 m) to 165.5 ± 4.3 µM at the bottom of the main thermocline (1000 m), with a parallel decline in the average DOC from 53.5 ± 0.2 to 43.4 ± 0.3 µM C (Fig. 1). In contrast, there is no significant decline in DOC with increasing depth beyond 1000 m depth (Fig. 1), indicating that DOC exported with overturning circulation plays a minor role in supporting respiration in the ocean interior (5). Assuming a molar respiratory quotient of 0.69, the decline in DOC accounts for 19.6 ± 0.4% of the AOU within the top 1000 m (Fig. 1). This estimate represents, however, an upper limit, because the correlation between DOC and AOU is partly due to mixing of DOC-rich warm surface waters with DOC-poor cold thermocline waters (6). Removal of this effect by regressing DOC against AOU and water temperature indicates that DOC supports only 8.4 ± 0.3% of the respiration in the mesopelagic waters.

Palaeoceanographic data of sediment core MD01-2416

We present an SiF4 separation line, coupled to a laser fluorination system, which allows for an efficient combined silica d18O and d30Si analysis (50 min per sample). The required sample weight of 1.5-2.0 mg allows for high-resolution isotope studies on biogenic opal. Besides analytical tests, the new instrumentation set-up was used to analyse two marine diatom fractions (>63 µm, 10-20 µm) with different diatom species compositions extracted from a Bølling/Allerød-Holocene core section [MD01-2416, North-West (NW) Pacific] to evaluate the palaeoceanographic significance of the diatom isotopic signals and to address isotopic effects related to contamination and species-related isotope effects (vital and environmental effects). While d30Si offsets between the two fractions were not discernible, supporting the absence of species-related silicon isotope effects, systematic offsets occur between the d18O records. Although small, these offsets point to species-related isotope effects, as bias by contamination can be discarded. The new records strengthen the palaeoceanographic history during the last deglaciation in the NW Pacific characterized by a sequence of events with varying surface water structure and biological productivity. With such palaeoceanographic evolution it becomes unlikely that the observed systematic d18O offsets signal seasonal temperature variability. This calls for reconsideration of vital effects, generally excluded to affect d18O measurements.