Accuracy of Cone Beam Computed Tomography for Periodontal Defect Measurements

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/142101/1/jper1261.pd

Adjuvant radiotherapy improves progression-free survival in intracranial atypical meningioma

BACKGROUND: Meningiomas are the most common primary tumors of the central nervous system. In patients with WHO grade I meningiomas no adjuvant therapy is recommended after resection. In case of anaplastic meningiomas (WHO grade III), adjuvant fractionated radiotherapy is generally recommended, regardless of the extent of surgical resection. For atypical meningiomas (WHO grade II) optimal postoperative management has not been clearly defined yet. METHODS: We conducted a retrospective analysis of patients treated for intracranial atypical meningioma at Charité Universitätsmedizin Berlin from March 1999 to October 2018. Considering the individual circumstances (risk of recurrence, anatomical location, etc.), patients were either advised to follow a wait-and-see approach or to undergo adjuvant radiotherapy. Primary endpoint was progression-free survival (PFS). RESULTS: This analysis included 99 patients with atypical meningioma (WHO grade II). Nineteen patients received adjuvant RT after primary tumor resection (intervention group). The remaining 80 patients did not receive any further adjuvant therapy after surgical resection (control group). Median follow-up was 37 months. Median PFS after primary resection was significantly longer in the intervention group than in the control group (64 m vs. 37 m, p = 0.009, HR = 0.204, 95% CI = 0.062-0.668). The influence of adjuvant RT was confirmed in multivariable analysis (p = 0.041, HR = 0.192, 95% CI = 0.039-0.932). CONCLUSIONS: Our study adds to the evidence that RT can improve PFS in patients with atypical meningioma

MRI-Based Risk Assessment for Incomplete Resection of Brain Metastases

Recent studies demonstrated that gross total resection of brain metastases cannot always be achieved. Subtotal resection (STR) can result in an early recurrence and might affect patient survival. We initiated a prospective observational study to establish a MRI-based risk assessment for incomplete resection of brain metastases.Peer Reviewe

Producción y comercialización de chocolates con diseños 3D

El presente proyecto desarrolla el análisis técnico, económico y financiero para la viabilidad en la implementación de una empresa de producción y comercialización de chocolates con diseños en 3D. En el capítulo I describimos la importancia del cacao peruano, el desarrollo de la tecnología 3D enfocando principalmente en la digitalización y la impresión y el análisis del mercado de chocolate peruano. En el capítulo II hacemos uso de las herramientas de investigación de mercado para validar nuestra hipótesis: “El chocolate es valorado por su diseño”. En el capítulo III analizamos el entorno y la industria. También establecemos los objetivos estratégicos de la empresa. En el capítulo IV desarrollamos el plan de marketing y elaboramos la proyección de ventas. En el capítulo V describimos la estructura organizacional y los recursos humanos necesarios para la puesta en marcha del proyecto. En el capítulo VI detallamos el proceso de producción: la digitalización de los modelos, la elaboración de los moldes y la producción del chocolate en su presentación final. Al final del capítulo, definimos cuales son los principales indicadores de control para la empresa utilizando el Balance Score Card. Finalmente, en el capítulo VII se presenta el plan económico financiero para el presente proyecto, requiriendo una inversión inicial de 188 mil soles, el cual se financiará 84% capital propio y el resto con deuda. Así mismo, se logra un retorno de la inversión a partir del año 4. Las proyecciones se realizan para 10 años, obteniendo un VAN de 529 mil soles y un TIR del 36.6%.This project develops the analysis of the technical, economic and financial viability in the implementation of a company for the production and marketing of chocolates with 3D designs. In chapter I we describe the importance of Peruvian cocoa; the development of 3D technology focusing mainly on digitization and printing; and the analysis of the Peruvian chocolate market. In chapter II we use market tools to validate our hypothesis: "Chocolate is valued for its design". In chapter III we analyze the macro environment and the analysis of the industry. Finally we develop the strategic objectives of the company. In chapter IV we develop the marketing plan and then we calculate the sales projection. In chapter V we describe the organizational structure and human resources necessary for the start-up of this project. In chapter VI we detail the production process, from the digitization of the models, the elaboration of the molds and the production of the chocolate in its final presentation. Lastly, we define which the main control indicators are, for the company using the Balance Score Card. Finally, in chapter 7 the financial economic plan for this project is presented, requiring an initial investment of 188 thousand soles, which is financed 84% with equity capital and the rest with debt. Likewise, a return on investment is achieved as of year 4. The projections are made for 10 years, obtaining a NPV of 529 thousand soles and a TIR of 36.6%

Catching Element Formation In The Act

Gamma-ray astronomy explores the most energetic photons in nature to address some of the most pressing puzzles in contemporary astrophysics. It encompasses a wide range of objects and phenomena: stars, supernovae, novae, neutron stars, stellar-mass black holes, nucleosynthesis, the interstellar medium, cosmic rays and relativistic-particle acceleration, and the evolution of galaxies. MeV gamma-rays provide a unique probe of nuclear processes in astronomy, directly measuring radioactive decay, nuclear de-excitation, and positron annihilation. The substantial information carried by gamma-ray photons allows us to see deeper into these objects, the bulk of the power is often emitted at gamma-ray energies, and radioactivity provides a natural physical clock that adds unique information. New science will be driven by time-domain population studies at gamma-ray energies. This science is enabled by next-generation gamma-ray instruments with one to two orders of magnitude better sensitivity, larger sky coverage, and faster cadence than all previous gamma-ray instruments. This transformative capability permits: (a) the accurate identification of the gamma-ray emitting objects and correlations with observations taken at other wavelengths and with other messengers; (b) construction of new gamma-ray maps of the Milky Way and other nearby galaxies where extended regions are distinguished from point sources; and (c) considerable serendipitous science of scarce events -- nearby neutron star mergers, for example. Advances in technology push the performance of new gamma-ray instruments to address a wide set of astrophysical questions.Comment: 14 pages including 3 figure

Design and validation of the Health Professionals' Attitudes Toward the Homeless Inventory (HPATHI)

BACKGROUND: Recent literature has called for humanistic care of patients and for medical schools to begin incorporating humanism into medical education. To assess the attitudes of health-care professionals toward homeless patients and to demonstrate how those attitudes might impact optimal care, we developed and validated a new survey instrument, the Health Professional Attitudes Toward the Homeless Inventory (HPATHI). An instrument that measures providers' attitudes toward the homeless could offer meaningful information for the design and implementation of educational activities that foster more compassionate homeless health care. Our intention was to describe the process of designing and validating the new instrument and to discuss the usefulness of the instrument for assessing the impact of educational experiences that involve working directly with the homeless on the attitudes, interest, and confidence of medical students and other health-care professionals. METHODS: The study consisted of three phases: identifying items for the instrument; pilot testing the initial instrument with a group of 72 third-year medical students; and modifying and administering the instrument in its revised form to 160 health-care professionals and third-year medical students. The instrument was analyzed for reliability and validity throughout the process. RESULTS: A 19-item version of the HPATHI had good internal consistency with a Cronbach's alpha of 0.88 and a test-retest reliability coefficient of 0.69. The HPATHI showed good concurrent validity, and respondents with more than one year of experience with homeless patients scored significantly higher than did those with less experience. Factor analysis yielded three subscales: Personal Advocacy, Social Advocacy, and Cynicism. CONCLUSIONS: The HPATHI demonstrated strong reliability for the total scale and satisfactory test-retest reliability. Extreme group comparisons suggested that experience with the homeless rather than medical training itself could affect health-care professionals' attitudes toward the homeless. This could have implications for the evaluation of medical school curricula

The state of the Martian climate

60°N was +2.0°C, relative to the 1981–2010 average value (Fig. 5.1). This marks a new high for the record. The average annual surface air temperature (SAT) anomaly for 2016 for land stations north of starting in 1900, and is a significant increase over the previous highest value of +1.2°C, which was observed in 2007, 2011, and 2015. Average global annual temperatures also showed record values in 2015 and 2016. Currently, the Arctic is warming at more than twice the rate of lower latitudes

Identification and support of autistic individuals within the UK Criminal Justice System: a practical approach based upon professional consensus with input from lived experience

Background: Autism spectrum disorder (hereafter referred to as autism) is characterised by difficulties with (i) social communication, social interaction, and (ii) restricted and repetitive interests and behaviours. Estimates of autism prevalence within the criminal justice system (CJS) vary considerably, but there is evidence to suggest that the condition can be missed or misidentified within this population. Autism has implications for an individual’s journey through the CJS, from police questioning and engagement in court proceedings through to risk assessment, formulation, therapeutic approaches, engagement with support services, and long-term social and legal outcomes. Methods: This consensus based on professional opinion with input from lived experience aims to provide general principles for consideration by United Kingdom (UK) CJS personnel when working with autistic individuals, focusing on autistic offenders and those suspected of offences. Principles may be transferable to countries beyond the UK. Multidisciplinary professionals and two service users were approached for their input to address the effective identification and support strategies for autistic individuals within the CJS. Results: The authors provide a consensus statement including recommendations on the general principles of effective identification, and support strategies for autistic individuals across different levels of the CJS. Conclusion: Greater attention needs to be given to this population as they navigate the CJS.Acknowledgements: We are grateful to the assistance of SW and MK, two service users who reviewed and contributed to the manuscript