Sample records for traditionally marginalized groups

  1. Opportunities for Action: Traditionally Marginalized Populations and the Economic Crisis

    ERIC Educational Resources Information Center

    Tate, Kevin A.; Kathleen M. Fallon; Casquarelli, Elaine J.; Marks, Laura Reid

    2014-01-01

    This study investigated the career and work life challenges faced by traditionally marginalized populations (e.g., women; historically oppressed racial/ethnic groups; people who identify as lesbian, gay, transgender, bisexual and/or queer; immigrants; individuals with mental or physical disabilities; older individuals; and those of lower…

  2. Marginal Fit of Lithium Disilicate Crowns Fabricated Using Conventional and Digital Methodology: A Three-Dimensional Analysis.

    PubMed

    Mostafa, Nezrine Z; Ruse, N Dorin; Ford, Nancy L; Carvalho, Ricardo M; Wyatt, Chris C L

    2018-02-01

    To compare the marginal fit of lithium disilicate (LD) crowns fabricated with digital impression and manufacturing (DD), digital impression and traditional pressed manufacturing (DP), and traditional impression and manufacturing (TP). Tooth #15 was prepared for all-ceramic crowns on an ivorine typodont. There were 45 LD crowns fabricated using three techniques: DD, DP, and TP. Microcomputed tomography (micro-CT) was used to assess the 2D and 3D marginal fit of crowns in all three groups. The 2D vertical marginal gap (MG) measurements were done at 20 systematically selected points/crown, while the 3D measurements represented the 3D volume of the gap measured circumferentially at the crown margin. Frequencies of different marginal discrepancies were also recorded, including overextension (OE), underextension (UE), and marginal chipping. Crowns with vertical MG > 120 μm at more than five points were considered unacceptable and were rejected. The results were analyzed by one-way ANOVA with Scheffe post hoc test (α = 0.05). DD crowns demonstrated significantly smaller mean vertical MG (33.3 ± 19.99 μm) compared to DP (54.08 ± 32.34 μm) and TP (51.88 ± 35.34 μm) crowns. Similarly, MG volume was significantly lower in the DD group (3.32 ± 0.58 mm 3 ) compared to TP group (4.16 ± 0.59 mm 3 ). The mean MG volume for the DP group (3.55 ± 0.78 mm 3 ) was not significantly different from the other groups. The occurrence of underextension error was higher in DP (6.25%) and TP (5.4%) than in DD (0.33%) group, while overextension was more frequent in DD (37.67%) than in TP (28.85%) and DP (18.75%) groups. Overall, 4 out of 45 crowns fabricated were deemed unacceptable based on the vertical MG measurements (three in TP group and one in DP group; all crowns in DD group were deemed acceptable). The results suggested that digital impression and CAD/CAM technology is a suitable, better alternative to traditional impression and manufacturing. © 2017 by the American College of Prosthodontists.

  3. Overcoming Multidimensional Marginality: The Significance of Higher Education for Traditionally Reared Single Mothers Living in the Outer Periphery

    ERIC Educational Resources Information Center

    Greenberg, Zeev; Shenaar-Golan, Vered

    2017-01-01

    The current study gives voice to a group of remarkable returning college students whose lives are defined by multidimensional marginality. These students are single mothers who grew up in traditional families in the outer periphery of Northern Israel, where they still lived at the time of this study. Drawing on the women's life stories gathered…

  4. The effect of various veneering techniques on the marginal fit of zirconia copings.

    PubMed

    Torabi, Kianoosh; Vojdani, Mahroo; Giti, Rashin; Taghva, Masumeh; Pardis, Soheil

    2015-06-01

    This study aimed to evaluate the fit of zirconia ceramics before and after veneering, using 3 different veneering processes (layering, press-over, and CAD-on techniques). Thirty standardized zirconia CAD/CAM frameworks were constructed and divided into three groups of 10 each. The first group was veneered using the traditional layering technique. Press-over and CAD-on techniques were used to veneer second and third groups. The marginal gap of specimens was measured before and after veneering process at 18 sites on the master die using a digital microscope. Paired t-test was used to evaluate mean marginal gap changes. One-way ANOVA and post hoc tests were also employed for comparison among 3 groups (α=.05). Marginal gap of 3 groups was increased after porcelain veneering. The mean marginal gap values after veneering in the layering group (63.06 µm) was higher than press-over (50.64 µm) and CAD-on (51.50 µm) veneered groups (P<.001). Three veneering methods altered the marginal fit of zirconia copings. Conventional layering technique increased the marginal gap of zirconia framework more than pressing and CAD-on techniques. All ceramic crowns made through three different veneering methods revealed clinically acceptable marginal fit.

  5. The effect of various veneering techniques on the marginal fit of zirconia copings

    PubMed Central

    Torabi, Kianoosh; Vojdani, Mahroo; Giti, Rashin; Pardis, Soheil

    2015-01-01

    PURPOSE This study aimed to evaluate the fit of zirconia ceramics before and after veneering, using 3 different veneering processes (layering, press-over, and CAD-on techniques). MATERIALS AND METHODS Thirty standardized zirconia CAD/CAM frameworks were constructed and divided into three groups of 10 each. The first group was veneered using the traditional layering technique. Press-over and CAD-on techniques were used to veneer second and third groups. The marginal gap of specimens was measured before and after veneering process at 18 sites on the master die using a digital microscope. Paired t-test was used to evaluate mean marginal gap changes. One-way ANOVA and post hoc tests were also employed for comparison among 3 groups (α=.05). RESULTS Marginal gap of 3 groups was increased after porcelain veneering. The mean marginal gap values after veneering in the layering group (63.06 µm) was higher than press-over (50.64 µm) and CAD-on (51.50 µm) veneered groups (P<.001). CONCLUSION Three veneering methods altered the marginal fit of zirconia copings. Conventional layering technique increased the marginal gap of zirconia framework more than pressing and CAD-on techniques. All ceramic crowns made through three different veneering methods revealed clinically acceptable marginal fit. PMID:26140175

  6. Mindfulness for Novice Pediatric Nurses: Smartphone Application Versus Traditional Intervention.

    PubMed

    Morrison Wylde, Chelsey; Mahrer, Nicole E; Meyer, Rika M L; Gold, Jeffrey I

    The current study compares the effects of a traditionally delivered mindfulness (TDM) intervention to a smartphone delivered mindfulness (SDM) intervention, Headspace, an audio-guided mindfulness meditation program, in a group of novice nurses. Novice nurses participating in a pediatric nurse residency program were asked to participate in either a TDM or SDM intervention. Participants (N=95) completed self-administered pencil and paper questionnaires measuring mindfulness skills, and risk and protective factors at the start of their residency and three months after entering the program. Nurses in the SDM group reported significantly more "acting with awareness" and marginally more "non-reactivity to inner experience" skills compared to the TDM group. The smartphone intervention group also showed marginally more compassion satisfaction and marginally less burnout. Additionally, nurses in the SDM group had lower risk for compassion fatigue compared to the TDM group, but only when the nurses had sub-clinical posttraumatic symptoms at the start of the residency training program. Smartphone delivered mindfulness interventions may provide more benefits for novice nurses than traditionally delivered mindfulness interventions. However, the smart-phone intervention may be better indicated for nurses without existing symptoms of posttraumatic stress. Mindfulness interventions delivered through smartphone applications show promise in equipping nurses with important coping skills to manage stress. Because of the accessibility of smartphone applications, more nurses can benefit from the intervention as compared to a therapist delivered intervention. However, nurses with existing stress symptoms may require alternate interventions. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Counterspaces for Women of Color in STEM Higher Education: Marginal and Central Spaces for Persistence and Success

    ERIC Educational Resources Information Center

    Ong, Maria; Smith, Janet M.; Ko, Lily T.

    2018-01-01

    Counterspaces in science, technology, engineering, and mathematics (STEM) are often considered "safe spaces" at the margins for groups outside the mainstream of STEM education. The prevailing culture and structural manifestations in STEM have traditionally privileged norms of success that favor competitive, individualistic, and solitary…

  8. Marginal discrepancy of noble metal-ceramic fixed dental prosthesis frameworks fabricated by conventional and digital technologies.

    PubMed

    Afify, Ahmed; Haney, Stephan; Verrett, Ronald; Mansueto, Michael; Cray, James; Johnson, Russell

    2018-02-01

    Studies evaluating the marginal adaptation of available computer-aided design and computer-aided manufacturing (CAD-CAM) noble alloys for metal-ceramic prostheses are lacking. The purpose of this in vitro study was to evaluate the vertical marginal adaptation of cast, milled, and direct metal laser sintered (DMLS) noble metal-ceramic 3-unit fixed partial denture (FDP) frameworks before and after fit adjustments. Two typodont teeth were prepared for metal-ceramic FDP abutments. An acrylic resin pattern of the prepared teeth was fabricated and cast in nickel-chromium (Ni-Cr) alloy. Each specimen group (cast, milled, DMLS) was composed of 12 casts made from 12 impressions (n=12). A single design for the FDP substructure was created on a laboratory scanner and used for designing the specimens in the 3 groups. Each specimen was fitted to its corresponding cast by using up to 5 adjustment cycles, and marginal discrepancies were measured on the master Ni-Cr model before and after laboratory fit adjustments. The milled and DMLS groups had smaller marginal discrepancy measurements than those of the cast group (P<.001). Significant differences were found in the number of adjustments among the groups, with the milled group requiring the minimum number of adjustments, followed by the DMLS and cast groups (F=30.643, P<.001). Metal-ceramic noble alloy frameworks fabricated by using a CAD-CAM workflow had significantly smaller marginal discrepancies compared with those with a traditional cast workflow, with the milled group demonstrating the best marginal fit among the 3 test groups. Manual refining significantly enhanced the marginal fit of all groups. All 3 groups demonstrated marginal discrepancies within the range of clinical acceptability. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  9. Fostering marginalized youths' political participation: longitudinal roles of parental political socialization and youth sociopolitical development.

    PubMed

    Diemer, Matthew A

    2012-09-01

    This study examines the roles of parental political socialization and the moral commitment to change social inequalities in predicting marginalized youths' (defined here as lower-SES youth of color) political participation. These issues are examined by applying structural equation modeling to a longitudinal panel of youth. Because tests of measurement invariance suggested racial/ethnic heterogeneity, the structural model was fit separately for three racial/ethnic groups. For each group, parental political socialization: discussion predicted youths' commitment to produce social change and for two groups, longitudinally predicted political participation. This study contributes to the literature by examining civic/political participation among disparate racial/ethnic groups, addresses an open scholarly question (whether youths' commitment to create social change predicts their "traditional" participation), and emphasizes parents' role in fostering marginalized youths' civic and political participation.

  10. Fracture resistance and marginal discrepancy of porcelain laminate veneers influenced by preparation design and restorative material in vitro.

    PubMed

    Lin, Tai-Min; Liu, Perng-Ru; Ramp, Lance C; Essig, Milton E; Givan, Daniel A; Pan, Yu-Hwa

    2012-03-01

    The purpose of this investigation is to evaluate marginal discrepancy and fracture resistance of two veneering materials using two preparation designs. Two veneer preparation designs (full and traditional) were restored with leucite-reinforced ceramic (ProCAD, Ivoclar Vivadent, Amherst, NY) milled by CAD/CAM (Cerec 3D milling system, Serona Dental Systems), and conventional sintered feldspathic porcelain (Noritake Super Porcelain EX3, Noritake Dental Supply Co). Forty-eight specimens were analysed with a sample size of n=12 per group. The thickness of each veneer was measured on four specific surfaces. Marginal discrepancy was evaluated with a replica technique and cross-sectional view using a digital microscope. The fracture resistance of veneers cemented on standardised composite resin dies was evaluated using a universal testing machine. Results were analysed with ANOVA, Tukey-Kramer post hoc testing, and linear regression. The results of this investigation revealed no correlation between the thickness and marginal discrepancy of the veneers. The full preparation design with ProCAD and the traditional preparation design with feldspathic porcelain manifested smaller gap. Fracture resistance was decreased for the full preparation design with feldspathic porcelain. In terms of marginal discrepancy and fracture resistance, the most favourable combination was a traditional veneer preparation design with conventional sintered feldspathic porcelain. For the full veneer preparation, a stronger ceramic material such as ProCAD is suggested. Published by Elsevier Ltd.

  11. Outdoor Recreation Constraints: An Examination of Race, Gender, and Rural Dwelling

    Treesearch

    Cassandra Y. Johnson; J. Michael Bowker; H. Ken Cordell

    2001-01-01

    We assess whether traditionally marginalized groups in American society (African-Americans, women, rural dwellers) perceive more constraints to outdoor recreation participation than other groups. A series of logistic regressions are applied to a national recreation survey and used to model the probability that individuals perceive certain constraints to...

  12. Coping strategies in an ethnic minority group: the Aeta of Mount Pinatubo.

    PubMed

    Seitz, S

    1998-03-01

    The particular problems arising in the aftermath of natural disasters in indigenous societies in the Third World, especially in ethnic or cultural minorities, have until now received only little attention in social scientific research. The potential of such indigenous groups to use their traditional knowledge and behaviour patterns in coping with natural disasters has been badly neglected. The example of the Aeta in Zambales, Philippines, a marginal group who were hit directly by the eruption of Mt Pinatubo in 1991, shows how traditional economic and social behaviour can in some measure determine their various survival strategies.

  13. Religion and Spirituality. International Advances in Education: Global Initiatives for Equity and Social Justice

    ERIC Educational Resources Information Center

    Dowson, Martin, Ed.; Devenish, Stuart, Ed.

    2010-01-01

    Religion and spirituality make critical contributions to an inclusive vision for the welfare of minorities, the marginalized and other disadvantaged groups in societies and cultures around the globe. Religious movements and spiritual traditions work to improve social outcomes for disenfranchised groups by enriching educational, political, and…

  14. Micro-CT Evaluation of Ceramic Inlays: Comparison of the Marginal and Internal Fit of Five and Three Axis CAM Systems with a Heat Press Technique.

    PubMed

    Alajaji, Norah K; Bardwell, David; Finkelman, Matthew; Ali, Ala

    2017-02-01

    To evaluate the marginal and internal adaptation of CAD/CAM lithium-disilicate inlay restorations fabricated by two milling systems (Five and Three-axis), and a traditional heat-press technique. Fifteen premolar teeth with an MOD cavity preparation were fabricated. Lithium-disilicate inlay restorations were obtained by three fabrication techniques and fitted to their dies (n = 15/gp) as follows: Group-1, three-axis milling system, Group-2, five-axis milling system, Group-3, conventional heat-press technique. Gaps were evaluated by X-ray microtomography. Marginal gap (MG), occlusal-marginal gap (OMG), proximal-marginal gap (PMG), gingival-marginal gap (GMG), absolute marginal discrepancy (AMD), axial-internal gap (AIG), and occlusal-internal gap (OIG) were evaluated at 120 different points per inlay. Data were analyzed using repeated measures ANOVA. Pairwise comparisons were conducted for post-hoc testes and the Bonferroni correction was used to adjust for multiple comparisons (α = 0.007). The heat-press group demonstrated significantly smaller mean-values amongst all outcomes compared with CAD/CAM groups except for GMG, where there was no statistically significant difference between groups in the ANOVA (p = 0.042). Within the CAD/CAM groups, the five-axis group showed significantly lower OMG mean-value compared with the three-axis group p < 0.001, and lower AIG mean-value compared with the three-axis group p < 0.001. There was no significant difference between the five-axis and the three-axis groups' AMD, MG, PMG, and OIG locations. Different fabrication techniques affected the marginal and internal adaptation of ceramic inlay restorations. The heat-press group showed the best marginal and internal adaptation results; however, in every group, all samples were within the clinically acceptable MG limit (100 μm). The marginal fit and internal adaptation of inlay ceramic restorations fabricated by a five-axis milling system have not been tested or compared with those fabricated by three-axis machines and the conventional heat-press method. The preferred method of inlay fabrication, whether in the lab or chair side, may be influenced by the results of this study and could affect future clinical decision-making. (J Esthet Restor Dent 29:49-58, 2017). © 2016 Wiley Periodicals, Inc.

  15. The culture and identity schedule a measure of cultural affiliation: acculturation, marginalization and schizophrenia.

    PubMed

    Bhugra, Dinesh; Leff, Julian; Mallett, Rosemarie; Morgan, Craig; Zhao, Jing-Hua

    2010-09-01

    Previous epidemiological studies have shown a high incidence of schizophrenia in African-Caribbeans in the UK, but not in Asians. We investigated the hypothesis that cultural adherence might protect the Asians against the stress of living in a majority white culture. The Culture and Identity Schedule (CANDID) was given to patients with a diagnosis of schizophrenia making their first contact with psychiatric services, and to a matched group of controls randomly selected from the general population. While the Asian patients displayed no drift away from the traditional values as espoused by their controls, the African-Caribbean patients were less traditional than their controls. The fact that a movement away from their traditional culture distinguishes African-Caribbean patients with a severe psychiatric illness, schizophrenia, from their mentally healthy controls strongly favours marginalization over biculturalism as an interpretation of this shift.

  16. Financial Incentives and Cervical Cancer Screening Participation in Ontario's Primary Care Practice Models.

    PubMed

    Pendrith, Ciara; Thind, Amardeep; Zaric, Gregory S; Sarma, Sisira

    2016-08-01

    The primary objective of this paper is to compare cervical cancer screening rates of family physicians in Ontario's two dominant reformed practice models, Family Health Group (FHG) and Family Health Organization (FHO), and traditional fee-for-service (FFS) model. Both reformed models formally enrol patients and offer extensive pay-for-performance incentives; however, they differ by remuneration for core services (FHG is FFS; FHO is capitated). The secondary objective is to estimate the average and marginal costs of screening in each model. Using administrative data on 7,298 family physicians and their 2,083,633 female patients aged 35-69 eligible for cervical cancer screening in 2011, we assessed screening rates after adjusting for patient and physician characteristics. Predicted screening rates, fees and bonus payments were used to estimate the average and marginal costs of cervical cancer screening. Adjusted screening rates were highest in the FHG (81.9%), followed by the FHO (79.6%), and then the traditional FFS model (74.2%). The cost of a cervical cancer screening was $18.30 in the FFS model. The estimated average cost of screening in the FHGs and FHOs were $29.71 and $35.02, respectively, while the corresponding marginal costs were $33.05 and $39.06. We found significant differences in cervical cancer screening rates across Ontario's primary care practice models. Cervical screening rates were significantly higher in practice models eligible for incentives (FHGs and FHOs) than the traditional FFS model. However, the average and marginal cost of screening were lowest in the traditional FFS model and highest in the FHOs. Copyright © 2016 Longwoods Publishing.

  17. Adapting Traditional Text Materials to Individualized Methodology

    ERIC Educational Resources Information Center

    Wood, Merle W.

    1977-01-01

    A consultant in business education presents his system for developing strategies of individualized instruction in using commercial materials designed for group instruction. To illustrate the process he includes seven figures of pages from an accounting text, with marginal notes to direct the student to an individualized supplement. (MF)

  18. Fixed and Growth Mindsets in Physics Graduate Admissions

    ERIC Educational Resources Information Center

    Scherr, Rachel E.; Plisch, Monica; Gray, Kara E.; Potvin, Geoff; Hodapp, Theodore

    2017-01-01

    Considering the evidence that standard physics graduate admissions practices tend to exclude women and traditionally marginalized racial and ethnic groups from the discipline, we investigate (a) the characteristics of students that physics graduate admissions committee members seek to admit to their programs and (b) the practices associated with…

  19. Micro‐provision of Social Care Support for Marginalized Communities – Filling the Gap or Building Bridges to the Mainstream?

    PubMed Central

    2015-01-01

    Abstract As English social care services reconstruct themselves in response to the personalization agenda, there is increased interest in the contribution of micro‐providers – very small community‐based organizations, which can work directly with individuals. These micro‐providers are assumed to be able to cater for the ‘seldom heard’ groups which have been marginalized within mainstream social care services. This article reviews recent literature from the UK published in peer‐reviewed journals from 2000 to 2013 on support provision for people with protected characteristics under the Equality Act 2010. It considers the marginalising dynamics in mainstream, statutory social care support provision, and how far local community, specialist or small‐scale services are responding to unmet need for support and advice among marginalized groups. The review found that there is a tradition of compensatory self‐organization, use of informal networks and a mobilization of social capital for all these groups in response to marginalization from mainstream, statutory services. This requires recognition and nurturing in ways that do not stifle its unique nature. Specialist and community‐based micro‐providers can contribute to a wider range of choices for people who feel larger, mainstream services are not suitable or accessible. However, the types of compensatory activity identified in the research need recognition and investment, and its existence does not imply that the mainstream should not address marginalization. PMID:27840462

  20. Micro-provision of Social Care Support for Marginalized Communities - Filling the Gap or Building Bridges to the Mainstream?

    PubMed

    Needham, Catherine; Carr, Sarah

    2015-12-01

    As English social care services reconstruct themselves in response to the personalization agenda, there is increased interest in the contribution of micro-providers - very small community-based organizations, which can work directly with individuals. These micro-providers are assumed to be able to cater for the 'seldom heard' groups which have been marginalized within mainstream social care services. This article reviews recent literature from the UK published in peer-reviewed journals from 2000 to 2013 on support provision for people with protected characteristics under the Equality Act 2010. It considers the marginalising dynamics in mainstream, statutory social care support provision, and how far local community, specialist or small-scale services are responding to unmet need for support and advice among marginalized groups. The review found that there is a tradition of compensatory self-organization, use of informal networks and a mobilization of social capital for all these groups in response to marginalization from mainstream, statutory services. This requires recognition and nurturing in ways that do not stifle its unique nature. Specialist and community-based micro-providers can contribute to a wider range of choices for people who feel larger, mainstream services are not suitable or accessible. However, the types of compensatory activity identified in the research need recognition and investment, and its existence does not imply that the mainstream should not address marginalization.

  1. The Future of Nontraditional/Interdisciplinary Programs: Margin or Mainstream? Selected Papers from the Annual Conference on Nontraditional and Interdisciplinary Programs (10th, Virginia Beach, Virginia, May 10-13, 1992).

    ERIC Educational Resources Information Center

    Reithlingshoefer, Sally J., Ed.

    This volume presents the proceedings of a conference on higher education non-traditional and interdisciplinary programs. The papers are grouped into 13 categories. The categories, together with some of the topics treated by the papers grouped within them, are as follows: (1) "Assessing Experiential Learning" (integration into a…

  2. Supporting Student Success through Authentic Partnerships: Reflection from Parents and Caregivers. Equity by Design

    ERIC Educational Resources Information Center

    Morton, Crystal

    2017-01-01

    When schools engage parents and caregivers as authentic partners in children's learning they begin to break down traditional barriers that have existed between home and school. Parents and caregivers from historically marginalized groups have expressed feeling unwelcome, disrespected, and devalued at school. Although many are involved in the…

  3. The Conduct of Socially Valid Investigation by Culturally Diverse Researchers: A Delphi Study

    ERIC Educational Resources Information Center

    Dutta, Alo; Kundu, Madan; Chan, Fong

    2010-01-01

    Minority researchers have traditionally exhibited a need for and interest in investigating non-mainstream issues involving diverse communities. Since faculty at colleges and universities within the United States are largely Caucasian, research on issues relevant to marginalized groups is lacking. This three-stage Delphi study was designed to…

  4. Environmental Justice Is a Social Justice Issue: Incorporating Environmental Justice into Social Work Practice Curricula

    ERIC Educational Resources Information Center

    Beltrán, Ramona; Hacker, Alice; Begun, Stephanie

    2016-01-01

    Social justice education for social work practice is concerned with addressing issues of power and oppression as they impact intersections of identity, experience, and the social environment. However, little focus is directed toward the physical and natural environment despite overwhelming evidence that traditionally marginalized groups bear the…

  5. Injection and adhesion palatoplasty: a preliminary study in a canine model.

    PubMed

    Martínez-Álvarez, Concepción; González-Meli, Beatriz; Berenguer-Froehner, Beatriz; Paradas-Lara, Irene; López-Gordillo, Yamila; Rodríguez-Bobada, Cruz; González, Pablo; Chamorro, Manuel; Arias, Pablo; Hilborn, Jöns; Casado-Gómez, Inmaculada; Martínez-Sanz, Elena

    2013-08-01

    Raising mucoperiosteal flaps in traditional palatoplasty impairs mid-facial growth. Hyaluronic acid-based hydrogels have been successfully tested for minimally invasive craniofacial bone generation in vivo as carriers of bone morphogenetic protein-2 (BMP-2). We aimed to develop a novel flapless technique for cleft palate repair by injecting a BMP-2 containing hydrogel. Dog pups with congenital cleft palate were either non-treated (n=4) or treated with two-flap palatoplasty (n=6) or with the proposed injection/adhesion technique (n=5). The experimental approach was to inject a hyaluronic acid-based hydrogel containing hydroxyapatite and BMP-2 subperiosteally at the cleft palate margins of pups aged six weeks. At week ten, a thin strip of the medial edge mucosa was removed and the margins were closed directly. Occlusal photographs and computed tomography (CT) scans were obtained up to week 20. Four weeks after the gel injection the cleft palate margins had reached the midline and engineered bone had enlarged the palatal bones. Removal of the medial edge mucosa and suturing allowed complete closure of the cleft. Compared to traditional palatoplasty, the injection/adhesion technique was easier, and the post-surgical recovery was faster. CT on week 20 revealed some overlapping or "bending" of palatal shelves in the two-flap repair group, which was not observed in the experimental nor control groups. A minimally invasive technique for cleft palate repair upon injectable scaffolds in a dog model of congenital cleft palate is feasible. Results suggest better growth of palatal bones. This represents an attractive clinical alternative to traditional palatoplasty for cleft palate patients. Copyright © 2013 Elsevier Inc. All rights reserved.

  6. The Effect of Gloss Type and Mode on Iranian EFL Learners' Reading Comprehension

    ERIC Educational Resources Information Center

    Sadeghi, Karim; Ahmadi, Negar

    2012-01-01

    This study investigated the effects of three kinds of gloss conditions that is traditional non-CALL marginal gloss, computer-based audio gloss, and computer-based extended audio gloss, on reading comprehension of Iranian EFL learners. To this end, three experimental and one control groups, each comprising 15 participants, took part in this study.…

  7. Full Disclosure: Examining the Experience of Male Faculty of Color at a Predominately White Institution

    ERIC Educational Resources Information Center

    Cruz-Soto, Thomas A., Jr.

    2017-01-01

    This study explores the lived experiences of male faculty of color (African American and Latino American) at Upstate University, a predominately White, private, liberal arts institution (PWI). To gain a better understanding of the lived experiences of male faculty of color, a group that has traditionally been underrepresented and marginalized in…

  8. Having Allies Makes a Difference

    ERIC Educational Resources Information Center

    Pardini, Priscilla

    2013-01-01

    Milwaukee's gay-friendly Alliance High School was conceived to be a welcoming and confirming school for kids who have been teased and bullied and had their interests marginalized in traditional schools. The result is a group of teens who feel they have found a safe place as they explore who they will be and how they will live the rest of their…

  9. Gender-based attitudes, HIV misconceptions and feelings towards marginalized groups are associated with stigmatization in Mumbai, India.

    PubMed

    Bharat, Shalini; Ramakrishna, Jayashree; Heylen, Elsa; Ekstrand, Maria L

    2014-11-01

    Summary This study examined the association of gender-based attitudes, HIV misconceptions and community feelings for marginalized groups with stigmatizing responses towards people with HIV/AIDS in Mumbai, India. Participants included 546 men and women sampled in hospital settings during 2007-2008. Structured measures were used to assess avoidance intentions and denial of rights of people with HIV/AIDS. Mean age of participants was 32 years; 42% had less than 10 years of education. Higher HIV transmission misconceptions (β=0.47; p<0.001), more traditional gender attitudes (β=0.11; p<0.01) and more negative feelings towards HIV-positive people (β=0.23; p<0.001) were related to higher avoidance intentions. Endorsement of denial of rights was also significantly associated with higher transmission misconceptions (β=0.20; p<0.001), more traditional gender attitudes (β=0.33; p<0.001) and greater negative feelings towards HIV-positive people (β=0.12; p<0.05), as well as with a lower education level (β=-0.10; p<0.05). The feelings respondents had towards people with HIV/AIDS were more strongly correlated with their feelings towards those with other diseases (tuberculosis, leprosy) than with feelings they had towards those associated with 'immoral' behaviour (e.g. sex workers). Eliminating HIV transmission misconceptions and addressing traditional gender attitudes are critical for reducing HIV stigma in Indian society.

  10. Intraoperative Molecular Imaging of Lung Adenocarcinoma Can Identify Residual Tumor Cells at the Surgical Margins

    PubMed Central

    Keating, Jane J.; Okusanya, Olugbenga T.; De Jesus, Elizabeth; Judy, Ryan; Jiang, Jack; Deshpande, Charuhas; Nie, Shuming; Low, Philip; Singhal, Sunil

    2017-01-01

    Purpose During lung surgery, identification of surgical margins is challenging. We hypothesized that molecular imaging with a fluorescent probe to pulmonary adenocarcinomas could enhance residual tumor during resection. Procedures Mice with flank tumors received a contrast agent targeting folate receptor alpha. Optimal dose and time of injection was established. Margin detection was compared using traditional methods versus molecular imaging. A pilot study was then performed in 3 humans with lung adenocarcinoma. Results The peak tumor-to background ratio (TBR) of murine tumors was 3.9. Fluorescence peaked at 2 hours and was not improved beyond 0.1 mg/kg. Traditional inspection identified 30% of mice with positive margins. Molecular imaging identified an additional 50% of residual tumor deposits (P<0.05). The fluorescent probe visually enhanced all human tumors with a mean TBR of 3.5. Conclusions Molecular imaging is an important adjunct to traditional inspection to identify surgical margins after tumor resection. PMID:26228697

  11. State Law and Policy Related to Twice-Exceptional Learners: Implications for Practitioners and Policymakers

    ERIC Educational Resources Information Center

    Roberts, Julia Link; Pereira, Nielsen; Knotts, J. Dusteen

    2015-01-01

    Legislation and policy lead to action. In the absence of law or policy, situations are addressed on a case-by-case basis or they are sometimes ignored. Legislation and policy become extremely important when they relate to groups that have traditionally been marginalized, such as students with disabilities or students with gifts and talents, and…

  12. Evaluating the Marginal Integrity of Bulk Fill Fibre Reinforced Composites in Bio-mimetically Restored Tooth.

    PubMed

    Patnana, Arun Kumar; Vanga, V Narsimha Rao; Chandrabhatla, Srinivas Kumar

    2017-06-01

    Over the past years, composites in aesthetic dentistry are showing a considerable progress, but mechanical strength and polymerization shrinkage are the two main drawbacks, which limit their use in high stress bearing areas. To evaluate the marginal integrity of short glass fibre reinforced composite restorations, fibre reinforced composites with composite superficial layer, and fibre reinforced composites with underlying flowable composite layer. This study was done on twenty eight sound premolar teeth with standardized class V cavities restored under four groups as Group I: Particulate filler composite (Filtek Z 250 XT, 3M ESPE); Group II: Short glass fibre reinforced composite (everX Posterior, GC); Group III: Short glass fibre reinforced composite with an overlying layer of particulate filler composite; Group IV: Short glass fibre reinforced composite with an underlying layer of flowable composite (Filtek Z 250 XT, 3M ESPE). Test samples were immersed in a 2% methylene blue dye for 24 hours at 37°C and each tooth was sectioned bucco-lingually. Staining along the tooth restoration interface was recorded and results were analysed statistically using Independent sample t-test and Tukey's post-hoc one-way ANOVA. The results showed significant difference in the dye penetration between the restorative materials in the occlusal and gingival margins (p=0.02). Short fibre reinforced composites showed a statistically significant difference in the microleakage scores when compared with the particulate filler composites (p=0.01). Short glass fibre reinforced composite restorations showed an improved marginal integrity when compared to the traditional particulate filler composite restorations.

  13. Health and indigenous people: intercultural health as a new paradigm toward the reduction of cultural and social marginalization?

    PubMed

    Torri, Maria Costanza

    2010-01-01

    The precarious socio-economic and health conditions of indigenous populations legitimize claims of marginalization and attest to the inherent inequality that indigenous groups suffer. In the last few years, advocates have urged the use of traditional indigenous health practices as more culturally fitting for most indigenous populations. An intercultural health program can reduce the conditions of social and cultural marginalization in an indigenous population. However, accepting and integrating indigenous medicine into a westernized health system presents a major challenge to intercultural healthcare in Latin America. The objective of this paper is to analyze the case of Makewe hospital, one of the first and few examples of intercultural health initiatives in Chile. The paper will examine the implementation of this initiative and the main challenges in creating an effective intercultural health program.

  14. Slogging and Stumbling toward Social Justice in a Private Elementary School: The Complicated Case of St. Malachy

    ERIC Educational Resources Information Center

    Scanlan, Martin

    2010-01-01

    This case study examines St. Malachy, an urban Catholic elementary school primarily serving children traditionally marginalized by race, class, linguistic heritage, and disability. As a private school, St. Malachy serves the public good by recruiting and retaining such traditionally marginalized students. As empirical studies involving Catholic…

  15. Clinical marginal and internal adaptation of CAD/CAM milling, laser sintering, and cast metal ceramic crowns.

    PubMed

    Tamac, Ece; Toksavul, Suna; Toman, Muhittin

    2014-10-01

    Metal ceramic crowns are widely used in clinical practice, but comparisons of the clinical adaptation of restorations made with different processing techniques are lacking. The purpose of this study was to compare the clinical marginal and internal adaptation of metal ceramic crowns fabricated with 3 different techniques: computer-aided design and computer-aided manufacturing (CAD/CAM) milling (CCM), direct metal laser sintering (DMLS), and traditional casting (TC). Twenty CCM, 20 DMLS, and 20 TC metal ceramic crowns were fabricated for 42 patients. Before luting the crowns, silicone replicas were obtained to measure marginal gap and internal adaptation that was evaluated at 3 regions: axial wall, axio-occlusal angle, and occlusal surface. Measurements were made with a reflected light binocular stereomicroscope at 20× magnification and analyzed with 1-way analysis of variance (ANOVA) and the Bonferroni post hoc test (α=.05). The mean marginal gap values were 86.64 μm for CCM, 96.23 μm for DMLS, and 75.92 μm for TC. The means at the axial wall region were 117.5 μm for the CCM group, 139.02 μm for the DMLS group, and 121.38 μm for the TC group. One-way ANOVA revealed no statistically significant differences among the groups for measurements at the marginal gap (P=.082) and the axial wall region (P=.114). The means at the axio-occlusal region were 142.1 μm for CCM, 188.12 μm for DMLS, and 140.63 μm for TC, and those at the occlusal surface region were 265.73 μm for CCM, 290.39 μm for DMLS, and 201.09 μm for TC. The mean values of group DMLS were significantly higher at the axio-occlusal region and the occlusal surface region than those of other groups (P<.05). CCM, DMLS and TC metal ceramic crowns performed similarly in terms of clinical marginal and axial wall adaptation. The cement film thickness at the occlusal region and axio-occlusal region were higher for DMLS crowns. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  16. Poverty, economic growth, deprivation, and water: the cases of Cambodia and Vietnam.

    PubMed

    Varis, Olli

    2008-05-01

    Poverty reduction decorates all development agendas, but the complexity of the poverty issue is too often hidden behind simplistic indicators and development goals. Here, a closer look is taken at the concepts of "deprivation" and "vulnerability" as outcomes of poverty. Deprivation leads typically to social exclusion and marginalization; such groups are particularly weak in getting themselves out of poverty by "self-help," and economic growth does not trickle down to these people. When looking at the connections between poverty reduction and economic growth, special emphasis should be put on the differences between modern and more traditional sectors: development of the modern sector should not marginalize and exclude those dependent on more traditional livelihoods. Two case studies--The Tonle Sap area, Cambodia, and the Mekong Delta, Vietnam--reveal that investment in education, empowerment of small-scale entrepreneurship and other means of microeconomic environment, along with good governance, infrastructure, and income distribution can ensure that economic growth includes the poorer echelons of society.

  17. GENDER-BASED ATTITUDES, HIV MISCONCEPTIONS AND FEELINGS TOWARDS MARGINALIZED GROUPS ARE ASSOCIATED WITH STIGMATIZATION IN MUMBAI, INDIA

    PubMed Central

    BHARAT, SHALINI; RAMAKRISHNA, JAYASHREE; HEYLEN, ELSA; EKSTRAND, MARIA L.

    2017-01-01

    Summary This study examined the association of gender-based attitudes, HIV misconceptions and community feelings for marginalized groups with stigmatizing responses towards people with HIV/AIDS in Mumbai, India. Participants included 546 men and women sampled in hospital settings during 2007–2008. Structured measures were used to assess avoidance intentions and denial of rights of people with HIV/AIDS. Mean age of participants was 32 years; 42% had less than 10 years of education. Higher HIV transmission misconceptions (β = 0.47; p < 0.001), more traditional gender attitudes (β = 0.11; p < 0.01) and more negative feelings towards HIV-positive people (β = 0.23; p < 0.001) were related to higher avoidance intentions. Endorsement of denial of rights was also significantly associated with higher transmission misconceptions (β = 0.20; p < 0.001), more traditional gender attitudes (β = 0.33; p < 0.001) and greater negative feelings towards HIV-positive people (β = 0.12; p < 0.05), as well as with a lower education level (β = −0.10; p < 0.05). The feelings respondents had towards people with HIV/AIDS were more strongly correlated with their feelings towards those with other diseases (tuberculosis, leprosy) than with feelings they had towards those associated with ‘immoral’ behaviour (e.g. sex workers). Eliminating HIV transmission misconceptions and addressing traditional gender attitudes are critical for reducing HIV stigma in Indian society. PMID:24524379

  18. Regularized rare variant enrichment analysis for case-control exome sequencing data.

    PubMed

    Larson, Nicholas B; Schaid, Daniel J

    2014-02-01

    Rare variants have recently garnered an immense amount of attention in genetic association analysis. However, unlike methods traditionally used for single marker analysis in GWAS, rare variant analysis often requires some method of aggregation, since single marker approaches are poorly powered for typical sequencing study sample sizes. Advancements in sequencing technologies have rendered next-generation sequencing platforms a realistic alternative to traditional genotyping arrays. Exome sequencing in particular not only provides base-level resolution of genetic coding regions, but also a natural paradigm for aggregation via genes and exons. Here, we propose the use of penalized regression in combination with variant aggregation measures to identify rare variant enrichment in exome sequencing data. In contrast to marginal gene-level testing, we simultaneously evaluate the effects of rare variants in multiple genes, focusing on gene-based least absolute shrinkage and selection operator (LASSO) and exon-based sparse group LASSO models. By using gene membership as a grouping variable, the sparse group LASSO can be used as a gene-centric analysis of rare variants while also providing a penalized approach toward identifying specific regions of interest. We apply extensive simulations to evaluate the performance of these approaches with respect to specificity and sensitivity, comparing these results to multiple competing marginal testing methods. Finally, we discuss our findings and outline future research. © 2013 WILEY PERIODICALS, INC.

  19. Maintenance of traditional cultural orientation is associated with lower rates of obesity and sedentary behaviours among African migrant children to Australia.

    PubMed

    Renzaho, A M N; Swinburn, B; Burns, C

    2008-04-01

    Migrants from developing to developed countries rapidly develop more obesity than the host population. While the effects of socio-economic status on obesity are well established, the influence of cultural factors, including acculturation, is not known. To examine the association between acculturation and obesity and its risk factors among African migrant children in Australia. A cross-sectional study using a non-probability sample of 3- to 12-year-old sub-Saharan African migrant children. A bidimensional model of strength of affiliation with African and Australian cultures was used to divide the sample into four cultural orientations: traditional (African), assimilated (Australian), integrated (both) and marginalized (neither). Body mass index (BMI), leisure-time physical activity (PA) and sedentary behaviours (SBs) and energy density of food. In all, 18.4% (95% confidence interval (CI): 14-23%) were overweight and 8.6% (95% CI: 6-12%) were obese. After adjustment for confounders, integrated (beta=1.1; P<0.05) and marginalized (beta=1.4; P<0.01) children had higher BMI than traditional children. However, integrated children had significantly higher time engaged in both PA (beta=46.9, P<0.01) and SBs (beta=43.0, P<0.05) than their traditional counterparts. In comparison with traditional children, assimilated children were more sedentary (beta=57.5, P<0.01) while marginalization was associated with increased consumption of energy-dense foods (beta=42.0, P<0.05). Maintenance of traditional orientation was associated with lower rates of obesity and SBs. Health promotion programs and frameworks need to be rooted in traditional values and habits to maintain and reinforce traditional dietary and PA habits, as well as identify the marginalized clusters and address their needs.

  20. Microbial communities in methane seep sediments along US Atlantic Margin are structured by organic matter and seepage dynamics

    NASA Astrophysics Data System (ADS)

    Graw, M. F.; Pohlman, J.; Treude, T.; Ruppel, C. D.; Colwell, F. S.

    2016-12-01

    Methane seeps are dynamic environments on continental margins where subsurface methane reaches the ocean. Microbial communities play a critical role in carbon cycling within seep sediments via organic carbon degradation, methane production, and anaerobic oxidation of methane (AOM), which consumes 20-80% of methane in seep sediments. However, biogeochemical controls on microbial community structure at seeps on a margin-wide scale remain unclear. The passive US Atlantic Margin (USAM) has been identified as a region of active methane seepage. Passive margin seeps have traditionally been understudied relative to seeps on active margins. Passive margins exhibit large cross-margin variability in organic carbon deposition and are anticipated to have divergent seep dynamics from active margins. Thus, the USAM offers a unique opportunity to investigate controls on microbial communities in seep sediments. We undertook analysis of microbial communities inhabiting seep sediments at 6 biogeochemically distinct sites along the USAM. Microbiological samples were co-located with measurements of sediment geochemistry and AOM and sulfate reduction rates. Illumina sequencing of the 16S rRNA gene, using both universal (83 samples) and archaeal-specific (64 samples) primers, and the mcrA gene (18 samples) identified 44 bacterial phyla and 7 archaeal phyla. Seeps in canyons and on open slope, likely representing high and low organic content sediments, hosted distinct communities; the former was dominated by ammonia-oxidizing Marine Group I Thaumarchaeota and the latter by mixotrophic Hadesarchaeota. Seep stability also impacted microbial community structure, and in particular the establishment of an AOM community rather than a Bathyarchaeota-dominated community. These findings contribute to understanding how microbial communities are structured within methane seep sediments and pave the way for investigating broad differences in carbon cycling between seeps on passive and active margins.

  1. Probabilistic Design of a Mars Sample Return Earth Entry Vehicle Thermal Protection System

    NASA Technical Reports Server (NTRS)

    Dec, John A.; Mitcheltree, Robert A.

    2002-01-01

    The driving requirement for design of a Mars Sample Return mission is to assure containment of the returned samples. Designing to, and demonstrating compliance with, such a requirement requires physics based tools that establish the relationship between engineer's sizing margins and probabilities of failure. The traditional method of determining margins on ablative thermal protection systems, while conservative, provides little insight into the actual probability of an over-temperature during flight. The objective of this paper is to describe a new methodology for establishing margins on sizing the thermal protection system (TPS). Results of this Monte Carlo approach are compared with traditional methods.

  2. Matching the Statistical Model to the Research Question for Dental Caries Indices with Many Zero Counts.

    PubMed

    Preisser, John S; Long, D Leann; Stamm, John W

    2017-01-01

    Marginalized zero-inflated count regression models have recently been introduced for the statistical analysis of dental caries indices and other zero-inflated count data as alternatives to traditional zero-inflated and hurdle models. Unlike the standard approaches, the marginalized models directly estimate overall exposure or treatment effects by relating covariates to the marginal mean count. This article discusses model interpretation and model class choice according to the research question being addressed in caries research. Two data sets, one consisting of fictional dmft counts in 2 groups and the other on DMFS among schoolchildren from a randomized clinical trial comparing 3 toothpaste formulations to prevent incident dental caries, are analyzed with negative binomial hurdle, zero-inflated negative binomial, and marginalized zero-inflated negative binomial models. In the first example, estimates of treatment effects vary according to the type of incidence rate ratio (IRR) estimated by the model. Estimates of IRRs in the analysis of the randomized clinical trial were similar despite their distinctive interpretations. The choice of statistical model class should match the study's purpose, while accounting for the broad decline in children's caries experience, such that dmft and DMFS indices more frequently generate zero counts. Marginalized (marginal mean) models for zero-inflated count data should be considered for direct assessment of exposure effects on the marginal mean dental caries count in the presence of high frequencies of zero counts. © 2017 S. Karger AG, Basel.

  3. Matching the Statistical Model to the Research Question for Dental Caries Indices with Many Zero Counts

    PubMed Central

    Preisser, John S.; Long, D. Leann; Stamm, John W.

    2017-01-01

    Marginalized zero-inflated count regression models have recently been introduced for the statistical analysis of dental caries indices and other zero-inflated count data as alternatives to traditional zero-inflated and hurdle models. Unlike the standard approaches, the marginalized models directly estimate overall exposure or treatment effects by relating covariates to the marginal mean count. This article discusses model interpretation and model class choice according to the research question being addressed in caries research. Two datasets, one consisting of fictional dmft counts in two groups and the other on DMFS among schoolchildren from a randomized clinical trial (RCT) comparing three toothpaste formulations to prevent incident dental caries, are analysed with negative binomial hurdle (NBH), zero-inflated negative binomial (ZINB), and marginalized zero-inflated negative binomial (MZINB) models. In the first example, estimates of treatment effects vary according to the type of incidence rate ratio (IRR) estimated by the model. Estimates of IRRs in the analysis of the RCT were similar despite their distinctive interpretations. Choice of statistical model class should match the study’s purpose, while accounting for the broad decline in children’s caries experience, such that dmft and DMFS indices more frequently generate zero counts. Marginalized (marginal mean) models for zero-inflated count data should be considered for direct assessment of exposure effects on the marginal mean dental caries count in the presence of high frequencies of zero counts. PMID:28291962

  4. OCT evaluation of single ceramic crowns: comparison between conventional and chair-side CAD/CAM technologies

    NASA Astrophysics Data System (ADS)

    Gabor, A.; Jivanescu, A.; Zaharia, C.; Hategan, S.; Topala, F. I.; Levai, C. M.; Negrutiu, M. L.; Sinescu, C.; Duma, V.-F.; Bradu, A.; Podoleanu, A. Gh.

    2016-03-01

    Digital impressions were introduced to overcome some of the obstacles due to traditional impression materials and techniques. The aim of this in vitro study is to compare the accuracy of all ceramic crowns obtained with digital impression and CAD-CAM technology with the accuracy of those obtained with conventional impression techniques. Two groups of 10 crowns each have been considered. The digital data obtained from Group 1 have been processed and the all-ceramic crowns were milled with a CAD/CAM technology (CEREC MCX, Sirona). The all ceramic crowns in Group 2 were obtained with the classical technique of pressing (emax, Ivoclar, Vivadent). The evaluation of the marginal adaptation was performed with Time Domain Optical Coherence Tomography (TD OCT), working at a wavelength of 1300 nm. Tri-dimensional (3D) reconstructions of the selected areas were obtained. Based on the findings in this study, one may conclude that the marginal accuracy of all ceramic crowns fabricated with digital impression and the CAD/CAM technique is superior to the conventional impression technique.

  5. A prospective comparison of cold snare polypectomy using traditional or dedicated cold snares for the resection of small sessile colorectal polyps

    PubMed Central

    Dwyer, Jeremy P.; Tan, Jonathan Y. C.; Urquhart, Paul; Secomb, Robyn; Bunn, Catherine; Reynolds, John; La Nauze, Richard; Kemp, William; Roberts, Stuart; Brown, Gregor

    2017-01-01

    Background and study aims  The evidence for efficacy and safety of cold snare polypectomy is limited. The aim of this study was to assess the completeness of resection and safety of cold snare polypectomy, using either traditional or dedicated cold snares. Patients and methods  This was a prospective, non-randomized study performed at a single tertiary hospital. Adult patients with at least one colorectal polyp (size ≤ 10 mm) removed by cold snare were included. In the first phase, all patients had polyps removed by traditional snare without diathermy. In the second phase, all patients had polyps removed by dedicated cold snare. Complete endoscopic resection was determined from histological examination of quadrantic polypectomy margin biopsies. Immediate or delayed bleeding within 2 weeks was recorded. Results  In total, 181 patients with 299 eligible polyps (n = 93 (173 polyps) traditional snare group, n = 88 (126 polyps) dedicated cold snare group) were included. Patient demographics and procedure indications were similar between groups. Mean polyp size was 6 mm in both groups ( P  = 0.25). Complete polyp resection was 165 /173 (95.4 %; 95 %CI 90.5 – 97.6 %) in the traditional snare group and 124/126 (98.4 %; 95 %CI 93.7 – 99.6 %) in the dedicated cold snare group ( P  = 0.16). Serrated polyps, compared with adenomatous polyps, had a higher rate of incomplete resection (7 % vs. 2 %, P  = 0.03). There was no statistically significant difference in the rate of immediate bleeding (3 % vs. 1 %, P  = 0.41) and there were no delayed hemorrhages or perforations. Conclusions  Cold snare polypectomy is effective and safe for the complete endoscopic resection of small (≤ 10 mm) colorectal polyps with either traditional or dedicated cold snares. PMID:29250580

  6. Traditional knowledge and use of wild mushrooms by Mixtecs or Ñuu savi, the people of the rain, from Southeastern Mexico.

    PubMed

    Santiago, Faustino Hernández; Moreno, Jesús Pérez; Cázares, Beatriz Xoconostle; Suárez, Juan José Almaraz; Trejo, Enrique Ojeda; de Oca, Gerardo Mata Montes; Aguilar, Irma Díaz

    2016-09-05

    Mexico is an important global reservoir of biological and cultural richness and traditional knowledge of wild mushrooms. However, there is a high risk of loss of this knowledge due to the erosion of traditional human cultures which is related with the rapid acculturation linked to high migration of rural populations to cities and the U.S.A., and the loss of natural ecosystems. The Mixtec people, the third largest native group in Mexico only after the Nahua and the Maya, maintain ancient traditions in the use and knowledge of wild mushrooms. Paradoxically, there are few studies of the Mixtec ethnomycology. This study shows our ethnomycological research, mainly focused on knowledge and use of wild mushrooms in communities of the Mixteca Alta, in southeastern Mexico. We hypothesized that among the studied communities those with a combination of higher vegetation cover of natural pine and oak forests, lower soil erosion and higher economic margination had a greater richness and knowledge of wild mushrooms. Our study therefore aimed to record traditional knowledge, use, nomenclature and classification of wild mushrooms in four Mixtec communities and to analyze how these aspects vary according to environmental and cultural conditions among the studied communities. In order to analyze the cultural significance of wild mushrooms for the Mixtec people, 116 non-structured and semi-structured interviews were performed from 2009 to 2014. Information about the identified species, particularly the regional nomenclature and classification, their edibility, toxicity and ludic uses, the habitat of useful mushrooms, traditional recipes and criteria to differentiate between toxic and edible species, and mechanisms of knowledge transmission were studied. The research had the important particularity that the first author is Mixtec, native of the study area. A comparative qualitative analysis between the richness of fungal species used locally and the official information of the natural vegetation cover, soil erosion and economic marginalization in each of the studied communities was conducted. A total of 106 species of mushrooms were identified growing in pine and oak forest, deciduous tropical forest and grassland; among the identified mushrooms we recorded 26 species locally consumed, 18 considered toxic, 6 having ludic uses and the remaining 56 species not being used in the studied areas but some of them having potential as food (56 species) or medicine (28 species). We recorded that 80, 22 and 4 species are ectomycorrhizal, saprotrophic and parasites, respectively. Our study shows that a complex and accurate knowledge related with the use, nomenclature, classification, ecology, gastronomy of wild mushrooms has been developed by Mixtecs; and that there is a relation between natural vegetation cover, lower soil erosion and higher economic marginalization and richness, knowledge and use of mushrooms in the studied communites. Our study showed that conservation and adaptation of ancestral mycological knowledge survives mainly through oral transmition, maintenance of cultural identity, forest protection, preservation native language and also paradoxically through the current socieconomical marginality among the Mixtec people. We also found that those studied communities with a combination of higher vegetation cover of natural pine and oak forests, lower soil erosion and higher economic marginalization showed a greater richness and knowledge of wild mushrooms. Use and sustainable management of wild mushrooms can be an alternative for local integrated development, but local knowledge and traditional worldview should be included into the regional programs of Mixtec biocultural conservation.

  7. Marginal abatement cost curve for nitrogen oxides incorporating controls, renewable electricity, energy efficiency, and fuel switching.

    PubMed

    Loughlin, Daniel H; Macpherson, Alexander J; Kaufman, Katherine R; Keaveny, Brian N

    2017-10-01

    A marginal abatement cost curve (MACC) traces out the relationship between the quantity of pollution abated and the marginal cost of abating each additional unit. In the context of air quality management, MACCs are typically developed by sorting control technologies by their relative cost-effectiveness. Other potentially important abatement measures such as renewable electricity, energy efficiency, and fuel switching (RE/EE/FS) are often not incorporated into MACCs, as it is difficult to quantify their costs and abatement potential. In this paper, a U.S. energy system model is used to develop a MACC for nitrogen oxides (NO x ) that incorporates both traditional controls and these additional measures. The MACC is decomposed by sector, and the relative cost-effectiveness of RE/EE/FS and traditional controls are compared. RE/EE/FS are shown to have the potential to increase emission reductions beyond what is possible when applying traditional controls alone. Furthermore, a portion of RE/EE/FS appear to be cost-competitive with traditional controls. Renewable electricity, energy efficiency, and fuel switching can be cost-competitive with traditional air pollutant controls for abating air pollutant emissions. The application of renewable electricity, energy efficiency, and fuel switching is also shown to have the potential to increase emission reductions beyond what is possible when applying traditional controls alone.

  8. --No Title--

    Science.gov Websites

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  9. Early Oral Tongue Squamous Cell Carcinoma: Sampling of Margins From Tumor Bed and Worse Local Control.

    PubMed

    Maxwell, Jessica H; Thompson, Lester D R; Brandwein-Gensler, Margaret S; Weiss, Bernhard G; Canis, Martin; Purgina, Bibianna; Prabhu, Arpan V; Lai, Chi; Shuai, Yongli; Carroll, William R; Morlandt, Anthony; Duvvuri, Umamaheswar; Kim, Seungwon; Johnson, Jonas T; Ferris, Robert L; Seethala, Raja; Chiosea, Simion I

    2015-12-01

    Positive margins are associated with poor prognosis among patients with oral tongue squamous cell carcinoma (SCC). However, wide variation exists in the margin sampling technique. To determine the effect of the margin sampling technique on local recurrence (LR) in patients with stage I or II oral tongue SCC. A retrospective study was conducted from January 1, 1986, to December 31, 2012, in 5 tertiary care centers following tumor resection and elective neck dissection in 280 patients with pathologic (p)T1-2 pN0 oral tongue SCC. Analysis was conducted from June 1, 2013, to January 20, 2015. In group 1 (n = 119), tumor bed margins were not sampled. In group 2 (n = 61), margins were examined from the glossectomy specimen, found to be positive or suboptimal, and revised with additional tumor bed margins. In group 3 (n = 100), margins were primarily sampled from the tumor bed without preceding examination of the glossectomy specimen. The margin status (both as a binary [positive vs negative] and continuous [distance to the margin in millimeters] variable) and other clinicopathologic parameters were compared across the 3 groups and correlated with LR. Local recurrence. Age, sex, pT stage, lymphovascular or perineural invasion, and adjuvant radiation treatment were similar across the 3 groups. The probability of LR-free survival at 3 years was 0.9 and 0.8 in groups 1 and 3, respectively (P = .03). The frequency of positive glossectomy margins was lowest in group 1 (9 of 117 [7.7%]) compared with groups 2 and 3 (28 of 61 [45.9%] and 23 of 95 [24.2%], respectively) (P < .001). Even after excluding cases with positive margins, the median distance to the closest margin was significantly narrower in group 3 (2 mm) compared with group 1 (3 mm) (P = .008). The status (positive vs negative) of margins obtained from the glossectomy specimen correlated with LR (P = .007), while the status of tumor bed margins did not. The status of the tumor bed margin was 24% sensitive (95% CI, 16%-34%) and 92% specific (95% CI, 85%-97%) for detecting a positive glossectomy margin. The margin sampling technique affects local control in patients with oral tongue SCC. Reliance on margin sampling from the tumor bed is associated with worse local control, most likely owing to narrower margin clearance and greater incidence of positive margins. A resection specimen-based margin assessment is recommended.

  10. Early Oral Tongue Squamous Cell Carcinoma Sampling of Margins From Tumor Bed and Worse Local Control

    PubMed Central

    Maxwell, Jessica H.; Thompson, Lester D. R.; Brandwein-Gensler, Margaret S.; Weiss, Bernhard G.; Canis, Martin; Purgina, Bibianna; Prabhu, Arpan V.; Lai, Chi; Shuai, Yongli; Carroll, William R.; Morlandt, Anthony; Duvvuri, Umamaheswar; Kim, Seungwon; Johnson, Jonas T.; Ferris, Robert L.; Seethala, Raja; Chiosea, Simion I.

    2017-01-01

    IMPORTANCE Positive margins are associated with poor prognosis among patients with oral tongue squamous cell carcinoma (SCC). However, wide variation exists in the margin sampling technique. OBJECTIVE To determine the effect of the margin sampling technique on local recurrence (LR) in patients with stage I or II oral tongue SCC. DESIGN, SETTING, AND PARTICIPANTS A retrospective study was conducted from January 1, 1986, to December 31, 2012, in 5 tertiary care centers following tumor resection and elective neck dissection in 280 patients with pathologic (p)T1-2 pN0 oral tongue SCC. Analysis was conducted from June 1, 2013, to January 20, 2015. INTERVENTIONS In group 1 (n = 119), tumor bed margins were not sampled. In group 2 (n = 61), margins were examined from the glossectomy specimen, found to be positive or suboptimal, and revised with additional tumor bed margins. In group 3 (n = 100), margins were primarily sampled from the tumor bed without preceding examination of the glossectomy specimen. The margin status (both as a binary [positive vs negative] and continuous [distance to the margin in millimeters] variable) and other clinicopathologic parameters were compared across the 3 groups and correlated with LR. MAIN OUTCOMES AND MEASURES Local recurrence. RESULTS Age, sex, pT stage, lymphovascular or perineural invasion, and adjuvant radiation treatment were similar across the 3 groups. The probability of LR-free survival at 3 years was 0.9 and 0.8 in groups 1 and 3, respectively (P = .03). The frequency of positive glossectomy margins was lowest in group 1 (9 of 117 [7.7%]) compared with groups 2 and 3 (28 of 61 [45.9%] and 23 of 95 [24.2%], respectively) (P < .001). Even after excluding cases with positive margins, the median distance to the closest margin was significantly narrower in group 3 (2 mm) compared with group 1 (3 mm) (P = .008). The status (positive vs negative) of margins obtained from the glossectomy specimen correlated with LR (P = .007), while the status of tumor bed margins did not. The status of the tumor bed margin was 24% sensitive (95% CI, 16%-34%) and 92% specific (95% CI, 85%-97%) for detecting a positive glossectomy margin. CONCLUSIONS AND RELEVANCE The margin sampling technique affects local control in patients with oral tongue SCC. Reliance on margin sampling from the tumor bed is associated with worse local control, most likely owing to narrower margin clearance and greater incidence of positive margins. A resection specimen–based margin assessment is recommended. PMID:26225798

  11. Some new results on the Levy, Levy and Solomon microscopic stock market model

    NASA Astrophysics Data System (ADS)

    Zschischang, Elmar; Lux, Thomas

    2001-03-01

    We report some findings from our simulations of the Levy, Levy and Solomon microscopic stock market model. Our results cast doubts on some of the results published in the original papers (i.e., chaotic stock price movements). We also point out the possibility of sensitive dependence on initial conditions of the emerging wealth distribution among agents. Extensions of the model set-up show that with varying degrees of risk aversion, the less risk averse traders will tend to dominate the market. Similarly, when introducing a new trader group (or even a single trader) with a constant share of stocks in their portfolio, the latter will eventually take over and marginalize the other groups. The better performance of the more sober investors is in accordance with traditional perceptions in financial economics. Hence, the survival of ‘noise traders’ looking at short-term trends and patterns remains as much of a puzzle in this framework as in the traditional Efficient Market Theory.

  12. Effect of two prophylaxis methods on marginal gap of Cl Vresin-modified glass-ionomer restorations.

    PubMed

    Kimyai, Soodabeh; Pournaghi-Azar, Fatemeh; Daneshpooy, Mehdi; Abed Kahnamoii, Mehdi; Davoodi, Farnaz

    2016-01-01

    Background. This study evaluated the effect of two prophylaxis techniques on the marginal gap of CI V resin-modified glass-ionomer restorations. Methods. Standard Cl V cavities were prepared on the buccal surfaces of 48 sound bovine mandibular incisors in this in vitro study. After restoration of the cavities with GC Fuji II LC resin-modified glass-ionomer, the samples were randomly assigned to 3 groups of 16. In group 1, the prophylactic procedures were carried out with rubber cup and pumice powder and in group 2 with air-powder polishing device (APD). In group 3 (control), the samples did not undergo any prophylactic procedures. Then the marginal gaps were measured. Two-way ANOVA was used to compare marginal gaps at the occlusal and gingival margins between the groups. Post hoc Tukey test was used for two-by-two comparisons. Statistical significance was set at P < 0.05. Results. There were significant differences in the means of marginal gaps in terms of prophylactic techniques (P < 0.001), with significantly larger marginal gaps in the APD group compared to the pumice and rubber cup group, which in turn exhibited significantly larger marginal gaps compared to the control group (P < 0.0005). In addition, the means of marginal gaps were significant in terms of the margin type (P < 0.001), with significantly larger gaps at gingival margins compared to the occlusal margins (P < 0.0005). Conclusion. The prophylactic techniques used in this study had a negative effect on the marginal gaps of Cl V resin-modified glass-ionomer restorations.

  13. WOMEN, SCIENCE AND SUFFRAGE IN WORLD WAR I.

    PubMed

    Fara, Patricia

    2015-03-20

    World War I is often said to have benefited British women by giving them the vote and by enabling them to take on traditionally male roles, including ones in science, engineering and medicine. In reality, conventional hierarchies were rapidly re-established after the Armistice. Concentrating mainly on a small group of well-qualified scientific and medical women, marginalized at the time and also in the secondary literature, I review the attitudes they experienced and the work they undertook during and immediately after the war. The effects of century-old prejudices are still felt today.

  14. Interval from prostate biopsy to radical prostatectomy does not affect immediate operative outcomes for open or minimally invasive approach.

    PubMed

    Park, Bumsoo; Choo, Seol Ho; Jeon, Hwang Gyun; Jeong, Byong Chang; Seo, Seong Il; Jeon, Seong Soo; Lee, Hyun Moo; Choi, Han Yong

    2014-12-01

    Traditionally, urologists recommend an interval of at least 4 weeks after prostate biopsy before radical prostatectomy. The aim of our study was to evaluate whether the interval from prostate biopsy to radical prostatectomy affects immediate operative outcomes, with a focus on differences in surgical approach. The study population of 1,848 radical prostatectomy patients was divided into two groups according to the surgical approach: open or minimally invasive. Open group included perineal and retropubic approach, and minimally invasive group included laparoscopic and robotic approach. The cut-off of the biopsy-to-surgery interval was 4 weeks. Positive surgical margin status, operative time and estimated blood loss were evaluated as endpoint parameters. In the open group, there were significant differences in operative time and estimated blood loss between the <4-week and ≥4-week interval subgroups, but there was no difference in positive margin rate. In the minimally invasive group, there were no differences in the three outcome parameters between the two subgroups. Multivariate analysis revealed that the biopsy-to-surgery interval was not a significant factor affecting immediate operative outcomes in both open and minimally invasive groups, with the exception of the interval ≥4 weeks as a significant factor decreasing operative time in the minimally invasive group. In conclusion, performing open or minimally invasive radical prostatectomy within 4 weeks of prostate biopsy is feasible for both approaches, and is even beneficial for minimally invasive radical prostatectomy to reduce operative time.

  15. The Margins as "Third Space": EAP Teacher Professionalism in Canadian Universities

    ERIC Educational Resources Information Center

    MacDonald, Jennifer

    2016-01-01

    Teachers of English for Academic Purposes (EAP) in the Canadian university setting often experience professional marginalization in terms of lack of status, clarity of mandate, or administrative home within their institutions. Despite having broadly benefited the ESL/EAL sector in Canada, traditional trait-focused professionalization efforts have…

  16. Undergraduate medical student's perceptions on traditional and problem based curricula: pilot study.

    PubMed

    Meo, Sultan Ayoub

    2014-07-01

    To evaluate and compare students' perceptions about teaching and learning, knowledge and skills, outcomes of course materials and their satisfaction in traditional Lecture Based learning versus Problem-Based Learning curricula in two different medical schools. The comparative cross-sectional questionnaire-based study was conducted in the Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia, from July 2009 to January 2011. Two different undergraduate medical schools were selected; one followed the traditional curriculum, while the other followed the problem-based learning curriculum. Two equal groups of first year medical students were selected. They were taught in respiratory physiology and lung function lab according to their curriculum for a period of two weeks. At the completion of the study period, a five-point Likert scale was used to assess students' perceptions on satisfaction, academic environment, teaching and learning, knowledge and skills and outcomes of course materials about effectiveness of problem-based learning compared to traditional methods. SPSS 19 was used for statistical analysis. Students used to problem-based learning curriculum obtained marginally higher scores in their perceptions (24.10 +/- 3.63) compared to ones following the traditional curriculum (22.67 +/- 3.74). However, the difference in perceptions did not achieve a level of statistical significance. Students following problem-based learning curriculum have more positive perceptions on teaching and learning, knowledge and skills, outcomes of their course materials and satisfaction compared to the students belonging to the traditional style of medical school. However, the difference between the two groups was not statistically significant.

  17. Anatomic comparison of traditional and enucleation partial nephrectomy specimens.

    PubMed

    Calaway, Adam C; Gondim, Dibson D; Flack, Chandra K; Jacob, Joseph M; Idrees, Muhammad T; Boris, Ronald S

    2017-05-01

    To compare pseudocapsule (PC) properties of clear cell renal cell carcinoma tumors removed via both traditional partial nephrectomy (PNx) and enucleative techniques as well as quantify the difference in volume of normal renal parenchyma removed between groups. A retrospective review of clear cell PNx specimens between 2011 and 2014 was performed. All patients undergoing tumor enucleation (TE) were included. A single pathologist reviewed the pathological specimens. This cohort was compared with a previously collected clear cell traditional PNx database. A total of 47 clear cell partial nephrectomies were reviewed (34 PNx and 13 TE). Invasion of tumor completely through the PC and positive surgical margins were seen in 2 (5.8%) and 1 (7.7%) of traditional and TE specimens, respectively (P = 0.82). PC mean (0.63 vs. 0.52mm), maximum (1.39 vs. 1.65mm), and minimum thickness (0.27 vs. 0.19mm) were similar between cohorts (P = 0.29, P = 0.36, and P = 0.44). Gross specimen volume varied considerably between the 2 groups (35.6 vs. 17.9cm 3 , P≤0.05) although tumor volume did not (12 vs. 14.2cm 3 , P = 0.64). The renal tumor consisted of only 37% of the total volume of the traditional PNx specimens compared to 80% of the volume in TEs (P<0.01). Four TE specimens (31%) were "true" TEs (no additional parenchyma identified outside of the PC). PC properties appear independent of surgical technique. True TEs are uncommon. Regardless, there is considerable volume discrepancy of normal renal parenchymal removed between enucleative and nonenucleative PNx groups. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Marginal Bone Loss after Ten Years in an Adult Danish Population: A Radiographic Study.

    PubMed

    Bahrami, Golnosh; Vaeth, Michael; Wenzel, Ann; Isidor, Flemming

    To evaluate marginal bone loss over a 10-year period in individuals and in tooth groups in relation to age and level of marginal bone. In 1997, 616 randomly selected individuals (mean age: 42 years, range: 21-63 years) underwent a full-mouth radiographic survey. In 2008, the survey was repeated in 362 of the same individuals (182 women and 180 men). The marginal bone level of each tooth was measured in mm from the cementoenamel junction to the marginal bone. These measurements were used to calculate marginal bone loss during the 10-year period for individuals and tooth groups in relation to age and to baseline marginal bone level, calculated as the average between measurements in 1997 and 2008 to circumvent regression towards the mean. The average annual marginal bone loss was 0.09 mm (SD ± 0.04 mm) during the 10-year study period. The association between marginal bone loss and baseline marginal bone level was more pronounced in the youngest age group, compared to the other age groups. Molars displayed the most severe bone loss during the study period. Marginal bone loss over a 10-year period is associated with age and baseline marginal bone level. Younger individuals with a reduced marginal bone level were at higher risk for further bone loss. Molars lose marginal bone more rapidly than other tooth groups.

  19. Race, gender, and marginalization in the context of the natural sciences

    NASA Astrophysics Data System (ADS)

    Jones, Leslie Sandra

    1997-06-01

    While natural science is no longer an exclusively white/masculine domain, and there have been some increases in both gender and racial/ethnic diversity, portions of our population remain seriously underserved in science classrooms and underrepresented in scientific career fields. This study sought explanations for the persistence of disproportional representation in the professional scientific community with an interest in how it might impact postsecondary and precollegiate science education. The descriptive and explanatory power of naturalistic inquiry was employed to explore the views and experiences of natural scientists with respect to equity issues. This qualitative research adhered most closely to the methodological traditions of critical ethnography, employing the assumption that, although a great deal of difference exists among disciplines and individual scientists, there is a set of common values and behaviors that can be defined as the "culture" of science. Open-ended interviews were conducted with participants who were both traditional (Caucasian males) and nontraditional (all women and men of color) researchers in both the basic and applied fields of the life and physical sciences. Systematic analysis of decontextualilzed, coded comments led to emergent thematic categories that included: Delusions of Equity, Myth of Meritocracy, Power of the Pedigree, Traditions of Gender, and Typing by Race. Parallel case studies indicated a high level of intersubjective agreement within demographic groups with respect to their perceptions of marginalization. Regardless of racial/ethnic identity, gender issues provide constant obstacles for women in the sciences. Certain racial ethnic groups are better tolerated and more easily assimilated, giving the impression that some people are "more different" than others. Women of color live at the intersection of racism and sexism, never sure which form of oppression is behind the treatment they receive. There was evidence that although the majority population in the scientific community would like to believe they treat people equitably and welcome diverse participation, patterns of discrimination are still prevalent and extremely insidious. The culture of science itself seems to contribute to the fact that certain underrepresented groups of people continue to be denied fundamental access to science knowledge as well as the important right to participate in its production.

  20. Marginal oil fields, profitable oil at low reserves: How?

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Agiza, M.N.; Shaheen, S.E.; Barawi, S.A.

    1995-12-31

    Fields with recoverable reserves of about five million barrels of oil are considered in Egypt as marginal fields. Economics of Egyptian marginal oil fields depend on non-traditional approaches followed in developing and operating such fields. The actual exploration, development and operating expenses and state fiscal terms were used to evaluate the sensitivity of the economic parameters of such marginal fields. The operator net present value (NPV) and internal rate of return (IRR) beside the government take are presented for different parameters used. The purpose is to make acceptable profits out of the marginal oil fields, for the mutual benefits ofmore » both the country and the investors.« less

  1. Exploring the Margin Recipe for Online Adaptive Radiation Therapy for Intermediate-Risk Prostate Cancer: An Intrafractional Seminal Vesicles Motion Analysis

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Sheng, Yang, E-mail: Yang.Sheng@duke.edu; Medical Physics Graduate Program, Duke University, Durham, North Carolina; Li, Taoran

    Purpose: To provide a benchmark for seminal vesicle (SV) margin selection to account for intrafractional motion and to investigate the effectiveness of 2 motion surrogates in predicting intrafractional SV coverage. Methods and Materials: Fifteen prostate patients were studied. Each patient had 5 pairs (1 patient had 4 pairs) of pretreatment and posttreatment cone beam CTs (CBCTs). Each pair of CBCTs was registered on the basis of prostate fiducial markers. All pretreatment SVs were expanded with 1-, 2-, 3-, 4-, 5-, and 8-mm isotropic margins to form a series of planning target volumes, and their intrafractional coverage to the posttreatment SVmore » determined the “ground truth” for exact coverage. Two motion surrogates, the center of mass (COM) and the border of contour, were evaluated by the use of Pearson product-moment correlation coefficient and exponential fitting for predicting SV underdosage. Action threshold of each surrogate was calculated. The margin for each surrogate was calculated according to a traditional margin recipe. Results: Ninety-five percent posttreatment SV coverage was achieved in 9%, 53%, 73%, 86%, 95%, and 97% of fractions with 1-, 2-, 3-, 4-, 5-, and 8-mm margins, respectively. The 5-mm margins provided 95% intrafractional SV coverage in over 90% of fractions. The correlation between the COM and border was weak, moderate, and strong in the left-right (L-R), anterior-posterior (A-P), and superior-inferior (S-I) directions, respectively. Exponential fitting gave the underdosage threshold of 4.5 and 7.0 mm for the COM and border. The Van Herk margin recipe recommended 0-, 0.5-, and 0.8-mm margins in the L-R, A-P, and S-I directions based on the COM, and 1.2-, 3.9-, and 2.5-mm margins based on the border. Conclusions: Five-millimeter isotropic margins for the SV constitute the minimum required to mitigate the intrafractional motion. Both the COM and the border are acceptable predictors for SV underdosage with 4.5- and 7.0-mm action threshold. Traditional margin based on the COM or border underestimates the margin.« less

  2. Access and Retention of Marginalized Populations within Undergraduate Music Education Degree Programs

    ERIC Educational Resources Information Center

    Fitzpatrick, Kate R.; Henninger, Jacqueline C.; Taylor, Don M.

    2014-01-01

    The purpose of this collective instrumental case study was to examine the experiences of six undergraduate students from traditionally marginalized populations with regard to their preparation for, admission to, and retention within a music education degree program. Analyzed and reported through the lens of critical theory, data sources included…

  3. Transoral bisected resection for T1-2 oral tongue squamous cell carcinoma to secure adequate deep margin.

    PubMed

    Choi, Nayeon; Cho, Jae-Keun; Lee, Eun Kyu; Won, Sung Jun; Kim, Bo Young; Baek, Chung-Hwan

    2017-10-01

    To investigate the clinical usefulness of transoral bisected resection (TBR) asa new method to secure adequate deep resection margin in T1-2 oral tongue squamous cell carcinomas (SCC). Among 75 patients with cT1-2N0 oral tongue SCCs, 45 (60%) received transoral en-bloc resection (TER) while 30 (40%) received patients underwent TBR. Primary tumor resection was performed with 1.5-cm surgical resection margin for both groups. Mucosal and deep resection margins, adjuvant treatments including re-resection of the tongue and cheomoradiotherapy, local and regional recurrence free survival, and overall survival were compared between the two groups. Mean deep resection margin in the TBR group was 9.9mm (95% CI: 8.4-11.4mm), which was significantly (P<0.001) wider than that of the TER group (mean: 5.4mm, 95% CI: 4.5-6.3mm). However, mucosal resection margins were not significantly (P=0.153) different between the two groups. Re-resection of tongue was performed for 6 (13.3%) of 17 (37.8%) patients with inadequate deep resection margin in the TER group and none (0%) in 4 (13.3%) patients with inadequate deep resection margin in the TBR group. Adjuvant radiation due to inadequate deep resection margin was performed for 6.7% of patients in both groups. The TBR group had better local recurrence free survival than the TER group. However, regional recurrence free survival and overall survival were not significantly different between the two groups. TBR could provide adequate deep resection margin for early stage tongue cancers with better local tumor control than TER. It can decrease the necessity of adjuvant treatment for re-resection of the tongue. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Comparison of a Traditional Probabilistic Risk Assessment Approach with Advanced Safety Analysis

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Smith, Curtis L; Mandelli, Diego; Zhegang Ma

    2014-11-01

    As part of the Light Water Sustainability Program (LWRS) [1], the purpose of the Risk Informed Safety Margin Characterization (RISMC) [2] Pathway research and development (R&D) is to support plant decisions for risk-informed margin management with the aim to improve economics, reliability, and sustain safety of current NPPs. In this paper, we describe the RISMC analysis process illustrating how mechanistic and probabilistic approaches are combined in order to estimate a safety margin. We use the scenario of a “station blackout” (SBO) wherein offsite power and onsite power is lost, thereby causing a challenge to plant safety systems. We describe themore » RISMC approach, illustrate the station blackout modeling, and contrast this with traditional risk analysis modeling for this type of accident scenario. We also describe our approach we are using to represent advanced flooding analysis.« less

  5. Microleakage of Four Dental Cements in Metal Ceramic Restorations With Open Margins.

    PubMed

    Eftekhar Ashtiani, Reza; Farzaneh, Babak; Azarsina, Mohadese; Aghdashi, Farzad; Dehghani, Nima; Afshari, Aisooda; Mahshid, Minu

    2015-11-01

    Fixed prosthodontics is a routine dental treatment and microleakage is a major cause of its failure. The aim of this study was to assess the marginal microleakage of four cements in metal ceramic restorations with adapted and open margins. Sixty sound human premolars were selected for this experimental study performed in Tehran, Iran and prepared for full-crown restorations. Wax patterns were formed leaving a 300 µm gap on one of the proximal margins. The crowns were cast and the samples were randomly divided into four groups based on the cement used. Copings were cemented using zinc phosphate cement (Fleck), Fuji Plus resin-modified glass ionomer, Panavia F2.0 resin cement, or G-Cem resin cement, according to the manufacturers' instructions. Samples were immersed in 2% methylene blue solution. After 24 hours, dye penetration was assessed under a stereomicroscope and analyzed using the respective software. Data were analyzed using ANOVA, paired t-tests, and Kruskal-Wallis, Wilcoxon, and Mann-Whitney tests. The least microleakage occurred in the Panavia F2.0 group (closed margin, 0.18 mm; open margin, 0.64 mm) and the maximum was observed in the Fleck group (closed margin, 1.92 mm; open margin, 3.32 mm). The Fleck group displayed significantly more microleakage compared to the Fuji Plus and Panavia F2.0 groups (P < 0.001) in both closed and open margins. In open margins, differences in microleakage between the Fuji Plus and G-Cem as well as between the G-Cem and Panavia F2.0 groups were significant (P < 0.001). In closed margins, only the G-Cem group displayed significantly more microleakage as compared to the Panavia F2.0 group (P < 0.05). Paired t-test results showed significantly more microleakage in open margins compared to closed margins, except in the Fuji Plus group (P = 0.539). Fuji Plus cement exhibited better sealing ability in closed and open margins compared to G-Cem and Fleck cements. When using G-Cem and Fleck cements for full metal ceramic restorations, clinicians should try to minimize marginal gaps in order to reduce restoration failure. In situations where there are doubts about perfect marginal adaptation, the use of Fuji Plus cement may be helpful.

  6. Blue diode laser versus traditional infrared diode laser and quantic molecular resonance scalpel: clinical and histological findings after excisional biopsy of benign oral lesions

    NASA Astrophysics Data System (ADS)

    Gobbo, Margherita; Bussani, Rossana; Perinetti, Giuseppe; Rupel, Katia; Bevilaqua, Lorenzo; Ottaviani, Giulia; Biasotto, Matteo

    2017-12-01

    This study aims to compare the use of the innovative blue diode laser (BLUE group) with two traditional surgical techniques: the infrared diode laser (IR group) and the quantic molecular resonance scalpel (QMR group) in the excision of benign oral lesions. Ninety-three patients underwent surgical excision of a benign oral lesion and were followed up for 30 days for pain (0 to 10 visual analogue scale), bleeding, and painkillers' assumption (yes/no). A blind pathologist evaluated the thermal damage along the cutting margin. Although referred pain was lowest in the BLUE group from day 7 on (p<0.05), all patients referred minimum discomfort after surgery. The BLUE group reported minimum bleeding and necessity of sutures (p<0.000). The QMR group showed the highest bleeding during surgery (p<0.000), while after 14 and 30 days no patient bled. Most of the patients in all groups did not need painkillers. The lowest thermal damage (p<0.000) was found in the BLUE group (71.3±51.8 μm), whereas the IR group proved the highest (186.8±82.7 μm) compared both with the BLUE and QMR (111.4±55.4 μm) groups. All the techniques allowed correct histological sampling. All the experimented techniques offer interesting advantages, although the blue laser minimizes risk of bleeding with limited thermal damage.

  7. Compressional reactivation of hyperextended domains on a rifted margin: a requirement for a reappraisal of traditional restoration procedures?

    NASA Astrophysics Data System (ADS)

    Cadenas Martínez, P.; Fernandez Viejo, G.; Pulgar, J. A.

    2017-12-01

    The North Iberian margin is an inverted hyperextended rifted margin that preserves the initial stages of compressional reactivation. Rift inheritance conditioned in a determinant way the contractional reactivation. The underthrusting of the hyperextended distal domains beneath the platform and the formation of an accretionary wedge at the toe of the slope focused most of the compression. The underthrusting gave place to the formation of a crustal root and the uplifting of the Cantabrian Mountains onshore. Meanwhile, the main rift basins within the continental platform were slightly inverted. Plate kinematic reconstructions and palinspatic restorations have provided different shortening values. Thereby, the amount of shortening linked with the Cenozoic compression is still unclear and a matter of debate on this area.In this work, we present a full cross-section at the central part of the North Iberian margin developed from the restoration of a high quality depth migrated seismic profile running from the continental platform to the Biscay abyssal plain. A shortening calculation gives an estimate of about 1 km within the Asturian Basin, in the continental platform, while in the accretionary wedge at the bottom of the slope, shortening values ranges between 12 km and 15 km. The limited values estimated within the Asturian Basin support the mild inversion observed within this basin, which preserves most of the extensional imprint. Within the abyssal plain, shortening values differ from previous estimations and cannot account for a high amount of compression in the upper crust. Deformation of the hyperextended crust and the exhumed mantle domains inherited from the rifting processes would have accommodated most of the compression. Restoration of these domains seems to be the key to decipher the structure and the tectonic evolution of the reactivated rifted margin but cannot be solved accurately using traditional restoration methods. This leads to a reappraisal of the traditional way of restoring compressional belt transects and particularly, when previous hyperextended domains within the rifted margins are involved.

  8. Comparative evaluation of traditional and self-priming hydrophilic resin

    PubMed Central

    Singla, Ruchi; Bogra, Poonam; Singal, Bhawana

    2012-01-01

    Background: The purpose of this study was to compare the microleakage of traditional composite (Charisma/Gluma Comfort Bond) and self-priming resin (Embrace Wetbond). Materials and Methods: Standardized Class V cavities partly in enamel and cementum were prepared in 20 extracted human premolars. Teeth were divided into two groups. Group 1 was restored with Charisma/Gluma Comfort Bond and Group 2 with Embrace Wetbond. The specimens were stored in distilled water at room temperature for 24 h and then subjected to 200 thermocycles at 5°C and 55°C with a 1 min dwell time. After thermocycling teeth were immersed in a 0.2% solution of methylene blue dye for 24 h. Teeth were sectioned vertically approximately midway through the facial and lingual surfaces using a diamond saw blade. Microleakage was evaluated at enamel and cementum surfaces using 10 × stereomicroscope. The statistical analysis was performed using Wilcoxon signed-rank test. Results: Wetbond showed less microleakage at occlusal and gingival margins as compared with Charisma/Gluma Comfort Bond and the results were statistically significant (P < 0.05). Conclusion: Class V cavities restored with Embrace Wetbond with fewer steps and fewer materials offers greater protection against microleakage at the tooth restorative interface. PMID:22876008

  9. Adopting Disruptive Technologies in Traditional Universities: Continuing Education as an Incubator for Innovation.

    ERIC Educational Resources Information Center

    Archer, Walter; Anderson, Terry; Garrison, Randy

    1999-01-01

    Traditional universities are feeling the impact of "disruptive technologies" such as distance education. Seeing how businesses have responded to such disruptions, universities should "incubate" innovations in a semiautonomous unit such as continuing education, which can address new markets with low margins. (SK)

  10. SU-E-T-364: Estimating the Minimum Number of Patients Required to Estimate the Required Planning Target Volume Margins for Prostate Glands

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Bakhtiari, M; Schmitt, J; Sarfaraz, M

    2015-06-15

    Purpose: To establish a minimum number of patients required to obtain statistically accurate Planning Target Volume (PTV) margins for prostate Intensity Modulated Radiation Therapy (IMRT). Methods: A total of 320 prostate patients, consisting of a total number of 9311 daily setups, were analyzed. These patients had gone under IMRT treatments. Daily localization was done using the skin marks and the proper shifts were determined by the CBCT to match the prostate gland. The Van Herk formalism is used to obtain the margins using the systematic and random setup variations. The total patient population was divided into different grouping sizes varyingmore » from 1 group of 320 patients to 64 groups of 5 patients. Each grouping was used to determine the average PTV margin and its associated standard deviation. Results: Analyzing all 320 patients lead to an average Superior-Inferior margin of 1.15 cm. The grouping with 10 patients per group (32 groups) resulted to an average PTV margin between 0.6–1.7 cm with the mean value of 1.09 cm and a standard deviation (STD) of 0.30 cm. As the number of patients in groups increases the mean value of average margin between groups tends to converge to the true average PTV of 1.15 cm and STD decreases. For groups of 20, 64, and 160 patients a Superior-Inferior margin of 1.12, 1.14, and 1.16 cm with STD of 0.22, 0.11, and 0.01 cm were found, respectively. Similar tendency was observed for Left-Right and Anterior-Posterior margins. Conclusion: The estimation of the required margin for PTV strongly depends on the number of patients studied. According to this study at least ∼60 patients are needed to calculate a statistically acceptable PTV margin for a criterion of STD < 0.1 cm. Numbers greater than ∼60 patients do little to increase the accuracy of the PTV margin estimation.« less

  11. Cognitive Skill and Traditional Trance Hypnotic Inductions: A Within-Subjects Comparison.

    ERIC Educational Resources Information Center

    Vickery, Anne R.; And Others

    1985-01-01

    Compared a traditional trance hypnotic induction and a cognitive skill induction using a within-subjects design with college students (N=40). The skill induction enhanced responses to suggestions and produced marginally significant increments in behavioral responses when preceded by the trance induction, but there were no significant differences…

  12. Visualizing Queer Spaces: LGBTQ Students and the Traditionally Heterogendered Institution

    ERIC Educational Resources Information Center

    Pryor, Jonathan T.

    2018-01-01

    As colleges and universities have increased campus programs, LGBTQ students continue to experience marginalization within the very spaces intended to support them. This study explored how LGBTQ college students experienced campus climate at a Midwest Urban Public (MUP) institution through a framework of the traditionally heterogendered institution…

  13. Redefining Practice: Challenging Academic and Institutional Traditions with Clinical Distance Learning

    ERIC Educational Resources Information Center

    Delgaty, Laura E.

    2017-01-01

    With the uptake of distance learning (DL), which has actually been marginal for most academics, teaching contexts, traditional power structures and relationships have been transformed, leaving lecturers potentially disenfranchised. Institutional and cultural change is vital, particularly changes concerning academic roles. The advent of DL has…

  14. Measuring and partitioning soil respiration in sharkey shrink-swell clays under plantation grown short-rotation woody crops

    Treesearch

    Wilson G. Hood; Michael C. Tyree; Dylan N. Dillaway Dillaway; Theodor D. Leininger

    2015-01-01

    The Lower Mississippi Alluvial Valley (LMAV) offers an ecological niche for short-rotation woody crop (SRWC) production by mating marginal agricultural land with optimal growing conditions. Approximately 1.7 million ha within the LMAV consist of Sharkey shrink-swell clays. They are considered marginal in terms of traditional agricultural productivity due to their...

  15. Effect of Cements at Different Temperatures on the Clinical Performance and Marginal Adaptation of Inlay-Onlay Restorations In Vivo.

    PubMed

    Aygün Emiroğlu, Şeyda; Evren, Buket; Kulak Özkan, Yasemin

    2016-06-01

    To evaluate the clinical performance of inlays and onlays luted with two different resin cements, mixed at different temperatures and to evaluate the marginal adaptation of the restorations. One hundred IPS e.max restorations (82 onlays, 18 inlays; 84 molars, 16 premolars) were placed in 50 patients (28 females, 22 males, mean age, 33 years). The restorations were assigned to six groups according to the luting agent temperature (25°C, 37°C, and 54°C) and cement type (Variolink N high viscosity or G-Cem Automix). All restorations were evaluated after 1 week and 1 year by two examiners using modified USPHS criteria. Replicas of 30 selected onlay restorations (5 per group) were assessed for marginal quality under a scanning electron microscope (SEM) at 200×. Marginal adaptation was quantitatively evaluated in terms of percentage of gap formation, and marginal gap width was measured. After 1 year, the total survival rates of the Variolink N high viscosity group and G-Cem Automix group were 100% and 93.8%, respectively. Three debondings occurred with the G-Cem Automix group, one from each temperature group. For 1-year clinical service time, no significant difference was noticed in the marginal adaptation of Variolink N high viscosity groups and the 37°C G-Cem Automix group, while 25°C and 54°C G-Cem Automix groups' marginal adaptation scores decreased (p < 0.05). Regarding the SEM evaluations, Variolink N high viscosity cement groups showed better marginal adaptation than G-Cem Automix cement groups (p < 0.05). Cementation with the cements preheated to 37°C increased continuous margins in both enamel-cement and cement-ceramic interfaces, but these results were not statistically significant (p > 0.05). Cements at different temperatures did not have significant effects on marginal gap widths of the restorations. The restorations cemented with Variolink N high viscosity cement mixed at the three tested temperatures exhibited better treatment options than the self-adhesive groups. Preheating the self-adhesive cement (G-Cem Automix) to 37°C can be an effective method to have better marginal adaptation than the other self-adhesive groups (25°C, 54°C) tested in this study. © 2015 by the American College of Prosthodontists.

  16. [Influence of different designs and porcelain/glaze firing on the marginal and internal fit of implant-supported zirconia crowns].

    PubMed

    Cuiling, Liu; Xu, Gao; Yuping, Qi; Liyuan, Yang

    2016-02-01

    This study investigated the influence of different designs and porcelain/glaze firing on the marginal and internal fit of three kinds of computer aided design/computer aided manufacturing (CAD/CAM) zirconia ceramic implant-supported crowns. Three groups of zirconia ceramic implant-supported crowns with different designs were produced from copings by using a Cercon CAD/CAM system (n = 8). The first two groups comprised double-layer crowns (zirconia coping + veneer) with regular (Group A) and full circumferential zirconia-collar marginal designs (Group B). The third group was composed of anatomic single-layer zirconia crowns without cores (Group C). Initially, the marginal and internal gaps of the copings and crowns were individually replicated by light-body silicon and then measured by micro-computed tomography scanning before and after porcelain/glaze firing. Five measurements were employed: vertical marginal gap (MG); horizontal marginal discrepancy (HMD); chamfer area (CA); axial wall (AW); and axial-occlusal transition area (AOT). Statistical analyses were performed by SPSS 17.0. HMD measurements in Group A were statistically higher than those in Groups B and C (P < 0.05), regardless of whether the values were obtained before or after porcelain/glaze firing. By contrast, the HIMD measurements in Groups B and C showed no significant difference (P > 0.05). Moreover, no differences were noted in MG, CA, AW, and AOT among the three groups (P > 0.05). All the measurements in the three groups showed no significant change after porcelain/glaze firing (P > 0.05), except for MG in Group A, which significantly decreased (P < 0.05). The marginal fits of the double-layer crowns with full circumferential zirconia-collar and the anatomic single-layer zirconia crowns were superior to that of the double-layer crowns with regular margins. The MG of the crowns with regular margins was obviously influenced by porcelain firing.

  17. The assessment of mucosal surgical margins in head and neck cancer surgery with narrow band imaging.

    PubMed

    Šifrer, Robert; Urbančič, Jure; Strojan, Primož; Aničin, Aleksandar; Žargi, Miha

    2017-07-01

    The diagnostic gain of narrow band imaging in the definition of surgical margins in the treatment of head and neck cancer was evaluated. A prospective study, blinded to the pathologist, with historical comparison. The study group included 45 patients subjected to the intraoperative definition of margins by narrow band imaging. The control group included 55 patients who had undergone standard definition of margins. All patients underwent resection of the tumor and frozen section analysis of superficial margins. The rate of initial R 0 resection and the ratio of histologically negative margins for both groups were statistically compared. The rate of initial R 0 resection in the study group and in the control group was 88.9% and 70.9% (P = .047), and the ratio of histologically negative margins was 95.9% and 88.4% (P = .017), respectively. Narrow band imaging reveals a microscopic extension of the tumor that could be effectively used to better define superficial margins and to achieve a higher rate of initial R 0 resections. 4 Laryngoscope, 127:1577-1582, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  18. Cervical and Incisal Marginal Discrepancy in Ceramic Laminate Veneering Materials: A SEM Analysis

    PubMed Central

    Ranganathan, Hemalatha; Ganapathy, Dhanraj M.; Jain, Ashish R.

    2017-01-01

    Context: Marginal discrepancy influenced by the choice of processing material used for the ceramic laminate veneers needs to be explored further for better clinical application. Aims: This study aimed to evaluate the amount of cervical and incisal marginal discrepancy associated with different ceramic laminate veneering materials. Settings and Design: This was an experimental, single-blinded, in vitro trial. Subjects and Methods: Ten central incisors were prepared for laminate veneers with 2 mm uniform reduction and heavy chamfer finish line. Ceramic laminate veneers fabricated over the prepared teeth using four different processing materials were categorized into four groups as Group I - aluminous porcelain veneers, Group II - lithium disilicate ceramic veneers, Group III - lithium disilicate-leucite-based veneers, Group IV - zirconia-based ceramic veneers. The cervical and incisal marginal discrepancy was measured using a scanning electron microscope. Statistical Analysis Used: ANOVA and post hoc Tukey honest significant difference (HSD) tests were used for statistical analysis. Results: The cervical and incisal marginal discrepancy for four groups was Group I - 114.6 ± 4.3 μm, 132.5 ± 6.5 μm, Group II - 86.1 ± 6.3 μm, 105.4 ± 5.3 μm, Group III - 71.4 ± 4.4 μm, 91.3 ± 4.7 μm, and Group IV - 123.1 ± 4.1 μm, 142.0 ± 5.4 μm. ANOVA and post hoc Tukey HSD tests observed a statistically significant difference between the four test specimens with regard to cervical marginal discrepancy. The cervical and incisal marginal discrepancy scored F = 243.408, P < 0.001 and F = 180.844, P < 0.001, respectively. Conclusion: This study concluded veneers fabricated using leucite reinforced lithium disilicate exhibited the least marginal discrepancy followed by lithium disilicate ceramic, aluminous porcelain, and zirconia-based ceramics. The marginal discrepancy was more in the incisal region than in the cervical region in all the groups. PMID:28839415

  19. Cervical and Incisal Marginal Discrepancy in Ceramic Laminate Veneering Materials: A SEM Analysis.

    PubMed

    Ranganathan, Hemalatha; Ganapathy, Dhanraj M; Jain, Ashish R

    2017-01-01

    Marginal discrepancy influenced by the choice of processing material used for the ceramic laminate veneers needs to be explored further for better clinical application. This study aimed to evaluate the amount of cervical and incisal marginal discrepancy associated with different ceramic laminate veneering materials. This was an experimental, single-blinded, in vitro trial. Ten central incisors were prepared for laminate veneers with 2 mm uniform reduction and heavy chamfer finish line. Ceramic laminate veneers fabricated over the prepared teeth using four different processing materials were categorized into four groups as Group I - aluminous porcelain veneers, Group II - lithium disilicate ceramic veneers, Group III - lithium disilicate-leucite-based veneers, Group IV - zirconia-based ceramic veneers. The cervical and incisal marginal discrepancy was measured using a scanning electron microscope. ANOVA and post hoc Tukey honest significant difference (HSD) tests were used for statistical analysis. The cervical and incisal marginal discrepancy for four groups was Group I - 114.6 ± 4.3 μm, 132.5 ± 6.5 μm, Group II - 86.1 ± 6.3 μm, 105.4 ± 5.3 μm, Group III - 71.4 ± 4.4 μm, 91.3 ± 4.7 μm, and Group IV - 123.1 ± 4.1 μm, 142.0 ± 5.4 μm. ANOVA and post hoc Tukey HSD tests observed a statistically significant difference between the four test specimens with regard to cervical marginal discrepancy. The cervical and incisal marginal discrepancy scored F = 243.408, P < 0.001 and F = 180.844, P < 0.001, respectively. This study concluded veneers fabricated using leucite reinforced lithium disilicate exhibited the least marginal discrepancy followed by lithium disilicate ceramic, aluminous porcelain, and zirconia-based ceramics. The marginal discrepancy was more in the incisal region than in the cervical region in all the groups.

  20. From the Margins to the Mainstream: Potential Impact of Early Colleges on Traditional High Schools

    ERIC Educational Resources Information Center

    Smith, Robert; Fischetti, John; Fort, Deron; Gurley, Tilly; Kelly, Mike

    2012-01-01

    Early colleges are one alternative to the traditional comprehensive high school. This article describes the establishment of an early college in partnership with a university, including the experiences for students, the challenges for teachers, and the difficulties in bridging higher and kindergarten through Grade-12 educations. The article…

  1. Single-Center Experience Using Marginal Liver Grafts in Korea.

    PubMed

    Park, P-J; Yu, Y-D; Yoon, Y-I; Kim, S-R; Kim, D-S

    2018-05-01

    Liver transplantation (LT) is an established therapeutic modality for patients with end-stage liver disease. The use of marginal donors has become more common worldwide due to the sharp increase in recipients, with a consequent shortage of suitable organs. We analyzed our single-center experience over the last 8 years in LT to evaluate the outcomes of using so-called "marginal donors." We retrospectively analyzed the database of all LTs performed at our institution from 2009 to 2017. Only patients undergoing deceased-donor LTs were analyzed. Marginal grafts were defined as livers from donors >60 years of age, livers from donors with serum sodium levels >155 mEq, graft steatosis >30%, livers with cold ischemia time ≥12 hours, livers from donors who were hepatitis B or C virus positive, livers recovered from donation after cardiac death, and livers split between 2 recipients. Patients receiving marginal grafts (marginal group) were compared with patients receiving standard grafts (standard group). A total of 106 patients underwent deceased-donor LT. There were 55 patients in the standard group and 51 patients in the marginal group. There were no significant differences in terms of age, sex, Model for End-Stage Liver Disease score, underlying liver disease, presence of hepatocellular carcinoma, and hospital stay between the 2 groups. Although the incidence of acute cellular rejection, cytomegalovirus infection, and postoperative complications was similar between the 2 groups, the incidence of early allograft dysfunction was higher in the marginal group. With a median follow-up of 26 months, the 1-, 3-, and 5-year overall and graft (death-censored) survivals in the marginal group were 85.5%, 75%, and 69.2% and 85.9%, 83.6%, and 77.2%, respectively. Patient overall survival and graft survival (death-censored) were significantly lower in the marginal group (P = .023 and P = .048, respectively). On multivariate analysis, receiving a marginal graft (hazard ratio [HR], 4.862 [95% confidence interval (CI), 1.233-19.171]; P = .024) and occurrence of postoperative complications (HR, 4.547 [95% CI, 1.279-16.168]; P = .019) were significantly associated with worse patient overall survival. Also, when factors associated with marginal graft were analyzed separately, graft steatosis >30% was independently associated with survival (HR, 5.947 [95% CI, 1.481-23.886]; P = .012). Patients receiving marginal grafts showed lower but acceptable overall survival and graft survival. However, because graft steatosis >30% was independently associated with worse survival, caution must be exercised when using this type of marginal graft by weighing the risk and benefits. Copyright © 2018 Elsevier Inc. All rights reserved.

  2. TU-AB-303-06: Does Online Adaptive Radiation Therapy Mean Zero Margin for Intermediate-Risk Prostate Cancer? An Intra-Fractional Seminal Vesicles Motion Analysis

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Sheng, Y; Li, T; Lee, W

    Purpose: To provide benchmark for seminal vesicles (SVs) margin selection to account for intra-fractional motion; and to investigate the effectiveness of two motion surrogates in predicting intra-fractional SV underdosage. Methods: 9 prostate SBRT patients were studied; each has five pairs of pre-treatment and post-treatment cone-beam CTs (CBCTs). Each pair of CBCTs was registered based on fiducial markers in the prostate. To provide “ground truth” for coverage evaluation, all pre-treatment SVs were expanded with isotropic margin of 1,2,3,5 and 8mm, and their overlap with post-treatment SVs were used to quantify intra-fractional coverage. Two commonly used motion surrogates, the center-of-mass (COM) andmore » the border of contour (the most distal points in SI/AP/LR directions) were evaluated using Receiver-Operating Characteristic (ROC) analyses for predicting SV underdosage due to intra-fractional motion. Action threshold of determining underdosage for each surrogate was calculated by selecting the optimal balancing between sensitivity and specificity. For comparison, margin for each surrogate was also calculated based on traditional margin recipe. Results: 90% post-treatment SV coverage can be achieved in 47%, 82%, 91%, 98% and 98% fractions for 1,2,3,5 and 8mm margins. 3mm margin ensured the 90% intra-fractional SV coverage in 90% fractions when prostate was aligned. The ROC analysis indicated the AUC for COM and border were 0.88 and 0.72. The underdosage threshold was 2.9mm for COM and 4.1mm for border. The Van Herk’s margin recipe recommended 0.5, 0 and 1.8mm margin in LR, AP and SI direction based on COM and for border, the corresponding margin was 2.1, 4.5 and 3mm. Conclusion: 3mm isotropic margin is the minimum required to mitigate the intra-fractional SV motion when prostate is aligned. ROC analysis reveals that both COM and border are acceptable predictors for SV underdosage with 2.9mm and 4.1mm action threshold. Traditional margin calculation is less reliable for this application. This work is partially supported a master research grant from Varian Medical Systems.« less

  3. Randomized open-labbel non-inferiority trial of acetaminophen or loxoprofen for patients with acute low back pain.

    PubMed

    Miki, Kenji; Ikemoto, Tatsunori; Hayashi, Kazuhiro; Arai, Young-Chang; Sekiguchi, Miho; Shi, Kenrin; Ushida, Takahiro

    2018-05-01

    Current worldwide clinical practice guidelines recommend acetaminophen as the first option for the treatment of acute low back pain. However, there is no concrete evidence regarding whether acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) is more effective for treating acute low back pain (LBP) in Japan. The present study aimed to investigate whether acetaminophen treatment for acute musculoskeletal pain was comparable with loxoprofen (a traditional NSAID in Japan) treatment. Of the 140 patients with acute LBP who visited out-patient hospitals, 127 were considered eligible and were randomly allocated to a group taking acetaminophen or one taking loxoprofen. As primary outcome measure, pain intensity was measured using a 0-10-numeric rating scale (NRS). Moreover, pain disability, pain catastrophizing, anxiety, depression, and quality of life, as well as adverse events, were assessed as secondary outcomes. The primary outcome was tested with a noninferiority margin (0.84 on changes in pain-NRS), and the secondary outcomes were compared using conventional statistical methods at week 2 and week 4. Seventy patients completed the study (acetaminophen: 35, loxoprofen: 35). The dropout rates showed no significant difference between the two medication-groups. We found that the mean differences of changes in pain-NRS from baseline to week 2 or 4 between the two medication groups were not statistically beyond the noninferiority margin (mean [95% confidence interval]: -0.51 [-1.70, 0.67], at week 2 and -0.80 [-2.08, 0.48] at week 4). There were no consistent differences between the two medication groups in terms of secondary outcomes. The results suggest that acetaminophen has comparable analgesic effects on acute LBP, based on at least a noninferiority margin, compared with loxoprofen at 4 weeks. Acetaminophen seems to be a reasonable first-line option for patients with acute LBP in Japan. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

  4. [The dynamics of blood circulation in marginal gingiva after crown preparation by different ledge locations].

    PubMed

    Shcherbakov, A S; Kuznetsova, M B; Kuznetsov, D L; Ivanova, S B

    2013-01-01

    The periodontal tissue level may change after gingival margin retraction and tooth preparation. The aim of the study was to assess the influence of these manipulations on the condition of free gingival margin. The study included 53 persons (29 women and 24 men) divided into 4 groups followed-up for 6 to 8 weeks. Blood circulation in marginal gingiva of 118 teeth with healthy periodontal tissues was assessed by ultrasonic Doppler evaluation to reveal the circulation impairments in cervical margin after teeth crown preparation. The first group included 39 teeth, in which the gum was retracted by Roeko stay put non impregna cords ("Langenau", Germany). The second group included 39 teeth with shoulders prepared at the gingival margin; in the third group (40 teeth) the shoulder was located subgingivally. The fourth group (40 teeth) was control. The changes in recovery indices have been analyzed. The linear values were established as most significant and demonstrative. The indices variations and recovery period length depended on the coronal edge location. Statistically significant differences were found among all the groups (p>0.05). The results may be used to improve crown preparation for fixed dentures and decrease the recession rate of free gingival margin.

  5. Marginal adaptation of newer root canal sealers to dentin: A SEM study.

    PubMed

    Polineni, Swapnika; Bolla, Nagesh; Mandava, Pragna; Vemuri, Sayesh; Mallela, Madhusudana; Gandham, Vijaya Madhuri

    2016-01-01

    This in vitro study evaluated and compared the marginal adaptation of three newer root canal sealers to root dentin. Thirty freshly extracted human single-rooted teeth with completely formed apices were taken. Teeth were decoronated, and root canals were instrumented. The specimens were randomly divided into three groups (n = 10) based upon the sealer used. Group 1 - teeth were obturated with epoxy resin sealer (MM-Seal). Group 2 - teeth were obturated with mineral trioxide aggregate (MTA) based sealer (MTA Fillapex), Group 3 - teeth were obturated with bioceramic sealer (EndoSequence BC sealer). Later samples were vertically sectioned using hard tissue microtome and marginal adaptation of sealers to root dentin was evaluated under coronal and apical halves using scanning electron microscopy (SEM) and marginal gap values were recorded. The data were statistically analyzed by two-way ANOVA and Tukey's multiple post hoc test. The highest marginal gap was seen in Group 2 (apical-16680.00 nm, coronal-10796 nm) and the lowest marginal gap was observed in Group 1 (apical-599.42 nm, coronal-522.72 nm). Coronal halves showed superior adaptation compared to apical halves in all the groups under SEM. Within the limitations of this study epoxy resin-based MM-Seal showed good marginal adaptation than other materials tested.

  6. In vitro evaluation of marginal discrepancy of monolithic zirconia restorations fabricated with different CAD-CAM systems.

    PubMed

    Hamza, Tamer A; Sherif, Rana M

    2017-06-01

    Dental laboratories use different computer-aided design and computer-aided manufacturing (CAD-CAM) systems to fabricate fixed prostheses; however, limited evidence is available concerning which system provides the best marginal discrepancy. The purpose of this in vitro study was to evaluate the marginal fit of 5 different monolithic zirconia restorations milled with different CAD-CAM systems. Thirty monolithic zirconia crowns were fabricated on a custom-designed stainless steel die and were divided into 5 groups according to the type of monolithic zirconia crown and the CAD-CAM system used: group TZ, milled with an MCXL milling machine; group CZ, translucent zirconia milled with a motion milling machine; group ZZ, zirconia milled with a dental milling unit; group PZ, translucent zirconia milled with a zirconia milling unit; and group BZ, solid zirconia milled using an S1 VHF milling machine. The marginal fit was measured with a binocular microscope at an original magnification of ×100. The results were tabulated and statistically analyzed with 1-way ANOVA and post hoc surface range test, and pairwise multiple comparisons were made using Bonferroni correction (α=.05). The type of CAD-CAM used affected the marginal fit of the monolithic restoration. The mean (±SD) highest marginal discrepancy was recorded in group TZI at 39.3 ±2.3 μm, while the least mean marginal discrepancy was recorded in group IZ (22.8 ±8.9 μm). The Bonferroni post hoc test showed that group TZI was significantly different from all other groups tested (P<.05). Within the limitation of this in vitro study, all tested CAD-CAM systems produced monolithic zirconia restorations with clinically acceptable marginal discrepancies; however, the CAD-CAM system with the 5-axis milling unit produced the best marginal fit. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  7. Images of Place: Visuals from Migrant Women Sex Workers in South Africa.

    PubMed

    Oliveira, Elsa; Vearey, Jo

    2015-01-01

    Many migrants in inner-city Johannesburg survive through unconventional and sometimes criminalized livelihood activities. In this article, we draw on data from a study that applied a participatory visual methodology to work with migrant women who sell sex, and explored the suitability of this approach as a way to engage with a presumed 'hard to reach' urban population. The lived experiences of migrant women sex workers were documented by combining participatory visual methods with a more traditional ethnographic approach, and this approach led us to new ways of seeing their worlds. This methodological approach raises important considerations for working with marginalized and criminalized urban groups.

  8. Influence of incorrect application of a water-based adhesive system on the marginal adaptation of Class V restorations.

    PubMed

    Peschke, A; Blunck, U; Roulet, J F

    2000-10-01

    To determine the influence of incorrectly performed steps during the application of the water-based adhesive system OptiBond FL on the marginal adaptation of Class V composite restorations. In 96 extracted human teeth Class V cavities were prepared. Half of the margin length was situated in dentin. The teeth were randomly divided into 12 groups. The cavities were filled with Prodigy resin-based composite in combination with OptiBond FL according to the manufacturer's instructions (Group O) and including several incorrect application steps: Group A: prolonged etching (60 s); Group B: no etching of dentin; Group C: excessive drying after etching; Group D: short rewetting after excessive drying; Group E: air drying and rewetting; Group F: blot drying; Group G: saliva contamination; Group H: application of primer and immediate drying; group I: application of only primer; group J: application of only adhesive; Group K: no light curing of the adhesive before the application of composite. After thermocycling, replicas were taken and the margins were quantitatively analyzed in the SEM. Statistical analysis of the results was performed using non-parametric procedures. With exception of the "rewetting groups" (D and E) and the group with saliva contamination (G), all other application procedures showed a significantly higher amount of marginal openings in dentin compared to the control group (O). Margin quality in enamel was only affected when the primer was not applied.

  9. Marginal and internal fit of metal copings fabricated with rapid prototyping and conventional waxing.

    PubMed

    Farjood, Ehsan; Vojdani, Mahroo; Torabi, Kiyanoosh; Khaledi, Amir Ali Reza

    2017-01-01

    Given the limitations of conventional waxing, computer-aided design and computer-aided manufacturing (CAD-CAM) technologies have been developed as alternative methods of making patterns. The purpose of this in vitro study was to compare the marginal and internal fit of metal copings derived from wax patterns fabricated by rapid prototyping (RP) to those created by the conventional handmade technique. Twenty-four standardized brass dies were milled and divided into 2 groups (n=12) according to the wax pattern fabrication method. The CAD-RP group was assigned to the experimental group, and the conventional group to the control group. The cross-sectional technique was used to assess the marginal and internal discrepancies at 15 points on the master die by using a digital microscope. An independent t test was used for statistical analysis (α=.01). The CAD-RP group had a total mean (±SD) for absolute marginal discrepancy of 117.1 (±11.5) μm and a mean marginal discrepancy of 89.8 (±8.3) μm. The conventional group had an absolute marginal discrepancy 88.1 (±10.7) μm and a mean marginal discrepancy of 69.5 (±15.6) μm. The overall mean (±SD) of the total internal discrepancy, separately calculated as the axial internal discrepancy and occlusal internal discrepancy, was 95.9 (±8.0) μm for the CAD-RP group and 76.9 (±10.2) μm for the conventional group. The independent t test results showed significant differences between the 2 groups. The CAD-RP group had larger discrepancies at all measured areas than the conventional group, which was statistically significant (P<.01). Within the limitations of this in vitro study, the conventional method of wax pattern fabrication produced copings with better marginal and internal fit than the CAD-RP method. However, the marginal and internal fit for both groups were within clinically acceptable ranges. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  10. Comparative assessment of marginal accuracy of grade II titanium and Ni–Cr alloy before and after ceramic firing: An in vitro study

    PubMed Central

    Patil, Abhijit; Singh, Kishan; Sahoo, Sukant; Suvarna, Suraj; Kumar, Prince; Singh, Anupam

    2013-01-01

    Objective: The aims of the study are to assess the marginal accuracy of base metal and titanium alloy casting and to evaluate the effect of repeated ceramic firing on the marginal accuracy of base metal and titanium alloy castings. Materials and Methods: Twenty metal copings were fabricated with each casting material. Specimens were divided into 4 groups of 10 each representing base metal alloys castings without (Group A) and with metal shoulder margin (Group B), titanium castings without (Group C) and with metal shoulder margin (Group D). The measurement of fit of the metal copings was carried out before the ceramic firing at four different points and the same was followed after porcelain build-up. Results: Significant difference was found when Ni–Cr alloy samples were compared with Grade II titanium samples both before and after ceramic firings. The titanium castings with metal shoulder margin showed highest microgap among all the materials tested. Conclusions: Based on the results that were found and within the limitations of the study design, it can be concluded that there is marginal discrepancy in the copings made from Ni–Cr and Grade II titanium. This marginal discrepancy increased after ceramic firing cycles for both Ni–Cr and Grade II titanium. The comparative statistical analysis for copings with metal-collar showed maximum discrepancy for Group D. The comparative statistical analysis for copings without metal-collar showed maximum discrepancy for Group C. PMID:24926205

  11. Marginal predation: do encounter or confusion effects explain the targeting of prey group edges?

    PubMed

    Duffield, Callum; Ioannou, Christos C

    2017-01-01

    Marginal predation, also known as the edge effect, occurs when aggregations of prey are preferentially targeted on their periphery by predators and has long been established in many taxa. Two main processes have been used to explain this phenomenon, the confusion effect and the encounter rate between predators and prey group edges. However, it is unknown at what size a prey group needs to be before marginal predation is detectable and to what extent each mechanism drives the effect. We conducted 2 experiments using groups of virtual prey being preyed upon by 3-spined sticklebacks ( Gasterosteus aculeatus ) to address these questions. In Experiment 1, we show that group sizes do not need to be large for marginal predation to occur, with this being detectable in groups of 16 or more. In Experiment 2, we find that encounter rate is a more likely explanation for marginal predation than the confusion effect in this system. We find that while confusion does affect predatory behaviors (whether or not predators make an attack), it does not affect marginal predation. Our results suggest that marginal predation is a more common phenomenon than originally thought as it also applies to relatively small groups. Similarly, as marginal predation does not need the confusion effect to occur, it may occur in a wider range of predator-prey species pairings, for example those where the predators search for prey using nonvisual sensory modalities.

  12. The Ills of Marginality: New Perspectives on Health in South Asia.

    PubMed

    Ecks, Stefan; Sax, William S

    2005-12-01

    Social marginality and ill health can form an unholy dyad: firstly, groups who suffer from chronic or infectious diseases often find themselves pushed to the margins. Secondly, people who are already on the edge of society tend to suffer more from illness than those at the centre. In development discourse, marginal people are defined as those who are 'not yet' on the same level as the developed mainstream and are in urgent need of aid from the centre. The papers in this special issue take a different approach by insisting that marginality is a radically relational concept: the centre and its margins constitute each other, and the boundaries between them are constantly shifting. The papers show that there are many types of marginality (based on geography, class, caste, sex/gender, ethnicity, etc.), and that each of them has different effects on the health of a particular group. Yet instead of speaking of a plurality of unrelated 'group identities', marginality preserves a sharp sense of unequal power relations between groups. The specific ethnographic contribution to the study of marginality comes from its attention to the point of view of marginal people. This is of critical importance since marginality puts health most under stress when it is clearly and steadily perceived in everyday life. This, in turn, makes it possible to show that living on the margins is not always and everywhere bad for health. While all of the papers present South Asian case studies, the insights and questions are relevant for the study of the ills of marginality in a global perspective.

  13. Acculturation and dietary patterns among residents of Surinamese origin in the Netherlands: the HELIUS dietary pattern study.

    PubMed

    Sturkenboom, Suzanne M; Dekker, Louise H; Lamkaddem, Majda; Schaap, Laura A; de Vries, Jeanne H M; Stronks, Karien; Nicolaou, Mary

    2016-03-01

    Insight into the role of acculturation in dietary patterns is important to inform the development of nutrition programmes that target ethnic minority groups. Therefore, the present study aimed to investigate how the adherence to dietary patterns within an ethnic minority population in the Netherlands varies by acculturation level compared with the host population. Cross-sectional study using data of the HELIUS study. Dietary patterns were assessed with an ethnic-specific FFQ. Acculturation was operationalized using unidimensional proxies (residence duration, age at migration and generation status) as well as on the basis of the bidimensional perspective, defined by four distinct acculturation strategies: assimilation, integration, separation and marginalization. Amsterdam, the Netherlands. Participants of Dutch (n 1370) and Surinamese (n 1727) origin. Three dietary patterns were identified: (i) 'noodle/rice dishes and white meat' (traditional Surinamese pattern); (ii) 'red meat, snacks and sweets'; and (iii) 'vegetables, fruit and nuts'. Surinamese-origin respondents adhered more to the traditional Surinamese pattern than the other dietary patterns. Neither the unidimensional proxies nor the bidimensional acculturation strategies demonstrated consistent associations with dietary patterns. The lack of consistent association between acculturation and dietary patterns in the present study indicates that dietary patterns are quite robust. Understanding the continued adherence to traditional dietary patterns when developing dietary interventions in ethnic minority groups is warranted.

  14. System Guidelines for EMC Safety-Critical Circuits: Design, Selection, and Margin Demonstration

    NASA Technical Reports Server (NTRS)

    Lawton, R. M.

    1996-01-01

    Demonstration of safety margins for critical points (circuits) has traditionally been required since it first became a part of systems-level Electromagnetic Compatibility (EMC) requirements of MIL-E-6051C. The goal of this document is to present cost-effective guidelines for ensuring adequate Electromagnetic Effects (EME) safety margins on spacecraft critical circuits. It is for the use of NASA and other government agencies and their contractors to prevent loss of life, loss of spacecraft, or unacceptable degradation. This document provides practical definition and treatment guidance to contain costs within affordable limits.

  15. A microcomputed tomography evaluation of the marginal fit of cobalt-chromium alloy copings fabricated by new manufacturing techniques and alloy systems.

    PubMed

    Kim, Eun-Ha; Lee, Du-Hyeong; Kwon, Sung-Min; Kwon, Tae-Yub

    2017-03-01

    Although new digital manufacturing techniques are attracting interest in dentistry, few studies have comprehensively investigated the marginal fit of fixed dental prostheses fabricated with such techniques. The purpose of this in vitro microcomputed tomography (μCT) study was to evaluate the marginal fit of cobalt-chromium (Co-Cr) alloy copings fabricated by casting and 3 different computer-aided design and computer-aided manufacturing (CAD-CAM)-based processing techniques and alloy systems. Single Co-Cr metal crowns were fabricated using 4 different manufacturing techniques: casting (control), milling, selective laser melting, and milling/sintering. Two different commercial alloy systems were used for each fabrication technique (a total of 8 groups; n=10 for each group). The marginal discrepancy and absolute marginal discrepancy of the crowns were determined with μCT. For each specimen, the values were determined from 4 different regions (sagittal buccal, sagittal lingual, coronal mesial, and coronal distal) by using imaging software and recorded as the average of the 4 readings. For each parameter, the results were statistically compared with 2-way analysis of variance and appropriate post hoc analysis (using Tukey or Student t test) (α=.05). The milling and selective laser melting groups showed significantly larger marginal discrepancies than the control groups (70.4 ±12.0 and 65.3 ±10.1 μm, respectively; P<.001), whereas the milling/sintering groups exhibited significantly smaller values than the controls (P=.004). The milling groups showed significantly larger absolute marginal discrepancy than the control groups (137.4 ±29.0 and 139.2 ±18.9 μm, respectively; P<.05). In the selective laser melting and milling/sintering groups, the absolute marginal discrepancy values were material-specific (P<.05). Nonetheless, the milling/sintering groups yielded statistically comparable (P=.935) or smaller (P<.001) absolute marginal discrepancies to the control groups. The findings of this in vitro μCT study showed that the marginal fit values of the Co-Cr alloy greatly depended on the fabrication methods and, occasionally, the alloy systems. Fixed dental prostheses produced by using the milling/sintering technique can be considered clinically acceptable in terms of marginal fit. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  16. [Study on the effect of different impression methods on the marginal fit of all-ceramic crowns].

    PubMed

    Zhan, Lilin; Zeng, Liwei; Chen, Ping; Liao, Lan; Li, Shiyue; Liu, Renying

    2015-08-01

    To investigate the effect of three different impression methods on the marginal fit of all-ceramic crowns. The three methods include scanning silicone rubber impression, cast models, and direct optical impression. The polymethyl methacrylate (PMMA) material of a mandibular first molar in standard model was prepared with 16 models duplicated. The all-ceramic crowns were prepared using three different impression methods. Accurate impressions were made using silicone rubber, and the cast models were obtained. The PMMA models, silicone rubber impressions, and cast models were scanned, and digital models of three groups were obtained to produce 48 zirconia all-ceramic crowns with computer aided design/computer aided manufacture. The marginal fit of these groups was measured by silicone rubber gap impression. Statistical analysis was performed with SPSS 17.0 software. The marginal fit of direct optical impression groups, silicone rubber impression groups, cast model groups was (69.18±9.47), (81.04±10.88), (84.42±9.96) µm. A significant difference was observed in the marginal fit of the direct optical impression groups and the other groups (P<0.05). No statistically significant difference was observed in the marginal fit of the silicone rubber impression groups and the cast model groups (P>0.05). All marginal measurement sites are clinically acceptable by the three different impression scanning methods. The silicone rubber impression scanning method can be used for all-ceramic restorations.

  17. Influence of porcelain firing and cementation on the marginal adaptation of metal-ceramic restorations prepared by different methods.

    PubMed

    Kaleli, Necati; Saraç, Duygu

    2017-05-01

    Marginal adaptation plays an important role in the survival of metal-ceramic restorations. Porcelain firings and cementation may affect the adaptation of restorations. Moreover, conventional casting procedures and casting imperfections may cause deteriorations in the marginal adaptation of metal-ceramic restorations. The purpose of this in vitro study was to compare the marginal adaptation after fabrication of the framework, porcelain application, and cementation of metal-ceramic restorations prepared by using the conventional lost-wax technique, milling, direct metal laser sintering (DMLS), and LaserCUSING, a direct process powder-bed system. Alterations in the marginal adaptation of the metal frameworks during the fabrication stages and the precision of fabrication methods were evaluated. Forty-eight metal dies simulating prepared premolar and molar abutment teeth were fabricated to investigate marginal adaptation. They were divided into 4 groups (n=12) according to the fabrication method used (group C serving as the control group: lost-wax method; group M: milling method; group LS: DMLS method; group DP: direct process powder-bed method). Sixty marginal discrepancy measurements were recorded separately on each abutment tooth after fabrication of the framework, porcelain application, and cementation by using a stereomicroscope. Thereafter, each group was divided into 3 subgroups according to the measurements recorded in each fabrication stage: subgroup F (framework), subgroup P (porcelain application), and subgroup C (cementation). Data were statistically analyzed with univariate analysis of variance (followed by 1-way ANOVA and Tamhane T2 test (α=.05). The lowest marginal discrepancy values were observed in restorations prepared by using the direct process powder-bed method, and this was significantly different (P<.001) from the other methods. The highest marginal discrepancy values were recorded after the cementation procedure in all groups. The results showed that the direct process powder-bed method is quite successful in terms of marginal adaptation. The marginal discrepancy increased after porcelain application and cementation. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  18. Trouble and Triumph: German Life-Turkish Tradition in Renan Demirkan's "Schwarzer Tee mit drei Stuck Zucker"

    ERIC Educational Resources Information Center

    Ebert, Reika

    2004-01-01

    This paper explores Demirkan's narrative strategies in "Schwarzer Tee mit drei Stuck Zucker" to negotiate issues of a life between two cultures and traditions. Based on Bhabha's insights that mainstream culture needs intellectual and artistic infusion from the margins of a society in order to remain vital; and that cultural production…

  19. Marginal bone level changes in association with different vertical implant positions: a 3-year retrospective study

    PubMed Central

    2017-01-01

    Purpose To retrospectively evaluate the relationship between the vertical position of the implant-abutment interface and marginal bone loss over 3 years using radiological analysis. Methods In total, 286 implant surfaces of 143 implants from 61 patients were analyzed. Panoramic radiographic images were taken immediately after implant installation and at 6, 12, and 36 months after loading. The implants were classified into 3 groups based on the vertical position of the implant-abutment interface: group A (above bone level), group B (at bone level), and group C (below bone level). The radiographs were analyzed by a single examiner. Results Changes in marginal bone levels of 0.99±1.45, 1.13±0.91, and 1.76±0.78 mm were observed at 36 months after loading in groups A, B, and C, respectively, and bone loss was significantly greater in group C than in groups A and B. Conclusions The vertical position of the implant-abutment interface may affect marginal bone level change. Marginal bone loss was significantly greater in cases where the implant-abutment interface was positioned below the marginal bone. Further long-term study is required to validate our results. PMID:28861287

  20. In vitro marginal fit of three all-ceramic crown systems.

    PubMed

    Yeo, In-Sung; Yang, Jae-Ho; Lee, Jai-Bong

    2003-11-01

    Studies on marginal discrepancies of single restorations using various systems and materials have resulted in statistical inferences that are ambiguous because of small sample sizes and limited numbers of measurements per specimen. The purpose of this study was to compare the marginal adaptation of single anterior restorations made using different systems. The in vitro marginal discrepancies of 3 different all-ceramic crown systems (Celay In-Ceram, conventional In-Ceram, and IPS Empress 2 layering technique), and a control group of metal ceramic restorations were evaluated and compared by measuring the gap dimension between the crowns and the prepared tooth at the marginal opening. The crowns were made for 1 extracted maxillary central incisor prepared with a 1-mm shoulder margin and 6-degree tapered walls by milling. Thirty crowns per system were fabricated. Crown measurements were recorded with an optical microscope, with an accuracy of +/-0.1 microm, at 50 points spaced approximately 400 microm along the circumferential margin. The criterion of 120 microm was used as the maximum clinically acceptable marginal gap. Mean gap dimensions and standard deviations were calculated for marginal opening. The data were analyzed with a 1-way analysis of variance (alpha=.05). Mean gap dimensions and standard deviations at the marginal opening for the incisor crowns were 87 +/- 34 microm for control, 83 +/- 33 microm for Celay In-Ceram, 112 +/- 55 microm for conventional In-Ceram, and 46 +/- 16 microm for the IPS Empress 2 layering technique. Significant differences were found among the crown groups (P<.05). Compared with the control group, the IPS Empress 2 group had significantly smaller marginal discrepancies (P<.05), and the conventional In-Ceram group exhibited significantly greater marginal discrepancies (P<.05). There was no significant difference between the Celay In-Ceram and the control group. Within the limitations of this study, the marginal discrepancies were all within the clinically acceptable standard set at 120 microm. However, the IPS Empress 2 system showed the smallest and most homogeneous gap dimension, whereas the conventional In-Ceram system presented the largest and more variable gap dimension compared with the metal ceramic (control) restoration.

  1. The Effect of Sintering Time on the Marginal Fit of Zirconia Copings.

    PubMed

    Khaledi, Amir Ali Reza; Vojdani, Mahroo; Farzin, Mitra; Pirouzi, Sudabeh; Orandi, Sepideh

    2018-01-03

    This study analyzed the effect of different sintering times on the marginal adaptation of zirconia ceramic copings. Thirty copings of pre-sintered 3Y-TZP blanks were milled and subsequently sintered in a special furnace for three different durations (n = 10 per group). The sintering time was 1 hour, 15 minutes for IPS e.max ZirCAD, 4 hours 20 minutes for Speed ZrO 2, and 7 hours 20 minutes for the conventional ZrO 2 group. The marginal gaps of specimens were measured at 18 spots on the master die by employing a digital microscope. One-way ANOVA test compared the mean differences among the 3 groups (α = 0.05). The mean values for the marginal gap of the IPS e.max ZirCAD, Speed ZrO 2 , and conventional ZrO 2 groups were 41.06 ± 14.03, 43.03 ± 11.67, and 39.88 ± 15.23 μm, respectively. There was no statistically significant difference among the groups regarding the marginal gap. Different sintering times did not alter the marginal fit of the zirconia copings. The mean values of the marginal gap were within the clinically acceptable level for all three groups. © 2018 by the American College of Prosthodontists.

  2. Effect of cement space on the marginal fit of CAD-CAM-fabricated monolithic zirconia crowns.

    PubMed

    Kale, Ediz; Seker, Emre; Yilmaz, Burak; Özcelik, Tuncer Burak

    2016-12-01

    Monolithic zirconia crowns fabricated with computer-aided design and computer-aided manufacturing (CAD-CAM) have recently become a common practice for the restoration of posterior teeth. The marginal fit of monolithic zirconia crowns may be affected by different cement space parameters set in the CAD software. Information is scarce regarding the effect of cement space on the marginal fit of monolithic zirconia crowns fabricated with CAD-CAM technology. The purpose of this in vitro study was to evaluate the effect of cement space on the marginal fit of CAD-CAM-fabricated monolithic zirconia crowns before cementation. Fifteen right maxillary first molar typodont teeth with standardized anatomic preparations for complete-coverage ceramic crowns were scanned with a 3-dimensional laboratory scanner. Crowns were designed 3-dimensionally using software and then milled from presintered monolithic zirconia blocks in a computer numerical control dental milling machine. The cement space was set at 25 μm around the margins for all groups, and additional cement space starting 1 mm above the finish lines of the teeth was set at 30 μm for group 25-30, 40 μm for group 25-40, and 50 μm for group 25-50 in the CAD software. A total of 120 images (3 groups, 5 crowns per group, 8 sites per crown) were measured for vertical marginal discrepancy under a stereoscopic zoom microscope and the data were statistically analyzed with 1-way analysis of variance, followed by the Tukey honestly significant difference test (α=.05). The results showed that different cement space values had statistically significant effect on the mean vertical marginal discrepancy value of tested crowns (P<.001). The mean marginal discrepancy was 85 μm for group 25-30, 68 μm for group 25-40, and 53 μm for group 25-50. Within the limitations of this in vitro study, it was concluded that the cement space had a significant effect on the marginal fit of CAD-CAM-fabricated monolithic zirconia crowns. The marginal fit improved as the cement space decreased. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  3. Microleakage of class V resin composite restorations after bur, air-abrasion or Er:YAG laser preparation.

    PubMed

    Corona, S A; Borsatto, M; Dibb, R G; Ramos, R P; Brugnera, A; Pécora, J D

    2001-01-01

    This in vitro study compared the microleakage of Class V resin composite restorations placed in cavities prepared with a high-speed dental bur, air-abrasion or Er:YAG laser. Twenty sound extracted human third molars were selected and randomly assigned to four equal Groups (n=10): Group I, cavities were cut by dental drill at high-speed; Group II, aluminum oxide air-abrasion was used for cavity preparation, and in Groups III and IV, cavities were prepared by Er:YAG laser. Following cavity preparation, Groups I and II were acid-etched, Group III was treated only by Er:YAG laser and Group IV was conditioned by Er:YAG laser followed by acid-etching. Cavities were restored (Single Bond + Z-100) and the teeth stored for seven days in distilled water. Then, the restorations were polished and the specimens thermocycled, immersed in a 0.2% Rhodamine solution, sectioned and analyzed for leakage at the occlusal (enamel) and cervical (dentin/cementum) interfaces using an optical microscope connected to a video camera. The images were digitized and software was utilized for microleakage assessment. Upon analyzing the results, statistically significant differences (p<0.01) between the occlusal and cervical regions for all groups was observed, and, as a rule, there was better marginal sealing at the enamel margins. The highest degree of infiltration was observed for cavities prepared and treated exclusively by Er:YAG (Group III). The other experimental groups showed statistical similarities in the amount of marginal leakage at the enamel margins. However, at the cervical margins, there was a significant difference (p<0.05) between Group I and the remaining groups. None of the techniques completely eliminated marginal microleakage at the dentin/ cementum margins.

  4. Acculturation styles and their associations with psychiatric symptoms and quality of life in ethnic minorities with schizophrenia.

    PubMed

    Weisman de Mamani, Amy; Weintraub, Marc J; Maura, Jessica; Martinez de Andino, Ana; Brown, Caitlin A; Gurak, Kayla

    2017-09-01

    This study examined whether Berry's model of acculturative stress would predict psychiatric symptom severity and quality of life (QoL) in ethnic minorities with schizophrenia. Tested extensively in non-psychiatric populations, Berry's framework generally suggests that integration, or engagement with both the host and minority culture, is most adaptive. Using the Abbreviated Multidimensional Acculturation Scale (AMAS), we tested the hypothesis that individuals with schizophrenia who employed an integrative acculturation strategy would have the highest QoL and lowest symptom severity, followed by the assimilation and enculturation groups, then the marginalized group. Psychiatric symptoms and QoL were regressed on AMAS assimilation scores, enculturation scores, and the interaction term in a sample of 128 Hispanic and Blacks with schizophrenia (M age = 41.28; 70% male). Acculturation strategy was not found to relate to psychiatric symptoms (measured from the Brief Psychiatric Rating Scale). However, acculturation strategy did predict QoL (measured from the Quality of Life Inventory), and results were in line with Berry's model. Marginalization may exacerbate issues surrounding social identity in schizophrenia, including low self-concept clarity and internalized stigma. Encouraging bicultural individuals with schizophrenia to interact with the host culture while also practicing traditions from their minority culture may help improve their quality of life. Copyright © 2017. Published by Elsevier B.V.

  5. Clinical usefulness of extending the proximal margin in total gastrectomies for gastric adenocarcinoma.

    PubMed

    Clemente-Gutiérrez, U; Sánchez-Morales, G; Santes, O; Medina-Franco, H

    2018-05-09

    Surgical resection with negative margins is part of the curative treatment of gastric adenocarcinoma. Positive surgical margins are associated with worse outcome. The aim of the present study was to determine the clinical usefulness of extending the proximal surgical margin in patients undergoing total gastrectomy for gastric adenocarcinoma. A retrospective analysis of patients that underwent total gastrectomy within the time frame of 2002 and 2017 was conducted. Patients diagnosed with adenocarcinoma that underwent curative surgery were included. Patients were divided into three groups, depending on proximal surgical margin status: negative margin (R0), positive margin with additional resection to achieve negative margin (R1-R0), and positive margin (R1). Demographic and clinical variables were analyzed. The outcome measures to evaluate were recurrence, disease-free survival, and overall survival. Forty-eight patients were included in the study. Thirty-seven were classified as R0, 9 as R1-R0, and 2 as R1. Fifty-two percent of the patients had clinical stage III disease. The overall surgical mortality rate was 2% and the morbidity rate was higher than 29%. The local recurrence rate was 0% in the R1-R0 group vs. 50% in the R1 group (p = 0.02). Disease-free survival was 49 months in the R1-R0 group vs. 32 months in the R1 group (p = 0.6). Overall survival was 51 months for the R1-R0 group vs. 35 months for the R1 group (p = 0.5). Intraoperative extension of the positive surgical margin improved the local recurrence rate but was not associated with improvement in overall survival or disease-free survival and could possibly increase postoperative morbidity. Copyright © 2018 Asociación Mexicana de Gastroenterología. Publicado por Masson Doyma México S.A. All rights reserved.

  6. Beyond Diversity as Usual: Expanding Critical Cultural Approaches to Marginalization in Engineering Education

    ERIC Educational Resources Information Center

    Secules, Stephen

    2017-01-01

    In general, what we think of as "diversity work" in undergraduate engineering education focuses in the following ways: more on the overlooked assets of minority groups than on the acts of overlooking, more on the experiences of marginalized groups than on the mechanisms of marginalization by dominant groups, more on supporting and…

  7. A Systematic Review of Training Interventions Addressing Sexual Violence against Marginalized At-Risk Groups of Women

    ERIC Educational Resources Information Center

    Kouta, Christiana; Pithara, Christalla; Zobnina, Anna; Apostolidou, Zoe; Christodoulou, Josie; Papadakaki, Maria; Chliaoutakis, Joannes

    2015-01-01

    Women from marginalized groups working in occupations such as domestic work are at increased risk for sexual violence. Scarce evidence exists about training interventions targeting such groups. The article aims to identify community and workplace-based training interventions aiming to increase capacity among marginalized at-risk women to deal with…

  8. Lateral view dissection of the prostato-urethral junction to reduce positive apical margin in laparoscopic radical prostatectomy.

    PubMed

    Sasaki, Hiroshi; Miki, Jun; Kimura, Takahiro; Sanuki, Kunitaro; Miki, Kenta; Takahashi, Hiroyuki; Egawa, Shin

    2009-08-01

    To assess the impact of lateral view apical dissection in laparoscopic radical prostatectomy (LRP) on the reduction of positive surgical margin rates and recovery of postoperative continence. One hundred and forty-four consecutive patients underwent LRP from October 2004 to March 2008. Lateral view dissection of the prostato-urethral junction was conducted in 76 of them (Group 2). Standard dissection was used in the remaining patients (Group 1). The effect of this technical modification on the reduction of positive surgical margin rates and postoperative recovery of urinary continence was assessed in the two groups. Overall, the incidence of positive margins decreased from 23 (35.9%) in Group 1 to 16 cases (21.9%) in Group 2 (P = 0.07). Positive margin rates in pT2 decreased from 30.6% to 6.5% (P = 0.006). Apical and dorso-apical margins were reduced from 26.5% to 4.3% (P = 0.009) and from 10.2% to 0% (P < 0.001), respectively. Postoperative recovery of urinary continence improved significantly, with a pad-free rate over the first 3 months of 55.9% in Group 1 vs 71.7% in Group 2 (P = 0.01). Multivariate logistic regression analysis showed this modified surgical technique to predict a lower rate of positive margins. Lateral view dissection of the prostato-urethral junction is an easily applicable technical modification. It provides better visualization of apical anatomy substantially contributing to the reduction of positive surgical margin rates, especially at the level of prostatic apex.

  9. Voices of the poor from the margins of Bengal: structural inequities and health.

    PubMed

    Dutta, Mohan J; Dutta, Uttaran

    2013-01-01

    In opposition to the traditional approaches to health communication that treat the subaltern sectors as passive recipients of messages of enlightenment configured in top-down interventions, the culture-centered approach foregrounds the importance of listening to subaltern communities at the margins through dialogue. We build on earlier culture-centered projects in rural communities of West Bengal, India, to develop participatory research strategies for understanding the local processes through which the structural marginalization of the poor plays out in rural Bengal. Study results point toward the marginalization of the poor both communicatively and economically, attending to the ways in which communicative marginalization lies at the heart of economic oppressions. Through locally articulated concepts of "health as shortage" and "communication as shortage," community members put forth alternative rationalities of health that highlight structural resources at the heart of health. These local articulations of shortage offer an alternative rationality for organizing health promotion efforts in the rural margins of Bengal through the foregrounding of discourses of shortage.

  10. The use and abuse of religious beliefs in dividing and conquering between socially marginalized groups: the same-sex marriage debate.

    PubMed

    Greene, Beverly

    2009-11-01

    This article discusses the use and abuse of religious beliefs and their role in divide-and-conquer strategies. Divide-and-conquer strategies are engaged to disrupt potential coalitions between and among marginalized group members, specifically sexual minority groups and people of color. Tensions between these groups have been exacerbated by the debate on same-sex marriage and comparisons between the discriminatory treatment of each group. A component of this discussion includes a brief exploration of one of the historical abuses of religious doctrine used to legitimize the marginalization of people of color and sexual minorities in the United States. For African Americans, one form of marginalization was reflected in criminalizing interracial marriage, and for members of sexual minority groups, a form of marginalization is denying group members the right to marry. The author also explores culturally competent and respectful disciplinary and clinical responses to religiously derived prejudice against sexual minority group members and people of color and discusses the implications for multicultural discourse. Copyright 2009 by the American Psychological Association

  11. Network Approaches to Substance Use and HIV/Hepatitis C Risk among Homeless Youth and Adult Women in the United States: A Review

    PubMed Central

    Dombrowski, Kirk; Sittner, Kelley; Crawford, Devan; Welch-Lazoritz, Melissa; Habecker, Patrick; Khan, Bilal

    2016-01-01

    During the United States economic recession of 2008–2011, the number of homeless and unstably housed people in the United States increased considerably. Homeless adult women and unaccompanied homeless youth make up the most marginal segments of this population. Because homeless individuals are a hard to reach population, research into these marginal groups has traditionally been a challenge for researchers interested in substance abuse and mental health. Network analysis techniques and research strategies offer means for dealing with traditional challenges such as missing sampling frames, variation in definitions of homelessness and study inclusion criteria, and enumeration/population estimation procedures. This review focuses on the need for, and recent steps toward, solutions to these problems that involve network science strategies for data collection and analysis. Research from a range of fields is reviewed and organized according to a new stress process framework aimed at understanding how homeless status interacts with issues related to substance abuse and mental health. Three types of network innovation are discussed: network scale-up methods, a network ecology approach to social resources, and the integration of network variables into the proposed stress process model of homeless substance abuse and mental health. By employing network methods and integrating these methods into existing models, research on homeless and unstably housed women and unaccompanied young people can address existing research challenges and promote more effective intervention and care programs. PMID:28042394

  12. Network Approaches to Substance Use and HIV/Hepatitis C Risk among Homeless Youth and Adult Women in the United States: A Review.

    PubMed

    Dombrowski, Kirk; Sittner, Kelley; Crawford, Devan; Welch-Lazoritz, Melissa; Habecker, Patrick; Khan, Bilal

    2016-09-01

    During the United States economic recession of 2008-2011, the number of homeless and unstably housed people in the United States increased considerably. Homeless adult women and unaccompanied homeless youth make up the most marginal segments of this population. Because homeless individuals are a hard to reach population, research into these marginal groups has traditionally been a challenge for researchers interested in substance abuse and mental health. Network analysis techniques and research strategies offer means for dealing with traditional challenges such as missing sampling frames, variation in definitions of homelessness and study inclusion criteria, and enumeration/population estimation procedures. This review focuses on the need for, and recent steps toward, solutions to these problems that involve network science strategies for data collection and analysis. Research from a range of fields is reviewed and organized according to a new stress process framework aimed at understanding how homeless status interacts with issues related to substance abuse and mental health. Three types of network innovation are discussed: network scale-up methods, a network ecology approach to social resources, and the integration of network variables into the proposed stress process model of homeless substance abuse and mental health. By employing network methods and integrating these methods into existing models, research on homeless and unstably housed women and unaccompanied young people can address existing research challenges and promote more effective intervention and care programs.

  13. Comparison of marginal and internal adaptation of copings fabricated from three different fabrication techniques: An in vitro study.

    PubMed

    Arora, Aman; Yadav, Avneet; Upadhyaya, Viram; Jain, Prachi; Verma, Mrinalini

    2018-01-01

    The purpose of this study was to compare the marginal and internal adaptation of cobalt-chromium (Co-Cr) copings fabricated from conventional wax pattern, three-dimensional (3D)-printed resin pattern, and laser sintering technique. A total of thirty copings were made, out of which ten copings were made from 3D-printed resin pattern (Group A), ten from inlay wax pattern (Group B), and ten copings were obtained from direct metal laser sintering (DMLS) technique (Group C). All the thirty samples were seated on their respective dies and sectioned carefully using a laser jet cutter and were evaluated for marginal and internal gaps at the predetermined areas using a stereomicroscope. The values were then analyzed using one-way ANOVA test and post hoc Bonferroni test. One-way ANOVA showed lowest mean marginal discrepancy for DMLS and highest value for copings fabricated from inlay wax. The values for internal discrepancy were highest for DMLS (169.38) and lowest for 3D-printed resin pattern fabricated copings (133.87). Post hoc Bonferroni test for both marginal and internal discrepancies showed nonsignificant difference when Group A was compared to Group B ( P > 0.05) and significant when Group A was compared with Group C ( P < 0.05). Group B showed significant difference ( P < 0.05) when compared with Group C. Marginal and internal discrepancies of all the three casting techniques were within clinically acceptable values. Marginal fit of DMLS was superior as compared to other two techniques, whereas when internal fit was evaluated, conventional technique showed the best internal fit.

  14. Marginal bone loss around non-submerged implants is associated with salivary microbiome during bone healing.

    PubMed

    Duan, Xiao-Bo; Wu, Ting-Xi; Guo, Yu-Chen; Zhou, Xue-Dong; Lei, Yi-Ling; Xu, Xin; Mo, An-Chun; Wang, Yong-Yue; Yuan, Quan

    2017-06-01

    Marginal bone loss during bone healing exists around non-submerged dental implants. The aim of this study was to identify the relationship between different degrees of marginal bone loss during bone healing and the salivary microbiome. One hundred patients were recruited, and marginal bone loss around their implants was measured using cone beam computed tomography during a 3-month healing period. The patients were divided into three groups according to the severity of marginal bone loss. Saliva samples were collected from all subjected and were analysed using 16S MiSeq sequencing. Although the overall structure of the microbial community was not dramatically altered, the relative abundance of several taxonomic groups noticeably changed. The abundance of species in the phyla Spirochaeta and Synergistetes increased significantly as the bone loss became more severe. Species within the genus Treponema also exhibited increased abundance, whereas Veillonella, Haemophilus and Leptotrichia exhibited reduced abundances, in groups with more bone loss. Porphyromonasgingivalis, Treponemadenticola and Streptococcus intermedius were significantly more abundant in the moderate group and/or severe group. The severity of marginal bone loss around the non-submerged implant was associated with dissimilar taxonomic compositions. An increased severity of marginal bone loss was related to increased proportions of periodontal pathogenic species. These data suggest a potential role of microbes in the progression of marginal bone loss during bone healing.

  15. Enhancing the diversity of breeding invertebrates within field margins of intensively managed grassland: Effects of alternative management practices.

    PubMed

    Fritch, Rochelle A; Sheridan, Helen; Finn, John A; McCormack, Stephen; Ó hUallacháin, Daire

    2017-11-01

    Severe declines in biodiversity have been well documented for many taxonomic groups due to intensification of agricultural practices. Establishment and appropriate management of arable field margins can improve the diversity and abundance of invertebrate groups; however, there is much less research on field margins within grassland systems. Three grassland field margin treatments (fencing off the existing vegetation "fenced"; fencing with rotavation and natural regeneration "rotavated" and; fencing with rotavation and seeding "seeded") were compared to a grazed control in the adjacent intensively managed pasture. Invertebrates were sampled using emergence traps to investigate species breeding and overwintering within the margins. Using a manipulation experiment, we tested whether the removal of grazing pressure and nutrient inputs would increase the abundance and richness of breeding invertebrates within grassland field margins. We also tested whether field margin establishment treatments, with their different vegetation communities, would change the abundance and richness of breeding invertebrates in the field margins. Exclusion of grazing and nutrient inputs led to increased abundance and richness in nearly all invertebrate groups that we sampled. However, there were more complex effects of field margin establishment treatment on the abundance and richness of invertebrate taxa. Each of the three establishment treatments supported a distinct invertebrate community. The removal of grazing from grassland field margins provided a greater range of overwintering/breeding habitat for invertebrates. We demonstrate the capacity of field margin establishment to increase the abundance and richness in nearly all invertebrate groups in study plots that were located on previously more depauperate areas of intensively managed grassland. These results from grassland field margins provide evidence to support practical actions that can inform Greening (Pillar 1) and agri-environment measures (Pillar 2) of the Common Agricultural Policy (CAP). Before implementing specific management regimes, the conservation aims of agri-environment measures should be clarified by defining the target species or taxonomic groups.

  16. Marginal Vertical Discrepancies of Monolithic and Veneered Zirconia and Metal-Ceramic Three-Unit Posterior Fixed Dental Prostheses.

    PubMed

    Lopez-Suarez, Carlos; Gonzalo, Esther; Pelaez, Jesus; Serrano, Benjamin; Suarez, Maria J

    2016-01-01

    The aim of this study was to investigate and compare the marginal fit of posterior fixed dental prostheses (FDPs) made of monolithic and veneered computer-aided design/computer-assisted manufacture (CAD/CAM) zirconia ceramic with metal-ceramic posterior FDPs. Thirty standardized steel dies were prepared to receive posterior three-unit FDPs. Specimens were randomly divided into three groups (n = 10): (1) metal-ceramic (control group), (2) veneered zirconia, and (3) monolithic zirconia. All FDPs were cemented using a glass-ionomer cement. The specimens were subjected to thermal cycling (5°C to 55°C). A scanning electron microscope (SEM) with a magnification of ×500 was used for measurements. The data were statistically analyzed using one-way analysis of variance and paired t test. Both zirconia groups showed similar vertical marginal discrepancies, and no significant differences (P = .661) in marginal adaptation were observed among the groups. No differences were observed in either group in marginal discrepancies between surfaces or abutments. Monolithic zirconia posterior FDPs exhibit similar vertical marginal discrepancies to veneered zirconia posterior FDPs. No influence of localization measurements was observed.

  17. Use of marginal grafts in deceased donor liver transplant: assessment of early outcomes.

    PubMed

    Godara, Rajesh; Naidu, C Sudeep; Rao, Pankaj P; Sharma, Sanjay; Banerjee, Jayant K; Saha, Anupam; Vijay, Kapileshwer

    2014-03-01

    Orthotopic liver transplantation has become a routinely applied therapy for an expanding group of patients with end-stage liver disease. Shortage of organs has led centers to expand their criteria for the acceptance of marginal donors. There is current debate about the regulation and results of liver transplantation using marginal grafts. The study included data of all patients who received deceased donor liver grafts between March 2007 to December 2011. Patients with acute liver failure, living donor transplantation, split liver transplantation, and retransplantation were excluded. Early allograft dysfunction, primary nonfunction, patient survival, and incidence of surgical complications were measured. A total of 33 patients were enrolled in this study. There were 20 marginal and 13 nonmarginal grafts. The two groups were well matched regarding age, sex and indication of liver transplantation, model for end-stage liver disease score, technique of transplant, requirement of vascular reconstruction, warm ischemia time, blood loss, mean operative time, etc. In our study, posttransplant peak level of liver enzymes, international normalization ratio, and bilirubin were not statistically significant in the marginal and nonmarginal group. Wound infection occurred in 10 % of marginal compared with 7.7 % of nonmarginal graft recipients (p > 0.05). In the marginal group, the incidences of vascular complications, hepatic artery thrombosis (four), and portal vein thrombosis (one) were not statistically significant compared to the nonmarginal group. Acute rejection was observed in a total of seven patients (21.2 %)-five (25 %) in the marginal group and two (15.4 %) in the nonmarginal graft recipients. Primary nonfunction occurred in three (9.1 %) patients-two (10 %) in the marginal and one (7.7 %) in the nonmarginal group. Average patient survival for the whole group was 91 % at 1 week, 87.8 % at 3 months, and 84.8 % at 6 months. Because organ scarcity persists, additional pressure will build to use a greater proportion of the existing donor pool. The study, although small, clearly indicates that marginal livers can assure a normal early functional recovery after transplantation.

  18. Psychoanalytic psychodrama in France and group elaboration of counter-transference: Therapeutic operators in play therapy.

    PubMed

    Blanc, Adrien; Boutinaud, Jérôme

    2017-06-01

    In France, psychoanalytic psychodrama is mainly envisioned in its individual form - that is, a single patient working with a group of therapists. Its originality consists in bringing together several clinicians within a clinical experience that is shared as a group. This experience is fundamentally different from traditional individual therapies, psychotherapies or group co-led therapies. Its configuration may be confusing or overwhelming due to the large number of co-therapists involved in the setting. However, thanks to group elaboration based on the transferential-countertransferential dynamics induced by the treated patient, this potential 'cacophony' can lead to fruitful psychic development embedded in play. This is tied to the co-therapists' positioning in the transitional space shared with the patient as well as to the patient's subjective appropriation of their initiatives. By reflecting on clinical material taken from actual sessions as well as from the exchanges and elaborations occurring at their margins, this article shows how psychodrama and group come to metabolize the transferential elements, shaping the engagement of participants in the context of improvised play. Copyright © 2016 Institute of Psychoanalysis.

  19. Presurgical mapping of basal cell carcinoma or squamous cell carcinoma by confocal laser endomicroscopy compared to traditional micrographic surgery: a single-centre prospective feasibility study.

    PubMed

    Schulz, Alexandra; Daali, Samira; Javed, Mehreen; Fuchs, Paul Christian; Brockmann, Michael; Igressa, Alhadi; Charalampaki, Patra

    2016-12-01

    At present, no ideal diagnostic tools exist in the market to excise cancer tissue with the required safety margins and to achieve optimal aesthetic results using tissue-conserving techniques. In this prospective study, confocal laser endomicroscopy (CLE) and the traditional gold standard of magnifying glasses (MG) were compared regarding the boundaries of in vivo basal cell carcinoma and squamous cell carcinoma. Tumour diameters defined by both methods were measured and compared with those determined by histopathological examination. Nineteen patients were included in the study. The CLE technique was found to be superior to excisional margins based on MG only. Re-excision was required in 68% of the cases following excision based on MG evaluation, but only in 27% of the cases for whom excision margins were based on CLE. Our results are promising regarding the distinction between tumour and healthy surrounding tissue, and indicate that presurgical mapping of basal cell carcinoma and squamous cell carcinoma is possible. The tool itself should be developed further with special attention to early detection of skin cancer.

  20. Marginal fit of all-ceramic crowns fabricated using two extraoral CAD/CAM systems in comparison with the conventional technique.

    PubMed

    Alqahtani, Fawaz

    2017-01-01

    The purpose of this study was to determine the effect of two extraoral computer-aided design (CAD) and computer-aided manufacturing (CAM) systems, in comparison with conventional techniques, on the marginal fit of monolithic CAD/CAM lithium disilicate ceramic crowns. This is an in vitro interventional study. The study was carried out at the Department of Prosthodontics, School of Dentistry, Prince Sattam Bin Abdul-Aziz University, Saudi Arabia, from December 2015 to April 2016. A marginal gap of 60 lithium disilicate crowns was evaluated by scanning electron microscopy. In total, 20 pressable lithium disilicate (IPS e.max Press [Ivoclar Vivadent]) ceramic crowns were fabricated using the conventional lost-wax technique as a control group. The experimental all-ceramic crowns were produced based on a scan stone model and milled using two extraoral CAD/CAM systems: the Cerec group was fabricated using the Cerec CAD/CAM system, and the Trios group was fabricated using Trios CAD and milled using Wieland Zenotec CAM. One-way analysis of variance (ANOVA) and the Scheffe post hoc test were used for statistical comparison of the groups (α=0.05). The mean (±standard deviation) of the marginal gap of each group was as follows: the Control group was 91.15 (±15.35) µm, the Cerec group was 111.07 (±6.33) µm, and the Trios group was 60.17 (±11.09) µm. One-way ANOVA and the Scheffe post hoc test showed a statistically significant difference in the marginal gap between all groups. It can be concluded from the current study that all-ceramic crowns, fabricated using the CAD/CAM system, show a marginal accuracy that is acceptable in clinical environments. The Trios CAD group displayed the smallest marginal gap.

  1. Minimum Abutment Height to Eliminate Bone Loss: Influence of Implant Neck Design and Platform Switching.

    PubMed

    Spinato, Sergio; Galindo-Moreno, Pablo; Bernardello, Fabio; Zaffe, Davide

    This retrospective study quantitatively analyzed the minimum prosthetic abutment height to eliminate bone loss after 4.7-mm-diameter implant placement in maxillary bone and how grafting techniques can affect the marginal bone loss in implants placed in maxillary areas. Two different implant types with a similar neck design were singularly placed in two groups of patients: the test group, with platform-switched implants, and the control group, with conventional (non-platform-switched) implants. Patients requiring bone augmentation underwent unilateral sinus augmentation using a transcrestal technique with mineralized xenograft. Radiographs were taken immediately after implant placement, after delivery of the prosthetic restoration, and after 12 months of loading. The average mesial and distal marginal bone loss of the control group (25 patients) was significantly more than twice that of the test group (26 patients), while their average abutment height was similar. Linear regression analysis highlighted a statistically significant inverse relationship between marginal bone loss and abutment height in both groups; however, the intercept of the regression line, both mesially and distally, was 50% lower for the test group than for the control group. The marginal bone loss was annulled with an abutment height of 2.5 mm for the test group and 3.0 mm for the control group. No statistically significant differences were found regarding marginal bone loss of implants placed in native maxillary bone compared with those placed in the grafted areas. The results suggest that the shorter the abutment height, the greater the marginal bone loss in cement-retained prostheses. Abutment height showed a greater influence in platform-switched than in non-platform-switched implants on the limitation of marginal bone loss.

  2. Comparison of the marginal adaptation of direct and indirect composite inlay restorations with optical coherence tomography.

    PubMed

    Türk, Ayşe Gözde; Sabuncu, Metin; Ünal, Sena; Önal, Banu; Ulusoy, Mübin

    2016-01-01

    The purpose of the study was to use the photonic imaging modality of optical coherence tomography (OCT) to compare the marginal adaptation of composite inlays fabricated by direct and indirect techniques. Class II cavities were prepared on 34 extracted human molar teeth. The cavities were randomly divided into two groups according to the inlay fabrication technique. The first group was directly restored on cavities with a composite (Esthet X HD, Dentsply, Germany) after isolating. The second group was indirectly restored with the same composite material. Marginal adaptations were scanned before cementation with an invisible infrared light beam of OCT (Thorlabs), allowing measurement in 200 µm intervals. Restorations were cemented with a self-adhesive cement resin (SmartCem2, Dentsply), and then marginal adaptations were again measured with OCT. Mean values were statistically compared by using independent-samples t-test and paired samples t-test (p<0.05), before and after cementation. Direct inlays presented statistically smaller marginal discrepancy values than indirect inlays, before (p=0.00001442) and after (p=0.00001466) cementation. Marginal discrepancy values were increased for all restorations after cementation (p=0.00008839, p=0.000000952 for direct and indirect inlays, respectively). The mean marginal discrepancy value of the direct group increased from 56.88±20.04 µm to 91.88±31.7 µm, whereas the indirect group increased from 107.54±35.63 µm to 170.29±54.83 µm. Different techniques are available to detect marginal adaptation of restorations, but the OCT system can give quantitative information about resin cement thickness and its interaction between tooth and restoration in a nondestructive manner. Direct inlays presented smaller marginal discrepancy than indirect inlays. The marginal discrepancy values were increased for all restorations that refer to cement thickness after cementation.

  3. The Effect of Casting Ring Liner Length and Prewetting on the Marginal Adaptation and Dimensional Accuracy of Full Crown Castings.

    PubMed

    Haralur, Satheesh B; Hamdi, Osama A; Al-Shahrani, Abdulaziz A; Alhasaniah, Sultan

    2017-01-01

    To evaluate the effect of varying cellulose casting ring liner length and its prewetting on the marginal adaptation and dimensional accuracy of full veneer metal castings. The master die was milled in stainless steel to fabricate the wax pattern. Sixty wax patterns were fabricated with a uniform thickness of 1.5 mm at an occlusal surface and 1 mm axial surface, cervical width at 13.5 mm, and 10 mm cuspal height. The samples were divided into six groups ( n = 10). Groups I and II samples had the full-length cellulose prewet and dry ring liner, respectively. The groups III and IV had 2 mm short prewet and dry cellulose ring liner, respectively, whereas groups V and VI were invested in 6 mm short ring liner. The wax patterns were immediately invested in phosphate bonded investment, and casting procedure was completed with nickel-chrome alloy. The castings were cleaned and mean score of measurements at four reference points for marginal adaption, casting height, and cervical width was calculated. The marginal adaption was calculated with Imaje J software, whereas the casting height and cervical width was determined using a digital scale. The data was subjected to one-way analysis of varaince and Tukey post hoc statistical analysis with Statistical Package for the Social Sciences version 20 software. The group II had the best marginal adaption with a gap of 63.786 μm followed by group I (65.185 μm), group IV (87.740 μm), and group III (101.455 μm). A large marginal gap was observed in group V at 188.871 μm. Cuspal height was more accurate with group V (10.428 mm), group VI (10.421 mm), and group II (10.488 mm). The cervical width was approximately similar in group I, group III, and group V. Statistically significant difference was observed in Tukey post hoc analysis between group V and group VI with all the other groups with regards to marginal adaptation. The dry cellulose ring liners provided better marginal adaptation in comparison to prewet cellulose ring liners. Accurate cuspal height was obtained with shorter ring liner in comparison to full-length cellulose ring liners.

  4. The Effect of Casting Ring Liner Length and Prewetting on the Marginal Adaptation and Dimensional Accuracy of Full Crown Castings

    PubMed Central

    Haralur, Satheesh B.; Hamdi, Osama A.; Al-Shahrani, Abdulaziz A.; Alhasaniah, Sultan

    2017-01-01

    Aim: To evaluate the effect of varying cellulose casting ring liner length and its prewetting on the marginal adaptation and dimensional accuracy of full veneer metal castings. Materials and Methods: The master die was milled in stainless steel to fabricate the wax pattern. Sixty wax patterns were fabricated with a uniform thickness of 1.5 mm at an occlusal surface and 1 mm axial surface, cervical width at 13.5 mm, and 10 mm cuspal height. The samples were divided into six groups (n = 10). Groups I and II samples had the full-length cellulose prewet and dry ring liner, respectively. The groups III and IV had 2 mm short prewet and dry cellulose ring liner, respectively, whereas groups V and VI were invested in 6 mm short ring liner. The wax patterns were immediately invested in phosphate bonded investment, and casting procedure was completed with nickel-chrome alloy. The castings were cleaned and mean score of measurements at four reference points for marginal adaption, casting height, and cervical width was calculated. The marginal adaption was calculated with Imaje J software, whereas the casting height and cervical width was determined using a digital scale. The data was subjected to one-way analysis of varaince and Tukey post hoc statistical analysis with Statistical Package for the Social Sciences version 20 software. Results: The group II had the best marginal adaption with a gap of 63.786 μm followed by group I (65.185 μm), group IV (87.740 μm), and group III (101.455 μm). A large marginal gap was observed in group V at 188.871 μm. Cuspal height was more accurate with group V (10.428 mm), group VI (10.421 mm), and group II (10.488 mm). The cervical width was approximately similar in group I, group III, and group V. Statistically significant difference was observed in Tukey post hoc analysis between group V and group VI with all the other groups with regards to marginal adaptation. Conclusion: The dry cellulose ring liners provided better marginal adaptation in comparison to prewet cellulose ring liners. Accurate cuspal height was obtained with shorter ring liner in comparison to full-length cellulose ring liners. PMID:28316950

  5. Deep Marginalized Sparse Denoising Auto-Encoder for Image Denoising

    NASA Astrophysics Data System (ADS)

    Ma, Hongqiang; Ma, Shiping; Xu, Yuelei; Zhu, Mingming

    2018-01-01

    Stacked Sparse Denoising Auto-Encoder (SSDA) has been successfully applied to image denoising. As a deep network, the SSDA network with powerful data feature learning ability is superior to the traditional image denoising algorithms. However, the algorithm has high computational complexity and slow convergence rate in the training. To address this limitation, we present a method of image denoising based on Deep Marginalized Sparse Denoising Auto-Encoder (DMSDA). The loss function of Sparse Denoising Auto-Encoder is marginalized so that it satisfies both sparseness and marginality. The experimental results show that the proposed algorithm can not only outperform SSDA in the convergence speed and training time, but also has better denoising performance than the current excellent denoising algorithms, including both the subjective and objective evaluation of image denoising.

  6. Influence of coping design on the cervical color of ceramic crowns.

    PubMed

    Paniz, Gianluca; Kang, Ki-Ho; Kim, Yongjeong; Kumagai, Naota; Hirayama, Hiroshi

    2013-12-01

    The replication of natural teeth, especially with single-tooth restorations, represents a challenge. Similar to metal ceramic crowns, different designs of zirconia substructures have been suggested to improve the esthetic results of zirconia ceramic crowns. The purpose of the study was to analyze the color of the cervical portion of single zirconia ceramic crowns fabricated with different zirconia coping designs. The color, measured on the CIELAB color scale, of 3 different groups of restorations (n=10) fabricated with zirconia coping (Lava) and feldspathic porcelain (Noritake Super Porcelain) was analyzed with a spectrophotometer. Conventional zirconia crowns with zirconia facial margins were compared with ceramic crowns with porcelain facial margins and either a horizontal reduction of the zirconia coping (1.0 mm reduction) or an additional vertical reduction (1.0 mm additional reduction). The 3 groups, each with a different coping extension, were examined with a 1-way ANOVA and the Fisher exact test, and the differences of the groups were evaluated by applying ΔE thresholds (α=.05). The mean color difference among all the groups was not clinically significant (ΔE<3.7). Reduced color differences were present between the 2 porcelain butt margin groups of crowns (ΔE=1.06, between group H and V). Increased differences were present between the zirconia margin group and the porcelain butt margin group (ΔE=2.54 between group C and H; ΔE=2.41 between group C and V). Lab* values were examined in all the groups of crowns to determine the clinical implications. Within the limitation of the study, no significant differences were present among the tested groups of crowns. Nevertheless, although some differences were present between the zirconia margin group and the porcelain butt margin group, reduced differences were present between the 2 different cutback designs. Copyright © 2013 Editorial Council for the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.

  7. A novel double fine guide sensor design on space telescope

    NASA Astrophysics Data System (ADS)

    Zhang, Xu-xu; Yin, Da-yi

    2018-02-01

    To get high precision attitude for space telescope, a double marginal FOV (field of view) FGS (Fine Guide Sensor) is proposed. It is composed of two large area APS CMOS sensors and both share the same lens in main light of sight. More star vectors can be get by two FGS and be used for high precision attitude determination. To improve star identification speed, the vector cross product in inter-star angles for small marginal FOV different from traditional way is elaborated and parallel processing method is applied to pyramid algorithm. The star vectors from two sensors are then used to attitude fusion with traditional QUEST algorithm. The simulation results show that the system can get high accuracy three axis attitudes and the scheme is feasibility.

  8. Giardia muris and Giardia duodenalis groups: ultrastructural differences between the trophozoites.

    PubMed

    Sogayar, M I; Gregório, E A

    1989-01-01

    Trophozoites of the Giardia muris group from hamsters, domestic rats and mice and of the Giardia duodenalis group from hamsters and domestic rats were examined by transmission electron microscopy. The basic ultrastructure of the trophozoites was similar. Differences were shown in the morphology of the ventrolateral flange of the trophozoites of Giardia muris and Giardia duodenalis groups. Marginal plates are less developed in the species of the Giardia duodenalis group. In this group, the distal extremity of the lateral flange is short and thick and the marginal plate does not penetrate into the distal extremity of the flange. In the Giardia muris group, the ventro-lateral flange is well developed and narrow and the marginal plate penetrates the distal extremity of the flange. The osmiophilic lamella, which accompanies the dorsal surface of the marginal plate is seen only in the Giardia muris group.

  9. The influence of FRCs reinforcement on marginal adaptation of CAD/CAM composite resin endocrowns after simulated fatigue loading.

    PubMed

    Rocca, Giovanni Tommaso; Saratti, Carlo Massimo; Poncet, Antoine; Feilzer, Albert J; Krejci, Ivo

    2016-05-01

    To evaluate the marginal adaptation of endodontically treated molars restored with CAD/CAM composite resin endocrowns either with or without reinforcement by fibre reinforced composites (FRCs), used in different configurations. 32 human endodontically treated molars were cut 2 mm over the CEJ. Two interproximal boxes were created with the margins located 1 mm below the CEJ (distal box) and 1 mm over the CEJ (mesial box). All specimens were divided in four groups (n = 8). The pulp chamber was filled with: group 1 (control), hybrid resin composite (G-aenial Posterior, GC); group 2, as group 1 but covered by 3 meshes of E-glass fibres (EverStick NET, Stick Tech); group 3, FRC resin (EverX Posterior, GC); group 4, as group 3 but covered by 3 meshes of E-glass fibres. The crowns of all teeth were restored with CAD/CAM composite resin endocrowns (LAVA Ultimate, 3M). All specimens were thermo-mechanically loaded in a computer-controlled chewing machine (600,000 cycles, 1.6 Hz, 49 N and simultaneously 1500 thermo-cycles, 60 s, 5-55 °C). Marginal analysis before and after the loading was carried out on epoxy replicas by SEM at 200× magnification. For all the groups, the percentage values of perfect marginal adaptation after loading were always significantly lower than before loading (p < 0.05). The marginal adaptation before and after loading was not significantly different between the experimental groups (p > 0.05). Within the limitations of this in vitro study, the use of FRCs to reinforce the pulp chamber of devitalized molars restored with CAD/CAM composite resin restorations did not significantly influenced their marginal quality.

  10. The association between cultural orientation and drinking behaviors among university students in Wuhan, China.

    PubMed

    Tang, Hongxiu; Cai, Weibin; Wang, Hongjing; Zhang, Qing; Qian, Ling; Shell, Duane F; Newman, Ian M; Yin, Ping

    2013-01-01

    This study examines the association between cultural orientation and drinking behaviors among university students. Cultural orientation is the measure of how the cultural values of individuals living in their own society are influenced by cultural values introduced from the outside. In 2011, a cross-sectional survey collected data from 1279 university students from six universities in central China. Participants used a likert scale to rank a series of statements reflecting cultural values from the previously validated Chinese Cultural Orientation Scale and answered questions about their drinking behaviors and socio-demographic characteristics. Statistically significant differences in cultural orientation were observed for gender, hometown and type of university attendance. Traditional-oriented students were more likely to be occasional drinkers or nondrinkers, while marginal-oriented students, bicultural-oriented students and western-oriented students were more likely to be regular drinkers. Bicultural orientation (OR = 1.80, P<0.05) and marginal orientation (OR = 1.64, P<0.05) increased the likelihood of the student being regular drinking, compared to students with traditional orientations. Males (OR = 4.40, P<0.05) had a higher likelihood of regular drinking than females, graduate students (OR = 2.59, P<0.05) had a higher likelihood of regular drinking than undergraduates, students from urban areas (OR = 1.79, P<0.05) had a higher likelihood of regular drinking than those from towns/rural areas, and students attending key universities (OR = 0.48, P<0.05) had a lower likelihood of regular drinking than those attending general universities. Cultural orientation influences drinking behaviors. Traditional cultural orientation was associated with less drinking while western cultural orientation, marginal cultural orientation and bicultural orientation were associated with more drinking. The role of gender, hometown and university attendance is partially moderated through the influence of cultural orientation. The relationship between a traditional cultural orientation and alcohol drinking suggests that traditional Chinese cultural values should be examined for their role in possibly reducing alcohol-related risks through education and policy initiatives.

  11. Women, science and suffrage in World War I

    PubMed Central

    Fara, Patricia

    2015-01-01

    Oh! This War! How it is tearing down walls and barriers, and battering in fast shut doors …Women's Liberal Review, 1915World War I is often said to have benefited British women by giving them the vote and by enabling them to take on traditionally male roles, including ones in science, engineering and medicine. In reality, conventional hierarchies were rapidly re-established after the Armistice. Concentrating mainly on a small group of well-qualified scientific and medical women, marginalized at the time and also in the secondary literature, I review the attitudes they experienced and the work they undertook during and immediately after the war. The effects of century-old prejudices are still felt today. PMID:26489180

  12. Tumour border configuration in colorectal cancer: proposal for an alternative scoring system based on the percentage of infiltrating margin.

    PubMed

    Karamitopoulou, Eva; Zlobec, Inti; Koelzer, Viktor Hendrik; Langer, Rupert; Dawson, Heather; Lugli, Alessandro

    2015-10-01

    Information on tumour border configuration (TBC) in colorectal cancer (CRC) is currently not included in most pathology reports, owing to lack of reproducibility and/or established evaluation systems. The aim of this study was to investigate whether an alternative scoring system based on the percentage of the infiltrating component may represent a reliable method for assessing TBC. Two hundred and fifteen CRCs with complete clinicopathological data were evaluated by two independent observers, both 'traditionally' by assigning the tumours into pushing/infiltrating/mixed categories, and alternatively by scoring the percentage of infiltrating margin. With the pushing/infiltrating/mixed pattern method, interobserver agreement (IOA) was moderate (κ = 0.58), whereas with the percentage of infiltrating margins method, IOA was excellent (intraclass correlation coefficient of 0.86). A higher percentage of infiltrating margin correlated with adverse features such as higher grade (P = 0.0025), higher pT (P = 0.0007), pN (P = 0.0001) and pM classification (P = 0.0063), high-grade tumour budding (P < 0.0001), lymphatic invasion (P < 0.0001), vascular invasion (P = 0.0032), and shorter survival (P = 0.0008), and was significantly associated with an increased probability of lymph node metastasis (P < 0.001). Information on TBC gives additional prognostic value to pathology reports on CRC. The novel proposed scoring system, by using the percentage of infiltrating margin, outperforms the 'traditional' way of reporting TBC. Additionally, it is reproducible and simple to apply, and can therefore be easily integrated into daily diagnostic practice. © 2015 John Wiley & Sons Ltd.

  13. Marginal and Internal Gap of Handmade, Milled and 3D Printed Additive Manufactured Patterns for Pressed Lithium Disilicate Onlay Restorations.

    PubMed

    Revilla-León, M; Olea-Vielba, M; Esteso-Saiz, A; Martínez-Klemm, I; Özcan, M

    2018-03-01

    On a pressed lithium disilicate restoration, the building up of a wax pattern of the future restoration is a necessary step on the fabrication process. Conventionally, a wax pattern can be produced by handmade or milled procedures; however, the development of additive manufacturing technologies allows a new fabrication method. The present study measured the marginal and internal gap of handmade, milled and additive manufactured patterns for an onlay restoration. A preparation of an onlay restoration was made on an extracted mandibular tooth. A definitive cast was fabricated from a conventional silicone impression of the prepared tooth. Three groups were established: handmade (HM), milled (ML) and additive manufactured (AM); 4 specimens per group were obtained. The marginal and internal gap of each pattern was measured on the extracted molar through a computed tomography test. Sixty measurements were done to measure the marginal gap and another 60 measurements were calculated to analyze the internal gap on each pattern on the prepared tooth. A total of 1.440 measurements were completed. Mann-Whitney and Turkey statistical tests were used for pairwise comparison. The mean of the marginal and internal gap was of 67.56 ± 6.08 μm and 80.62 ± 3.26 μm for the HM group, 85.28 ± 2.17 μm and 96 ± 1.97 μm for the ML group and 86.49 ± 1.74 μm and 91.86 ± 2.88 μm for the AM group, respectively. The HM group presented significantly lower marginal (p=0.029) and internal (p=0.029) gap compared to the ML and AM groups. There was no statistical significant difference (p=0.486) on the marginal gap between the ML and the AM groups, but the AM group, showed significantly (p=0.029) smaller internal gap than the ML group. All the groups presented less than 100 μm marginal and internal gap, which is a considered clinically acceptable. The three fabrication processes are viable option for manufacturing patterns for lithium disilicate onlay restorations, but the best marginal and internal fit was still obtained by the conventional handmade procedures. Copyright© 2018 Dennis Barber Ltd.

  14. The effect of consumers’ perception to the satisfaction of use of traditional medicines in Medan

    NASA Astrophysics Data System (ADS)

    Siregar, R. S.; Supriana, T.; Haryanti, S.

    2018-02-01

    Consumption of chemical medicines fluctuated in 2009-2014, whereas the consumption of solid traditional medicine increased in 2009-2014. The purpose of this study is to analyse the influence of consumers’s perception on the consumption of traditional medicinal plants. The data was analysed by using a binomial logit regression analysis. It is found that the consumers’s perceptions affect customer satisfaction simultaneously are the health benefits variable, quality of traditional medicine variable, price of traditional medicine and available product; the health benefits variable and quality of traditional medicine variable partially have significant effects to customers’s satisfaction simultaneously satisfaction partially; the health benefit variable and quality of traditional medicine is found to have a marginal effect of 7% and 4%, respectively.

  15. A Longitudinal View of the Relationship Between Social Marginalization and Obesity

    NASA Astrophysics Data System (ADS)

    Apolloni, Andrea; Marathe, Achla; Pan, Zhengzheng

    We use 3 Waves of the Add Health data collected between 1994 and 2002 to conduct a longitudinal study of the relationship between social marginalization and the weight status of adolescents and young adults. Past studies have shown that overweight and obese children are socially marginalized. This research tests (1) if this is true when we account for the sample size of each group, (2) does this phenomenon hold over time and (3) is it obesity or social marginalization that precedes in time. Our results show that when the sample size for each group is considered, the share of friendship is conforming to the size of the group. This conformity seems to increase over time as the population becomes more obese. Finally, we find that obesity precedes social marginalization which lends credence to the notion that obesity causes social marginalization and not vice versa.

  16. Mohs micrographic surgery vs traditional surgical excision: a cost comparison analysis.

    PubMed

    Bialy, Tracy L; Whalen, James; Veledar, Emir; Lafreniere, Denis; Spiro, Jeffrey; Chartier, Timothy; Chen, Suephy C

    2004-06-01

    To compare the cost and margin adequacy of Mohs micrographic surgery (Mohs) and traditional surgical excision (TSE) for the treatment of facial and auricular nonmelanoma skin cancer (NMSC). Prospective cost analysis with each patient serving as his or her own control. Study was performed from 1999 to 2001 at the University of Connecticut dermatology clinic, a tertiary care referral center. A total of 98 consecutive patients with a primary diagnosis of NMSC on the face and ears. The average cost of Mohs and TSE per patient for the treatment and repair of NMSC; adequacy of TSE margins after the initial procedure(because this outcome affects overall cost). Mohs was cost comparable to TSE when the subsequent procedure for inadequate TSE margins after permanent section was Mohs (937 vs 1029 US dollars; P =.16) or a subsequent TSE (937 vs 944 US dollars; P =.53). When facility-based frozen sections were requested for TSE, Mohs was significantly less costly (956 vs 1399 US dollars; P<.001). The cost difference between Mohs and TSE was sensitive to the type of repair chosen. If the end point is clear margins, Mohs is cost comparable to TSE performed by otolaryngologic surgeons. Some caution is needed when evaluating the cost of facial and auricular NMSC treatment because the choice of repair can significantly affect the cost conclusions.

  17. In vitro evaluation of prosthodontic impression on natural dentition: a comparison between traditional and digital techniques

    PubMed Central

    MALAGUTI, G.; ROSSI, R.; MARZIALI, B.; ESPOSITO, A.; BRUNO, G.; DARIOL, C.; DI FIORE, A.

    2016-01-01

    SUMMARY Objectives The aim of this in vitro study is to evaluate the marginal and internal fit of zirconia core crowns manufactured following different digital and traditional workflows. Methods A 6° taper shoulder prepared abutment tooth was used to produce 20 zirconia core crowns using four different scanning techniques: scanned directly with the extraoral lab scanner, scanned with intraoral scanner, dental impressions using individual dental tray and polyether, dental casts from a polyether impressions. Marginal and internal fits were evaluated with digital photography and the silicone replica method. Results Medium marginal gaps were 76,00 μm ± 28.9 for extraoral lab scanner, 80.50 μm ± 36,2 for intraoral scanner, 88.10 μm ± 34,8 for dental impression scan and 112,4 μm ± 37,2 for dental cast scan. Medium internal gaps were 23.20 μm ± 10,3 for extraoral lab scanner, 16.20 μm ± 8.3 for intraoral scanner, 27.20 μm ± 16.7 for dental impression scan and 30.20 μm ± 12.7 for dental cast scan. Conclusion Internal gap were extensively lower than 70 μm described in literature. Marginal fit was higher than ideal values for all the techniques but within the limit of clinical success. Intraoral scanners obtained the best results for internal gap. PMID:28280529

  18. Tunnel restorations using glass ionomer or glass cermet: in vitro marginal ridge fracture and microleakage.

    PubMed

    Shetty, R; Munshi, A K

    1996-01-01

    The purpose of this in vitro study was to compare the marginal ridge fracture resistance and microleakage following restorations of partial tunnel preparations using glass ionomer and glass cermet cements. Sixty eight sound premolars were selected for this study and were divided randomly into six groups. A standardized partial tunnel preparation was done on all the teeth except specimens belonging to Group I. The partial tunnel preparations of Groups III & V were restored with glass ionomer and that of Groups IV & VI were restored with glass cermet. The teeth belonging to Groups I, II, III & IV were subjected to marginal ridge fracture resistance testing. The teeth of Groups V & VI were tested for microleakage after immersing them in 5% methylene blue solution for 4 hours. The results indicated that the teeth restored with glass cermet were marginally better than that with glass ionomer in terms of marginal ridge fracture resistance. Both the materials failed to reinforce the marginal ridge to the level of an intact tooth. The microleakage which occurred around both the materials were statistically insignificant, but on comparison glass ionomer showed better results. Hence, glass ionomer is preferred as a restorative material for partial tunnel preparations because of additional inherent advantages like superior esthetics and fluoride leachability.

  19. Analysis of vertical marginal discrepancy in feldspathic porcelain crowns manufactured with different CAD/CAM systems: Closed and open.

    PubMed

    Kricheldorf, Fabio; Bueno, Cleuber Rodrigo de Souza; Amaral, Wilson da Silva; Junior, Joel Ferreira Santiago; Filho, Hugo Nary

    2018-01-01

    The objective of this study is to compare the marginal adaptation of feldspathic porcelain crowns using two computer-aided design/computer-aided manufacturing systems, one of them is open and the other is closed. Twenty identical titanium abutments were divided into two groups: open system (OS), where ceramic crowns were created using varied equipment and software, and closed system (CS), where ceramic crowns were created using the CEREC system. Through optical microscopy analysis, we assess the marginal adaptation of the prosthetic interfaces. The data were subjected to the distribution of normality and variance. The t -test was used for the analysis of the comparison factor between the groups, and the one-way ANOVA was used to compare the variance of crown analysis regions within the group. A significance level of 5% was considered for the analyses. There was a significant difference between the systems ( P = 0.007), with the CS group having the higher mean (23.75 μm ± 3.05) of marginal discrepancy when compared to the open group (17.94 μm ± 4.77). Furthermore, there were no differences in marginal discrepancy between the different points between the groups ( P ≥ 0.05). The studied groups presented results within the requirements set out in the literature. However, the OS used presented better results in marginal adaptation.

  20. Comparative evaluation of different periods of enamel microabrasion on the microleakage of class V resin-modified glass ionomer and compomer restorations: An In vitro study.

    PubMed

    Bansal, Disha; Mahajan, Mrinalini

    2017-01-01

    The design of the class V cavity presents a clinical challenge in the field of adhesive dentistry as the margin placement is partially in enamel and partly in dentin, and the trouble associated with this design is the microleakage at the dentinal margin. When these restorations undergo microabrasion due to cosmetic reasons, this trouble aggravates to the significant levels. The aim of this study was the measurement of microleakage of class V glass ionomer restorations over two different periods of enamel microabrasion. This in vitro experimental study was conducted on 120 class V cavities which had been prepared on the buccal and lingual surfaces of 60 sound human premolars. One-half of the cavities were restored with the resin-modified glass ionomer cement (GIC) (60 cavities) and another half with the compomer (60 cavities). Finishing and polishing were performed. Then, the teeth were classified into six groups (n = 20). Microabrasion treatment was performed with Opaluster (Ultradent Product Inc., South Jordan, UT, USA) for 0 (control no treatment), 60 and 120 s. Then, teeth were thermocycled between 5°C and 55°C, immersed in rhodamine B solution (24 h), and sectioned longitudinally in buccolingual direction. Dye penetration was examined with stereomicroscope (×10). Microleakage scores were statistically analyzed. The mean occlusal margin scores and gingival margin scores were compared between all the groups using the Kruskal-Wallis test, Mann-Whitney U-test, Wilcoxon signed-rank test, and post hoc comparison. There was a significant difference between Group 1a, Group 2a, Group 1b, Group 2b, Group 1c, and Group 2c. Statistical analysis used in this study was Kruskal-Wallis test, Mann-Whitney U-test, Wilcoxon signed-rank test, and post hoc comparison. The least microleakage scores were observed in occlusal margins of control groups (without microabrasion). Moreover, in both restorations, the microleakage scores in occlusal margins were higher than gingival margins, and compoglass had less microleakage in occlusal and occlusal plus axial walls of class V cavities compared with resin-modified GIC. Whereas, the light-cured glass ionomer had less microleakage in the gingival and gingival plus axial walls of class V cavities when compared with compoglass. The least microleakage scores were observed in occlusal margins of control groups (without microabrasion). Moreover, in both restorations, the microleakage scores in occlusal margins were higher than gingival margins.

  1. Comparison of marginal ulcer rates between antecolic and retrocolic laparoscopic Roux-en-Y gastric bypass.

    PubMed

    Ribeiro-Parenti, Lara; Arapis, Konstantinos; Chosidow, Denis; Marmuse, Jean-Pierre

    2015-02-01

    Marginal ulcer can be a serious complication after laparoscopic gastric bypass surgery. The aim of this study was to compare the rates of marginal ulcer between the antecolic and the retrocolic technique, in a large cohort of patients. Over a near 10-year period, 1,142 patients underwent laparoscopic gastric bypass surgery. The antecolic and the retrocolic technique were used in respectively 572 and 570 consecutive patients. All procedures were performed using a circular stapled gastrojejunostomy. Patients were followed for 18 to 99 months (mean 48.8 months). During follow-up, 46 patients developed a marginal ulcer (4 %), 32 in the antecolic group (5.6 %) and 14 in the retrocolic group (2.5 %). Nineteen patients (3.3 %) in the antecolic group and eight patients in the retrocolic group (1.4 %) developed early marginal ulcer (i.e., within 3 months after surgery). The mean time to onset of anastomotic ulcer symptoms after surgery was 11 months (range 0.25-72). Forty-four patients were submitted to medical treatment, and 35 patients (79.5 %) had complete resolution of their symptoms. Patients with an antecolic Roux limb develop significantly more marginal ulcers (p = 0.007) and early marginal ulcer (p = 0.033) than the patients with a retrocolic Roux limb. The antecolic technique seems to be a risk factor for appearance of marginal ulcer.

  2. Conservation of Pollinators in Traditional Agricultural Landscapes - New Challenges in Transylvania (Romania) Posed by EU Accession and Recommendations for Future Research.

    PubMed

    Kovács-Hostyánszki, Anikó; Földesi, Rita; Mózes, Edina; Szirák, Ádám; Fischer, Joern; Hanspach, Jan; Báldi, András

    2016-01-01

    Farmland biodiversity is strongly declining in most of Western Europe, but still survives in traditional low intensity agricultural landscapes in Central and Eastern Europe. Accession to the EU however intensifies agriculture, which leads to the vanishing of traditional farming. Our aim was to describe the pollinator assemblages of the last remnants of these landscapes, thus set the baseline of sustainable farming for pollination, and to highlight potential measures of conservation. In these traditional farmlands in the Transylvanian Basin, Romania (EU accession in 2007), we studied the major pollinator groups-wild bees, hoverflies and butterflies. Landscape scale effects of semi-natural habitats, land cover diversity, the effects of heterogeneity and woody vegetation cover and on-site flower resources were tested on pollinator communities in traditionally managed arable fields and grasslands. Our results showed: (i) semi-natural habitats at the landscape scale have a positive effect on most pollinators, especially in the case of low heterogeneity of the direct vicinity of the studied sites; (ii) both arable fields and grasslands hold abundant flower resources, thus both land use types are important in sustaining pollinator communities; (iii) thus, pollinator conservation can rely even on arable fields under traditional management regime. This has an indirect message that the tiny flower margins around large intensive fields in west Europe can be insufficient conservation measures to restore pollinator communities at the landscape scale, as this is still far the baseline of necessary flower resources. This hypothesis needs further study, which includes more traditional landscapes providing baseline, and exploration of other factors behind the lower than baseline level biodiversity values of fields under agri-environmental schemes (AES).

  3. Flowable resin and marginal gap on tooth third medial cavity involving enamel and radicular cementum: a SEM evaluation of two restoration techniques.

    PubMed

    Lo Giudice, G; Cicciù, M; Cervino, G; Lizio, A; Visco, A M

    2012-01-01

    The aim of this study is to investigate the presence and the extent of a possible marginal gap after the interposition of a flowable composite between the composite restoration and the dental structures (enamel and cementum). This technique is also used to eliminate the infiltration in a zone of the cavity preparation that is frequently at a risk of secondary decay. Fifteen human premolars extracted for orthodontic reasons were used for the study. A cavity with mesial and distal margin in enamel and cementum was realized in every tooth. The cavities were then restored with an adhesive system (ScotchBond 3MÔ) and composite (Filtek Supreme 3MÔ); and, a fine layer of flowable composite was applied in the distal margin of each cavity. Scanning electron microscopy (SEM) in secondary electron imaging (S.E.I.) modality was used for the study and identifying the marginal gaps in the composite restorations. Data was investigated on the mesial and distal margin of each cavity at the restoration-enamel interface, and at the restoration-cementum interface. The interfaces were divided in four groups: Group A (enamel/composite); Group B (enamel/flow/composite); Group C (cementum/composite); and, Group D (cementum/flow/composite). By the comparison of the gap's average width found in each group, it is evidenced that the average width of the gap increases when the interface moves from the coronal to the radicular end (Group A 0,1 ± 0,4 μm Vs Group C 12,3 ± 11,6 μm; Group B 0,2 ± 0,8 μm Vs Group D 2,8 ± 6,6 μm). Correlating the measurements of the marginal gap's average width among the Group A and Group B, no significant variations were obtained; and instead, on comparing Group C with Group D, the gap's average width decreases. The interposition of a low elastic modulus composite between the adhesive layer and the composite resin allows an improvement of the cementum-restoration interface by the means of a lower shrinkage stress during polymerization.

  4. [The influence of the different polishing methods on the marginal sealing property of the computer aided design and computer aided manufacture zirconium dioxide full crown].

    PubMed

    Zhou, Jianying; Deng, Jiupeng; Li, Jinyuan; Wang, Jide; Shen, Baolian

    2016-05-01

    To evaluate the influence of different polishing methods on marginal microleakage of zirconium dioxide full crown. Thirty extracted premolars were selected and randomly divided into three groups, A, B and C, with 10 in each group. Group A was prepared with MANI TF-13 bur completely without the treatment of shoulder. The shoulder of group B was polished with MANI TR13-EF bur after the preparation using MANI TF-13. The shoulder of group C was polished with the dental pneumatic ultrasonic hand-piece of KaVo SONICflex after the preparation using MANI TF-13 bur. Five specimens after preparation were selected in each group. Fifteen CAD/CAM zirconium dioxide full crowns have been made. The crowns were bonded using PULPDENT resin cement, and the root canals were sealed using nail polish, and apical foramen were closed using flow resin. The test-pieces have been immersed in a 3% solution of methylene blue for 24 h. The condition of shoulder marginal microleakage was observed using light stereomicroscopy and evaluated in classification index. The remaining specimens in each group were used for roughness test and scanning electron microscope(SEM) experiment. The marginal microleakage situations of specimens in three groups was analyzed by SPSS 17.0. The enamel surface of different polishing methods was observed using SEM. The specimens in group C demonstrated the least marginal microleakage, and those in group B showed an intermediate level of marginal microleakage, and those in group A characterized the most serious marginal microleakage (total, χ2=44.610, P<0.01; among the different groups, P<0.05). The roughness experiment showed that specimens in group C achieve the smoothest results ([0.27±0.03] μm). Preparation shoulder polished using the dental pneumatic ultrasonic hand-piece demonstrated the best result under the SEM among the three groups. The anti-microleakage effectiveness of dental pneumatic ultrasonic hand-piece in shoulder refinement is better than ordinary shoulder treatment.

  5. Marginal fit of all-ceramic crowns fabricated using two extraoral CAD/CAM systems in comparison with the conventional technique

    PubMed Central

    Alqahtani, Fawaz

    2017-01-01

    Objective The purpose of this study was to determine the effect of two extraoral computer-aided design (CAD) and computer-aided manufacturing (CAM) systems, in comparison with conventional techniques, on the marginal fit of monolithic CAD/CAM lithium disilicate ceramic crowns. Study design This is an in vitro interventional study. Place and duration of study The study was carried out at the Department of Prosthodontics, School of Dentistry, Prince Sattam Bin Abdul-Aziz University, Saudi Arabia, from December 2015 to April 2016. Methodology A marginal gap of 60 lithium disilicate crowns was evaluated by scanning electron microscopy. In total, 20 pressable lithium disilicate (IPS e.max Press [Ivoclar Vivadent]) ceramic crowns were fabricated using the conventional lost-wax technique as a control group. The experimental all-ceramic crowns were produced based on a scan stone model and milled using two extraoral CAD/CAM systems: the Cerec group was fabricated using the Cerec CAD/CAM system, and the Trios group was fabricated using Trios CAD and milled using Wieland Zenotec CAM. One-way analysis of variance (ANOVA) and the Scheffe post hoc test were used for statistical comparison of the groups (α=0.05). Results The mean (±standard deviation) of the marginal gap of each group was as follows: the Control group was 91.15 (±15.35) µm, the Cerec group was 111.07 (±6.33) µm, and the Trios group was 60.17 (±11.09) µm. One-way ANOVA and the Scheffe post hoc test showed a statistically significant difference in the marginal gap between all groups. Conclusion It can be concluded from the current study that all-ceramic crowns, fabricated using the CAD/CAM system, show a marginal accuracy that is acceptable in clinical environments. The Trios CAD group displayed the smallest marginal gap. PMID:28352204

  6. The Space That Difference Makes: On Marginality, Social Justice and the Future of the Health Humanities.

    PubMed

    Gutierrez, Kevin J; DasGupta, Sayantani

    2016-12-01

    Feminist theorist and educator, bell hooks, asserts that to seek true liberation one must choose marginality. One must choose to occupy the space outside the binary between colonizer-colonized, hegemonic center-periphery, and us-them in order to create a location of possibility. This essay will reveal the practice of social justice as the navigation of the space that difference makes and argue that choosing marginality provides a framework for health humanities work towards social justice in health care. The space of the launderette that is depicted in Hanif Kureishi's 1986 film, My Beautiful Laundrette, provides an example of choosing marginality and illustrates how difference structures both real and imagined spaces, which influences how individuals ultimately perceive one another. We will draw from the work of bell hooks; political geographer, Edward Soja; and Marxist philosopher, Henri Lefebvre, to demonstrate the importance of the health humanities' position at the margin to traditional health care education.

  7. Characteristics of carbon nanotubes based micro-bubble generator for thermal jet printing.

    PubMed

    Zhou, Wenli; Li, Yupeng; Sun, Weijun; Wang, Yunbo; Zhu, Chao

    2011-12-01

    We propose a conceptional thermal printhead with dual microbubble generators mounted parallel in each nozzle chamber, where multiwalled carbon nanotubes are adopted as heating elements with much higher energy efficiency than traditional approaches using noble metals or polysilicon. Tailing effect of droplet can be excluded by appropriate control of grouped bubble generations. Characteristics of the corresponding micro-fabricated microbubble generators were comprehensively studied before the formation of printhead. Electrical properties of the microheaters on glass substrate in air and performance of bubble generation underwater focusing on the relationships between input power, device resistance and bubble behavior were probed. Proof-of-concept bubble generations grouped to eliminate the tailing effect of droplet were performed indicating precise pattern with high resolution could be realized by this kind of printhead. Experimental results revealed guidance to the geometric design of the printhead as well as its fabrication margin and the electrical control of the microbubble generators.

  8. Determining factors for implant referral rates.

    PubMed

    Levin, Roger P

    2002-01-01

    The research findings indicate that the field of implant dentistry will only grow at a moderately low level unless certain changes are made. Findings indicated that the effort by the implant companies has been nothing short of dramatic, and yet almost 60% of restorative doctors do not participate annually in any implant case. There was no clear indication that younger restorative doctors will significantly increase the number of implant referrals, as their overall implant education has not dramatically differed from those dentists who graduated in earlier years. Once the research was completed, it became obvious to Levin Group that the driving force behind implant referral growth will be implant surgeons, because of their one-to-one relationship with restorative doctors. The Levin Group Implant Management and Marketing Consulting Program is based on approaching restorative doctors in several different levels, starting with awareness all the way through to case facilitation and long-term tracking and communication. Finally, a continuing marketing/education effort needs to be consistently in place with effective materials, not only to create a high level of awareness, but also to motivate restorative doctors to refer cases and then work through the case with the implant surgeon to a satisfactory completion for the restorative doctor, implant surgeon, and patient. While the surgical insertion of implants may seem to carry a high-profit margin relative to the restoration of implants, the truth is that the restoration of implants usually provides a 40% higher profit margin for the restorative doctor than traditional dental services. One of the key issues is that referring doctors have not necessarily learned how to set fees and present cases with regard to implant dentistry. The key factor here is to ensure that the patient understands that implant services involve higher fees than traditional services, because of the necessarily higher levels of experience, education, and cost associated with implant dentistry. It is also important to emphasize to patients that the quality of life far outweighs the differential in fees.

  9. Comparison of the marginal adaptation of direct and indirect composite inlay restorations with optical coherence tomography

    PubMed Central

    TÜRK, Ayşe Gözde; SABUNCU, Metin; ÜNAL, Sena; ÖNAL, Banu; ULUSOY, Mübin

    2016-01-01

    ABSTRACT Objective The purpose of the study was to use the photonic imaging modality of optical coherence tomography (OCT) to compare the marginal adaptation of composite inlays fabricated by direct and indirect techniques. Material and Methods Class II cavities were prepared on 34 extracted human molar teeth. The cavities were randomly divided into two groups according to the inlay fabrication technique. The first group was directly restored on cavities with a composite (Esthet X HD, Dentsply, Germany) after isolating. The second group was indirectly restored with the same composite material. Marginal adaptations were scanned before cementation with an invisible infrared light beam of OCT (Thorlabs), allowing measurement in 200 µm intervals. Restorations were cemented with a self-adhesive cement resin (SmartCem2, Dentsply), and then marginal adaptations were again measured with OCT. Mean values were statistically compared by using independent-samples t-test and paired samples t-test (p<0.05), before and after cementation. Results Direct inlays presented statistically smaller marginal discrepancy values than indirect inlays, before (p=0.00001442) and after (p=0.00001466) cementation. Marginal discrepancy values were increased for all restorations after cementation (p=0.00008839, p=0.000000952 for direct and indirect inlays, respectively). The mean marginal discrepancy value of the direct group increased from 56.88±20.04 µm to 91.88±31.7 µm, whereas the indirect group increased from 107.54±35.63 µm to 170.29±54.83 µm. Different techniques are available to detect marginal adaptation of restorations, but the OCT system can give quantitative information about resin cement thickness and its interaction between tooth and restoration in a nondestructive manner. Conclusions Direct inlays presented smaller marginal discrepancy than indirect inlays. The marginal discrepancy values were increased for all restorations that refer to cement thickness after cementation. PMID:27556210

  10. [A comparative study of marginal microleakage using different cements in porcelain-fused-to-metal crown].

    PubMed

    Jiang, Ming-Xin; Huang, Ke-Qiang; Li, Zhi-Gang; Gao, Xiu-Qiu; Li, Chun-Shan

    2011-04-01

    To evaluate the marginal microleakage of porcelain-fused-to-metal crown using four different cements. Sixteen porcelain-fused-to-metal crowns were built and randomly divided into 4 group, luted onto standard prepared human forward molars using four different cements (glass ionomer cement, resin-modified glass ionomer cement, PanaviaF, Super-Bond C&B adhesive luting system). After temperature cycling test, all the crowns were then submerged in 2% fuchsin for 24 h. The marginal microleakage at tooth cement interfaces was observed using light stereomicroscopy and evaluated in classification index. The marginal microleakage grade of 4 groups were analyzed by SPSS 13.0. The PanaviaF demonstrated the least marginal microleakage, Super-Bond C&B adhesive luting system, resin-modified glass ionomer cement showed an intermediate level of marginal microleakage, glass ionomer cement was associated with severe marginal microleakage (total, Chi2 = 157.60, P < 0.01; among the different groups, P<0.05). Adhesive resin luting system which is the first selection in clinical is better than glass ionomer cement and is good at porcelain-fused-to-metal crown.

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    Science.gov Websites

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    Science.gov Websites

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  13. Evaluation of marginal fit of single implant-supported metal-ceramic crowns prepared by using presintered metal blocks.

    PubMed

    Pasali, Baris; Sarac, Duygu; Kaleli, Necati; Sarac, Yakup Sinasi

    2018-02-01

    Recently, presintered metal blocks for nonprecious and precious metal implant-supported restorations have gained popularity in computer-aided design and computer-aided manufacturing (CAD-CAM) systems. However, few studies have evaluated the marginal discrepancy of implant-supported restorations made with these new alloy systems. The purpose of this in vitro study was to compare the milling-sintering method with the lost-wax and milling methods in terms of the marginal fit of implant-supported metal-ceramic restorations. Thirty implant abutments screwed to implant analogs were embedded into acrylic resin to investigate marginal fit and then divided according to fabrication methods into the following 3 groups (n=10): lost-wax (LW; control group), milling (M), and milling-sintering (MS). Porcelain material was applied to all specimens after completion of the fabrication process. Subsequently, all specimens were cemented to implant abutments for the measurement of marginal discrepancies. Twelve marginal discrepancy measurements were recorded on each implant abutment by using a stereomicroscope. The arithmetic mean of these 12 measurements was considered the mean marginal discrepancy value of each abutment. Data were statistically analyzed by using 1-way ANOVA and Tukey honest significant difference tests (α=.05). The lowest mean marginal discrepancy values (81 ±2 μm) were observed in the M group, which was significantly different (P<.001) from the other methods. The highest mean marginal discrepancy values (99 ±2 μm) were observed in the MS group. The results revealed that restorations prepared by the milling-sintering method provided clinically acceptable results (<120 μm); however, this new technique was not found to be as precise as the milling method in terms of marginal fit. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  14. The use of Mohs micrographic surgery (MMS) for melanoma in situ (MIS) of the trunk and proximal extremities.

    PubMed

    Stigall, Landon E; Brodland, David G; Zitelli, John A

    2016-11-01

    Evaluation of the entire surgical margin results in high rates of complete excision, low local recurrence rates, and maximal tissue conservation. Although well recognized for melanoma of the head and neck, few studies have focused exclusively on the trunk and proximal extremities. We sought to evaluate the efficacy of Mohs micrographic surgery for melanoma in situ (MIS) of the trunk and proximal extremities, and determine adequate excision margins for MIS when total margin evaluation is not used. Long-term outcomes in 882 cases of MIS treated with Mohs micrographic surgery were analyzed and compared with historical controls. Rates of complete excision were determined for increasing surgical margin intervals. One local recurrence occurred in our cohort (0.1%). Only 83% of MIS were excised with a 6-mm margin. Margins of 9 mm were needed to excise 97% of MIS, statistically equivalent to thin melanomas. We used a nonrandomized, single-institution, retrospective design. Mohs micrographic surgery may cure the 17% of MIS that exceed traditional excision margins of 5 mm and is a valuable option for these patients. Surgical margins of at least 0.9 cm should be considered for MIS of the trunk and extremities when total margin evaluation is not used. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  15. Randomized clinical trial of two resin-modified glass ionomer materials: 1-year results.

    PubMed

    Perdigão, J; Dutra-Corrêa, M; Saraceni, S H C; Ciaramicoli, M T; Kiyan, V H

    2012-01-01

    With institutional review board approval, 33 patients who needed restoration of noncarious cervical lesions (NCCL) were enrolled in this study. A total of 92 NCCL were selected and randomly assigned to three groups: (1) Ambar (FGM), a two-step etch-and-rinse adhesive (control), combined with the nanofilled composite resin Filtek Supreme Plus (FSP; 3M ESPE); (2) Fuji II LC (GC America), a traditional resin-modified glass ionomer (RMGIC) restorative material; (3) Ketac Nano (3M ESPE), a nanofilled RMGIC restorative material. Restorations were evaluated at six months and one year using modified United States Public Health Service parameters. At six months after initial placement, 84 restorations (a 91.3% recall rate) were evaluated. At one year, 78 restorations (a 84.8% recall rate) were available for evaluation. The six month and one year overall retention rates were 93.1% and 92.6%, respectively, for Ambar/FSP; 100% and 100%, respectively, for Fuji II LC; and 100% and 100%, respectively, for Ketac Nano with no statistical difference between any pair of groups at each recall. Sensitivity to air decreased for all three adhesive materials from the preoperative to the postoperative stage, but the difference was not statistically significant. For Ambar/FSP, there were no statistical differences for any of the parameters from baseline to six months and from baseline to one year. For Fuji II LC, surface texture worsened significantly from baseline to six months and from baseline to one year. For Ketac Nano, enamel marginal staining increased significantly from baseline to one year and from six months to one year. Marginal adaptation was statistically worse at one year compared with baseline only for Ketac Nano. When parameters were compared for materials at each recall, Ketac Nano resulted in significantly worse color match than any of the other two materials at any evaluation period. At one year, Ketac Nano resulted in significantly worse marginal adaptation than the other two materials and worse marginal staining than Fuji II LC. Surface texture was statistically worse for Fuji II LC compared with the other two materials at all evaluation periods. The one-year retention rate was statistically similar for the three adhesive materials. Nevertheless, enamel marginal deficiencies and color mismatch were more prevalent for Ketac Nano. Surface texture of Fuji II LC restorations deteriorated quickly.

  16. Comparison the Marginal and Internal Fit of Metal Copings Cast from Wax Patterns Fabricated by CAD/CAM and Conventional Wax up Techniques.

    PubMed

    Vojdani, M; Torabi, K; Farjood, E; Khaledi, Aar

    2013-09-01

    Metal-ceramic crowns are most commonly used as the complete coverage restorations in clinical daily use. Disadvantages of conventional hand-made wax-patterns introduce some alternative ways by means of CAD/CAM technologies. This study compares the marginal and internal fit of copings cast from CAD/CAM and conventional fabricated wax-patterns. Twenty-four standardized brass dies were prepared and randomly divided into 2 groups according to the wax-patterns fabrication method (CAD/CAM technique and conventional method) (n=12). All the wax-patterns were fabricated in a standard fashion by means of contour, thickness and internal relief (M1-M12: representative of CAD/CAM group, C1-C12: representative of conventional group). CAD/CAM milling machine (Cori TEC 340i; imes-icore GmbH, Eiterfeld, Germany) was used to fabricate the CAD/CAM group wax-patterns. The copings cast from 24 wax-patterns were cemented to the corresponding dies. For all the coping-die assemblies cross-sectional technique was used to evaluate the marginal and internal fit at 15 points. The Student's t- test was used for statistical analysis (α=0.05). The overall mean (SD) for absolute marginal discrepancy (AMD) was 254.46 (25.10) um for CAD/CAM group and 88.08(10.67) um for conventional group (control). The overall mean of internal gap total (IGT) was 110.77(5.92) um for CAD/CAM group and 76.90 (10.17) um for conventional group. The Student's t-test revealed significant differences between 2 groups. Marginal and internal gaps were found to be significantly higher at all measured areas in CAD/CAM group than conventional group (p< 0.001). Within limitations of this study, conventional method of wax-pattern fabrication produced copings with significantly better marginal and internal fit than CAD/CAM (machine-milled) technique. All the factors for 2 groups were standardized except wax pattern fabrication technique, therefore, only the conventional group results in copings with clinically acceptable margins of less than 120um.

  17. Comparison the Marginal and Internal Fit of Metal Copings Cast from Wax Patterns Fabricated by CAD/CAM and Conventional Wax up Techniques

    PubMed Central

    Vojdani, M; Torabi, K; Farjood, E; Khaledi, AAR

    2013-01-01

    Statement of Problem: Metal-ceramic crowns are most commonly used as the complete coverage restorations in clinical daily use. Disadvantages of conventional hand-made wax-patterns introduce some alternative ways by means of CAD/CAM technologies. Purpose: This study compares the marginal and internal fit of copings cast from CAD/CAM and conventional fabricated wax-patterns. Materials and Method: Twenty-four standardized brass dies were prepared and randomly divided into 2 groups according to the wax-patterns fabrication method (CAD/CAM technique and conventional method) (n=12). All the wax-patterns were fabricated in a standard fashion by means of contour, thickness and internal relief (M1-M12: representative of CAD/CAM group, C1-C12: representative of conventional group). CAD/CAM milling machine (Cori TEC 340i; imes-icore GmbH, Eiterfeld, Germany) was used to fabricate the CAD/CAM group wax-patterns. The copings cast from 24 wax-patterns were cemented to the corresponding dies. For all the coping-die assemblies cross-sectional technique was used to evaluate the marginal and internal fit at 15 points. The Student’s t- test was used for statistical analysis (α=0.05). Results: The overall mean (SD) for absolute marginal discrepancy (AMD) was 254.46 (25.10) um for CAD/CAM group and 88.08(10.67) um for conventional group (control). The overall mean of internal gap total (IGT) was 110.77(5.92) um for CAD/CAM group and 76.90 (10.17) um for conventional group. The Student’s t-test revealed significant differences between 2 groups. Marginal and internal gaps were found to be significantly higher at all measured areas in CAD/CAM group than conventional group (p< 0.001). Conclusion: Within limitations of this study, conventional method of wax-pattern fabrication produced copings with significantly better marginal and internal fit than CAD/CAM (machine-milled) technique. All the factors for 2 groups were standardized except wax pattern fabrication technique, therefore, only the conventional group results in copings with clinically acceptable margins of less than 120um. PMID:24724133

  18. Influence of Manufacturing Methods of Implant-Supported Crowns on External and Internal Marginal Fit: A Micro-CT Analysis.

    PubMed

    Moris, Izabela C M; Monteiro, Silas Borges; Martins, Raíssa; Ribeiro, Ricardo Faria; Gomes, Erica A

    2018-01-01

    To evaluate the influence of different manufacturing methods of single implant-supported metallic crowns on the internal and external marginal fit through computed microtomography. Forty external hexagon implants were divided into 4 groups ( n = 8), according to the manufacturing method: GC, conventional casting; GI, induction casting; GP, plasma casting; and GCAD, CAD/CAM machining. The crowns were attached to the implants with insertion torque of 30 N·cm. The external (vertical and horizontal) marginal fit and internal fit were assessed through computed microtomography. Internal and external marginal fit data ( μ m) were submitted to a one-way ANOVA and Tukey's test ( α = .05). Qualitative evaluation of the images was conducted by using micro-CT. The statistical analysis revealed no significant difference between the groups for vertical misfit ( P = 0.721). There was no significant difference ( P > 0.05) for the internal and horizontal marginal misfit in the groups GC, GI, and GP, but it was found for the group GCAD ( P ≤ 0.05). Qualitative analysis revealed that most of the samples of cast groups exhibited crowns underextension while the group GCAD showed overextension. The manufacturing method of the crowns influenced the accuracy of marginal fit between the prosthesis and implant. The best results were found for the crowns fabricated through CAD/CAM machining.

  19. Adjuvant Radiation is Associated with Improved Survival for Select Patients with Non-metastatic Adrenocortical Carcinoma.

    PubMed

    Nelson, Daniel W; Chang, Shu-Ching; Bandera, Brad C; Fischer, Trevan D; Wollman, Robert; Goldfarb, Melanie

    2018-07-01

    Adrenocortical carcinoma (ACC) is a rare and aggressive malignancy for which surgery is the mainstay of treatment and for which adjuvant radiation is infrequently employed; however, small, single-institution series suggest adjuvant radiation may improve outcomes. All patients with non-metastatic ACC treated with either surgery alone or surgery followed by adjuvant radiation were identified in the 2004-2013 National Cancer Database. Factors associated with receipt of radiation and the impact of adjuvant radiation on survival were determined by multivariable analysis. Of 1184 patients, 171 (14.4%) received adjuvant radiation. Patient demographics were similar between the two groups, but those receiving radiation were more likely to have had positive margins following surgery (37.4 vs. 14.6%; p < 0.001), evidence of vascular invasion (14.0 vs. 5.1%; p = 0.05), and receive concurrent chemotherapy (57.3 vs. 28.8%; p < 0.001). After adjustment for tumor and other treatment factors, only positive margins following surgery was associated with an increased likelihood of receiving adjuvant radiation (odds ratio 3.84, 95% confidence interval [CI] 1.95-7.56). Radiation therapy did not confer a difference in median overall survival in the general cohort. However, for patients with positive margins, adjuvant radiation was associated with a 40% decreased yearly risk of death after adjustment for concurrent chemotherapy (hazard ratio 0.60, 95% CI 0.40-0.92; p = 0.02). This survival advantage was not evident for other traditional high-risk features. Adjuvant radiation appears to decrease the risk of death in ACC patients with positive margins following surgical resection, but only a small percentage are currently receiving radiation. Multidisciplinary treatment with surgery and radiation should be considered for these patients.

  20. [Influence of coping material selection and porcelain firing on marginal and internal fit of computer-aided design/computer- aided manufacturing of zirconia and titanium ceramic implant-supported crowns].

    PubMed

    Cuiling, Liu; Liyuan, Yang; Xu, Gao; Hong, Shang

    2016-06-01

    This study aimed to investigate the influence of coping material and porcelain firing on the marginal and internal fit of computer-aided design/computer-aided manufacturing (CAD/CAM) of zirconia ceramic implant- and titanium ceramic implant-supported crowns. Zirconia ceramic implant (group A, n = 8) and titanium metal ceramic implant-supported crowns (group B, n = 8) were produced from copings using the CAD/CAM system. The marginal and internal gaps of the copings and crowns were measured by using a light-body silicone replica technique combined with micro-computed tomography scanning to obtain a three-dimensional image. Marginal gap (MG), horizontal marginal discrepancy (HMD), and axial wall (AW) were measured. Statistical analyses were performed using SPSS 17.0. Prior to porcelain firing, the measurements for MG, HMD, and AW of copings in group A were significantly larger than those in group B (P < 0.05). After porcelain firing, the measurements for MG of crowns in group A were smaller than those in group B (P < 0.05), whereas HMD and AW showed no significant difference between the two groups (P > 0.05). Porcelain firing significantly reduced MG (P < 0.05) in group A but significantly increased MG, HMD, and AW in group B (P < 0.05) HMD and AW were not influenced by porcelain firing in group A (P > 0.05). The marginal fits of CAD/CAM zirconia ceramic implant-supported crowns were superior to those of CAD/CAM titanium ceramic-supported crowns. The fits of both the CAD/CAM zirconia ceramic implant- and titanium ceramic implant-supported crowns were obviously influenced by porcelain firing.

  1. Effect of Margin Designs on the Marginal Adaptation of Zirconia Copings.

    PubMed

    Habib, Syed Rashid; Al Ajmi, Mohammed Ginan; Al Dhafyan, Mohammed; Jomah, Abdulrehman; Abualsaud, Haytham; Almashali, Mazen

    2017-09-01

    The aim of this in vitro study was to investigate the effect of Shoulder versus Chamfer margin design on the marginal adaptation of zirconia (Zr) copings. 40 extracted molar teeth were mounted in resin and prepared for zirconia crowns with two margin preparation designs (20=Shoulder and 20=Chamfer). The copings were manufactured by Cercon® (DeguDent GmbH, Germany) using the CAD/CAM system for each tooth. They were tried on each tooth, cemented, thermocycled, re-embedded in resin and were subsequently cross sectioned centrally into two equal mesial and distal halves. They were examined under electron microscope at 200 X magnification and the measurements were recorded at 5 predetermined points in micrometers (µm). The o verall mean marginal gap for the two groups was found to be 206.98+42.78µm with Shoulder margin design (Marginal Gap=199.50+40.72µm) having better adaptation compared to Chamfer (Marginal Gap=214.46+44.85µm). The independent-samples t-test showed a statistically non-significant difference (p=.113) between the means of marginal gap for Shoulder and Chamfer margin designs and the measurements were recorded at 5 predetermined points for the two groups. The Chamfer margin design appeared to offer the same adaptation results as the Shoulder margin design.

  2. Chagas Disease, Migration and Community Settlement Patterns in Arequipa, Peru

    PubMed Central

    Gilman, Robert H.; Cornejo del Carpio, Juan G.; Naquira, Cesar; Bern, Caryn; Levy, Michael Z.

    2009-01-01

    Background Chagas disease is one of the most important neglected tropical diseases in the Americas. Vectorborne transmission of Chagas disease has been historically rare in urban settings. However, in marginal communities near the city of Arequipa, Peru, urban transmission cycles have become established. We examined the history of migration and settlement patterns in these communities, and their connections to Chagas disease transmission. Methodology/Principal Findings This was a qualitative study that employed focus group discussions and in-depth interviews. Five focus groups and 50 in-depth interviews were carried out with 94 community members from three shantytowns and two traditional towns near Arequipa, Peru. Focus groups utilized participatory methodologies to explore the community's mobility patterns and the historical and current presence of triatomine vectors. In-depth interviews based on event history calendars explored participants' migration patterns and experience with Chagas disease and vectors. Focus group data were analyzed using participatory analysis methodologies, and interview data were coded and analyzed using a grounded theory approach. Entomologic data were provided by an ongoing vector control campaign. We found that migrants to shantytowns in Arequipa were unlikely to have brought triatomines to the city upon arrival. Frequent seasonal moves, however, took shantytown residents to valleys surrounding Arequipa where vectors are prevalent. In addition, the pattern of settlement of shantytowns and the practice of raising domestic animals by residents creates a favorable environment for vector proliferation and dispersal. Finally, we uncovered a phenomenon of population loss and replacement by low-income migrants in one traditional town, which created the human settlement pattern of a new shantytown within this traditional community. Conclusions/Significance The pattern of human migration is therefore an important underlying determinant of Chagas disease risk in and around Arequipa. Frequent seasonal migration by residents of peri-urban shantytowns provides a path of entry of vectors into these communities. Changing demographic dynamics of traditional towns are also leading to favorable conditions for Chagas disease transmission. Control programs must include surveillance for infestation in communities assumed to be free of vectors. PMID:20016830

  3. Examining marginalized communities and local conservation institutions: the case of Nepal's Annapurna Conservation Area.

    PubMed

    Dahal, Smriti; Nepal, Sanjay K; Schuett, Michael A

    2014-01-01

    In developing countries, participatory conservation initiatives have been criticized for many reasons, mainly for excluding marginalized groups which have led to unequal benefits. Using concepts from the literature on participation, conservation, and political ecology, this research explored the participation of marginal groups, i.e., poor, women, lower caste, and landless, in management institutions in Nepal's Annapurna Conservation Area. Field work for this research was conducted through the use of interviews and participant observation during August-October 2010. Results show that although marginal groups were involved in local management institutions, their representation was minimal and had not led to meaningful participation or empowerment to influence the decisions being made in conservation and development programs. Our study findings indicate that the involvement of marginal groups in local initiatives is complex and influenced by several factors. The study concludes that the Annapurna Conservation Area Project needs to re-orient its conservation projects by adopting a more inclusive form of participation and move beyond the quota system.

  4. Examining Marginalized Communities and Local Conservation Institutions: The Case of Nepal's Annapurna Conservation Area

    NASA Astrophysics Data System (ADS)

    Dahal, Smriti; Nepal, Sanjay K.; Schuett, Michael A.

    2014-01-01

    In developing countries, participatory conservation initiatives have been criticized for many reasons, mainly for excluding marginalized groups which have led to unequal benefits. Using concepts from the literature on participation, conservation, and political ecology, this research explored the participation of marginal groups, i.e., poor, women, lower caste, and landless, in management institutions in Nepal's Annapurna Conservation Area. Field work for this research was conducted through the use of interviews and participant observation during August-October 2010. Results show that although marginal groups were involved in local management institutions, their representation was minimal and had not led to meaningful participation or empowerment to influence the decisions being made in conservation and development programs. Our study findings indicate that the involvement of marginal groups in local initiatives is complex and influenced by several factors. The study concludes that the Annapurna Conservation Area Project needs to re-orient its conservation projects by adopting a more inclusive form of participation and move beyond the quota system.

  5. Biofuel crops with CAM photosynthesis: Economic potential on moisture-limited lands

    NASA Astrophysics Data System (ADS)

    Bartlett, Mark; Hartzell, Samantha; Porporato, Amilcare

    2017-04-01

    As the demand for food and renewable energy increases, the intelligent utilization of marginal lands is becoming increasingly critical. In marginal lands classified by limited rainfall or soil salinity, the cultivation of traditional C3 and C4 photosynthesis crops often is economically infeasible. However, in such lands, nontraditional crops with crassulacean acid metabolism (CAM) photosynthesis show great economic potential for cultivation. CAM crops including Opuntia (prickly pear) and Ananas (pineapple) achieve a water use efficiency which is three fold higher than C4 crops such as corn and 6-fold higher than C3 crops such as wheat, leading to a comparable annual productivity with only 20% of the water demand. This feature, combined with a shallow rooting depth and a high water storage capacity, allows CAM plants to take advantage of small, infrequent rainfall amounts in shallow, quickly draining soils. Furthermore, CAM plants typically have properties (e.g., high content of non-structural carbohydrates) that are favorable for biofuel production. Here, for marginal lands characterized by low soil moisture availability and/or high salinity, we assess the potential productivity and economic benefits of CAM plants. CAM productivity is estimated using a recently developed model which simulates CAM photosynthesis under a range of soil and climate conditions. From these results, we compare the energy and water resource inputs required by CAM plants to those required by more traditional C3 and C4 crops (corn, wheat, sorghum), and we evaluate the economic potential of CAM crops as sources of food, fodder, or biofuel in marginal soils. As precipitation events become more intense and infrequent, we show that even though marginal land area may increase, CAM crop cultivation shows great promise for maintaining high productivity with minimal water inputs. Our analysis indicates that on marginal lands, widespread cultivation of CAM crops as biofuel feedstock may help alleviate existing tensions between food and fuel production.

  6. Marginal and internal fit of pressed lithium disilicate inlays fabricated with milling, 3D printing, and conventional technologies.

    PubMed

    Homsy, Foudda R; Özcan, Mutlu; Khoury, Marwan; Majzoub, Zeina A K

    2018-05-01

    The subtractive and additive computer-aided design and computer-aided manufacturing (CAD-CAM) of lithium disilicate partial coverage restorations is poorly documented. The purpose of this in vitro study was to compare the marginal and internal fit accuracy of lithium disilicate glass-ceramic inlays fabricated with conventional, milled, and 3-dimensional (3D) printed wax patterns. A dentoform mandibular first molar was prepared for a mesio-occlusal ceramic inlay. Five groups of 15 inlays were obtained through conventional impression and manual wax pattern (group CICW); conventional impression, laboratory scanning of the stone die, CAD-CAM milled wax blanks (group CIDW) or 3D printed wax patterns (group CI3DW); and scanning of the master preparation with intraoral scanner and CAD-CAM milled (group DSDW) or 3D printed wax patterns (group DS3DW). The same design was used to produce the wax patterns in the last 4 groups. The replica technique was used to measure marginal and internal adaptation by using stereomicroscopy. Mixed-model ANOVA was used to assess differences according to the groups and discrepancy location (α=.05). Group DSDW showed the smallest marginal discrepancy (24.3 μm) compared with those of groups CICW (45.1 μm), CIDW (33.7 μm), CI3DW (39.8 μm), and DS3DW (39.7 μm) (P<.001). No statistically significant differences were detected among groups CICW, CIDW, CI3DW, and DS3DW relative to the marginal discrepancy. The internal discrepancy was significantly larger than the marginal discrepancy within all groups (P<.001). Lithium disilicate glass-ceramic inlays produced from digital scans and subtractive milling of wax patterns resulted in better marginal and internal fit accuracy than either conventional impression/fabrication or additive 3D manufacturing. Three-dimensional printed wax patterns yielded fit values similar to those of the conventionally waxed inlays. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  7. Isostatic and dynamic support of high topography on a North Atlantic passive margin

    NASA Astrophysics Data System (ADS)

    Pedersen, Vivi K.; Huismans, Ritske S.; Moucha, Robert

    2016-07-01

    Substantial controversy surrounds the origin of high topography along passive continental margins. Here we focus on the well-documented elevated passive margin in southwestern Scandinavia, and quantify the relative contributions of crustal isostasy and dynamic topography in controlling the present topography. We find that majority of the topography is compensated by the crustal structure, suggesting a topographic age that is in accord with the 400 Myr old Caledonian orogenesis. In addition, we propose that dynamic uplift of ∼300 m has rejuvenated existing topography locally in the coastal region over the last 10 Myr. Such uplift, combined with a general sea level fall, can help explain a variety of observations that have traditionally been interpreted in favor of a peneplain uplift model. We conclude that high topography along the Scandinavian margin cannot represent remnants of a peneplain uplifted within the last 20 Myr. The topography must have been high since the Caledonian orogeny.

  8. Informal and Formal Support Groups Retain Women and Minorities in Physics

    NASA Astrophysics Data System (ADS)

    Ong, Maria

    2005-10-01

    Ten U.S. minority female undergraduates who aspire to become physicists were followed over an 8-year period. Participant observation and in-depth interviews recorded the strategies they used to earn bachelor's degrees in physics or physics-related fields, and then go on to graduate school and/or careers in science. One significant strategy these women of color employed was participating in small subcommunities with other women or underrepresented ethnic minorities at the margins of their local physics community. The study found that informal peer groups offered safe spaces to counter negative experiences, to normalize their social realities, and to offer practical guidance for persevering in the field. Formal women- and minority-serving programs in physics provided foundations for community building, stronger curriculum and instruction, networking, and role models. The positive effects of informal and formal support groups on these students' experiences challenge a standard application of Pierre Bourdieu's framework of social and cultural capital. Women of color in the study initially lacked traditional capital of "acceptable" appearance, cultural background and habits, and networks that are more easily acquired by white males and are rewarded by the U.S. physics culture. However, instead of failing or leaving, as Bourdieu's theory would predict, the minority women persisted and achieved in science. The marginal communities contributed to their retention by offering safe spaces in which they could learn and share alternative ways of "accruing capital." Moreover, as these women made strides along their academic and career paths, they also engaged in social justice work in efforts to change the physics culture to be more welcoming of nontraditional members. The outcomes of the study offer empirical confirmation of the critical need for informal and institutionally supported women's and minorities' support groups to promote diversity in science.

  9. The Effect of Water or Wax-based Binders on the Chemical and Morphological Characteristics of the Margin Ceramic-Framework Interface.

    PubMed

    Güler, Umut; de Queiroz, José Renato Cavalcanti; de Oliveira, Luiz Fernando Cappa; Canay, Senay; Ozcan, Mutlu

    2015-09-01

    This study evaluated the effect of binder choice in mixing ceramic powder on the chemical and morphological features between the margin ceramic-framework interfaces. Titanium and zirconia frameworks (15 x 5 x 0.5 mm3) were veneered with margin ceramics prepared with two different binders, namely a) water/conventional or b) wax-based. For each zirconia framework material, four different margin ceramics were used: a- Creation Zi (Creation Willi Geller International); b- GC Initial Zr (GC America); Triceram (Dentaurum); and d- IPS emax (voclar Vivadent). For the titanium framework, three different margin ceramics were used: a- Creation Ti (Creation Willi Geller International); b- Triceram (Dentaurum); and c- VITA Titaniumkeramik (Vita Zahnfabrik). The chemical composition of the framework-margin ceramic interface was analyzed using Energy Dispersive X-ray Spectroscopy (EDS) and porosity level was quantified within the margin ceramic using an image program (ImageJ) from four random areas (100 x 100 pixels) on each SEM image. EDS analysis showed the presence of Carbon at the margin ceramic-framework interface in the groups where wax-based binder technique was used with the concentration being the highest for the IPS emax ZirCAD group. While IPS system (IPS ZirCAD and IPS Emax) presented higher porosity concentration using wax binder, in the other groups wax-based binder reduced the porosity of margin ceramic, except for Titanium - Triceram combination.

  10. Influence of Different Ceramic Systems on Marginal Misfit.

    PubMed

    Vargas, S P; Neves, A C C; Vitti, R; Amaral, M; Henrique, M N; Silva-Concílio, L R

    2017-09-01

    the aim of this study was to evaluate the marginal misfit at the interface between a ceramic coping and its abutment. Twenty-four specimens were made with solid abutments. The specimens were divided into 3 groups according to the ceramic system (n = 8): Lava (zirconia), IPS e.max Press (lithium disilicate), and IPS Empress Esthetic (leucite). All copings were cemented with resin luting agent (RelyX U200) and the marginal misfit were evaluated at 3 different times: initial, after cementation, and after mechanical cycling using a linear measuring microscope (Measuring Microscope STM-Olympus) at a magnification of 40x. All specimens were subjected to mechanical cycling (1 million cycles) by an universal testing machine (Instron 8800). The results were statistically analyzed using Analysis of Variance and Student's t-test (α = 0.05). all groups showed an increase in the marginal misfit after cementation. The lithium disilicate group demonstrated the lowest interacial gap values at each evaluation (p = 0.001). The zirconia and leucite groups showed similar interfacial gap values (initial, p = 0.244; and post cementation, p = 0.751). the cementation increase the marginal misfit, but the mechanical cycling did not influence the marginal misfit of the ceramics systems evaluated. Copyright© 2017 Dennis Barber Ltd.

  11. A Comparison of the Marginal and Internal Fit of Cobalt- Chromium Copings Fabricated by Two Different CAD/CAM Systems (CAD/ Milling, CAD/ Ceramill Sintron).

    PubMed

    Vojdani, Mahroo; Torabi, Kianoosh; Atashkar, Berivan; Heidari, Hossein; Torabi Ardakani, Mahshid

    2016-12-01

    Marginal fitness is the most important criteria for evaluation of the clinical acceptability of a cast restoration. Marginal gap which is due to cement solubility and plaque retention is potentially detrimental to both tooth and periodontal tissues. This in vitro study aimed to evaluate the marginal and internal fit of cobalt- chromium (Co-Cr) copings fabricated by two different CAD/CAM systems: (CAD/ milling and CAD/ Ceramill Sintron). We prepared one machined standard stainless steel master model with following dimensions: 7 mm height, 5mm diameter, 90˚ shoulder marginal finish line with 1 mm width, 10˚ convergence angle and anti-rotational surface on the buccal aspect of the die. There were 10 copings produced from hard presintered Co-Cr blocks according to CAD/ Milling technique and ten copings from soft non- presintered Co-Cr blocks according to CAD/ Ceramill Sintron technique. Marginal and internal accuracies of copings were documented by the replica technique. Replicas were examined at ten reference points under a digital microscope (230X). The Student's t-test was used for statistical analysis. p < 0.001 was considered significant. Statistically significant differences existed between the groups ( p < 0.001). The CAD/milling group (hard copings) had a mean marginal discrepancy (MD) of 104 µm, axial discrepancy (AD) of 23 µm and occlusal discrepancy of 130 µm. For CAD/ Ceramill Sintron group, these values were 195 µm (MD), 46 µm (AD), and 232 µm (OD). Internal total discrepancy (ITD) for the CAD/milling group was 77 µm, whereas for the CAD/Ceramill Sintron group was 143 µm. Hard presintered Co-Cr copings had significantly higher marginal and internal accuracies compared to the soft non-presintered copings.

  12. Phenotyping nutritional and antinutritional traits

    USDA-ARS?s Scientific Manuscript database

    Evolution of nutrient-rich food systems to calorie-focused production agriculture has created serious agricultural and human health issues: marginalization of traditional agricultural crops, greater dependence of agricultural inputs, and creation of both energy and micronutrient malnutrition. To dat...

  13. Marginal Accuracy and Internal Fit of 3-D Printing Laser-Sintered Co-Cr Alloy Copings.

    PubMed

    Kim, Myung-Joo; Choi, Yun-Jung; Kim, Seong-Kyun; Heo, Seong-Joo; Koak, Jai-Young

    2017-01-23

    Laser sintered technology has been introduced for clinical use and can be utilized more widely, accompanied by the digitalization of dentistry and the development of direct oral scanning devices. This study was performed with the aim of comparing the marginal accuracy and internal fit of Co-Cr alloy copings fabricated by casting, CAD/CAM (Computer-aided design/Computer-assisted manufacture) milled, and 3-D laser sintered techniques. A total of 36 Co-Cr alloy crown-copings were fabricated from an implant abutment. The marginal and internal fit were evaluated by measuring the weight of the silicone material, the vertical marginal discrepancy using a microscope, and the internal gap in the sectioned specimens. The data were statistically analyzed by One-way ANOVA (analysis of variance), a Scheffe's test, and Pearson's correlation at the significance level of p = 0.05, using statistics software. The silicone weight was significantly low in the casting group. The 3-D laser sintered group showed the highest vertical discrepancy, and marginal-, occlusal-, and average- internal gaps ( p < 0.05). The CAD/CAM milled group revealed a significantly high axial internal gap. There are moderate correlations between the vertical marginal discrepancy and the internal gap variables ( r = 0.654), except for the silicone weight. In this study, the 3-D laser sintered group achieved clinically acceptable marginal accuracy and internal fit.

  14. Marginal Accuracy and Internal Fit of 3-D Printing Laser-Sintered Co-Cr Alloy Copings

    PubMed Central

    Kim, Myung-Joo; Choi, Yun-Jung; Kim, Seong-Kyun; Heo, Seong-Joo; Koak, Jai-Young

    2017-01-01

    Laser sintered technology has been introduced for clinical use and can be utilized more widely, accompanied by the digitalization of dentistry and the development of direct oral scanning devices. This study was performed with the aim of comparing the marginal accuracy and internal fit of Co-Cr alloy copings fabricated by casting, CAD/CAM (Computer-aided design/Computer-assisted manufacture) milled, and 3-D laser sintered techniques. A total of 36 Co-Cr alloy crown-copings were fabricated from an implant abutment. The marginal and internal fit were evaluated by measuring the weight of the silicone material, the vertical marginal discrepancy using a microscope, and the internal gap in the sectioned specimens. The data were statistically analyzed by One-way ANOVA (analysis of variance), a Scheffe’s test, and Pearson’s correlation at the significance level of p = 0.05, using statistics software. The silicone weight was significantly low in the casting group. The 3-D laser sintered group showed the highest vertical discrepancy, and marginal-, occlusal-, and average- internal gaps (p < 0.05). The CAD/CAM milled group revealed a significantly high axial internal gap. There are moderate correlations between the vertical marginal discrepancy and the internal gap variables (r = 0.654), except for the silicone weight. In this study, the 3-D laser sintered group achieved clinically acceptable marginal accuracy and internal fit. PMID:28772451

  15. Effect of Preparation Depth on the Marginal and Internal Adaptation of Computer-aided Design/Computer-assisted Manufacture Endocrowns.

    PubMed

    Gaintantzopoulou, M D; El-Damanhoury, H M

    The aim of the study was to evaluate the effect of preparation depth and intraradicular extension on the marginal and internal adaptation of computer-aided design/computer-assisted manufacture (CAD/CAM) endocrown restorations. Standardized preparations were made in resin endodontic tooth models (Nissin Dental), with an intracoronal preparation depth of 2 mm (group H2), with extra 1- (group H3) or 2-mm (group H4) intraradicular extensions in the root canals (n=12). Vita Enamic polymer-infiltrated ceramic-network material endocrowns were fabricated using the CEREC AC CAD/CAM system and were seated on the prepared teeth. Specimens were evaluated by microtomography. Horizontal and vertical tomographic sections were recorded and reconstructed by using the CTSkan software (TView v1.1, Skyscan).The surface/void volume (S/V) in the region of interest was calculated. Marginal gap (MG), absolute marginal discrepancy (MD), and internal marginal gap were measured at various measuring locations and calculated in microscale (μm). Marginal and internal discrepancy data (μm) were analyzed with nonparametric Kruskal-Wallis analysis of variance by ranks with Dunn's post hoc, whereas S/V data were analyzed by one-way analysis of variance and Bonferroni multiple comparisons (α=0.05). Significant differences were found in MG, MD, and internal gap width values between the groups, with H2 showing the lowest values from all groups. S/V calculations presented significant differences between H2 and the other two groups (H3 and H4) tested, with H2 again showing the lowest values. Increasing the intraradicular extension of endocrown restorations increased the marginal and internal gap of endocrown restorations.

  16. Real-Time Stability Margin Measurements for X-38 Robustness Analysis

    NASA Technical Reports Server (NTRS)

    Bosworth, John T.; Stachowiak, Susan J.

    2005-01-01

    A method has been developed for real-time stability margin measurement calculations. The method relies on a tailored-forced excitation targeted to a specific frequency range. Computation of the frequency response is matched to the specific frequencies contained in the excitation. A recursive Fourier transformation is used to make the method compatible with real-time calculation. The method was incorporated into the X-38 nonlinear simulation and applied to an X-38 robustness test. X-38 stability margins were calculated for different variations in aerodynamic and mass properties over the vehicle flight trajectory. The new method showed results comparable to more traditional stability analysis techniques, and at the same time, this new method provided coverage that is more complete and increased efficiency.

  17. Radiographic evaluation of marginal bone level around implants with different neck designs after 1 year.

    PubMed

    Shin, Young-Kyu; Han, Chong-Hyun; Heo, Seong-Joo; Kim, Sunjai; Chun, Heoung-Jae

    2006-01-01

    To evaluate the influence of macro- and microstructure of the implant surface at the marginal bone level after functional loading. Sixty-eight patients were randomly assigned to 1 of 3 groups. The first group received 35 implants with a machined neck (Ankylos); the second group, 34 implants with a rough-surfaced neck (Stage 1); and the third, 38 implants with a rough-surfaced neck with microthreads (Oneplant). Clinical and radiographic examinations were conducted at baseline (implant loading) and 3, 6, and 12 months postloading. Two-way repeated analysis of variance (ANOVA) was used to test the significance of marginal bone change of each tested group at baseline, 3, 6, and 12 month follow-ups and 1-way ANOVA was also used to compare the bone loss of each time interval within the same implant group (P < .05). At 12 months, significant differences were noted in the amount of alveolar bone loss recorded for the 3 groups (P < .05). The group with the rough-surfaced microthreaded neck had a mean crestal bone loss of 0.18 +/- 0.16 mm; the group with the rough-surfaced neck, 0.76 +/- 0.21 mm; and the group with the machined neck, 1.32 +/- 0.27 mm. In the rough-surfaced group and the rough-surfaced microthreaded group, no statistically significant changes were observed after 3 months, whereas the machined-surface group showed significant bone loss for every interval (P < .05). To minimize marginal bone loss, in addition to the use of a rough surface at the marginal bone level, a macroscopic modification such as the addition of microthreads could be recommended. A rough surface and microthreads at the implant neck not only reduce crestal bone loss but also help with early biomechanical adaptation against loading in comparison to the machined neck design. A rough surface with microthreads at the implant neck was the most effective design to maintain the marginal bone level against functional loading.

  18. Effect of three surface sealants on marginal sealing of Class V composite resin restorations.

    PubMed

    Ramos, R P; Chimello, D T; Chinelatti, M A; Dibb, R G; Mondelli, J

    2000-01-01

    This study evaluated in vitro the effectiveness of three different surface sealants (Fortify, Protect-it! and Optiguard) on the marginal sealing of Class V light-activated composite resin restorations (Prodigy). For this purpose, 20 sound noncarious human premolars extracted within a six-month period were selected. Class V cavities with the occlusal margin in enamel and cervical margin in cementum were prepared in both buccal and lingual surfaces. The teeth, randomly assigned in four groups with 10 cavities in each group, were restored with composite resin after applying an adhesive system (Optibond FL). After the finishing and polishing procedures, the restorations were covered with a specific surface sealant, except for the control samples, which were not sealed. After placing restorations, the specimens were thermocycled and immersed in a 50% silver nitrate solution (tracer agent) for eight hours, sectioned longitudinally and analyzed for leakage using an optical microscope in a blind study with three examiners. The marginal microleakage was evaluated at the occlusal and cervical interfaces and compared among the four groups using the Kruskall-Wallis and the Wilcoxon Tests. There was better sealing at the occlusal margin, and in this region, there were no statistically significant differences among the materials (p > 0.05). In the cervical region, Fortify and Protect-it! showed improved results over the Control Group, and Optiguard showed similar results to the Control Group (without sealing).

  19. Marginal and internal adaptation of ceramic crown restorations fabricated with CAD/CAM technology and the heat-press technique.

    PubMed

    Mously, Hisham A; Finkelman, Matthew; Zandparsa, Roya; Hirayama, Hiroshi

    2014-08-01

    The accuracy of chairside computer-aided design and computer-aided manufacturing (CAD/CAM) restorations is questionable, and the effect of the die spacer settings is not well stated in the literature. The purpose of the study was to evaluate the marginal and internal adaptation of E4D crowns fabricated with different spacer thicknesses and to compare these crowns with those fabricated with the heat-press technique. The E4D system was used to fabricate 30 crowns for the first 3 groups, with different spacer thickness settings: 30 μm, 60 μm, and 100 μm. In the fourth group, 10 lithium disilicate crowns were fabricated with the heat-press technique. The occlusal gap, axial gap, vertical marginal gap, and absolute marginal discrepancy were evaluated by x-ray microtomography. Statistical significance was assessed with the Kruskal-Wallis test (α=.05). For post hoc analyses, the Mann-Whitney U test was used alongside the Bonferroni correction for multiple comparisons (α=.008). Within the CAD/CAM groups, the 30-μm spacer thickness resulted in the lowest median axial gap (90.04 μm), whereas the 60-μm spacer thickness resulted in the lowest median occlusal gap (152.39 μm). The median marginal gap values of the CAD/CAM-60 group (49.35 μm) and CAD/CAM-100 group (46.65 μm) were lower than those of the CAD/CAM-30 group (55.18 μm). No significant differences among the CAD/CAM groups were observed for absolute marginal discrepancy. The heat-press group had significantly different values than those of the CAD/CAM groups. The spacer thickness and fabrication technique affected the adaptation of ceramic crowns. The heat-press group yielded the best marginal and internal crown adaptation results. The 30- or 60-μm spacer settings are recommended for the E4D CAD/CAM system. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  20. The effect of surface sealants with different filler content on microleakage of Class V resin composite restorations.

    PubMed

    Hepdeniz, Ozge Kam; Temel, Ugur Burak; Ugurlu, Muhittin; Koskan, Ozgur

    2016-01-01

    Microleakage is still one of the most cited reasons for failure of resin composite restorations. Alternative methods to prevent microleakage have been investigated increasingly. The aim of this study is to evaluate the microleakage in Class V resin composite restorations with or without application of surface sealants with different filler content. Ninety-six cavities were prepared on the buccal and lingual surfaces with the coronal margins located in enamel and the cervical margins located in dentin. The cavities restored with an adhesive system (Clearfil SE Bond, Kuraray, Tokyo, Japan) and resin composite (Clearfil Majesty ES-2, Kuraray, Tokyo, Japan). Teeth were stored in distilled water for 24 h and separated into four groups according to the surface sealants (Control, Fortify, Fortify Plus, and G-Coat Plus). The teeth were thermocycled (500 cycles, 5-55° C), immersed in basic fuchsine, sectioned, and analyzed for dye penetration using stereomicroscope. The data were submitted to statistical analysis by Kruskal-Wallis and Bonferroni-Dunn test. The results of the study indicated that there was minimum leakage at the enamel margins of all groups. Bonferroni-Dunn tests revealed that Fortify and GC-Coat groups showed significantly less leakage than the Control group and the Fortify Plus group at dentin margins in lingual surfaces (P < 0.05). The all surface sealants used in this study eliminated microleakage at enamel margins. Moreover, unfilled or nanofilled surface sealants were the most effective in decreasing the degree of marginal microleakage at dentin margins. However, viscosity and penetrability of the sealants could be considered for sealing ability besides composition.

  1. Comparison and evaluation of marginal and internal gaps in cobalt-chromium alloy copings fabricated using subtractive and additive manufacturing.

    PubMed

    Kim, Dong-Yeon; Kim, Ji-Hwan; Kim, Hae-Young; Kim, Woong-Chul

    2018-01-01

    To evaluate the marginal and internal gaps of cobalt-chromium (Co-Cr) alloy copings fabricated using subtractive and additive manufacturing. A study model of an abutment tooth 46 was prepared by a 2-step silicone impression with dental stone. Fifteen stereolithography files for Co-Cr alloy copings were compiled using a model scanner and dental CAD software. Using the lost wax (LW), wax block (WB), soft metal block (SMB), microstereolithography (μ-SLA), and selected laser melting (SLM) techniques, 15 Co-Cr alloy copings were fabricated per group. The marginal and internal gaps of these Co-Cr alloy copings were measured using a digital microscope (160×), and the data obtained were analyzed using the non-parametric Kruskal-Wallis H-test and post-hoc Mann-Whitney U-test with Bonferroni correction. The mean values of the marginal, axial wall, and occlusal gaps were 91.8, 83.4, and 163μm in the LW group; 94.2, 77.5, and 122μm in the WB group; 60.0, 79.4, and 90.8μm in the SMB group; 154, 72.4, and 258μm in the μ-SLA group; and 239, 73.6, and 384μm in the SLM group, respectively. The differences in the marginal and occlusal gaps between the 5 groups were statistically significant (P<.05). The marginal gaps of the LW, WB, and SMB groups were within the clinically acceptable limit, but further improvements in the μ-SLA and SLM approaches may be required prior to clinical implementation. Copyright © 2017 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

  2. Experiences with Recruitment of Marginalized Groups in a Danish Health Promotion Program: A Document Evaluation Study.

    PubMed

    Rasmussen, Marianne; Poulsen, Eva Kanstrup; Rytter, Anne Stoffersen; Kristiansen, Tine Mechlenborg; Bak, Carsten Kronborg

    2016-01-01

    Studies have found that marginalized groups living in deprived neighborhoods are less likely to participate in health programs compared to the majority of society. This study evaluates recruitment approaches conducted during a national government-funded project in 12 deprived neighborhoods across Denmark between 2010 and 2014. The aim of this study was to understand how recruitment approaches could promote participation in health programs within deprived neighborhoods to reach marginalized groups. Documents from all 12 of the included municipalities were collected to conduct a document evaluation. The collected documents consisted of 1,500 pages of written material with 12 project descriptions, three midterm and 10 final evaluations. The collected data were analyzed through a qualitative content analysis. The results are based on the fact that only 10 municipalities have developed evaluations related to recruitment, and only three evaluations provided a description of which marginalized groups were recruited. Challenges related to recruitment consist of difficulties involving the target group, including general distrust, language barriers and a lack of ability to cope with new situations and strangers. Additional geographical challenges emerged, especially in rural areas. Positive experiences with recruitment approaches were mainly related to relationship building and trust building, especially through face-to-face contact and the project employees' presence in the neighborhood. Additionally, adjusting some of the interventions and the recruitment strategy increased participation. This study found that relation and trust between the residents and the project employees is an important factor in the recruitment of marginalized groups in deprived neighborhoods as well as adjusting the health interventions or recruitment strategy to the target groups. In future research, it is necessary to examine which recruitment approaches are effective under which circumstances to increase participation among marginalized groups.

  3. The Effect of Various Finish Line Configurations on the Marginal Seal and Occlusal Discrepancy of Cast Full Crowns After Cementation - An In-vitro Study.

    PubMed

    Nemane, Vaishali; Akulwar, Ravikumar Suryakanth; Meshram, Suresh

    2015-08-01

    The marginal fit of crowns is of clinical importance. It is found that marginal and occlusal discrepancies are commonly increased following cementation. The resistance of cementing materials is a factor that prevents cast restorations from being correctly seated. Different finish lines behave differently in facilitating the escape of the cement. When the escape path of the cement decreases, the crown fails to seat further. This study was planned with an aim to evaluate the effect of various finish lines on the marginal seal and occlusal seat of full crown preparations. Six stainless steel metal dies were machined to simulate molar crown preparations. The diameter was 10 mm and height was 6mm. The occlusal surface was kept flat and a small circular dimple was machined for reorientation of the wax pattern and metal copings, margins of various designs were machined accurately. The margins prepared were Group A- 90(0)C shoulder, Group B- Rounded shoulder, Group C- 45 degree sloped shoulder, Group D- Chamfer, Group E- Long chamfer, Group F- Feather edge. Full cast metal crowns of base metal alloy were fabricated over the metal dies. Zinc phosphate luting cement was used for the cementation. After twenty four hours, the cemented crown and die assembly were embedded in clear acrylic resin so as to hold the assembly together while sectioning. Twenty four hours later, all the samples were sectioned sagitally. The sectioned halves were focused under a stereomicroscope and the cement spaces were measured to the nearest micron. The cement thickness was measured at two points on the occlusal surface and one at each margin. Significant differences were observed in the occlusal seat and marginal seal of all the finish line configurations. The rounded shoulder had the best occlusal seat, followed by 90(0)C shoulder. The occlusal seat and marginal seal afforded by the shoulder finish lines were similar whereas there was a vast difference in the seating and sealing of long chamfer and feather edged preparations. They showed the worst occlusal seat. It was found that the finish lines like shoulder preparations which exhibit poor sealing prior to complete cementation allow good seating whereas margins which seal earlier do not allow escape of cement and hence do not seat completely.

  4. The Effect of Various Finish Line Configurations on the Marginal Seal and Occlusal Discrepancy of Cast Full Crowns After Cementation - An In-vitro Study

    PubMed Central

    Nemane, Vaishali; Meshram, Suresh

    2015-01-01

    Background The marginal fit of crowns is of clinical importance. It is found that marginal and occlusal discrepancies are commonly increased following cementation. The resistance of cementing materials is a factor that prevents cast restorations from being correctly seated. Different finish lines behave differently in facilitating the escape of the cement. When the escape path of the cement decreases, the crown fails to seat further. Materials and Methods This study was planned with an aim to evaluate the effect of various finish lines on the marginal seal and occlusal seat of full crown preparations. Six stainless steel metal dies were machined to simulate molar crown preparations. The diameter was 10 mm and height was 6mm. The occlusal surface was kept flat and a small circular dimple was machined for reorientation of the wax pattern and metal copings, margins of various designs were machined accurately. The margins prepared were Group A- 900C shoulder, Group B- Rounded shoulder, Group C- 45 degree sloped shoulder, Group D- Chamfer, Group E- Long chamfer, Group F- Feather edge. Full cast metal crowns of base metal alloy were fabricated over the metal dies. Zinc phosphate luting cement was used for the cementation. After twenty four hours, the cemented crown and die assembly were embedded in clear acrylic resin so as to hold the assembly together while sectioning. Twenty four hours later, all the samples were sectioned sagitally. The sectioned halves were focused under a stereomicroscope and the cement spaces were measured to the nearest micron. The cement thickness was measured at two points on the occlusal surface and one at each margin. Results Significant differences were observed in the occlusal seat and marginal seal of all the finish line configurations. The rounded shoulder had the best occlusal seat, followed by 900C shoulder. The occlusal seat and marginal seal afforded by the shoulder finish lines were similar whereas there was a vast difference in the seating and sealing of long chamfer and feather edged preparations. They showed the worst occlusal seat. Conclusion It was found that the finish lines like shoulder preparations which exhibit poor sealing prior to complete cementation allow good seating whereas margins which seal earlier do not allow escape of cement and hence do not seat completely. PMID:26436039

  5. The Association between Cultural Orientation and Drinking Behaviors among University Students in Wuhan, China

    PubMed Central

    Tang, Hongxiu; Cai, Weibin; Wang, Hongjing; Zhang, Qing; Qian, Ling; Shell, Duane F.; Newman, Ian M.; Yin, Ping

    2013-01-01

    Objectives This study examines the association between cultural orientation and drinking behaviors among university students. Cultural orientation is the measure of how the cultural values of individuals living in their own society are influenced by cultural values introduced from the outside. Methods In 2011, a cross-sectional survey collected data from 1279 university students from six universities in central China. Participants used a likert scale to rank a series of statements reflecting cultural values from the previously validated Chinese Cultural Orientation Scale and answered questions about their drinking behaviors and socio-demographic characteristics. Results Statistically significant differences in cultural orientation were observed for gender, hometown and type of university attendance. Traditional-oriented students were more likely to be occasional drinkers or nondrinkers, while marginal-oriented students, bicultural-oriented students and western-oriented students were more likely to be regular drinkers. Bicultural orientation (OR = 1.80, P<0.05) and marginal orientation (OR = 1.64, P<0.05) increased the likelihood of the student being regular drinking, compared to students with traditional orientations. Males (OR = 4.40, P<0.05) had a higher likelihood of regular drinking than females, graduate students (OR = 2.59, P<0.05) had a higher likelihood of regular drinking than undergraduates, students from urban areas (OR = 1.79, P<0.05) had a higher likelihood of regular drinking than those from towns/rural areas, and students attending key universities (OR = 0.48, P<0.05) had a lower likelihood of regular drinking than those attending general universities. Conclusions Cultural orientation influences drinking behaviors. Traditional cultural orientation was associated with less drinking while western cultural orientation, marginal cultural orientation and bicultural orientation were associated with more drinking. The role of gender, hometown and university attendance is partially moderated through the influence of cultural orientation. The relationship between a traditional cultural orientation and alcohol drinking suggests that traditional Chinese cultural values should be examined for their role in possibly reducing alcohol-related risks through education and policy initiatives. PMID:23359611

  6. Effect of protective coating on microhardness of a new glass ionomer cement: Nanofilled coating versus unfilled resin.

    PubMed

    Faraji, Foad; Heshmat, Haleh; Banava, Sepideh

    2017-01-01

    EQUIA TM is a new gastrointestinal (GI) system with high compressive strength, surface microhardness (MH), and fluoride release potential. This in vitro study aimed to assess the effect of aging and type of protective coating on the MH of EQUIA TM GI cement. A total of 30 disc-shaped specimens measuring 9 mm in diameter and 2 mm in thickness were fabricated of EQUIA TM GI and divided into three groups of G-Coat nanofilled coating (a), no coating (b) and margin bond (c). The Vickers MH value of specimens was measured before (baseline) and at 3 and 6 months after water storage. Data were analyzed using repeated measures ANOVA. Group B had significantly higher MH than the other two groups at baseline. Both G-Coat and margin bond increased the surface MH of GI at 3 and 6 months. The MH values of G-Coat and margin bond groups did not significantly increase or decrease between 3 and 6 months. The increase in MH was greater in the G-Coat compared to the margin bond group in the long-term. Clinically, margin bond may be a suitable alternative when G-Coat is not available.

  7. Break-even analysis revisited: the need to adjust for profitability, the collection rate and autonomous income.

    PubMed

    Broyles, R W; Narine, L; Khaliq, A

    2003-08-01

    This paper modifies traditional break-even analysis and develops a model that reflects the influence of variation in payer mix, the collection rate, profitability and autonomous income on the desired volume alternative. The augmented model indicates that a failure to adjust for uncollectibles and the net surplus results in a systematic understatement of the desired volume alternative. Conversely, a failure to adjust for autonomous income derived from the operation of cafeterias, gift shops or an organization's investment in marketable securities produces an overstatement of the desired volume. In addition, this paper uses Microsoft Excel to develop a spreadsheet that constructs a pro forma income statement, expressed in terms of the contribution margin. The spreadsheet also relies on the percentage of sales or revenue approach to prepare a balance sheet from which indicators of fiscal performance are calculated. Hence, the analysis enables the organization to perform a sensitivity analysis of potential changes in the desired volume, the operating margin, the current ratio, the debt: equity ratio and the amount of cash derived from operations that are associated with expected variation in payer mix, the collection rate, grouped by payer, the net surplus and autonomous income.

  8. An In Vitro Comparison of the Marginal Adaptation Accuracy of CAD/CAM Restorations Using Different Impression Systems.

    PubMed

    Shembesh, Marwa; Ali, Ala; Finkelman, Matthew; Weber, Hans-Peter; Zandparsa, Roya

    2017-10-01

    To compare the marginal adaptation of 3-unit zirconia fixed dental prostheses (FDPs) obtained from intraoral digital scanners (Lava True Definition, Cadent iTero), scanning of a conventional silicone impression, and the resulting master cast with an extraoral scanner (3Shape lab scanner). One reference model was fabricated from intact, non-carious, unrestored human mandibular left first premolar and first molar teeth (teeth #19 and 21), prepared for a three-unit all-ceramic FDP. Impressions of the reference model were obtained using four impression systems (n = 10), group 1 (PVS impression scan), group 2 (stone cast scan), group 3 (Cadent iTero), and group 4 (Lava True Defintion). Then the three-unit zirconia FDPs were milled. Marginal adaptation of the zirconia FDPs was evaluated using an optical comparator at four points on each abutment. The mean (SD) was reported for each group. One-way ANOVA was used to assess the statistical significance of the results, with post hoc tests conducted via Tukey's HSD. p < 0.05 was considered statistically significant. All analyses were done using SPSS 22.0. The mean (SD) marginal gaps for the recorded data from highest to lowest were silicone impression scans 81.4 μm (6.8), Cadent iTero scan 62.4 μm (5.0), master cast scan 50.2 μm (6.1), and Lava True definition scan 26.6 μm (4.7). One-way ANOVA revealed significant differences (p < 0.001) in the mean marginal gap among the groups. The Tukey's HSD tests demonstrated that the differences between all groups (silicone impression scan, master cast scan, Lava True definition scan, iTero Cadent scan) were statistically significant (all p < 0.001). On the basis of the criterion of 120 μm as the limit of clinical acceptance, all marginal discrepancy values of all groups were clinically acceptable. Within the confines of this in vitro study, it can be concluded that the marginal gap of all impression techniques was within the acceptable clinical limit (120 μm). Group 4 (Lava True Defintion) showed the lowest average gap among all groups followed by group 2 (stone cast scan), group 3 (Cadent iTero), and group 1 (PVS impression scan); these differences were statistically significant. © 2016 by the American College of Prosthodontists.

  9. Simulated and Virtual Science Laboratory Experiments: Improving Critical Thinking and Higher-Order Learning Skills

    NASA Astrophysics Data System (ADS)

    Simon, Nicole A.

    Virtual laboratory experiments using interactive computer simulations are not being employed as viable alternatives to laboratory science curriculum at extensive enough rates within higher education. Rote traditional lab experiments are currently the norm and are not addressing inquiry, Critical Thinking, and cognition throughout the laboratory experience, linking with educational technologies (Pyatt & Sims, 2007; 2011; Trundle & Bell, 2010). A causal-comparative quantitative study was conducted with 150 learners enrolled at a two-year community college, to determine the effects of simulation laboratory experiments on Higher-Order Learning, Critical Thinking Skills, and Cognitive Load. The treatment population used simulated experiments, while the non-treatment sections performed traditional expository experiments. A comparison was made using the Revised Two-Factor Study Process survey, Motivated Strategies for Learning Questionnaire, and the Scientific Attitude Inventory survey, using a Repeated Measures ANOVA test for treatment or non-treatment. A main effect of simulated laboratory experiments was found for both Higher-Order Learning, [F (1, 148) = 30.32,p = 0.00, eta2 = 0.12] and Critical Thinking Skills, [F (1, 148) = 14.64,p = 0.00, eta 2 = 0.17] such that simulations showed greater increases than traditional experiments. Post-lab treatment group self-reports indicated increased marginal means (+4.86) in Higher-Order Learning and Critical Thinking Skills, compared to the non-treatment group (+4.71). Simulations also improved the scientific skills and mastery of basic scientific subject matter. It is recommended that additional research recognize that learners' Critical Thinking Skills change due to different instructional methodologies that occur throughout a semester.

  10. Marginal integrity of resin composite restorations restored with PPD initiatorcontaining resin composite cured by QTH, monowave and polywave LED units.

    PubMed

    Bortolotto, Tissiana; Betancourt, Francisco; Krejci, Ivo

    2016-12-01

    This study evaluated the influence of curing devices on marginal adaptation of cavities restored with self-etching adhesive containing CQ and PPD initiators and hybrid composite. Twenty-four class V (3 groups, n=8) with margins located on enamel and dentin were restored with Clearfil S3 Bond and Clearfil APX PLT, light-cured with a monowave LED, multiwave LED and halogen light-curing unit (LCU). Marginal adaptation was evaluated with SEM before/after thermo-mechanical loading (TML). On enamel, significantly lower % continuous margins (74.5±12.6) were found in group cured by multiwave LED when compared to monowave LED (87.6±9.5) and halogen LCU (94.4±9.1). The presence of enamel and composite fractures was significantly higher in the group light-cured with multiwave LED, probably due to an increased materials' friability resulted from an improved degree of cure. The clinician should aware that due to a distinct activation of both initiators, marginal quality may be influenced on the long-term.

  11. Freiluftschulen: Eine Historisch-Padagogische Randerscheinung als Reflex Sozial-Historischer Modernisierungsprozesse? Das Beispiel Belgiens (Open-Air Schools: A Marginal Appearance in Pedagogical History as a Reflection of Socio-Historical Processes of Modernization? The Example of Belgium).

    ERIC Educational Resources Information Center

    Depaepe, Marc; Simon, Frank

    2003-01-01

    Discusses the history of open-air schools using an evaluation of Belgian schools. Expounds on the complex relationship between educational space and the educational act, and between traditional and progressive education. Demonstrates that open-air schools provided the same education as traditional schools and were not a real alternative for…

  12. Marginal and Internal Discrepancies of Posterior Zirconia-Based Crowns Fabricated with Three Different CAD/CAM Systems Versus Metal-Ceramic.

    PubMed

    Ortega, Rocio; Gonzalo, Esther; Gomez-Polo, Miguel; Suárez, María J

    2015-01-01

    The aim of this study was to analyze the marginal and internal fit of metalceramic and zirconia-based crowns. Forty standardized steel specimens were prepared to receive posterior crowns and randomly divided into four groups (n = 10): (1) metal-ceramic, (2) NobelProcera Zirconia, (3) Lava Zirconia, and (4) VITA In-Ceram YZ. All crowns were cemented with glass-ionomer agent and sectioned buccolingually. A scanning electron microscope was used for measurements. Kruskal-Wallis and Wilcoxon signed rank test (α = .05) statistical analyses were conducted. Significant differences (P < .0001) in marginal discrepancies were observed between metal-ceramic and zirconia groups. No differences were found for the axial wall fit (P = .057). Significant differences were shown among the groups in discrepancies at the occlusal cusp (P = .0012) and at the fossa (P = .0062). No differences were observed between surfaces. All zirconia groups showed better values of marginal discrepancies than the metal-ceramic group. Procera Zirconia showed the lowest gaps.

  13. Comparative evaluation of effects of bleaching on color stability and marginal adaptation of discolored direct and indirect composite laminate veneers under in vivo conditions.

    PubMed

    Jain, Veena; Das, Taposh K; Pruthi, Gunjan; Shah, Naseem; Rajendiran, Suresh

    2015-01-01

    Change in color and loss of marginal adaptation of tooth colored restorative materials is not acceptable. Bleaching is commonly used for treating discolored teeth. However, the literature is scanty regarding its effect on color and marginal adaptation of direct and indirect composite laminate veneers (CLVs) under in vivo conditions. Purpose of the study was to determine the effect of bleaching on color change and marginal adaptation of direct and indirect CLVs over a period of time when exposed to the oral environment. For this purpose, a total of 14 subjects irrespective of age and sex indicated for CLV restorations on maxillary anterior teeth were selected following the inclusion and exclusion criteria. For each subject, indirect CLVs were fabricated and looted in the first quadrant (Group 1) and direct CLV's (Group 2), were given in the second quadrant. Color change was assessed clinically using intra-oral digital spectrophotometer and marginal adaptation was assessed on epoxy resin replica of the tooth-restoration interface under scanning electron microscope. After 6 months, the subjects underwent a home bleaching regimen for 14 days using 10% carbamide peroxide. The assessment of color change and marginal adaptation was done at 6 months after veneering (0-180 days), immediately after the bleaching regimen (0-194 days) and 3 months after the bleaching regimen (0-284 days). The difference in median color change (ΔE) between the groups was tested using Wilcoxon rank sum test while the median color change with time within the groups was tested using Wilcoxon signed rank test. The difference in the rates of marginal adaptation was tested between the groups using Chi-square/Fisher's exact test. Bleaching led to statistically significant color change at cervical (CE), middle and incisal (IE) regions when direct and indirect composites were compared (P < 0.05). During intra-group comparison, direct CLV's showed significant color change at CE and IE regions when ΔE was compared at 180 days and 284 days (CE 10 vs. CE 30, P = 0.008, IE 10 vs. IE 30, P = 0.003). No significant differences were found when within group comparison was made for indirect laminates. Intergroup comparison between the groups showed significant difference in marginal adaptation at CE margin at all.time points (at baseline, P = 0.005; at 180 days, P = 0.007; 194 days, P = 0.025; at 284 days, P = 0.067). After bleaching, indirect CLVs performed better in terms of color stability whereas direct CLVs performed better in terms of marginal adaptation. Indirect composites should be preferred to direct composites as veneering materials as they have better color stability. Special attention should be given to their marginal adaptation especially in the CE region. Bleaching should be avoided in patients with composite restorations in the mouth.

  14. Clinical marginal and internal fit of metal ceramic crowns fabricated with a selective laser melting technology.

    PubMed

    Huang, Zhuoli; Zhang, Lu; Zhu, Jingwei; Zhang, Xiuyin

    2015-06-01

    Selective laser melting (SLM) technology has been introduced to fabricate dental restorations. However, the fit of these restorations still needs further study. The purpose of this in vivo investigation was to compare the marginal and internal fit of SLM metal ceramic crowns with 2 lost-wax cast metal ceramic crowns and to evaluate the influence of tooth type on the marginal and internal fit of these crowns. A total of 330 metal ceramic crowns were evaluated. The metal copings were fabricated with SLM Co-Cr, cast Au-Pt, and cast Co-Cr alloy (n=110). The marginal and internal gaps of crowns were recorded by using a replica technique. The anterior and premolar replicas were sectioned 2 times, and molar replicas were sectioned 4 times. The marginal and internal gap width of each cross section was examined by stereomicroscope at ×30 magnification. Two-way analysis of variance was performed to identify the statistical difference among the groups. The marginal fit of the SLM Co-Cr group (75.6 ±32.6 μm) was not different from the cast Au-Pt group (76.8 ±32.1 μm) (P>.05) but was better than the cast Co-Cr group (91.0 ±36.3 μm) (P<.01). No significant difference was found among the SLM Co-Cr group (127.3 ±45.8 μm), cast Au-Pt group (129.9 ±61.1 μm). and cast Co-Cr group (142.5 ±63.7 μm) (P>.05). The mean occlusal gap width of the SLM Co-Cr group (309.8 ±106.6 μm) was significantly higher than that of the cast Au-Pt group (254.6 ±109.6 μm) and the cast Co-Cr group (249.6 ±110.4 μm) (P<.005). No significant difference was found in the marginal fit among the anterior group (84.4 ±35.1 μm), the premolar group (80.6 ±26.3 μm), and the molar group (82.7 ±38.0 μm) (P>.05). Also, no significant difference was found in the axial fit among the anterior group (138.3 ±52.5 μm), the premolar group (132.9 ±50.4 μm), and the molar group (134.4 ±52.5 μm) (P>.05). The anterior group (267.6 ±110.2 μm) did not differ from the premolar group (270.2 ±112.8 μm) and the molar group (268.6 ±110.5 μm) in occlusal fit (P>.05). The marginal fit of SLM Co-Cr metal ceramic crowns was similar to that of the cast Au-Pt metal ceramic crowns and was better than that of the cast Co-Cr metal ceramic crowns. The SLM Co-Cr metal ceramic crowns were not significantly different from the 2 cast metal ceramic crowns in axial fit but were less accurate in occlusal fit. Tooth type did not influence the marginal and internal fit of the metal ceramic crowns. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  15. Real-time transrectal ultrasound guidance during laparoscopic radical prostatectomy: impact on surgical margins.

    PubMed

    Ukimura, Osamu; Magi-Galluzzi, Cristina; Gill, Inderbir S

    2006-04-01

    We evaluated whether intraoperative real-time TRUS navigation during LRP can decrease the incidence of positive surgical margins. Since March 2001, 294 patients with clinically organ confined prostate cancer undergoing LRP have been retrospectively divided into 2 groups, including group 1-217 who underwent LRP without TRUS from March 2001 to February 2003 and group 2-77 who have undergone LRP with TRUS since March 2003. Various baseline parameters were similar between the groups. Before March 2001 the senior surgeon had already performed more than 50 cases of LRP, thus, gaining reasonable familiarity with the technique. Compared to group 1, group 2 had a significantly decreased rate of positive surgical margins in patients with pT3 disease (57% vs 18%, p = 0.002). Positive margin rates also decreased in our overall experience (29% vs 9%, p = 0.0002). Intraoperative TRUS correctly predicted pT2 and pT3 disease in 85% and 86% of patients, respectively. Of the 54 TRUS visualized hypoechoic lesions at sites corresponding to biopsy proven cancer extracapsular extension was suspected in 31, leading to a real-time recommendation of calibrated wider, site specific dissection to achieve negative surgical margins. Intraoperative TRUS monitoring during LRP allows individualized, precise dissection tailored to the specific prostate contour anatomy, thus, compensating for the muted tactile feedback of laparoscopy. In what is to our knowledge the initial experience real-time TRUS guidance significantly decreased the incidence of positive surgical margins during LRP. In the future this concept of rectum based, intraoperative real-time navigation may facilitate a more sophisticated performance of radical prostatectomy.

  16. Comparison of microleakage of Scotchbond™ Universal Adhesive with methacrylate resin in Class V restorations by two methods: Swept source optical coherence tomography and dye penetration

    PubMed Central

    Kermanshah, Hamid; Khorsandian, Hossein

    2017-01-01

    Background: One of the most important factors in restoration failure is microleakage at the restoration interface. Furthermore, a new generation of bonding, Scotchbond Universal (multi-mode adhesive), has been introduced to facilitate the bonding steps. The aim of this study was to compare the microleakage of Class V cavities restored using Scotchbond™ Universal with Scotchbond Multi-Purpose in two procedures. Materials and Methods: Eighteen freshly extracted human molars were used in this study. Thirty-six standardized Class V cavities were prepared on the buccal and lingual surfaces. The teeth were divided into three groups: (1) Group A: Scotchbond Universal with “self-etching” procedure and nanohybrid composite Filtek Z350. (2) Group B: Scotchbond Universal with “total etching” procedure and Filtek Z350. (3) Group C: Scotchbond Multi-Purpose and Filtek Z350. Microleakage at enamel and dentinal margins was evaluated after thermocycling under 5000 cycles by two methods of microleakage assay: swept source optical coherence tomography (OCT) and dye penetration. Wilcoxon's signed-rank test and Kruskal–Wallis test were used to analyze microleakage. Results: In silver nitrate dye penetration method, group A exhibited the minimum microleakage at dentin margins and group C exhibited the minimum microleakage at enamel margins (P < 0.05). Furthermore, in OCT method, group C demonstrated the minimum microleakage at enamel margins (P = 0.047), with no difference in the microleakage rate at dentin margins. Conclusion: Scotchbond Universal with “self-etching” procedure at dentin margin exhibited more acceptable performance compared to the Scotchbond Multi-Purpose with the two methods. PMID:28928782

  17. Comparative evaluation of marginal fit and axial wall adaptability of copings fabricated by metal laser sintering and lost-wax technique: An in vitro study.

    PubMed

    Gaikwad, Bhushan Satish; Nazirkar, Girish; Dable, Rajani; Singh, Shailendra

    2018-01-01

    The present study aims to compare and evaluate the marginal fit and axial wall adaptability of Co-Cr copings fabricated by metal laser sintering (MLS) and lost-wax (LW) techniques using a stereomicroscope. A stainless steel master die assembly was fabricated simulating a prepared crown; 40 replicas of master die were fabricated in gypsum type IV and randomly divided in two equal groups. Group A coping was fabrication by LW technique and the Group B coping fabrication by MLS technique. The copings were seated on their respective gypsum dies and marginal fit was measured using stereomicroscope and image analysis software. For evaluation of axial wall adaptability, the coping and die assembly were embedded in autopolymerizing acrylic resin and sectioned vertically. The discrepancies between the dies and copings were measured along the axial wall on each halves. The data were subjected to statistical analysis using unpaired t -test. The mean values of marginal fit for copings in Group B (MLS) were lower (24.6 μm) than the copings in Group A (LW) (39.53 μm), and the difference was statistically significant ( P < 0.05). The mean axial wall discrepancy value was lower for Group B (31.03 μm) as compared with Group A (54.49 μm) and the difference was statistically significant ( P < 0.05). The copings fabricated by MLS technique had better marginal fit and axial wall adaptability in comparison with copings fabricated by the LW technique. However, the values of marginal fit of copings fabricated that the two techniques were within the clinically acceptable limit (<50 μm).

  18. Effect of repeated ceramic firings on the marginal and internal adaptation of metal-ceramic restorations fabricated with different CAD-CAM technologies.

    PubMed

    Kocaağaoğlu, Hasan; Albayrak, Haydar; Kilinc, Halil Ibrahim; Gümüs, Hasan Önder

    2017-11-01

    The use of computer-aided design and computer-aided manufacturing (CAD-CAM) for metal-ceramic restorations has increased with advances in the technology. However, little is known about the marginal and internal adaptation of restorations fabricated using laser sintering (LS) and soft milling (SM). Moreover, the effects of repeated ceramic firings on the marginal and internal adaptation of metal-ceramic restorations fabricated with LS and SM is also unknown. The purpose of this in vitro study was to investigate the effects of repeated ceramic firings on the marginal and internal adaptation of metal-ceramic copings fabricated using the lost wax (LW), LS, and SM techniques. Ten LW, 10 LS, and 10 SM cobalt-chromium (Co-Cr) copings were fabricated for an artificial tooth (Frasaco GmbH). After the application of veneering ceramic (VITA VMK Master; VITA Zahnfabrik), the marginal and internal discrepancies of these copings were measured with a silicone indicator paste and a stereomicroscope at ×100 magnification after the first, second, and third clinical simulated ceramic firing cycles. Repeated measures 2-way ANOVA and the Fisher LSD post hoc test were used to evaluate differences in marginal and internal discrepancies (α=.05). Neither fabrication protocol nor repeated ceramic firings had any statistically significant effect on internal discrepancy values (P>.05). Marginal discrepancy values were also statistically unaffected by repeated ceramic firings (P>.05); however, the fabrication protocol had a significant effect on marginal discrepancy values (P<.001), with LW resulting in higher marginal discrepancy values than LS or SM (P<.05). Marginal discrepancy values did not vary between LS and SM (P>.05). All groups demonstrated clinically acceptable marginal adaptation after repeated ceramic firing cycles; however, the LS and SM groups demonstrated better marginal adaptation than that of LW group and may be appropriate clinical alternatives to LW. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  19. The effect of surface sealants with different filler content on microleakage of Class V resin composite restorations

    PubMed Central

    Hepdeniz, Ozge Kam; Temel, Ugur Burak; Ugurlu, Muhittin; Koskan, Ozgur

    2016-01-01

    Objective: Microleakage is still one of the most cited reasons for failure of resin composite restorations. Alternative methods to prevent microleakage have been investigated increasingly. The aim of this study is to evaluate the microleakage in Class V resin composite restorations with or without application of surface sealants with different filler content. Materials and Methods: Ninety-six cavities were prepared on the buccal and lingual surfaces with the coronal margins located in enamel and the cervical margins located in dentin. The cavities restored with an adhesive system (Clearfil SE Bond, Kuraray, Tokyo, Japan) and resin composite (Clearfil Majesty ES-2, Kuraray, Tokyo, Japan). Teeth were stored in distilled water for 24 h and separated into four groups according to the surface sealants (Control, Fortify, Fortify Plus, and G-Coat Plus). The teeth were thermocycled (500 cycles, 5–55° C), immersed in basic fuchsine, sectioned, and analyzed for dye penetration using stereomicroscope. The data were submitted to statistical analysis by Kruskal–Wallis and Bonferroni–Dunn test. Results: The results of the study indicated that there was minimum leakage at the enamel margins of all groups. Bonferroni–Dunn tests revealed that Fortify and GC-Coat groups showed significantly less leakage than the Control group and the Fortify Plus group at dentin margins in lingual surfaces (P < 0.05). Conclusion: The all surface sealants used in this study eliminated microleakage at enamel margins. Moreover, unfilled or nanofilled surface sealants were the most effective in decreasing the degree of marginal microleakage at dentin margins. However, viscosity and penetrability of the sealants could be considered for sealing ability besides composition. PMID:27095890

  20. Robotic unclamped "minimal-margin" partial nephrectomy: ongoing refinement of the anatomic zero-ischemia concept.

    PubMed

    Satkunasivam, Raj; Tsai, Sheaumei; Syan, Sumeet; Bernhard, Jean-Christophe; de Castro Abreu, Andre Luis; Chopra, Sameer; Berger, Andre K; Lee, Dennis; Hung, Andrew J; Cai, Jie; Desai, Mihir M; Gill, Inderbir S

    2015-10-01

    Anatomic partial nephrectomy (PN) techniques aim to decrease or eliminate global renal ischemia. To report the technical feasibility of completely unclamped "minimal-margin" robotic PN. We also illustrate the stepwise evolution of anatomic PN surgery with related outcomes data. This study was a retrospective analysis of 179 contemporary patients undergoing anatomic PN at a tertiary academic institution between October 2009 and February 2013. Consecutive consented patients were grouped into three cohorts: group 1, with superselective clamping and developmental-curve experience (n = 70); group 2, with superselective clamping and mature experience (n = 60); and group 3, which had completely unclamped, minimal-margin PN (n = 49). Patients in groups 1 and 2 underwent superselective tumor-specific devascularization, whereas patients in group 3 underwent completely unclamped minimal-margin PN adjacent to the tumor edge, a technique that takes advantage of the radially oriented intrarenal architecture and anatomy. Primary outcomes assessed the technical feasibility of robotic, completely unclamped, minimal-margin PN; short-term changes in estimated glomerular filtration rate (eGFR); and development of new-onset chronic kidney disease (CKD) stage >3. Secondary outcome measures included perioperative variables, 30-d complications, and histopathologic outcomes. Demographic data were similar among groups. For similarly sized tumors (p = 0.13), percentage of kidney preserved was greater (p = 0.047) and margin width was narrower (p = 0.0004) in group 3. In addition, group 3 had less blood loss (200, 225, and 150ml; p = 0.04), lower transfusion rates (21%, 23%, and 4%; p = 0.008), and shorter hospital stay (p = 0.006), whereas operative time and 30-d complication rates were similar. At 1-mo postoperatively, median percentage reduction in eGFR was similar (7.6%, 0%, and 3.0%; p = 0.53); however, new-onset CKD stage >3 occurred less frequently in group 3 (23%, 10%, and 2%; p = 0.003). Study limitations included retrospective analysis, small sample size, and short follow-up. We developed an anatomically based technique of robotic, unclamped, minimal-margin PN. This evolution from selective clamped to unclamped PN may further optimize functional outcomes but requires external validation and longer follow-up. The technical evolution of partial nephrectomy surgery is aimed at eliminating global renal damage from the cessation of blood flow. An unclamped minimal-margin technique is described and may offer renal functional advantage but requires long-term follow-up and validation at other institutions. Copyright © 2015 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  1. In vitro evaluation of marginal, axial, and occlusal discrepancies in metal ceramic restorations produced with new technologies.

    PubMed

    Kocaağaoğlu, Hasan; Kılınç, Halil İbrahim; Albayrak, Haydar; Kara, Meryem

    2016-09-01

    Marginal and axial discrepancies of metal ceramic restorations are key to their long-term success. Little information is available for metal ceramic restorations fabricated with soft metal milling and laser sintering technologies. The purpose of this in vitro study was to compare the marginal, axial, and occlusal discrepancies in single-unit metal ceramic restorations fabricated with new production techniques with those in a single-unit restoration fabricated using a conventional technique. After the artificial tooth was prepared, impressions were made, and 40 dies were obtained. Dies were randomly divided into 4 groups (n=10). Cobalt-chromium (Co-Cr) cast (C), hard metal milled (HM), laser sintered (LS), and soft metal milled (SM) copings were fabricated. Marginal, axial, and occlusal discrepancies of these copings were measured using the silicone replica technique before and after the application of veneering ceramic. Data were analyzed with repeated measurements 2-way ANOVAs and Bonferroni post hoc tests (α=.05). Significant differences were found in the increase of marginal discrepancy after the application of veneering ceramic in the LS group (P=.016). However, no significant differences in marginal discrepancy were found whether veneering ceramic was applied to copings before or after in the other groups (P>.05). With regard to marginal and occlusal discrepancies, significant differences were found among the production techniques (P<.001 and P<.05, respectively). No significant differences in axial discrepancies were found among the groups (P>.05). This in vitro study showed that metal ceramic restorations produced with HM and newly introduced SM techniques exhibited better marginal adaptations than those produced with the LS or C technique. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  2. Atraumatic restorative treatment with resin-modified glass ionomer material: short-term results of a pilot study.

    PubMed

    Dülgergil, Coruh Türksel; Soyman, Mübin; Civelek, Arzu

    2005-01-01

    The aim of this study was to assess the feasibility of the resin-modified glass ionomer (RMGI) material in atraumatic restorative treatment (ART) approach and compare RMGI with the high-strength traditional glass ionomer cement (GIC) in permanent teeth with one or more surface-carious cavities. This study was conducted in a village school in rural southeastern Anatolia, Turkey. The RMGI and GIC restorations with the ART technique were placed randomly employing a split mouth design. In addition, the ART approach was used when necessary for both primary and/or permanent teeth with no pulpal involvement and no perceived pain before treatment. Ninety-one fillings were placed on contralateral molar pairs of 37 children. Baseline and 6-month evaluation of the fillings were made with the classic ART, modified Ryge and USPHS criteria. Based on the ART criteria, 100% of RMGI and 92.4% of GIC restorations were classified as successful after 6 months, and the difference between the 2 groups was statistically significant (p=0.009). While marginal discoloration was the commonest failure in the RMGI group according to both the modified Ryge and USPHS criteria, unsatisfactory surface texture and low anatomic form were the commonly seen failures in the ART technique. Generally, for each rating system, RMGI exhibited better clinical performance than GIC in all categories, except for marginal discoloration. Results based on the 6-month evaluation show that RMGI can be an alternative material to the GIC. Copyright (c) 2005 S. Karger AG, Basel.

  3. Incidence and location of positive surgical margin among open, laparoscopic and robot-assisted radical prostatectomy in prostate cancer patients: a single institutional analysis.

    PubMed

    Koizumi, Atsushi; Narita, Shintaro; Nara, Taketoshi; Takayama, Koichiro; Kanda, Sohei; Numakura, Kazuyuki; Tsuruta, Hiroshi; Maeno, Atsushi; Huang, Mingguo; Saito, Mitsuru; Inoue, Takamitsu; Tsuchiya, Norihiko; Satoh, Shigeru; Nanjo, Hiroshi; Habuchi, Tomonori

    2018-06-19

    To evaluate the positive surgical margin rates and locations in radical prostatectomy among three surgical approaches, including open radical prostatectomy, laparoscopic radical prostatectomy and robot-assisted radical prostatectomy. We retrospectively reviewed clinical outcomes at our institution of 450 patients who received radical prostatectomy. Multiple surgeons were involved in the three approaches, and a single pathologist conducted the histopathological diagnoses. Positive surgical margin rates and locations among the three approaches were statistically assessed, and the risk factors of positive surgical margin were analyzed. This study included 127, 136 and 187 patients in the open radical prostatectomy, laparoscopic radical prostatectomy and robot-assisted radical prostatectomy groups, respectively. The positive surgical margin rates were 27.6% (open radical prostatectomy), 18.4% (laparoscopic radical prostatectomy) and 13.4% (robot-assisted radical prostatectomy). In propensity score-matched analyses, the positive surgical margin rate in the robot-assisted radical prostatectomy was significantly lower than that in the open radical prostatectomy, whereas there was no significant difference in the positive surgical margin rates between robot-assisted radical prostatectomy and laparoscopic radical prostatectomy. In the multivariable analysis, PSA level at diagnosis and surgical approach (open radical prostatectomy vs robot-assisted radical prostatectomy) were independent risk factors for positive surgical margin. The apex was the most common location of positive surgical margin in the open radical prostatectomy and laparoscopic radical prostatectomy groups, whereas the bladder neck was the most common location in the robot-assisted radical prostatectomy group. The significant difference of positive surgical margin locations continued after the propensity score adjustment. Robot-assisted radical prostatectomy may potentially achieve the lowest positive surgical margin rate among three surgical approaches. The bladder neck was the most common location of positive surgical margin in robot-assisted radical prostatectomy and apex in open radical prostatectomy and laparoscopic radical prostatectomy. Although robot-assisted radical prostatectomy may contribute to the reduction of positive surgical margin, dissection of the bladder neck requires careful attention to avoid positive surgical margins.

  4. Abutment Disconnection/Reconnection Affects Peri-implant Marginal Bone Levels: A Meta-Analysis.

    PubMed

    Koutouzis, Theofilos; Gholami, Fatemeh; Reynolds, John; Lundgren, Tord; Kotsakis, Georgios A

    Preclinical and clinical studies have shown that marginal bone loss can be secondary to repeated disconnection and reconnection of abutments that affect the peri-implant mucosal seal. The aim of this systematic review and meta-analysis was to evaluate the impact of abutment disconnections/reconnections on peri-implant marginal bone level changes. To address this question, two reviewers independently performed an electronic search of three major databases up to October 2015 complemented by manual searches. Eligible articles were selected on the basis of prespecified inclusion and exclusion criteria after a two-phase search strategy and assessed for risk of bias. A random-effects meta-analysis was performed for marginal bone loss. The authors initially identified 392 titles and abstracts. After evaluation, seven controlled clinical studies were included. Qualitative assessment of the articles revealed a trend toward protective marginal bone level preservation for implants with final abutment placement (FAP) at the time of implant placement compared with implants for which there were multiple abutment placements (MAP). The FAP group exhibited a marginal bone level change ranging from 0.08 to 0.34 mm, whereas the MAP group exhibited a marginal bone level change ranging from 0.09 to 0.55 mm. Meta-analysis of the seven studies reporting on 396 implants showed significantly greater bone loss in cases of multiple abutment disconnections/reconnections. The weighted mean difference in marginal bone loss was 0.19 mm (95% confidence interval, 0.06-0.32 mm), favoring bone preservation in the FAP group. Within the limitations of this meta-analysis, abutment disconnection and reconnection significantly affected peri-implant marginal bone levels. These findings pave the way for revisiting current restorative protocols at the restorative treatment planning stage to prevent incipient marginal bone loss.

  5. [An experimental study on the effect of different optical impression methods on marginal and internal fit of all-ceramic crowns].

    PubMed

    Tan, Fa-Bing; Wang, Lu; Fu, Gang; Wu, Shu-Hong; Jin, Ping

    2010-02-01

    To study the effect of different optical impression methods in Cerec 3D/Inlab MC XL system on marginal and internal fit of all-ceramic crowns. A right mandibular first molar in the standard model was used to prepare full crown and replicated into thirty-two plaster casts. Sixteen of them were selected randomly for bonding crown and the others were used for taking optical impression, in half of which the direct optical impression taking method were used and the others were used for the indirect method, and then eight Cerec Blocs all-ceramic crowns were manufactured respectively. The fit of all-ceramic crowns were evaluated by modified United States Public Health Service (USPHS) criteria and scanning electron microscope (SEM) imaging, and the data were statistically analyzed with SAS 9.1 software. The clinically acceptable rate for all marginal measurement sites was 87.5% according to USPHS criteria. There was no statistically significant difference in marginal fit between direct and indirect method group (P > 0.05). With SEM imaging, all marginal measurement sites were less than 120 microm and no statistically significant difference was found between direct and indirect method group in terms of marginal or internal fit (P > 0.05). But the direct method group showed better fit than indirect method group in terms of mesial surface, lingual surface, buccal surface and occlusal surface (P < 0.05). The distal surface's fit was worse and the obvious difference was observed between mesial surface and distal surface in direct method group (P < 0.01). Under the conditions of this study, the optical impression method had no significant effect on marginal fit of Cerec Blocs crowns, but it had certain effect on internal fit. Overall all-ceramic crowns appeared to have clinically acceptable marginal fit.

  6. A Comparison of the Marginal and Internal Fit of Cobalt- Chromium Copings Fabricated by Two Different CAD/CAM Systems (CAD/ Milling, CAD/ Ceramill Sintron)

    PubMed Central

    Vojdani, Mahroo; Torabi, Kianoosh; Atashkar, Berivan; Heidari, Hossein; Torabi Ardakani, Mahshid

    2016-01-01

    Statement of the Problem: Marginal fitness is the most important criteria for evaluation of the clinical acceptability of a cast restoration. Marginal gap which is due to cement solubility and plaque retention is potentially detrimental to both tooth and periodontal tissues. Purpose: This in vitro study aimed to evaluate the marginal and internal fit of cobalt- chromium (Co-Cr) copings fabricated by two different CAD/CAM systems: (CAD/ milling and CAD/ Ceramill Sintron). Materials and Method: We prepared one machined standard stainless steel master model with following dimensions: 7 mm height, 5mm diameter, 90˚ shoulder marginal finish line with 1 mm width, 10˚ convergence angle and anti-rotational surface on the buccal aspect of the die. There were 10 copings produced from hard presintered Co-Cr blocks according to CAD/ Milling technique and ten copings from soft non- presintered Co-Cr blocks according to CAD/ Ceramill Sintron technique. Marginal and internal accuracies of copings were documented by the replica technique. Replicas were examined at ten reference points under a digital microscope (230X). The Student's t-test was used for statistical analysis. p< 0.001 was considered significant. Results: Statistically significant differences existed between the groups (p< 0.001). The CAD/milling group (hard copings) had a mean marginal discrepancy (MD) of 104 µm, axial discrepancy (AD) of 23 µm and occlusal discrepancy of 130 µm. For CAD/ Ceramill Sintron group, these values were 195 µm (MD), 46 µm (AD), and 232 µm (OD). Internal total discrepancy (ITD) for the CAD/milling group was 77 µm, whereas for the CAD/Ceramill Sintron group was 143 µm. Conclusion: Hard presintered Co-Cr copings had significantly higher marginal and internal accuracies compared to the soft non-presintered copings. PMID:27942545

  7. The effects of implementing synoptic pathology reporting in cancer diagnosis: a systematic review.

    PubMed

    Sluijter, Caro E; van Lonkhuijzen, Luc R C W; van Slooten, Henk-Jan; Nagtegaal, Iris D; Overbeek, Lucy I H

    2016-06-01

    Pathology reporting is evolving from a traditional narrative report to a more structured synoptic report. Narrative reporting can cause misinterpretation due to lack of information and structure. In this systematic review, we evaluate the impact of synoptic reporting on completeness of pathology reports and quality of pathology evaluation for solid tumours. Pubmed, Embase and Cochrane databases were systematically searched to identify studies describing the effect of synoptic reporting implementation on completeness of reporting and quality of pathology evaluation of solid malignant tumours. Thirty-three studies met the inclusion criteria. All studies, except one, reported an increased overall completeness of pathology reports after introduction of synoptic reporting (SR). Most frequently studied cancers were breast (n = 9) and colorectal cancer (n = 16). For breast cancer, narrative reports adequately described 'tumour type' and 'nodal status'. Synoptic reporting resulted in improved description of 'resection margins', 'DCIS size', 'location' and 'presence of calcifications'. For colorectal cancer, narrative reports adequately reported 'tumour type', 'invasion depth', 'lymph node counts' and 'nodal status'. Synoptic reporting resulted in increased reporting of 'circumferential margin', 'resection margin', 'perineural invasion' and 'lymphovascular invasion'. In addition, increased numbers of reported lymph nodes were found in synoptic reports. Narrative reports of other cancer types described the traditional parameters adequately, whereas for 'resection margins' and '(lympho)vascular/perineural invasion', implementation of synoptic reporting was necessary. Synoptic reporting results in improved reporting of clinical relevant data. Demonstration of clinical impact of this improved method of pathology reporting is required for successful introduction and implementation in daily pathology practice.

  8. Biomechanical comparison of suture anchor versus margin convergence plus suture anchor for rotator cuff repair.

    PubMed

    Chen, Shi-yi; Malcarney, Hilary L; Murrell, George A C

    2009-02-01

    To evaluate results of margin convergence versus suture anchors in rotator cuff repair, and to determine which method is mechanically superior. Eighteen kangaroo shoulders were randomly divided into three groups (n = 6). A full thickness tendon defect 1.0 cm × 1.5 cm in size was created in the supraspinatus tendon at humeral insertion, simulating a massive rotator cuff tear. Three different techniques were employed for rotator cuff repair: (i) Mitek GII suture anchor alone (Group 1); (ii) margin convergence alone (Group 2); and (iii) margin convergence plus Mitek GII suture anchor (Group 3). Combined loads were applied to each specimen. After completion of cyclic loading, the construct was loaded to failure. ANOVA and LSD (Least Significant Difference) multiple comparisons of the means were applied to results. Cyclic load testing showed progressive gap formation in each repaired specimen with increasing cycles. Group 1 reached 50% failure at an average of 34 cycles, Group 2 at 75 cycles and Group 3 at 73 cycles. There were significant difference between Groups 1 and 2, and Groups 1 and 3 (P ≤ 0.001). After 100 loading cycles, the average gap size was 6.8 mm, 6.1 mm and 4.7 mm in Groups 1, 2 and 3, respectively. There was a significant difference between Groups 1 and 3 (P ≤ 0.015). All specimens eventually reached failure. Rotator cuff repairs with margin convergence +/- suture anchor were far stronger than suture anchor alone, both in gap formation and ultimate failure load. However, progressive gap formation with cyclic loading seems inevitable after cuff repair, which may facilitate clinical understanding of the phenomena of re-tear or residual defect. © 2009 Tianjin Hospital and Blackwell Publishing Asia Pty Ltd.

  9. Effect of protective coating on microhardness of a new glass ionomer cement: Nanofilled coating versus unfilled resin

    PubMed Central

    Faraji, Foad; Heshmat, Haleh; Banava, Sepideh

    2017-01-01

    Background and Objectives: EQUIATM is a new gastrointestinal (GI) system with high compressive strength, surface microhardness (MH), and fluoride release potential. This in vitro study aimed to assess the effect of aging and type of protective coating on the MH of EQUIATM GI cement. Materials and Methods: A total of 30 disc-shaped specimens measuring 9 mm in diameter and 2 mm in thickness were fabricated of EQUIATM GI and divided into three groups of G-Coat nanofilled coating (a), no coating (b) and margin bond (c). The Vickers MH value of specimens was measured before (baseline) and at 3 and 6 months after water storage. Data were analyzed using repeated measures ANOVA. Results: Group B had significantly higher MH than the other two groups at baseline. Both G-Coat and margin bond increased the surface MH of GI at 3 and 6 months. The MH values of G-Coat and margin bond groups did not significantly increase or decrease between 3 and 6 months. Conclusion: The increase in MH was greater in the G-Coat compared to the margin bond group in the long-term. Clinically, margin bond may be a suitable alternative when G-Coat is not available. PMID:29259364

  10. Gigapixel surface imaging of radical prostatectomy specimens for comprehensive detection of cancer-positive surgical margins using structured illumination microscopy

    PubMed Central

    Wang, Mei; Tulman, David B.; Sholl, Andrew B.; Kimbrell, Hillary Z.; Mandava, Sree H.; Elfer, Katherine N.; Luethy, Samuel; Maddox, Michael M.; Lai, Weil; Lee, Benjamin R.; Brown, J. Quincy

    2016-01-01

    Achieving cancer-free surgical margins in oncologic surgery is critical to reduce the need for additional adjuvant treatments and minimize tumor recurrence; however, there is a delicate balance between completeness of tumor removal and preservation of adjacent tissues critical for normal post-operative function. We sought to establish the feasibility of video-rate structured illumination microscopy (VR-SIM) of the intact removed tumor surface as a practical and non-destructive alternative to intra-operative frozen section pathology, using prostate cancer as an initial target. We present the first images of the intact human prostate surface obtained with pathologically-relevant contrast and subcellular detail, obtained in 24 radical prostatectomy specimens immediately after excision. We demonstrate that it is feasible to routinely image the full prostate circumference, generating gigapixel panorama images of the surface that are readily interpreted by pathologists. VR-SIM confirmed detection of positive surgical margins in 3 out of 4 prostates with pathology-confirmed adenocarcinoma at the circumferential surgical margin, and furthermore detected extensive residual cancer at the circumferential margin in a case post-operatively classified by histopathology as having negative surgical margins. Our results suggest that the increased surface coverage of VR-SIM could also provide added value for detection and characterization of positive surgical margins over traditional histopathology. PMID:27257084

  11. Calculating radiotherapy margins based on Bayesian modelling of patient specific random errors

    NASA Astrophysics Data System (ADS)

    Herschtal, A.; te Marvelde, L.; Mengersen, K.; Hosseinifard, Z.; Foroudi, F.; Devereux, T.; Pham, D.; Ball, D.; Greer, P. B.; Pichler, P.; Eade, T.; Kneebone, A.; Bell, L.; Caine, H.; Hindson, B.; Kron, T.

    2015-02-01

    Collected real-life clinical target volume (CTV) displacement data show that some patients undergoing external beam radiotherapy (EBRT) demonstrate significantly more fraction-to-fraction variability in their displacement (‘random error’) than others. This contrasts with the common assumption made by historical recipes for margin estimation for EBRT, that the random error is constant across patients. In this work we present statistical models of CTV displacements in which random errors are characterised by an inverse gamma (IG) distribution in order to assess the impact of random error variability on CTV-to-PTV margin widths, for eight real world patient cohorts from four institutions, and for different sites of malignancy. We considered a variety of clinical treatment requirements and penumbral widths. The eight cohorts consisted of a total of 874 patients and 27 391 treatment sessions. Compared to a traditional margin recipe that assumes constant random errors across patients, for a typical 4 mm penumbral width, the IG based margin model mandates that in order to satisfy the common clinical requirement that 90% of patients receive at least 95% of prescribed RT dose to the entire CTV, margins be increased by a median of 10% (range over the eight cohorts -19% to +35%). This substantially reduces the proportion of patients for whom margins are too small to satisfy clinical requirements.

  12. Fit of cast commercially pure titanium and Ti-6Al-4V alloy crowns before and after marginal refinement by electrical discharge machining.

    PubMed

    Contreras, Edwin Fernando Ruiz; Henriques, Guilherme Elias Pessanha; Giolo, Suely Ruiz; Nobilo, Mauro Antonio Arruda

    2002-11-01

    Titanium has been suggested as a replacement for alloys currently used in single-tooth restorations and fixed partial dentures. However, difficulties in casting have resulted in incomplete margins and discrepancies in marginal fit. This study evaluated and compared the marginal fit of crowns fabricated from a commercially pure titanium (CP Ti) and from Ti-6Al-4V alloy with crowns fabricated from a Pd-Ag alloy that served as a control. Evaluations were performed before and after marginal refinement by electrical discharge machining (EDM). Forty-five bovine teeth were prepared to receive complete cast crowns. Stone and copper-plated dies were obtained from impressions. Fifteen crowns were cast with each alloy (CP Ti, Ti-6Al-4V, and Pd-Ag). Marginal fit measurements (in micrometers) were recorded at 4 reference points on each casting with a traveling microscope. Marginal refinement with EDM was conducted on the titanium-based crowns, and measurements were repeated. Data were analyzed with the Kruskal-Wallis test, paired t test, and independent t test at a 1% probability level. The Kruskal-Wallis test showed significant differences among mean values of marginal fit for the as-cast CP Ti crowns (mean [SD], 83.9 [26.1] microm) and the other groups: Ti-6Al-4V (50.8 [17.2] microm) and Pd-Ag (45.2 [10.4] microm). After EDM marginal refinement, significant differences were detected among the Ti-6Al-4V crowns (24.5 [10.9] microm) and the other 2 groups: CP Ti (50.6 [20.0] microm) and Pd-Ag (not modified by EDM). Paired t test results indicated that marginal refinement with EDM effectively improved the fit of CP Ti crowns (from 83.9 to 50.6 microm) and Ti-6Al-4V crowns (from 50.8 to 24.5 microm). However, the difference in improvement between the two groups was not significant by t test. Within the limitations of this study, despite the superior results for Ti-6Al-4V, both groups of titanium-based crowns had clinically acceptable marginal fits. After EDM marginal refinement, the fit of cast CP Ti and Ti-6Al-4V crowns improved significantly.

  13. Effect of flowable composite liner and glass ionomer liner on class II gingival marginal adaptation of direct composite restorations with different bonding strategies.

    PubMed

    Aggarwal, Vivek; Singla, Mamta; Yadav, Suman; Yadav, Harish

    2014-05-01

    The purpose of the present study was to comparatively evaluate the effect of flowable composite resin liner and resin modified glass ionomer liner on gingival marginal adaptation of class II cavities restored using three bonding agents (Single Bond 3M ESPE, One Coat Self Etching Bond Coltene Whaledent; Adper Easy Bond Self-Etch Adhesive 3M ESPE) and respective composite resins, under cyclic loading. The marginal adaptation was evaluated in terms of 'continuous margin' (CM) at the gingival margin. Ninety class II cavities with margins extending 1mm below the cement-enamel junction were prepared in extracted mandibular third molars. The samples were divided into three groups: no liner placement; 0.5-1mm thick flowable resin liner placement (Filtek Z350 XT flowable resin) on gingival floor and; light cure glass ionomer (Ketac N100) liner. The groups were further subdivided into three sub-groups on the basis of the bonding agents used. Cavities were restored with composite resins (Z350 for Single Bond and Adper Easy Bond; and Synergy D6 Universal, for One Coat Self Etching Bond) in 2mm increments and the samples were mechanically loaded (60N, 1,50,000 cycles). Marginal adaptation was evaluated using a low vacuum scanning electron microscope. Statistical analysis was done with two way ANOVA with Holm-Sidak's correction for multiple comparisons. Placement of flowable composite liner significantly improved the CM values of Single Bond (78±11%) and One Coat Self Etching Bond (77±9%) compared with no liner group, but the values of CM of Adper Easy Bond were not improved (61±12%). Placement of glass ionomer liner significantly improved the values of CM in all the sub-groups (78±9%, 72±10% and 77±10% for Single Bond, One Coat Self Etching Bond & Adper Easy Bond respectively) compared with no liner group. Placement of liners improved the values of 'continuous margin' in the gingival floor of the proximal cavities restored with composite resins using different bonding agent. Placement of flowable composite liner or glass ionomer liner will improve the marginal integrity of composite restorations using etch-and-rinse and two bottle-two step self etch adhesives. To improve the marginal integrity of a single bottle adhesive, glass ionomer liner should be applied. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. Influence of different restorative techniques on marginal seal of class II composite restorations

    PubMed Central

    RODRIGUES JUNIOR, Sinval Adalberto; PIN, Lúcio Fernando da Silva; MACHADO, Giovanna; DELLA BONA, Álvaro; DEMARCO, Flávio Fernando

    2010-01-01

    Objective To evaluate the gingival marginal seal in class II composite restorations using different restorative techniques. Material and Methods Class II box cavities were prepared in both proximal faces of 32 sound human third molars with gingival margins located in either enamel or dentin/cementum. Restorations were performed as follows: G1 (control): composite, conventional light curing technique; G2: composite, soft-start technique; G3: amalgam/composite association (amalcomp); and G4: resin-modified glass ionomer cement/ composite, open sandwich technique. The restored specimens were thermocycled. Epoxy resin replicas were made and coated for scanning electron microscopy examination. For microleakage evaluation, teeth were coated with nail polish and immersed in dye solution. Teeth were cut in 3 slices and dye penetration was recorded (mm), digitized and analyzed with Image Tool software. Microleakage data were analyzed statistically by non-parametric Kruskal-Wallis and Mann-Whitney tests. Results Leakage in enamel was lower than in dentin (p<0.001). G2 exhibited the lowest leakage values (p<0.05) in enamel margins, with no differences between the other groups. In dentin margins, groups G1 and G2 had similar behavior and both showed less leakage (p<0.05) than groups G3 and G4. SEM micrographs revealed different marginal adaptation patterns for the different techniques and for the different substrates. Conclusion The soft-start technique showed no leakage in enamel margins and produced similar values to those of the conventional (control) technique for dentin margins. PMID:20379680

  15. Circumferential fit assessment of CAD/CAM single crowns--a pilot investigation on a new virtual analytical protocol.

    PubMed

    Matta, Ragai E; Schmitt, Johannes; Wichmann, Manfred; Holst, Stefan

    2012-10-01

    Techniques currently applied to determine the marginal accuracy of dental crown restorations yield inadequate information. This investigation aimed to test a new virtual approach for determining the precision of fit of single-crown copings. Zirconia single crown copings were manufactured on 10 gypsum, single-tooth master casts with two different established computer-aided design/computer-assisted manufacture (CAD/CAM) systems (groups A and B). After cementation, the circumferential fit was assessed with an industrial noncontact scanner and virtual 3D analysis, following a triple-scan protocol. Marginal fit was determined by virtual sectioning; each abutment-coping complex was digitally sliced in 360 vertical sections (1 degree per section). Standardized measurement distances for analyzing the marginal fit (z, xy, xyz) were selected, and a crosshair alignment was utilized to determine whether crowns were horizontally and/or vertically too large or small. The Mann-Whitney test was applied to test for differences between groups. Significant differences in the xy direction (P = .008) were measured between groups. Group A showed a greater number of horizontally overextended margins and a higher frequency of xy distances greater than 150 Μm, in addition to a tendency for excessive z distances (P = .095). The mean marginal gap values were clinically acceptable in the present investigation; however, a full circumferential analysis revealed significant differences in marginal coping quality.

  16. Robust Stability Analysis of the Space Launch System Control Design: A Singular Value Approach

    NASA Technical Reports Server (NTRS)

    Pei, Jing; Newsome, Jerry R.

    2015-01-01

    Classical stability analysis consists of breaking the feedback loops one at a time and determining separately how much gain or phase variations would destabilize the stable nominal feedback system. For typical launch vehicle control design, classical control techniques are generally employed. In addition to stability margins, frequency domain Monte Carlo methods are used to evaluate the robustness of the design. However, such techniques were developed for Single-Input-Single-Output (SISO) systems and do not take into consideration the off-diagonal terms in the transfer function matrix of Multi-Input-Multi-Output (MIMO) systems. Robust stability analysis techniques such as H(sub infinity) and mu are applicable to MIMO systems but have not been adopted as standard practices within the launch vehicle controls community. This paper took advantage of a simple singular-value-based MIMO stability margin evaluation method based on work done by Mukhopadhyay and Newsom and applied it to the SLS high-fidelity dynamics model. The method computes a simultaneous multi-loop gain and phase margin that could be related back to classical margins. The results presented in this paper suggest that for the SLS system, traditional SISO stability margins are similar to the MIMO margins. This additional level of verification provides confidence in the robustness of the control design.

  17. A comparison between three different pit and fissure sealants with regard to marginal integrity.

    PubMed

    Fernandes, Kristlee Sabrin; Chalakkal, Paul; de Ataide, Ida de Noronha; Pavaskar, Rajdeep; Fernandes, Precylia Philo; Soni, Harleen

    2012-04-01

    THE AIM OF THIS STUDY IS TO COMPARE THE OCCURRENCE OF ENAMEL FRACTURES, SEALANT FRACTURES AND MARGINAL FISSURES AFTER PLACEMENT OF THREE SEALANTS: Helioseal F, Conseal F and Clinpro. Thirty individuals between 13 and 15 years of age, diagnosed with pit and fissure caries by visual and DIAGNOdent examination, were chosen for sealant placement on their mandibular molars. The sealants were placed at random, after which, impressions were made with polyvinyl siloxane and casts were fabricated. Dies were prepared, each of which were sputter coated with gold in order to be examined under a scanning electron microscope. The following morphologies were analyzed from dies from each of the sealant groups: Continuous margins, sealant fractures, marginal fissures and enamel fractures. After six months, they were recalled for impression making. Dies were prepared and microscopically analyzed as mentioned. Based on the time of evaluation, there were two groups: Initial group (soon after placement) and final group (after six months). Statistical analysis was done using the paired 't' test and One-way analysis of variance (ANOVA). Clinpro had the greatest fracture resistance, followed by Conseal F and Helioseal F. The occurrence of marginal fissure was found to be least with Clinpro.

  18. Electricity market pricing, risk hedging and modeling

    NASA Astrophysics Data System (ADS)

    Cheng, Xu

    In this dissertation, we investigate the pricing, price risk hedging/arbitrage, and simplified system modeling for a centralized LMP-based electricity market. In an LMP-based market model, the full AC power flow model and the DC power flow model are most widely used to represent the transmission system. We investigate the differences of dispatching results, congestion pattern, and LMPs for the two power flow models. An appropriate LMP decomposition scheme to quantify the marginal costs of the congestion and real power losses is critical for the implementation of financial risk hedging markets. However, the traditional LMP decomposition heavily depends on the slack bus selection. In this dissertation we propose a slack-independent scheme to break LMP down into energy, congestion, and marginal loss components by analyzing the actual marginal cost of each bus at the optimal solution point. The physical and economic meanings of the marginal effect at each bus provide accurate price information for both congestion and losses, and thus the slack-dependency of the traditional scheme is eliminated. With electricity priced at the margin instead of the average value, the market operator typically collects more revenue from power sellers than that paid to power buyers. According to the LMP decomposition results, the revenue surplus is then divided into two parts: congestion charge surplus and marginal loss revenue surplus. We apply the LMP decomposition results to the financial tools, such as financial transmission right (FTR) and loss hedging right (LHR), which have been introduced to hedge against price risks associated to congestion and losses, to construct a full price risk hedging portfolio. The two-settlement market structure and the introduction of financial tools inevitably create market manipulation opportunities. We investigate several possible market manipulation behaviors by virtual bidding and propose a market monitor approach to identify and quantify such behavior. Finally, the complexity of the power market and size of the transmission grid make it difficult for market participants to efficiently analyze the long-term market behavior. We propose a simplified power system commercial model by simulating the PTDFs of critical transmission bottlenecks of the original system.

  19. Measuring Institutional Quality in Head and Neck Surgery Using Hospital-Level Data: Negative Margin Rates and Neck Dissection Yield.

    PubMed

    Schoppy, David W; Rhoads, Kim F; Ma, Yifei; Chen, Michelle M; Nussenbaum, Brian; Orosco, Ryan K; Rosenthal, Eben L; Divi, Vasu

    2017-11-01

    Negative margins and lymph node yields (LNY) of 18 or more from neck dissections in patients with head and neck squamous cell carcinomas (HNSCC) have been associated with improved patient survival. It is unclear whether these metrics can be used to identify hospitals with improved outcomes. To determine whether 2 patient-level metrics would predict outcomes at the hospital level. A retrospective review of records from the National Cancer Database (NCDB) was used to identify patients who underwent primary surgery and concurrent neck dissection for HNSCC between 2004 and 2013. The percentage of patients at each hospital with negative margins on primary resection and an LNY 18 or more from a neck dissection was quantified. Cox proportional hazard models were used to define the association between hospital performance on these metrics and overall survival. Margin status and lymph node yield at hospital level. Overall survival (OS). We identified 1008 hospitals in the NCDB where 64 738 patients met inclusion criteria. Of the 64 738 participants, 45 170 (69.8%) were men and 19 568 (30.2%) were women. The mean SD age of included patients was 60.5 (12.0) years. Patients treated at hospitals attaining the combined metric of a 90% or higher negative margin rate and 80% or more of cases with LNYs of 18 or more experienced a significant reduction in mortality (hazard ratio [HR] 0.93; 95% CI, 0.89-0.98). This benefit in survival was independent of the patient-level improvement associated with negative margins (HR, 0.73; 95% CI, 0.71-0.76) and LNY of 18 or more (HR, 0.85; 95% CI, 0.83-0.88). Including these metrics in the model neutralized the association of traditional measures of hospital quality (volume and teaching status). Treatment at hospitals that attain a high rate of negative margins and LNY of 18 or more is associated with improved survival in patients undergoing surgery for HNSCC. These surgical outcome measures predicted outcomes independent of traditional, but generally nonmodifiable characteristics. Tracking of these metrics may help identify high-quality centers and provide guidance for institution-level quality improvement.

  20. Does the Laser-Microtextured Short Implant Collar Design Reduce Marginal Bone Loss in Comparison with a Machined Collar?

    PubMed Central

    Sirali, Ali; Gultekin, Pinar; Yalcin, Serdar; Mijiritsky, Eitan

    2016-01-01

    Purpose. To compare marginal bone loss between subgingivally placed short-collar implants with machined collars and those with machined and laser-microtextured collars. Materials and Methods. The investigators used a retrospective study design and included patients who needed missing posterior teeth replaced with implants. Short-collar implants with identical geometries were divided into two groups: an M group, machined collar; and an L group, machined and laser-microtextured collar. Implants were evaluated according to marginal bone loss, implant success, and probing depth (PD) at 3 years of follow-up. Results. Sixty-two patients received 103 implants (56 in the M group and 47 in the L group). The cumulative survival rate was 100%. All implants showed clinically acceptable marginal bone loss, although bone resorption was lower in the L group (0.49 mm) than in the M group (1.38 mm) at 3 years (p < 0.01). A significantly shallower PD was found for the implants in the L group during follow-up (p < 0.01). Conclusions. Our results suggest predictable outcomes with regard to bone loss for both groups; however, bone resorption was less in the L group than in the M group before and after loading. The laser-microtextured collar implant may provide a shallower PD than the machined collar implant. PMID:27660765

  1. Computed Tomography Assessment of Ablation Zone Enhancement in Patients With Early-Stage Lung Cancer After Stereotactic Ablative Radiotherapy.

    PubMed

    Moore, William; Chaya, Yair; Chaudhry, Ammar; Depasquale, Britney; Glass, Samantha; Lee, Susan; Shin, James; Mikhail, George; Bhattacharji, Priya; Kim, Bong; Bilfinger, Thomas

    2015-01-01

    Stereotactic ablative radiotherapy (SABR) offers a curative treatment for lung cancer in patients who are marginal surgical candidates. However, unlike traditional surgery the lung cancer remains in place after treatment. Thus, imaging follow-up for evaluation of recurrence is of paramount importance. In this retrospective designed Institutional Review Board-approved study, follow-up contrast-enhanced computed tomography (CT) exams were performed on sixty one patients to evaluate enhancement pattern in the ablation zone at 1, 3, 6, and 12 months after SABR. Eleven patients had recurrence within the ablation zone after SABR. The postcontrast enhancement in the recurrence group showed a washin and washout phenomenon, whereas the radiation-induced lung injury group showed continuous enhancement suggesting an inflammatory process. The textural feature of the ablation zone of enhancement and perfusion as demonstrated in computed tomography nodule enhancement may allow early differentiation of recurrence from radiation-induced lung injury in patients' status after SABR or primary lung cancer.

  2. A comparison of the marginal vertical discrepancies of zirconium and metal ceramic posterior fixed dental prostheses before and after cementation.

    PubMed

    Gonzalo, Esther; Suárez, Maria J; Serrano, Benjamin; Lozano, Jose F L

    2009-12-01

    Marginal discrepancies of zirconia posterior fixed dental prostheses (FDPs) fabricated using various systems have been assessed to determine the quality of the restorations and facilitate clinical use; however, studies are limited and results are ambiguous because of the sample sizes and measurement methods. The purpose of this in vitro study was to compare changes in marginal fit of posterior fixed dental prostheses of 3 zirconia systems manufactured using CAD/CAM technology and metal ceramic posterior fixed dental protheses fabricated with the conventional lost-wax technique, before and after cementation. Forty standardized master steel dies with 2 abutments simulating first mandibular premolars were fabricated to receive a posterior 3-unit FDP (from first molar to first premolar) and divided into 4 groups (n=10): Lava All-Ceramic System, Procera Bridge Zirconia, VITA In-Ceram 2000 YZ, and metal ceramic (control group). All FDPs were prepared for an internal space of 50 microm. The external marginal gap of the restorations was investigated by measuring 30 points in the middle of the buccal and lingual surfaces; therefore, 60 measurements per abutment were recorded. Measurements were made with an image analysis program on the master steel model before and after conventional cementation with a glass ionomer agent (Ketac Cem Easymix). The data obtained were statistically analyzed using 1-way ANOVA, Duncan's multiple range post hoc test, and Student's paired t test (alpha=.05). No significant differences in the vertical marginal fit before and after cementation were recorded for the analyzed groups. The marginal discrepancy of Procera abutments before and after cementation (9 +/-10 microm and 12 +/-9 microm, respectively) was less than that of the other groups. Significant differences (P=.001) were observed in marginal adaptation between Procera Bridge Zirconia and the other groups. The results of this study showed that cementation did not cause a significant increase in the vertical marginal discrepancies of the FDPs and that an internal space of 50 mum provided a high precision of fit of the restorations. The accuracy of fit achieved for the 3 zirconium oxide groups analyzed was within the range of clinical acceptance, and the discrepancies were lower than in the metal ceramic group. Procera Bridge Zirconia showed the lowest vertical discrepancies.

  3. Influence of Hand Instrumentation and Ultrasonic Scaling on the Microleakage of various Cervical Restorations: An in vitro Study.

    PubMed

    Rohani, Bita; Barekatain, Mehrdad; Farhad, Shirin Z; Haghayegh, Navid

    2017-06-01

    In cervical lesions, various restorative materials can be inserted, which can be affected by the application of periodontal scalers. This study evaluated and compared the marginal seal of class V glass ionomer, composite resin, and amalgam restorations after subjecting them to hand instrumentation and ultrasonic scaling. In this experimental study, 30 sound human first premolars were selected. In each tooth, buccal and lingual cavities (4 mm mesiodistal width, 3 mm occlusogingival height, and 2 mm depth) were made. The teeth were randomly assigned to three groups of 10 teeth: (1) Glass ionomer group, (2) composite group, and (3) amalgam group. Teeth were subjected to thermocycling procedure for 1,000 cycles between 5 and 55°C water baths and a 1-minute dwell time. Then, each group was randomly subdivided: (1) Margins of 30 restorations were exposed to hand instrumentation procedures by applying 10 working strokes, (2) margins of 30 restorations were exposed to a periodontal tip mounted on a piezoelectric ultrasonic handpiece working at 25 kHz for 10 seconds. The specimens were serially sectioned mesiodistally. Each section was examined under a stereomicroscope. The extent of microleakage was ranked using a 0 to 4 scale at both occlusal and cervical margins of the restorations. Data were analyzed initially using the Kruskal-Wallis test, followed by multiple comparisons using the Mann-Whitney and Wilcoxon test. The type of restorative material had a significant influence on dye penetration, whether in the enamel margin or in the dentinal margin (p < 0.001). The microleakage of glass ionomer group was the highest. No statistical differences were found in dye penetration between scaling groups (hand instrumentation and ultrasonic scaling) (p > 0.05). Type of restorative material had a significant influence on microleakage. No statistical differences were found in dye penetration between scaling groups. The microleakage of glass ionomer restoration is greater than amalgam and composite restorations after subjecting them to hand instrumentation and ultrasonic scaling.

  4. Women and children last: the poverty and marginalization of one-parent families.

    PubMed

    Winchester, H P

    1990-01-01

    The spatial distribution and socioeconomic status of one-parent families in Great Britain and Australia are described, and reasons for the increase in this type of family are analyzed. The author finds that "one-parent families, largely composed of women and children, constitute one of the most rapidly-growing family types. Evidence from Britain and Australia reveals their extreme marginalization in the labour market, and their concentration into public housing. These problems are related to patriarchal structures within society, particularly the expectations of traditional gender roles and the segregation of women's job opportunities." excerpt

  5. Heart Sound Biometric System Based on Marginal Spectrum Analysis

    PubMed Central

    Zhao, Zhidong; Shen, Qinqin; Ren, Fangqin

    2013-01-01

    This work presents a heart sound biometric system based on marginal spectrum analysis, which is a new feature extraction technique for identification purposes. This heart sound identification system is comprised of signal acquisition, pre-processing, feature extraction, training, and identification. Experiments on the selection of the optimal values for the system parameters are conducted. The results indicate that the new spectrum coefficients result in a significant increase in the recognition rate of 94.40% compared with that of the traditional Fourier spectrum (84.32%) based on a database of 280 heart sounds from 40 participants. PMID:23429515

  6. The 2009 Influenza A(H1N1) Outbreak: Selected Legal Issues

    DTIC Science & Technology

    2009-05-06

    used primarily against marginalized, nonwhite persons underscores the need for legal oversight —if only so that affected communities can be assured of...traditional or alternative settings. Potential strategies and or guidance addressing telecommuting , alternative schedules, or modified operating hours

  7. Prospective Analysis of Surgical Bone Margins After Partial Foot Amputation in Diabetic Patients Admitted With Moderate to Severe Foot Infections.

    PubMed

    Schmidt, Brian M; McHugh, Jonathan B; Patel, Rajiv M; Wrobel, James S

    2018-04-01

    Osteomyelitis is common in diabetic foot infections and medical management can lead to poor outcomes. Surgical management involves sending histopathologic and microbiologic specimens which guides future intervention. We examined the effect of obtainment of surgical margins in patients undergoing forefoot amputations to identify patient characteristics associated with outcomes. Secondary aims included evaluating interobserver reliability of histopathologic data at both the distal-to and proximal-to surgical bone margin. Data were prospectively collected on 72 individuals and was pooled for analysis. Standardized method to retrieve intraoperative bone margins was established. A univariate analysis was performed. Negative outcomes, including major lower extremity amputation, wound dehiscence, reulceration, reamputation, or death were recorded. Viable proximal margins were obtained in 63 out of 72 cases (87.5%). Strong interobserver reliability of histopathology was recorded. Univariate analysis demonstrated preoperative platelets, albumin, probe-to-bone testing, absolute toe pressures, smaller wound surface area were associated with obtaining viable margins. Residual osteomyelitis resulted in readmission 2.6 times more often and more postoperative complications. Certain patients were significantly different in the viable margin group versus dirty margin group. High interobserver reliability was demonstrated. Obtainment of viable margins resulted in reduced rates of readmission and negative outcomes. Prognostic, Level I: Prospective.

  8. Cost analysis of store-and-forward telepsychiatry as a consultation model for primary care.

    PubMed

    Butler, Thomas N; Yellowlees, Peter

    2012-01-01

    Store-and-forward telepsychiatry, or asynchronous telepsychiatry (ATP), which allows clinical data, including video to be collected to be reviewed at a later time by a specialist, has been described as a feasible alternative to real-time telepsychiatry, or synchronous telepsychiatry (STP), as a consultation model for primary care. In theory, ATP should be economically more cost-effective than STP due to the increased flexibility of patient data collection and the substitution of the time of specialists with that of lower-cost providers. The aim of this study was to conduct a retrospective cost-analysis comparing ATP with STP and traditional in-person psychiatric consultations in the primary care setting. One hundred and twenty five ATP consultations were performed and fixed and marginal costs were calculated for each model using inputs such as equipment costs, time spent by providers and support staff, and hourly salaries. The fixed costs were $7,000 and $20,000 for ATP and STP and marginal costs were $68.18, $107.50, and $96.36, respectively, for the three groups. STP was the most expensive of the three types of consultations. ATP became the most cost-effective of the three models beyond 249 consultations. The marginal cost savings of ATP were due to substitution of low-cost providers for specialists. ATP represents a potential disruptive healthcare process that could allow more affordable care to be delivered to a larger population of patients. A full accounting of ATP's efficiency will require further studies, including prospective cost-benefit analyses from the perspectives of the patient, provider, and society.

  9. Effect of Resin Bonded Luting Agents Influencing Marginal Discrepancy in All Ceramic Complete Veneer Crowns.

    PubMed

    Ganapathy, Dhanraj; Sathyamoorthy, Anusha; Ranganathan, Hemalatha; Murthykumar, Karthikeyan

    2016-12-01

    Marginal discrepancy severely affects the long term success of All ceramic complete veneer crowns. The precise role of resin luting agents influencing this phenomenon needs to be explored further. To estimate and compare the marginal discrepancy in CAD/CAM processed All ceramic complete veneer crowns prior and following luting with resin bonded luting agents. Extracted human maxillary first premolars were randomly allocated into four groups of 27 samples each Viz., Group I-Resin Modified Glass Ionomer Cement (GIC) (RelyX), Group II-Bis-GMA based dual cure resin cement (Variolink II), Group III-PMMA based resin cement (Superbond), Group IV- Urethane Dimethacrylate resin cement (Calibra). Following tooth preparation, CAD/CAM All ceramic complete veneer crowns were fabricated and sectioned and marginal discrepancy was evaluated using a scanning electron microscope (TESCAN, Magnification power-1,00,000x) prior and after luting with the experimental resin cements. The vertical and horizontal discrepancy before and after cementation with Group I [270.08±103.10μm, 165.3±53.00μm and 270.86±102.70μm, 166.62±54.96μm respectively]; Group II [254.21±79.20μm, 117.75±24.29μm and 234.81±79μm, 116.89±18.22μm respectively]; Group III [272.47±86.25μm, 142.08±50.83μm and 251.82±62.69μm, 136.07±44.95μm respectively]; Group IV were [260.28±64.81μm, 116.98±17.71μm and 233.08±69.44μm, 116.58±21.13μm respectively]. ANOVA inferred a statistically significant difference between the four test specimen with regards to vertical and horizontal marginal discrepancy after cementation (F=9.092, p<0.001), (F=10.97, p<0.001). Tukey HSD Post-hoc test observed significant differences in vertical and horizontal marginal discrepancies between the resin modified glass ionomer and resin cements (p<0.05). Resin cements exhibited a greater reduction in the marginal discrepancy than the resin modified glass ionomer following luting in All ceramic complete veneer crowns. Hence resin cements are more preferable to GIC for luting All ceramic complete veneer crowns.

  10. Effect of Resin Bonded Luting Agents Influencing Marginal Discrepancy in All Ceramic Complete Veneer Crowns

    PubMed Central

    Sathyamoorthy, Anusha; Ranganathan, Hemalatha; Murthykumar, Karthikeyan

    2016-01-01

    Introduction Marginal discrepancy severely affects the long term success of All ceramic complete veneer crowns. The precise role of resin luting agents influencing this phenomenon needs to be explored further. Aim To estimate and compare the marginal discrepancy in CAD/CAM processed All ceramic complete veneer crowns prior and following luting with resin bonded luting agents. Materials and Methods Extracted human maxillary first premolars were randomly allocated into four groups of 27 samples each Viz., Group I-Resin Modified Glass Ionomer Cement (GIC) (RelyX), Group II-Bis-GMA based dual cure resin cement (Variolink II), Group III-PMMA based resin cement (Superbond), Group IV- Urethane Dimethacrylate resin cement (Calibra). Following tooth preparation, CAD/CAM All ceramic complete veneer crowns were fabricated and sectioned and marginal discrepancy was evaluated using a scanning electron microscope (TESCAN, Magnification power-1,00,000x) prior and after luting with the experimental resin cements. Results The vertical and horizontal discrepancy before and after cementation with Group I [270.08±103.10μm, 165.3±53.00μm and 270.86±102.70μm, 166.62±54.96μm respectively]; Group II [254.21±79.20μm, 117.75±24.29μm and 234.81±79μm, 116.89±18.22μm respectively]; Group III [272.47±86.25μm, 142.08±50.83μm and 251.82±62.69μm, 136.07±44.95μm respectively]; Group IV were [260.28±64.81μm, 116.98±17.71μm and 233.08±69.44μm, 116.58±21.13μm respectively]. ANOVA inferred a statistically significant difference between the four test specimen with regards to vertical and horizontal marginal discrepancy after cementation (F=9.092, p<0.001), (F=10.97, p<0.001). Tukey HSD Post-hoc test observed significant differences in vertical and horizontal marginal discrepancies between the resin modified glass ionomer and resin cements (p<0.05). Conclusion Resin cements exhibited a greater reduction in the marginal discrepancy than the resin modified glass ionomer following luting in All ceramic complete veneer crowns. Hence resin cements are more preferable to GIC for luting All ceramic complete veneer crowns. PMID:28209008

  11. Optimizing Survival of Patients With Marginally Operable Stage IIIA Non-Small-Cell Lung Cancer Receiving Chemoradiotherapy With or Without Surgery.

    PubMed

    Yang, Kai-Lin; Chang, Yih-Chen; Ko, Hui-Ling; Chi, Mau-Shin; Wang, Hsin-Ell; Hsu, Pei-Sung; Lin, Chen-Chun; Yeh, Diana Yu-Wung; Kao, Shang-Jyh; Jiang, Jiunn-Song; Chi, Kwan-Hwa

    2016-11-01

    For marginally operable stage IIIA non-small-cell lung cancer (NSCLC), surgery might not be done as planned after neoadjuvant concurrent chemoradiotherapy (CCRT) for reasons (unresectable or medically inoperable conditions, or patient refusal). This study aims to investigate the outcomes of a phased CCRT protocol established to maximize the operability of marginally operable stage IIIA NSCLC and to care for reassessed inoperable patients, in comparison with continuous-course definitive CCRT. Forty-seven patients with marginally operable stage IIIA NSCLC receiving CCRT were included. Twenty-eight patients were treated with our phased CCRT protocol, including neoadjuvant CCRT followed by surgery (group A, n = 16) or, for reassessed inoperable patients, maintenance chemotherapy and split-course CCRT boost (group B, n = 12). The other 19 were treated with continuous-course definitive CCRT (group C). Overall survival (OS) and progression-free survival (PFS) were analyzed. Among all, median OS and PFS were 35.6 and 12.8 months, respectively (median follow-up, 22.3 months). The median OS of group A (not reached) was better than that of group B (34.4 months) and group C (15.2 months) (P = .009). On multivariate analysis, performance status 0 to 1 (hazard ratio [HR], 0.026; P < .001), adenocarcinoma (HR, 0.156; P = .003), and group A (HR, 0.199; P = .033) were independent prognostic factors. The OS of group B (HR, 0.450; 95% confidence interval, 0.118-1.717; P = .243) was not statistically different from that of group C. For marginally operable stage IIIA NSCLC, our phased CCRT strategy may optimize survival by maximizing operability and maintain an acceptable survival for reassessed inoperable patients by split-course CCRT boost following maintenance chemotherapy. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Home-based telerehabilitation is not inferior to a centre-based program in patients with chronic heart failure: a randomised trial.

    PubMed

    Hwang, Rita; Bruning, Jared; Morris, Norman R; Mandrusiak, Allison; Russell, Trevor

    2017-04-01

    Is a 12-week, home-based telerehabilitation program conducted in small groups non-inferior to a traditional centre-based program in terms of the change in 6-minute walk distance? Is the telerehabilitation program also non-inferior to a centre-based program in terms of functional capacity, muscle strength, quality of life, urinary incontinence, patient satisfaction, attendance rates, and adverse events? Randomised, parallel, non-inferiority trial with concealed allocation, intention-to-treat analysis and assessor blinding. Patients with stable chronic heart failure (including heart failure with reduced or preserved ejection fraction) were recruited from two tertiary hospitals in Brisbane, Australia. The experimental group received a 12-week, real-time exercise and education intervention delivered into the participant's home twice weekly, using online videoconferencing software. The control group received a traditional hospital outpatient-based program of the same duration and frequency. Both groups received similar exercise prescription. Participants were assessed by independent assessors at baseline (Week 0), at the end of the intervention (Week 12) and at follow-up (Week 24). The primary outcome was a between-group comparison of the change in 6-minute walk distance, with a non-inferiority margin of 28m. Secondary outcomes included other functional measures, quality of life, patient satisfaction, program attendance rates and adverse events. In 53 participants (mean age 67 years, 75% males), there were no significant between-group differences on 6-minute walk distance gains, with a mean difference of 15m (95% CI -28 to 59) at Week 12. The confidence intervals were within the predetermined non-inferiority range. The secondary outcomes indicated that the experimental intervention was at least as effective as traditional rehabilitation. Significantly higher attendance rates were observed in the telerehabilitation group. Telerehabilitation was not inferior to a hospital outpatient-based rehabilitation program in patients with chronic heart failure. Telerehabilitation appears to be an appropriate alternative because it promotes greater attendance at the rehabilitation sessions. ACTRN12613000390785. [Hwang R, Bruning J, Morris NR, Mandrusiak A, Russell T (2017) Home-based telerehabilitation is not inferior to a centre-based program in patients with chronic heart failure: a randomised trial. Journal of Physiotherapy 63: 101-107]. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

  13. Sustainable biomass production on Marginal Lands (SEEMLA)

    NASA Astrophysics Data System (ADS)

    Barbera, Federica; Baumgarten, Wibke; Pelikan, Vincent

    2017-04-01

    Sustainable biomass production on Marginal Lands (SEEMLA) The main objective of the H2020 funded EU project SEEMLA (acronym for Sustainable Exploitation of Biomass for Bioenergy from Marginal Lands in Europe) is the establishment of suitable innovative land-use strategies for a sustainable production of plant-based energy on marginal lands while improving general ecosystem services. The use of marginal lands (MagL) could contribute to the mitigation of the fast growing competition between traditional food production and production of renewable bio-resources on arable lands. SEEMLA focuses on the promotion of re-conversion of MagLs for the production of bioenergy through the direct involvement of farmers and forester, the strengthening of local small-scale supply chains, and the promotion of plantations of bioenergy plants on MagLs. Life cycle assessment is performed in order to analyse possible impacts on the environment. A soil quality rating tool is applied to define and classify MagL. Suitable perennial and woody bioenergy crops are selected to be grown in pilot areas in the partner countries Ukraine, Greece and Germany. SEEMLA is expected to contribute to an increasing demand of biomass for bioenergy production in order to meet the 2020 targets and beyond.

  14. Analyzing big data with the hybrid interval regression methods.

    PubMed

    Huang, Chia-Hui; Yang, Keng-Chieh; Kao, Han-Ying

    2014-01-01

    Big data is a new trend at present, forcing the significant impacts on information technologies. In big data applications, one of the most concerned issues is dealing with large-scale data sets that often require computation resources provided by public cloud services. How to analyze big data efficiently becomes a big challenge. In this paper, we collaborate interval regression with the smooth support vector machine (SSVM) to analyze big data. Recently, the smooth support vector machine (SSVM) was proposed as an alternative of the standard SVM that has been proved more efficient than the traditional SVM in processing large-scale data. In addition the soft margin method is proposed to modify the excursion of separation margin and to be effective in the gray zone that the distribution of data becomes hard to be described and the separation margin between classes.

  15. Analyzing Big Data with the Hybrid Interval Regression Methods

    PubMed Central

    Kao, Han-Ying

    2014-01-01

    Big data is a new trend at present, forcing the significant impacts on information technologies. In big data applications, one of the most concerned issues is dealing with large-scale data sets that often require computation resources provided by public cloud services. How to analyze big data efficiently becomes a big challenge. In this paper, we collaborate interval regression with the smooth support vector machine (SSVM) to analyze big data. Recently, the smooth support vector machine (SSVM) was proposed as an alternative of the standard SVM that has been proved more efficient than the traditional SVM in processing large-scale data. In addition the soft margin method is proposed to modify the excursion of separation margin and to be effective in the gray zone that the distribution of data becomes hard to be described and the separation margin between classes. PMID:25143968

  16. Microshear bond strength of composite resins to enamel and porcelain substrates utilizing unfilled versus filled resins.

    PubMed

    Najafi-Abrandabadi, Ahmad; Najafi-Abrandabadi, Siamak; Ghasemi, Amir; Kotick, Philip G

    2014-11-01

    Failures such as marginal discoloration and composite chipping are still the problems of tooth-colored restorations on the substrate of enamel and porcelain, which some of these problems are consequently as a result of failures in the bonding layer. Using filled resin has been recently introduced to increase the bond strength of this layer. The aim of this study was to compare the microshear bond strength (μ-SBS) of composite resins to enamel incubated in periods of 24 h and 9 months and porcelain with unfilled resin and flowable composites (filled resin). In this in vitro study, two groups of 75 enamel samples with different storage times (24 h and 9 months) and a group of 75 porcelain samples were used. They were divided into 5 experimental groups of 15 samples in each. Composite cylinders in tygon tubes were bonded on the surface of acid-etched enamel and pretreated porcelain. Wave, Wave MV, Wave HV, Grandioflow and Margin Bond were used as bonding agents. The μ-SBS was measured at the speed of 1.0 mm/min. The bond strengths were analyzed with one-way analysis of variance (ANOVA) test followed by Tukey test. P < 0.05 was selected as the level of statistical significance in this study. The results showed that for enamel (24 h), the μ-SBS of the Wave MV and Wave HV groups were significantly lower than the Margin Bond group. Tukey test indicated the absence of a significant difference between the μ-SBS of the Wave group and the Margin Bond group. However, the μ-SBS of the Grandioflow group was significantly higher than the one for the Margin Bond as a bonding agent. In enamel (9 months), there was a significant difference between the Grandioflow and Margin Bond groups. Regarding bonding to the porcelain the one-way ANOVA test did not show a significant difference among the groups. This study revealed that flowable composites (filled resins) can be used instead of unfilled resins in bonding composite resins to enamel and porcelain substrates.

  17. Effects of Traditional Gender Role Norms and Religious Fundamentalism on Self-Identified Heterosexual Men's Attitudes, Anger, and Aggression Toward Gay Men and Lesbians

    PubMed Central

    Vincent, Wilson; Parrott, Dominic J.; Peterson, John L.

    2011-01-01

    Sexual prejudice and antigay anger were examined as mediators of the associations between traditional male gender norms, religious fundamentalism, and aggression toward gay men and lesbians. Participants were 201 self-identified heterosexual men recruited from the community to complete computer-administered measures of adherence to traditional male gender norms (i.e., status, toughness, antifemininity), religious fundamentalism, sexual prejudice, and frequency of aggression toward gay men and lesbians. Additionally, participants completed a structured interview designed to assess anger in response to a vignette depicting a male-male intimate relationship (i.e., partners saying “I love you,” holding hands, kissing). Results showed that sexual prejudice and antigay anger partially mediated the effect of antifemininity on aggression and fully mediated the effect of religious fundamentalism on aggression. Sexual prejudice alone fully mediated the effect of status on aggression and neither sexual prejudice nor antigay anger mediated the effect of toughness on aggression. Further, results suggested that religious fundamentalism is a multifaceted construct of which some aspects increase risk for aggression toward gay men and lesbians, whereas other aspects decrease this risk. These data provide multivariate evidence from a nonprobability, community-based sample that extreme internalization of dominant cultural values can set the stage for violence toward marginalized groups. Implications for intervention programming and future research are reviewed. PMID:22081759

  18. Effect of various putty-wash impression techniques on marginal fit of cast crowns.

    PubMed

    Nissan, Joseph; Rosner, Ofir; Bukhari, Mohammed Amin; Ghelfan, Oded; Pilo, Raphael

    2013-01-01

    Marginal fit is an important clinical factor that affects restoration longevity. The accuracy of three polyvinyl siloxane putty-wash impression techniques was compared by marginal fit assessment using the nondestructive method. A stainless steel master cast containing three abutments with three metal crowns matching the three preparations was used to make 45 impressions: group A = single-step technique (putty and wash impression materials used simultaneously), group B = two-step technique with a 2-mm relief (putty as a preliminary impression to create a 2-mm wash space followed by the wash stage), and group C = two-step technique with a polyethylene spacer (plastic spacer used with the putty impression followed by the wash stage). Accuracy was assessed using a toolmaker microscope to measure and compare the marginal gaps between each crown and finish line on the duplicated stone casts. Each abutment was further measured at the mesial, buccal, and distal aspects. One-way analysis of variance was used for statistical analysis. P values and Scheffe post hoc contrasts were calculated. Significance was determined at .05. One-way analysis of variance showed significant differences among the three impression techniques in all three abutments and at all three locations (P < .001). Group B yielded dies with minimal gaps compared to groups A and C. The two-step impression technique with 2-mm relief was the most accurate regarding the crucial clinical factor of marginal fit.

  19. Effect of different resin luting cements on the marginal fit of lithium disilicate pressed crowns.

    PubMed

    Mounajjed, Radek; Salinas, Thomas J; Ingr, Tomas; Azar, Basel

    2017-11-15

    The vertical marginal discrepancy of restorations can increase upon cementation, and poor marginal fit can lead to cement dissolution, marginal discoloration, microleakage, and secondary caries. The amount of increase is related to the type of luting cement used, but how lithium disilicate pressed crowns are affected by different resin cements is unclear. The purpose of this in vitro study was to compare the effect of using different resin luting cements on the vertical marginal discrepancy of lithium disilicate pressed crowns. A total of 18 intact extracted mandibular third molars were disinfected in a solution of 10% formalin for 7 days and were then prepared to receive a ceramic crown. Impressions were made with polyvinyl siloxane and lithium disilicate pressed crowns made and cemented with 1 of 3 resin luting cements. The marginal discrepancy was measured at 4 points on the finishing line of each tooth, with optical microscopy at ×200 magnification before and after cementation. Statistical analysis was done with the Kruskal-Wallis test to compare the median marginal increase among the 3 groups. The least amount of marginal increase after cementation was with Harvard PremiumFlow cement, with an average marginal increase of 42 ±11 μm. RelyX Ultimate cement increased the margins by an average 45 ±29 μm. The highest marginal increase was found in the Enamel Plus HRi preheated composite resin group (116 ±47 μm). The marginal increase of pressed crowns cemented with preheated composite resin (Enamel Plus HRi) exceeded the clinically acceptable range of marginal discrepancy. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  20. Automated Lumber Processing

    Treesearch

    Powsiri Klinkhachorn; J. Moody; Philip A. Araman

    1995-01-01

    For the past few decades, researchers have devoted time and effort to apply automation and modern computer technologies towards improving the productivity of traditional industries. To be competitive, one must streamline operations and minimize production costs, while maintaining an acceptable margin of profit. This paper describes the effort of one such endeavor...

  1. Mapping the Discourse of Physical Education: Articulating a Female Tradition.

    ERIC Educational Resources Information Center

    Wright, Janice

    1996-01-01

    Argues that a male perspective, valuing individual achievement through aggressive competition, has dominated physical education. This agenda has marginalized other pedagogies and sports such as gymnastics and dance. Supports this interpretation with an analysis of policy documents, archival material, interviews, and journal articles. (MJP)

  2. Digital "Testimonio" as a Signature Pedagogy for Latin@ Studies

    ERIC Educational Resources Information Center

    Benmayor, Rina

    2012-01-01

    This article proposes the curricular integration of digital "testimonio" as a "signature" pedagogy in Latin@ Studies. The "testimonio" tradition of urgent narratives and the creative multimedia languages of digital storytelling--text, voice, image, and sound--invite historically marginalized subjects, especially younger generations, to author and…

  3. Life on the Margins: Stories of Techguides.

    ERIC Educational Resources Information Center

    Zhao, Yong; Rop, Sheri; Banghart, Rick; Hou, Kaijun; Topper, Andrew

    Traditionally, in the intersection of technology and education, two distinct cultures have existed side by side: the "techies"--technologically sophisticated or enthusiastic experts, and the teachers--elementary through higher education. In an effort to bring the two separated cultures together to engineer a new culture and to support…

  4. Comparison of Microleakage under Rebonded Stainless Steel Orthodontic Brackets Using Two Methods of Adhesive Removal: Sandblast and Laser.

    PubMed

    Tudehzaeim, Mohamad Hossein; Yassaei, Soghra; Taherimoghadam, Shohreh

    2015-02-01

    Debonding is a common occurrence in orthodontic treatment and a considerable number of orthodontists prefer to rebond the detached brackets because of economic issues. The aim of this study was to compare the microleakage beneath rebonded stainless steel brackets using two methods of adhesive removal namely sandblast and laser. Sixty human premolar teeth were randomly divided into three groups. Following bonding the brackets, group 1 served as the control group. Brackets in groups 2 and 3 were debonded, and adhesive removal from the bracket bases was done by means of sandblasting and Er-YAG laser, respectively. After rebonding, teeth in each group were stained with 2% methylene blue for 24 hours, sectioned and examined under a stereomicroscope. Marginal microleakage at the adhesive-enamel and bracket-adhesive interfaces in the occlusal and gingival margins was determined. Statistical analysis was done using the Kruskal-Wallis test. Comparison of the microleakage scores among the three groups revealed no statistically significant difference (P > 0.05). At the enamel-adhesive interface, the gingival margins in all groups showed higher microleakage while in the adhesive-bracket interface, the occlusal margin exhibited greater microleakage. Er-YAG laser irradiation and sandblasting for adhesive removal from the debonded brackets yielded clinically acceptable microleakage scores.

  5. Comparison of Conventional Methods and Laser-Assisted Rapid Prototyping for Manufacturing Fixed Dental Prostheses: An In Vitro Study.

    PubMed

    Pompa, Giorgio; Di Carlo, Stefano; De Angelis, Francesca; Cristalli, Maria Paola; Annibali, Susanna

    2015-01-01

    This study assessed whether there are differences in marginal fit between laser-fusion and conventional techniques to produce fixed dental prostheses (FDPs). A master steel die with 2 abutments was produced to receive a posterior 4-unit FDPs and single copings. These experimental models were divided into three groups (n = 20/group) manufactured: group 1, Ni-Cr alloy, with a lost-wax casting technique; group 2, Co-Cr alloy, with selective laser melting (SLM); and group 3, yttria-tetragonal zirconia polycrystal (Y-TZP), with a milling system. All specimens were cut along the longitudinal axis and their adaptation was measured at the marginal and shoulder areas on the right and left sides of each abutment. Measurements were made using a stereomicroscope (×60 magnification) and a scanning electron microscope (×800 magnification). The data were analyzed using one-way analysis of variance and the Bonferroni post hoc test, with a significance cutoff of 5%. Significant differences (P < 0.05) were observed between group 3 and the other groups. The marginal opening was smallest with Co-Cr alloy substructures, while the shoulder opening was smallest with Ni-Cr alloy substructures. Within the limitations of this study, the marginal fit of an FDP is better with rapid prototyping (RP) via SLM than conventional manufacturing systems.

  6. Comparison of Microleakage under Rebonded Stainless Steel Orthodontic Brackets Using Two Methods of Adhesive Removal: Sandblast and Laser

    PubMed Central

    Tudehzaeim, Mohamad Hossein; Yassaei, Soghra; Taherimoghadam, Shohreh

    2015-01-01

    Objectives: Debonding is a common occurrence in orthodontic treatment and a considerable number of orthodontists prefer to rebond the detached brackets because of economic issues. The aim of this study was to compare the microleakage beneath rebonded stainless steel brackets using two methods of adhesive removal namely sandblast and laser. Materials and Methods: Sixty human premolar teeth were randomly divided into three groups. Following bonding the brackets, group 1 served as the control group. Brackets in groups 2 and 3 were debonded, and adhesive removal from the bracket bases was done by means of sandblasting and Er-YAG laser, respectively. After rebonding, teeth in each group were stained with 2% methylene blue for 24 hours, sectioned and examined under a stereomicroscope. Marginal microleakage at the adhesive-enamel and bracket-adhesive interfaces in the occlusal and gingival margins was determined. Statistical analysis was done using the Kruskal-Wallis test. Results: Comparison of the microleakage scores among the three groups revealed no statistically significant difference (P > 0.05). At the enamel-adhesive interface, the gingival margins in all groups showed higher microleakage while in the adhesive-bracket interface, the occlusal margin exhibited greater microleakage. Conclusion: Er-YAG laser irradiation and sandblasting for adhesive removal from the debonded brackets yielded clinically acceptable microleakage scores. PMID:26056521

  7. In vitro evaluation of reverse torque value of abutment screw and marginal opening in a screw- and cement-retained implant fixed partial denture design.

    PubMed

    Kim, Seok-Gyu; Park, Jae-Uk; Jeong, Jae-Heon; Bae, Chang; Bae, Tae-Soo; Chee, Winston

    2009-01-01

    The purpose of this study was to evaluate the clinical efficacy of implant prostheses retained by screws and cement (SCPs) by examining the reverse torque values (RTVs) of the abutment screws and the marginal openings of the implant prostheses. Two implants (3.8 x 13 mm; Camlog Biotechnologies) were embedded in an acrylic resin block 5 mm apart. Eighteen copies of this resin specimen were fabricated and randomly divided into two groups. Two-unit implant prostheses with two different designs-purely cement-retained implant prostheses (group 1) and SCPs (group 2)-were made out of type IV gold alloy and placed on the implants. After tightening to about 30 Ncm, the preloading RTVs of the abutment screws were measured. After retightening the abutment screws or cementing the prostheses, followed by cyclic loading, the postloading RTVs of the abutment screws were examined. Also, the marginal openings of the prostheses in the two groups were measured under a stereomicroscope. These measurements were compared statistically. The postloading RTVs and their differences from the preloading RTVs of the abutment screws demonstrated no significant differences between groups (P > .05). Group 2 prostheses showed significantly smaller marginal openings than group 1 prostheses (P < .05). The forces generated when torquing the abutment screw of the SCP did not cause more loosening of the abutment screws than the purely cement-retained implant prosthesis. The SCP showed better marginal adaptation of the cement-retained part than the purely cement-retained implant prosthesis, possibly as a result of the screw-retained abutment seating the restoration. Within the limitations of this in vitro test, the SCP showed no significant difference in RTV of the abutment screw and a smaller marginal gap compared to a purely cement-retained implant prosthesis.

  8. Out-of-pocket expenditures on traditional and Western medicine in Taiwan.

    PubMed

    Yen, Steven T; Chang, Hung-Hao; Lin, Tsui-Fang

    2013-08-01

    Coexistence of traditional and modern medicine is common in Asian countries. This paper investigates out-of-pocket expenditures on traditional medicine, traditional medical service, and Western medicine by households in Taiwan. Using a national sample of 13,765 households, the three expenditure equations are estimated with a censored system procedure. Effects of socio-demographic variables are explored by calculating marginal effects on probabilities and levels of medical expenses. Different types of medical expenditures are correlated. Households with higher income and more aging members use more traditional medicine than others, as do households in agricultural sector and in urban areas. In addition, households living in rural areas relative to those in the cities are more likely to use and also spend more on traditional service. Regional disparity of health care utilization is found. Higher income households spend more on traditional medicine, likely due to the fact that patients usually pay out-of-pocket for herbal materials needed in preparation of traditional medicine. To ensure equity in health care utilization, establishment of hospitals and clinics in rural areas should be considered.

  9. Marginal adaptation, fracture load and macroscopic failure mode of adhesively luted PMMA-based CAD/CAM inlays.

    PubMed

    Ender, Andreas; Bienz, Stefan; Mörmann, Werner; Mehl, Albert; Attin, Thomas; Stawarczyk, Bogna

    2016-02-01

    To evaluate marginal adaptation, fracture load and failure types of CAD/CAM polymeric inlays. Standardized prepared human molars (48) were divided into four groups (n=12): (A) PCG (positive control group); adhesively luted glass-ceramic inlays, (B) TRX; CAD/CAM polymeric inlays luted using a self-adhesive resin cement, (C) TAC; CAD/CAM polymeric inlays luted using a conventional resin cement, and (D) NCG (negative control group); direct-filled resin-based composite restorations. All specimens were subjected to a chewing simulator. Before and after chewing fatigue, marginal adaptation was assessed at two interfaces: (1) between dental hard tissues and luting cement and (2) between luting cement and restoration. Thereafter, the specimens were loaded and the fracture loads, as well as the failure types, were determined. The data were analysed using three- and one-way ANOVA with post hoc Scheffé test, two sample Student's t-test (p<0.05). Before and after chewing fatigue, marginal adaptation for interface 1 showed significantly better results for TRX and PCG than for TAC (p=0.001-0.02) and NCG (p=0.001-0.047). For interface 2, marginal adaptation for TAC was significantly inferior to TRX (p<0.001) and PCG (p<0.001). Chewing fatigue had a negative impact on the marginal adaptation of TAC and NCG. No significant differences in fracture load were found between all tested groups. Self-adhesive luted polymeric CAD/CAM inlays showed similar marginal adaptation and fracture load values compared to adhesively luted glass-ceramic inlays. Copyright © 2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

  10. Marginal and internal fit of CAD-CAM-fabricated composite resin and ceramic crowns scanned by 2 intraoral cameras.

    PubMed

    de Paula Silveira, Alessandra C; Chaves, Sacha B; Hilgert, Leandro A; Ribeiro, Ana Paula D

    2017-03-01

    The precision of fit of chairside computer-aided design and computer-aided manufacturing (CAD-CAM) complete crowns is affected by digital impression and restorative material. The purpose of this in vitro study was to evaluate by microcomputed tomography (μCT) the marginal and internal adaptation of composite resin and ceramic complete crowns fabricated with 2 different intraoral cameras and 2 restorative materials. Ten extracted human third molars received crown preparations. For each prepared molar, 2 digital impressions were made with different intraoral cameras of the CEREC system, Bluecam and Omnicam. Four groups were formed: LB (Lava Ultimate+Bluecam), EB (Emax+Bluecam), LO (Lava Ultimate+Omnicam), and EO (Emax+Omnicam). Before measuring the precision of fit, all crowns were stabilized with a silicone material. Each unit (crown + prepared tooth) was imaged with μCT, and marginal and internal discrepancies were analyzed. For the 2D analysis, 120 measurements were made of each crown for marginal adaptation, 20 for marginal discrepancy (MD), and 20 for absolute marginal discrepancy (AMD); and for internal adaptation, 40 for axial space (AS) and 40 for occlusal space (OS). After reconstructing the 3D images, the average internal space (AIS) was calculated by dividing the total volume of the internal space by the contact surface. Data were analyzed with 2-way ANOVA and quantile regression. Regarding marginal adaptation, no significant differences were observed among groups. For internal adaptation measured in the 2D evaluation, a significant difference was observed between LO and EO for the AS variable (Mann-Whitney test; P<.008). In assessment of AIS by the 3D reconstruction, LB presented significantly lower values than the other groups (Tukey post hoc test; P<.05). Bluecam presented lower values of AIS than Omnicam, and composite resin crowns showed less discrepancy than did ceramic crowns. The marginal adaptations assessed in all groups showed values within the clinically accepted range. Moreover, the composite resin blocks associated with the Bluecam intraoral camera demonstrated the best results for AIS compared with those of the other groups. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  11. Evaluation of Microleakage and Marginal Ridge Fracture Resistance of Primary Molars Restored with Three Restorative Materials: A Comparative in vitro Study

    PubMed Central

    Yeolekar, Tapan Satish; Mukunda, KS; Kiran, NK

    2015-01-01

    ABSTRACT Composite restorations are popular because of their superior esthetics and acceptable clinical performance. But shrinkage is still a drawback. Polymerization shrinkage results in volumetric contraction, leading to deformation of the cusps, microleakage, decrease of marginal adaptation, enamel micro-cracks and postoperative sensitivity. A new class of ring opening resin composite based on silorane chemistry has been introduced with claims of less than 1% shrinkage during polymerization. The present study was conducted to evaluate and compare the ability of low shrink silorane based material, a packable composite and a compomer to resist microleakage in class II restorations on primary molars and evaluate marginal ridge fracture resistance of these materials. Sixty human primary molars were selected. Class II cavities were prepared and the teeth were divided into three groups of twenty each. Groups were as follows group I: low shrink composite resin (Filtek P90). Group II: packable composite (Filtek P60) and Group III: compomer (Compoglass F). Half of the teeth were used for microleakage and the rest for marginal ridge fracture resistance. For microleakage testing, dye penetration method was used with 1% methylene blue dye. Followed by evaluation and grading under stereomicroscope at 10* magnification. Fracture resistance was tested with universal testing machine. It was concluded that low shrink silorane based composite resin showed the least amount of microleakage, whereas compomer showed the highest microleakage. Packable composite resisted fracture of marginal ridge better than other composite resins. Marginal ridge fracture resistance of packable composite was comparable to the intact side. How to cite this article: Yeolekar TS, Chowdhary NR, Mukunda KS, Kiran NK. Evaluation of Microleakage and Marginal Ridge Fracture Resistance of Primary Molars Restored with Three Restorative Materials: A Comparative in vitro Study. Int J Clin Pediatr Dent 2015;8(2):108-113. PMID:26379377

  12. Influence of Material Selection on the Marginal Accuracy of CAD/CAM-Fabricated Metal- and All-Ceramic Single Crown Copings

    PubMed Central

    Schneider, Lea; Rinke, Sven

    2018-01-01

    This study evaluated the marginal accuracy of CAD/CAM-fabricated crown copings from four different materials within the same processing route. Twenty stone replicas of a metallic master die (prepared upper premolar) were scanned and divided into two groups. Group 1 (n = 10) was used for a pilot test to determine the design parameters for best marginal accuracy. Group 2 (n = 10) was used to fabricate 10 specimens from the following materials with one identical CAD/CAM system (GAMMA 202, Wissner GmbH, Goettingen, Germany): A = commercially pure (cp) titanium, B = cobalt-chromium alloy, C = yttria-stabilized zirconia (YSZ), and D = leucite-reinforced glass-ceramics. Copings from group 2 were evaluated for the mean marginal gap size (MeanMG) and average maximum marginal gap size (AMaxMG) with a light microscope in the “as-machined” state. The effect of the material on the marginal accuracy was analyzed by multiple pairwise comparisons (Mann–Whitney, U-test, α = 0.05, adjusted by Bonferroni-Holmes method). MeanMG values were as follows: A: 46.92 ± 23.12 μm, B: 48.37 ± 29.72 μm, C: 68.25 ± 28.54 μm, and D: 58.73 ± 21.15 μm. The differences in the MeanMG values proved to be significant for groups A/C (p = 0.0024), A/D (p = 0.008), and B/C (p = 0.0332). AMaxMG values (A: 91.54 ± 23.39 μm, B: 96.86 ± 24.19 μm, C: 120.66 ± 32.75 μm, and D: 100.22 ± 10.83 μm) revealed no significant differences. The material had a significant impact on the marginal accuracy of CAD/CAM-fabricated copings. PMID:29765979

  13. Clinical Marginal and Internal Adaptation of Maxillary Anterior Single All-Ceramic Crowns and 2-year Randomized Controlled Clinical Trial.

    PubMed

    Akın, Aslı; Toksavul, Suna; Toman, Muhittin

    2015-07-01

    The aims of this randomized-controlled clinical trial were to compare marginal and internal adaptation of all-ceramic crowns fabricated with CAD/CAM and heat-pressed (HP) techniques before luting and to evaluate the clinical outcomes at baseline and at 6, 12, and 24 months after luting. Fifteen CAD/CAM (CC) and 15 HP all-ceramic crowns were placed in 15 patients. A silicone replica was obtained to measure marginal and internal adaptation of each all-ceramic crown before luting, and they were sectioned buccolingually and mesiodistally. Marginal and internal adaptations were measured using computerized light microscope at 40× magnification. Clinical evaluations took place at baseline (2 days after luting) and at 6, 12, and 24 months after luting. Replica scores were analyzed with Mann-Whitney U and Student's t-test (α = 0.05). Survival rate of crowns was determined using Kaplan-Meier statistical analysis. The median marginal gap for the CC group was 132.2 μm and was 130.2 μm for the HP group. The mean internal adaptation for the CC group was 220.3 ± 51.3 μm and 210.5 ± 31 μm for the HP group. There were no statistically significant differences with respect to marginal opening (Mann-Whitney U test; p = 0.95) and internal adaptation (Student's t-test; p = 0.535) between the 2 groups. Based on modified Ryge criteria, 100% of the crowns were rated satisfactory during the 2-year period. In this in vivo study, CAD/CAM and HP all-ceramic crowns exhibited similar marginal and internal adaptations. A 100% success rate was recorded for the 15 CAD/CAM and for the 15 HP all-ceramic crowns during the 2-year period. © 2014 by the American College of Prosthodontists.

  14. Efficacy of an asynchronous electronic curriculum in emergency medicine education in the United States.

    PubMed

    Wray, Alisa; Bennett, Kathryn; Boysen-Osborn, Megan; Wiechmann, Warren; Toohey, Shannon

    2017-01-01

    The aim of this study was to measure the effect of an iPad-based asynchronous curriculum on emergency medicine resident performance on the in-training exam (ITE). We hypothesized that the implementation of an asynchronous curriculum (replacing 1 hour of weekly didactic time) would result in non-inferior ITE scores compared to the historical scores of residents who had participated in the traditional 5-hour weekly didactic curriculum. The study was a retrospective, non-inferiority study. conducted at the University of California, Irvine Emergency Medicine Residency Program. We compared ITE scores from 2012 and 2013, when there were 5 weekly hours of didactic content, with scores from 2014 and 2015, when 1 hour of conference was replaced with asynchro-nous content. Examination results were compared using a non-inferiority data analysis with a 10% margin of difference. Using a non-inferiority test with a 95% confidence interval, there was no difference between the 2 groups (before and after implementation of asynchronous learning), as the confidence interval for the change of the ITE was -3.5 to 2.3 points, whereas the 10% non-inferiority margin was 7.8 points. Replacing 1 hour of didactic conference with asynchronous learning showed no negative impact on resident ITE scores.

  15. Self-etching aspects of a three-step etch-and-rinse adhesive.

    PubMed

    Bahillo, Jose; Roig, Miguel; Bortolotto, Tissiana; Krejci, Ivo

    2013-11-01

    The purpose of this study is to assess the marginal adaptation of cavities restored with a three-step etch-and-rinse adhesive, OptiBond FL (OFL) under different application protocols. Twenty-four class V cavities were prepared with half of the margins located in enamel and half in dentin. Cavities were restored with OFL and a microhybrid resin composite (Clearfil AP-X). Three groups (n = 8) that differed in the etching technique were tested with thermomechanical loading, and specimens were subjected to quantitative marginal analysis before and after loading. Micromorphology of etching patters on enamel and dentin were observed with SEM. Data was evaluated with Kruskal-Wallis and Bonferroni post hoc test. Significantly lower percent CM (46.9 ± 19.5) were found after loading on enamel in group 3 compared to group 1 (96.5 ± 5.1) and group 2 (93.1 ± 8.1). However, no significant differences (p = 0.30) were observed on dentin margins. Etching enamel with phosphoric acid but avoiding etching dentin before the application of OFL, optimal marginal adaptation could be obtained, evidencing a self-etching primer effect. A reliable adhesive interface was attained with the application of the three-step etch-and-rinse OFL adhesive with a selective enamel etching, representing an advantage on restoring deep cavities.

  16. [Eyelid hygiene for contact lens wearers with blepharitis. Comparative investigation of treatment with baby shampoo versus phospholipid solution].

    PubMed

    Khaireddin, R; Hueber, A

    2013-02-01

    Blepharitis due to Meibom gland dysfunction (MGD) is presumed to be one of the main reasons for dry eye symptoms which occur in up to 50% of contact lens users. Thus, MGD presumably plays an important role in dry eye in contact lens wearers. In the present prospective, randomized and double blind trial the efficacy of two established treatment options for MGD and blepharitis was evaluated in symptomatic contact lens wearers. In this prospective, randomized 2-centre trial 53 symptomatic contact lens wearers suffering from blepharitis were included. Patients were randomly selected for two treatment groups: group A performed lid margin hygiene using the commonly recommended mild baby shampoo (Bübchen Kinder Shampoo-extra augenmild, Bübchen Werk Ewald Hermes Pharmazeutische Fabrik GmbH, Soest, Germany) and group B performed lid margin hygiene using a phospholipid-liposome solution specially designed for lid hygiene (Blepha Cura, Optima, Moosburg/Wang, Germany), each for 4 weeks. Before as well as 4 weeks after initiation of this study the following tests were performed: standardized subjective assessment using the ocular surface disease index, non-invasive break-up time (NIBUT) and objective evaluation of lid-parallel conjunctival folds (LIPCOF) and further lid margin criteria by double blinded evaluation of slit lamp photographs. Of the 53 symptomatic contact lens wearers suffering from blepharitis 21 (39,6%) were randomly selected for treatment group A and 32 (60.4%) for group B. In both treatment groups there was objective and subjective improvement of symptoms of dry eye in contact lens wearers. Interestingly, there was a significantly greater improvement, subjective as well as objective, in treatment group B which used the phospholipidliposome solution for lid margin hygiene compared to group A using baby shampoo. Although both therapies improved symptoms of dry eye due to blepharitis in symptomatic contact lens wearers, patients using phospholipid-liposomal solution for lid margin hygiene demonstrated a significantly greater clinical benefit from the therapy. Thus, clinical practice recommending just baby shampoo for lid margin hygiene should be re-considered, as phospholipid-liposomal solution for lid margin hygiene appears to yield greater and faster clinical benefits for symptomatic contact lens wearers suffering from dry eye symptoms.

  17. Comparison of marginal and internal fit of 3-unit ceramic fixed dental prostheses made with either a conventional or digital impression.

    PubMed

    Su, Ting-Shu; Sun, Jian

    2016-09-01

    For 20 years, the intraoral digital impression technique has been applied to the fabrication of computer aided design and computer aided manufacturing (CAD-CAM) fixed dental prostheses (FDPs). Clinical fit is one of the main determinants of the success of an FDP. Studies of the clinical fit of 3-unit ceramic FDPs made by means of a conventional impression versus a digital impression technology are limited. The purpose of this in vitro study was to evaluate and compare the internal fit and marginal fit of CAD-CAM, 3-unit ceramic FDP frameworks fabricated from an intraoral digital impression and a conventional impression. A standard model was designed for a prepared maxillary left canine and second premolar and missing first premolar. The model was scanned with an intraoral digital scanner, exporting stereolithography (STL) files as the experimental group (digital group). The model was used to fabricate 10 stone casts that were scanned with an extraoral scanner, exporting STL files to a computer connected to the scanner as the control group (conventional group). The STL files were used to produce zirconia FDP frameworks with CAD-CAM. These frameworks were seated on the standard model and evaluated for marginal and internal fit. Each framework was segmented into 4 sections per abutment teeth, resulting in 8 sections per framework, and was observed using optical microscopy with ×50 magnification. Four measurement points were selected on each section as marginal discrepancy (P1), mid-axial wall (P2), axio-occusal edge (P3), and central-occlusal point (P4). Mean marginal fit values of the digital group (64 ±16 μm) were significantly smaller than those of the conventional group (76 ±18 μm) (P<.05). The mean internal fit values of the digital group (111 ±34 μm) were significantly smaller than those of the conventional group (132 ±44 μm) (P<.05). CAD-CAM 3-unit zirconia FDP frameworks fabricated from intraoral digital and conventional impressions showed clinically acceptable marginal and internal fit. The marginal and internal fit of frameworks fabricated from the intraoral digital impression system were better than those fabricated from conventional impressions. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  18. Effect of metal selection and porcelain firing on the marginal accuracy of titanium-based metal ceramic restorations.

    PubMed

    Shokry, Tamer E; Attia, Mazen; Mosleh, Ihab; Elhosary, Mohamed; Hamza, Tamer; Shen, Chiayi

    2010-01-01

    Titanium is the most biocompatible metal used for dental casting; however, there is concern about its marginal accuracy after porcelain application since this aspect has direct influence on marginal fit. The purpose of this study was to determine the effect that metal selection and the porcelain firing procedure have on the marginal accuracy of metal ceramic prostheses. Cast CP Ti, milled CP Ti, cast Ti-6Al-7Nb, and cast Ni-Cr copings (n=5) were fired with compatible porcelains (Triceram for titanium-based metals and VITA VMK 95 for Ni-Cr alloy). The Ni-Cr alloy fired with its porcelain served as the control. Photographs of metal copings placed on a master die were made. Marginal discrepancy was determined on the photographs using an image processing program at 8 predetermined locations before airborne-particle abrasion for porcelain application, after firing of the opaque layer, and after firing of the dentin layer. Repeated-measures 2-way ANOVA was used to investigate the effect of metal selection and firing stage, and paired t tests were used to determine the effect of each firing stage within each material group (alpha=.05). ANOVA showed that both metal selection and firing stage significantly influenced the measured marginal discrepancy (P<.001), and there was interaction between the 2 variables (P<.001). Student-Newman-Keuls multiple comparison tests showed that there were significant differences between any 2 metals compared, at each stage of measurement. Paired t tests showed that significant changes in marginal discrepancy occurred with opaque firing on milled CP Ti (P=.017) and cast Ti-6Al-7Nb alloy (P=.003). Titanium copings fabricated by CAD/CAM demonstrated the least marginal discrepancy among all groups, while the base metal (Ni-Cr) groups exhibited the most discrepancy of all groups tested. Copyright 2010 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.

  19. Marginal and internal fit of curved anterior CAD/CAM-milled zirconia fixed dental prostheses: an in-vitro study.

    PubMed

    Büchi, Dominik L; Ebler, Sabine; Hämmerle, Christoph H F; Sailer, Irena

    2014-01-01

    To test whether or not different types of CAD/CAM systems, processing zirconia in the densely and in the pre-sintered stage, lead to differences in the accuracy of 4-unit anterior fixed dental prosthesis (FDP) frameworks, and to evaluate the efficiency. 40 curved anterior 4-unit FDP frameworks were manufactured with four different CAD/CAM systems: DCS Precident (DCS) (control group), Cercon (DeguDent) (test group 1), Cerec InLab (Sirona) (test group 2), Kavo Everest (Kavo) (test group 3). The DCS System was chosen as the control group because the zirconia frameworks are processed in its densely sintered stage and there is no shrinkage of the zirconia during the manufacturing process. The initial fit of the frameworks was checked and adjusted to a subjectively similar level of accuracy by one dental technician, and the time taken for this was recorded. After cementation, the frameworks were embedded into resin and the abutment teeth were cut in mesiodistal and orobuccal directions in four specimens. The thickness of the cement gap was measured at 50× (internal adaptation) and 200× (marginal adaptation) magnification. The measurement of the accuracy was performed at four sites. Site 1: marginal adaptation, the marginal opening at the point of closest perpendicular approximation between the die and framework margin. Site 2: Internal adaptation at the chamfer. Site 3: Internal adaptation at the axial wall. Site 4: Internal adaptation in the occlusal area. The data were analyzed descriptively using the ANOVA and Bonferroni/ Dunn tests. The mean marginal adaptation (site 1) of the control group was 107 ± 26 μm; test group 1, 140 ± 26 μm; test group 2, 104 ± 40 μm; and test group 3, 95 ± 31 μm. Test group 1 showed a tendency to exhibit larger marginal gaps than the other groups, however, this difference was only significant when test groups 1 and 3 were compared (P = .0022; Bonferroni/Dunn test). Significantly more time was needed for the adjustment of the frameworks of test group 1 compared to the other test groups and the control group (21.1 min vs 3.8 min) (P < .0001; Bonferroni/Dunn test). For the adjustment of the frameworks of test groups 2 and 3, the same time was needed as for the frameworks of the control group. No differences of the framework accuracy resulting from the different CAM and CAD/CAM procedures were found; however, only after adjustment of the fit by an experienced dental technician. Hence, the influence of a manual correction of the fit was crucial, and the efforts differed for the tested systems. The CAM system led to lower initial accuracy of the frameworks than the CAD/CAM systems, which may be crucial for the dental laboratory. The stage of the zirconia materials used for the different CAD/CAM procedures, ie presintered or densely sintered, exhibited no influence.

  20. Marginalization of girl mothers during reintegration from armed groups in Sierra Leone.

    PubMed

    Burman, M E; McKay, S

    2007-12-01

    Although the widespread presence of girls who participate in fighting forces is increasingly recognized, they remain a highly marginalized group globally, receiving little attention either during or after armed conflict. This is especially true for "girl mothers," girls who return to communities with children born while members of fighting forces. The concept of marginalization (Hall et al. 1994) is used to examine what happens to girl soldiers, especially girl mothers, in the aftermath of armed conflict when they seek to reintegrate back into their communities. This analysis, as part of a larger study of reintegration of girl mothers, is based on field work with girls who were in fighting forces in northwest Sierra Leone, especially those who returned with children. The type and level of marginalization these girls experience is consistent with the conceptualization of marginalization; however, they lack voice and experience shame and vulnerability. Moreover, economics were fundamentally related to their marginalization. The girls' access to resources was significantly constrained because the area was heavily impacted by the war and because of widespread poverty throughout Sierra Leone. The findings raise important questions about marginalization of girls affected by war. Girls and girl mothers experience an extremely high level of marginalization; however, some aspects are not consistent with the original conceptualization of marginalization. Theory development in nursing needs to incorporate multiple voices, especially those of the very marginalized and be done in such a manner that benefits and empowers.

  1. Wide versus narrow excision margins for high-risk, primary cutaneous melanomas: long-term follow-up of survival in a randomised trial.

    PubMed

    Hayes, Andrew J; Maynard, Lauren; Coombes, Gillian; Newton-Bishop, Julia; Timmons, Michael; Cook, Martin; Theaker, Jeffrey; Bliss, Judith M; Thomas, J Meirion

    2016-02-01

    The necessary margin of excision for cutaneous melanomas greater than 2 mm in thickness is controversial. At a median follow-up of 5 years, findings from our previously published randomised trial of narrow (1 cm) versus wide (3 cm) excision margins in patients with thick cutaneous melanomas showed that narrow margins were associated with an increased frequency of locoregional relapse, but no significant difference in overall survival was apparent. We now report a long-term survival analysis of that trial. We did a randomised, open-label multicentre trial in 59 hospitals--57 in the UK, one in Poland, and one in South Africa. Patients with one primary localised cutaneous melanoma greater than 2 mm in Breslow thickness on the trunk or limbs (excluding palms or soles) were randomly assigned (1:1) centrally to receive surgery with either a 1 cm or 3 cm excision margin following an initial surgery. The randomisation lists were generated with random permuted blocks and stratified by centre and extent of initial surgery. The endpoints of this analysis were overall survival and melanoma-specific survival. Analyses were done in the intention-to-treat population. This trial was not registered because it predated mandatory trial registration. Between Dec 16, 1992, and May 22, 2001, we randomly assigned 900 patients to surgery with either a 1 cm excision margin (n=453) or a 3 cm excision margin (n=447). At a median follow-up of 8·8 years (106 months [IQR 76-135], 494 patients had died, with 359 of these deaths attributed to melanoma. 194 deaths were attributed to melanoma in the 1 cm group compared with 165 in the 3 cm group (unadjusted hazard ratio [HR] 1·24 [95% CI 1·01-1·53]; p=0·041). Although a higher number of deaths overall occurred in the 1 cm group compared with the 3 cm group (253 vs 241), the difference was not significant (unadjusted HR 1·14 [95% CI 0·96-1·36]; p=0·14). Surgical complications were reported in 35 (8%) patients in the 1 cm excision margin group and 65 (15%) patients in the 3 cm group. Our findings suggest that a 1 cm excision margin is inadequate for cutaneous melanoma with Breslow thickness greater than 2 mm on the trunk and limbs. Current guidelines advise a 2 cm margin for melanomas greater than 2 mm in thickness but only a 1 cm margin for thinner melanomas. The adequacy of a 1 cm margin for thinner melanomas with poor prognostic features should be addressed in future randomised studies. Cancer Research UK, North Thames National Health Service Executive, Northern and Yorkshire National Health Service Executive, British United Provident Association Foundation, British Association of Plastic Surgeons, the Meirion Thomas Cancer Research Fund, and the National Institute for Health and Research Biomedical Research Centre at The Royal Marsden NHS Foundation Trust. Copyright © 2016 Hayes et al. Open Access article distributed under the terms of CC BY. Published by Elsevier Ltd.. All rights reserved.

  2. Money well spent: a comparison of hospital operating margin for laparoscopic and open colectomies.

    PubMed

    Koopmann, M C; Harms, B A; Heise, C P

    2007-10-01

    Cost analysis after laparoscopic colectomy has been examined, although reports evaluating the effects of laparoscopy on hospital operating margin are lacking. We compared several cost/revenue measures, including hospital operating margin, between open and laparoscopic colectomies at an academic center. Our cost-accounting database was queried for laparoscopic partial (LPC) and total colectomies (LTC), and open partial (OPC) and total colectomies (OTC) to analyze net revenue, total costs, and total hospital operating margin over a 4-year period. Laparoscopic and open colectomy cases were compared, with mean operating margin as the primary outcome. From July, 2002 through May, 2006, 842 patients were included for analysis with 138 undergoing laparoscopic colectomy. Net revenue was higher in the LTC group compared with open (US dollars 30,300 vs US dollars 26,800 [P = .02]), and lower in the LPC group (US dollars 15,300 vs US dollars 21,300 open [P < .0001]). Total costs were reduced in both the LPC and LTC groups compared with open [US dollars 11,700 vs US dollars 17,600 [P < .0001] and US dollars 18,000 vs US dollars 19,400 [P = .0019], respectively). LPC resulted in a similar HOM (US dollars 3,602) compared with OPC (US dollars 3,647; P = .35). LTC resulted in a higher HOM (US dollars 12,300) compared with OTC (US dollars 7,400; P = .02). LTC generates a significantly higher hospital operating margin than an OTC, although the margins are similar for LPC and OPC.

  3. Street Sex Work: Re/Constructing Discourse from Margin to Center

    ERIC Educational Resources Information Center

    McCracken, Jill Linnette

    2009-01-01

    Newspaper media create interpretations of marginalized groups that require rhetorical analysis so that we can better understand these representations. This article focuses on how newspaper articles create interpretations of sex work that affect both the marginalized and mainstream communities. My ethnographic case study argues that the material…

  4. Intraoperative narrow band imaging better delineates superficial resection margins during transoral laser microsurgery for early glottic cancer.

    PubMed

    Garofolo, Sabrina; Piazza, Cesare; Del Bon, Francesca; Mangili, Stefano; Guastini, Luca; Mora, Francesco; Nicolai, Piero; Peretti, Giorgio

    2015-04-01

    The high rate of positive margins after transoral laser microsurgery (TLM) remains a matter of debate. This study investigates the effect of intraoperative narrow band imaging (NBI) examination on the incidence of positive superficial surgical margins in early glottic cancer treated by TLM. Between January 2012 and October 2013, 82 patients affected by Tis-T1a glottic cancer were treated with TLM by type I or II cordectomies. Intraoperative NBI evaluation was performed using 0-degree and 70-degree rigid telescopes. Surgical specimens were oriented by marking the superior edge with black ink and sent to a dedicated pathologist. Comparison between the rate of positive superficial margins in the present cohort and in a matched historical control group treated in the same way without intraoperative NBI was calculated by chi-square test. At histopathological examination, all surgical margins were negative in 70 patients, whereas 7 had positive deep margins, 2 close, and 3 positive superficial margins. The rate of positive superficial margins was thus 3.6% in the present group and 23.7% in the control cohort (P<.001). Routine use of intraoperative NBI increases the accuracy of neoplastic superficial spreading evaluation during TLM for early glottic cancer. © The Author(s) 2014.

  5. Confidence Level Based Approach to Total Dose Specification for Spacecraft Electronics

    NASA Technical Reports Server (NTRS)

    Xapsos, M. A.; Stauffer, C.; Phan, A.; McClure, S. S.; Ladbury, R. L.; Pellish, J. A.; Campola, M. J.; Label, K. A.

    2017-01-01

    A confidence level based approach to total dose radiation hardness assurance is presented for spacecraft electronics. It is applicable to both ionizing and displacement damage dose. Results are compared to the traditional approach that uses radiation design margin and advantages of the new approach are discussed.

  6. Gender Issues in Training: Voices at the Margins of School Psychology.

    ERIC Educational Resources Information Center

    Henning-Stout, Mary

    The entry of more "non-traditional" students into graduate social psychology programs brings varied life experiences into the field. Women in particular bring different experiences than those conventionally assumed by the academy. Research shows that many women who have succeeded in higher education did so by adopting…

  7. Why Students Lose When "Tougher Standards" Win: A Conversation with Alfie Kohn.

    ERIC Educational Resources Information Center

    O'Neil, John; Tell, Carol

    1999-01-01

    Kohn believes the "tougher standards" movement is incompatible with personalized learning, excellence, and marginalized kids' interests. Horizontal standards that shift how teaching and learning happen in classrooms are terrific, but vertical standards using traditional pedagogy are macho and mindless. Kids need freedom to design their…

  8. Critical Civic Literacy: Knowledge at the Intersection of Career and Community

    ERIC Educational Resources Information Center

    Pollack, Seth S.

    2013-01-01

    Traditional approaches to civic engagement have been marginalized and have had little impact on the core curriculum. "Critical civic literacy" is an alternative curricular approach to civic engagement that explicitly moves departments, disciplines, and degree programs to examine issues of social responsibility and social justice from the…

  9. The Public Discourse of U.S. Graduate Employee Unions: Social Movement Identities, Ideologies, and Strategies.

    ERIC Educational Resources Information Center

    Rhoades, Gary; Rhoads, Robert A.

    2003-01-01

    Drew on extensive archives from 10 graduate employee unions' Web sites to examine their publicly presented identities (marginalized workers and future professionals), ideologies (traditional and professional unionism with little focus on social justice), and strategies (disruptive protest and professional politics locally). (EV)

  10. (dis)Ability and Postsecondary Education: One Woman's Experience

    ERIC Educational Resources Information Center

    Myers, Melissa; MacDonald, Judy E.; Jacquard, Sarah; Mcneil, Matthew

    2014-01-01

    The storied experiences of a (dis)Abled student negotiating postsecondary education in Canada are highlighted within this article, including advocacy strategies and a critique of related policies. Persons with (dis)Abilities are a particularly marginalized population, traditionally excluded from society, with modern day views of pity or heroics…

  11. Elementary ELA/Social Studies Integration: Challenges and Limitations

    ERIC Educational Resources Information Center

    Heafner, Tina L.

    2018-01-01

    Adding instructional time and holding teachers accountable for teaching social studies are touted as practical, logical steps toward reforming the age-old tradition of marginalization. This qualitative case study of an urban elementary school, examines how nine teachers and one administrator enacted district reforms that added 45 minutes to the…

  12. Assessing Students in the Margin: Challenges, Strategies, and Techniques

    ERIC Educational Resources Information Center

    Russell, Michael; Kavanaugh, Maureen

    2011-01-01

    The importance of student assessment, particularly for summative purposes, has increased greatly over the past thirty years. At the same time, emphasis on including all students in assessment programs has also increased. Assessment programs, whether they are large-scale, district-based, or teacher developed, have traditionally attempted to assess…

  13. Community-Based Service-Learning for Youth Empowerment in Palestine

    ERIC Educational Resources Information Center

    Stewart, Trae

    2012-01-01

    Palestinian youth face developmental, cultural, and political barriers that impede them from fully engaging in civic life. Non-traditional, youth-centered pedagogies of engagement, like community-based service-learning (CBSL), have shown promise to motivate marginalized populations and provide space and roles for them to form individual identities…

  14. Student-Mentor Relationships and Students' College Attitudes

    ERIC Educational Resources Information Center

    Woods, Chenoa S.; Preciado, Mariana

    2016-01-01

    Many college and SAT preparation programs are designed to improve the postsecondary success of traditionally marginalized students. In addition to academic preparation, students' social and emotional preparation is important for the transition from high school to college. Mentors can serve as role models and supports to aid students in this…

  15. Exploring the Relationships between Dialogue and Inclusive School Communities

    ERIC Educational Resources Information Center

    Orzel, Courtney Leigh

    2012-01-01

    High standards and expectations for all students drive current school reform efforts which target accountability measures and focus on standardized tests, leaving many American students, particularly those who have been traditionally underserved and marginalized, feeling excluded and silenced in school. Thus, it is important for school leaders to…

  16. Intercultural Education and Academic Achievement: A Framework for School-Based Policies in Multilingual Schools

    ERIC Educational Resources Information Center

    Cummins, Jim

    2015-01-01

    The paper reviews quantitative and qualitative research evidence regarding the relationship between intercultural education and academic achievement among students from socially marginalized communities. Intercultural education is conceptualized as including a focus both on generating understanding and respect for diverse cultural traditions and…

  17. Optimal moment determination in POME-copula based hydrometeorological dependence modelling

    NASA Astrophysics Data System (ADS)

    Liu, Dengfeng; Wang, Dong; Singh, Vijay P.; Wang, Yuankun; Wu, Jichun; Wang, Lachun; Zou, Xinqing; Chen, Yuanfang; Chen, Xi

    2017-07-01

    Copula has been commonly applied in multivariate modelling in various fields where marginal distribution inference is a key element. To develop a flexible, unbiased mathematical inference framework in hydrometeorological multivariate applications, the principle of maximum entropy (POME) is being increasingly coupled with copula. However, in previous POME-based studies, determination of optimal moment constraints has generally not been considered. The main contribution of this study is the determination of optimal moments for POME for developing a coupled optimal moment-POME-copula framework to model hydrometeorological multivariate events. In this framework, margins (marginals, or marginal distributions) are derived with the use of POME, subject to optimal moment constraints. Then, various candidate copulas are constructed according to the derived margins, and finally the most probable one is determined, based on goodness-of-fit statistics. This optimal moment-POME-copula framework is applied to model the dependence patterns of three types of hydrometeorological events: (i) single-site streamflow-water level; (ii) multi-site streamflow; and (iii) multi-site precipitation, with data collected from Yichang and Hankou in the Yangtze River basin, China. Results indicate that the optimal-moment POME is more accurate in margin fitting and the corresponding copulas reflect a good statistical performance in correlation simulation. Also, the derived copulas, capturing more patterns which traditional correlation coefficients cannot reflect, provide an efficient way in other applied scenarios concerning hydrometeorological multivariate modelling.

  18. [Upbringing and Sexuality in Children from Marginal Prostitute Women Downtown in Bogotá].

    PubMed

    Amaya, Javier Guillermo Díaz; Acosta, Miguel Barrios; Rojas, Rafael Vásquez

    2012-09-01

    Child upbringing of women engaged in prostitution has been little explored. Child upbringing beliefs, attitudes and practices regarding sexuality in prostitutes' children and adolescents were explored downtown in Bogota. Analytical-interpretive research included in-depth interviews and a focus group. There were ten women between 28 and 56 years of age. Core issues were their subjectivity as mothers, sexual development challenges, upbringing social and cultural conditions. Structural, symbolic and economic violence are the main determinants of parenting. Sexual abuse and the possibility of pregnancy in their adolescent daughters are the most important concerns. In general, the participants share the same values and reproduce traditional ideals in gender and sexuality, which are transmitted and modeled from upbringing. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  19. Marginal Groups in Marginal Times: Gypsy and Traveller Parents and Home Education in England, UK

    ERIC Educational Resources Information Center

    Bhopal, Kalwant; Myers, Martin

    2016-01-01

    This article examines the experiences of home education for Gypsy and Traveller groups in England, UK. We argue that home education is perceived in a particular historical "moment" characterised in the media and more generally throughout society by "risk". Against this backdrop this article considers Gypsy and Traveller…

  20. Robustness analysis of multirate and periodically time varying systems

    NASA Technical Reports Server (NTRS)

    Berg, Martin C.; Mason, Gregory S.

    1991-01-01

    A new method for analyzing the stability and robustness of multirate and periodically time varying systems is presented. It is shown that a multirate or periodically time varying system can be transformed into an equivalent time invariant system. For a SISO system, traditional gain and phase margins can be found by direct application of the Nyquist criterion to this equivalent time invariant system. For a MIMO system, structured and unstructured singular values can be used to determine the system's robustness. The limitations and implications of utilizing this equivalent time invariant system for calculating gain and phase margins, and for estimating robustness via singular value analysis are discussed.

  1. Reproducing normative and marginalized masculinities: adolescent male popularity and the outcast.

    PubMed

    Phillips, Debby A

    2005-09-01

    Every day, in professional work and in our personal lives, we reproduce by words and behaviors particular understandings of life and how it works. This includes understandings about what is 'normal' and 'not normal' masculinity and who are 'normal' and 'not normal' boys and men. Being marginalized or outcast from the norm is rarely a free choice. The language that constructs normal and abnormal is not innocent and does not simply arrive in our minds transparently reflected in our behavior or in our client advice or student education. Examining words and behaviors from adolescent boys and from media sources, this research explores the role of cultural discourses in producing normative and marginalized masculinities. It builds upon recent scholarship that questions cultural prescriptions for masculinity and traditional male norms. Feminist, poststructural, psychoanalytic discourse analysis and multiple methods were used to explore links between cultural discourses of masculinity and performativity of masculinity. Practices of heterosexuality, homophobia, athleticism, economic privilege, toughness, and violence provided pathways toward achieving and/or maintaining status as the hegemonic masculine norm in adolescence. 'Popularity' signified the norm and 'outcasts' from the norm signified marginalized masculinities.

  2. A confusing world: what to call histology of three-dimensional tumour margins?

    PubMed

    Moehrle, M; Breuninger, H; Röcken, M

    2007-05-01

    Complete three-dimensional histology of excised skin tumour margins has a long tradition and, unfortunately, a multitude of names as well. Mohs, who introduced it, called it 'microscopically controlled surgery'. Others have described it as 'micrographic surgery', 'Mohs' micrographic surgery', or simply 'Mohs' surgery'. Semantic confusion became truly rampant when variant forms, each useful in its own way for detecting subclinical outgrowths of malignant skin tumours, were later introduced under such names as histographic surgery, systematic histologic control of the tumour bed, histological control of excised tissue margins, the square procedure, the perimeter technique, etc. All of these methods are basically identical in concept. All involve complete, three-dimensional histological visualization and evaluation of excision margins. Their common goal is to detect unseen tumour outgrowths. For greater clarity, the authors of this paper recommend general adoption of '3D histology' as a collective designation for all the above methods. As an added advantage, 3D histology can also be used in other medical disciplines to confirm true R0 resection of, for example, breast cancer or intestinal cancer.

  3. Internal adaptation, marginal accuracy and microleakage of a pressable versus a machinable ceramic laminate veneers.

    PubMed

    Aboushelib, Moustafa Nabil; Elmahy, Waleed AbdelMeguid; Ghazy, Mohammed Hamed

    2012-08-01

    The aim of this study was to evaluate the internal adaptation and marginal properties of ceramic laminate veneers fabricated using pressable and machinable CAD/CAM techniques. 40 ceramic laminate veneers were fabricated by either milling ceramic blocks using a CAD/CAM system (group 1 n=20) or press-on veneering using lost wax technique (group 2 n=20). The veneers were acid etched using hydrofluoric acid, silanated, and cemented on their corresponding prepared teeth. All specimens were stored under water (37 °C) for 60 days, then received thermocycling (15,000 cycles between 5 and 55 °C and dwell time of 90 s) followed by cyclic loading (100,000 cycles between 50 and 100 N) before immersion in basic fuchsine dye for 24 h. Half of the specimens in each group were sectioned in labio-lingual direction and the rest were horizontally sectioned using precision cutting machine (n=10). Dye penetration, internal cement film thickness, and vertical and horizontal marginal gaps at the incisal and cervical regions were measured (α=0.05). Pressable ceramic veneers demonstrated significantly lower (F=8.916, P<0.005) vertical and horizontal marginal gaps at the cervical and incisal margins and lower cement film thickness (F=50.921, P<0.001) compared to machinable ceramic veneers. The inferior marginal properties of machinable ceramic veneers were associated with significantly higher microleakage values. Pressable ceramic laminate veneers produced higher marginal adaptation, homogenous and thinner cement film thickness, and improved resistance to microleakage compared to machinable ceramic veneers. The manufacturing process influences internal and marginal fit of ceramic veneers. Therefore, dentist and laboratory technicians should choose a manufacturing process with careful consideration. Copyright © 2012 Elsevier Ltd. All rights reserved.

  4. The effect of repeated preheating of dimethacrylate and silorane-based composite resins on marginal gap of class V restorations.

    PubMed

    Alizadeh Oskoee, Parnian; Pournaghi Azar, Fatemeh; Jafari Navimipour, Elmira; Ebrahimi Chaharom, Mohammad Esmaeel; Naser Alavi, Fereshteh; Salari, Ashkan

    2017-01-01

    Background. One of the problems with composite resin restorations is gap formation at resin‒tooth interface. The present study evaluated the effect of preheating cycles of silorane- and dimethacrylate-based composite resins on gap formation at the gingival margins of Class V restorations. Methods. In this in vitro study, standard Class V cavities were prepared on the buccal surfaces of 48 bovine incisors. For restorative procedure, the samples were randomly divided into 2 groups based on the type of composite resin (group 1: di-methacrylate composite [Filtek Z250]; group 2: silorane composite [Filtek P90]) and each group was randomly divided into 2 subgroups based on the composite temperature (A: room temperature; B: after 40 preheating cycles up to 55°C). Marginal gaps were measured using a stereomicroscope at ×40 and analyzed with two-way ANOVA. Inter- and intra-group comparisons were analyzed with post-hoc Tukey tests. Significance level was defined at P < 0.05. Results. The maximum and minimum gaps were detected in groups 1-A and 2-B, respectively. The effects of composite resin type, preheating and interactive effect of these variables on gap formation were significant (P<0.001). Post-hoc Tukey tests showed greater gap in dimethacrylate compared to silorane composite resins (P< 0.001). In each group, gap values were greater in composite resins at room temperature compared to composite resins after 40 preheating cycles (P<0.001). Conclusion. Gap formation at the gingival margins of Class V cavities decreased due to preheating of both composite re-sins. Preheating of silorane-based composites can result in the best marginal adaptation.

  5. The effect of repeated preheating of dimethacrylate and silorane-based composite resins on marginal gap of class V restorations

    PubMed Central

    Alizadeh Oskoee, Parnian; Pournaghi Azar, Fatemeh; Jafari Navimipour, Elmira; Ebrahimi chaharom, Mohammad Esmaeel; Naser Alavi, Fereshteh; Salari, Ashkan

    2017-01-01

    Background. One of the problems with composite resin restorations is gap formation at resin‒tooth interface. The present study evaluated the effect of preheating cycles of silorane- and dimethacrylate-based composite resins on gap formation at the gingival margins of Class V restorations. Methods. In this in vitro study, standard Class V cavities were prepared on the buccal surfaces of 48 bovine incisors. For restorative procedure, the samples were randomly divided into 2 groups based on the type of composite resin (group 1: di-methacrylate composite [Filtek Z250]; group 2: silorane composite [Filtek P90]) and each group was randomly divided into 2 subgroups based on the composite temperature (A: room temperature; B: after 40 preheating cycles up to 55°C). Marginal gaps were measured using a stereomicroscope at ×40 and analyzed with two-way ANOVA. Inter- and intra-group comparisons were analyzed with post-hoc Tukey tests. Significance level was defined at P < 0.05. Results. The maximum and minimum gaps were detected in groups 1-A and 2-B, respectively. The effects of composite resin type, preheating and interactive effect of these variables on gap formation were significant (P<0.001). Post-hoc Tukey tests showed greater gap in dimethacrylate compared to silorane composite resins (P< 0.001). In each group, gap values were greater in composite resins at room temperature compared to composite resins after 40 preheating cycles (P<0.001). Conclusion. Gap formation at the gingival margins of Class V cavities decreased due to preheating of both composite re-sins. Preheating of silorane-based composites can result in the best marginal adaptation. PMID:28413594

  6. Evaluation of marginal and internal fit of ceramic and metallic crown copings using x-ray microtomography (micro-CT) technology.

    PubMed

    Pimenta, Manuel Antonio; Frasca, Luis Carlos; Lopes, Ricardo; Rivaldo, Elken

    2015-08-01

    Prosthetic crown fit to the walls of the tooth preparation may vary depending on the material used for crown fabrication. The purpose of this study was to compare the marginal and internal fit of crown copings fabricated from 3 different materials. The selected materials were zirconia (ZirkonZahn system, group Y-TZP), lithium disilicate (IPS e.max Press system, group LSZ), and nickel-chromium alloy (lost-wax casting, group NiCr). Five specimens of each material were seated on standard dies. An x-ray microtomography (micro-CT) device was used to obtain volumetric reconstructions of each specimen. Points for fit measurement were located in Adobe Photoshop, and measurements were obtained in the CTAn SkyScan software environment. Marginal fit was measured at 4 points and internal fit at 9 points in each coping. Mean measurements from the 3 groups were compared by analysis of variance (ANOVA) at the 5% significance level, and between-group differences were assessed with the Tukey range test. The nickel-chromium alloy exhibited the best marginal fit overall, comparable with zirconia and significantly different from lithium disilicate. Lithium disilicate exhibited the lowest mean values for internal fit, similar to zirconia and significantly different from the nickel-chrome alloy. The marginal and internal fit parameters of the 3 tested materials were within clinically acceptable range. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  7. Comparative Evaluation of Marginal Adaptation and Fracture Strength of Different Ceramic Inlays Produced by CEREC Omnicam and Heat-Pressed Technique.

    PubMed

    Oz, F D; Bolay, S

    2018-01-01

    The aim of this in vitro study was to evaluate marginal adaptation and fracture strength of inlays produced by CEREC Omnicam using different types of blocs and heat-pressed technique. Methods: Seventy-five extracted human mandibular molars were divided randomly into 5 groups ( n =15). 60 molars in four groups received MOD inlay preparations. Experimental groups were CO: Intact teeth, EC: IPS e.max CAD and CEREC, LU: Lava Ultimate and CEREC, EL: IPS Empress CAD and CEREC, EP: IPS Empress Esthetic ingots and heat-pressed technique. Marginal gap measurements were taken with a stereomicroscope. Restorations were cemented with Variolink N and stored in distilled water at 37°C for 24 hours. All samples were subjected to thermocycling. The fracture strength of specimens was determined at a 0.5 mm/min crosshead speed until fracture. Fracture modes were determined. Statistical analyses were performed using one-way analysis of variance for fracture strength data and Kruskal-Wallis for marginal gap data ( p =0.05). The mean marginal gap size of EC, LU, EL, and EP were 33.54  µ m, 33.77  µ m, 34.23  µ m, and 85.34  µ m, respectively. EP had statistically higher values than other groups. The fracture strength values were significantly higher in the intact teeth group (3959,00 ± 1279,79 N) than those of restored groups EC (2408,00 ± 607,97 N), LU (2206,73 ± 675,16), EL (2573.27 ± 644,73) ve EP (2879,53 ± 897,30). Inlays fabricated using CEREC Omnicam demonstrated better marginal adaptation than inlays produced with heat-pressed technique, whereas fracture strength values of inlays fabricated with different type of blocks using CEREC Omnicam exhibited similarity to those fabricated with heat-pressed technique.

  8. Comparative Evaluation of Marginal Adaptation and Fracture Strength of Different Ceramic Inlays Produced by CEREC Omnicam and Heat-Pressed Technique

    PubMed Central

    Bolay, S.

    2018-01-01

    Objective The aim of this in vitro study was to evaluate marginal adaptation and fracture strength of inlays produced by CEREC Omnicam using different types of blocs and heat-pressed technique. Methods: Seventy-five extracted human mandibular molars were divided randomly into 5 groups (n=15). 60 molars in four groups received MOD inlay preparations. Experimental groups were CO: Intact teeth, EC: IPS e.max CAD and CEREC, LU: Lava Ultimate and CEREC, EL: IPS Empress CAD and CEREC, EP: IPS Empress Esthetic ingots and heat-pressed technique. Marginal gap measurements were taken with a stereomicroscope. Restorations were cemented with Variolink N and stored in distilled water at 37°C for 24 hours. All samples were subjected to thermocycling. The fracture strength of specimens was determined at a 0.5 mm/min crosshead speed until fracture. Fracture modes were determined. Statistical analyses were performed using one-way analysis of variance for fracture strength data and Kruskal–Wallis for marginal gap data (p=0.05). Results The mean marginal gap size of EC, LU, EL, and EP were 33.54 µm, 33.77 µm, 34.23 µm, and 85.34 µm, respectively. EP had statistically higher values than other groups. The fracture strength values were significantly higher in the intact teeth group (3959,00 ± 1279,79 N) than those of restored groups EC (2408,00 ± 607,97 N), LU (2206,73 ± 675,16), EL (2573.27 ± 644,73) ve EP (2879,53 ± 897,30). Conclusion Inlays fabricated using CEREC Omnicam demonstrated better marginal adaptation than inlays produced with heat-pressed technique, whereas fracture strength values of inlays fabricated with different type of blocks using CEREC Omnicam exhibited similarity to those fabricated with heat-pressed technique. PMID:29853894

  9. Probe-based confocal laser endomicroscopy in the margin delineation of early gastric cancer for endoscopic submucosal dissection.

    PubMed

    Park, Jun Chul; Park, Yehyun; Kim, Hyun Ki; Jo, Jeong-Hyeon; Park, Chan Hyuk; Kim, Eun Hye; Jung, Da Hyun; Chung, Hyunsoo; Shin, Sung Kwan; Lee, Sang Kil; Lee, Yong Chan

    2017-05-01

    We evaluated probe-based confocal laser endomicroscopy (pCLE) in the margin delineation of early gastric cancer (EGC) for endoscopic submucosal dissection in comparison with white-light imaging with chromoendoscopy (CE). We conducted a prospective, randomized controlled study from November 2013 to October 2014 in a tertiary referral hospital. A total of 101 patients scheduled for endoscopic submucosal dissection due to differentiated EGC were randomized into pCLE and CE groups (pCLE 51, CE 50). Markings were made by electrocautery at the proximal and distal tumor margins, as determined by either pCLE or CE. The distance from the marking to the tumor margin was measured in the resected specimen histopathologically and was compared between the two groups by a linear mixed model. Among 104 lesions, 80 lesions with 149 markings (pCLE 68, CE 81) were analyzed after excluding undifferentiated EGCs (n = 8) and unidentifiable markings (n = 13). Although the complete resection rate showed no difference between the groups (94.6% vs 93.2%, P = 1.000), the median distance from the marking to the margin was shorter in the pCLE group (1.3 vs 1.8 mm, P = 0.525) and the proportion of the distance <1 mm was higher (43.9% vs 27.6%, P = 0.023) in the pCLE group. Finally, subgroup analysis with superficial flat lesions (18 lesions, 31 marking dots) showed a significantly decreased distance in the pCLE group (0.5 vs 3.1 mm, P = 0.007). Among EGCs with superficial flat morphology, in which the accurate evaluation of lateral extent is difficult with CE, pCLE would be useful for more precise margin delineation. © 2016 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

  10. Effect of At-home and In-office Bleaching on Marginal Microleakage in Composite Resin Restorations using Two Adhesive Systems.

    PubMed

    Klein, Celso A; da Silva, Douglas; Reston, Eduardo G; Borghetti, Diana Lb; Zimmer, Roberto

    2018-03-01

    The aim of this study is to assess marginal microleakage of cervical cavities restored with composite resins and two different adhesive techniques subjected to at-home and in-office bleaching. In this randomized, blind laboratory experiment, 60 bovine teeth recently extracted were collected and divided into six groups (n = 10 each group). The teeth received cervical cavity preparations (2 mm × 3 mm × 1 mm) with enamel margins. Two different adhesive systems were used (Single Bond 2 and Clearfil SE Bond), in addition to composite resin (Z250). Restored teeth received two different bleaching gels (Opalescence PF and Opalescence Boost). Teeth were thermo-cycled and analyzed under confocal laser scanning microscopy. No significant differences were observed (p > 0.05) in microleakage scores between the two groups not subjected to bleaching nor between the four groups that received bleaching treatment (p > 0.05), regardless of the gel and adhesive system employed. However, when comparing nonbleached with bleached teeth, those not subjected to bleaching showed statistically lower marginal microleakage scores (p < 0.05). Data were statistically analyzed using the Kruskal-Wallis test followed by Student-Newman-Keuls post hoc test, with significance set at 5%. Marginal microleakage in composite resin restorations is influenced by the action of bleaching agents used both at-home and in-office, regardless of the adhesive system employed (total-etch or self-etch). Both at-home and in-office bleaching agents have an influence on the adhesive interface of resin restorations, producing changes and inducing marginal leakage.

  11. An evaluation of marginal fit of three-unit fixed dental prostheses fabricated by direct metal laser sintering system.

    PubMed

    Kim, Ki-Baek; Kim, Woong-Chul; Kim, Hae-Young; Kim, Ji-Hwan

    2013-07-01

    This in vitro study aimed to evaluate and compare marginal fit of three-unit fixed dental prostheses (FDPs) fabricated using a newly developed direct metal laser sintering (DMLS) system with that of three-unit FDPs by a conventional lost wax technique (LW) method. Ten cobalt-chromium alloy three-unit FDPs using DMLS system and another ten nickel-chromium alloy FDPs using LW method were fabricated. Marginal fit was examined using a light-body silicone. After setting, the silicon film was cut into four parts and the thickness of silicon layer was measured at 160× magnification using a digital microscope to measure absolute marginal discrepancy (AMD), marginal gap (MG) and internal gap (IG). A repeated measure ANOVA for statistical analysis was performed using the SPSS statistical package version 12.0 (α=0.05). The mean values of AMD, MG, and IG were significantly larger in the DMLS group than in the LW group (p<0.001). Means of AMD, MG and IG in the first molars were 83.3, 80.0, and 82.0μm in the LW group; and 128.0, 112.0, and 159.5μm in the DMLS group, respectively. No significant difference between measurements for premolars and molars was found (p>0.05). The marginal fit of the DMLS system appeared significantly inferior compared to that of the conventional LW method and slightly larger than the acceptable range. For clinical application further improvement of DMLS system may be required. Copyright © 2013 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

  12. --No Title--

    Science.gov Websites

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  13. Influence of space size of abutment screw access channel on the amount of extruded excess cement and marginal accuracy of cement-retained single implant restorations.

    PubMed

    Al Amri, Mohammad D; Al-Johany, Sulieman S; Al-Qarni, Mohammed N; Al-Bakri, Ahmed S; Al-Maflehi, Nassr S; Abualsaud, Haythem S

    2018-02-01

    The detrimental effect of extruded excess cement on peri-implant tissue has been well documented. Although several techniques have been proposed to reduce this effect by decreasing the amount of extruded cement, how the space size of the abutment screw access channel (SAC) affects the amount of extruded cement and marginal accuracy is unclear. The purpose of this in vitro study was to evaluate the effect of the size of the unfilled space of the abutment SAC on the amount of extruded excess cement and the marginal accuracy of zirconia copings. Twelve implant replicas and corresponding standard abutments were attached and embedded in acrylic resin blocks. Computer-aided design and computer-aided manufacturing (CAD-CAM) zirconia copings with a uniform 30-μm cement space were fabricated by 1 dental technician using the standard method. The copings were temporarily cemented 3 times at different sizes of the left space of the SAC as follows: the nonspaced group (NS), in which the entire SAC was completely filled, the 1-mm-spaced group (1MMS), and the 2-mm-spaced group (2MMS). Abutments and crowns were ultrasonically cleaned, steam cleaned, and air-dried. The excess cement was collected and weighed. To measure the marginal accuracy, 20 measurements were made every 18 degrees along the coping margin at ×300 magnification and compared with the pre-cementation readings. One-way ANOVA was calculated to determine whether the amount of extruded excess cement differed among the 3 groups, and the Tukey test was applied for multiple comparisons (α=.05). The mean weights (mg) of extruded excess cement were NS (33.53 ±1.5), 1MMS (22.97 ±5.4), and 2MMS (15.17 ±5.9). Multiple comparisons showed significant differences in the amount of extruded excess cement among the 3 test groups (P<.001). The mean marginal discrepancy (μm) of the pre-cemented group (29.5 ±8.2) was significantly different (P<.01) from that of the NS (72.3 ±13.7), the 1MMS (70.1 ±19), and the 2MMS group (70.1 ±18.8). No significant differences were found in marginal accuracy among the 3 test groups (P=.942). Within the limitations of this in vitro study, leaving a 2-mm space in the SAC reduced the amount of extruded excess cement by 55% in comparison with the nonspaced abutments. However, no effect was found on the marginal accuracy of zirconia copings. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  14. Comparison of Conventional Methods and Laser-Assisted Rapid Prototyping for Manufacturing Fixed Dental Prostheses: An In Vitro Study

    PubMed Central

    Pompa, Giorgio; Di Carlo, Stefano; De Angelis, Francesca; Cristalli, Maria Paola; Annibali, Susanna

    2015-01-01

    This study assessed whether there are differences in marginal fit between laser-fusion and conventional techniques to produce fixed dental prostheses (FDPs). A master steel die with 2 abutments was produced to receive a posterior 4-unit FDPs and single copings. These experimental models were divided into three groups (n = 20/group) manufactured: group 1, Ni-Cr alloy, with a lost-wax casting technique; group 2, Co-Cr alloy, with selective laser melting (SLM); and group 3, yttria-tetragonal zirconia polycrystal (Y-TZP), with a milling system. All specimens were cut along the longitudinal axis and their adaptation was measured at the marginal and shoulder areas on the right and left sides of each abutment. Measurements were made using a stereomicroscope (×60 magnification) and a scanning electron microscope (×800 magnification). The data were analyzed using one-way analysis of variance and the Bonferroni post hoc test, with a significance cutoff of 5%. Significant differences (P < 0.05) were observed between group 3 and the other groups. The marginal opening was smallest with Co-Cr alloy substructures, while the shoulder opening was smallest with Ni-Cr alloy substructures. Within the limitations of this study, the marginal fit of an FDP is better with rapid prototyping (RP) via SLM than conventional manufacturing systems. PMID:26576419

  15. Three-Dimensional Analysis of Internal Adaptations of Crowns Cast from Resin Patterns Fabricated Using Computer-Aided Design/Computer-Assisted Manufacturing Technologies.

    PubMed

    Liu, Yushu; Ye, Hongqiang; Wang, Yong; Zhao, Yijao; Sun, Yuchun; Zhou, Yongsheng

    2018-05-17

    To evaluate the internal adaptations of cast crowns made from resin patterns produced using three different computer-aided design/computer-assisted manufacturing technologies. A full-crown abutment made of zirconia was digitized using an intraoral scanner, and the design of the crown was finished on the digital model. Resin patterns were fabricated using a fused deposition modeling (FDM) 3D printer (LT group), a digital light projection (DLP) 3D printer (EV group), or a five-axis milling machine (ZT group). All patterns were cast in cobalt-chromium alloy crowns. Crowns made from traditional handmade wax patterns (HM group) were used as controls. Each group contained 10 samples. The internal gaps of the patterns were analyzed using a 3D replica method and optical digitization. The results were compared using Kruskal-Wallis analysis of variance (ANOVA), a one-sample t test, and signed rank test (α = .05). For the LT group, the marginal and axial gaps were significantly larger than in the other three groups (P < .05), but the occlusal adaptation did not reveal a significant difference (P > .05). In the ZT group, the axial gap was slightly smaller than in the HM group (P < .0083). All the means of gaps in all areas in the four groups were less than 150 μm. Casting crowns using casting patterns made from all three CAD/CAM systems could not produce the prescribed parameters, but the crowns showed clinically acceptable internal adaptations.

  16. Effect of resealing on microleakage of resin composite restorations in relationship to margin design and composite type

    PubMed Central

    Antonson, Sibel A.; Yazici, A. Ruya; Okte, Zeynep; Villalta, Patricia; Antonson, Donald E.; Hardigan, Patrick C.

    2012-01-01

    Objective: To determine the relationship between margin preparation design and resin-composite type on microleakage with or without re-application of surface-penetrating sealant. Methods: Class-I resin-composite restorations were completed for 128 extracted human molars. Half of the margins were beveled, the other half, butt-joint. Half of each group was restored with Filtek-Supreme (FS), the other half with Esthet-X (EX) using their respective adhesive systems. Margins were etched and sealed with a surface-penetrating sealant, Fortify. The samples were stored in water 24h, and thermocycled (5,000 cycles, 5°C–55°C). Then, samples were abraded using a toothbrush machine (6,000 strokes). Half of the restorations from each sealant group (n=16) were resealed, and the other half had no further treatment. Thermocycling and tooth brushing were repeated. The samples were sealed with nail polish, immersed in methylene-blue for 8h, sectioned, and magnified digital photographs were taken. Three examiners assessed dye penetration. A 2×2×2 multi-layered Chi-Square analysis, using Cochran-Mantel-Haenszel test was conducted for statistical analysis. Results: No difference was observed between sealed and resealed FS and EX restorations with butt-joint margins. In beveled margins, resealing caused significantly less microleakage (P<.01). No differences were found between restorations either sealed or resealed with bevel margins. In butt-joint margins, at the leakage level deeper than 2/3 of the preparation depth, resealed FS showed less microleakage than EX resealed restorations (P<.01). Conclusion: Resealing reduced microleakage in bevel margins, however, in butt-joint margins resealing did not affect the leakage. A significant statistical relationship exists between and within resealing, margin preparation design, type of composite, and microleakage. PMID:23077418

  17. Rifting and Subsidence in the Gulf of Mexico: Implications for Syn-rift, Sag, and Salt Sections, and Subsequent Paleogeography

    NASA Astrophysics Data System (ADS)

    Pindell, J. L.; Graham, R.; Horn, B.

    2013-05-01

    Thick (up to 5 km), rapid (<3 Ma), salt deposition is problematic for basin modelling because such accommodation cannot be thermal, yet GoM salt deposits (Late Callovian-Early Oxfordian) appear to be post-rift (most salt overlies planar sub-salt unconformities on syn-rift section). One possible solution is that the pre-drift GoM was a deep (~2 km) air-filled rift depression where basement had already subsided tectonically, and thus could receive up to 5 km of salt, roughly the isostatic maximum on exhumed mantle, hyper-thinned continent, or new ocean crust. ION-GXT and other seismic data along W Florida and NW Yucatán show that (1) mother salt was only 1 km thick in these areas, (2) that these areas were depositionally connected to areas of thicker deposition, and (3) the top of all salt was at global sea level, and hence the sub-salt unconformity along Florida and Yucatán was only 1 km deep by end of salt deposition. These observations fit the air-filled chasm hypothesis; however, two further observations make that mechanism highly improbable: (1) basinward limits of sub-salt unconformities along Florida/Yucatán are deeper than top of adjacent ocean crust emplaced at ~2.7 km subsea (shown by backstripping), and (2) deepest abyssal sediments over ocean crust onlap the top of distal salt, demonstrating that the salt itself was rapidly drowned after deposition. Study of global ION datasets demonstrates the process of "rapid outer marginal collapse" at most margins, which we believe is achieved by low-angle detachment on deep, landward-dipping, Moho-equivalent surfaces such that outer rifted margins are hanging walls of crustal scale half-grabens over mantle. The tectonic accommodation space produced (up to 3 km, < 3 Ma) can be filled by ~5 km of sag/salt sequences with little apparent hanging wall rifting. When salt (or other) deposition lags behind, or ends during, outer marginal collapse, deep-water settings result. We suggest that this newly identified, "outer marginal detachment phase", normally separates the traditional "rift" from "drift" stages during continental margin creation. Importantly, this 2-3 km of subsidence presently is neither treated as tectonic nor as thermal in traditional subsidence analysis; thus, Beta estimates may be excessive at many outer margins. Outer marginal collapse was probably eastwardly diachronous with initiation of spreading in the GoM. Additionally, recent paleo-climate studies suggest humid Early/Middle Jurassic conditions in equatorial GoM, hindering air-filled chasm development, but North America's northward flight into middle latitudes initiated Callovian aridity.

  18. Evaluation of the marginal fit of metal copings fabricated on three different marginal designs using conventional and accelerated casting techniques: an in vitro study.

    PubMed

    Vaidya, Sharad; Parkash, Hari; Bhargava, Akshay; Gupta, Sharad

    2014-01-01

    Abundant resources and techniques have been used for complete coverage crown fabrication. Conventional investing and casting procedures for phosphate-bonded investments require a 2- to 4-h procedure before completion. Accelerated casting techniques have been used, but may not result in castings with matching marginal accuracy. The study measured the marginal gap and determined the clinical acceptability of single cast copings invested in a phosphate-bonded investment with the use of conventional and accelerated methods. One hundred and twenty cast coping samples were fabricated using conventional and accelerated methods, with three finish lines: Chamfer, shoulder and shoulder with bevel. Sixty copings were prepared with each technique. Each coping was examined with a stereomicroscope at four predetermined sites and measurements of marginal gaps were documented for each. A master chart was prepared for all the data and was analyzed using Statistical Package for the Social Sciences version. Evidence of marginal gap was then evaluated by t-test. Analysis of variance and Post-hoc analysis were used to compare two groups as well as to make comparisons between three subgroups . Measurements recorded showed no statistically significant difference between conventional and accelerated groups. Among the three marginal designs studied, shoulder with bevel showed the best marginal fit with conventional as well as accelerated casting techniques. Accelerated casting technique could be a vital alternative to the time-consuming conventional casting technique. The marginal fit between the two casting techniques showed no statistical difference.

  19. Metaphors and the Pejorative Framing of Marginalized Groups: Implications for Social Work Education

    ERIC Educational Resources Information Center

    O'Brien, Gerald V.

    2009-01-01

    Although the importance of metaphors is described in the social work literature, few articles or books in the profession have considered the role of metaphors in social policy, especially in providing a negative frame within which marginalized groups can be considered. This negative framing naturally supports aversive social policies designed to…

  20. Looking Outside Education: Expanding Our Thinking about Moving Research into Practice

    ERIC Educational Resources Information Center

    Schneider, Jack

    2015-01-01

    This essay explores the usefulness of looking outside of education for inspiration, particularly with regard to seemingly intractable issues that have been resigned to the margins. First, it proposes that, rather than comparing education to medicine and law--the traditional comparison fields for education--we turn instead to the "helping…

  1. Civic Participation Reimagined: Youth Interrogation and Innovation in the Multimodal Public Sphere

    ERIC Educational Resources Information Center

    Mirra, Nicole; Garcia, Antero

    2017-01-01

    This chapter challenges dominant narratives about the civic disengagement of youth from marginalized communities by reconceptualizing what counts as civic participation in public life and how youth are positioned as civic agents. We examine ideologies that undergird traditional forms of civic education and engagement in the United States and offer…

  2. Student Academic Reading Preferences: A Study of Online Reading Habits and Inclinations

    ERIC Educational Resources Information Center

    Podolsky, Tim; Soiferman, Karen

    2014-01-01

    The purpose of this study was to explore student preferences regarding reading print materials or online reading materials for academic purposes, as well as to examine how students adapt traditional reading strategies such as underlining, highlighting, and taking marginal notes when reading electronic texts. A total of 61 participants (32…

  3. Transformational Bilingual Learning: Re-Engaging Marginalized Learners through Language, Culture, Community, and Identity

    ERIC Educational Resources Information Center

    Tulloch, Shelley; Kusugak, Adriana; Chenier, Cayla; Pilakapsi, Quluaq; Uluqsi, Gloria; Walton, Fiona

    2017-01-01

    The Miqqut project was a participatory action research project through which Inuit language and literacy learning was embedded in a traditional skills program. Community-based researchers tracked learners' progress through entrance, exit, and post-program interviews and questionnaires, as well as through participant observation. Results show that…

  4. The Three C's for Urban Science Education

    ERIC Educational Resources Information Center

    Emdin, Chris

    2008-01-01

    In this article, the author outlines briefly what he calls the three C's--a set of tools that can be used to improve urban science education. The author then describes ways that these tools can support students who have traditionally been marginalized. These three aligned and closely connected tools provide practical ways to engage students in…

  5. The Best of Both Worlds--How Vocational Education Can Enhance University Studies in Construction Management

    ERIC Educational Resources Information Center

    McLaughlin, Patricia; Mills, Anthony

    2010-01-01

    Australian post-compulsory vocational or technical education and higher education (university) has traditionally been delivered separately. Attempts to collaborate on curriculum development and delivery have mostly been at the margins of articulation and educational pathways. This study examines a pilot project in construction management education…

  6. Language, Literacy, and Culture: Aha! Moments in Personal and Sociopolitical Understanding

    ERIC Educational Resources Information Center

    Nieto, Sonia

    2013-01-01

    This article focuses on the intersections among language, literacy, and culture, and what these intersections have meant for the author personally, and what they can mean for students who have been marginalized, neglected, or made invisible by traditional understandings of the role of education. Although not linked conceptually in the past, the…

  7. Organizational Learning in Schools Pursuing Social Justice: Fostering Educational Entrepreneurship and Boundary Spanning

    ERIC Educational Resources Information Center

    Scanlan, Martin

    2011-01-01

    The field of socially just educational leadership is focused on promoting improvements in the teaching and learning environment as demonstrated by student learning gains, particularly for traditionally marginalized students. The field has identified priorities (i.e., school improvement, democratic community, and social justice) and steps to pursue…

  8. Marginal Mentoring in the Contact Space: Diversified Mentoring Relationships at a Midsized Midwestern State University (MMSU)

    ERIC Educational Resources Information Center

    Meyer, Marcy; Warren-Gordon, Kiesha

    2013-01-01

    This study is a collaborative investigation that melds traditional qualitative social scientific and contemporary autoethnographic methods to examine diversified mentoring relationships at a midsized midwestern state university (MMSU). The first author conducted 21 semi-structured interviews with MMSU faculty members and professional personnel who…

  9. Personal Lineages and the Development of Community Psychology: 1965 to 2005

    ERIC Educational Resources Information Center

    Fowler, Patrick J.; Toro, Paul A.

    2008-01-01

    The purpose of this study was twofold: (a) to examine and document the role of personal influence in the history of community psychology, and (b) to measure the field's inclusion of traditionally marginalized populations. In addition to presenting visually the genealogy of community psychology, results suggest that people have mattered in the…

  10. The Politics of Marginality in Wallowa County, Oregon: Contesting the Production of Landscapes of Consumption

    ERIC Educational Resources Information Center

    Abrams, Jesse B.; Gosnell, Hannah

    2012-01-01

    The state of Oregon's (USA) land use planning framework has long been characterized by tensions between state and local authority, between traditionally-defined "urban" and "rural" concerns, and between the competing interests of various landowners. An examination of Wallowa County, Oregon's implementation of House Bill 3326, a…

  11. "Disorienting, Fun or Meaningful?": Looking beyond the Boundaries of the Museum

    ERIC Educational Resources Information Center

    Birmingham, Daniel

    2016-01-01

    A growing body of research highlights how informal science learning environments (ISLE's) can alter modes of participation in science for youth who are traditionally marginalized in science (Calabrese Barton and Tan in "J Learn Sci" 19(2):187-229, 2010). While these findings reveal successful examples of ISLE's potential to bridge…

  12. Building New Networks from the Old: Women's Experiences with Electronic Communications.

    ERIC Educational Resources Information Center

    Takayoshi, Pamela

    1994-01-01

    Presents research to support the argument that patterns of interaction deeply entrenched within a patriarchal system cannot be undermined simply by offering access to a new medium such as computer-mediated communication. Claims that, in moving away from traditional discourse forms that oppress and marginalize women, scholars run the risk of those…

  13. The Process and Product: Crafting Community Portraits with Young People in Flexible Learning Settings

    ERIC Educational Resources Information Center

    Baker, Alison M.

    2016-01-01

    Community-based alternative education is situated on the margins in relation to mainstream education. Young people attending these learning sites are often characterised as "disengaged learners", who have fallen through the cracks of the traditional schooling system. The aim of this project was to use participatory visual methods with…

  14. Aboriginal Environmental Wisdom, Stewardship, and Sustainability: Lessons from the Walpole Island First Nations, Ontario, Canada

    ERIC Educational Resources Information Center

    Beckford, Clinton L.; Jacobs, Clint; Williams, Naomi; Nahdee, Russell

    2010-01-01

    Generally speaking, environmental education teaching, research, and practice have been informed by the traditions of western, Euro-centric culture. In this context indigenous perspectives are often marginalized, maligned, and perceived to be unscientific and therefore inferior. This essay adds to the growing body of literature exploring aboriginal…

  15. Revitalization of the Shared Commons: Education for Sustainability and Marginalized Cultures

    ERIC Educational Resources Information Center

    Glasson, George E.

    2010-01-01

    Education for sustainability provides a vision for revitalizing the environmental commons while preserving cultural traditions and human rights. What happens if the environmental commons is shared by two politically disparate and conflicting cultures? As in many shared common lands, what happens if one culture is dominant and represents a more…

  16. Social Mobility and Reproduction for Whom? College Readiness and First-Year Retention

    ERIC Educational Resources Information Center

    DeAngelo, Linda; Franke, Ray

    2016-01-01

    Completing college is now the minimum threshold for entry into the middle class. This has pushed college readiness issues to the forefront in efforts to increase educational attainment. Little is known about how college readiness improves outcomes for students traditionally marginalized in educational settings or if social background factors…

  17. Forest site classification for cultural plant harvest by tribal weavers can inform management

    Treesearch

    S. Hummel; F.K. Lake

    2015-01-01

    Do qualitative classifications of ecological conditions for harvesting culturally important forest plants correspond to quantitative differences among sites? To address this question, we blended scientific methods (SEK) and traditional ecological knowledge (TEK) to identify conditions on sites considered good, marginal, or poor for harvesting the leaves of a plant (...

  18. Kichwa or Quichua? Competing Alphabets, Political Histories, and Complicated Reading in Indigenous Languages

    ERIC Educational Resources Information Center

    Limerick, Nicholas

    2018-01-01

    Over the past century, missionary educators, nation-state and academic planners, and literacy development workers have used alphabets for political ends for traditionally marginalized languages, and Native peoples have contested such planning with other alphabet proposals. Yet literacy work now often overlooks that there are multiple alphabets…

  19. Building Intercultural Empathy through Writing: Reflections on Teaching Alternatives to Argumentation

    ERIC Educational Resources Information Center

    Peirce, Karen P.

    2007-01-01

    Writing assignments that focus on nonargumentative discourse can take many forms. Such assignments can prompt students to produce individually constructed writing, or they can be more collaborative in nature. They can focus on traditional formats, following MLA citation guidelines, using Times New Roman 12-point font, maintaining one-inch margins,…

  20. The Balika Shivir: A Girls' Education Program with a Social Change Agenda

    ERIC Educational Resources Information Center

    Singh, Manjari

    2010-01-01

    The Balika Shivir, a six-month, non-formal, residential, education program for illiterate adolescent girls was an intervention strategy used to reach a traditionally underserved and marginalized population in rural western India. The primary objective of the Balika Shivir was to impart literacy and numeracy skills to attending girls, and to…

  1. The School Social Worker: A Marginalized Commodity within the School Ecosystem

    ERIC Educational Resources Information Center

    Sherman, Megan Callahan

    2016-01-01

    For more than a century, social workers have been a life force within the education system. Throughout recent history school social workers have had an array of responsibilities within the school community. They have served as counselors, mediators, and advocates. Traditionally, school social workers have been primary facilitators of communication…

  2. Representation Radio: Digital Art-Making as Transformative Pedagogical Practice in the College Classroom

    ERIC Educational Resources Information Center

    Bass, Michelle B.; Halverson, Erica R.

    2012-01-01

    In this article, the authors unpack a first-year college seminar where students explored digital representations of self-afforded pedagogies of possibility for traditionally marginalized student populations, specifically students of colour and first-generation college goers. An artefact analysis model is used to trace the relationship between the…

  3. Interruption of Community: A Chronicle of the Journey from Segregation to Dis-Integration

    ERIC Educational Resources Information Center

    Roberson, Deborah C.

    2017-01-01

    Traditional research often excludes the voices of marginalized populations such as African Americans, who are usually written about instead of being allowed to tell their own stories (King, 2005). This research gives African Americans the opportunity to "tell their stories" of segregation and integration. Leaving the telling of our…

  4. Poetics, Politics, and the Life of Latino Catholics in California

    ERIC Educational Resources Information Center

    Sandell, David P.

    2009-01-01

    This essay explores poetics and politics among Latino Catholics in Fresno, California, who draw on a tradition of storytelling and religious ritual to mitigate the hardships that result from their marginal social assignment. Storytelling and ritual allow them to recognize where faith and daily life intersect, exposing the tensions--including those…

  5. The Arts as a Venue for Developmental Science: Realizing a Latent Opportunity

    ERIC Educational Resources Information Center

    Goldstein, Thalia R.; Lerner, Matthew D.; Winner, Ellen

    2017-01-01

    Children in all cultures readily engage in artistic activities, yet the arts (dance, drama, drawing, and music) have traditionally been marginal topics in the discipline of developmental science. We argue that developmental psychologists cannot afford to ignore such naturalistic activities that involve so many basic phenomena--attention,…

  6. Health Status of Homeless and Marginally Housed Users of Mental Health Self-Help Agencies.

    ERIC Educational Resources Information Center

    Segal, Steven P.; Gomory, Tomi; Silverman, Carol J.

    1998-01-01

    Investigates the health status of 310 homeless and marginally housed people to determine the usefulness of mental health self-help agencies (SHAs) in addressing their physical health needs. Findings indicated that frequencies of health problems among respondents were similar to those of other homeless or marginally housed groups and that the study…

  7. Marginal and Random Intercepts Models for Longitudinal Binary Data with Examples from Criminology

    ERIC Educational Resources Information Center

    Long, Jeffrey D.; Loeber, Rolf; Farrington, David P.

    2009-01-01

    Two models for the analysis of longitudinal binary data are discussed: the marginal model and the random intercepts model. In contrast to the linear mixed model (LMM), the two models for binary data are not subsumed under a single hierarchical model. The marginal model provides group-level information whereas the random intercepts model provides…

  8. [Impact of Gleason score on biochemical recurrence free survival after radical prostatectomy with positive surgical margins].

    PubMed

    Roux, V; Eyraud, R; Brureau, L; Gourtaud, G; Senechal, C; Fofana, M; Blanchet, P

    Research of predictive factors of biochemical recurrence to guide the establishment of an adjuvant treatment after radical prostatectomy for cancer with positive surgical margins. A retrospective cohort of 1577 afro-caribbean patients undergoing radical prostatectomy operated between 1st January 2000 and 1st July 2013 was analyzed. In this cohort, 406 patients had positive surgical margin, we excluded 11 patients who received adjuvant therapy (radiotherapy, hormonotherapy, radio-hormonotherapy) and 2 patients for whom histological analysis of the surgical specimen was for a pT4 pathological stage. After a descriptive analysis, we used a Cox model to look for predictors of survival without biochemical recurrence then, depending on the significant variables, we separated our population into six groups: stage pT2 with Gleason score≤3+4 (group 1), stage pT2 with a score of Gleason≥4+3 (group 2), stage pT3a with a Gleason core≤3+4 (group 3), pT3a stage with a score of Gleason≥4+3 (group 4), stage pT3b with a Gleason score≤3+4 (group 5) and stage pT3b Gleason≥with a score of 4+3 (group 6) and compared survival without biochemical recurrence using a log rank test. After radical prostatectomy with surgical margins with an anatomopathological stage≤pT3b, a Gleason score≥4+3 had a pejorative survival without biochemical recurrence than pathological stage (P<0.001). In multivariate analysis, predictors of survival without biochemical recurrence after radical prostatectomy with positive surgical margins were the majority Gleason postoperative (P<0.0001), pathological stage (P=0.049) adjusted preoperative PSA (P=0.826), with the body mass index (BMI) (P=0.59) and tumor volume (P=0.95). A high postoperatively Gleason score (≥4+3) has a better predictive value of biochemical recurrence than pathological stage pT2 or pT3 at the patients having been treated for prostate cancer by radical prostatectomy with positive surgical margins. 4. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  9. Incidence of positive surgical margins after robotic assisted radical prostatectomy: Does the surgeon's experience have an influence on all pathological stages?

    PubMed

    Villamil, A W; Costabel, J I; Billordo Peres, N; Martínez, P F; Giudice, C R; Damia, O H

    2014-03-01

    The aim of this study is to analyze the clinical and surgical features of patients who underwent robotic-assisted radical prostatectomy (RARP) at our institution, and the impact of the surgeon's experience in the oncological results related to pathological stage. An analysis of 300 RARP consecutively performed by the same urologist was conducted. Patients were divided into 3 groups of 100 patients in chronological order, according to surgery date. All patients had organ-confined clinical stage. Variables which could impact in positive margins rates were analyzed. Finally, positive surgical margins (PSM) in regard to pathological stage and surgeon's experience were compared and analyzed. No significant differences were found in variables which could impact in PSM rates. The overall PSM rate was 21%, with 28% in the first group, 20% in the second, and 16% in the third (P = .108). Significant lineal decreasing tendency was observed (P = .024). In pT2 patients, the overall PSM rate was 16.6%, with 27%, 13.8%, and 7.3% in each group respectively (P = .009). A significant difference was found between group 1 and group 3 (P = .004). In pT3 patients, the surgeon's experience was not significantly associated with margin reductions with an overall PSM rate of 27.7% (28.2%, 28.6%, and 26.7% in each group respectively). Clinical and surgical features in our patients did not vary over time. We found a significant reduction of PSM related to surgeon's experience in pT2 patients. Contrariwise, the margin status remained stable despite increasing experience in pT3 patients. Copyright © 2013 AEU. Published by Elsevier Espana. All rights reserved.

  10. Comparison of Marginal and Internal Adaptation of Heat-Pressed and CAD/CAM Porcelain Laminate Veneers and a 2-Year Follow-Up.

    PubMed

    Yuce, Mert; Ulusoy, Mubin; Turk, Ayse Gozde

    2017-12-22

    To compare marginal and internal adaptations of porcelain laminate veneers fabricated with heat-pressed and CAD/CAM techniques, and to evaluate the clinical performances 2 years after cementation. Thirty heat-pressed and 31 CAD/CAM porcelain laminate veneers were fabricated for 12 patients. Silicone replicas of each veneer were obtained. Replicas were sectioned into 4 parts to measure adaptations of the veneers. A stereomicroscope was used to measure from 3 locations of replicas for marginal, and 9 locations for internal adaptations at 40x magnification. Clinical evaluations were done at baseline and 6, 12, 18, and 24 months after cementation according to the modified United States Public Health Service (USPHS) criteria. Independent samples t-test compared the adaptation values between heat-pressed and CAD/CAM groups. Paired t-test was used to evaluate marginal and internal adaptations of each group. Differences between the modified USPHS criteria ratings of heat-pressed and CAD/CAM groups were determined by the Mann-Whitney U test. Kaplan-Meier analysis was used to analyze the survival ratings of the veneers (p < 0.05). The mean marginal adaptation values of heat-pressed and CAD/CAM veneers were 295 and 314.98 μm, respectively, and there was no statistically significant difference (p = 0.541). Internal adaptation values of groups were not statistically different either (201.82 μm for heat pressed; 195.47 μm for CAD/CAM p = 0.734). When marginal and internal adaptation values were compared within groups, there were significant differences both for heat-pressed (p < 0.001) and CAD/CAM (p < 0.001). All veneers were rated 100% satisfactory during the 2-year period. Within the limitations of this study, fabrication method, whether CAD/CAM or heat-pressed, had no effect on the marginal and internal adaptation of porcelain laminate veneers. The results showed that both fabrication techniques performed well after 2 years of clinical performance. © 2017 by the American College of Prosthodontists.

  11. Genital marginal failures after intensity-modulated radiation therapy (IMRT) in squamous cell anal cancer: no higher risk with IMRT when compared to 3DCRT.

    PubMed

    Dell'Acqua, V; Kobiela, J; Kraja, F; Leonardi, M C; Surgo, A; Zerella, M A; Arculeo, S; Fodor, C; Ricotti, R; Zampino, M G; Ravenda, S; Spinoglio, G; Biffi, R; Bazani, A; Luraschi, R; Vigorito, S; Spychalski, P; Orecchia, R; Glynne-Jones, R; Jereczek-Fossa, B A

    2018-03-28

    Intensity-modulated radiotherapy (IMRT) is considered the preferred option in squamous cell canal cancer (SCAC), delivering high doses to tumor volumes while minimizing dose to surrounding normal tissues. IMRT has steep dose gradients, but the technique is more demanding as deep understanding of target structures is required. To evaluate genital marginal failure in a cohort of patients with non-metastatic SCAC treated either with IMRT or 3DCRT and concurrent chemotherapy, 117 patients with SCAC were evaluated: 64 and 53 patients were treated with IMRT and 3DCRT techniques, respectively. All patients underwent clinical and radiological examination during their follow-up. Tumor response was evaluated with response evaluation criteria in solid tumors v1.1 guideline on regular basis. All patients' data were analyzed, and patients with marginal failure were identified. Concomitant chemotherapy was administered in 97 and 77.4% of patients in the IMRT and 3DCRT groups, respectively. In the IMRT group, the median follow-up was 25 months (range 6-78). Progressive disease was registered in 15.6% of patients; infield recurrence, distant recurrence and both infield recurrence and distant recurrence were identified in 5, 4 and 1 patient, respectively. Two out of 64 patients (3.1%) had marginal failures, localized at vagina/recto-vaginal septum and left perineal region. In the 3DCRT group, the median follow-up was 71.3 months (range 6-194 months). Two out of 53 patients (3.8%) had marginal failures, localized at recto-vaginal septum and perigenital structures. The rate of marginal failures was comparable in IMRT and 3DCRT groups (χ 2 test p = 0.85). In this series, the use of IMRT for the treatment of SCAC did not increase the rate of marginal failures offering improved dose conformity to the target. Dose constraints should be applied with caution-particularly in females with involvement of the vagina or the vaginal septum.

  12. Marginal and internal fit of heat pressed versus CAD/CAM fabricated all-ceramic onlays after exposure to thermo-mechanical fatigue.

    PubMed

    Guess, Petra C; Vagkopoulou, Thaleia; Zhang, Yu; Wolkewitz, Martin; Strub, Joerg R

    2014-02-01

    The aim of the study was to evaluate the marginal and internal fit of heat-pressed and CAD/CAM fabricated all-ceramic onlays before and after luting as well as after thermo-mechanical fatigue. Seventy-two caries-free, extracted human mandibular molars were randomly divided into three groups (n=24/group). All teeth received an onlay preparation with a mesio-occlusal-distal inlay cavity and an occlusal reduction of all cusps. Teeth were restored with heat-pressed IPS-e.max-Press* (IP, *Ivoclar-Vivadent) and Vita-PM9 (VP, Vita-Zahnfabrik) as well as CAD/CAM fabricated IPS-e.max-CAD* (IC, Cerec 3D/InLab/Sirona) all-ceramic materials. After cementation with a dual-polymerising resin cement (VariolinkII*), all restorations were subjected to mouth-motion fatigue (98 N, 1.2 million cycles; 5°C/55°C). Marginal fit discrepancies were examined on epoxy replicas before and after luting as well as after fatigue at 200× magnification. Internal fit was evaluated by multiple sectioning technique. For the statistical analysis, a linear model was fitted with accounting for repeated measurements. Adhesive cementation of onlays resulted in significantly increased marginal gap values in all groups, whereas thermo-mechanical fatigue had no effect. Marginal gap values of all test groups were equal after fatigue exposure. Internal discrepancies of CAD/CAM fabricated restorations were significantly higher than both press manufactured onlays. Mean marginal gap values of the investigated onlays before and after luting as well as after fatigue were within the clinically acceptable range. Marginal fit was not affected by the investigated heat-press versus CAD/CAM fabrication technique. Press fabrication resulted in a superior internal fit of onlays as compared to the CAD/CAM technique. Clinical requirements of 100 μm for marginal fit were fulfilled by the heat-press as well as by the CAD/CAM fabricated all-ceramic onlays. Superior internal fit was observed with the heat-press manufacturing method. The impact of present findings on the clinical long-term behaviour of differently fabricated all-ceramic onlays warrants further investigation. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. Marginal and internal fit of heat pressed versus CAD/CAM fabricated all-ceramic onlays after exposure to thermo-mechanical fatigue

    PubMed Central

    Guess, Petra C.; Vagopoulou, Thaleia; Zhang, Yu; Wolkewitz, Martin; Strub, Joerg R.

    2015-01-01

    Objectives The aim of the study was to evaluate the marginal and internal fit of heat-pressed and CAD/CAM fabricated all-ceramic onlays before and after luting as well as after thermo-mechanical fatigue. Materials and Methods Seventy-two caries-free, extracted human mandibular molars were randomly divided into three groups (n=24/group). All teeth received an onlay preparation with a mesio-occlusal-distal inlay cavity and an occlusal reduction of all cusps. Teeth were restored with heat-pressed IPS-e.max-Press* (IP, *Ivoclar-Vivadent) and Vita-PM9 (VP, Vita-Zahnfabrik) as well as CAD/CAM fabricated IPS-e.max-CAD* (IC, Cerec 3D/InLab/Sirona) all-ceramic materials. After cementation with a dual-polymerizing resin cement (VariolinkII*), all restorations were subjected to mouth-motion fatigue (98N, 1.2 million cycles; 5°C/55°C). Marginal fit discrepancies were examined on epoxy replicas before and after luting as well as after fatigue at 200x magnification. Internal fit was evaluated by multiple sectioning technique. For the statistical analysis, a linear model was fitted with accounting for repeated measurements. Results Adhesive cementation of onlays resulted in significantly increased marginal gap values in all groups, whereas thermo-mechanical fatigue had no effect. Marginal gap values of all test groups were equal after fatigue exposure. Internal discrepancies of CAD/CAM fabricated restorations were significantly higher than both press manufactured onlays. Conclusions Mean marginal gap values of the investigated onlays before and after luting as well as after fatigue were within the clinically acceptable range. Marginal fit was not affected by the investigated heat-press versus CAD/CAM fabrication technique. Press fabrication resulted in a superior internal fit of onlays as compared to the CAD/CAM technique. Clinical Relevance Clinical requirements of 100 μm for marginal fit were fulfilled by the heat-press as well as by the CAD/CAM fabricated all-ceramic onlays. Superior internal fit was observed with the heat-press manufacturing method. The impact of present findings on the clinical long-term behaviour of differently fabricated all-ceramic onlays warrants further investigation. PMID:24161516

  14. Grit blasting and the marginal accuracy of two ceramic veneer systems--a pilot study.

    PubMed

    Lim, C; Ironside, J G

    1997-04-01

    Margins of ceramic restorations can be damaged during removal of investment materials with grit blasting and result in relatively large marginal discrepancies and excessive marginal discrepancies with greater exposure of cement to the oral environment. Subsequent dissolution of cement can encourage plaque retention, dental caries, and periodontal problems. This study compared marginal adaptation of ceramic veneers created by the refractory die technique (R), Dicor glass ceramic technique (D), and effects of grit blasting on their margins. Two groups of ceramic veneers were constructed for each system, one without grit blasting (R g and D g) and one with grit blasting (R+g and D+g). Statistical analyses revealed that grit blasting had a greater effect in reducing marginal accuracy for Dicor ceramic veneers compared with refractory die ceramic veneers.

  15. A generalized sizing method for revolutionary concepts under probabilistic design constraints

    NASA Astrophysics Data System (ADS)

    Nam, Taewoo

    Internal combustion (IC) engines that consume hydrocarbon fuels have dominated the propulsion systems of air-vehicles for the first century of aviation. In recent years, however, growing concern over rapid climate changes and national energy security has galvanized the aerospace community into delving into new alternatives that could challenge the dominance of the IC engine. Nevertheless, traditional aircraft sizing methods have significant shortcomings for the design of such unconventionally powered aircraft. First, the methods are specialized for aircraft powered by IC engines, and thus are not flexible enough to assess revolutionary propulsion concepts that produce propulsive thrust through a completely different energy conversion process. Another deficiency associated with the traditional methods is that a user of these methods must rely heavily on experts' experience and advice for determining appropriate design margins. However, the introduction of revolutionary propulsion systems and energy sources is very likely to entail an unconventional aircraft configuration, which inexorably disqualifies the conjecture of such "connoisseurs" as a means of risk management. Motivated by such deficiencies, this dissertation aims at advancing two aspects of aircraft sizing: (1) to develop a generalized aircraft sizing formulation applicable to a wide range of unconventionally powered aircraft concepts and (2) to formulate a probabilistic optimization technique that is able to quantify appropriate design margins that are tailored towards the level of risk deemed acceptable to a decision maker. A more generalized aircraft sizing formulation, named the Architecture Independent Aircraft Sizing Method (AIASM), was developed for sizing revolutionary aircraft powered by alternative energy sources by modifying several assumptions of the traditional aircraft sizing method. Along with advances in deterministic aircraft sizing, a non-deterministic sizing technique, named the Probabilistic Aircraft Sizing Method (PASM), was developed. The method allows one to quantify adequate design margins to account for the various sources of uncertainty via the application of the chance-constrained programming (CCP) strategy to AIASM. In this way, PASM can also provide insights into a good compromise between cost and safety.

  16. The influence of prophylactic proton pump inhibitor treatment on the development of symptomatic marginal ulceration in Roux-en-Y gastric bypass patients: a historic cohort study.

    PubMed

    Coblijn, Usha K; Lagarde, Sjoerd M; de Castro, Steve M M; Kuiken, Sjoerd D; van Tets, Willem F; van Wagensveld, Bart A

    2016-02-01

    Marginal ulceration at the gastrojejunostomy is a serious complication after laparoscopic Roux-en-Y gastric bypass surgery (LRYGB) and occurs in 1%-16% of patients. Proton pump inhibitors (PPIs) might lower the occurrence of these ulcers. The aim of the present study was to evaluate the effect of 6 months prophylactic usage of PPIs on the development of marginal ulceration and compare this with a historic patient control group. A single institution cohort at a bariatric center of excellence, The Sint Lucas Andreas Zienkenhuis, Amsterdam A consecutive database of patients who underwent LRYGB from November 2007 to September 2012 in a single institution was retrospectively reviewed. From August 2011, patients received a standard dose of pantozol 40 mg once daily directly postoperatively for 6 months. No standard PPI prophylaxis was administered before August 2011, and the patients not using PPIs in this historic cohort served as the control group. A total of 610 patients underwent LRYGB, of which 128 patients (21.0%) underwent revisional surgery. Postoperative PPIs were administered in the intervention group of 337 patients, compared with the historic control group consisting of 273 patients. Six patients (1.2%) who received postoperative PPIs versus 20 patients (7.3 %) in the historic control group developed marginal ulceration (P = .001). Patients using proton pump inhibitors developed fewer gastrointestinal complaints postoperatively (P< .001). Routine usage of PPIs reduced the occurrence of marginal ulceration after LRYGB. Copyright © 2016 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  17. Evaluation of marginal and internal gap of three-unit metal framework according to subtractive manufacturing and additive manufacturing of CAD/CAM systems.

    PubMed

    Kim, Dong-Yeon; Kim, Eo-Bin; Kim, Hae-Young; Kim, Ji-Hwan; Kim, Woong-Chul

    2017-12-01

    To evaluate the fit of a three-unit metal framework of fixed dental prostheses made by subtractive and additive manufacturing. One master model of metal was fabricated. Twenty silicone impressions were made on the master die, working die of 10 poured with Type 4 stone, and working die of 10 made of scannable stone. Ten three-unit wax frameworks were fabricated by wax-up from Type IV working die. Stereolithography files of 10 three-unit frameworks were obtained using a model scanner and three-dimensional design software on a scannable working die. The three-unit wax framework was fabricated using subtractive manufacturing (SM) by applying the prepared stereolithography file, and the resin framework was fabricated by additive manufacturing (AM); both used metal alloy castings for metal frameworks. Marginal and internal gap were measured using silicone replica technique and digital microscope. Measurement data were analyzed by Kruskal-Wallis H test and Mann-Whitney U-test (α=.05). The lowest and highest gaps between premolar and molar margins were in the SM group and the AM group, respectively. There was a statistically significant difference in the marginal gap among the 3 groups ( P <.001). In the marginal area where pontic was present, the largest gap was 149.39 ± 42.30 µm in the AM group, and the lowest gap was 24.40 ± 11.92 µm in the SM group. Three-unit metal frameworks made by subtractive manufacturing are clinically applicable. However, additive manufacturing requires more research to be applied clinically.

  18. Nursing casualization and communication: a critical ethnography.

    PubMed

    Batch, Mary; Windsor, Carol

    2015-04-01

    The aim was to explore the relationship between nursing casualization and the culture of communication for nurses in a healthcare facility. Casualization, or non-standard work, is the use of temporary, contract, part-time and casual labour. An increase in casual labour has been part of a global shift in work organization aimed at creating a more flexible and cheaper workforce. It has been argued that flexibility of labour has enabled nurses to manage both non-work related needs and an increasingly complex work environment. Yet no research has explored casualization and how it impacts on the communication culture for nurses in a healthcare facility. Critical ethnography. Methods included observation, field notes, formal interviews and focus groups. Data collection was undertaken over the 2 years 2008-2009. The concepts of knowing and belonging were perceived as important to nursing teamwork and yet the traditional time/task work model, designed for a full-time workforce, marginalized non-standard workers. The combination of medical dominance and traditional stereotyping of the nurse and work as full-time shaped the behaviours of nurses and situated casual workers on the periphery. The overall finding was that entrenched systemic structures and processes shaped the physical and cultural dimensions of a contemporary work environment and contributed to an ineffective communication culture. Flexible work is an important feature of contemporary nursing. Traditional work models and nurse attitudes and practices have not progressed and are discordant with a contemporary approach to nursing labour management. © 2014 John Wiley & Sons Ltd.

  19. Wigner functions defined with Laplace transform kernels.

    PubMed

    Oh, Se Baek; Petruccelli, Jonathan C; Tian, Lei; Barbastathis, George

    2011-10-24

    We propose a new Wigner-type phase-space function using Laplace transform kernels--Laplace kernel Wigner function. Whereas momentum variables are real in the traditional Wigner function, the Laplace kernel Wigner function may have complex momentum variables. Due to the property of the Laplace transform, a broader range of signals can be represented in complex phase-space. We show that the Laplace kernel Wigner function exhibits similar properties in the marginals as the traditional Wigner function. As an example, we use the Laplace kernel Wigner function to analyze evanescent waves supported by surface plasmon polariton. © 2011 Optical Society of America

  20. In vitro evaluation of marginal adaptation in five ceramic restoration fabricating techniques.

    PubMed

    Ural, Cağri; Burgaz, Yavuz; Saraç, Duygu

    2010-01-01

    To compare in vitro the marginal adaptation of crowns manufactured using ceramic restoration fabricating techniques. Fifty standardized master steel dies simulating molars were produced and divided into five groups, each containing 10 specimens. Test specimens were fabricated with CAD/CAM, heat-press, glass-infiltration, and conventional lost-wax techniques according to manufacturer instructions. Marginal adaptation of the test specimens was measured vertically before and after cementation using SEM. Data were statistically analyzed by one-way ANOVA with Tukey HSD tests (a = .05). Marginal adaptation of ceramic crowns was affected by fabrication technique and cementation process (P < .001). The lowest marginal opening values were obtained with Cerec-3 crowns before and after cementation (P < .001). The highest marginal discrepancy values were obtained with PFM crowns before and after cementation. Marginal adaptation values obtained in the compared systems were within clinically acceptable limits. Cementation causes a significant increase in the vertical marginal discrepancies of the test specimens.

  1. Social representations of memory and gender in later medieval England.

    PubMed

    Kane, Bronach

    2012-12-01

    Social representations in later medieval culture have attracted little attention amongst psychologists, pre-dating the development of the so-called 'public sphere' in the eighteenth century. In addition, the association of pre-modern societies with 'traditional' modes of communication in social psychology places implicit limits on areas that may be studied through the lens of social representation theory. This article analyses the way in which knowledge circulated in late medieval society, noting initially the plural nature of representations of events and marginal groups, and the myriad channels through which beliefs were consolidated. In later medieval England perceptions of the past depended on collective and group memory, with customary rights and local histories forged through 'common knowledge', hearsay and the opinions of 'trustworthy men' of the village. The final section of this commentary provides an analysis of testimony from the late medieval church courts, in which witnesses articulated gender ideologies that reflected perceptions drawn from everyday life. Social representations of women were thus deployed in ecclesiastical suits, on the one hand supporting evidence of female witnesses and on the other justifying misogynistic stereotypes of women's behaviour.

  2. Evaluation of the fit of zirconia copings fabricated by direct and indirect digital impression procedures.

    PubMed

    Lee, Bora; Oh, Kyung Chul; Haam, Daewon; Lee, Joon-Hee; Moon, Hong-Seok

    2018-02-07

    Intraoral scanners are effective for direct digital impression when dental restorations are fabricated using computer-aided design and computer-aided manufacturing (CAD-CAM); however, if the abutment tooth cannot be dried completely or the prepared margin is placed subgingivally, accurate digital images cannot always be guaranteed. The purpose of this in vitro study was to compare the internal and marginal discrepancies of zirconia copings fabricated directly using an intraoral scanner with those fabricated indirectly with impression scanning. Forty-five resin dies fabricated with a 3-dimensional (3D) printer were divided into 3 groups: direct scanning (DS), impression scanning (IMP), and lost-wax casting (LW). For the DS group, a resin die was scanned with an intraoral scanner (Trios; 3Shape), whereas for the IMP group, impressions made with polyether were scanned with a cast scanner (D700; 3Shape). The zirconia copings were fabricated in the same way in the DS and IMP groups. For the LW group, impressions were made in the same way as in the IMP group, and Ni-Cr alloy copings were fabricated using LW. The marginal and internal discrepancies of the copings were measured by cementing them onto resin dies, embedding them in acrylic resin, and sectioning them in a buccolingual direction. The cement layer was measured, and the Kruskal-Wallis test was used to detect significant differences (α=.05). A nonparametric Friedman test was also performed to compare the measurements of each group by location (α=.05). The mean marginal discrepancies in the DS, IMP, and LW groups were 18.1 ±9.8, 23.2 ±17.2, and 32.3 ±18.6 μm (mean ±standard deviation), respectively. The mean internal discrepancies of the DS, IMP, and LW groups in the axial area were 38.0 ±9.1, 47.0 ±16.3, and 36.5 ±15.8 μm, and those in the occlusal area were 36.7 ±16.9, 33.4 ±21.6, and 44.5 ±31.9 μm, respectively. No statistically significant differences were found in marginal or internal discrepancies among groups (P>.05). Within the limitations of this study, the zirconia copings fabricated with CAD-CAM using different digitization methods and Ni-Cr copings fabricated using the lost-wax technique and casting produced clinically acceptable marginal and internal discrepancies. No significant differences were found among the DS, IMP, and LW groups. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  3. Marginal adaptation of full-coverage CAD/CAM restorations: in vitro study using a non-destructive method.

    PubMed

    Romeo, E; Iorio, M; Storelli, S; Camandona, M; Abati, S

    2009-03-01

    Marginal fit of full-coverage crowns is a major requirement for long term success of this kind of restorations. The purpose of the study was to verify the marginal adaptation of computer assisted design (CAD)/computer assisted manufacturing (CAM) crowns on prepared teeth and on plaster dies. Four couples of materials: zirconia-ceramic veneering (DC-Zircon, DCS Dental, Allschwill, CH/Cercon S, Degussa, DeguDent GmbH, Hanau, Germany), fiber-reinforced composite-composite veneering (DC-Tell, DCS Dental/Gradia, GC Europe, LEuven, Belgium), titanium-ceramic veneering (DC Titan, DCS Dental/Tikrom, Orotig, Verona, Italy) and titanium-composite veneering (DC Titan, DCS Dental/Gradia, GC Europe) were evaluated following the guidelines provided by ADA specific #8. Five crowns were fabricated for each material. Marginal gap values were measured at four points (0 degrees, 90 degrees, 180 degrees and 270 degrees starting from the centre of the vestibular surface) around the finishing line, on prepared teeth and on plaster dies at each step of the fabrication process. Digital photographs were taken at each reference point and a computer software was used to measure the amount of marginal discrepancy in microm. Statistical analysis was performed using t test at 95 percent confidence interval. All the tested materials, except for fiber-reinforced composite, show a marginal adaptation within the limits of ADA specification (25-40 microm). The application of veneering material causes decay in marginal adaptation, except for fiber-reinforced composite. Within the limitations of this study, it was concluded that marginal fit of CAD/CAM restoration is within the limits considered clinically acceptable by ADA specification #8. From the results of this in vitro study, it can be stated that CAD/CAM crowns produced with DCS system show a marginal adaptation within the limits of ADA specific #8, therefore milled CAD/CAM crowns can be considered a good alternative to more traditional waxing-investing-casting technique.

  4. Effect of Blood Contamination on Marginal Adaptation and Surface Microstructure of Mineral Trioxide Aggregate: A SEM Study.

    PubMed

    Salem Milani, Amin; Rahimi, Saeed; Froughreyhani, Mohammad; Vahid Pakdel, Mahdi

    2013-01-01

    In various clinical situations, mineral trioxide aggregate (MTA) may come into direct contact or even be mixed with blood. The aim of the present study was to evaluate the effect of exposure to blood on marginal adaptation and surface microstructure of MTA. Thirty extracted human single-rooted teeth were used. Standard root canal treatment was carried out. Root-ends were resected, and retrocavities were prepared. The teeth were randomly divided into two groups (n = 15): in group 1, the internal surface of the cavities was coated with fresh blood. Then, the cavities were filled with MTA. The roots were immersed in molds containing fresh blood. In group 2, the aforementioned procedures were performed except that synthetic tissue fluid (STF) was used instead of blood. To assess the marginal adaptation, "gap perimeter" and "maximum gap width" were measured under scanning electron microscope. The surface microstructure was also examined. Independent samples t-test and Mann-Whitney U test were used to analyze the data. Maximum gap width and gap perimeter in the blood-exposed group were significantly larger than those in the STF-exposed group (p < 0.01). In the blood-exposed group, the crystals tended to be more rounded and less angular compared with the STF-exposed group, and there was a general lack of needle-like crystals. Exposure to blood during setting has a negative effect on marginal adaptation of MTA, and blood-exposed MTA has a different surface microstructure compared to STF-exposed MTA.

  5. Performance-oriented: toward a successful strategy.

    PubMed

    Kumar, K; Subramanian, R; Yauger, C

    1997-01-01

    Changes in the health care industry have profoundly affected hospital management and have caused severe declines in hospital profitability. In 1993, Health Care Management Review reported that the average operating profit margin, around 2% in 1984, had declined to a 0.2% loss by 1990. In the past, hospitals were buffered by entry regulations and cost reimbursement; thus, they rarely dealt with traditional market pressures. But the changed terrain means that competitive factors now underscore all strategic decisions. This study examines the strategic significance of market orientation in the health care industry. The authors identified forms of market orientation by emphasizing different components, and discovered that hospitals fell into four distinct clusters or groups. They also found a critical relationship between market orientation and performance scores on a number of criteria. Finally, the authors suggest that different forms of market orientation should be employed to target specific performance measures.

  6. A novel approach emphasising intra-operative superficial margin enhancement of head-neck tumours with narrow-band imaging in transoral robotic surgery.

    PubMed

    Vicini, C; Montevecchi, F; D'Agostino, G; DE Vito, A; Meccariello, G

    2015-06-01

    The primary goal of surgical oncology is to obtain a tumour resection with disease-free margins. Transoral robotic surgery (TORS) for surgical treatment of head-neck cancer is commensurate with standard treatments. However, the likelihood of positive margins after TORS is up to 20.2% in a recent US survey. The aim of this study is to evaluate the efficacy and the feasibility of narrow-band imaging (NBI) during TORS in order to improve the ability to achieve disease-free margins during tumour excision. The present study was conducted at the ENT, Head- Neck Surgery and Oral Surgery Unit, Department of Special Surgery, Morgagni Pierantoni Hospital, Azienda USL Romagna. From March 2008 to January 2015, 333 TORS were carried out for malignant and benign diseases. For the present study, we retrospectively evaluated 58 biopsy-proven squamous cell carcinoma patients who underwent TORS procedures. Patients were divided into 2 groups: (1) 32 who underwent TORS and intra-operative NBI evaluation (NBI-TORS); (2) 21 who underwent TORS with standard intra-operative white-light imaging (WLITORS). Frozen section analysis of margins on surgical specimens showed a higher rate of negative superficial lateral margins in the NBI-TORS group compared with the WLI-TORS group (87.9% vs. 57.9%, respectively, p = 0.02). The sensitivity and specificity of intra-operative use of NBI, respectively, were 72.5% and 66.7% with a negative predictive value of 87.9%. Tumour margin enhancement provided by NBI associated with magnification and 3-dimensional view of the surgical field might increase the capability to achieve an oncologically-safe resection in challenging anatomical areas where minimal curative resection is strongly recommended for function preservation.

  7. NRC Continental Margins Workshop

    NASA Astrophysics Data System (ADS)

    Katsouros, Mary Hope

    The Ocean Studies Board of the National Research Council is organizing a workshop, “Continental Margins: Evolution of Passive Continental Margins and Active Marginal Processes,” to stimulate discussion and longterm planning in the scientific community about the evolution of all types of continental margins. We want to coordinate academic, industry, and government agency efforts in this field, and to enhance communication between sea-based and land-based research programs.The continental margins constitute the only available record of the long-term dynamic interaction of oceanic and continental lithosphere. Of great interest are the unique structures and thick sedimentary sequences associated with this interaction. A major focus of the workshop will be to define strategies for exploring and understanding the continental margins in three dimensions and through geologic time. The workshop will be divided into 7 working groups, each concentrating on a major issue in continental margins research. A background document is being prepared summarizing recent research in specific continental margin fields and identifying key scientific and technical issues.

  8. Evaluation of marginal and internal gaps of metal ceramic crowns obtained from conventional impressions and casting techniques with those obtained from digital techniques.

    PubMed

    Rai, Rathika; Kumar, S Arun; Prabhu, R; Govindan, Ranjani Thillai; Tanveer, Faiz Mohamed

    2017-01-01

    Accuracy in fit of cast metal restoration has always remained as one of the primary factors in determining the success of the restoration. A well-fitting restoration needs to be accurate both along its margin and with regard to its internal surface. The aim of the study is to evaluate the marginal fit of metal ceramic crowns obtained by conventional inlay casting wax pattern using conventional impression with the metal ceramic crowns obtained by computer-aided design and computer-aided manufacturing (CAD/CAM) technique using direct and indirect optical scanning. This in vitro study on preformed custom-made stainless steel models with former assembly that resembles prepared tooth surfaces of standardized dimensions comprised three groups: the first group included ten samples of metal ceramic crowns fabricated with conventional technique, the second group included CAD/CAM-milled direct metal laser sintering (DMLS) crowns using indirect scanning, and the third group included DMLS crowns fabricated by direct scanning of the stainless steel model. The vertical marginal gap and the internal gap were evaluated with the stereomicroscope (Zoomstar 4); post hoc Turkey's test was used for statistical analysis. One-way analysis of variance method was used to compare the mean values. Metal ceramic crowns obtained from direct optical scanning showed the least marginal and internal gap when compared to the castings obtained from inlay casting wax and indirect optical scanning. Indirect and direct optical scanning had yielded results within clinically acceptable range.

  9. Comparative analysis of two measurement methods for marginal fit in metal-ceramic and zirconia posterior FPDs.

    PubMed

    Gonzalo, Esther; Suárez, María J; Serrano, Benjamin; Lozano, José F L

    2009-01-01

    The purpose of this study was to compare two measurement methods for the external marginal fit of zirconia posterior fixed partial dentures (FPDs) fabricated using computer-aided design/manufacturing technology and metal-ceramic posterior FPDs fabricated using the conventional lost-wax technique. The null hypothesis was that there would be no differences between the measurement methods. Forty standardized steel specimens were prepared to receive posterior three-unit FPDs. Specimens were divided into four groups (n = 10): (1) metal-ceramic, (2) Procera Bridge Zirconia, (3) Lava AllCeramic System, and (4) Vita In-Ceram YZ 2000. All FPDs were luted with glass-ionomer cement (Ketac Cem EasyMix, 3M ESPE). Two measurement methods were used to analyze marginal fit: an image analysis (IA) program and a scanning electron microscope (SEM) (JEOL JSM-6400) with magnifications of 340 and 31,000, respectively. Marginal fit was measured at the same point on each abutment. Significant interaction was observed between measurement method and material (P = .0019). Therefore, the measurement method is not independent of the restoration material. Differences among groups were observed for IA (P = .0001) and SEM (P = .0013). Significant differences were observed for the Procera (P = .0050) and metal-ceramic (P = .0039) specimen groups when both measurement methods were evaluated separately. Accuracy of fit achieved by the four groups analyzed was within the range of clinical acceptance, yielding Procera Bridge Zirconia to have the best marginal fit using both measurement methods.

  10. Predictors of Traditional and Cyber-Bullying Victimization: A Longitudinal Study of Australian Secondary School Students.

    PubMed

    Hemphill, Sheryl A; Tollit, Michelle; Kotevski, Aneta; Heerde, Jessica A

    2015-09-01

    The purpose of the present article is to compare the individual, peer, family, and school risk and protective factors for both traditional and cyber-bullying victimization. This article draws on data from 673 students from Victoria, Australia, to examine Grade 7 (aged 12-13 years) predictors of traditional and cyber-bullying victimization in Grade 9 (aged 14-15 years). Participants completed a modified version of the Communities That Care youth survey. There were few similarities and important differences in the predictors of traditional and cyber-bullying victimization. For Grade 9 cyber-bullying victimization, in the fully adjusted model, having been a victim of traditional bullying in Grade 7 and emotional control in Grade 7 were predictors. For Grade 9 traditional bullying victimization, predictors were Grade 7 traditional bullying victimization, association with antisocial peers, and family conflict, with family attachment and emotional control marginally statistically significant. The use of evidence-based bullying prevention programs is supported to reduce experiences of both traditional and cyber-bullying victimization, as is the implementation of programs to assist students to regulate their emotions effectively. In addition, traditional bullying victimization may be reduced by addressing association with antisocial friends, family conflict, and bonding to families. © The Author(s) 2014.

  11. Program budgeting and marginal analysis: a case study in chronic airflow limitation.

    PubMed

    Crockett, A; Cranston, J; Moss, J; Scown, P; Mooney, G; Alpers, J

    1999-01-01

    Program budgeting and marginal analysis is a method of priority-setting in health care. This article describes how this method was applied to the management of a disease-specific group, chronic airflow limitation. A sub-program flow chart clarified the major cost drivers. After assessment of the technical efficiency of the sub-programs and careful and detailed analysis, incremental and decremental wish lists of activities were established. Program budgeting and marginal analysis provides a framework for rational resource allocation. The nurturing of a vigorous program management group, with members representing all participants in the process (including patients/consumers), is the key to a successful outcome.

  12. Defibrillation threshold testing fails to show clinical benefit during long-term follow-up of patients undergoing cardiac resynchronization therapy defibrillator implantation.

    PubMed

    Michowitz, Yoav; Lellouche, Nicolas; Contractor, Tahmeed; Bourke, Tara; Wiener, Isaac; Buch, Eric; Boyle, Noel; Bersohn, Malcolm; Shivkumar, Kalyanam

    2011-05-01

    The utility of defibrillation threshold testing in patients undergoing implantable cardioverter-defibrillator (ICD) implantation is controversial. Higher defibrillation thresholds have been noted in patients undergoing implantation of cardiac resynchronization therapy defibrillators (CRT-D). Since the risks and potential benefits of testing may be higher in this population, we sought to assess the impact of defibrillation safety margin or vulnerability safety margin testing in CRT-D recipients. A total of 256 consecutive subjects who underwent CRT-D implantation between January 2003 and December 2007 were retrospectively reviewed. Subjects were divided into two groups based on whether (n= 204) or not (n= 52) safety margin testing was performed. Patient characteristics, tachyarrhythmia therapies, procedural results, and clinical outcomes were recorded. Baseline characteristics, including heart failure (HF) severity, were comparable between the groups. Four cases of HF exacerbation (2%), including one leading to one death, were recorded in the tested group immediately post-implantation. No complications were observed in the untested group. After a mean follow-up of 32 ± 20 months, the proportion of appropriate shocks in the two groups was similar (31 vs. 25%, P = 0.49). There were three cases of failed appropriate shocks in the tested group, despite adequate safety margins at implantation, whereas no failed shocks were noted in the untested group. Survival was similar in the two groups. Defibrillation efficacy testing during implant of CRT-D was associated with increased morbidity and did not predict the success of future device therapy or improve survival during long-term follow-up.

  13. Dangerous Discourses: Using Controversial Books To Support Engagement, Diversity, and Democracy.

    ERIC Educational Resources Information Center

    Lewison, Mitzi; Leland, Christine; Flint, Amy Seely; Moller, Karla J.

    2002-01-01

    Notes that social issues books can enrich the understanding of history and life by giving voice to those who have traditionally been silenced or marginalized. Discusses how these books show how people can begin to take action on important social issues and rarely end with "they lived happily ever after." Presents four accounts of teaching with…

  14. Relationships among Reading Performance, Locus of Control and Achievement for Marginal Admission Students.

    ERIC Educational Resources Information Center

    Pepper, Roger S.; Drexler, John A., Jr.

    The first phase of the study was a 2 x 2 factorial design, with locus of control and instructional method (lecture and demonstration) as independent variables and honor point average (HPA) as the dependent variable. The second phase used correlational techniques to test the extent to which reading performance and traditional predictors of…

  15. Pedagogy of the Anxious: Rethinking Critical Pedagogy in the Context of Neoliberal Autonomy and Responsibilization

    ERIC Educational Resources Information Center

    De Lissovoy, Noah

    2018-01-01

    Critical pedagogy, and the work of Paulo Freire in particular, understands the struggle for emancipation as involving the emergence, as historical subjects, of those who have been marginalized. In this regard, this tradition could be said to foreground a "politics of the subject" as central to its philosophy. However, scholars of…

  16. Claiming the Cultural Space of the Classroom: Issues of Ethics and Social Justice

    ERIC Educational Resources Information Center

    Kirshner, David

    2011-01-01

    Issues of social justice are accorded scant space in the professional scope of most teachers. The purview of ideologues and do-gooders, social justice would seem to have little to do with practical, everyday teaching of subject matter content. This marginalization of social justice is supported by a traditionally individualist psychology that…

  17. Review of Hisham Ghassib: Where Does Creativity Fit into the Productivist Industrial Model of Knowledge Production?

    ERIC Educational Resources Information Center

    Neber, Heinz

    2010-01-01

    In this article, the author presents his comments on Hisham Ghassib's article entitled "Where Does Creativity Fit into the Productivist Industrial Model of Knowledge Production?" Ghassib (2010) describes historical transformations of science from a marginal and non-autonomous activity which had been constrained by traditions to a self-autonomous,…

  18. The Role of Race and Teachers' Cultural Awareness in Predicting Low-Income, Black and Hispanic Students' Perceptions of Educational Attainment

    ERIC Educational Resources Information Center

    Mahatmya, Duhita; Lohman, Brenda J.; Brown, Elizabeth L.; Conway-Turner, Jameela

    2016-01-01

    Demographic shifts in the United States have resulted in similar demographic shifts between K-12 teachers and their students, resulting in important implications for the educational outcomes of traditionally marginalized students and educators' cultural awareness required in teaching diverse classrooms. Using data from the Three-City Teacher…

  19. Globalisation, Neo-Liberalism and Vocational Learning: The Case of English Further Education Colleges

    ERIC Educational Resources Information Center

    Simmons, Robin

    2010-01-01

    Further education (FE) has traditionally been a rather unspectacular activity. Lacking the visibility of schools or the prestige of universities, for the vast majority of its existence FE has had a relatively low profile on the margins of English education. Over recent years this situation has altered significantly and further education has…

  20. Legal Problems of Religious and Private Schools. Third Edition. NOLPE Monograph Series, No. 53.

    ERIC Educational Resources Information Center

    Mawdsley, Ralph D.

    The almost universal doctrine of charitable immunity was traditionally justified at one time because of the altruistic nature of charities. The reasons for abolition of charitable immunity in most states have generally been two-fold: (1) charities are no longer low-budget, marginal operations; (2) the risk of crippling verdicts can be minimized…

  1. Coming in from the Margins: Faculty Development's Emerging Organizational Development Role in Institutional Change

    ERIC Educational Resources Information Center

    Schroeder, Connie

    2010-01-01

    Recognizing that a necessary and significant role change is underway in faculty development, this book calls for centers to merge their traditional responsibilities and services with a leadership role as organizational developers. Failing to define and outline the dimensions and expertise of this new role puts centers at risk of not only…

  2. Can Education Play a Role in the Prevention of Youth Gangs in Indian Country? One Tribe's Approach. ERIC Digest.

    ERIC Educational Resources Information Center

    Hernandez, Arturo

    Traditionally an urban problem, gang involvement is growing on Native American reservations. This digest examines common factors in gang development and one tribe's response through a Native-centric education and juvenile justice system. The sum of handicaps associated with gang involvement has been termed "multiple marginality," and…

  3. Rabbits and Flying Warriors: The Postindian Imagery of Jim Denomie

    ERIC Educational Resources Information Center

    Martinez, David

    2011-01-01

    In an art world dominated by non-Indian curators and experts, being "Indian" was confined to an ethnographic fiction of storytellers, dancers, and medicine men attired in traditional clothing and regalia, in which the colonization of indigenous lands and peoples is left to the margins like an Edward S. Curtis portrait. These are the…

  4. Using Workforce Strategy to Address Academic Casualisation: A University of Newcastle Case Study

    ERIC Educational Resources Information Center

    Crawford, Tina; Germov, John

    2015-01-01

    Casual and sessional academic staff have traditionally been on the margins of institutional life despite the expansion of this cohort across the university sector. This paper details a project to address this lack of recognition through a workforce strategy to engage, support and effectively manage this often neglected cohort of the academic…

  5. The Case for Teaching Grammar

    ERIC Educational Resources Information Center

    Budra, Paul

    2010-01-01

    While it is true that text is moving from the page to the screen, that does not mean the end or even marginalization of traditional reading and writing. If anything, it means more. And students leaving high school and entering university do not have, for the most part, the necessary skills to make themselves consistently understood in writing.…

  6. 77 FR 50526 - Proposed Safe Harbor Agreement for the Northern Spotted Owl, Skamania, Klickitat, and Yakima...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-21

    ... possibly that spotted owls are not responding to traditional survey methods. As of 2011, only one site... the following methods. You may request hard copies or a CD-ROM of the documents. Email: [email protected] marginal habitat,'' if the conditions associated with that habitat are verified by surveys using...

  7. "Little Pig, Little Pig, Yet Me Come In!" Animating "The Three Little Pigs" with Preschoolers

    ERIC Educational Resources Information Center

    Rhoades, Mindi

    2016-01-01

    Early childhood education, particularly through the influence of the Reggio Emilia model, traditionally has a strong affinity for arts-based, inquiry-based, interdisciplinary pedagogy. However, in the US, as standardized testing and curricula creep into early childhood classrooms, they marginalize arts-based learning and the kinds of playful,…

  8. Station Blackout: A case study in the interaction of mechanistic and probabilistic safety analysis

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Curtis Smith; Diego Mandelli; Cristian Rabiti

    2013-11-01

    The ability to better characterize and quantify safety margins is important to improved decision making about nuclear power plant design, operation, and plant life extension. As research and development (R&D) in the light-water reactor (LWR) Sustainability (LWRS) Program and other collaborative efforts yield new data, sensors, and improved scientific understanding of physical processes that govern the aging and degradation of plant SSCs needs and opportunities to better optimize plant safety and performance will become known. The purpose of the Risk Informed Safety Margin Characterization (RISMC) Pathway R&D is to support plant decisions for risk-informed margin management with the aim tomore » improve economics, reliability, and sustain safety of current NPPs. In this paper, we describe the RISMC analysis process illustrating how mechanistic and probabilistic approaches are combined in order to estimate a safety margin. We use the scenario of a “station blackout” wherein offsite power and onsite power is lost, thereby causing a challenge to plant safety systems. We describe the RISMC approach, illustrate the station blackout modeling, and contrast this with traditional risk analysis modeling for this type of accident scenario.« less

  9. Emergent supersymmetry in the marginal deformations of $$\\mathcal{N}=4$$ SYM

    DOE PAGES

    Jin, Qingjun

    2016-10-24

    Here, we study the one loop renormalization group flow of the marginal deformations ofmore » $$\\mathcal{N}=4$$ SYM theory using the a-function. We found that in the planar limit some non-supersymmetric deformations flow to the supersymmetric infrared fixed points described by the Leigh-Strassler theory. This means supersymmetry emerges as a result of renormalization group flow.« less

  10. 2009 Carolyn Wood Sherif Award Address: Riding Trojan Horses from Symbolism to Structural Change--In Feminist Psychology, Context Matters

    ERIC Educational Resources Information Center

    Greene, Beverly

    2010-01-01

    Against the backdrop of the historical 2008 presidential election, I discuss the ways that the election of marginalized group members to public office can be used to silence the discourse on the social marginalization of group members and to remove these analyses from their appropriate context. I emphasize the need to materialize alternatives to…

  11. Effect of electric arc, gas oxygen torch and induction melting techniques on the marginal accuracy of cast base-metal and noble metal-ceramic crowns.

    PubMed

    Gómez-Cogolludo, Pablo; Castillo-Oyagüe, Raquel; Lynch, Christopher D; Suárez-García, María-Jesús

    2013-09-01

    The aim of this study was to identify the most appropriate alloy composition and melting technique by evaluating the marginal accuracy of cast metal-ceramic crowns. Seventy standardised stainless-steel abutments were prepared to receive metal-ceramic crowns and were randomly divided into four alloy groups: Group 1: palladium-gold (Pd-Au), Group 2: nickel-chromium-titanium (Ni-Cr-Ti), Group 3: nickel-chromium (Ni-Cr) and Group 4: titanium (Ti). Groups 1, 2 and 3 were in turn subdivided to be melted and cast using: (a) gas oxygen torch and centrifugal casting machine (TC) or (b) induction and centrifugal casting machine (IC). Group 4 was melted and cast using electric arc and vacuum/pressure machine (EV). All of the metal-ceramic crowns were luted with glass-ionomer cement. The marginal fit was measured under an optical microscope before and after cementation using image analysis software. All data was subjected to two-way analysis of variance (ANOVA). Duncan's multiple range test was run for post-hoc comparisons. The Student's t-test was used to investigate the influence of cementation (α=0.05). Uncemented Pd-Au/TC samples achieved the best marginal adaptation, while the worst fit corresponded to the luted Ti/EV crowns. Pd-Au/TC, Ni-Cr and Ti restorations demonstrated significantly increased misfit after cementation. The Ni-Cr-Ti alloy was the most predictable in terms of differences in misfit when either torch or induction was applied before or after cementation. Cemented titanium crowns exceeded the clinically acceptable limit of 120μm. The combination of alloy composition, melting technique, casting method and luting process influences the vertical seal of cast metal-ceramic crowns. An accurate use of the gas oxygen torch may overcome the results attained with the induction system concerning the marginal adaptation of fixed dental prostheses. Copyright © 2013 Elsevier Ltd. All rights reserved.

  12. Comparison of marginal fit of cemented zirconia copings manufactured after digital impression with lava™ C.O.S and conventional impression technique.

    PubMed

    Dauti, Rinet; Cvikl, Barbara; Franz, Alexander; Schwarze, Uwe Yacine; Lilaj, Bledar; Rybaczek, Tina; Moritz, Andreas

    2016-12-08

    Evaluation of the marginal fit of cemented zirconia copings manufactured after digital impression with Lava™ Chairside Oral Scanner in comparison to that of zirconia copings manufactured after conventional impressions with polyvinyl siloxane. A prepared typodont tooth #36, was replicated 40 times with a vinyl silicone and precise model resin. The dies were randomly divided into two groups according to the impression taking technique. Digital impressions with Lava™ C.O.S. and conventional impressions were taken according to the group. Subsequently zirconia copings were manufactured and cemented on their respective dies with zinc oxide phosphate cement. After embedding in resin, mesio-distal section of each coping was performed with a diamond saw in order to obtain two slices. One half of the specimen was used for evaluation with an optical microscope (OM) and the other half for evaluation with a scanning electron microscope (SEM). Marginal gap (MG) and absolute marginal discrepancy (AMD) were measured mesial and distal on each slice. No significant difference of the marginal parameters between the digital and the conventional group was found. The mean values for MG in the digital group were 96.28 μm (+/-43.21 μm) measured with the OM and 99.26 μm (+/-48.73 μm) measured with the SEM, respectively. AMD mean values were 191.54 μm (+/-85.42 μm) measured with the optical microscope and 211.6 μm (+/-96.55 μm) with the SEM. For the conventional group the mean MG values were 94.84 μm (+/-50.77 μm) measured with the OM and 83.37 μm (+/-44.38 μm) measured with the SEM, respectively. AMD mean values were 158.60 μm (+/-69.14 μm) for the OM and 152.72 μm (+/-72.36) for the SEM. Copings manufactured after digital impression with Lava™ C.O.S. show comparable marginal parameters with the copings manufactured after conventional impression with polyvinyl syloxane. The mean MG values of both groups fit in the clinically acceptable range.

  13. Influence of surgical and prosthetic techniques on marginal bone loss around titanium implants. Part I: immediate loading in fresh extraction sockets.

    PubMed

    Berberi, Antoine N; Tehini, Georges E; Noujeim, Ziad F; Khairallah, Alexandre A; Abousehlib, Moustafa N; Salameh, Ziad A

    2014-10-01

    Delayed placement of implant abutments has been associated with peri-implant marginal bone loss; however, long-term results obtained by modifying surgical and prosthetic techniques after implant placement are still lacking. This study aimed to evaluate the marginal bone loss around titanium implants placed in fresh extraction sockets using two loading protocols after a 5-year follow-up period. A total of 36 patients received 40 titanium implants (Astra Tech) intended for single-tooth replacement. Implants were immediately placed into fresh extraction sockets using either a one-stage (immediate loading by placing an interim prosthesis into functional occlusion) or a two-stage prosthetic loading protocol (insertion of abutments after 8 weeks of healing time). Marginal bone levels relative to the implant reference point were evaluated at four time intervals using intraoral radiographs: at time of implant placement, and 1, 3, and 5 years after implant placement. Measurements were obtained from mesial and distal surfaces of each implant (α = 0.05). One-stage immediate implant placement into fresh extraction sockets resulted in a significant reduction in marginal bone loss (p < 0.002) compared to the traditional two-stage technique. Whereas mesial surfaces remained stable for the 5-year observation period, significant marginal bone loss was observed on distal surfaces of implants after cementation of interim prostheses (p < 0.007) and after 12 months (p < 0.034). Within the limitations of this study, immediate loading of implants placed into fresh extraction sockets reduced marginal bone loss and did not compromise the success rate of the restorations. © 2014 by the American College of Prosthodontists.

  14. An Integrative Cultural Model to better situate marginalized science students in postsecondary science education

    NASA Astrophysics Data System (ADS)

    Labouta, Hagar Ibrahim; Adams, Jennifer Dawn; Cramb, David Thomas

    2018-03-01

    In this paper we reflect on the article "I am smart enough to study postsecondary science: a critical discourse analysis of latecomers' identity construction in an online forum", by Phoebe Jackson and Gale Seiler (Cult Stud Sci Educ. https://doi.org/10.1007/s11422-017-9818-0). In their article, the authors did a significant amount of qualitative analysis of a discussion on an online forum by four latecomer students with past negative experiences in science education. The students used this online forum as an out-of-class resource to develop a cultural model based on their ability to ask questions together with solidarity as a new optimistic way to position themselves in science. In this forum, we continue by discussing the identity of marginalized science students in relation to resources available in postsecondary science classes. Recent findings on a successful case of a persistent marginalized science student in spite of prior struggles and failures are introduced. Building on their model and our results, we proposed a new cultural model, emphasizing interaction between inside and outside classroom resources which can further our understanding of the identity of marginalized science students. Exploring this cultural model could better explain drop-outs or engagement of marginalized science students to their study. We, then, used this model to reflect on both current traditional and effective teaching and learning practices truncating or re-enforcing relationships of marginalized students with the learning environment. In this way, we aim to further the discussion initiated by Jackson and Seiler and offer possible frameworks for future research on the interactions between marginalized students with past low achievements and other high and mid achieving students, as well as other interactions between resources inside and outside science postsecondary classrooms.

  15. The Local Wind Pump for Marginal Societies in Indonesia: A Perspective of Fault Tree Analysis

    NASA Astrophysics Data System (ADS)

    Gunawan, Insan; Taufik, Ahmad

    2007-10-01

    There are many efforts to reduce a cost of investment of well established hybrid wind pump applied to rural areas. A recent study on a local wind pump (LWP) for marginal societies in Indonesia (traditional farmers, peasant and tribes) was one of the efforts reporting a new application area. The objectives of the study were defined to measure reliability value of the LWP due to fluctuated wind intensity, low wind speed, economic point of view regarding a prolong economic crisis occurring and an available local component of the LWP and to sustain economics productivity (agriculture product) of the society. In the study, a fault tree analysis (FTA) was deployed as one of three methods used for assessing the LWP. In this article, the FTA has been thoroughly discussed in order to improve a better performance of the LWP applied in dry land watering system of Mesuji district of Lampung province-Indonesia. In the early stage, all of local component of the LWP was classified in term of its function. There were four groups of the components. Moreover, all of the sub components of each group were subjected to failure modes of the FTA, namely (1) primary failure modes; (2) secondary failure modes and (3) common failure modes. In the data processing stage, an available software package, ITEM was deployed. It was observed that the component indicated obtaining relative a long life duration of operational life cycle in 1,666 hours. Moreover, to enhance high performance the LWP, maintenance schedule, critical sub component suffering from failure and an overhaul priority have been identified in term of quantity values. Throughout a year pilot project, it can be concluded that the LWP is a reliable product to the societies enhancing their economics productivities.

  16. Soft tissues stability of cad-cam and stock abutments in anterior regions: 2-year prospective multicentric cohort study.

    PubMed

    Lops, Diego; Bressan, Eriberto; Parpaiola, Andrea; Sbricoli, Luca; Cecchinato, Denis; Romeo, Eugenio

    2015-12-01

    Aim of this study was to verify if the type of implant abutment manufacturing, stock or cad-cam, could influence the maintenance of stable gingival margins around single restorations in anterior areas. After 16 weeks of healing, implants (Osseospeed, Astra Tech Dental Implant) were positioned. Depending on the different fixture inclination and the thickness of buccal peri-implant soft tissue, abutment selection resulted in four groups: Group 1 (patients with zirconia ZirDesign(®) stock abutments), Group 2 (titanium stock TiDesign(®) abutments), Group 3 (zirconia cad-cam abutments), and Group 4 (titanium cad-cam abutments). The following parameters were assessed: buccal gingival margin modification (BGM). The modification of the implant gingival margin was followed at 1 and 2 years of follow-up. A computerized analysis was performed for measurements. Differences between soft tissue margin at baseline and after 2 years measured the gingival margin recession. A general linear model was used to evaluate each group in relation to gingival recession after two years. Tukey's post hoc test was used to compare the mean REC indexes of each group of abutments. Seventy-two healthy patients (39 males and 33 females; mean age of 46 years) scheduled for single gap rehabilitation in anterior areas were enrolled. A 100% of implant survival rate was observed after 24 months of function. One failure occurred due to fracture of a Zirconia cad-cam abutment. Moreover, two abutment screw unscrewing were observed. Both for zirconia and titanium stock abutments (Group 1 and 2), the mean recession of implant buccal soft tissue was of 0.3 mm (SD of 0.3 and 0.4 mm, respectively). Soft tissue mean recession of zirconia and titanium cad-cam abutments (Group 3 and 4) was of 0.1 and -0.3 mm, respectively (SD of 0.3 and 0.4 mm, respectively). REC values of cad-cam titanium abutments (Group 4) were significantly lower than that of Group 1 (-0.57 mm), Group 2 (-0.61 mm), and Group 3 (-0.40 mm), respectively (Table 4). In the anterior area, the use of cad-cam abutments is related to a better soft tissue stability. Such a relationship is significant if cad-cam titanium abutments are compared to both titanium and zirconia stock abutments. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Numerical analysis of flow in a centrifugal compressor with circumferential grooves: influence of groove location and number on flow instability

    NASA Astrophysics Data System (ADS)

    Chen, X.; Qin, G.; Ai, Z.; Ji, Y.

    2017-08-01

    As an effective and economic method for flow range enhancement, circumferential groove casing treatment (CGCT) is widely used to increase the stall margin of compressors. Different from traditional grooved casing treatments, in which the grooves are always located over the rotor in both axial and radial compressors, one or several circumferential grooves are located along the shroud side of the diffuser passage in this paper. Numerical investigations were conducted to predict the performance of a low flow rate centrifugal compressor with CGCT in diffuser. Computational fluid dynamics (CFD) analysis is performed under stage environment in order to find the optimum location of the circumferential casing groove in consideration of stall margin enhancement and efficiency gain at design point, and the impact of groove number to the effect of this grooved casing treatment configuration in enhancing the stall margin of the compressor stage is studied. The results indicate that the centrifugal compressor with circumferential groove in vaned diffuser can obtain obvious improvement in the stall margin with sacrificing design efficiency a little. Efforts were made to study blade level flow mechanisms to determine how the CGCT impacts the compressor’s stall margin (SM) and performance. The flow structures in the passage, the tip gap, and the grooves as well as their mutual interactions were plotted and analysed.

  18. Effect of postoperative peroxide bleaching on the marginal seal of composite restorations bonded with self-etch adhesives.

    PubMed

    Roubickova, A; Dudek, M; Comba, L; Housova, D; Bradna, P

    2013-01-01

    The aim of this study was to determine the effect of peroxide bleaching on the marginal seal of composite restorations bonded with several adhesive systems. Combined cylindrical Class V cavities located half in enamel and half in dentin were prepared on the buccal and lingual surfaces of human molars. The cavities were bonded with the self-etch adhesives Clearfil SE-Bond (CLF), Adper Prompt (ADP), and iBond (IBO) and an etch-and-rinse adhesive Gluma Comfort Bond (GLU) and restored with a microhybrid composite Charisma. Experimental groups were treated 25 times for eight hours per day with a peroxide bleaching gel Opalescence PF 20, while the control groups were stored in distilled water for two months and then subjected to a microleakage test using a dye penetration method. Scanning electron microscopy was used to investigate the etching and penetration abilities of the adhesives and morphology of debonded restoration-enamel interfaces after the microleakage tests. Statistical analyses were performed using nonparametric Kruskal-Wallis, Mann-Whitney, and Wilcoxon tests at p=0.05. The microleakage of all GLU groups was low and not significantly affected by peroxide bleaching. Low microleakage was recorded for CLF control groups, but after bleaching, a small but significant increase in microleakage at the enamel margin indicated its sensitivity to peroxide bleaching. For ADP and IBO control groups, the microleakage at the enamel margins was significantly higher than for GLU and CLF and exceeded that at the dentin margins. Bleaching did not induce any significant changes in the microleakage. Electron microscopy analysis indicated that in our experimental setup, decreased adhesion and mechanical resistance of the ADP- and IBO-enamel interfaces could be more important than the chemical degradation effects induced by the peroxide bleaching gel.

  19. Evaluation of marginal and internal gap of three-unit metal framework according to subtractive manufacturing and additive manufacturing of CAD/CAM systems

    PubMed Central

    Kim, Dong-Yeon; Kim, Eo-Bin; Kim, Hae-Young; Kim, Ji-Hwan

    2017-01-01

    PURPOSE To evaluate the fit of a three-unit metal framework of fixed dental prostheses made by subtractive and additive manufacturing. MATERIALS AND METHODS One master model of metal was fabricated. Twenty silicone impressions were made on the master die, working die of 10 poured with Type 4 stone, and working die of 10 made of scannable stone. Ten three-unit wax frameworks were fabricated by wax-up from Type IV working die. Stereolithography files of 10 three-unit frameworks were obtained using a model scanner and three-dimensional design software on a scannable working die. The three-unit wax framework was fabricated using subtractive manufacturing (SM) by applying the prepared stereolithography file, and the resin framework was fabricated by additive manufacturing (AM); both used metal alloy castings for metal frameworks. Marginal and internal gap were measured using silicone replica technique and digital microscope. Measurement data were analyzed by Kruskal-Wallis H test and Mann-Whitney U-test (α=.05). RESULTS The lowest and highest gaps between premolar and molar margins were in the SM group and the AM group, respectively. There was a statistically significant difference in the marginal gap among the 3 groups (P<.001). In the marginal area where pontic was present, the largest gap was 149.39 ± 42.30 µm in the AM group, and the lowest gap was 24.40 ± 11.92 µm in the SM group. CONCLUSION Three-unit metal frameworks made by subtractive manufacturing are clinically applicable. However, additive manufacturing requires more research to be applied clinically. PMID:29279766

  20. Application value of different transformation zone types and its genetic relationship with high-risk HPV type in diagnosis and therapy of cervical disease.

    PubMed

    Chen, Yan; Zhou, Jia-De

    2015-01-01

    This study aims to discuss the influence of different types of transformation zone (TZ) on positive surgical margin of loop electrosurgical excision procedure (LEEP) and the significance of infection of different genetic high-risk HPV for cervical intraepithelial neoplasm. The clinical data of patients who had CIN2+ and received LEEP during January to December 2013 was investigated. The conditions of positive surgical margin of patients of different transformation zone (type I, II, III) were analyzed. The clinical high-risk types of HPV were divided into three groups, including A5/6, A7 and A9, compared with the pathological conditions of pre-operation and post-operation of the patients in respective group. The results indicated that type III transformation zone is more likely to cause positive cutting margin. For CIN2+ patients, sensitivity and specificity are 0.89% and 79.56% in group A5/6, and negative and positive predicted value (NPV, PPV) are 40% and 5%. The sensitivity, specificity, NPV, PPV in group A7 is 12.5%, 44.08%, 29.49% and 21.21%, respectively. The sensitivity, specificity, NPV, PPV in group A9 is 88.99%, 87.09%, 85.26%, 81.51%, respectively. Transformation zone type was correlated positively with positive cutting margin percentage (r = 0.8732, P < 0.05). Compared with type I, type II and III transformation zone is more likely to cause pathological upgrades. In conclusion, different types of transformation zone and high-risk HPV have clinical significance in causing positive cutting margin of surgery and disease extent.

  1. Effect of investment type and mold temperature on casting accuracy and titanium-ceramic bond.

    PubMed

    Leal, Mônica Barbosa; Pagnano, Valéria Oliveira; Bezzon, Osvaldo Luiz

    2013-01-01

    This study evaluated the casting accuracy of crown margins and metal-ceramic shear bond strength (SBS) of pure titanium injected into casting molds made using 2 investment types at 3 mold temperatures. Sixty crown (30-degree beveled finish line) and 60 cylinder (5mm diameter × 8mm high) patterns were divided into 6 groups (n=10), and cast using a phosphate-bonded investment (P) and a magnesium oxide-bonded investment (U), at 400°C (groups P400 and U400), 550°C (groups P550 and U550) and 700°C (groups P700 and U700) mold temperatures. Crown margins were recorded in impression material, the degree of marginal rounding was measured and margin length deficiencies (µm) were calculated. Titanium-ceramic specimens were prepared using Triceram ceramic (2mm high) and SBS was tested. Failure modes were assessed by optical microscopy. Data were subjected to two-way ANOVA and Tukey's HSD test (α=0.05). For casting accuracy, expressed by marginal deficiency (µm), investment U provided more accurate results (64 ± 11) than P (81 ± 23) (p<0.001). The increase in temperature resulted in different effects for the tested investments (p<0.001), as it provided better casting accuracy for U700 (55 ± 7) and worse for P700 (109 ± 18). Casting accuracy at 700°C (82 ± 31) was significantly different from 400°C (69 ± 9) and 550°C (68 ± 9) (p<0.05). For SBS, there was no significant differences among the groups for factors investment (p=0.062) and temperature (p=0.224), or for their interaction (p=0.149). Investment U provided better casting accuracy than investment P. The SBS was similar for all combinations of investments and temperatures.

  2. Evaluation of the efficacy of flowable composite as lining material on microleakage of composite resin restorations: A systematic review and meta-analysis.

    PubMed

    Boruziniat, Alireza; Gharaee, Samineh; Sarraf Shirazi, Alireza; Majidinia, Sara; Vatanpour, Mehdi

    2016-02-01

    The efficacy of flowable composite in improving marginal adaptation or reducing microleakage is not fully understood. The purpose of this study was to systematically evaluate existing evidence to verify whether an application of flowable composite as a liner provided less microleakage in Class 2 composite restorations. PubMed, ISI (Web of Science), and Scopus databases were searched according to the selected keywords, up to 15 Feb 2015, without any restriction on date or language. Full texts of published articles that seemed to meet primary criteria for inclusion in this research were obtained. Data of studies were extracted if they were assessed as high or moderate level of evidence. Due to the variation of methods used in different studies, they were divided into five groups: groups 1 and 2, studies that evaluated the effect of flowable composite as a liner on dentinal or enamel margins and applied flowable composite on all of the cavity wall margins; groups 3 and 4, studies that evaluated the effect of flowable composite as a liner on dentinal and enamel margins and applied flowable composite only on gingival margin; and group 5, clinical studies. The initial search yielded 1,370 publications. After hand searching, six extra studies were included in the review. The abstracts of all were read independently by AB and SG. After methodologic assessment and evaluation of the level of evidence, 18 studies were selected for this study. The results of this study indicate that flowable composite liners have no significant effect on microleakage of composite restorations in all of five groups. Application of flowable composite as a liner in composite restorations cannot reduce microleakage or improve clinical performance.

  3. On-Line Mu Method for Robust Flutter Prediction in Expanding a Safe Flight Envelope for an Aircraft Model Under Flight Test

    NASA Technical Reports Server (NTRS)

    Lind, Richard C. (Inventor); Brenner, Martin J.

    2001-01-01

    A structured singular value (mu) analysis method of computing flutter margins has robust stability of a linear aeroelastic model with uncertainty operators (Delta). Flight data is used to update the uncertainty operators to accurately account for errors in the computed model and the observed range of aircraft dynamics of the aircraft under test caused by time-varying aircraft parameters, nonlinearities, and flight anomalies, such as test nonrepeatability. This mu-based approach computes predict flutter margins that are worst case with respect to the modeling uncertainty for use in determining when the aircraft is approaching a flutter condition and defining an expanded safe flight envelope for the aircraft that is accepted with more confidence than traditional methods that do not update the analysis algorithm with flight data by introducing mu as a flutter margin parameter that presents several advantages over tracking damping trends as a measure of a tendency to instability from available flight data.

  4. Marginal integrity of low-shrinkage and methacrylate-based composite resins: Effect of three different hemostatic agents

    PubMed Central

    Khoroushi, Maryam; Sahraneshin-Samani, Mahsa

    2016-01-01

    Background Moisture control is very important in restorative procedures in dentistry. Use of hemostatic agents helps control moisture; however, they might result in changes on enamel and dentin surfaces, affecting composite resin bond quality. The aim of this in vitro study was to evaluate the marginal microleakage of two different composite resins with the use of three different hemostatic agents. Material and Methods Standardized Class V cavities were prepared on the buccal and lingual surfaces of 48 premolars with cervical margins 1 mm apical to the cementoenamel junction (CEJ). The samples were randomly divided into 8 groups. In groups 1 to 4, an etch-and-rinse adhesive (Adper Single Bond) was applied as the bonding system, followed by exposure to different hemostatic agent: group 1: no hemostatic agent (control); group 2: ViscoStat; group 3: ViscoStat Clear; and group 4: trichloracetic acid, as hemostatic agents. The cavities were restored with Z-250 composite resin. In group 5 to 8 Silorane System Adhesive (Filtek P90 Adhesive) was applied as a bonding agent, followed by exposure to different hemostatic agents in a manner similar to that in groups 1to 4. The cavities were restored with Filtek P90, a low-shrinkage composite resin. The samples in each group were evaluated for dye penetration under a stereomicroscope at ×36 after 24 hours and a 500-round thermocycling procedure at enamel and dentin margins. Statistical analysis was carried out using Kruskal-Wallis and Mann-Whitney tests (α=0.05). Results Z-250 composite resin exhibited significantly higher dentin microleakage scores compared to Filtek P90 (P = 0.004). Trichloracetic acid increased dentin microleakage with Filtek P90 (P=0.033). Conclusions Under the limitations of this in vitro study, application of hemostatic agents did not affect microleakage of the two tested composite resins except for trichloracetic acid that increased marginal microleakage when used with Filtek P90. Key words:Composite resin, dental leakage, hemostatics, silorane system adhesive. PMID:27034759

  5. Comparison of Selected Protein Levels in Tumour and Surgical Margin in a Group of Patients with Oral Cavity Cancer.

    PubMed

    Strzelczyk, Joanna Katarzyna; Gołąbek, Karolina; Cuber, Piotr; Krakowczyk, Łukasz; Owczarek, Aleksander Jerzy; Fronczek, Martyna; Choręża, Piotr; Hudziec, Edyta; Ostrowska, Zofia

    2017-08-01

    Oral cavity cancer belongs to head-and-neck squamous cell carcinoma group. The purpose of the study was to assess the levels of certain proteins in a tumour and surgical margin in a group of patients with oral cavity cancer. The levels of DAPK1, MGMT, CDH1, SFRP1, SFRP2, RORA, TIMP3, p16, APC and RASSF1 proteins were measured by ELISA in tissue homogenates. The protein levels of DAPK1, MGMT, CDH1, SFRP2 and RASSF1 were significantly higher in tumour tissue than in the margin, contrary to TIMP3 which was lower in the tumour itself. DAPK1 level in the tumour was significantly higher in females than in males, the MGMT and p16 levels were lower in the tumours with lymph node metastasis (N1 + N2) than in N0 samples. The CDH1 expression was higher in a group with smoking habits, whereas TIMP3 was lower in this group. Changes in the levels of proteins in tumour and surgical margin may be either reflective of tumour occurrence and development, or they might be also responsible for the progress and reoccurrence of the disease. Levels of the studied proteins might be good prognostic factors; however, further studies are required.

  6. Reconstructing marginality: a new model of cultural diversity in nursing.

    PubMed

    Southwick, Margaret; Polaschek, Nick

    2014-05-01

    This article presents a new model of cultural diversity in nursing that critically reconstructs the concept of marginality that underpins other models. Rather than viewing the marginal as "other," marginality is redefined as the space in between the dominant cultural reality and the cultural realities of minority groups located within a society. Members of a minority cultural group who become skilled in the difficult process of negotiating this in-between space open the possibility of transformation within nursing education and practice. This model has been applied in a study of the experience of nursing students of Pacific ethnicity in New Zealand. Subsequently, an undergraduate Pacific nursing program was developed, with greatly increased success rates in registration of Pacific nurses. This model of cultural diversity can also be used to understand nursing practice involving people from minority cultures or other socially excluded categories. Copyright 2014, SLACK Incorporated.

  7. Paleomagnetic tests for tectonic reconstructions of the Late Jurassic-Early Cretaceous Woyla Group, Sumatra

    NASA Astrophysics Data System (ADS)

    Advokaat, Eldert; Bongers, Mayke; van Hinsbergen, Douwe; Rudyawan, Alfend; Marshal, Edo

    2017-04-01

    SE Asia consists of multiple continental blocks, volcanic arcs and suture zones representing remnants of closing ocean basins. The core of this mainland is called Sundaland, and was formed by accretion of continental and arc fragments during the Paleozoic and Mesozoic. The former positions of these blocks are still uncertain but reconstructions based on tectonostratigraphic, palaeobiogeographic, geological and palaeomagnetic studies indicate the continental terranes separated from the eastern margin of Gondwana. During the mid-Cretaceous, more continental and arc fragments accreted to Sundaland, including the intra-oceanic Woyla Arc now exposed on Sumatra. These continental fragments were derived from Australia, but the former position of the Woyla Arc is unconstrained. Interpretations on the former position of the Woyla Arc fall in two end-member groups. The first group interprets the Woyla Arc to be separated from West Sumatra by a small back-arc basin. This back arc basin opened in the Late Jurassic, and closed mid-Cretaceous, when the Woyla Arc collided with West Sumatra. The other group interprets the Woyla Arc to be derived from Gondwana, at a position close to the northern margin of Greater India in the Late Jurassic. Subsequently the Woyla Arc moved northwards and collided with West Sumatra in the mid-Cretaceous. Since these scenarios predict very different plate kinematic evolutions for the Neotethyan realm, we here aim to place paleomagnetic constraints on paleolatitudinal evolution of the Woyla Arc. The Woyla Arc consists mainly of basaltic to andesitic volcanics and dykes, and volcaniclastic shales and sandstones. Associated limestones with volcanic debris are interpreted as fringing reefs. This assemblage is interpreted as remnants of an Early Cretaceous intra-oceanic arc. West Sumatra exposes granites, surrounded by quartz sandstones, shales and volcanic tuffs. These sediments are in part metamorphosed. This assemblage is interpreted as a Jurassic-Early Cretaceous Andean margin above a NE dipping subduction zone. We sampled limestones of the Woyla Group, and sediments of the West Sumatra margin for paleomagnetic analyses. Here we present new paleomagnetic data from Upper Jurassic-Lower Cretaceous limestones of the Woyla Arc. Preliminary results suggest that the Woyla Arc was formed near equatorial latitudes. This precludes interpretations that the Woyla arc was derived from Gondwana, near the northern Indian margin. To account for (1) synchronous magmatism at the Woyla Arc and the West Sumatra continental margin, and (2) the juxtaposition of unmetamorphosed units of the Woyla Arc to highly metamorphosed units of the West Sumatra margin, we interpret the Woyla Group to be intra-oceanic arc formed above a SW dipping subduction zone in the Early Cretaceous, which was subsequently thrusted over the West Sumatra margin during the mid-Cretaceous.

  8. Different CAD/CAM-processing routes for zirconia restorations: influence on fitting accuracy.

    PubMed

    Kohorst, Philipp; Junghanns, Janet; Dittmer, Marc P; Borchers, Lothar; Stiesch, Meike

    2011-08-01

    The aim of the present in vitro study was to evaluate the influence of different processing routes on the fitting accuracy of four-unit zirconia fixed dental prostheses (FDPs) fabricated by computer-aided design/computer-aided manufacturing (CAD/CAM). Three groups of zirconia frameworks with ten specimens each were fabricated. Frameworks of one group (CerconCAM) were produced by means of a laboratory CAM-only system. The other frameworks were made with different CAD/CAM systems; on the one hand by in-laboratory production (CerconCAD/CAM) and on the other hand by centralized production in a milling center (Compartis) after forwarding geometrical data. Frameworks were then veneered with the recommended ceramics, and marginal accuracy was determined using a replica technique. Horizontal marginal discrepancy, vertical marginal discrepancy, absolute marginal discrepancy, and marginal gap were evaluated. Statistical analyses were performed by one-way analysis of variance (ANOVA), with the level of significance chosen at 0.05. Mean horizontal discrepancies ranged between 22 μm (CerconCAM) and 58 μm (Compartis), vertical discrepancies ranged between 63 μm (CerconCAD/CAM) and 162 μm (CerconCAM), and absolute marginal discrepancies ranged between 94 μm (CerconCAD/CAM) and 181 μm (CerconCAM). The marginal gap varied between 72 μm (CerconCAD/CAM) and 112 μm (CerconCAM, Compartis). Statistical analysis revealed that, with all measurements, the marginal accuracy of the zirconia FDPs was significantly influenced by the processing route used (p < 0.05). Within the limitations of this study, all restorations showed a clinically acceptable marginal accuracy; however, the results suggest that the CAD/CAM systems are more precise than the CAM-only system for the manufacture of four-unit FDPs.

  9. Significance of lobular intraepithelial neoplasia at margins of breast conservation specimens: a report of 38 cases and literature review

    PubMed Central

    2010-01-01

    Background Presence of lobular intraepithelial neoplasia (LIN) is not routinely reported as part of margin assessment in breast conservation therapy (BCT) as in ductal carcinoma in situ (DCIS). With new emerging evidence of LIN as possible precursor lesion, the hypothesis is that LIN at the margin may increase the risk of local recurrence with BCT. The aim is to determine whether there is an increase incidence of recurrence when LIN is found at surgical margins on BCT. Methods We retrospectively reviewed a total of 1,334 BCT at a single institution in a 10 year period. Inclusion criteria are positive margin with LIN from primary BCT containing invasive and/or in situ carcinoma with comparison to the negative control group who had similar diseases with negative margin for LIN. Results We identified 38 cases (2.8%) with LIN either lobular carcinoma in situ/atypical lobular hyperplasia (LCIS/ALH) at a margin on initial BCT with 36% recurrence rate. Of the 38 cases: 5 (13%) were lost to follow-up, 12 (32%) had no further procedures performed and 21 (55%) had re-excision. Out of 21 patients who had re-excisions, 12 (57%) had residual invasive carcinoma or DCIS, three (14%) had pleomorphic LCIS and 4 (19%) showed residual classic type LCIS. 71% had significant residual disease (local recurrence) and 29% had no residual disease. A negative control group consisted of 38 cases. We found two patients with bone or brain metastasis and one local recurrence. Clinical follow up periods range from 1 to 109 months. Conclusions LIN found at a margin on BCT showed a significant recurrent ipsilateral disease. Our study supports the view that LIN seen at the margin may play a role in recurrence. PMID:20727142

  10. Evaluation and comparison of the marginal adaptation of two different substructure materials.

    PubMed

    Karaman, Tahir; Ulku, Sabiha Zelal; Zengingul, Ali Ihsan; Guven, Sedat; Eratilla, Veysel; Sumer, Ebru

    2015-06-01

    In this study, we aimed to evaluate the amount of marginal gap with two different substructure materials using identical margin preparations. Twenty stainless steel models with a chamfer were prepared with a CNC device. Marginal gap measurements of the galvano copings on these stainless steel models and Co-Cr copings obtained by a laser-sintering method were made with a stereomicroscope device before and after the cementation process and surface properties were evaluated by scanning electron microscopy (SEM). A dependent t-test was used to compare the mean of the two groups for normally distributed data, and two-way variance analysis was used for more than two data sets. Pearson's correlation analysis was also performed to assess relationships between variables. According to the results obtained, the marginal gap in the galvano copings before cementation was measured as, on average, 24.47 ± 5.82 µm before and 35.11 ± 6.52 µm after cementation; in the laser-sintered Co-Cr structure, it was, on average, 60.45 ± 8.87 µm before and 69.33 ± 9.03 µm after cementation. A highly significant difference (P<.001) was found in marginal gap measurements of galvano copings and a significant difference (P<.05) was found in marginal gap measurements of the laser-sintered Co-Cr copings. According to the SEM examination, surface properties of laser sintered Co-Cr copings showed rougher structure than galvano copings. The galvano copings showed a very smooth surface. Marginal gaps values of both groups before and after cementation were within the clinically acceptable level. The smallest marginal gaps occurred with the use of galvano copings.

  11. Evaluation and comparison of the marginal adaptation of two different substructure materials

    PubMed Central

    Karaman, Tahir; Ulku, Sabiha Zelal; Zengingul, Ali Ihsan; Eratilla, Veysel; Sumer, Ebru

    2015-01-01

    PURPOSE In this study, we aimed to evaluate the amount of marginal gap with two different substructure materials using identical margin preparations. MATERIALS AND METHODS Twenty stainless steel models with a chamfer were prepared with a CNC device. Marginal gap measurements of the galvano copings on these stainless steel models and Co-Cr copings obtained by a laser-sintering method were made with a stereomicroscope device before and after the cementation process and surface properties were evaluated by scanning electron microscopy (SEM). A dependent t-test was used to compare the mean of the two groups for normally distributed data, and two-way variance analysis was used for more than two data sets. Pearson's correlation analysis was also performed to assess relationships between variables. RESULTS According to the results obtained, the marginal gap in the galvano copings before cementation was measured as, on average, 24.47 ± 5.82 µm before and 35.11 ± 6.52 µm after cementation; in the laser-sintered Co-Cr structure, it was, on average, 60.45 ± 8.87 µm before and 69.33 ± 9.03 µm after cementation. A highly significant difference (P<.001) was found in marginal gap measurements of galvano copings and a significant difference (P<.05) was found in marginal gap measurements of the laser-sintered Co-Cr copings. According to the SEM examination, surface properties of laser sintered Co-Cr copings showed rougher structure than galvano copings. The galvano copings showed a very smooth surface. CONCLUSION Marginal gaps values of both groups before and after cementation were within the clinically acceptable level. The smallest marginal gaps occurred with the use of galvano copings. PMID:26140178

  12. Comparison of the marginal fit of milled yttrium stabilized zirconium dioxide crowns obtained by scanning silicone impressions and by scanning stone replicas.

    PubMed

    Aranda Yus, Estefanía; Cantarell, Josep Maria Anglada; Miñarro Alonso, Antonio

    2018-06-01

    To determine the discrepancy in monolithic zirconium dioxide crowns made with computer-aided design and computer-aided manufacturing (CAD/CAM) systems by comparing scans of silicone impressions and of master casts. From a Cr-Co master die of a first upper left molar, 30 silicone impressions were taken. The 30 silicone impressions were scanned with the laboratory scanner, thus obtaining 30 milled monolithic yttrium stabilized zirconium dioxide (YSZD) crowns (the silicone group). They were poured and the working models were scanned, obtaining 30 milled monolithic yttrium stabilized zirconium dioxide (YSZD) crowns (the plaster group). Three predetermined points were analyzed in each side of the crown (Mesial, Distal ,Vestibular and Palatal), and the marginal fit was evaluated with SEM (×600). The response variable is the discrepancy from the master model. A repeated measures ANOVA with two within subject factors was performed to study significance of main factors and interaction. Mean marginal discrepancy was 22.42±35.65 µm in the silicone group and 8.94±14.69 µm in the plaster group. The statistical analysis showed significant differences between the two groups and also among the four aspects. Interaction was also significant ( P =.02). The mean marginal fit values of the two groups were within the clinically acceptable values. Significant differences were found between the groups according to the aspects studied. Various factors influenced the accuracy of digitizing, such as the design, the geometry, and the preparation guidance, as well as the texture, roughness and the color of the scanned material.

  13. Influence of chlorhexidine digluconate on the clinical performance of adhesive restorations: a 3-year follow-up.

    PubMed

    Sartori, Neimar; Stolf, Sheila C; Silva, Silvana B; Lopes, Guilherme C; Carrilho, Marcela

    2013-12-01

    The aim of this clinical study was to evaluate the long-term clinical performance of non-carious Class V restorations with and without application of chlorhexidine digluconate to acid-etched dentine. After the approval of the Ethics and Informed Consent Committee, 70 non-carious cervical lesions were selected and randomly assigned into two groups, according to the split mouth design. The control group was restored with a two-step etch-and-rinse adhesive (Adper Single Bond 2) following manufacturer's instructions; whereas in the experimental group 2% chlorhexidine digluconate solution was applied to acid etched dentine for 30s after etching and prior to the adhesive application. All lesions were restored with a nanofilled composite resin (Filtek Supreme XT) and polymerized with a light-curing unit operating at 600mW/cm(2). Clinical performance was recorded after 1 week, 6, 12, and 36 months using modified Ryge/USPHS criteria in terms of retention, marginal discoloration, marginal integrity, post-operative sensitivity, and secondary caries incidence. Data were analyzed using Chi-Square, Fisher's exact test and McNemar tests (α=.05). After 36 months the control group showed a success rate of 88% in comparison to 76% of experimental group; however, no statistically difference between them was found (p=.463). Moreover, no statistical differences were observed between groups in the criteria post-operative sensitivity, marginal discoloration, marginal integrity, and secondary caries incidence between the two groups. The addition of 2% chlorhexidine digluconate conditioning step does not improve the clinical durability of adhesive restorations. Copyright © 2013 Elsevier Ltd. All rights reserved.

  14. Comparison of Marginal and Internal Adaptation of CAD/CAM and Conventional Cement Retained Implant-Supported Single Crowns.

    PubMed

    Nejatidanesh, Farahnaz; Shakibamehr, Amir Hossein; Savabi, Omid

    2016-02-01

    To evaluate the accuracy of marginal and internal adaptation of 2 computer-aided design/computer-aided manufacturing (CAD/CAM) and 2 conventionally made cement retained implant-supported restorations. An abutment and its corresponding fixture analog (Astra Tech) were inserted in left central incisor area of a maxillary cast. Four types of implant-supported single restorations were fabricated on the abutment (n = 10): e.max CAD (Cerec AC system), zirconia-based (Cercon system), IPS e.max Press, and metal-ceramic restorations. The internal and marginal gaps of the studied groups were measured by replica method and stereomicroscope. Data were subjected to 1-way ANOVA and Scheffe post hoc tests (α = 0.05). Mean internal gaps of Cercon (59.48 ± 16.49 μm) and e.max Press (75.62 ± 26.92 μm) groups were significantly different from e.max CAD (120.29 ± 16.74 μm) group, but there was no significant difference between metal-ceramic restorations (89.65 ± 47.84 μm) and e.max CAD. The marginal gaps of e.max CAD (32.02 ± 10.38 μm) and Cercon restorations (34.26 ± 11.41 μm) were significantly superior from metal ceramics (59.19 ± 17.81 μm) and e.max press (74.99 ± 24.51 μm). Within the limitations of this study, it can be concluded that although the marginal and internal gaps of the studied implant-supported restorations were in the clinically acceptable range, single crowns made with CAD/CAM technology provide better marginal fit.

  15. Marginal microleakage of triage sealant under different moisture contamination.

    PubMed

    Peng, Yawen; Stark, Paul C; Rich, Alfred; Loo, Cheen Y

    2011-01-01

    Glass ionomer sealants (GISs) are promoted in pediatric dentistry for their moisture-friendly properties. This study's purpose was to investigate the marginal leakage of a glass ionomer sealant (Fuji Triage) under different moisture environments. Eighty extracted teeth were distributed into 4 groups: (1) control; (2) saliva contamination with 1-second air-thinning; (3) saliva contamination with 10 seconds of air-drying; and (4) saliva contamination with reconditioning. Sealants were placed after contamination. All extracted teeth underwent thermocycling followed by 1% methylene blue dye and distilled water wash. All extracted teeth were then sectioned buccolingually into 3 cross-sections and examined at 60X under a stereomicroscope. Microleakage was assessed using a dye penetration scoring system (score=0-3). Data were analyzed with Kruskal-Wallis and Mann-Whitney tests. The control group showed significantly lower marginal leakage than the other 3 groups (P<.02). There was no statistically significant difference among the 3 contaminated groups (P>.34). Fuji Triage sealant had the least marginal leakage under a moisture-controlled environment. When saliva was introduced during the application of the material, microleakage significantly increased. When contamination occurred, 1-second air-thinning of the saliva, 10-second air-drying of the saliva, or reconditioning before sealant application did not show a difference in decreasing microleakage.

  16. Pathology of nodal marginal zone lymphomas.

    PubMed

    Pileri, Stefano; Ponzoni, Maurilio

    Nodal marginal zone B cell lymphomas (NMZLs) are a rare group of lymphoid disorders part of the spectrum of marginal zone B-cell lymphomas, which encompass splenic marginal one B-cell lymphoma (SMZL) and extra nodal marginal zone of B-cell lymphoma (EMZL), often of MALT-type. Two clinicopathological forms of NMZL are recognized: adult-type and pediatric-type, respectively. NMZLs show overlapping features with other types of MZ, but distinctive features as well. In this review, we will focus on the salient distinguishing features of NMZL mostly under morphological/immunophenotypical/molecular perspectives in views of the recent acquisitions and forthcoming updated 2016 WHO classification of lymphoid malignancies. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Comparison of prosthetic models produced by traditional and additive manufacturing methods.

    PubMed

    Park, Jin-Young; Kim, Hae-Young; Kim, Ji-Hwan; Kim, Jae-Hong; Kim, Woong-Chul

    2015-08-01

    The purpose of this study was to verify the clinical-feasibility of additive manufacturing by comparing the accuracy of four different manufacturing methods for metal coping: the conventional lost wax technique (CLWT); subtractive methods with wax blank milling (WBM); and two additive methods, multi jet modeling (MJM), and micro-stereolithography (Micro-SLA). Thirty study models were created using an acrylic model with the maxillary upper right canine, first premolar, and first molar teeth. Based on the scan files from a non-contact blue light scanner (Identica; Medit Co. Ltd., Seoul, Korea), thirty cores were produced using the WBM, MJM, and Micro-SLA methods, respectively, and another thirty frameworks were produced using the CLWT method. To measure the marginal and internal gap, the silicone replica method was adopted, and the silicone images obtained were evaluated using a digital microscope (KH-7700; Hirox, Tokyo, Japan) at 140X magnification. Analyses were performed using two-way analysis of variance (ANOVA) and Tukey post hoc test (α=.05). The mean marginal gaps and internal gaps showed significant differences according to tooth type (P<.001 and P<.001, respectively) and manufacturing method (P<.037 and P<.001, respectively). Micro-SLA did not show any significant difference from CLWT regarding mean marginal gap compared to the WBM and MJM methods. The mean values of gaps resulting from the four different manufacturing methods were within a clinically allowable range, and, thus, the clinical use of additive manufacturing methods is acceptable as an alternative to the traditional lost wax-technique and subtractive manufacturing.

  18. Egypt`s first remotely controlled subsea completion -- A Gulf of Suez case history

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    El Hawary, A.; Hoffman, J.G.

    1995-11-01

    A case history of the Gulf of Suez Petroleum Company`s (GUPCO) first remotely controlled subsea completion is provided. The first completion was for well GS 373-2, a previously drilled and tested exploration well located in the south portion of the Gulf of Suez. Subsea technology was utilized to economically justify development of this one well marginal field which was discovered in 1978. Traditional methods proved to be too costly for development, therefore application of a low cost subsea tree was utilized to capture the resources. In the Gulf of Suez many fields have been discovered by have not been developedmore » due to low reserves. These marginal projects can have a profound impact on the revenue and shareholder value if any economic method is used to exploit these opportunities. Platform installation was not feasible due to reserve size, hence the well has remained abandoned until recently. Capturing the experience of Amoco in the Gulf of Mexico and in the Dutch North Sea, GUPCO was able to build a low cost subsea system which would allow for the economic development of the marginal fields discovered in the past. This paper presents a summarized look at subsea completion technology. The cost comparison of traditional development methods will be made, given the local cost structure in Egypt. The application of this technology has some limitations and constraints which will be discussed in the paper. Furthermore the actual field installation of Egypt`s first remotely controlled subsea tree will be summarized. Also included is a discussion on simple remote controls,and offshore installation operations.« less

  19. Is computer navigation when used in the surgery of iliosacral pelvic bone tumours safer for the patient?

    PubMed

    Laitinen, M K; Parry, M C; Albergo, J I; Grimer, R J; Jeys, L M

    2017-02-01

    Due to the complex anatomy of the pelvis, limb-sparing resections of pelvic tumours achieving adequate surgical margins, can often be difficult. The advent of computer navigation has improved the precision of resection of these lesions, though there is little evidence comparing resection with or without the assistance of navigation. Our aim was to evaluate the efficacy of navigation-assisted surgery for the resection of pelvic bone tumours involving the posterior ilium and sacrum. Using our prospectively updated institutional database, we conducted a retrospective case control study of 21 patients who underwent resection of the posterior ilium and sacrum, for the treatment of a primary sarcoma of bone, between 1987 and 2015. The resection was performed with the assistance of navigation in nine patients and without navigation in 12. We assessed the accuracy of navigation-assisted surgery, as defined by the surgical margin and how this affects the rate of local recurrence, the disease-free survival and the effects on peri-and post-operative morbidity. The mean age of the patients was 36.4 years (15 to 66). The mean size of the tumour was 10.9 cm. In the navigation-assisted group, the margin was wide in two patients (16.7%), marginal in six (66.7%) and wide-contaminated in one (11.1%) with no intralesional margin. In the non-navigated-assisted group; the margin was wide in two patients (16.7%), marginal in five (41.7%), intralesional in three (25.0%) and wide-contaminated in two (16.7%). Local recurrence occurred in two patients in the navigation-assisted group (22.2%) and six in the non-navigation-assisted group (50.0%). The disease-free survival was significantly better when operated with navigation-assistance (p = 0.048). The blood loss and operating time were less in the navigated-assisted group, as was the risk of a foot drop post-operatively. The introduction of navigation-assisted surgery for the resection of tumours of the posterior ilium and sacrum has increased the safety for the patients and allows for a better oncological outcome. Cite this article: Bone Joint J 2017;99-B:261-6. ©2017 The British Editorial Society of Bone & Joint Surgery.

  20. Comparative Evaluation of Marginal Discrepancy in Tooth Colored Self Cure Acrylic Provisional Restorations With and Without Reinforcement of Glass Beads: An In-Vitro Study.

    PubMed

    Yasangi, Manoj Kumar; Mannem, Dhanalakshmi; Bommireddy, Vikram Simha; Neturi, Sirisha; Ravoori, Srinivas; Jyothi

    2015-05-01

    This invitro study was conducted to compare and evaluate marginal discrepancy in two types of tooth colored self cure provisional restorative materials {DPI&UNIFAST TRAD} before and after reinforcement of glass beads. The aim of the present study was to evaluate and compare marginal discrepancy in two types of provisional restorative materials (DPI and UNI FAST TRAD) before and after reinforcement with Glass beads. Tooth shaped resin copings were fabricated on custom made brass metal die. A total of 60 resin copings were fabricated in which 30 samples were prepared with DPI and 30 samples with UNIFAST material. Each group of 30 samples were divided in to two sub groups in which 15 samples were prepared with glass bead reinforcement and 15 samples without reinforcement. The marginal discrepancy was evaluated with photomicroscope {Reichet Polyvar 2 met} by placing the resin copings on custom made brass resin coping holder. Measurements obtained were statistically analysed by unpaired t-test to know any significance between two variables. Unreinforced DPI specimens had shown lower marginal discrepancy (442.82) than reinforced specimens (585.77). Unreinforced UNIFAST specimens have shown high values of marginal discrepancy (592.83) than reinforced specimens (436.35). p-value between reinforced and unreinforced specimens of DPI (p=0.0013) and UNIFAST (p= 0.0038) has shown statistical significance. This in-vitro study revealed that unreinforced DPI specimens have shown lower marginal discrepancy than reinforced specimens and unreinforced UNIFAST specimens have shown higher values of marginal discrepancy than reinforced specimens.

  1. Margins within Margins?: Voices Speaking through a Study of the Provision of an Educational Program for the Children of One Australian Show Circuit.

    ERIC Educational Resources Information Center

    Rose, C. G.; And Others

    This paper examines the tactics used by the Showmen's Guild of Australasia in successfully lobbying for the development of a distance education program for their children. The Guild is considered to be a "marginalized" group, meaning members have less access to wealth, power, and status. Since 1930, members of the Showmen's Guild and…

  2. Marginal and Random Intercepts Models for Longitudinal Binary Data With Examples From Criminology.

    PubMed

    Long, Jeffrey D; Loeber, Rolf; Farrington, David P

    2009-01-01

    Two models for the analysis of longitudinal binary data are discussed: the marginal model and the random intercepts model. In contrast to the linear mixed model (LMM), the two models for binary data are not subsumed under a single hierarchical model. The marginal model provides group-level information whereas the random intercepts model provides individual-level information including information about heterogeneity of growth. It is shown how a type of numerical averaging can be used with the random intercepts model to obtain group-level information, thus approximating individual and marginal aspects of the LMM. The types of inferences associated with each model are illustrated with longitudinal criminal offending data based on N = 506 males followed over a 22-year period. Violent offending indexed by official records and self-report were analyzed, with the marginal model estimated using generalized estimating equations and the random intercepts model estimated using maximum likelihood. The results show that the numerical averaging based on the random intercepts can produce prediction curves almost identical to those obtained directly from the marginal model parameter estimates. The results provide a basis for contrasting the models and the estimation procedures and key features are discussed to aid in selecting a method for empirical analysis.

  3. Evolution of Evaluation and Assessment in Diverse Audiences in the Digital Age

    NASA Astrophysics Data System (ADS)

    Eriksson, S. C.

    2015-12-01

    Over the past decades, researchers have learned more about how people think and act and about the social and political aspects of teaching and learning. This understanding has brought changes in researchers' and practitioners' interactions with diverse groups and individuals. This paper addresses evaluation, a process that measures the degree to which learning and project goals are met and factors contributing to or hindering outcomes. Parallels are drawn to learning assessment. The concepts of inclusion, participation, and constructivism (Mertens, 1999; Mertens and Hopson, 2006) now drive best evaluation practices for projects with persons with disabilities (AEA, 2011). This is also true in cases of other people who have been marginalized in STEM fields, e.g. women and underrepresented groups. Inclusion of these stakeholders has important implications for the validity of an evaluation, including the accuracy of results (Jacobson et al, 2012; Gill, 1999; Lee, 1999). The American Indian Higher Education Consortium's framework for indigenous groups incorporates their values and goals into evaluation design and implementation. It is feasible to include participant input in designing the questions and methods of obtaining data, ensuring that issues of access, opportunity, and power (Shuffelbeam, 2001) are taken into consideration. Geoscience projects with u-learning and m-learning provide opportunities to test these theoretical models in innovative programs such as: field work for students with physical disability; underrepresented minority, secondary students using mobile devices in contextualized learning in informal settings; and graduate students using digital maps to enhance traditional field work. This study compares program evaluation methodology of tradition learning with that of programs for diverse groups of students using digital technology. Ref: Mertens doi:10.1177/109821409902000102; Mertens and Hopson DOI: 10.1002/ev.177; AEA http://www.eval.org/p/cm/ld/fid=92; Jacobson et al DOI 10.1177/1098214012461558; Gill DOI:10.1016/S1098-2140(99)00018-1; Lee DOI: 10.1177/109821409902000210; Shuffelbeam ISBN: 978-0-7879-5755-1

  4. Can Tooth Preparation Design Affect the Fit of CAD/CAM Restorations?

    PubMed

    Roperto, Renato Cassio; Oliveira, Marina Piolli; Porto, Thiago Soares; Ferreira, Lais Alaberti; Melo, Lucas Simino; Akkus, Anna

    2017-03-01

    The purpose of this study was to evaluate if the marginal fit of computer-aided design and computer-aided manufacturing (CAD/CAM) restorations manufactured with CAD/CAM systems can be affected by different tooth preparation designs. Twenty-six typodont (plastic) teeth were divided into two groups (n = 13) according to the occlusal curvature of the tooth preparation. These were the group 1 (control group) (flat occlusal design) and group 2 (curved occlusal design). Scanning of the preparations was performed, and crowns were milled using ceramic blocks. Blocks were cemented using epoxy glue on the pulpal floor only, and finger pressure was applied for 1 minute. On completion of the cementation step, poor fits between the restoration and abutment were measured by microphotography and the silicone replica technique using light-body silicon material on mesial, distal, buccal, and lingual surfaces. Two-way ANOVA analysis did not reveal a statistical difference between flat (83.61 ± 50.72) and curved (79.04 ± 30.97) preparation designs. Buccal, mesial, lingual, and distal sites on the curved design preparation showed less of a gap when compared with flat design. No difference was found on flat preparations among mesial, buccal, and distal sites (P < .05). The lingual aspect had no difference from the distal side but showed a statistically significant difference from mesial and buccal (P < .05). Difference in occlusal design did not significantly impact the marginal fit. Marginal fit was significantly affected by the location of the margin; lingual and distal locations exhibited greater margin gap values compared with buccal and mesial sites regardless of the preparation design.

  5. Assessing the Financial Condition of Provider-Sponsored Health Plans.

    PubMed

    McCue, Michael J

    2015-06-01

    The aim of this study was to assess the performance of health plans sponsored by provider organizations, with respect to plans generating strong positive cash flow relative to plans generating weaker cash flow. A secondary aim was to assess their capital adequacy. The study identified 24 provider-sponsored health plans (PSHPs) with an average positive cash flow margin from 2011 through 2013 at or above the top 75th percentile, defined as "strong cash flow PSHPs:" This group was compared with 72 PSHPs below the 75th percentile, defined as "weak cash flow PSHPs:" Atlantic Information Services Directory of Health Plans was used to identify the PSHPs. Financial ratios were computed from 2013 National Association of Insurance Commissioners Financial Filings. The study conducted a t test mean comparison between strong and weak cash flow PSHPs across an array of financial performance and capital adequacy measures. In 2013, the strong cash flow PSHPs averaged a cash-flow margin ratio of 6.6%. Weak cash flow PSHPs averaged a cash-flow margin of -0.4%. The net worth capital position of both groups was more than 4.5 times authorized capital. The operational analysis shows that strong cash-flow margin PSHPs are managing their medical costs to achieve this position. Although their medical loss ratio increased by almost 300 basis points from 2011 to 2013, it was still statistically significantly lower than the weaker cash flow PSHP group (P<.001). In terms of capital adequacy, both strong and weak cash-flow margin PSHP groups possessed sufficient capital to ensure the viability of these plans.

  6. A systematic review of training interventions addressing sexual violence against marginalized at-risk groups of women.

    PubMed

    Kouta, Christiana; Pithara, Christalla; Zobnina, Anna; Apostolidou, Zoe; Christodoulou, Josie; Papadakaki, Maria; Chliaoutakis, Joannes

    2015-12-01

    Women from marginalized groups working in occupations such as domestic work are at increased risk for sexual violence. Scarce evidence exists about training interventions targeting such groups. The article aims to identify community and workplace-based training interventions aiming to increase capacity among marginalized at-risk women to deal with sexual violence. A systematic review was applied. Inclusion criteria were English language published between 2003 and 2013; reporting on delivery and/or evaluation; focusing on any form of sexual violence; delivered to professionals, affected or at-risk women; targeting migrant, at-risk women or domestic workers. Data were extracted on the setting, content, evaluation process and target population. Four studies which focused on prevention or responding to sexual violence were included. One study provided sexual violence training to vulnerable female and one provided a HIV prevention intervention to marginalized women. Learning objectives included increasing knowledge around issues of sexual violence and/or gender and human rights, prevention and response strategies. Two studies aimed to train trainers. All studies conducted an outcome evaluation and two a process evaluation. It seems there is a gap on participatory empowerment training for marginalized women. Community train-the-trainer interventions are imperative to protect themselves and deal with the risk of sexual violence. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  7. Role of Surgical Margin on Local Recurrence in High Risk Extremity Osteosarcoma: A Case-Controlled Study

    PubMed Central

    Song, Won Seok; Kong, Chang-Bae; Cho, Wan Hyeong; Cho, Sang Hyun; Lee, Jeong Dong; Lee, Soo-Yong

    2013-01-01

    Background The relationship between surgical margin and local recurrence (LR) in osteosarcoma patients with poor responses to chemotherapy is unclear. Moreover, the incidences of LR according to three different resection planes (bone, soft tissue, and perineurovascular) are not commonly known. Methods We evaluated the incidence of LR in three areas. To assess whether there is a role of surgical margin on LR in patients resistant to preoperative chemotherapy, we designed a case (35 patients with LR) and control (70 patients without LR) study. Controls were matched for age, location, initial tumor volume, and tumor volume change during preoperative chemotherapy. Results LR occurred at the soft tissues in 18 cases (51.4%), at the perineurovascular tissues in 11 cases (31.4%), and at the bones in six cases (17.2%). The proportion of inadequate perineurovascular margin was higher in the case group than in the control group (p = 0.01). Within case-control group (105 patients), a correlation between each margin status and LR at corresponding area was found in the bone (p < 0.001) and perineurovascular area (p = 0.001). Conclusions LR is most common in soft tissues. In patients showing similar unfavorable responses to chemotherapy, the losses of perineurovascular fat plane on preoperative magnetic resonance imaging may be a valuable finding in predicting LR. PMID:24009908

  8. Tendon-Holding Capacities of Two Newly Designed Implants for Tendon Repair: An Experimental Study on the Flexor Digitorum Profundus Tendon of Sheep

    PubMed Central

    Ağır, İsmail; Aytekin, Mahmut Nedim; Başçı, Onur; Çaypınar, Barış; Erol, Bülent

    2014-01-01

    Background: Two main factors determine the strength of tendon repair; the tensile strength of material and the gripping capacity of a suture configuration. Different repair techniques and suture materials were developed to increase the strength of repairs but none of techniques and suture materials seem to provide enough tensile strength with safety margins for early active mobilization. In order to overcome this problem tendon suturing implants are being developed. We designed two different suturing implants. The aim of this study was to measure tendon-holding capacities of these implants biomechanically and to compare them with frequently used suture techniques Materials and Methods: In this study we used 64 sheep flexor digitorum profundus tendons. Four study groups were formed and each group had 16 tendons. We applied model 1 and model 2 implant to the first 2 groups and Bunnell and locking-loop techniques to the 3rd and 4th groups respectively by using 5 Ticron sutures. Results: In 13 tendons in group 1 and 15 tendons in group 2 and in all tendons in group 3 and 4, implants and sutures pulled out of the tendon in longitudinal axis at the point of maximum load. The mean tensile strengths were the largest in group 1 and smallest in group 3. Conclusion: In conclusion, the new stainless steel tendon suturing implants applied from outside the tendons using steel wires enable a biomechanically stronger repair with less tendon trauma when compared to previously developed tendon repair implants and the traditional suturing techniques. PMID:25067965

  9. A comparison of marginal fit between press-fabricated and CAD/CAM lithium disilicate crowns.

    PubMed

    Carlile, Richard S; Owens, Wade H; Greenwood, William J; Guevara, Peter H

    2018-01-01

    The purpose of this study was to compare the marginal fit of press-fabricated lithium disilicate crowns with that of computer-aided design/computer-aided manufacturing (CAD/CAM) lithium disilicate crowns to determine if the fabrication method has an influence on marginal fit. The marginal fit of 25 pressed and 25 CAD/CAM crowns was measured using the replica technique. The sites measured were the mesial, distal, facial, and lingual margins. A microscope at 10× magnification was used to obtain the measurements. Each site was measured 4 times, and intraclass correlation coefficients were used to assess measurement errors. An unpaired t test was used to evaluate the differences between the 2 groups. Mean marginal gap measurements were greater for CAD/CAM crowns than for pressed crowns at all sites. Only the difference in mean gap at the facial margin was statistically significant (P < 0.001). Press-fabricated lithium disilicate crowns provided a better marginal fit than those fabricated by CAD/CAM, but both fabrication methods provided crowns with a clinically acceptable marginal fit.

  10. Positive Surgical Margins in Favorable-Stage Differentiated Thyroid Cancer.

    PubMed

    Mercado, Catherine E; Drew, Peter A; Morris, Christopher G; Dziegielewski, Peter T; Mendenhall, William M; Amdur, Robert J

    2018-04-16

    The significance of positive margin in favorable-stage well-differentiated thyroid cancer is controversial. We report outcomes of positive-margin patients with a matched-pair comparison to a negative-margin group. A total of 25 patients with classic-histology papillary or follicular carcinoma, total thyroidectomy +/- node dissection, stage T1-3N0-1bM0, positive surgical margin at primary site, adjuvant radioactive iodine (I-131), and age older than 18 years were treated between 2003 and 2013. Endpoints were clinical and biochemical (thyroglobulin-only) recurrence-free survival. Matched-pair analysis involved a 1:1 match with negative-margin cases matched for overall stage and I-131 dose. Recurrence-free survival in positive-margin patients was 71% at 10 years. No patient was successfully salvaged with additional treatment. Only 1 patient died of thyroid cancer. Recurrence-free survival at 10 years was worse with a positive (71%) versus negative (90%) margin (P=0.140). Cure with a microscopically positive margin was suboptimal (71%) despite patients having classic-histology papillary and follicular carcinoma, favorable stage, and moderate-dose I-131 therapy.

  11. Comparative in vitro evaluation of CAD/CAM vs conventional provisional crowns

    PubMed Central

    ABDULLAH, Adil Othman; TSITROU, Effrosyni A; POLLINGTON, Sarah

    2016-01-01

    ABSTRACT Objective This study compared the marginal gap, internal fit, fracture strength, and mode of fracture of CAD/CAM provisional crowns with that of direct provisional crowns. Material and Methods An upper right first premolar phantom tooth was prepared for full ceramic crown following tooth preparation guidelines. The materials tested were: VITA CAD-Temp®, Polyetheretherketone “PEEK”, Telio CAD-Temp, and Protemp™4 (control group). The crowns were divided into four groups (n=10), Group1: VITA CAD-Temp®, Group 2: PEEK, Group 3: Telio CAD-Temp, and Group 4: Protemp™4. Each crown was investigated for marginal and internal fit, fracture strength, and mode of fracture. Statistical analysis was performed using GraphPad Prism software version 6.0. Results The average marginal gap was: VITA CAD-Temp® 60.61 (±9.99) µm, PEEK 46.75 (±8.26) µm, Telio CAD-Temp 56.10 (±5.65) µm, and Protemp™4 193.07(±35.96) µm (P<0.001). The average internal fit was: VITA CAD-Temp® 124.94 (±22.96) µm, PEEK 113.14 (±23.55) µm, Telio CAD-Temp 110.95 (±11.64) µm, and Protemp™4 143.48(±26.74) µm. The average fracture strength was: VITA CAD-Temp® 361.01 (±21.61) N, PEEK 802.23 (±111.29) N, Telio CAD-Temp 719.24 (±95.17) N, and Protemp™4 416.40 (±69.14) N. One-way ANOVA test showed a statistically significant difference for marginal gap, internal gap, and fracture strength between all groups (p<0.001). However, the mode of fracture showed no differences between the groups (p>0.05). Conclusions CAD/CAM fabricated provisional crowns demonstrated superior fit and better strength than direct provisional crowns. PMID:27383707

  12. Comparative in vitro evaluation of CAD/CAM vs conventional provisional crowns.

    PubMed

    Abdullah, Adil Othman; Tsitrou, Effrosyni A; Pollington, Sarah

    2016-01-01

    This study compared the marginal gap, internal fit, fracture strength, and mode of fracture of CAD/CAM provisional crowns with that of direct provisional crowns. An upper right first premolar phantom tooth was prepared for full ceramic crown following tooth preparation guidelines. The materials tested were: VITA CAD-Temp®, Polyetheretherketone "PEEK", Telio CAD-Temp, and Protemp™4 (control group). The crowns were divided into four groups (n=10), Group1: VITA CAD-Temp®, Group 2: PEEK, Group 3: Telio CAD-Temp, and Group 4: Protemp™4. Each crown was investigated for marginal and internal fit, fracture strength, and mode of fracture. Statistical analysis was performed using GraphPad Prism software version 6.0. The average marginal gap was: VITA CAD-Temp® 60.61 (±9.99) µm, PEEK 46.75 (±8.26) µm, Telio CAD-Temp 56.10 (±5.65) µm, and Protemp™4 193.07(±35.96) µm (P<0.001). The average internal fit was: VITA CAD-Temp® 124.94 (±22.96) µm, PEEK 113.14 (±23.55) µm, Telio CAD-Temp 110.95 (±11.64) µm, and Protemp™4 143.48(±26.74) µm. The average fracture strength was: VITA CAD-Temp® 361.01 (±21.61) N, PEEK 802.23 (±111.29) N, Telio CAD-Temp 719.24 (±95.17) N, and Protemp™4 416.40 (±69.14) N. One-way ANOVA test showed a statistically significant difference for marginal gap, internal gap, and fracture strength between all groups (p<0.001). However, the mode of fracture showed no differences between the groups (p>0.05). CAD/CAM fabricated provisional crowns demonstrated superior fit and better strength than direct provisional crowns.

  13. The efficacy and utilisation of preoperative multiparametric magnetic resonance imaging in robot-assisted radical prostatectomy: does it change the surgical dissection plan?

    PubMed

    Tavukçu, Hasan Hüseyin; Aytaç, Ömer; Balcı, Numan Cem; Kulaksızoğlu, Haluk; Atuğ, Fatih

    2017-12-01

    We investigated the effect of the use of multiparametric prostate magnetic resonance imaging (mp-MRI) on the dissection plan of the neurovascular bundle and the oncological results of our patients who underwent robot-assisted radical prostatectomy. We prospectively evaluated 60 consecutive patients, including 30 patients who had (Group 1), and 30 patients who had not (Group 2) mp-MRI before robot-assisted radical prostatectomy. Based on the findings of mp-MRI, the dissection plan was changed as intrafascial, interfascial, and extrafascial in the mp-MRI group. Two groups were compared in terms of age, prostate-specific antigen (PSA), Gleason sum scores and surgical margin positivity. There was no statistically significant difference between the two groups in terms of age, PSA, biopsy Gleason score, final pathological Gleason score and surgical margin positivity. mp-MRI changed the initial surgical plan in 18 of 30 patients (60%) in Group 1. In seventeen of these patients (56%) surgical plan was changed from non-nerve sparing to interfascial nerve sparing plan. In one patient dissection plan was changed to non-nerve sparing technique which had extraprostatic extension on final pathology. Surgical margin positivity was similar in Groups 1, and 2 (16% and 13%, respectively) although, Group 1 had higher number of high- risk patients. mp-MRI confirmed the primary tumour localisation in the final pathology in 27 of of 30 patients (90%). Preoperative mp-MRI effected the decision to perform a nerve-sparing technique in 56% of the patients in our study; moreover, changing the dissection plan from non-nerve-sparing technique to a nerve sparing technique did not increase the rate of surgical margin positivity.

  14. East Meets West: Teaching the Elite on Both Sides of the Pacific

    ERIC Educational Resources Information Center

    Richards, Elisabeth; Sze, Susan

    2006-01-01

    Park (1928) describes the condition of marginal man is that of "a cultural hybrid, living and sharing intimately in the life and traditions of two distinct people" (p. 892). While there has been concerted effort to study the lives of female academic faculty in terms of class (Dews, Leste and Leste, 1995), race (hooks, 1989, Williams, 1994) and…

  15. Magic Women on the Margins: Ec-Centric Models in Mary Poppins and Ms Wiz

    ERIC Educational Resources Information Center

    Valverde, Cristina Perez

    2009-01-01

    This paper offers a comparative analysis of two characters belonging to the tradition of empowered "spinster" in children's fiction, namely Mary Poppins and Ms Wiz, from the perspective of gender politics and child/adult interactions. A distinction is made between the figure portrayed in P. L. Travers' texts and the Disney film starring Julie…

  16. Including Alternative Stories in the Mainstream. How Transcultural Young People in Norway Perform Creative Cultural Resistance in and outside of School

    ERIC Educational Resources Information Center

    Dewilde, Joke; Skrefsrud, Thor-André

    2016-01-01

    The development of an inclusive pedagogy takes on new urgency in Norwegian schools as the student body has become increasingly culturally and linguistically diverse. Traditionally, the Norwegian school has been dominated by homogenising and assimilating discourses, whereas alternative voices have been situated at the margins. In response to this…

  17. Transforming participatory science into socioecological praxis: valuing marginalized environmental knowledges in the face of the neoliberalization of nature and science

    Treesearch

    Brian J. Burke; Nik Heynen

    2014-01-01

    Citizen science and sustainability science promise the more just and democratic production of environmental knowledge and politics. In this review, we evaluate these participatory traditions within the context of (a) our theorization of how the valuation and devaluation of nature, knowledge, and people help to produce socio-ecological hierarchies, the uneven...

  18. Indira’s story

    PubMed Central

    Dawe, Russell

    2017-01-01

    Indira is an independent woman who does not live a traditional Nepali life. She rescues abandoned and abused young women from sexual exploitation and provides them with love, support, and education. Her story highlights the key role of the social determinants of health in caring for marginalized populations. Challenges and benefits of attempting to learn from another’s personal narrative are also considered. PMID:29114350

  19. Participation and Participatory Action Research (PAR) in Environmental Education Processes: For What Are People Empowered?

    ERIC Educational Resources Information Center

    Le Grange, Lesley

    2009-01-01

    Participatory action research (PAR) derived from anti-colonial struggles in the third world in the 1960s. Traditionally it has been a method of the margins because of its commitment to linking social justice to research. Because of its counter-hegemonic tendency it has had great appeal among environmental educators advocating a socially critical…

  20. School Performance and Gender Differences in Suicidal Behaviour--A 30-Year Follow-Up of a Stockholm Cohort Born in 1953

    ERIC Educational Resources Information Center

    Rojas, Yerko

    2013-01-01

    Astonishingly little is known about the relationship between high educational achievements and suicidal behaviour among women. This is remarkable given that a woman breaking into traditionally male-dominant spheres is a well established example of social-role marginality. The current study combines fatal and non-fatal suicidal behaviour and…

  1. Factors Associated with Depressive Symptoms among Mexican Immigrant Men in South Mississippi: An Exploratory Study

    ERIC Educational Resources Information Center

    Lee, Joohee; Rehner, Tim; Castellanos, Diana Cuy

    2011-01-01

    Despite increased interest in mental health among Latino immigrants in the United States, it is particularly salient to note that minimal or marginal attention has been paid to Mexican immigrant men settling in non-metro or rural areas outside of traditional settlement places. The purpose of this study was to examine factors associated with…

  2. WE-AB-207B-09: Margin Reduction for Planning Target Volume (PTV) in Patients with Localized Prostate Cancer: Impact On Delivered Dose and Quality of Life

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kumarasiri, A; Liu, C; Brown, S

    Purpose: To estimate the delivered (cumulative) dose to targets and organs at risk for localized prostate cancer patients treated with reduced PTV margins and to evaluate preliminary patient reported quality-of-life (QOL). Methods: Under an IRB-approved protocol, 20 prostate cancer patients (including 11 control patients) were treated with reduced planning margins (5 mm uniform with 4 mm at prostate/rectum interface). Control patients had standard margin (10/6 mm)-based treatments. A parameter-optimized Elastix algorithm along with energy-mass mapping was used to deform and resample dose of the day onto the planning CT for each fraction to estimate the delivered dose over all fractions.more » QOL data were collected via Expanded Prostate cancer Index Composite (EPIC-26) questionnaires at time points pre-treatment, post-treatment, and at 2, 6, 12, 18 month follow-ups. Standardized QOL scores [range: 0–100] were determined and baseline-corrected by subtracting pre-treatment QOL data. Mean QOL differences between the margin reduced group and control group (QOLmr-QOLcontrol) were calculated for first 18 months. Results: The difference between the cumulative mean dose (Dmean) and the planned mean dose (±SD) for PTV, prostate, bladder, and rectum were −2.2±1.0, 0.3±0.5, −0.7±2.6, and −2.1±1.3 Gy respectively for the margin-reduced group, and −0.8±2.0, 0.9±1.4, - 0.7±3.1 and −1.0±2.4 Gy for the control group. Difference between the two groups was statistically insignificant (p=0.1). Standardized and baseline corrected QOLmr-QOLcontrol for EPIC domains categorized as “Urinary Incontinence”, “Urinary Irritative/Obstructive”, “Bowel”, “Sexual”, and “Hormonal” were 0.6, 12.1, 9.1, 13.3, and −0.9 for the 18 months following radiation therapy (higher values better). Delivered dose to rectum showed a weak correlation to “Bowel” domain (Pearson’s coefficient −0.24, p<0.001), while bladder dose did not correlate to Urinary Incontinence/Irritative/Obstructive QOL domains. Conclusion: The margin-reduced group exhibited clinically meaningful improvement of QOL without compromising the PTV dose. A larger number of patients and greater follow-up is needed to draw unequivocal conclusions. This work was supported in part by a research grant from Varian Medical Systems, Palo Alto, CA.« less

  3. Tailored Excitation for Frequency Response Measurement Applied to the X-43A Flight Vehicle

    NASA Technical Reports Server (NTRS)

    Baumann, Ethan

    2007-01-01

    An important aspect of any flight research project is assessing aircraft stability and flight control performance. In some programs this assessment is accomplished through the estimation of the in-flight vehicle frequency response. This estimation has traditionally been a lengthy task requiring separate swept sine inputs for each control axis at a constant flight condition. Hypersonic vehicles spend little time at any specific flight condition while they are decelerating. Accordingly, it is difficult to use traditional methods to calculate the vehicle frequency response and stability margins for this class of vehicle. A technique has been previously developed to significantly reduce the duration of the excitation input by tailoring the input to excite only the frequency range of interest. Reductions in test time were achieved by simultaneously applying tailored excitation signals to multiple control loops, allowing a quick estimate of the frequency response of a particular aircraft. This report discusses the flight results obtained from applying a tailored excitation input to the X-43A longitudinal and lateral-directional control loops during the second and third flights. The frequency responses and stability margins obtained from flight data are compared with preflight predictions.

  4. Modified suture-bridge technique to prevent a marginal dog-ear deformity improves structural integrity after rotator cuff repair.

    PubMed

    Ryu, Keun Jung; Kim, Bang Hyun; Lee, Yohan; Lee, Yoon Seok; Kim, Jae Hwa

    2015-03-01

    The arthroscopic suture-bridge technique has proved to provide biomechanically firm fixation of the torn rotator cuff to the tuberosity by increasing the footprint contact area and pressure. However, a marginal dog-ear deformity is encountered not infrequently when this technique is used, impeding full restoration of the torn cuff. To evaluate the structural and functional outcomes of the use of a modified suture-bridge technique to prevent a marginal dog-ear deformity compared with a conventional suture-bridge method in rotator cuff repair. Cohort study; Level of evidence 2. A consecutive series of 71 patients aged 50 to 65 years who underwent arthroscopic rotator cuff repair for full-thickness medium-sized to massive tears was evaluated. Patients were divided into 2 groups according to repair technique: a conventional suture-bridge technique (34 patients; group A) versus a modified suture-bridge technique to prevent a marginal dog-ear deformity (37 patients; group B). Radiographic evaluations included postoperative cuff integrity using MRI. Functional evaluations included pre- and postoperative range of motion (ROM), pain visual analog scale (VAS), the University of California, Los Angeles (UCLA) shoulder rating scale, the Constant score, and the American Shoulder and Elbow Surgeons (ASES) score. All patients were followed up clinically at a minimum of 1 year. When the 2 surgical techniques were compared, postoperative structural integrity by Sugaya classification showed the distribution of types I:II:III:IV:V to be 4:20:2:4:4 in group A and 20:12:4:0:1 in group B. More subjects in group B had a favorable Sugaya type compared with group A (P < .001). The postoperative healed:retear rate was 26:8 in group A and 36:1 in group B, with a significantly lower retear rate in group B (P = .011). However, there were no significant differences in ROM and all functional outcome scores between the 2 groups postoperatively. When surgical techniques were compared across healed (n = 62) and retear (n = 9) groups, significantly fewer modified suture-bridge technique repairs were found in the retear group (P = .03). There were significant differences between healed and retear groups in functional outcome scores, with worse results in the retear group. A modified suture-bridge technique to prevent a marginal dog-ear deformity provided better structural outcomes than a conventional suture-bridge technique for medium-sized to massive rotator cuff tears. This technique may ultimately provide better functional outcomes by decreasing the retear rate. © 2014 The Author(s).

  5. Carbon dioxide laser fiber for the excision of oral leukoplakia.

    PubMed

    Chee, Michael; Sasaki, Clarence

    2013-09-01

    We compared the efficacies of cold knife excision and carbon dioxide (CO2) laser fiber excision of oral cavity leukoplakia. Between August 2009 and June 2011,45 patients who underwent excision of oral cavity leukoplakia were assessed for operative time, use of bipolar cautery, blood loss, and number of intraoperative margins needed. Patients were assigned randomly to either a cold knife group (23 procedures) or a CO2 laser fiber group (24 procedures) at the time of the procedure. The times of excision were similar in the CO2 laser fiber group (1.64 min/cm2) and the cold knife group (1.70 min/cm2). There were large differences between the CO2 laser fiber group and the cold knife group in the categories of bipolar cautery uses per square centimeter (0.34 uses versus 3.32 uses) and blood loss (0.19 g/cm2 versus 2.55 g/cm2). The average number of margins needed to clear a specimen by frozen section was 1.21 for the CO2 laser fiber group and 1.83 for the cold knife group. The CO2 laser fiber did not show an advantage in operative time. The CO2 laser fiber did show better outcomes in the areas of blood loss, bipolar cautery use, and intraoperative margins needed.

  6. Beyond faith-based organizations: using comparative institutional ethnography to understand religious responses to HIV and AIDS in Brazil.

    PubMed

    Muñoz-Laboy, Miguel A; Murray, Laura; Wittlin, Natalie; Garcia, Jonathan; Terto, Veriano; Parker, Richard G

    2011-06-01

    Religious institutions, which contribute to understanding of and mobilization in response to illness, play a major role in structuring social, political, and cultural responses to HIV and AIDS. We used institutional ethnography to explore how religious traditions--Catholic, Evangelical, and Afro-Brazilian--in Brazil have influenced HIV prevention, treatment, and care at the local and national levels over time. We present a typology of Brazil's division of labor and uncover overlapping foci grounded in religious ideology and tradition: care of people living with HIV among Catholics and Afro-Brazilians, abstinence education among Catholics and Evangelicals, prevention within marginalized communities among Evangelicals and Afro-Brazilians, and access to treatment among all traditions. We conclude that institutional ethnography, which allows for multilevel and interlevel analysis, is a useful methodology.

  7. Influence of melting and casting methods and finish line design on the marginal discrepancy of nickel-chromium-titanium alloy crowns.

    PubMed

    Cogolludo, Pablo G; Suarez, María J; Peláez, Jesús; Lozano, José F L

    2010-01-01

    The aim of this study was to analyze the influence of melting and casting procedures and the cervical finish line design on the marginal fit of nickel-chromium-titanium alloy crowns. Sixty standardized specimens were prepared to receive metal-ceramic crowns and were divided into two groups according to the cervical finish line: chamfer or rounded shoulder. Three melting and casting procedures were analyzed: (1) induction-centrifuge (IC), (2) gas oxygen torch-centrifuge (TC), and (3) induction-vacuum/pressure (IP). The marginal fit was measured with an image analysis system. Significant differences (P =.005) were observed among the groups, with TC showing the lowest discrepancies (45.87 μm). No significant differences were observed between the two finish lines. The accuracy of fit achieved for the groups analyzed may be regarded as within the range of clinical acceptance.

  8. Optimal Patient Positioning (Prone Versus Supine) for VMAT in Gynecologic Cancer: A Dosimetric Study on the Effect of Different Margins

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Heijkoop, Sabrina T., E-mail: s.heijkoop@erasmusmc.nl; Westerveld, Henrike; Bijker, Nina

    Purpose/Objective: It is unknown whether the historically found dosimetric advantages of treating gynecologic cancer with the patient in a prone position with use of a small-bowel displacement device (belly-board) remain when volumetric arc therapy (VMAT) is used and whether these advantages depend on the necessary margin between clinical target volume (CTV) and planning target volume (PTV). The aim of this study is to determine the best patient position (prone or supine) in terms of sparing organs at risk (OAR) for various CTV-to-PTV margins and VMAT dose delivery. Methods and Materials: In an institutional review board—approved study, 26 patients with gynecologicmore » cancer scheduled for primary (9) or postoperative (17) radiation therapy were scanned in a prone position on a belly-board and in a supine position on the same day. The primary tumor CTV, nodal CTV, bladder, bowel, and rectum were delineated on both scans. The PTVs were created each with a different margin for the primary tumor and nodal CTV. The VMAT plans were generated with our in-house system for automated treatment planning. For all margin combinations, the supine and prone plans were compared with consideration of all OAR dose-volume parameters but with highest priority given to bowel cavity V{sub 45Gy} (cm{sup 3}). Results: For both groups, the prone position reduced the bowel cavity V{sub 45Gy}, in particular for nodal margins ≥10 mm (ΔV{sub 45Gy} = 23.9 ± 10.6 cm{sup 3}). However, for smaller margins, the advantage was much less pronounced (ΔV{sub 45Gy} = 6.5 ± 3.0 cm{sup 3}) and did not reach statistical significance. The rectum mean dose (D{sub mean}) was significantly lower (ΔD{sub mean} = 2.5 ± 0.3 Gy) in the prone position for both patient groups and for all margins, and the bladder D{sub mean} was significantly lower in the supine position (ΔD{sub mean} = 2.6 ± 0.4 Gy) only for the postoperative group. The advantage of the prone position was not present if it needed a larger margin than the supine position. Conclusion: For patients with gynecologic cancer, the historically found dosimetric advantages for the prone position remain for modern dose delivery techniques if large margins are needed. However, the advantage is lost for small margins and if the prone position needs a larger margin than the supine position.« less

  9. Radiographic Features of Acute Patellar Tendon Rupture.

    PubMed

    Fazal, Muhammad Ali; Moonot, Pradeep; Haddad, Fares

    2015-11-01

    The purpose of our study was to assess soft tissue features of acute patellar tendon rupture on lateral knee radiograph that would facilitate early diagnosis. The participants were divided into two groups of 35 patients each. There were 28 men and seven women with a mean age of 46 years in the control group and 26 men and nine women with a mean age of 47 years in the rupture group. The lateral knee radiograph of each patient was evaluated for Insall-Salvati ratio for patella alta, increased density of the infrapatellar fat pad, appearance of the soft tissue margin of the patellar tendon and bony avulsions. In the rupture group there were three consistent soft tissue radiographic features in addition to patellar alta. These were increased density of infrapatellar fat pad; loss of sharp, well-defined linear margins of the patellar tendon and angulated wavy margin of the patellar tendon while in the control group these features were not observed. The soft tissue radiographic features described in the rupture group are consistent and reliable. When coupled with careful clinical assessment, these will aid in early diagnosis and further imaging will be seldom required. © 2015 Chinese Orthopaedic Association and Wiley Publishing Asia Pty Ltd.

  10. Microleakage in Class V Composite Restorations after Desensitizing Surface Treatment with Er:YAG and CO2 Lasers.

    PubMed

    Mozaffari, Hamid Reza; Ehteshami, Alireza; Zallaghi, Farshad; Chiniforush, Nasim; Moradi, Zohreh

    2016-12-30

    Aims: Glutaraldehyde, CO 2 and Er:YAG lasers can be used for treatment of dentin hypersensitivity. However, their application may have adverse effects on the clinical service of restorations. This study aimed to assess the microleakage in composite restorations following surface treatment with Glutaraldehyde desensitizer, CO 2 and Er:YAG laser irradiation for treatment of dentin hypersensitivity. Materials and methods: This experimental study was conducted on 60 extracted sound human teeth. Class V cavities were prepared measuring 3×3 mm using a diamond bur. Specimens were randomly divided into 4 groups of 15. Group one:no surface treatment, Group two:applying Glutaraldehyde desensitizer, Groups of three and four were irradiated with CO 2 and Er:YAG lasers, respectively. Surfaces were restored with bonding agent (Single Bond 2, 3M, USA) and Z250 composite (3M, USA). Specimens were thermocycled and immersed in 1% methylene blue solution for 24 hours. Microleakage scores were assessed under a stereomicroscope at ×20 magnification. Data were analyzed using SPSS and the Kruskal Wallis test (P=0.05). Results: There was no significant difference between microleakage of groups in enamel margins (P=0.694). The difference in microleakage at the dentin margin was significant between groups (P=0.018). Conclusions: Application of Glutaraldehyde-desensitizer and CO 2 laser irradiation of surfaces prior to composite restoration do not increase microleakage at the enamel or dentin margins but tooth surface treatment with Er:YAG laser significantly increased the microleakage at the dentin margins.

  11. Traditional CVD risk factors and socio-economic deprivation in Roma minority population of Croatia.

    PubMed

    Zeljko, Hrvojka; Skarić-Jurić, Tatjana; Narancic, Nina Smolej; Salihović, Marijana Pericić; Klarić, Irena Martinović; Barbalić, Maja; Starcević, Boris; Lauc, Lovorka Barać; Janićijević, Branka

    2008-09-01

    Researches into health inequalities consistently show disadvantages in health status, morbidity and mortality for various ethnic minority groups. Current knowledge about prevention of cardiovascular diseases (CVD) mainly derives from studies carried out in populations of European origin while the evidences involving Roma population are scarce. Roma, an ethnic minority of northern Indian origin, live in many countries throughout the world and are well known for preserved traditions and resistance to assimilation. They are most often marginalized economically, spatially, politically and in terms of culture. In order to assess the health status and health-related lifestyle attributes, a multidisciplinary anthropological and epidemiological community-based study was carried out including a total of 423 members of the Bayash Roma minority population living in two regions of Croatia (144 men and 279 women, aged 18-84 yrs). Hypertension (HT) was found in 24.8% Bayash Roma (21.5% men and 26.5% women) using standard diagnostic criteria (i.e. BP > or = 140/90 mm Hg or taking antihypertensive therapy). The prevalence increases from 5.9% in the age group 18-34 yrs; 35.0% in the age group 35-64 yrs, and 51.4% in the age group 65+ yrs. The prevalence of hypertension in the Bayash Roma is almost half of the magnitude of what is usually reported for the general population of Croatia. It is also lower when compared with other European populations and this finding is not due to comparatively younger average age of the Bayash sample. The significant association of hypertension with age and BMI was confirmed in this study and the importance of non-traditional SES-related CVD risk factors was highlighted. Smoking is a part of traditional Roma life-style and with 70% of smokers almost the entire population is equally exposed to this risk factor in their family environment. Since homogenously distributed, this risk factor did not show to be a significant predictor of hypertension. The extent to which hypertension is influenced by traditional CVD risk factors as well as by some SES indicators was also assessed using a forward stepwise method of the multivariate logistic analysis. Each risk factor was explored as quantitative variable as well as qualitative one using various cut-offs. The best model showed to be the one having age and BMI presented as quantitative variables and sex, region, smoking status, income and schooling years as categorical ones; with cut-off 3 for number of income sources and 8 for the number of schooling years. In spite of the low prevalence of hypertension, the presented results are showing that Bayash Roma are bearing a high CVD risk factors load. We expect that with westernization of their life-style and along with increase of the economic power, the proportion of CVD in population of Bayash Roma will also increase. Therefore, it is important to recognize the need for early cardiovascular disease risk factors prevention in this minority population.

  12. Implementation of a Surgeon-Level Comparative Quality Performance Review to Improve Positive Surgical Margin Rates during Radical Prostatectomy.

    PubMed

    Matulewicz, Richard S; Tosoian, Jeffrey J; Stimson, C J; Ross, Ashley E; Chappidi, Meera; Lotan, Tamara L; Humphreys, Elizabeth; Partin, Alan W; Schaeffer, Edward M

    2017-05-01

    Success in the era of value-based payment will depend on the capacity of health systems to improve quality while controlling costs. Comparative quality performance review can be used to drive improvements in surgical outcomes and thereby reduce costs. We sought to determine the efficacy of a comparative quality performance review to improve a surgeon-level measure of surgical oncologic quality, that is the positive surgical margin rate at the time of radical prostatectomy. Eight surgeons who performed consecutive radical prostatectomies at a single high volume institution between January 1, 2015 and December 31, 2015 were included in analysis. Individual surgeons were provided with confidential report cards every 6 months detailing their case mix, case volume and pT2 radical prostatectomy positive surgical margin rate relative to 1) their own self-matched data, 2) the de-identified data of their colleagues and 3) institutional aggregate data during the study period. Positive surgical margin rates were compared before and after intervention. Hierarchal logistic regression analysis was used to examine the association of study period on the odds of positive surgical margins, adjusted for prostate specific antigen level and National Comprehensive Cancer Network® risk group. Overall, 1,822 (1,392 before and 430 after intervention) radical prostatectomies were performed that met study inclusion criteria. The aggregate departmental unadjusted positive surgical margin rates were 10.6% and 7.4% in the pre-intervention and post-intervention groups, respectively. After adjusting for higher risk cancer in the post-intervention group, there was a significant protective association of post-intervention status on positive margins (OR 0.64, 95% CI 0.43-0.97, p = 0.03). All 5 surgeons with positive surgical margin rates higher than the aggregate department rate in the pre-intervention period showed improvement after intervention. Comparative quality performance review can be implemented at the surgeon level and can promote improvement in an objective measure of surgical oncology quality. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  13. Are different generations of CAD/CAM milling machines capable to produce restorations with similar quality?

    PubMed

    Roperto, Renato; Assaf, Hussein; Soares-Porto, Thiago; Lang, Lisa; Teich, Sorin

    2016-10-01

    Different CAD/CAM machines' generation may impact the restoration overall quality. The present study evaluated the marginal fit of CAD/CAM restorations manufactured with different generations of CEREC milling unit systems. Sixteen typodont teeth were divided into two groups (n=8) according to the machine's generation assigned. These are control group (G1): Cerec AC with Bluecam/Cerec 3 milling unit and (G2): Cerec AC with Bluecam/MC XL Premium Package milling unit. Scanning of the preparation were performed and crowns were milled using the Vita Mark II blocks. Blocks were cemented using epoxy glue on the pulpal floor only and finger pressure applied for 1 min. Upon completion of the cementation step, misfits between the restoration and abutment were measured by microphotography and the silicone replica technique using light body silicon material on Mesial (M) and Distal (D) surfaces. Mean and SDs of marginal gaps in micrometers were: G1/M: 94.90 (±38.52), G1/D: 88.53 (±44.87), G2/M: 85.65 (±29.89), G2/D: 95.28 (±28.13). Two-way ANOVA indicated no significant differences among different groups ( P >0.05); surface area ( P >0.05) and the interaction ( P >0.05). Overall, G2 had greater margin gaps than G1, however, without statistical difference ( P >0.05). Difference in milling unit generation did not significantly affect the marginal fit. Marginal gap means were in the range of the clinical acceptance levels for both generations of Cerec milling units, regardless the teeth site area. Key words: CAD/CAM, margin, ceramics.

  14. PubMed Central

    VICINI, C.; MONTEVECCHI, F.; D'AGOSTINO, G.; DE VITO, A.

    2015-01-01

    SUMMARY The primary goal of surgical oncology is to obtain a tumour resection with disease-free margins. Transoral robotic surgery (TORS) for surgical treatment of head-neck cancer is commensurate with standard treatments. However, the likelihood of positive margins after TORS is up to 20.2% in a recent US survey. The aim of this study is to evaluate the efficacy and the feasibility of narrow-band imaging (NBI) during TORS in order to improve the ability to achieve disease-free margins during tumour excision. The present study was conducted at the ENT, Head- Neck Surgery and Oral Surgery Unit, Department of Special Surgery, Morgagni Pierantoni Hospital, Azienda USL Romagna. From March 2008 to January 2015, 333 TORS were carried out for malignant and benign diseases. For the present study, we retrospectively evaluated 58 biopsy-proven squamous cell carcinoma patients who underwent TORS procedures. Patients were divided into 2 groups: (1) 32 who underwent TORS and intra-operative NBI evaluation (NBI-TORS); (2) 21 who underwent TORS with standard intra-operative white-light imaging (WLITORS). Frozen section analysis of margins on surgical specimens showed a higher rate of negative superficial lateral margins in the NBI-TORS group compared with the WLI-TORS group (87.9% vs. 57.9%, respectively, p = 0.02). The sensitivity and specificity of intra-operative use of NBI, respectively, were 72.5% and 66.7% with a negative predictive value of 87.9%. Tumour margin enhancement provided by NBI associated with magnification and 3-dimensional view of the surgical field might increase the capability to achieve an oncologically-safe resection in challenging anatomical areas where minimal curative resection is strongly recommended for function preservation. PMID:26246659

  15. Impact of surgical margins on survival of 37 dogs with massive hepatocellular carcinoma.

    PubMed

    Matsuyama, A; Takagi, S; Hosoya, K; Kagawa, Y; Nakamura, K; Deguchi, T; Takiguchi, M

    2017-09-01

    To compare the survival of dogs with completely resected massive hepatocellular carcinoma (HCC) with that of dogs in which HCC were incompletely excised. A retrospective cohort study was conducted. Dogs that underwent surgical excision of massive HCC between November 2006 and April 2015 were included. Dogs that died in the perioperative period or were lost to follow-up within 2 months after surgery were excluded. Data were collected from the medical records and a single pathologist examined all available histology slides to confirm the diagnosis of HCC. Surgical margins were defined as complete if no neoplastic cells were seen at the edge of excised tissues, based on original histopathology reports. Progression-free survival (PFS) and overall survival (OS) were compared between dogs with complete surgical margins (CM) and those with incomplete margins (IM) using a log-rank test. Of the 37 dogs included in the study, 25 were allocated to the CM group and 12 to the IM group. Progressive local disease developed after surgery in three dogs in the CM group and seven dogs in the IM group. Three dogs in the CM group and five dogs in the IM group died due to tumour progression. Median PFS was longer for dogs in the CM group (1,000 (95% CI=562-1,438) days) compared to dogs in the IM group (521 (95% CI=243-799) days; p=0.007). OS was also longer for dogs in the CM group (>1,836 days) compared to those in the IM group (median 765 (95% CI=474-1,056) days; p=0.02). Compared with complete resection, incomplete resection decreased PFS and OS in dogs with massive HCC. Dogs with incompletely excised HCC should be closely monitored for local recurrence, although median OS was >2 years following incomplete excision. Further prospective studies are warranted to confirm these findings.

  16. Face recognition using total margin-based adaptive fuzzy support vector machines.

    PubMed

    Liu, Yi-Hung; Chen, Yen-Ting

    2007-01-01

    This paper presents a new classifier called total margin-based adaptive fuzzy support vector machines (TAF-SVM) that deals with several problems that may occur in support vector machines (SVMs) when applied to the face recognition. The proposed TAF-SVM not only solves the overfitting problem resulted from the outlier with the approach of fuzzification of the penalty, but also corrects the skew of the optimal separating hyperplane due to the very imbalanced data sets by using different cost algorithm. In addition, by introducing the total margin algorithm to replace the conventional soft margin algorithm, a lower generalization error bound can be obtained. Those three functions are embodied into the traditional SVM so that the TAF-SVM is proposed and reformulated in both linear and nonlinear cases. By using two databases, the Chung Yuan Christian University (CYCU) multiview and the facial recognition technology (FERET) face databases, and using the kernel Fisher's discriminant analysis (KFDA) algorithm to extract discriminating face features, experimental results show that the proposed TAF-SVM is superior to SVM in terms of the face-recognition accuracy. The results also indicate that the proposed TAF-SVM can achieve smaller error variances than SVM over a number of tests such that better recognition stability can be obtained.

  17. Comparative Evaluation of Marginal Discrepancy in Tooth Colored Self Cure Acrylic Provisional Restorations With and Without Reinforcement of Glass Beads: An In-Vitro Study

    PubMed Central

    Yasangi, Manoj Kumar; Mannem, Dhanalakshmi; Neturi, Sirisha; Ravoori, Srinivas; Jyothi

    2015-01-01

    Context This invitro study was conducted to compare and evaluate marginal discrepancy in two types of tooth colored self cure provisional restorative materials {DPI&UNIFAST TRAD} before and after reinforcement of glass beads. Aim The aim of the present study was to evaluate and compare marginal discrepancy in two types of provisional restorative materials (DPI and UNI FAST TRAD) before and after reinforcement with Glass beads. Materials and Methods Tooth shaped resin copings were fabricated on custom made brass metal die. A total of 60 resin copings were fabricated in which 30 samples were prepared with DPI and 30 samples with UNIFAST material. Each group of 30 samples were divided in to two sub groups in which 15 samples were prepared with glass bead reinforcement and 15 samples without reinforcement. The marginal discrepancy was evaluated with photomicroscope {Reichet Polyvar 2 met} by placing the resin copings on custom made brass resin coping holder. Results Measurements obtained were statistically analysed by unpaired t-test to know any significance between two variables. Unreinforced DPI specimens had shown lower marginal discrepancy (442.82) than reinforced specimens (585.77). Unreinforced UNIFAST specimens have shown high values of marginal discrepancy (592.83) than reinforced specimens (436.35). p-value between reinforced and unreinforced specimens of DPI (p=0.0013) and UNIFAST (p= 0.0038) has shown statistical significance. Conclusion This in-vitro study revealed that unreinforced DPI specimens have shown lower marginal discrepancy than reinforced specimens and unreinforced UNIFAST specimens have shown higher values of marginal discrepancy than reinforced specimens. PMID:26155574

  18. Addressing the knowledge gap in clinical recommendations for management and complete excision of clinically atypical nevi/dysplastic nevi: Pigmented Lesion Subcommittee consensus statement.

    PubMed

    Kim, Caroline C; Swetter, Susan M; Curiel-Lewandrowski, Clara; Grichnik, James M; Grossman, Douglas; Halpern, Allan C; Kirkwood, John M; Leachman, Sancy A; Marghoob, Ashfaq A; Ming, Michael E; Nelson, Kelly C; Veledar, Emir; Venna, Suraj S; Chen, Suephy C

    2015-02-01

    The management of clinically atypical nevi/dysplastic nevi (CAN/DN) is controversial, with few data to guide the process. Management recommendations for DN with positive histologic margins were developed by the Delphi method to achieve consensus among members of the Pigmented Lesion Subcommittee (PLS) of the Melanoma Prevention Working Group (MPWG) after reviewing the current evidence. To outline key issues related to the management of CAN/DN: (1) biopsies of CAN and how positive margins arise, (2) whether incompletely excised DN evolve into melanoma, (3) current data on the outcomes of DN with positive histologic margins, (4) consensus recommendations, and (5) a proposal for future studies, including a large-scale study to help guide the management of DN with positive margins. The literature, including recent studies examining management and outcomes of DN with positive margins between 2009 to 2014, was reviewed. A consensus statement by the PLS of the MPWG following review of the literature, group discussions, and a structured Delphi method consensus. This consensus statement reviews the complexities of management of CAN/DN. A review of the literature and 2 rounds of a structured Delphi consensus resulted in the following recommendations: (1) mildly and moderately DN with clear margins do not need to be reexcised, (2) mildly DN biopsied with positive histologic margins without clinical residual pigmentation may be safely observed rather than reexcised, and (3) observation may be a reasonable option for management of moderately DN with positive histologic margins without clinically apparent residual pigmentation; however, more data are needed to make definitive recommendations in this clinical scenario.

  19. Influence of Cavity Margin Design and Restorative Material on Marginal Quality and Seal of Extended Class II Resin Composite Restorations In Vitro.

    PubMed

    Soliman, Sebastian; Preidl, Reinhard; Karl, Sabine; Hofmann, Norbert; Krastl, Gabriel; Klaiber, Bernd

    2016-01-01

    To investigate the influence of three cavity designs on the marginal seal of large Class II cavities restored with low-shrinkage resin composite limited to the enamel. One hundred twenty (120) intact human molars were randomly divided into 12 groups, with three different cavity designs: 1. undermined enamel, 2. box-shaped, and 3. proximal bevel. The teeth were restored with 1. an extra-low shrinkage (ELS) composite free of diluent monomers, 2. microhybrid composite (Herculite XRV), 3. nanohybrid composite (Filtek Supreme XTE), and 4. silorane-based composite (Filtek Silorane). After artificial aging by thermocycling and storage in physiological saline, epoxy resin replicas were prepared. To determine the integrity of the restorations' approximal margins, two methods were sequentially employed: 1. replicas were made of the 120 specimens and examined using SEM, and 2. the same 120 specimens were immersed in AgNO3 solution, and the dye penetration depth was observed with a light microscope. Statistical analysis was performed using the Kruskal-Wallis and the Dunn-Bonferroni tests. After bevel preparation, SEM observations showed that restorations did not exhibit a higher percentage of continuous margin (SEM-analysis; p>0.05), but more leakage was found than with the other cavity designs (p<0.05). The lowest percentage of continuous margin was observed in ELS restorations (p<0.05). More fractured margins were observed in the undermined enamel cavity design groups (p<0.05). Bevel preparation failed to improve margin quality in large Class II composite restorations and is no longer recommended. However, undermined enamel should be removed to prevent enamel fractures.

  20. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Studenski, M; Abramowitz, M; Dogan, N

    Purpose: Quantify the dosimetric cost for a margin around the MRI-defined high risk GTV for simultaneous integrated intra-prostatic boosts (SIIB) treated with RapidArc. Methods: For external beam radiotherapy of the prostate, a 3-7 mm PTV margin is typically used to account for setup and intra-fraction uncertainties after adjusting for inter-fraction motion. On the other hand, our current paradigm is to treat the MRI-defined high risk GTV with no margin. In this work, 11 patients treated SIIB (7 post-prostatectomy, 4 intact prostate) with RapidArc were re-planned with 1-5 mm margins around the GTV to quantify dosimetric effects. Two 358 degree, 10more » MV RapidArcs were used to deliver 68 Gy (76.5 Gy boost) to the post-prostatectomy patients and 80 Gy (86 Gy boost) to the intact prostates. Paired, two tail t-tests were used to determine if there were any significant differences (p<0.05) in the total MUs and dosimetric parameters used to evaluate rectum, bladder, and PTV dose with and without margin. Results: The average GTV volume without margin was 8.1cc (2.8% of the PTV volume) while the average GTV volume with a 5 mm margin was 20.1cc (9.0% of the PTV volume). GTV volumes ranged from 0.2% of the PTV volume up to 33.0%. Despite these changes in volume, the only statistical difference was found for the rectal V65 Gy with a 5 mm margin (18.6% vs. 19.4%; p-value = 0.026) when all patients were considered as a single group. No difference was found when analyzed as two groups. The rectum V40Gy, bladder V40Gy and V65Gy, PTV Dmax and D95% or the total MUs did not show any significant difference for any margin. Conclusion: A 4 mm margin on the high risk GTV is possible with no statistically significant change in dosimetry or total MUs. Further work will assess the appropriate margin required for intra-prostatic boosts.« less

  1. Evaluation of smear layer removal and marginal adaptation of root canal sealer after final irrigation using ethylenediaminetetraacetic, peracetic, and etidronic acids with different concentrations.

    PubMed

    Ulusoy, Özgür İlke; Zeyrek, Salev; Çelik, Bülent

    2017-07-01

    The purpose of this study was to investigate the effects of different irrigation solutions on the smear layer removal and marginal adaptation of a resin-based sealer to root canal dentine. A total of 152 instrumented roots were irrigated with the following irrigants: 9,18% etidronic acid (HEBP), 0.5, 1,2% peracetic acid (PAA), 17% ethylenediaminetetraacetic acid (EDTA), saline. The amount of smear layer was evaluated using scanning electron microscope (SEM) in seventy root samples. Eighty-two roots were filled with AH Plus and gutta-percha. Slices obtained from apical third of each specimen were viewed with SEM to assess marginal adaptation. Use of 9% and 18% HEBP resulted in more efficient smear layer removal in the apical third than the other chelators (p < 0.05). Higher smear layer scores in the coronal and middle thirds were obtained from 0.5%, 1% PAA groups. Regarding marginal adaptation, 18% HEBP group showed the lowest gap size values (p < 0.05), and better marginal adaptation. Etidronic acid is a promising candidate for final irrigation of root canals. © 2017 Wiley Periodicals, Inc.

  2. Sickness absence, marginality, and medically unexplained physical symptoms: a focus-group study of patients' experiences.

    PubMed

    Aamland, Aase; Werner, Erik L; Malterud, Kirsti

    2013-06-01

    Medically unexplained physical symptoms (MUPS) form a major cause of sickness absence. The purpose of this study was to explore factors which may influence further marginalization among patients with MUPS on long-term sickness absence. Two focus-group discussions were conducted with a purposive sample of 12 participants, six men and six women, aged 24-59 years. Their average duration of sickness absence was 10.5 months. Participants were invited to share stories about experiences from the process leading to the ongoing sickness absence, with a focus on the causes being medically unexplained. Systematic text condensation was applied for analysis. Inspired by theories of marginalization and coping, the authors searched for knowledge of how patients' positive resources can be mobilized to counteract processes of marginality. Analysis revealed how invisible symptoms and lack of objective findings were perceived as an additional burden to the sickness absence itself. Factors that could counteract further marginalization were a supportive social network, positive coping strategies such as keeping to the daily schedule and physical activity, and positive attention and confidence from professionals. Confidence from both personal and professional contacts is crucial. GPs have an important and appreciated role in this aspect.

  3. The marginal fit of E.max Press and E.max CAD lithium disilicate restorations: A critical review.

    PubMed

    Mounajjed, Radek; M Layton, Danielle; Azar, Basel

    2016-12-01

    This critical review aimed to assess the vertical marginal gap that was present when E.max lithium disilicate-based restoration (Press and CAD) are fabricated in-vitro. Published articles reporting vertical marginal gap measurements of in-vitro restorations that had been fabricated from E.Max lithium disilicate were sought with an electronic search of MEDLINE (PubMed) and hand search of selected dental journals. The outcomes were reviewed qualitatively. The majority of studies that compared the marginal fit of E.max press and E.max CAD restorations, found that the E.max lithium disilicate restorations fabricated with the press technique had significantly smaller marginal gaps than those fabricated with CAD technique. This research indicates that E.max lithium disilicate restorations fabricated with the press technique have measurably smaller marginal gaps when compared with those fabricated with CAD techniques within in-vitro environments. The marginal gaps achieved by the restorations across all groups were within a clinically acceptable range.

  4. Hall versus conventional stainless steel crown techniques: in vitro investigation of marginal fit and microleakage using three different luting agents.

    PubMed

    Erdemci, Zeynep Yalçınkaya; Cehreli, S Burçak; Tirali, R Ebru

    2014-01-01

    This study's purpose was to investigate microleakage and marginal discrepancies in stainless steel crowns (SSCs) placed using conventional and Hall techniques and cemented with three different luting agents. Seventy-eight human primary maxillary second molars were randomly assigned to two groups (N=39), and SSCs were applied either with the Hall or conventional technique. These two groups were further subgrouped according to the material used for crown cementation (N=13 per group). Two specimens in each group were processed for scanning electron microscopy investigation. The extent of microleakage and marginal fit was quantified in millimeters on digitally photographed sections using image analysis software. The data were compared with a two-way independent and a two-way mixed analysis of variance (P=.05). The scores in the Hall group were significantly worse than those in the conventional technique group (P<.05). In both groups, resin cement displayed the lowest extent of microleakage, followed by glass ionomer and polycarboxylate cements (P<.05). Stainless steel crowns applied using the Hall technique displayed higher microleakage scores than those applied using the conventional technique, regardless of the cementation material. When the interaction of the material and technique was assessed, resin cement presented as the best choice for minimizing microleakage in both techniques.

  5. Australasian Gastrointestinal Trials Group (AGITG) Contouring Atlas and Planning Guidelines for Intensity-Modulated Radiotherapy in Anal Cancer

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ng, Michael, E-mail: mng@radoncvic.com.au; Leong, Trevor; University of Melbourne

    2012-08-01

    Purpose: To develop a high-resolution target volume atlas with intensity-modulated radiotherapy (IMRT) planning guidelines for the conformal treatment of anal cancer. Methods and Materials: A draft contouring atlas and planning guidelines for anal cancer IMRT were prepared at the Australasian Gastrointestinal Trials Group (AGITG) annual meeting in September 2010. An expert panel of radiation oncologists contoured an anal cancer case to generate discussion on recommendations regarding target definition for gross disease, elective nodal volumes, and organs at risk (OARs). Clinical target volume (CTV) and planning target volume (PTV) margins, dose fractionation, and other IMRT-specific issues were also addressed. A steeringmore » committee produced the final consensus guidelines. Results: Detailed contouring and planning guidelines and a high-resolution atlas are provided. Gross tumor and elective target volumes are described and pictorially depicted. All elective regions should be routinely contoured for all disease stages, with the possible exception of the inguinal and high pelvic nodes for select, early-stage T1N0. A 20-mm CTV margin for the primary, 10- to 20-mm CTV margin for involved nodes and a 7-mm CTV margin for the elective pelvic nodal groups are recommended, while respecting anatomical boundaries. A 5- to 10-mm PTV margin is suggested. When using a simultaneous integrated boost technique, a dose of 54 Gy in 30 fractions to gross disease and 45 Gy to elective nodes with chemotherapy is appropriate. Guidelines are provided for OAR delineation. Conclusion: These consensus planning guidelines and high-resolution atlas complement the existing Radiation Therapy Oncology Group (RTOG) elective nodal ano-rectal atlas and provide additional anatomic, clinical, and technical instructions to guide radiation oncologists in the planning and delivery of IMRT for anal cancer.« less

  6. Cement Thickness of Inlay Restorations Made of Lithium Disilicate, Polymer-Infiltrated Ceramic and Nano-Ceramic CAD/CAM Materials Evaluated Using 3D X-Ray Micro-Computed Tomography.

    PubMed

    Uzgur, Recep; Ercan, Ertuğrul; Uzgur, Zeynep; Çolak, Hakan; Yalçın, Muhammet; Özcan, Mutlu

    2016-08-12

    To evaluate the marginal and internal cement thicknesses of inlay restorations made of various CAD/CAM materials using 3D X-ray micro-computed tomography (micro-CT) technique. Caries-free extracted mandibular molars (N = 30) with similar size were randomly assigned to three groups (N = 10 per group). Mesio-occlusal-distal (MOD) cavities were prepared, and inlay restorations were obtained by milling out CAD/CAM materials namely, (a) IPS: monolithic lithium disilicate (control), (b) VE: polymer-infiltrated ceramic, and (c) CS: nano-ceramic using a CAM unit. Marginal and internal cement thicknesses were measured using 3D micro-CT. Data were analyzed using 1-way ANOVA and Tukey's tests (alpha = 0.05). The mean marginal and internal cement thickness were not significant in all inlay materials (p > 0.05). Mean marginal cement thickness (μm) was the lowest for the IPS group (67.54 ± 10.16) followed by VE (84.09 ± 3.94) and CS (95.18 ± 10.58) (p > 0.05). The internal cement thickness (μm) was the lowest in the CS group (54.85 ± 6.94) followed by IPS (60.58 ± 9.22) and VE (77.53 ± 12.13) (p > 0.05). Marginal and internal cement thicknesses of MOD inlays made of monolithic lithium disilicate, polymer-infiltrated ceramic, and nano-ceramic CAD/CAM materials were similar and all less than 100 μm, which could be considered clinically acceptable. MOD inlays made of different CAD/CAM materials presented similar cement thickness, less than 100 μm. © 2016 by the American College of Prosthodontists.

  7. Infusing Social Justice into Rehabilitation Education: Making a Case for Curricula Refinement

    ERIC Educational Resources Information Center

    Harley, Debra A.; Alston, Reginald J.; Middleton, Renee A.

    2007-01-01

    Persons with disabilities are among minority groups who frequently experience marginalization and disenfranchisement. As a paradigm, social justice attempts to address marginalization through equitable redistribution of resources, policy and legislative revisions, and personal empowerment. The limited response of rehabilitation counseling to…

  8. 48 CFR 25.702-1 - Definitions.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... apparatus of business or commerce. Marginalized populations of Sudan means— (1) Adversely affected groups in... specific authorization from the Office of Foreign Assets Control in the Department of the Treasury, or are...) Consist of providing goods or services to marginalized populations of Sudan; (iv) Consist of providing...

  9. 48 CFR 25.702-1 - Definitions.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... apparatus of business or commerce. Marginalized populations of Sudan means— (1) Adversely affected groups in... specific authorization from the Office of Foreign Assets Control in the Department of the Treasury, or are...) Consist of providing goods or services to marginalized populations of Sudan; (iv) Consist of providing...

  10. 48 CFR 25.702-1 - Definitions.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... apparatus of business or commerce. Marginalized populations of Sudan means— (1) Adversely affected groups in... specific authorization from the Office of Foreign Assets Control in the Department of the Treasury, or are...) Consist of providing goods or services to marginalized populations of Sudan; (iv) Consist of providing...

  11. 48 CFR 25.702-1 - Definitions.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... apparatus of business or commerce. Marginalized populations of Sudan means— (1) Adversely affected groups in... specific authorization from the Office of Foreign Assets Control in the Department of the Treasury, or are...) Consist of providing goods or services to marginalized populations of Sudan; (iv) Consist of providing...

  12. Teaching on the Margins: Tutors, Discourse and Pedagogy in Work-Based Learning for Young People

    ERIC Educational Resources Information Center

    Thompson, Ron

    2010-01-01

    This paper presents research findings on practitioners working with young people on Entry to Employment (E2E) programmes in the north of England. E2E continues a long tradition of work-related learning for unemployed school leavers for whom other forms of education or training are deemed unsuitable, and is part of the UK government's strategy for…

  13. Mobilising Spaces of Agency through Genealogies of Race and Gender: Issues of Indigeneity, Marginality and Schooling

    ERIC Educational Resources Information Center

    Keddie, Amanda; Williams, Nicole

    2012-01-01

    This article presents data from a case study of a non-traditional secondary school for Indigenous girls located in a suburban area of Queensland (Australia). The focus is predominantly on the identity and practices of Nicole who is one of the school's teachers. Nicole's identity as an Indigenous woman and teacher and the school's approach to…

  14. The Rise of Childhood Poverty in Georgia: Implications for Public School Planning and Pedagogy

    ERIC Educational Resources Information Center

    Boggs, Olivia M.

    2011-01-01

    The rapid and steady growth of poverty in Georgia's public schools is a clarion call to re-examine the extent to which educators are reaching and teaching all students, regardless of their economic standing. The traditional view of poverty as a marginal condition affecting a minority of students no longer holds as 56% of Georgia's 1.6-million…

  15. Aging and World Order, The Whole Earth Papers No. 13 [And] Project Aging and World Order, Bulletin No. l, February, 1980.

    ERIC Educational Resources Information Center

    Baines, Jim

    Various aspects of aging in industrially developed and traditional societies are discussed in this monograph and bulletin. The objective of the monograph is to foster consciousness of the link between local and global concerns and of the need for a more humane world order. Discussion focuses on the marginality of older adults in industrialized…

  16. More than Nickels and Dimes: The Health Benefits of a Community-Based Lifelong Learning Programme for Older Adults

    ERIC Educational Resources Information Center

    Narushima, Miya

    2008-01-01

    In Canada, as in many countries, public continuing education of the non-vocational general interest type for people in post-work languishes on the margins of political discourse. This case study of one such traditional program for seniors run by a school board in Ontario explores the experiences of older adults and the meanings they attach to…

  17. Economic impacts of short-rotation woody crops for energy or oriented strand board: a Minnesota case study

    Treesearch

    William F. Lazarus; Douglas G. Tiffany; Ronald S. Zalesny Jr.; Don E. Riemenschneider

    2011-01-01

    Short-rotation woody crops (SRWC) such as hybrid poplars are becoming increasingly competitive with agriculture on marginal land. The trees can be grown for energy and for traditional uses such as oriented strandboard. Using IMPLAN (Impact Analysis for Planning) software, we modeled the impacts of shifting land use from hay and pasture for cow-calf beef operations to...

  18. The effect of porcelain firing and type of finish line on the marginal fit of zirconia copings.

    PubMed

    Vojdani, Mahroo; Safari, Anahita; Mohaghegh, Mina; Pardis, Soheil; Mahdavi, Farideh

    2015-06-01

    Although all-ceramic restorations are broadly used, there is a lack of information concerning how their fit is affected by fabrication procedure and marginal configuration. The purpose of this study was to evaluate the marginal fit of zirconia CAD/CAM ceramic crowns before and after porcelain firing. The influence of finish line configuration on the marginal fit was also evaluated. Twenty standardized zirconia CAD/CAM copings were fabricated for chamfer and shoulder finish line designs (n=10). The marginal fit of specimens was measured on 18 points, marked on the master metal die by using a digital microscope. After the crowns were finalized by porcelain veneering, the measurements of marginal fit were performed again. The means and standard deviations were calculated and data were analyzed using student's t-test and paired t-test (α=0.05). There were significant differences between marginal fit of chamfer and shoulder finish line groups before and after porcelain firing (p= 0.014 and p= 0.000, respectively). The marginal gap of copings with shoulder finish line was significantly smaller than those with chamfer configuration (p= 0.000), but there were no significant differences between the two marginal designs, after porcelain firing (p= 0.341). Porcelain veneering was found to have a statistically significant influence on the marginal fit of zirconia CAD/CAM crowns. Both margin configurations showed marginal gaps that were within a reported clinically acceptable range of marginal discrepancy.

  19. Combination Effect of Hemostatic and Disinfecting Agents on Micro-leakage of Restorations Bonded with Different Bonding Systems

    PubMed Central

    H, Farhadpour; F, Sharafeddin; Sc, Akbarian; B, Azarian

    2016-01-01

    Statement of Problem: Hemostatic agents may affect the micro-leakage of different adhesive systems. Also, chlorhexidine has shown positive effects on micro-leakage. However, their interaction effect has not been reported yet. Objectives: To evaluate the effect of contamination with a hemostatic agent on micro-leakage of total- and self-etching adhesive systems and the effect of chlorhexidine application after the removal of the hemostatic agent. Materials and Methods: Standardized Class V cavity was prepared on each of the sixty caries free premolars at the cemento-enamel junction, with the occlusal margin located in enamel and the gingival margin in dentin. Then, the specimens were randomly divided into 6 groups (n = 10) according to hemostatic agent (H) contamination, chlorhexidine (CHX) application, and the type of adhesive systems (Adper Single Bond and Clearfil SE Bond) used. After filling the cavities with resin composite, the root apices were sealed with utility wax. Furthermore, all the surfaces, except for the restorations and 1mm from the margins, were covered with two layers of nail varnish. The teeth were immersed in a 0.5% basic fuschin dye for 24 hours, rinsed, blot-dried and sectioned longitudinally through the center of the restorations bucco- lingualy. The sections were examined using a stereomicroscope and the extension of dye penetration was analyzed according to a non-parametric scale from 0 to 3. Statistical analysis was performed using Kruskal-Wallis test and Mann-Whitney U-test. Results: While ASB group showed no micro-leakage in enamel, none of the groups showed complete elimination of micro-leakage from the dentin. Regarding micro-leakage at enamel, and dentin margins, there was no significant difference between groups 1 and 2, 1 and 3, and 2 and 3 (p > 0.05). A significantly lower micro-leakage at the enamel and dentin margins was observed in group 3, compared to group 6. No significant difference was observed between groups 4 and 5 in enamel (p = 0.35) and dentin (p = 0.34). Group 6 showed significantly higher micro-leakage, compared to group 4 and 5 (p < 0.05). Conclusions: Hemostatic agent contamination had no significant effect on micro-leakage of total- and self-etching adhesive systems. Application of chlorhexidine after the removal of hemostatic agent increased micro-leakage in self-etching adhesives but did not affect when total-etching was used. PMID:28959756

  20. Effect of dual-cure composite resin as restorative material on marginal adaptation of class 2 restorations.

    PubMed

    Bortolotto, Tissiana; Melian, Karla; Krejci, Ivo

    2013-10-01

    The present study attempted to find a simple direct adhesive restorative technique for the restoration of Class 2 cavities. A self-etch adhesive system with a dual-cured core buildup composite resin (paste 1 + paste 2) was evaluated in its ability to restore proximo-occlusal cavities with margins located on enamel and dentin. The groups were: A, cavity filling (cf) with paste 1 (light-curing component) by using a layering technique; B, cf by mixing both pastes, bulk insertion, and dual curing; and C, cf by mixing both pastes, bulk insertion, and chemical curing. Two control groups (D, negative, bulk; and E, positive, layering technique) were included by restoring cavities with a classic three-step etch-and-rinse adhesive and a universal restorative composite resin. SEM margin analysis was performed before and after thermomechanical loading in a chewing simulator. Percentages (mean ± SD) of "continuous margins" were improved by applying the material in bulk and letting it self cure (54 ± 6) or dual cure (59 ± 9), and no significant differences were observed between these two groups and the positive control (44 ± 19). The present study showed that the dual-cured composite resin tested has the potential to be used as bulk filling material for Class 2 restorations. When used as filling materials, dual-cure composite resins placed in bulk can provide marginal adaptation similar to light-cured composites applied with a complex stratification technique.

  1. The influence of different soft-tissue grafting procedures at single implant placement on esthetics: A randomized controlled trial.

    PubMed

    Zuiderveld, Elise G; Meijer, Henny J A; Vissink, Arjan; Raghoebar, Gerry M

    2018-05-13

    Soft tissue grafting to thicken the soft tissue around dental implants was proposed to ameliorate the esthetic outcome. Traditionally, connective tissue is used as a grafting material, but a xenogeneic collagen matrix was introduced as an alternative to reduce patient morbidity. Sixty patients randomly received either no graft (n = 20, NG group), a connective tissue graft (n = 20, CTG group) or a xenogeneic collagen matrix (n = 20, XCM group) when placing an implant in a preserved alveolar ridge. Changes in mid-buccal mucosal level (MBML) at one (T 1 ) and twelve (T 12 ) months after final implant crown placement were compared to the pre-extraction situation. Additionally, esthetics, marginal bone level, clinical peri-implant parameters and patient satisfaction were assessed. At T 12 , mean changes in MBML were -0.48±1.5 mm, -0.04±1.1 mm and -0.17±1.3 mm in the NG, CTG and XCM groups (p = 0.56), respectively. Regarding the other outcome variables, no significant inter-group differences were observed. Soft tissue grafting at single implant placement in preserved alveolar ridges does not result in a better esthetic outcome or in better peri-implant health and should not be considered as a standard procedure. This article is protected by copyright. All rights reserved. © 2018 American Academy of Periodontology.

  2. Fixed and growth mindsets in physics graduate admissions

    NASA Astrophysics Data System (ADS)

    Scherr, Rachel E.; Plisch, Monica; Gray, Kara E.; Potvin, Geoff; Hodapp, Theodore

    2017-12-01

    Considering the evidence that standard physics graduate admissions practices tend to exclude women and traditionally marginalized racial and ethnic groups from the discipline, we investigate (a) the characteristics of students that physics graduate admissions committee members seek to admit to their programs and (b) the practices associated with these admissions goals. The data for this investigation are interviews with 18 faculty who chair graduate admissions committees in programs that prioritize diversity in their graduate admissions practices. We find that some express elements of an implicit theory of intelligence known as a "fixed mindset," in which intelligence is understood as an inherent capacity or ability primarily measured by standardized test scores and grades. Some also express elements of a "growth mindset," in which intelligence is understood in terms of acquired knowledge and effort. Overall, most faculty interviewed expressed elements of both mindsets. A fixed mindset in physics graduate admissions is consistent with research identifying physics as a "brilliance-required" field, whose members tend to believe that raw, innate talent is a primary requirement for success in the discipline. Such a mindset directly affects the participation of women and some racial or ethnic groups, who are stereotyped as lacking such high-level intellectual ability.

  3. Advancing alternate tools: why science education needs CRP and CRT

    NASA Astrophysics Data System (ADS)

    Dodo Seriki, Vanessa

    2018-03-01

    Ridgeway and Yerrick's paper, Whose banner are we waving?: exploring STEM partnerships for marginalized urban youth, unearthed the tensions that existed between a local community "expert" and a group of students and their facilitator in an afterschool program. Those of us who work with youth who are traditionally marginalized, understand the importance of teaching in culturally relevant ways, but far too often—as Ridgeway and Yerrick shared—community partners have beliefs, motives, and ideologies that are incompatible to the program's mission and goals. Nevertheless, we often enter partnerships assuming that the other party understands the needs of the students or community; understands how in U.S. society White is normative while all others are deficient; and understands how to engage with students in culturally relevant ways. This forum addresses the underlying assumption, described in the Ridgeway and Yerrick article, that educators—despite their background and experiences—are able to teach in culturally relevant ways. Additionally, I assert based on the finding in the article that just as Ladson-Billings and Tate (Teach Coll Rec 97(1):47-68, 1995) asserted, race in the U.S. society, as a scholarly pursuit, was under theorized. The same is true of science education; race in science education is under theorized and the use of culturally relevant pedagogy and critical race theory as a pedagogical model and analytical tool, respectively, in science education is minimal. The increased use of both would impact our understanding of who does science, and how to broaden participation among people of color.

  4. Effect of prostate weight on operative and postoperative outcomes of robotic-assisted laparoscopic prostatectomy.

    PubMed

    Zorn, Kevin C; Orvieto, Marcelo A; Mikhail, Albert A; Gofrit, Ofer N; Lin, Shang; Schaeffer, Anthony J; Shalhav, Arieh L; Zagaja, Gregory P

    2007-02-01

    To determine the effect of prostate weight (PW) on robotic laparoscopic radical prostatectomy (RLRP) outcomes. The effect of PW on surgical and pathologic outcomes has been reviewed in open and laparoscopic prostatectomy series. Little is known about its effects during RLRP. From February 2003 to November 2005, 375 men underwent RLRP. Patients were divided into four groups on the basis of the pathologic PW: group 1, less than 30 g; group 2, 30 g or more to less than 50 g; group 3, 50 g or more to less than 80 g; and group 4, 80 g or larger. The groups were compared prospectively. Continence and sexual function were assessed using validated questionnaires. Of the 375 patients, 20, 201, 123, and 31 had a PW of less than 30 g, 30 g or more to less than 50 g, 50 g or more to less than 80 g, and 80 g or larger, respectively. A significant difference was found in age and prostate-specific antigen values among the four groups (P <0.001). No significant differences in operative time, estimated blood loss, transfusion rate, hospital stay, length of catheterization, and complication incidence were observed among the four groups. The overall rate of positive surgical margins was significantly different among the groups (P = 0.002), demonstrating a trend of increasing positive surgical margins with a lower PW. Within the patients with Stage pT2, a significant increase in positive surgical margins was found with lower PWs (P = 0.026). The objective return of baseline and subjective sexual and urinary function, as determined by questionnaire scores, was not affected by the PW. RLRP can be performed safely and with similar perioperative outcomes in men, regardless of the PW. We found a significant inverse relationship between surgical margin status and PW, specifically in those with Stage pT2 disease.

  5. Augmented reality in a tumor resection model.

    PubMed

    Chauvet, Pauline; Collins, Toby; Debize, Clement; Novais-Gameiro, Lorraine; Pereira, Bruno; Bartoli, Adrien; Canis, Michel; Bourdel, Nicolas

    2018-03-01

    Augmented Reality (AR) guidance is a technology that allows a surgeon to see sub-surface structures, by overlaying pre-operative imaging data on a live laparoscopic video. Our objectives were to evaluate a state-of-the-art AR guidance system in a tumor surgical resection model, comparing the accuracy of the resection with and without the system. Our system has three phases. Phase 1: using the MRI images, the kidney's and pseudotumor's surfaces are segmented to construct a 3D model. Phase 2: the intra-operative 3D model of the kidney is computed. Phase 3: the pre-operative and intra-operative models are registered, and the laparoscopic view is augmented with the pre-operative data. We performed a prospective experimental study on ex vivo porcine kidneys. Alginate was injected into the parenchyma to create pseudotumors measuring 4-10 mm. The kidneys were then analyzed by MRI. Next, the kidneys were placed into pelvictrainers, and the pseudotumors were laparoscopically resected. The AR guidance system allows the surgeon to see tumors and margins using classical laparoscopic instruments, and a classical screen. The resection margins were measured microscopically to evaluate the accuracy of resection. Ninety tumors were segmented: 28 were used to optimize the AR software, and 62 were used to randomly compare surgical resection: 29 tumors were resected using AR and 33 without AR. The analysis of our pathological results showed 4 failures (tumor with positive margins) (13.8%) in the AR group, and 10 (30.3%) in the Non-AR group. There was no complete miss in the AR group, while there were 4 complete misses in the non-AR group. In total, 14 (42.4%) tumors were completely missed or had a positive margin in the non-AR group. Our AR system enhances the accuracy of surgical resection, particularly for small tumors. Crucial information such as resection margins and vascularization could also be displayed.

  6. Marginal accuracy of nickel chromium copings fabricated by conventional and accelerated casting procedures, produced with ringless and metal ring investment procedures: A comparative in vitro study.

    PubMed

    Alex, Deepa; Shetty, Y Bharath; Miranda, Glynis Anita; Prabhu, M Bharath; Karkera, Reshma

    2015-01-01

    Conventional investing and casting techniques are time-consuming and usually requires 2-4 h for completion. Accelerated nonstandard, casting techniques have been reported to achieve similar quality results in significantly less time, namely, in 30-40 min. During casting, it is essential to achieve compensation for the shrinkage of solidifying alloy by investment expansion. The metal casting ring restricts the thermal expansion of investment because the thermal expansion of the ring is lesser than that of the investment. The use of casting ring was challenged with the introduction of the ringless technique. A total of 40 test samples of nickel chromium (Ni-Cr) cast copings were obtained from the patterns fabricated using inlay casting wax. The 20 wax patterns were invested using metal ring and 20 wax patterns were invested using the ringless investment system. Of both the groups, 10 samples underwent conventional casting, and the other 10 underwent accelerated casting. The patterns were casted using the induction casting technique. All the test samples of cast copings were evaluated for vertical marginal gaps at four points on the die employing a stereo optical microscope. The vertical marginal discrepancy data obtained were tabulated. Mean and standard deviations were obtained. Vertical discrepancies were analyzed using analysis of variance and Tukey honestly significantly different. The data obtained were found to be very highly significant (P < 0.001). Mean vertical gap was the maximum for Group II (53.64 μm) followed by Group IV (47.62 μm), Group I (44.83 μm) and Group III (35.35 μm). The Ni-Cr cast copings fabricated with the conventional casting using ringless investment system showed significantly better marginal fit than that of cast copings fabricated from conventional and accelerated casting with metal ring investment and accelerated casting using ringless investment since those copings had shown the least vertical marginal discrepancies among the four methods evaluated in this study.

  7. Tectonic types of marginal and inner seas; their place in the development of the crust

    NASA Astrophysics Data System (ADS)

    Khain, V. E.; Levin, L. E.

    1980-12-01

    Inner and marginal deep seas are of considerable interest not only for their genesis but also as "micromodels" of oceans. In the latter case it must be noted that some of them essentially differ from oceans in several parameters. They have a shorter period of development, thicker sedimentary cover, less distinct linear magnetic anomalies or an absence of them, high heat-flow values and seismic activity over their whole area. Consequently, the analogy with the oceans has certain limitations as the deep structure of such seas is not homogeneous and they probably vary in genesis. Only a few marginal seas are cut off from the principal areas of the oceans by island arcs formed, most probably, along transform faults. The origin of this type is more or less reliably demonstrated for the Bering Sea. Other types of marginal seas are more numerous. Some of them (such as the Gulf of Aden and the Gulf of California) are embryonic apophyses connected with the oceans. Others are atrophied (the Tasman and the Labrador seas) small oceans. The group of marginal and inner seas which lie in the inside zone of mature or young island arcs is even more numerous. Only a few basins of this group resulted from linear spreading imprinted in the system of magnetic anomalies (the Shikoku-Parese-Vela basin), the rest are supposed to have been formed in the process of diffusal or polyaxial spreading of recent time as in Afar. The majority of inner and marginal seas are younger than recent oceans. They are formed by rifting, oriented crosswise to continental margins of the Atlantic type or along the strike of margins of Andean type. More ancient basins of marginal and inner seas have been involved in Phanerozoic orogens or more rarely became parts of platforms (Ciscaspian syneclise).

  8. Do Medicare Advantage Plans Select Enrollees in Higher Margin Clinical Categories?

    PubMed Central

    Newhouse, Joseph P.; McWilliams, J. Michael; Price, Mary; Huang, Jie; Fireman, Bruce; Hsu, John

    2013-01-01

    The CMS-HCC risk adjustment system for Medicare Advantage (MA) plans calculates weights, which are effectively relative prices, for beneficiaries with different observable characteristics. To do so it uses the relative amounts spent per beneficiary with those characteristics in Traditional Medicare (TM). For multiple reasons one might expect relative amounts in MA to differ from TM, thereby making some beneficiaries more profitable to treat than others. Much of the difference comes from differences in how TM and MA treat different diseases or diagnoses. Using data on actual medical spending from two MA-HMO plans, we show that the weights calculated from MA costs do indeed differ from those calculated using TM spending. One of the two plans (Plan 1) is more typical of MA-HMO plans in that it contracts with independent community providers, while the other (Plan 2) is vertically integrated with care delivery. We calculate margins, or Average Revenue/Average Cost, for Medicare beneficiaries in the two plans who have one of 48 different combinations of medical conditions. The two plans’ margins for these 48 conditions are correlated (r=0.39, p<0.01). Both plans have margins that are more positive for persons with conditions that are managed by primary care physicians and where medical management can be effective. Conversely they have lower margins for persons with conditions that tend to be treated by specialists with greater market power than primary care physicians and for acute conditions where little medical management is possible. The two plan’s margins among beneficiaries with different observable characteristics vary over a range of 160 and 98 percentage points, respectively, and thus would appear to offer substantial incentive for selection by HCC. Nonetheless, we find no evidence of overrepresentation of beneficiaries in high margin HCC’s in either plan. Nor, using the margins from Plan 1, the more typical plan, do we find evidence of overrepresentation of high margin HCC’s in Medicare more generally. These results do not permit a conclusion on overall social efficiency, but we note that selection according to margin could be socially efficient. In addition, our findings suggest there are omitted interaction terms in the risk adjustment model that Medicare currently uses. PMID:24308879

  9. Comparative Evaluation of Marginal Accuracy of a Cast Fixed Partial Denture Compared to Soldered Fixed Partial Denture Made of Two Different Base Metal Alloys and Casting Techniques: An In vitro Study.

    PubMed

    Jei, J Brintha; Mohan, Jayashree

    2014-03-01

    The periodontal health of abutment teeth and the durability of fixed partial denture depends on the marginal adaptation of the prosthesis. Any discrepancy in the marginal area leads to dissolution of luting agent and plaque accumulation. This study was done with the aim of evaluating the accuracy of marginal fit of four unit crown and bridge made up of Ni-Cr and Cr-Co alloys under induction and centrifugal casting. They were compared to cast fixed partial denture (FPD) and soldered FPD. For the purpose of this study a metal model was fabricated. A total of 40 samples (4-unit crown and bridge) were prepared in which 20 Cr-Co samples and 20 Ni-Cr samples were fabricated. Within these 20 samples of each group 10 samples were prepared by induction casting technique and other 10 samples with centrifugal casting technique. The cast FPD samples obtained were seated on the model and the samples were then measured with travelling microscope having precision of 0.001 cm. Sectioning of samples was done between the two pontics and measurements were made, then the soldering was made with torch soldering unit. The marginal discrepancy of soldered samples was measured and all findings were statistically analysed. The results revealed minimal marginal discrepancy with Cr-Co samples when compared to Ni-Cr samples done under induction casting technique. When compared to cast FPD samples, the soldered group showed reduced marginal discrepancy.

  10. Foucauldian diagnostics: space, time, and the metaphysics of medicine.

    PubMed

    Bishop, Jeffrey P

    2009-08-01

    This essay places Foucault's work into a philosophical context, recognizing that Foucault is difficult to place and demonstrates that Foucault remains in the Kantian tradition of philosophy, even if he sits at the margins of that tradition. For Kant, the forms of intuition-space and time-are the a priori conditions of the possibility of human experience and knowledge. For Foucault, the a priori conditions are political space and historical time. Foucault sees political space as central to understanding both the subject and objects of medicine, psychiatry, and the social sciences. Through this analysis one can see that medicine's metaphysics is a metaphysics of efficient causation, where medicine's objects are subjected to mechanisms of efficient control.

  11. Comparison of Onsite Versus Online Chart Reviews as Part of the American College of Radiation Oncology Accreditation Program.

    PubMed

    Hepel, Jaroslaw T; Heron, Dwight E; Mundt, Arno J; Yashar, Catheryn; Feigenberg, Steven; Koltis, Gordon; Regine, William F; Prasad, Dheerendra; Patel, Shilpen; Sharma, Navesh; Hebert, Mary; Wallis, Norman; Kuettel, Michael

    2017-05-01

    Accreditation based on peer review of professional standards of care is essential in ensuring quality and safety in administration of radiation therapy. Traditionally, medical chart reviews have been performed by a physical onsite visit. The American College of Radiation Oncology Accreditation Program has remodeled its process whereby electronic charts are reviewed remotely. Twenty-eight radiation oncology practices undergoing accreditation had three charts per practice undergo both onsite and online review. Onsite review was performed by a single reviewer for each practice. Online review consisted of one or more disease site-specific reviewers for each practice. Onsite and online reviews were blinded and scored on a 100-point scale on the basis of 20 categories. A score of less than 75 was failing, and a score of 75 to 79 was marginal. Any failed charts underwent rereview by a disease site team leader. Eighty-four charts underwent both onsite and online review. The mean scores were 86.0 and 86.9 points for charts reviewed onsite and online, respectively. Comparison of onsite and online reviews revealed no statistical difference in chart scores ( P = .43). Of charts reviewed, 21% had a marginal (n = 8) or failing (n = 10) score. There was no difference in failing charts ( P = .48) or combined marginal and failing charts ( P = .13) comparing onsite and online reviews. The American College of Radiation Oncology accreditation process of online chart review results in comparable review scores and rate of failing scores compared with traditional on-site review. However, the modern online process holds less potential for bias by using multiple reviewers per practice and allows for greater oversight via disease site team leader rereview.

  12. A review and assessment of non-governmental organization-based STD/AIDS education and prevention projects for marginalized groups.

    PubMed

    Crane, S F; Carswell, J W

    1992-06-01

    A review of projects run by non-governmental organizations (NGOs) in primarily developing countries, which have aimed to provide STD/AIDS education and prevention skills to various marginalized groups, reveals that past quantitative and formative research has failed to identify key programmatic factors which lead to more successful project implementation and sustainability. In observations, interviews with field staff, visits to program sites and information drawn from the literature, a variety of methods to reach a wide range of groups such as men who have sex with men, prostitutes, clients of prostitutes, prisoners, street children, migrant workers and refugees are explored. Factors found to facilitate project success include the following: at least one full-time committed staff member; respectful treatment and appropriate motivation of the target group; suitable and sufficient equipment and supplies (particularly condoms); planning ahead for the participation of HIV-positive individuals and ways to meet their needs; focusing on qualitative rather than quantitative evaluation; planning in advance beyond a 9 or 12 month 'model'. Despite some evidence that marginalized groups can be successfully motivated to practise safer sex through prevention education, long-term behaviour change still presents major challenges--even when specific conditions are met.

  13. The Influence of the Crown-Implant Ratio on the Crestal Bone Level and Implant Secondary Stability: 36-Month Clinical Study.

    PubMed

    Hadzik, Jakub; Krawiec, Maciej; Sławecki, Konstanty; Kunert-Keil, Christiane; Dominiak, Marzena; Gedrange, Tomasz

    2018-01-01

    When the era of dental implantology began, the pioneers defined some gold standards used in dental prosthetics treatment for implant-supported restorations. Referring to traditional prosthetics, it was taken for granted that the length of an implant placed in the alveolar bone (the equivalent of the root) should exceed the length of the superstructure. The aim of the study was to determine whether implant length and the crown-to-implant ( C / I ) ratio influence implant stability and the loss of the surrounding marginal bone and whether short implants can be used instead of sinus augmentation procedures. The patients participating in the study ( n = 30) had one single tooth implant, a short (OsseoSpeed™ L6 Ø4 mm, Implants) or a regular implant (OsseoSpeed L11 and L13 Ø4 mm, DENTSPLY Implants), placed in the maxilla. The evaluation was based on clinical and radiological examination. The crown-to-implant ratio was determined by dividing the length of the crown together with the abutment by the length of the implant placed crestally. Mean crown-to-implant ratios were calculated separately for each group and its correlation with the MBL (marginal bone loss) and stability was assessed. The authors compared the correlation between the C / I ratio values, MBL, and secondary implant stability. Positive results in terms of primary and secondary stability were achieved with both (short and conventional) implants. The MBL was low for short and conventional implants being 0.34 ± 0.24 mm and 0.22 ± 0.46 mm, respectively. No significant correlation was found between the C / I ratio and secondary stability as well as the C / I ratio and the marginal bone loss. Short implants can be successfully used to support single crowns. The study has revealed no significant differences in the clinical performance of prosthetic restorations supported by short implants. Clinical trial registration number is NCT03471000.

  14. Impact of Text Message Reminders on Caregivers’ Adherence to a Home Fortification Program Against Child Anemia in Rural Western China: A Cluster-Randomized Controlled Trial

    PubMed Central

    Zhou, Huan; Sun, Shuai; Sylvia, Sean; Yue, Ai; Shi, Yaojiang; Zhang, Linxiu; Medina, Alexis; Rozelle, Scott

    2016-01-01

    Objectives. To test whether text message reminders sent to caregivers improve the effectiveness of a home micronutrient fortification program in western China. Methods. We carried out a cluster-randomized controlled trial in 351 villages (clusters) in Shaanxi Province in 2013 and 2014, enrolling children aged 6 to 12 months. We randomly assigned each village to 1 of 3 groups: free delivery group, text messaging group, or control group. We collected information on compliance with treatments and hemoglobin concentrations from all children at baseline and 6-month follow-up. We estimated the intent-to-treat effects on compliance and child anemia using a logistic regression model. Results. There were 1393 eligible children. We found that assignment to the text messaging group led to an increase in full compliance (marginal effect = 0.10; 95% confidence interval [CI] = 0.03, 0.16) compared with the free delivery group and decrease in the rate of anemia at end line relative to the control group (marginal effect = −0.07; 95% CI = −0.12, −0.01), but not relative to the free delivery group (marginal effect = −0.03; 95% CI = −0.09, 0.03). Conclusions. Text messages improved compliance of caregivers to a home fortification program and children’s nutrition. PMID:27077354

  15. Effects of different types of temporary cements on the tensile strength and marginal adaptation of crowns on implants.

    PubMed

    Akashia, Ana Eliza; Francischone, Carlos Eduardo; Tokutsune, Edson; da Silva, Walter

    2002-01-01

    The aim of this study was to evaluate the influence of four different types of temporary cements, Tempbond (Kerr), Tempbond NE (Kerr), Improv (Sterioss), and Dycal (Dentsply/Caulk), on the marginal adaptation and tensile strength of prosthetic specimens cemented on replicas of CeraOne abutments. Four test groups were formed: Group 1 (G-1), Tempbond (Kerr); Group 2 (G-2), Tempbond NE (Kerr); Group 3 (G-3), Improv (Sterioss); Group 4 (G-4), Dycal (Dentsply/Caulk). For the specimens, gold cylinders (DCB 160, Nobel Biocare) adapted to stainless steel replicas of CeraOne abutments (Nobel Biocare) were utilized. The replicas on a stainless steel base were made in a special machine for implant components. The cement thicknesses for each luting agent were measured using a Measurement Comparative Microscope (Mitutoyo). The readings obtained before cementation were used as the controls (G-0). Following each group's cementation, the specimens were submitted to tensile strength tests with a Universal Testing Machine (Kratus). The results of the marginal adaptation test as reflected by cement thicknesses were: G-0 = 11.7 microm, G-1 = 35.7 microm (+/- 8.8), G-2 = 41.7 microm (+/- 9.0), G-3 = 32.6 microm (+/- 9.7) and G-4 = 38.2 microm (+/- 6.7). The tensile strength tests yielded the following values: G-1 = 58.5 N (+/- 14.8), G-2 = 51 N (+/- 8.2), G-3 = 61.8 N (+/- 17.1) and G-4 = 71.8 N (+/- 9.3). The four temporary cements tested all provided similar marginal adaptation. G-4 (Dycal) showed a higher tensile strength than G-2 (Tempbond NE).

  16. Effectiveness of Neuromuscular Electrical Stimulation on Patients With Dysphagia With Medullary Infarction.

    PubMed

    Zhang, Ming; Tao, Tao; Zhang, Zhao-Bo; Zhu, Xiao; Fan, Wen-Guo; Pu, Li-Jun; Chu, Lei; Yue, Shou-Wei

    2016-03-01

    To evaluate and compare the effects of neuromuscular electrical stimulation (NMES) acting on the sensory input or motor muscle in treating patients with dysphagia with medullary infarction. Prospective randomized controlled study. Department of physical medicine and rehabilitation. Patients with dysphagia with medullary infarction (N=82). Participants were randomized over 3 intervention groups: traditional swallowing therapy, sensory approach combined with traditional swallowing therapy, and motor approach combined with traditional swallowing therapy. Electrical stimulation sessions were for 20 minutes, twice a day, for 5d/wk, over a 4-week period. Swallowing function was evaluated by the water swallow test and Standardized Swallowing Assessment, oral intake was evaluated by the Functional Oral Intake Scale, quality of life was evaluated by the Swallowing-Related Quality of Life (SWAL-QOL) Scale, and cognition was evaluated by the Mini-Mental State Examination (MMSE). There were no statistically significant differences between the groups in age, sex, duration, MMSE score, or severity of the swallowing disorder (P>.05). All groups showed improved swallowing function (P≤.01); the sensory approach combined with traditional swallowing therapy group showed significantly greater improvement than the other 2 groups, and the motor approach combined with traditional swallowing therapy group showed greater improvement than the traditional swallowing therapy group (P<.05). SWAL-QOL Scale scores increased more significantly in the sensory approach combined with traditional swallowing therapy and motor approach combined with traditional swallowing therapy groups than in the traditional swallowing therapy group, and the sensory approach combined with traditional swallowing therapy and motor approach combined with traditional swallowing therapy groups showed statistically significant differences (P=.04). NMES that targets either sensory input or motor muscle coupled with traditional therapy is conducive to recovery from dysphagia and improves quality of life for patients with dysphagia with medullary infarction. A sensory approach appears to be better than a motor approach. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  17. The role of welding techniques in the biomechanical behavior of implant-supported prostheses.

    PubMed

    Rodrigues, Sabrina Alessandra; Presotto, Anna Gabriella Camacho; Barão, Valentim Adelino Ricardo; Consani, Rafael Leonardo Xediek; Nóbilo, Mauro Antônio Arruda; Mesquita, Marcelo Ferraz

    2017-09-01

    This in vitro study investigated the role of welding techniques of implant-supported prostheses in the 2D and 3D marginal misfits of prosthetic frameworks, strain induced on the mini abutment, and detorque of prosthetic screws. The correlations between the analyzed variables were also investigated. Frameworks were cast in commercially pure titanium (cp-Ti). A marginal misfit of 200μm was simulated in the working models (control group) (n=20). The 2D marginal misfit was analyzed according to the single-screw test protocol using a precision optical microscope. The 3D marginal misfit was performed by X-ray microtomography. Strain gauge analysis was performed to investigate the strain induced on the mini abutment. A digital torque meter was used for analysis of the detorque and the mean value was calculated for each framework. Afterwards, the frameworks were divided into two experimental groups (n=10): Laser (L) and TIG (T). The welding techniques were performed according to the following parameters: L (390V/9ms); T (36A/60ms). The L and T groups were reevaluated according to the marginal misfit, strain, and detorque. The results were submitted to one-way ANOVA followed by Tukey's HSD test and Person correlation analysis (α=0.05). Welding techniques statistically reduced the 2D and 3D marginal misfits of prosthetic frameworks (p<0.001), the strain induced on the mini abutment replicas (p=0.006), and improved the screw torque maintenance (p<0.001). Similar behavior was noted between L and T groups for all dependent variables (p>0.05). Positive correlations were observed between 2D and 3D marginal misfit reading methods (r=0.943, p<0.0001) and between misfit and strain (2D r=0.844, p<0.0001 and 3D r=0.864, p<0.0001). Negative correlation was observed between misfit and detorque (2D r=-0.823, p=0.003 and 3D r=-0.811, p=0.005). In conclusion, the welding techniques improved the biomechanical behavior of the implant-supported system. TIG can be an acceptable and affordable technique to reduce the misfit of 3-unit Ti frameworks. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Dream Catchers: "Margin Call," "Boss," and Climbing the Beanstalk

    ERIC Educational Resources Information Center

    Beck, Bernard

    2012-01-01

    Two recent popular entertainments, "Margin Call" (Barnum, Dodson, Jenckes, Moosa, Quinto & Chandor, 2011) and "Boss" (Safinia, 2011), depict powerful and successful groups of bosses confronting sudden, extreme threats. They are forced to react quickly and sacrifice important values to achieve survival of their organizations. In these emergencies,…

  19. Marginalization and School Nursing

    ERIC Educational Resources Information Center

    Smith, Julia Ann

    2004-01-01

    The concept of marginalization was first analyzed by nursing researchers Hall, Stevens, and Meleis. Although nursing literature frequently refers to this concept when addressing "at risk" groups such as the homeless, gays and lesbians, and those infected with HIV/AIDS, the concept can also be applied to nursing. Analysis of current school nursing…

  20. 48 CFR 52.225-20 - Prohibition on Conducting Restricted Business Operations in Sudan-Certification.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... commerce. Marginalized populations of Sudan means— (1) Adversely affected groups in regions authorized to... Sudan; (2) Are conducted pursuant to specific authorization from the Office of Foreign Assets Control in... conducted under such authorization; (3) Consist of providing goods or services to marginalized populations...

  1. 48 CFR 52.225-20 - Prohibition on Conducting Restricted Business Operations in Sudan-Certification.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... commerce. Marginalized populations of Sudan means— (1) Adversely affected groups in regions authorized to... Sudan; (2) Are conducted pursuant to specific authorization from the Office of Foreign Assets Control in... conducted under such authorization; (3) Consist of providing goods or services to marginalized populations...

  2. 48 CFR 52.225-20 - Prohibition on Conducting Restricted Business Operations in Sudan-Certification.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... commerce. Marginalized populations of Sudan means— (1) Adversely affected groups in regions authorized to... Sudan; (2) Are conducted pursuant to specific authorization from the Office of Foreign Assets Control in... conducted under such authorization; (3) Consist of providing goods or services to marginalized populations...

  3. 48 CFR 52.225-20 - Prohibition on Conducting Restricted Business Operations in Sudan-Certification.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... commerce. Marginalized populations of Sudan means— (1) Adversely affected groups in regions authorized to... Sudan; (2) Are conducted pursuant to specific authorization from the Office of Foreign Assets Control in... conducted under such authorization; (3) Consist of providing goods or services to marginalized populations...

  4. Clinical Effectiveness of a Resin-modified Glass Ionomer Cement and a Mild One-step Self-etch Adhesive Applied Actively and Passively in Noncarious Cervical Lesions: An 18-Month Clinical Trial.

    PubMed

    Jassal, M; Mittal, S; Tewari, S

    2018-05-21

    To evaluate the clinical effectiveness of two methods of application of a mild one-step self-etch adhesive and composite resin as compared with a resin-modified glass ionomer cement (RMGIC) control restoration in noncarious cervical lesions (NCCLs). A total of 294 restorations were placed in 56 patients, 98 in each one of the following groups: 1) G-Bond active application combined with Solare-X composite resin (A-1SEA), 2) G-Bond passive application combined with Solare-X composite resin (P-1SEA), and 3) GC II LC RMGIC. The restorations were evaluated at baseline and after six, 12, and 18 months according to the FDI criteria for fractures/retention, marginal adaptation, marginal staining, postoperative sensitivity, and secondary caries. Cumulative failure rates were calculated for each criterion at each recall period. The effect of adhesive, method of application, and recall period were assessed. The Kruskal-Wallis test for intergroup comparison and Friedman and Wilcoxon signed ranks tests for intragroup comparison were used for each criterion ( α=0.05). The retention rates at 18 months were 93.26% for the A-1SEA group, 86.21% for the P-1SEA group, and 90.91% for the RMGIC group. The active application improved the retention rates compared with the passive application of mild one-step self-etch adhesive; however, no statistically significant difference was observed between the groups. Marginal staining was observed in 13 restorations (1 in A-1SEA, 4 in P-1SEA, and 8 in RMGIC) with no significant difference between the groups. The RMGIC group showed a significant increase in marginal staining at 12 and 18 months from the baseline. There was no significant difference between the groups for marginal adaptation, secondary caries, or postoperative sensitivity. Within the limitations of the study, we can conclude that mild one-step self-etch adhesive followed by a resin composite restoration can be an alternative to RMGIC with similar retention and improved esthetics in restoration of NCCLs. Agitation could possibly benefit the clinical performance of mild one-step self-etch adhesives, but this study did not confirm that the observed benefit was statistically significant.

  5. Salivary contamination during bonding procedures with a one-bottle adhesive system.

    PubMed

    Fritz, U B; Finger, W J; Stean, H

    1998-09-01

    The effect of salivary contamination of enamel and dentin on bonding efficacy of an experimental one-bottle resin adhesive was investigated. The adhesive was a light-curing urethane dimethacrylate/hydroxyethyl methacrylate/4-methacryloxyethyl trimellitate anhydride mixture dissolved in acetone. Evaluation parameters were shear bond strength and marginal gap width in a dental cavity. Apart from a control group without contamination (group 1), etched enamel and dentin were (2) contaminated with saliva and air dried; (3) contaminated, rinsed, and blot dried; (4) coated with adhesive, contaminated, rinsed, and blot dried; (5) coated with adhesive, light cured, contaminated, rinsed, and air dried; or (6) treated as in group 5, with additional adhesive application after air drying. There was no negative effect in groups 3 and 4, compared with control. Air drying after salivary contamination (group 2) resulted in low shear bond strengths and wide marginal gaps. Contamination of the cured adhesive layer (groups 5 and 6) had no adverse effect on enamel shear bond strengths, but resulted in 50% reduced dentin shear bond strengths and wide marginal gaps. The one-bottle adhesive system is relatively insensitive to salivary contamination, provided that the contamination occurs prior to light curing of the adhesive and is carefully rinsed and blot dried. Salivary contact after adhesive curing must be avoided.

  6. Effect of protective coating on marginal integrity of nanohybrid composite during bleaching with carbamide peroxide: A microleakage study.

    PubMed

    Kumar, A Ashok; Hariharavel, V P; Narayanan, Ashwin; Murali, S

    2015-01-01

    The aim of the study was to evaluate the microleakage on the marginal integrity of nanohybrid composite during bleaching with carbamide peroxide after applying a protective coating of G-Coat plus (GC, Japan). Class V cavities were prepared and restored with nanohybrid composite restoration in 60 freshly extracted noncarious premolars extracted for orthodontic reasons. Then they were divided into 3 groups. Group 1 - bleaching with carbamide peroxide without G coat plus (n = 20), Group 2 - bleaching with carbamide peroxide with G-Coat plus (n = 20), Group 3 - without bleaching procedure (n = 20) (control group). In Group 2, G coat plus was applied over the restorative surface and margins. Then all teeth in Groups 1 and 2 were taken and mounted in dental stone. Bleaching trays were custom fabricated over the cast with the help of a heated vacuum-forming machine. 10% carbamide peroxide (opalescence PF) was applied over the tooth, and the bleaching process was done for about 2 weeks. Then all samples underwent thermocycling and were then immersed in the 2% methylene blue solution for 24 h and observed under a stereomicroscope to evaluate the amount of dye penetration. Data were compared using Kruskal-Wallis test and Mann-Whitney test using SPSS Inc.; Chicago, IL, USA, Version 17.0. Mann-Whitney test shows that the difference in microleakage between Group 1-Group 2 and Group 2-Group 3 is statistically significant (P < 0.05). Significant reduction in microleakage was seen in Group 2 when compared to other groups.

  7. Comparison of disposable sutureless silicone ring and traditional metal ring in 23-gauge vitrectomy combined with cataract surgery

    PubMed Central

    Wu, Jian-Guo; Wei, Rui-Hua; Liu, Ai-Hua; Zhou, Xiao-Xu; Sun, Guo-Ling; Li, Xiao-Rong

    2011-01-01

    Background: The purpose of this prospective, interventional, comparative case series was to evaluate the efficiency and feasibility of a disposable sutureless silicone lens ring for corneal contact lens stabilization during combined 23-gauge vitrectomy and cataract surgery. Methods: We developed a ring consisting of a single silicone component with three footplates along the ring margin to fit cannulae for holding conventional contact lenses. Thirty eyes from 30 patients with cataract and vitreoretinal disease were included, and divided into two matched groups according to disease type and ring used. In Group A, we used a 23-gauge transconjunctival vitrectomy system and a disposable sutureless silicone lens ring (n = 15). In Group B, we used a 23-gauge transconjunctival vitrectomy system and a conventional metal lens ring (n = 15). The main outcome measures were: time required for vitrectomy preparation, rate of intraoperative corneal limbus bleeding, and limbus scar rate at the final follow-up visit. Results: Thirty cases were successfully completed. The average vitrectomy preparation time was less in Group A than in Group B (P < 0.01), and the average preparation time saved was 3.94 minutes. None of the Group A patients had intraoperative bleeding or postoperative scarring, whereas all 15 Group B cases had bleeding and five had scarring. There was a statistically significant difference between Group A and Group B for these complications (P ≤ 0.05). Conclusion: This report demonstrates the advantages of using a sutureless silicone ring during combined 23-gauge vitrectomy and cataract surgery. Using this method could allow extra time for the surgeon to pay more attention to complex vitreoretinal procedures. PMID:21760720

  8. Comparison of disposable sutureless silicone ring and traditional metal ring in 23-gauge vitrectomy combined with cataract surgery.

    PubMed

    Wu, Jian-Guo; Wei, Rui-Hua; Liu, Ai-Hua; Zhou, Xiao-Xu; Sun, Guo-Ling; Li, Xiao-Rong

    2011-01-01

    The purpose of this prospective, interventional, comparative case series was to evaluate the efficiency and feasibility of a disposable sutureless silicone lens ring for corneal contact lens stabilization during combined 23-gauge vitrectomy and cataract surgery. We developed a ring consisting of a single silicone component with three footplates along the ring margin to fit cannulae for holding conventional contact lenses. Thirty eyes from 30 patients with cataract and vitreoretinal disease were included, and divided into two matched groups according to disease type and ring used. In Group A, we used a 23-gauge transconjunctival vitrectomy system and a disposable sutureless silicone lens ring (n = 15). In Group B, we used a 23-gauge transconjunctival vitrectomy system and a conventional metal lens ring (n = 15). The main outcome measures were: time required for vitrectomy preparation, rate of intraoperative corneal limbus bleeding, and limbus scar rate at the final follow-up visit. Thirty cases were successfully completed. The average vitrectomy preparation time was less in Group A than in Group B (P < 0.01), and the average preparation time saved was 3.94 minutes. None of the Group A patients had intraoperative bleeding or postoperative scarring, whereas all 15 Group B cases had bleeding and five had scarring. There was a statistically significant difference between Group A and Group B for these complications (P ≤ 0.05). This report demonstrates the advantages of using a sutureless silicone ring during combined 23-gauge vitrectomy and cataract surgery. Using this method could allow extra time for the surgeon to pay more attention to complex vitreoretinal procedures.

  9. Lithospheric structure of east Asia from ambient noise and two-station Rayleigh wave tomography

    NASA Astrophysics Data System (ADS)

    Li, M.; Song, X.; Li, J.; Bao, X.

    2017-12-01

    The complex tectonic background of east Asia makes it an ideal region to investigate the evolution of continental lithosphere. High-resolution lithospheric structure models are essential in this endeavor. Surface-wave tomography has been an important technique for constructing 3D lithospheric structure in global and regional scales. In this study, using event data recorded by more than 1000 seismic stations from multiple national and international networks in and surrounding China (CEArray, PASSCAL, GSN), we systematically measured Rayleigh-wave phase-velocity dispersion curves at periods 10-120 s and group-velocity dispersion curves at periods 10-140 s based on the traditional two-station method. The dispersion curves were extracted from the cross-correlation functions of the earthquake data at the two stations near the great circle path using frequency-time analysis method. The new measurements extend the phase and group dispersion data to longer periods (i.e. >70 s), which are difficult to extract from ambient noise cross-correlation. The longer-period data allow us to image deeper lithospheric velocity structure. We combined the new dispersion measurements with two previously obtained data sets: (1) data set from Bao et al. (2015) across the Chinese continent that includes group and phase dispersion measurements from ambient noise correlations and group velocity measurements from earthquakes, and (2) data set from Wang et al. (2017) across the marginal seas in east Asia from ambient noise correlations. We used the combined data set to invert for the phase velocity maps up to 120 s and group velocity maps up to 140 s at a grid spacing of 0.5°×0.5°and then invert for the 1D shear-wave velocity structure at each grid to obtain the new 3D shear-wave velocity model. The new model is generally consistent with that of Bao et al. (2015) but with improved resolution particularly in greater depths and in east-Asia marginal seas. We also derived crustal thickness and lithospheric thickness models. The lithospheric thickness model shows strong spatial heterogeneity and thinning trend from west to east in our study region. These models reveal important lithospheric features beneath east Asia and provide a fundamental data set for understanding continental dynamics and evolution.

  10. The Effect of Porcelain Firing and Type of Finish Line on the Marginal Fit of Zirconia Copings

    PubMed Central

    Vojdani, Mahroo; Safari, Anahita; Mohaghegh, Mina; Pardis, Soheil; Mahdavi, Farideh

    2015-01-01

    Statement of the Problem Although all-ceramic restorations are broadly used, there is a lack of information concerning how their fit is affected by fabrication procedure and marginal configuration. Purpose The purpose of this study was to evaluate the marginal fit of zirconia CAD/CAM ceramic crowns before and after porcelain firing. The influence of finish line configuration on the marginal fit was also evaluated. Materials and Method Twenty standardized zirconia CAD/CAM copings were fabricated for chamfer and shoulder finish line designs (n=10). The marginal fit of specimens was measured on 18 points, marked on the master metal die by using a digital microscope. After the crowns were finalized by porcelain veneering, the measurements of marginal fit were performed again. The means and standard deviations were calculated and data were analyzed using student’s t-test and paired t-test (α=0.05). Results There were significant differences between marginal fit of chamfer and shoulder finish line groups before and after porcelain firing (p= 0.014 and p= 0.000, respectively). The marginal gap of copings with shoulder finish line was significantly smaller than those with chamfer configuration (p= 0.000), but there were no significant differences between the two marginal designs, after porcelain firing (p= 0.341). Conclusion Porcelain veneering was found to have a statistically significant influence on the marginal fit of zirconia CAD/CAM crowns. Both margin configurations showed marginal gaps that were within a reported clinically acceptable range of marginal discrepancy. PMID:26046107

  11. Disease Control After Reduced Volume Conformal and Intensity Modulated Radiation Therapy for Childhood Craniopharyngioma

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Merchant, Thomas E., E-mail: thomas.merchant@stjude.org; Kun, Larry E.; Hua, Chia-Ho

    2013-03-15

    Purpose: To estimate the rate of disease control after conformal radiation therapy using reduced clinical target volume (CTV) margins and to determine factors that predict for tumor progression. Methods and Materials: Eighty-eight children (median age, 8.5 years; range, 3.2-17.6 years) received conformal or intensity modulated radiation therapy between 1998 and 2009. The study group included those prospectively treated from 1998 to 2003, using a 10-mm CTV, defined as the margin surrounding the solid and cystic tumor targeted to receive the prescription dose of 54 Gy. The CTV margin was subsequently reduced after 2003, yielding 2 groups of patients: those treatedmore » with a CTV margin greater than 5 mm (n=26) and those treated with a CTV margin less than or equal to 5 mm (n=62). Disease progression was estimated on the basis of additional variables including sex, race, extent of resection, tumor interventions, target volume margins, and frequency of weekly surveillance magnetic resonance (MR) imaging during radiation therapy. Median follow-up was 5 years. Results: There was no difference between progression-free survival rates based on CTV margins (>5 mm vs ≤5 mm) at 5 years (88.1% ± 6.3% vs 96.2% ± 4.4% [P=.6386]). There were no differences based on planning target volume (PTV) margins (or combined CTV plus PTV margins). The PTV was systematically reduced from 5 to 3 mm during the time period of the study. Factors predictive of superior progression-free survival included Caucasian race (P=.0175), no requirement for cerebrospinal fluid shunting (P=.0066), and number of surveillance imaging studies during treatment (P=.0216). Patients whose treatment protocol included a higher number of weekly surveillance MR imaging evaluations had a lower rate of tumor progression. Conclusions: These results suggest that targeted volume reductions for radiation therapy using smaller margins are feasible and safe but require careful monitoring. We are currently investigating the differences in outcome based on host factors to explain the results.« less

  12. Message to complementary and alternative medicine: evidence is a better friend than power

    PubMed Central

    Vickers, Andrew J

    2001-01-01

    Background Evidence-based medicine (EBM) is being embraced by an increasing number of practitioners and advocates of complementary and alternative medicine (CAM). A significant constituency within CAM, however, appears to have substantive doubts about EBM and some are expressly hostile. Discussion Many of the arguments raised against EBM within the CAM community are based on a caricature radically at odds with established, accepted and published principles of EBM practice. Contrary to what has sometimes been argued, EBM is not cookbook medicine that ignores individual needs. Neither does EBM mandate that only proven therapies should be used. Before EBM, decisions on health care tended to be based on tradition, power and influence. Such modes usually act to the disadvantage of marginal groups. Conclusion By placing CAM on an equal footing with conventional medicine - what matters for both is evidence of effectiveness - EBM provides an opportunity for CAM to find an appropriate and just place in health care. PMID:11346455

  13. A critical exploration of how English language learners experience nursing education.

    PubMed

    Mulready-Shick, N

    2013-01-01

    With nursing education reform calling for greater numbers of graduates from diverse backgrounds, this study explored the experiences of students who identified as English language learners (ELs). Educators may view students from underrepresented groups at the margins of nursing education. Minimal research on the experiences of students identifying as ELs exists. Interpretive phenomenological and critical methodologies were used to explore students' lived experiences in the nursing classroom. Academic progress involved additional time and effort dedicated to learning English and the languages of health care and nursing. Traditional and monocultural pedagogical practices, representing acts of power and dominance, thwarted learning. Yet students made progress despite less effective pedagogical practices and socioeconomic realities. This inquiry began with one notion of identity, "English-learners," but evolved to students' perceptions of "being-in-the-world," wholeness, and future endeavors. This study counters the dominant view that students without a greater command of English are not ready for the rigors of nursing education.

  14. Results of Upfront Therapy for Marginal Zone Lymphoma.

    PubMed

    Ortega, José L; Cabanillas, Fernando; Rivera, Noridza; Tirado-Gomez, Maribel; Hallman, Deana; Pardo, Wandaly I; Bruno, Margarita

    2017-12-01

    Marginal zone lymphomas (MZLs) are indolent disorders composed of 3 subtypes: extranodal marginal zone lymphoma (MALT), splenic marginal zone lymphoma (SMZL), and nodal marginal zone lymphoma (NMZL). Early-stage MALT is treated with radiotherapy or antibiotics, and advanced MALT and NMZL are managed with either watch and wait or chemotherapy. SMZLs are treated with splenectomy or rituximab. However, because these approaches have failed to cure patients with SMZL and NMZL, we have systematically used upfront chemotherapy for them, as well as for advanced MALT. We report the outcomes of this approach. A total of 44 patients with MZL were identified from our database and divided into 2 groups. Group 1 (22 with early-stage MALT) patients received either radiotherapy (n = 17) or antibiotics with or without surgery (n = 5). Group 2 included 9 patients with advanced MALT, 9 with SMZL, and 4 with NMZL. Group 2 was treated with FND-R (fludarabine 25 mg/m 2 on days 1 to 3, mitoxantrone 10 mg/m 2 on day 1, dexamethasone 20 mg on days 1 to 5, and rituximab 375 mg/m 2 on day 1; n = 14) or CHOP-R (cyclophosphamide 750 mg/m 2 on day 1, doxorubicin 50 mg/m 2 on day 1, vincristine 2 mg intravenous push on day 1, prednisone 100 mg/m 2 orally on days 1 to 5, rituximab 375 mg/m 2 on day 1; n = 8), followed by maintenance rituximab for 70%. All patients achieved complete remission, and only 2 patients in group 1 had developed a relapse at 70 and 75 months. Both relapses were stage I MALT that had initially been treated with radiotherapy. Both were salvaged with FND-R and remained free of disease at 27 and 39 months after the relapse. At 10 years, the failure-free survival for the 44 patients was 80% and the overall survival was 100%. None of the patients in group 2 developed a relapse. The long-term toxicities have been acceptable. The excellent responses using upfront chemotherapy for MZL suggests that this disorder is curable. Our results should be confirmed in a prospective trial. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Type and location of placenta previa affect preterm delivery risk related to antepartum hemorrhage.

    PubMed

    Sekiguchi, Atsuko; Nakai, Akihito; Kawabata, Ikuno; Hayashi, Masako; Takeshita, Toshiyuki

    2013-01-01

    To evaluate whether type and location of placenta previa affect risk of antepartum hemorrhage-related preterm delivery. We retrospectively studied 162 women with singleton pregnancies presenting placenta previa. Through observation using transvaginal ultrasound the women were categorized into complete or incomplete placenta previa, and then assigned to anterior and posterior groups. Complete placenta previa was defined as a placenta that completely covered the internal cervical os, with the placental margin >2 cm from the os. Incomplete placenta previa comprised marginal placenta previa whose margin adjacent to the internal os and partial placenta previa which covered the os but the margin situated within 2 cm of the os. Maternal characteristics and perinatal outcomes in complete and incomplete placenta previa were compared, and the differences between the anterior and the posterior groups were evaluated. Antepartum hemorrhage was more prevalent in women with complete placenta previa than in those with incomplete placenta previa (59.1% versus 17.6%), resulting in the higher incidence of preterm delivery in women with complete than in those with incomplete placenta previa [45.1% versus 8.8%; odds ratio (OR) 8.51; 95% confidence interval (CI) 3.59-20.18; p < 0.001]. In complete placenta previa, incidence of antepartum hemorrhage did not significantly differ between the anterior and the posterior groups. However, gestational age at bleeding onset was lower in the anterior group than in the posterior group, and the incidence of preterm delivery was higher in the anterior group than in the posterior group (76.2% versus 32.0%; OR 6.8; 95% CI 2.12-21.84; p = 0.002). In incomplete placenta previa, gestational age at delivery did not significantly differ between the anterior and posterior groups. Obstetricians should be aware of the increased risk of preterm delivery related to antepartum hemorrhage in women with complete placenta previa, particularly when the placenta is located on the anterior wall.

  16. Type and Location of Placenta Previa Affect Preterm Delivery Risk Related to Antepartum Hemorrhage

    PubMed Central

    Sekiguchi, Atsuko; Nakai, Akihito; Kawabata, Ikuno; Hayashi, Masako; Takeshita, Toshiyuki

    2013-01-01

    Purpose: To evaluate whether type and location of placenta previa affect risk of antepartum hemorrhage-related preterm delivery. Methods: We retrospectively studied 162 women with singleton pregnancies presenting placenta previa. Through observation using transvaginal ultrasound the women were categorized into complete or incomplete placenta previa, and then assigned to anterior and posterior groups. Complete placenta previa was defined as a placenta that completely covered the internal cervical os, with the placental margin >2 cm from the os. Incomplete placenta previa comprised marginal placenta previa whose margin adjacent to the internal os and partial placenta previa which covered the os but the margin situated within 2 cm of the os. Maternal characteristics and perinatal outcomes in complete and incomplete placenta previa were compared, and the differences between the anterior and the posterior groups were evaluated. Results: Antepartum hemorrhage was more prevalent in women with complete placenta previa than in those with incomplete placenta previa (59.1% versus 17.6%), resulting in the higher incidence of preterm delivery in women with complete than in those with incomplete placenta previa [45.1% versus 8.8%; odds ratio (OR) 8.51; 95% confidence interval (CI) 3.59-20.18; p < 0.001]. In complete placenta previa, incidence of antepartum hemorrhage did not significantly differ between the anterior and the posterior groups. However, gestational age at bleeding onset was lower in the anterior group than in the posterior group, and the incidence of preterm delivery was higher in the anterior group than in the posterior group (76.2% versus 32.0%; OR 6.8; 95% CI 2.12-21.84; p = 0.002). In incomplete placenta previa, gestational age at delivery did not significantly differ between the anterior and posterior groups. Conclusion: Obstetricians should be aware of the increased risk of preterm delivery related to antepartum hemorrhage in women with complete placenta previa, particularly when the placenta is located on the anterior wall. PMID:24151440

  17. The role of sense of belonging in self-stigma among people with serious mental illnesses.

    PubMed

    Treichler, Emily B H; Lucksted, Alicia A

    2018-06-01

    Self-stigma significantly impacts people with serious mental illnesses. Evidence from other marginalized groups has indicated that sense of belonging may buffer these impacts. The purpose of this study was to assess the buffering of self-stigma by sense of belonging among this population, including the relationship between these effects and self-identification in other marginalized groups. In the study, 267 adults with serious mental illnesses completed demographic, self-stigma, exposure to stigma, and sense of belonging measures. Regression analyses were conducted to determine whether sense of belonging buffered self-stigma and, if so, whether those effects vary by race and gender identification. Sense of belonging buffered self-stigma. Self-identification with other marginalized groups did not impact the buffering effect. Sense of belonging can protect against self-stigma. Self-stigma interventions should integrate components that improve sense of belonging, including community integration. These components should be flexible to meet the cultural context of individual consumers. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  18. The business of pediatric hospital medicine.

    PubMed

    Percelay, Jack M; Zipes, David G

    2014-07-01

    Pediatric hospital medicine (PHM) programs are mission driven, not margin driven. Very rarely do professional fee revenues exceed physician billing collections. In general, inpatient hospital care codes reimburse less than procedures, payer mix is poor, and pediatric inpatient care is inherently time-consuming. Using traditional accounting principles, almost all PHM programs will have a negative bottom line in the narrow sense of program costs and revenues generated. However, well-run PHM programs contribute positively to the bottom line of the system as a whole through the value-added services hospitalists provide and hospitalists' ability to improve overall system efficiency and productivity. This article provides an overview of the business of hospital medicine with emphasis on the basics of designing and maintaining a program that attends carefully to physician staffing (the major cost component of a program) and physician charges (the major revenue component of the program). Outside of these traditional calculations, resource stewardship is discussed as a way to reduce hospital costs in a capitated or diagnosis-related group reimbursement model and further improve profit-or at least limit losses. Shortening length of stay creates bed capacity for a program already running at capacity. The article concludes with a discussion of how hospitalists add value to the system by making other providers and other parts of the hospital more efficient and productive. Copyright 2014, SLACK Incorporated.

  19. Why New Hybrid Organizations are Formed: Historical Perspectives on Epistemic and Academic Drift.

    PubMed

    Kaiserfeld, Thomas

    2013-06-01

    By comparing three types of hybrid organizations-18th-century scientific academies, 19th-century institutions of higher vocational education, and 20th-century industrial research institutes-it is the purpose here to answer the question of why new hybrid organizations are continuously formed. Traditionally, and often implicitly, it is often assumed that emerging groups of potential knowledge users have their own organizational preferences and demands influencing the setup of new hybrid organizations. By applying the concepts epistemic and academic drift, it will be argued here, however, that internal organizational dynamics are just as important as changing historical conjunctures in the uses of science when understanding why new hybrid organizations are formed. Only seldom have older hybrid organizations sought to make themselves relevant to new categories of knowledge users as the original ones have been marginalized. Instead, they have tended to accede to ideals supported by traditional academic organizations with higher status in terms of knowledge management, primarily universities. Through this process, demand has been generated for the founding of new hybrid organizations rather than the transformation of existing ones. Although this study focuses on Swedish cases, it is argued that since Sweden strove consistently to implement existing international policy trends during the periods in question, the observations may be generalized to apply to other national and transnational contexts.

  20. [The household economy: a determinant of maternal death among indigenous women in Chiapas, Mexico].

    PubMed

    Herrera Torres, María del Carmen; Cruz Burguete, Jorge Luis; Robledo Hernández, Gabriela Patricia; Montoya Gómez, Guillermo

    2006-02-01

    To assess the determining role of financial situation and gender relations on maternal mortality among Indigenous women in Chiapas, Mexico. A quantitative/qualitative study was performed by means of a survey of 158 families, as well as in-depth interviews of persons linked to cases of maternal death, community leaders from throughout the region, and focal groups composed of traditional birth attendants. Decision-making surrounding women's health within the household is a critical problem because it is entirely in the hands of the husband and his relatives. In cases of high-risk pregnancy or birth, options for seeking care outside the community become limited, so that 48.7% of all obstetric cases are assisted by traditional birth attendants, 45.3% by relatives, and 6% by the mate. The problem is compounded by the high level of marginalization and very low human development index that characterize the region under study, by women's exclusion from the ownership of goods, including land, and by the fact that 97.7% of women only speak indigenous languages. Gender inequities within Indigenous families, together with a household economy that does not cover the basic necessities, are among the factors that keep women from receiving the necessary care during their reproductive processes. Because of the low socioeconomic status these women have, decisions surrounding care during pregnancy, birth, and the puerperium take a large toll on their health and their lives.

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