Treatment and posttreatment effects of a facial mask combined with a bite-block appliance in Class III malocclusion.

Abstract INTRODUCTION: In this cephalometric investigation, we analyzed the treatment and posttreatment effects of an orthopedic protocol for Class III malocclusion consisting of a facial mask combined with a removable bite-block appliance. METHODS: The treated sample consisted of 22 Class III patients treated with the facial mask and bite-block protocol before the pubertal growth spurt (mean age, 8.9 +/- 1.5 years). Treated subjects were evaluated after facial mask and bite-block therapy and at a posttreatment observation in absence of retention. The treated group was compared with a matched control group of 12 untreated Class III subjects. All treated and control subjects were postpubertal at the final observation. Significant differences between the treated and control groups were assessed with the Mann-Whitney U test (P <0.05). RESULTS: Both angular and linear sagittal measurements of the maxilla showed significant improvements during active treatment. Significant improvements of SNA angle, ANB angle, overjet, and molar relationship remained stable during the posttreatment period. No significant effect was found in the mandibular skeletal measures. No significant protraction of the maxillary incisors or retraction of the mandibular incisors was observed. CONCLUSIONS: A bite-block appliance in the mandibular arch with a facial mask enabled effective control of mandibular rotation with progressive closure of the gonial angle. This added to the favorable maxillary outcomes of the treatment protocol. 2010 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved

Tachyonic media in analogue models of special relativity

In sonic models of special relativity, the fact that the sonic medium violates (ordinary) Lorentz symmetry is apparent to observers external to the sonic medium but not to a class of observers existing within the medium itself. We show that the situation is symmetric: internal observers will judge physics in the external laboratory to violate their own sonic Lorentz symmetries. We therefore treat all observers on an equal footing such that each is able to retain a commitment to their own Lorentz symmetries. We then generalize beyond the case of subsystem-environment decompositions to situations in which there exist multiple phonon fields, all obeying Lorentz symmetries but with different invariant speeds. In such cases, we argue that all observers have freedom to choose which field is symmetry preserving, and so -- in a certain precise sense -- which other fields are perceived as having an 'ether.' This choice is influenced -- but not determined -- by a desire for simplicity in the description of physical laws. Sending information faster than sound serves as a model of tachyonic signalling to a distant receiver. Immutable causality of the laboratory setup when perceived externally to a sonic medium manifests internally through the confinement of the tachyons to an apparent ether (with a rest frame), which we call a 'tachyonic medium,' thereby preventing tachyonic exchange from emulating the scenario of a round-trip signal travelling into an observer's past causal cone. The assignment of sonic-Lorentz-violating effects to fields that obey 'photonic' Lorentz symmetries thus ensures that causality associated with the 'sonic' Lorentz symmetries is preserved.Comment: (v2) minor changes after peer review; (v1) 13 pages, 4 figure

Accelerated expansion from ghost-free bigravity: a statistical analysis with improved generality

We study the background cosmology of the ghost-free, bimetric theory of gravity. We perform an extensive statistical analysis of the model using both frequentist and Bayesian frameworks and employ the constraints on the expansion history of the Universe from the observations of supernovae, the cosmic microwave background and the large scale structure to estimate the model's parameters and test the goodness of the fits. We explore the parameter space of the model with nested sampling to find the best-fit chi-square, obtain the Bayesian evidence, and compute the marginalized posteriors and mean likelihoods. We mainly focus on a class of sub-models with no explicit cosmological constant (or vacuum energy) term to assess the ability of the theory to dynamically cause a late-time accelerated expansion. The model behaves as standard gravity without a cosmological constant at early times, with an emergent extra contribution to the energy density that converges to a cosmological constant in the far future. The model can in most cases yield very good fits and is in perfect agreement with the data. This is because many points in the parameter space of the model exist that give rise to time-evolution equations that are effectively very similar to those of the $\Lambda$CDM. This similarity makes the model compatible with observations as in the $\Lambda$CDM case, at least at the background level. Even though our results indicate a slightly better fit for the $\Lambda$CDM concordance model in terms of the $p$-value and evidence, none of the models is statistically preferred to the other. However, the parameters of the bigravity model are in general degenerate. A similar but perturbative analysis of the model as well as more data will be required to break the degeneracies and constrain the parameters, in case the model will still be viable compared to the $\Lambda$CDM.Comment: 42 pages, 9 figures; typos corrected in equations (2.12), (2.13), (3.7), (3.8) and (3.9); more discussions added (footnotes 5, 8, 10 and 13) and abstract, sections 4.2, 4.3 and 5 (conclusions) modified in response to referee's comments; references added; acknowledgements modified; all results completely unchanged; matches version accepted for publication in JHE

Cosmological perturbations in Massive Gravity and the Higuchi bound

In de Sitter spacetime there exists an absolute minimum for the mass of a spin-2 field set by the Higuchi bound m^2 \geq 2H^2. We generalize this bound to arbitrary spatially flat FRW geometries in the context of the recently proposed ghost-free models of Massive Gravity with an FRW reference metric, by performing a Hamiltonian analysis for cosmological perturbations. We find that the bound generically indicates that spatially flat FRW solutions in FRW massive gravity, which exhibit a Vainshtein mechanism in the background as required by consistency with observations, imply that the helicity zero mode is a ghost. In contradistinction to previous works, the tension between the Higuchi bound and the Vainshtein mechanism is equally strong regardless of the equation of state for matter.Comment: 24 pages, typos and conventions correcte

¿Es la Argentina el país donde se cumple el trilema monetario?

Abstract The monetary trilemma states that it is impossible for a monetary authority to simultaneously have a fixed foreign exchange rate within a context of capital mobility and an independent monetary policy which targets internal objectives. The purpose of this paper is to validate said theory through a model which considers the capital and financial account as a function of the of currency exchange rate, the domestic and international interest rate and the inflation rate. The results show that even if the three objectives are desirable, it is impossible to to meet them simultaneously, in addittion to stating how the Central Bank can overcome this trilemma

Time to Treatment Intensification in Patients Receiving DPP4 Inhibitors Versus Sulfonylureas as the First Add-On to Metformin Monotherapy: A Retrospective Cohort Study

Background: To verify whether, in patients on metformin (MET) monotherapy for type 2 diabetes (T2D), the add-on of a dipeptidyl peptidase inhibitor (DPP4i) compared to a sulfonylurea (SU) can delay the time to the subsequent treatment intensification (TI). Methods: Population-based administrative data banks from four Italian geographic areas were used. Patients aged ≥18&nbsp;years on MET monotherapy receiving first DPP4i or SU dispensing between 2008 and 2015 (cohort entry) were followed up to the occurrence of TI (insulin dispensing or add-on of a third non-insulin hypoglicemic &gt;180&nbsp;days after cohort entry), treatment discontinuation, switch, cancer, death, TI occurrence within, end of data availability, end of study period (31 December 2016), whichever came first. Patients on MET + DPP4i were matched 1:1 with those on MET + SU by sex, age, year of cohort entry, and data bank. Hazard Ratio (HR) and 95% confidence intervals (95%CI) were estimated using multivariable Cox regression model including matching variables and potential confounders measured at baseline. Different sensitivity analyses were performed: i) matching at 180&nbsp;days after cohort entry, ii) intent to treat (ITT) analysis, iii) matching by duration of MET monotherapy, iv) matching by propensity score. Results: The matched study cohort included 10,600 patients. Overall, 763 TI were observed (4.5/100 person-years; mean follow-up = 1.6&nbsp;years). The primary analysis showed no difference in time to TI between the two groups (HR = 1.02; 95% CI = 0.88–1.19). Sensitivity analyses confirmed this result, except from the ITT analysis (HR = 1.27; 1.13–1.43). Conclusion: The use of a DPP4i rather than a SU as add-on to MET monotherapy was not associated with a delay in treatment intensification

Patterns and trends of utilization of incretin-based medicines between 2008 and 2014 in three Italian geographic areas

Background: The incretin-based medicines GLP1 analogues (GLP1a) and dipeptidyl peptidase-4 inhibitors (DPP4i) are hypoglycaemic agents licensed for the treatment of type 2 diabetes mellitus (T2DM). Although these drugs possess comparable efficacy and low risk of hypoglycaemia, differences in terms of route of administration (subcutaneous versus oral), effect on body weight and gastrointestinal tolerabily can impact their actual use in clinical practice. This study aimed to describe the real-world utilization of incretin-based medicines in the Italian clinical practice. Methods: A multi-database, population-based, descriptive, cohort study was performed using administrative data collected between 2008 and 2014 from three Italian geographic areas. Subjects aged 6518 were selected. New users were defined as those with 651 dispensing of GLP1a or DPP4i during the year of interest and none in the past. Trends of cumulative annual incidence of use in the general adult population were observed. New users of GLP1a or DPP4i were respectively described in terms of demographic characteristics and use of antidiabetic drugs during 1 year before and after the first incretin dispensing. Results: The overall study population included 4,943,952 subjects. A total of 7357 new users of GLP1a and 41,907 of DPP4i were identified during the study period. Incidence of use increased between 2008 (0.2\u2030 for both GLP1a and DPP4i) and 2011 (GLP1a = 0.6\u2030; DPP4i = 2.5\u2030) and slightly decreased thereafter. In 2014, 61% of new GLP1a users received once-daily liraglutide while 52% of new DPP4i users received metformin/DPP4i in fixed-dose. The percentage of new DPP4i users older than 65 years of age increased from 30.9 to 62.6% during the study period. Around 12% of new users had not received any antidiabetic before starting an incretin. Conclusions: During the study period, DPP4i rapidly became the most prescribed incretin-based medicine, particularly among older new user. The choice of the specific incretin-based medicine at first prescription appeared to be directed towards those with higher convenience of use (e.g. oral DPP4i rather than subcutaneous GLP1a, once-daily liraglutide rather than twice-daily exenatide). The non-negligibile use of incretin-based medicines as first-line pharmacotherapy for T2DM warrants further effectiveness and safety evaluations to better define their place in therapy