The effectiveness of Atraumatic Restorative Treatment versus conventional restorative treatment for permanent molars and premolars A critical assessment of existing systematic reviews and report of a new systematic review

Available for download at: http://mahara.qmul.ac.uk/view/view.php?id=16447Available for download at: http://mahara.qmul.ac.uk/view/view.php?id=16447Available for download at: http://mahara.qmul.ac.uk/view/view.php?id=16447Available for download at: http://mahara.qmul.ac.uk/view/view.php?id=16447Available for download at: http://mahara.qmul.ac.uk/view/view.php?id=16447Available for download at: http://mahara.qmul.ac.uk/view/view.php?id=16447Available for download at: http://mahara.qmul.ac.uk/view/view.php?id=16447Background: Atraumatic Restorative Treatment (ART) is the removal of caries using hand instruments and restoration of the resulting cavity using an adhesive restorative material. It was designed to restore teeth in communities without access to conventional dental clinics in poorer countries but has come to be used by dentists in the developed world too, as an alternative to conventional restorative treatment. Objectives: 1) to assess the scope and the methodological and reporting quality of existing systematic reviews of the effectiveness of ART compared to conventional restorative treatment; 2) to evaluate the effectiveness of ART compared to conventional treatment in permanent teeth with class I and II cavities. Methods: Searches: 1) for the assessment of existing systematic reviews: Electronic searches were conducted of OVID Medline, OVID Embase, The Cochrane Database of Systematic Reviews (CDSR), the Centre for Reviews and Dissemination (CRD) databases (DARE, NHSEED and HTA), Google Scholar, and the CNKI and CAOD Chinese databases; 2) for the systematic reviews of ART in permanent teeth: the above searches were supplemented by searches of the Cochrane Central Register of Controlled Trials (CENTRAL), LILAC, BBO, IMEAR (WHO Index Medicus for South East Region), WPRIM (WHO Western Pacific Region Index Medicus) and IndMed, Current Controlled Trials, Clinical Trials, OpenSIGLE, IADR conference abstracts and NLM Gateway. Hand searches were conducted of six dental journals known to have reported ART studies. References from retrieved systematic reviews, trials and other related papers were searched for additional reports. Authors were contacted. There were no language restrictions. Selection criteria: 1) for the assessment of existing systematic reviews: systematic reviews that compared ART to conventional treatment for the restoration of dental cavities; 2) for the systematic reviews of ART in permanent teeth: randomised controlled trials that compared ART using any adhesive material to conventional treatment using amalgam or any adhesive material Data collection: 1) for the assessment of existing systematic reviews: Reviews were selected and data was extracted by a single reviewer using a custom made data extraction sheet. Scope was assessed in terms of materials used, teeth and cavity type. Methodological quality was assessed using AMSTAR. Reporting quality was assessed using the PRISMA guidelines; 2) for the systematic reviews of ART in permanent teeth: reports of trials were screened and selected independently by two reviewers and data would have been extracted on a custom made data extraction sheet had there been eligible trials. Results: 1) for the assessment of existing systematic reviews: three systematic reviews were identified. Two of these were restricted to comparing ART with glass-ionomer to conventional treatment with amalgam; two allowed for inclusion of all cavity types in both deciduous and permanent teeth. None was of high methodological quality and reporting quality was good in one of the reviews only; 2) for the systematic reviews of ART in permanent teeth: no eligible trials were identified. Author’s conclusions: 1) existing systematic reviews do not have sufficient scope to allow for the inclusion of potentially eligible trials that would assess ARTs effectiveness and they have been of high to medium risk of bias; 2) it is disappointing that there are no properly conducted randomised controlled trials comparing ART to conventional treatment in class I and II cavities in the permanent dentition

Evaluation of superalloy heavy-duty grinding based on multivariate tests

The quality and economy of grinding depend on proper selection of grinding conditions for the materials to be ground. In order to evaluate the effect of heavy-duty grinding, a new performance index, which includes specific material removal rate, size accuracy, and grinding forces, was proposed. Robust design of experiment, including orthogonal arrays, the signal-to-noise ratio (SNR) method, and analysis of variance (ANOVA) for multivariate data, was employed to estimate the effect of uniform experimental design and to optimize grinding parameters. Empirical models of grinding force were investigated for finite element analysis of new fixture design. These empirical models, based on robust design of experiments and multiple regression methodology, have been confirmed through further verification experiments. Correlation coefficients from 0.87 to 0.96 were achieved

Dynamic Construction of Stimulus Values in the Ventromedial Prefrontal Cortex

Signals representing the value assigned to stimuli at the time of choice have been repeatedly observed in ventromedial prefrontal cortex (vmPFC). Yet it remains unknown how these value representations are computed from sensory and memory representations in more posterior brain regions. We used electroencephalography (EEG) while subjects evaluated appetitive and aversive food items to study how event-related responses modulated by stimulus value evolve over time. We found that value-related activity shifted from posterior to anterior, and from parietal to central to frontal sensors, across three major time windows after stimulus onset: 150–250 ms, 400–550 ms, and 700–800 ms. Exploratory localization of the EEG signal revealed a shifting network of activity moving from sensory and memory structures to areas associated with value coding, with stimulus value activity localized to vmPFC only from 400 ms onwards. Consistent with these results, functional connectivity analyses also showed a causal flow of information from temporal cortex to vmPFC. Thus, although value signals are present as early as 150 ms after stimulus onset, the value signals in vmPFC appear relatively late in the choice process, and seem to reflect the integration of incoming information from sensory and memory related regions

Development and Psychometric Properties of A Screening Tool for Assessing Developmental Coordination Disorder in Adults

Background: Developmental Coordination Disorder (DCD) is a neurodevelopmental disorder affecting motor coordination. Evidence suggests this disorder persists into adulthood and may be associated with biomechanical dysfunction and pain. We report on the development and initial validation of a questionnaire to assess for DCD in adults. Methods: An initial item pool (13 items) was derived from the American Psychiatric Association criteria and World Health Organisation definition for DCD. An expert panel assessed face and content validity which led to a 9-item Functional Difficulties Questionnaire (FDQ-9) with possible scores ranging from 9-36 (higher scores indicating greater functional difficulties). The FDQ-9 was piloted on individuals recruited from convenience samples. The underlying factor structure and aspects of reliability, validity and accuracy were tested. The Receiver Operating Characteristic Curve was employed to evaluate the diagnostic accuracy of the test using self-reported dyspraxia as the reference standard. Results: Principal Axis Factoring yielded a two factor solution relating to gross and fine motor skills; for conceptual parsimony these were combined. Internal reliability was high (0.81), the mean inter-item correlation was 0.51 and preliminary findings suggested satisfactory construct validity. The Area under the Curve was 0.918 [95% CI 0.84-1.00] indicating a diagnostic test with high accuracy. A cut-off score was established with a sensitivity and specificity of 86% [95% CI 78%-89%] and 81% [95 % CI 73%-89%] respectively. Test-retest reliability was good (ICC 0.96 [95% CI 0.92 to 0.98]. Conclusion: The psychometric properties of the FDQ-9 appear promising. Work is required to conduct further psychometric evaluations on new samples and apply the scale to clinical practice

Resource determinants of strategy and performance: the case of British exporters

This study adopts the RBV of the firm in order to identify critical advantage-generating resources and capabilities with strong positive export strategy and performance implications. The proposed export performance model is tested using a structural equation modeling approach on a sample of 356 British exporters. We examine the individual as well as the concurrent (simultaneous) direct and indirect effects of five resource bundles on export performance. We find that four resources/capabilities: managerial, knowledge, planning, and technology, have a significant positive direct effect on export performance, while relational and physical resources exhibited no unique positive effect. We also find that the firm’s export strategy mediates the resource-performance nexus in the case of managerial and knowledge-based resources. The theoretical and methodological grounding of this study contributes to the advancement of export related research by providing better specification of the nature of the effects – direct or indirect – of particular resource factors on export performance

Observations of Lick Standard Stars Using the SCORPIO Multi-Slit Unit at the SAO 6-m Telescope

We present Lick line-index measurements of standard stars from the list of Worthey. The spectra were taken with the multi-slit unit of the SCORPIO spectrograph at the 6-m Special Astrophysical observatory telescope. We describe in detail our method of analysis and explain the importance of using the Lick index system for studying extragalactic globular clusters. Our results show that the calibration of our instrumental system to the standard Lick system can be performed with high confidence.Comment: 12 pages, 3 figure

Effects of physical exercise on adiponectin, leptin, and inflammatory markers in childhood obesity: systematic review and meta-analysis

Background: New findings on adipose tissue physiology and obesity-Associated inflammation status suggest that modification of the adipokine level can be relevant for the long-Term prevention of obesity-Associated chronic disease. Objectives: The scope of the present study was to investigate the effectiveness of physical exercise in reducing the systemic inflammation related to obesity in children. Methods: We conducted a systematic review with meta-Analysis of controlled randomized trials, identified through electronic database search, which investigated the effect of physical exercise, without concomitant dietary intervention, on adiponectin, leptin, and/or other inflammatory markers in children up to age 18 years with a body mass index greater than the 95th percentile for age and sex. Results: Seven trials were included in the meta-Analysis, with a total of 250 participants. Compared with the control group without any lifestyle modification, the physical exercise resulted in a reduction in leptin [standardized mean difference (SMD)-1.13; 95% confidence interval (95%CI):-1.89 to-0.37; I2 = 79.9%] and interleukin-6 (SMD-0.84; 95%CI:-1.45 to-0.23, I2 = 0.9%) and an increase in adiponectin plasma concentration (SMD 0.69; 95%CI: 0.02-1.35; I2 = 74.3%). Conclusions: These results indicate that physical exercise improved the inflammatory state in children with obesity. It is unclear whether this effect can reduce the risk of cardiovascular and metabolic disease in adulthood. Clinical trials with a uniform intervention protocol and outcome measurements are required to put our knowledge on adipose tissue biology into a clinical perspective