Hypomineralized Second Primary Molars as Predictor of Molar Incisor Hypomineralization

Molar incisor hypomineralization (MIH) is a developmental defect of dental enamel that shares features with hypomineralized second primary molars (HSPM). Prior to permanent tooth eruption, second primary molars could have predictive value for permanent molar and incisor hypomineralization. To assess this possible relationship, a cross-sectional study was conducted in a sample of 414 children aged 8 and 9 years from the INMA cohort in Valencia (Spain). A calibrated examiner (linear-weighted Kappa 0.83) performed the intraoral examinations at the University of Valencia between November 2013 and 2014, applying the diagnostic criteria for MIH and HSPM adopted by the European Academy of Paediatric Dentistry. 100 children (24.2%) presented MIH and 60 (14.5%) presented HSPM. Cooccurrence of the two defects was observed in 11.1% of the children examined. The positive predictive value was 76.7% (63.9-86.6) and the negative predictive value 84.7% (80.6-88.3). The positive likelihood ratio (S/1-E) was 10.3 (5.9-17.9) and the negative likelihood ratio (1-S/E) 0.57 (0.47-0.68). The odds ratio was 18.2 (9.39-35.48). It was concluded that while the presence of HSPM can be considered a predictor of MIH, indicating the need for monitoring and control, the absence of this defect in primary dentition does not rule out the appearance of MIH

An Umbrella-Shaped Topology for Broadband MEMS Piezoelectric Vibration Energy Harvesting

While cantilever topologies offer high power responsiveness for MEMS vibration energy harvesting (VEH), they are less robust than multiply clamped or membrane topologies. This paper attempts to address this topological optimisation dilemma by attempting to achieve both high power density and robustness. The proposed umbrella-shaped topology constituents of a single central anchor while the membrane area extends outwards and is further enclosed by a ring of proof mass. Implemented on a 0.5 μm AlN on 10 μm doped Si process, a fabricated device (121 mm2 die area) recorded a peak power of 173 μW (1798 Hz and 0.56 g). The normalised power density compares favourably against the state-of-the-art cantilever piezoelectric MEMS VEH, while not sacrificing robustness. Furthermore, this device offers a broadband response, and it has experimentally demonstrated over 3 times higher band-limited noise induced power density than a cantilevered harvester fabricated using the same process

The impact of performing gastric cancer surgery during holiday periods. A population-based study using Dutch upper gastrointestinal cancer audit (DUCA) data

Existing literature suggests inferior quality of oncologic surgery during holiday periods. This study aimed to investigate the impact of holiday periods on surgical treatment of gastric cancer in the Netherlands. This nationwide study included all gastric cancer patients undergoing potentially curative surgery registered in the Dutch Upper Gastrointestinal Cancer Audit (DUCA). For each patient it was established whether they underwent surgery during or outside the 11 Dutch holiday weeks, based on date and region of surgery. Separate, single-day holidays were not included. Baseline and treatment characteristics were compared using descriptive statistics. Time from diagnosis to treatment and short-term surgical outcomes were compared using multilevel multivariable logistic regression analyses. To prevent bias from recent advancements, analyses were repeated in a recent cohort of patients (2015-2018). Between 2011-2018, 3440 patients were included in the DUCA. Some 555 (16.1%) patients underwent surgery during 11 holiday weeks. There were no differences in patient, tumor and treatment characteristics and time to treatment between holidays and non-holidays. Tumor-positive resection margins (R1/R2 vs R0) occurred more frequent during holidays (aOR:1.47, 95%CI:1.07-2.04). Subgroup analyses in a recent cohort of patients also found higher tumor-positive resection margins (aOR:1.59, 95%CI:1.01-2.43) and higher failure-to-rescue rates (aOR:2.55, 95%CI:1.18-5.49) during holidays. Even though time to treatment and patient, tumor and treatment characteristics were comparable between holidays and non-holidays, tumor-positive resection margin and failure to-rescue rates were higher during holidays. This suggests that steps must be taken to keep specialized and dedicated gastric cancer expertise up to standard during holiday periods. (C)& nbsp;2022 The Author(s). Published by Elsevier Inc.& nbsp;& nbsp

Analysis of the Emails From the Dutch Web-Based Intervention “Alcohol de Baas”:Assessment of Early Indications of Drop-Out in an Online Alcohol Abuse Intervention

Nowadays, traditional forms of psychotherapy are increasingly complemented by online interactions between client and counselor. In (some) web-based psychotherapeutic interventions, meetings are exclusively online through asynchronous messages. As the active ingredients of therapy are included in the exchange of several emails, this verbal exchange contains a wealth of information about the psychotherapeutic change process. Unfortunately, drop-out-related issues are exacerbated online. We employed several machine learning models to find (early) signs of drop-out in the email data from the “Alcohol de Baas” intervention by Tactus. Our analyses indicate that the email texts contain information about drop-out, but as drop-out is a multidimensional construct, it remains a complex task to accurately predict who will drop out. Nevertheless, by taking this approach, we present insight into the possibilities of working with email data and present some preliminary findings (which stress the importance of a good working alliance between client and counselor, distinguish between formal and informal language, and highlight the importance of Tactus' internet forum)

The Galactose Index measured in fibroblasts of GALT deficient patients distinguishes variant patients detected by newborn screening from patients with classical phenotypes

Background: The high variability in clinical outcome of patients with Classical Galactosemia (CG) is poorly understood and underlines the importance of prognostic biomarkers, which are currently lacking. The aim of this study was to investigate if residual galactose metabolism capacity is associated with clinical and biochemical outcomes in CG patients with varying geno- and phenotypes. Methods: Galactose Metabolite Profiling (GMP) was used to determine residual galactose metabolism in fibroblasts of CG patients. The association between the galactose index (GI) defined as the ratio of the measured metabolites [U13C]Gal-1-P/ [13C6]UDP-galactose, and both intellectual and neurological outcome and galactose-1-phosphate (Gal-1-P) levels was investigated. Results: GMP was performed in fibroblasts of 28 patients and 3 control subjects. The GI of the classical phenotype patients (n = 22) was significantly higher than the GI of four variant patients detected by newborn screening (NBS) (p = .002), two homozygous p.Ser135Leu patients (p = .022) and three controls (p = .006). In the classical phenotype patients, 13/18 (72%) had a poor intellectual outcome (IQ < 85) and 6/12 (50%) had a movement disorder. All the NBS detected variant patients (n = 4) had a normal intellectual outcome (IQ ≥ 85) and none of them has a movement disorder. In the classical phenotype patients, there was no significant difference in GI between patients with a poor and normal clinical outcome. The NBS detected variant patients had significantly lower GI levels and thus higher residual galactose metabolism than patients with classical phenotypes. There was a clear correlation between Gal-1-P levels in erythrocytes and the GI (p = .001). Conclusions: The GI was able to distinguish CG patients with varying geno- and phenotypes and correlated with Gal-1-P. The data of the NBS detected variant patients demonstrated that a higher residual galactose metabolism may result in a more favourable clinical outcome. Further research is needed to enable individual prognostication and treatment in all CG patients

High frequency of inactivating tetraspanin CD37 mutations in diffuse large B-cell lymphoma at immune-privileged sites

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Electromechanical finite element modelling for dynamic analysis of a cantilevered piezoelectric energy harvester with tip mass offset under base excitations

A new electromechanical finite element modelling of a vibration power harvester and its validation with experimental studies are presented in this paper. The new contributions for modelling the electromechanical finite element piezoelectric unimorph beam with tip mass offset under base excitation encompass five major solution techniques. These include the electromechanical discretization, kinematic equations, coupled field equations, Lagrangian electromechanical dynamic equations, and orthonormalised global matrix and scalar forms of electromechanical finite element dynamic equations. Such techniques have not been rigorously modelled previously by other researchers. There are also benefits to presenting the numerical techniques proposed in this paper. First, the proposed numerical techniques can be used for Q1 applications in many different geometrical models, including MEMS power harvesting devices. Second, applying tip mass offset located after the end of the piezoelectric beam length can result in a very practical design, which avoids direct contact with piezoelectric material because of its brittle nature.Since the surfaces of actual piezoelectric material are covered evenly with thin conducting electrodes for generating single voltage, we introduce the new electromechanical discretization, consisting of the mechanical and electrical discretised elements. Moreover, the reduced electromechanical finite element dynamic equations can be further formulated to obtain the series form of new multimode electromechanical frequency response functions (FRFs) of the displacement, velocity, voltage, current, and power, including optimal power harvesting. The normalized numerical strain node and eigenmode shapes are also further formulated using numerical discretization. Finally, the parametric numerical case studies of the piezoelectric unimorph beam under a resistive shunt circuit show good agreement with the experimental studies

Bargaining Chips: Coordinating one-to-many concurrent composite negotiations

This study presents Bargaining Chips: a framework for one-to-many concurrent composite negotiations, where multiple deals can be reached and combined. Our framework is designed to mirror the salient aspects of real-life procurement and trading scenarios, in which a buyer seeks to acquire a number of items from different sellers at the same time. To do so, the buyer needs to successfully perform multiple concurrent bilateral negotiations as well as coordinate the composite outcome resulting from each interdependent negotiation. This paper contributes to the state of the art by: (1) presenting a model and test-bed for addressing such challenges; (2) by proposing a new, asynchronous interaction protocol for coordinating concurrent negotiation threads; and (3) by providing classes of multi-deal coordinators that are able to navigate this new one-to-many multi-deal setting. We show that Bargaining Chips can be used to evaluate general asynchronous negotiation and coordination strategies in a setting that generalizes over a number of existing negotiation approaches

Short-term postoperative outcomes after liver resection in the elderly patient:a nationwide population-based study

BACKGROUND: Liver resection is high-risk surgery in particular in elderly patients. The aim of this study was to explore postoperative outcomes after liver resection in elderly patients. METHODS: In this nationwide study, all patients who underwent liver resection for primary and secondary liver tumours in the Netherlands between 2014 and 2019 were included. Age groups were composed as younger than 70 (70-), between 70 and 80 (septuagenarians), and 80 years or older (octogenarians). Proportion of liver resections per age group and 30-day major morbidity and 30-day mortality were assessed. RESULTS: In total, 6587 patients were included of whom 4023 (58.9%) were younger than 70, 2135 (32.4%) were septuagenarians and 429 (6.5%) were octogenarians. The proportion of septuagenarians increased during the study period (aOR:1.06, CI:1.02-1.09, p < 0.001). Thirty-day major morbidity was higher in septuagenarians (11%) and octogenarians (12%) compared to younger patients (9%, p = 0.049). Thirty-day mortality was higher in septuagenarians (4%) and octogenarians (4%) compared to younger patients (2%, p < 0.001). Cardiopulmonary complications occurred more frequently with higher age, liver-specific complications did not. Higher age was associated with higher 30-day morbidity and 30-day mortality in multivariable logistic regression. CONCLUSION: Thirty-day major morbidity and 30-day mortality are higher after liver resection in elderly patients, attributed mainly to non-surgical cardiopulmonary complications