Harvesting of autogenous grafts for gingival recession coverage

The ultimate aim of periodontal plastic surgery is to create optimal pink esthetics through the reconstruction of gingival recessions. Application of autogenous soft tissue grafts is considered as a gold standard treatment modality with predictable esthetic outcomes for gingival recession coverage. Harvesting a free soft tissue graft from an esthetically irrelevant region of the oral mucosa using various techniques can prevent donor site complications around the adjacent teeth

Long-term noninvasive ventilation in COPD:current evidence and future directions

Introduction: Long-term noninvasive ventilation (NIV) is an established treatment for end-stage COPD patients suffering from chronic hypercapnic respiratory failure. This is reflected by its prominent position in national and international medical guidelines. Areas covered: In recent years, novel developments in technology such as auto-titrating machines and hybrid modes have emerged, and when combined with advances in information and communication technologies, these developments have served to improve the level of NIV-based care. Such progress has largely been instigated by the fact that healthcare systems are now confronted with an increase in the number of patients, which has led to the need for a change in current infrastructures. This article discusses the current practices and recent trends, and offers a glimpse into the future possibilities and requirements associated with this form of ventilation therapy. Expert opinion: Noninvasive ventilation is an established and increasingly used treatment option for patients with chronic hypercapnic COPD and those with persistent hypercapnia following acute hypercapnic lung failure. The main target is to augment alveolar hypoventilation by reducing PaCO2 to relieve symptoms. Nevertheless, when dealing with severely impaired patients, it appears necessary to switch the focus to patient-related outcomes such as health-related quality of life

Treatment of multiple adjacent RT 1 gingival recessions with the modified coronally advanced tunnel (MCAT) technique and a collagen matrix or palatal connective tissue graft: 9-year results of a split-mouth randomized clinical trial.

OBJECTIVES To evaluate t he long-term outcomes following treatment of RT 1 multiple adjacent gingival recessions (MAGR) using the modified coronally advanced tunnel (MCAT) with either a collagen matrix CM or a connective tissue graft (CTG). MATERIAL AND METHODS Sixteen of the original 22 subjects included in a randomized, controlled split-mouth clinical trial were available for the 9-year follow-up (114 sites). Recessions were randomly treated by means of MCAT + CM (test) or MCAT + CTG (control). Complete root coverage (CRC), mean root coverage (MRC), gingival recession depth (GRD), probing pocket depth (PD), keratinized tissue width (KTW), and thickness (KGT) were compared with baseline values and with the 12-month results. RESULTS After 9 years, CRC was observed in 2 patients, one in each group. At 9 years, MRC was 23.0 ± 44.5% in the test and 39.7 ± 35.1% in the control group (p = 0.179). The MRC reduction compared to 12 months was - 50.1 ± 47.0% and - 48.3 ± 37.7%, respectively. The upper jaw obtained 31.92 ± 43.0% of MRC for the test and 51.1 ± 27.8% for the control group (p = 0.111) compared to the lower jaw with 8.3 ± 46.9% and 20.7 ± 40.3%. KTW and KGT increased for both CM and CTG together from 2.0 ± 0.7 to 3.1 ± 1.0 mm (< 0.0001). There were no statistically significant changes in PD. CONCLUSION The present results indicate that (a) treatment of MAGR using MCAT in conjunction with either CM or CTG is likely to show a relapse over a period of 9 years, and (b) the outcomes obtained in maxillary areas seem to be more stable compared to the mandibular ones. CLINICAL RELEVANCE The mean root coverage at 12 months could not be fully maintained over 9 years. On a long-term basis, the results seem to be less stable in the mandible as compared to maxillary areas

Precision Measurement of the 29Si, 33S, and 36Cl Binding Energies

The binding energies of 29Si, 33S, and 36Cl have been measured with a relative uncertainty $< 0.59 \times 10^{-6}$ using a flat-crystal spectrometer. The unique features of these measurements are 1) nearly perfect crystals whose lattice spacing is known in meters, 2) a highly precise angle scale that is derived from first principles, and 3) a gamma-ray measurement facility that is coupled to a high flux reactor with near-core source capability. The binding energy is obtained by measuring all gamma-rays in a cascade scheme connecting the capture and ground states. The measurements require the extension of precision flat-crystal diffraction techniques to the 5 to 6 MeV energy region, a significant precision measurement challenge. The binding energies determined from these gamma-ray measurements are consistent with recent highly accurate atomic mass measurements within a relative uncertainty of $4.3 \times 10^{-7}$. The gamma-ray measurement uncertainties are the dominant contributors to the uncertainty of this consistency test. The measured gamma-ray energies are in agreement with earlier precision gamma-ray measurements.Comment: 13 pages, 4 figure

A performance comparison of the contiguous allocation strategies in 3D mesh connected multicomputers

The performance of contiguous allocation strategies can be significantly affected by the distribution of job execution times. In this paper, the performance of the existing contiguous allocation strategies for 3D mesh multicomputers is re-visited in the context of heavy-tailed distributions (e.g., a Bounded Pareto distribution). The strategies are evaluated and compared using simulation experiments for both First-Come-First-Served (FCFS) and Shortest-Service-Demand (SSD) scheduling strategies under a variety of system loads and system sizes. The results show that the performance of the allocation strategies degrades considerably when job execution times follow a heavy-tailed distribution. Moreover, SSD copes much better than FCFS scheduling strategy in the presence of heavy-tailed job execution times. The results also show that the strategies that depend on a list of allocated sub-meshes for both allocation and deallocation have lower allocation overhead and deliver good system performance in terms of average turnaround time and mean system utilization

Soret Effect Study on High-Pressure CO2-Water Solutions Using UV-Raman Spectroscopy and a Concentric-Tube Optical Cell

Spatially resolved deep-UV Raman spectroscopy was applied to solutions of CO2 and H2O (or D2O), which were subject to a temperature gradient in a thermally regulated high-pressure concentric-tube Raman cell in an attempt to measure a Soret effect in the vicinity of the critical point of CO2. Although Raman spectra of solutions of CO2 dissolved in D2O at 10 MPa and temperatures near the critical point of CO2 had adequate signal-to-noise and spatial resolution to observe a Soret effect with a Soret coefficient with magnitude of |ST| &gt; 0.03, no evidence for an effect of this size was obtained for applied temperature gradients up to 19oC. The presence of 1 M NaCl did not make a difference. In contrast, the concentration of CO2 dissolved in H2O was shown to vary significantly across the temperature gradient when excess CO2 was present, but the results could be explained simply by the variation in CO2 solubility over the temperature range and not to kinetic factors. For mixtures of D2O dissolved in scCO2 at 10 MPa and temperatures close to the critical point of CO2, the Raman peaks for H2O were too weak to measure with confidence even at the limit of D2O solubility

First-principles based plasma profile predictions for optimized stellarators

In the present Letter, first-of-its-kind computer simulations predicting plasma profiles for modern optimized stellarators -- while self-consistently retaining neoclassical transport, turbulent transport with 3D effects, and external physical sources -- are presented. These simulations exploit a newly developed coupling framework involving the global gyrokinetic turbulence code GENE-3D, the neoclassical transport code KNOSOS, and the 1D transport solver TANGO. This framework is used to analyze the recently observed degradation of energy confinement in electron-heated plasmas in the Wendelstein 7-X stellarator, where the central ion temperature was "clamped" to $T_i \approx 1.5$ keV regardless of the external heating power. By performing first-principles based simulations, the key mechanism leading to this effect is identified and guidelines for improving the plasma performance in future experimental campaigns are put forth. This work paves the way towards the use of high-fidelity models for the development of the next generation of stellarators, in which neoclassical and turbulent transport are optimized simultaneously