The Randomized Shortened Dental Arch Study: Tooth Loss

The evidence concerning the management of shortened dental arch (SDA) cases is sparse. This multi-center study was aimed at generating data on outcomes and survival rates for two common treatments, removable dental prostheses (RDP) for molar replacement or no replacement (SDA). The hypothesis was that the treatments lead to different incidences of tooth loss. We included 215 patients with complete molar loss in one jaw. Molars were either replaced by RDP or not replaced, according to the SDA concept. First tooth loss after treatment was the primary outcome measure. This event occurred in 13 patients in the RDP group and nine patients in the SDA group. The respective Kaplan-Meier survival rates at 38 months were 0.83 (95% CI: 0.74-0.91) in the RDP group and 0.86 (95% CI: 0.78-0.95) in the SDA group, the difference being non-significant

Sleep stage classification using spectral analyses and support vector machine algorithm on C3- and C4-EEG signals [Abstract]

Introduction Sleep stage classification currently relies largely on visual classification methods. We tested a new pipeline for automated offline classification based upon power spectrum at six different frequency bands. The pipeline allowed sleep stage classification and provided whole-night visualization of sleep stages. Materials and methods 102 subjects (69 male; 53.74 ± 12.4 years) underwent full-night polysomnography. The recording system included C3- and C4-EEG channels. All signals were measured at sampling rate of 200 Hz. Four epochs (30 seconds each) of each sleep stage (N1, N2, N3, REM, awake) were marked in the visually scored recordings of each one of the 102 patients. Scoring of sleep stages was performed according to AASM 2007-criteria. In total 408 epochs for each sleep stage were included in the sleep stage classification analyses. Recordings of all these epochs were fed into the pipeline to estimate the power spectrum at six different frequency bands, namely from very low frequency (VLF, 0.1-1 Hz) to gamma frequency (30-50 Hz). The power spectrum was measured with a method called multitaper method. In this method the spectrum is estimated by multiplying the data with K windows (i.e tapers).The estimated parameters were given as input to the support vector machine (SVM) algorithm to classify the five different sleep stages based on the mean power amplitude estimated from six different frequency bands. The SVM algorithm was trained with 51 subjects and the testing was done with the other 51 subjects. In order to avoid bias of the training dataset, a 10-fold cross validation was additionally done to check the performance of the SVM algorithm Results The estimated testing accuracy of prediction of the sleep stages was 84.1% for stage N1 using the mean power amplitude from the delta frequency band. Accuracy was 67.8% for stage N2 from the delta frequency band and 74.9% for stage N3 from the VLF. Accuracy was 79.7% for REM stage from the delta frequency band and 84,8% for the wake stage from the theta frequency band. Conclusions We were able to successfully classify the sleep stages using the mean power amplitude at six different frequency bands separately and achieved up to 85% accuracy using the electrophysiological EEG signals. The delta and theta frequency bands gave the best accuracy of classification among all sleep stages

EEG-EMG-coherence in SDB patients with utilization of a support vector machine-algorithm [Poster Abstract]

Background We investigated whether the EEG-EMG-coherence allows a differentiation between patients with sleep-disordered breathing (SDB) without OSA and SDB-patients with mild, moderate or severe OSA. Methods Polysomnographic recordings of 102 patients with SDB (33 female; age: 53,± 12,4 years) were analyzed with the multitaper coherence method (MTM). Recordings contained 2 EEG-channels (C3 and C4) and a chin EMG-channel for one night. Four epochs (each 30 seconds, classified manually by AASM 2007 criteria) of each sleep stage were marked (1632 epochs in total), which were included in the classification analysis. The collected data sets were supplied to the support vector machine (SVM) algorithm to classify OSA severity. Twenty patients had a mild (RDI ≥10/h and < 15/h), 30 patients had a moderate (RDI ≥15/h and < 30/h) and 27 patients had a severe OSA (RDI ≥30/h). 25 patients had a RDI < 10/h. The AUC (area under the curve) value was calculated for each receiver operator curve (ROC) curve. Results EEG-EMG coherence was able to distinguish between the SDB-patients without OSA and SDB-patients with OSA in each of the 3 severity groups using an SVM algorithm. In mild OSA, the AUC was 0.616 (p = 0.024), in moderate OSA the AUC was 0.659 (p = 0.003), and in severe OSA the AUC was 0.823 (p < 0.001). Conclusions SDB patients with OSA can be differentiated from SDB patients without OSA on the basis of EEG-EMG coherence by using the Multitaper Coherence Method (MTM) and SVM algorithm

Longitudinal grey and white matter changes in frontotemporal dementia and Alzheimer's disease

Behavioural variant frontotemporal dementia (bvFTD) and Alzheimer's disease (AD) dementia are characterised by progressive brain atrophy. Longitudinal MRI volumetry may help to characterise ongoing structural degeneration and support the differential diagnosis of dementia subtypes. Automated, observer-independent atlas-based MRI volumetry was applied to analyse 102 MRI data sets from 15 bvFTD, 14 AD, and 10 healthy elderly control participants with consecutive scans over at least 12 months. Anatomically defined targets were chosen a priori as brain structures of interest. Groups were compared regarding volumes at clinic presentation and annual change rates. Baseline volumes, especially of grey matter compartments, were significantly reduced in bvFTD and AD patients. Grey matter volumes of the caudate and the gyrus rectus were significantly smaller in bvFTD than AD. The bvFTD group could be separated from AD on the basis of caudate volume with high accuracy (79% cases correct). Annual volume decline was markedly larger in bvFTD and AD than controls, predominantly in white matter of temporal structures. Decline in grey matter volume of the lateral orbitofrontal gyrus separated bvFTD from AD and controls. Automated longitudinal MRI volumetry discriminates bvFTD from AD. In particular, greater reduction of orbitofrontal grey matter and temporal white matter structures after 12 months is indicative of bvFTD

"Drop in" gastroscopy outpatient clinic - experience after 9 months

<p>Abstract</p> <p>Background</p> <p>Logistics handling referrals for gastroscopy may be more time consuming than the examination itself. For the patient, "drop in" gastroscopy may reduce uncertainty, inadequate therapy and time off work.</p> <p>Methods</p> <p>After an 8-9 month run-in period we asked patients, hospital staff and GPs to fill in a questionnaire to evaluate their experience with "drop in" gastroscopy and gastroscopy by appointment, respectively. The diagnostic gain was evaluated.</p> <p>Results</p> <p>112 patients had "drop in" gastroscopy and 101 gastroscopy by appointment. The number of "drop in" patients varied between 3 and 12 per day (mean 6.5). Mean time from first GP consultation to gastroscopy was 3.6 weeks in the "drop in" group and 14 weeks in the appointment group. The half-yearly number of outpatient gastroscopies increased from 696 before introducing "drop in" to 1022 after (47% increase) and the proportion of examinations with pathological findings increased from 42% to 58%. Patients and GPs expressed great satisfaction with "drop in". Hospital staff also acclaimed although it caused more unpredictable working days with no additional staff.</p> <p>Conclusions</p> <p>"Drop in" gastroscopy was introduced without increase in staff. The observed increase in gastroscopies was paralleled by a similar increase in pathological findings without any apparent disadvantages for other groups of patients. This should legitimise "drop in" outpatient gastroscopies, but it requires meticulous observation of possible unwanted effects when implemented.</p

Incidence and risk factors for community-acquired acute gastroenteritis in north-west Germany in 2004

In developed countries, acute gastroenteritis (AGE) is a major source of morbidity. However, only a few studies have estimated its incidence and the associated medical burden. This population-based study determined the incidence of community-acquired AGE patients seeking medical care and the relative role of various pathogens. Stool samples from patients with AGE presenting to a general practitioner (GP), pediatrician, or specialist in internal medicine for that reason were screened for various bacterial and viral enteropathogens. A control group was established as well. Incidences were calculated by the number of positive patients divided by the general population. The study was performed in north-west Germany in 2004. The incidence of AGE patients requiring medical consultation was 4,020/100,000 inhabitants. Children (<5 years of age) were at the highest risk (13,810/100,000 inhabitants). Of the patients, 6.6% were tested positive for an enteropathogenic bacteria and 17.7% for a viral agent. The predominant pathogens were norovirus (626/100,000) and rotavirus (270/100,000). Salmonella was the most frequently detected bacteria (162/100,000). The results presented confirm AGE and, specifically, AGE of viral origin as a major public health burden in developed countries

Synthesis of Alkaline Earth Diazenides MAEN2 (MAE = Ca, Sr, Ba) by Controlled Thermal Decomposition of Azides under High Pressure

The alkaline earth diazenides MAEN2 with MAE = Ca, Sr and Ba were synthesized by a novel synthetic approach, namely, a controlled decomposition of the corresponding azides in a multianvil press at highpressure/ high-temperature conditions. The crystal structure of hitherto unknown calcium diazenide (space group I4/mmm (no. 139), a = 3.5747(6) Å, c = 5.9844(9) Å, Z = 2, wRp = 0.078) was solved and refined on the basis of powder X-ray diffraction data as well as that of SrN2 and BaN2. Accordingly, CaN2 is isotypic with SrN2 (space group I4/mmm (no. 139), a = 3.8054(2) Å, c = 6.8961(4) Å, Z = 2, wRp = 0.057) and the corresponding alkaline earth acetylenides (MAEC2) crystallizing in a tetragonally distorted NaCl structure type. In accordance with literature data, BaN2 adopts a more distorted structure in space group C2/c (no. 15) with a = 7.1608(4) Å, b = 4.3776(3) Å, c = 7.2188(4) Å, β = 104.9679(33)°, Z = 4 and wRp = 0.049). The N−N bond lengths of 1.202(4) Å in CaN2 (SrN2 1.239(4) Å, BaN2 1.23(2) Å) correspond well with a double-bonded dinitrogen unit confirming a diazenide ion [N2]2−. Temperature-dependent in situ powder X-ray diffractometry of the three alkaline earth diazenides resulted in formation of the corresponding subnitrides MAE2N (MAE = Ca, Sr, Ba) at higher temperatures. FTIR spectroscopy revealed a band at about 1380 cm−1 assigned to the N−N stretching vibration of the diazenide unit. Electronic structure calculations support the metallic character of alkaline earth diazenides