PRELIMINARY FINDINGS OF A POTENZIATED PIEZOSURGERGICAL DEVICE AT THE RABBIT SKULL

The number of available ultrasonic osteotomes has remarkably increased. In vitro and in vivo studies have revealed differences between conventional osteotomes, such as rotating or sawing devices, and ultrasound-supported osteotomes (Piezosurgery®) regarding the micromorphology and roughness values of osteotomized bone surfaces. Objective: the present study compares the micro-morphologies and roughness values of osteotomized bone surfaces after the application of rotating and sawing devices, Piezosurgery Medical® and Piezosurgery Medical New Generation Powerful Handpiece. Methods: Fresh, standard-sized bony samples were taken from a rabbit skull using the following osteotomes: rotating and sawing devices, Piezosurgery Medical® and a Piezosurgery Medical New Generation Powerful Handpiece. The required duration of time for each osteotomy was recorded. Micromorphologies and roughness values to characterize the bone surfaces following the different osteotomy methods were described. The prepared surfaces were examined via light microscopy, environmental surface electron microscopy (ESEM), transmission electron microscopy (TEM), confocal laser scanning microscopy (CLSM) and atomic force microscopy. The selective cutting of mineralized tissues while preserving adjacent soft tissue (dura mater and nervous tissue) was studied. Bone necrosis of the osteotomy sites and the vitality of the osteocytes near the sectional plane were investigated, as well as the proportion of apoptosis or cell degeneration. Results and Conclusions: The potential positive effects on bone healing and reossification associated with different devices were evaluated and the comparative analysis among the different devices used was performed, in order to determine the best osteotomes to be employed during cranio-facial surgery

Advanced Applications of Rapid Prototyping Technology in Modern Engineering

Rapid prototyping (RP) technology has been widely known and appreciated due to its flexible and customized manufacturing capabilities. The widely studied RP techniques include stereolithography apparatus (SLA), selective laser sintering (SLS), three-dimensional printing (3DP), fused deposition modeling (FDM), 3D plotting, solid ground curing (SGC), multiphase jet solidification (MJS), laminated object manufacturing (LOM). Different techniques are associated with different materials and/or processing principles and thus are devoted to specific applications. RP technology has no longer been only for prototype building rather has been extended for real industrial manufacturing solutions. Today, the RP technology has contributed to almost all engineering areas that include mechanical, materials, industrial, aerospace, electrical and most recently biomedical engineering. This book aims to present the advanced development of RP technologies in various engineering areas as the solutions to the real world engineering problems

Multiobjective Optimization in Health Care Management. A metaheuristic and simulation approach.

This paper describes a methodology which combines elements of statistics, probability, mathematical programming, simulation, multiobjective optimization and metaheuristics, to analyze management problems in a health care context. We apply this approach to a staffing problem in a primary care center, taking into account both cost and service quality criteria. We illustrate our approach with a case study

Design, Development and Implementation Framework for a Postgraduate Non-Surgical Aesthetics Curriculum

Non-surgical aesthetics (NSA) procedures are primarily performed in private clinics away from traditional teaching hospital settings, establishing structured training and education in these procedures during residency training has been challenging. The objective of this study was to design and develop an evidence-based postgraduate curriculum in non-surgical aesthetics. It necessitated determining the current state of training and education for NSA procedures in postgraduate clinical education. Following a design-based research approach, a subsequent systematic literature review and a cross-sectional global-needs assessment study established the need for such a curriculum. Subsequent literature reviews and series of global Delphi studies have informed and guided the design and development of the conceptual framework, core curriculum content and finally, the implementation framework to facilitate the smooth delivery of the programme. The research also incorporated pilot studies for teaching methodology, assessment strategies like “objective structured practical examination (OSPE) and objective structured clinical examination (OSCE)”, which has shown to be very effective. The conceptual framework for curriculum design and development in NSA emerged from the global Delphi study. The conceptual framework is anchored on critical thinking and uses enquiry-based learning to develop information mastery, skills, and values and attitude. Moreover, relevant threshold concepts guided the construction of learning outcomes mapped against the core curriculum. The finding of this study is a crucial first step in bringing an evidence-based structure to training and education in NSA. This thesis will act as a ‘blueprint’ for the policymakers and program directors while curating a postgraduate programme in NSA

Directions in scenario planning literature - A review of the past decades

This paper provides a systematized overview of patterns in the scenario planning literature published in the last decades. Recently, scenario planning has enjoyed a revival, apparent in the 'boom' in published research on the matter. Consequently, a major issue that needs to be addressed is how to organize the literature along precise lines. A number of reviews that describe the current status of the body of literature and knowledge on scenario planning have made attempts to respond to such requirements. These studies agree that systematizing the existing literature is a necessary step in developing the field. This paper aims to contribute to this purpose. The review of the academic literature here conducted is thought to be useful for both academics and practitioners. For researchers, this systematic overview will be constructive not only in providing an analysis of the directions of published research but also in setting up a research agenda for the future. For managers and practitioners, it provides a clear outline of firm-related articles and discusses their contribution from a managerial point of view. It also raises awareness with regard to future analytical methods, and in particular, to scenario planning and its potential contribution to the competitiveness of firms. The research was carried out under the research Project Enterprise of the Future of the University of Aveiro. © 2009 Elsevier Ltd.Instituto de Investigação from University of Aveiro for the Project Enterprise of the Futur

Speech and Swallowing Outcomes in Patients Treated for Oral Cavity Cancer

This study investigated the natural history of speech and swallowing function of patients treated for oral cavity cancers (OCC) of the oral tongue and/or floor of mouth (FOM), and explored relationships among clinico-demographic and treatment-related variables and speech and swallowing performance. Patient-, disease- and treatment-related data were collected along with clinical outcomes data from medical charts of 72 individuals. Repeated measures analyses revealed changes in speech and swallowing function post-treatment with a general pattern of worse function at hospital discharge and improved function long-term post-treatment, although function did not return to baseline levels. Correlation and regression analyses identified that, in combination, an individual’s comorbidity status, tumour staging, and adjuvant treatment can predict variance in the normalcy of one’s diet and the social aspects of eating post-treatment. These results have the potential to inform patient education and counselling regarding anticipated outcomes and enhance future treatment decisions

Preradiation dental decisions in patients with head and neck cancer

This thesis presents a series of studies that investigated preradiation dental decision making in patients with head and neck cancer. In Chapter 1, it is ascertained that in view of the risk for oral sequelae resulting from high-dose radiotherapy, special attention to preradiation dental planning appears critical. Each case must be managed individually on the basis of the patient's needs, the status of the tumor, and the risks for dental health in irradiated tissues; a single-formula approach for all patients is contra-indicated. In accordance with the evidence-based approach that forms the basis of the healthcare paradigm of this new millennium, the main subject of this thesis is to develop and to test a decision support system, in order to enhance dental decision-making in patients with head and neck cancer. More specifically, studies were conducted to: (1) Identify the decision dilemma and perform a clinical decision analysis; (2) Analyze the decision policies of clinicians familiar with and experienced in preradiation dental screening in order to describe how dental- and radiotherapy-related risk factors influence their decision-making; (3) Propose a method for judgment analysis, in order to identify the characteristics of individual judgment policies of dental clinicians with respect to the prophylactic extraction of teeth; (4) Develop and test "SCREDENT," a system for dental decision support in patients with head and neck cancer. In the studies underlying this thesis, three different approaches to analyzing judgment and decision-making were used: normative, descriptive, and contextual. These approaches to analyzing judgment and decision-making relate to decision strategies