Equivalent dose in quartz from young samples using the SAR protocol and the effect of preheat temperature

Abstract Major concerns in the dating of samples younger than a few hundred years by the optically stimulated luminescence (OSL) technique are thermal transfer and partial bleaching. Thermal transfer during preheating enhances the OSL signal due to the charge transfer from thermally sensitive, but light-insensitive, traps to optical centres of quartz and results in an overestimate in equivalent dose, especially for very young samples. In this study, the single-aliquot regenerative-dose protocol is used to obtain values of equivalent dose (D e ) from young samples taken from various environments around Istanbul. Within this framework, we aim to investigate the effect of preheat temperature on equivalent dose from 150 to 300 • C, the reproducibility of D e measurements for young deposits and the contribution from thermal transfer of charge to the equivalent dose estimation. It was observed that the measured dose is influenced significantly by preheat temperature and the increase in the D e is clearly due to thermal transfer of charge from deep thermally sensitive traps to OSL trap during preheating of the samples prior to the main OSL measurements

Effects of Ethylene oxide resterilisation and In- Vitro degradation on mechanical properties of partially absorbable composite hernia meshes

Background: Prosthetic mesh repair for abdominal wall hernias is widely used because of its technical simplicity and low hernia recurrence rates. The most commonly used material is pure polypropylene mesh, however newer  composite materials are recommended by some centers because of their advantages. However, these meshes are more expensive than pure polypropylene meshes. Resterilisation of a pure polypropylene mesh has been  shown to be quite safe, and many centers prefer slicing a large mesh into smaller pieces that suitable for hernia type or defect size. Nevertheless there is no data about the safety after resterilisation of the composite meshes.Objective: To search the effects of resterilisation and In vitro degradation in phosphate buffered saline solution on the physical structure and the mechanical properties of partially absorbable lightweigth meshes.Design: Laboratory-based research.Subjects: Two composite meshes were used in the study: One mesh is consisted of monofilament polypropylene and monofilament polyglecaprone -a copolymer of glycolide and epsilon (ε)-caprolactone- (Ultrapro®, 28 g/m2, Ethicon, Hamburg, Germany), and the other one consisted of multifilament polypropylene and multifilament polyglactine (Vypro II®, 30 g/m2, Ethicon, Hamburg, Germany). Two large meshes were cut into rectangular specimens sized 50x20 mm for mechanical testing and 20x20 mm for In vitro degradation experiments. Meshes were divided into control group with no resterilisation and gas resterilisation. Ethylene oxide gas sterilisation was performed at 55°C for 4.5 hours. In vitro degradation in 0.01 M phosphate buffered saline (PBS, pH 7.4) solution at 37 ± 1°C for 8  weeks was applied to one subgroup in each mesh group. Tensiometric measurements and scanning electron microscopyic evaluations were completed for control and resterilisation specimens.Results: Regardless of resterilisation, when meshes were exposed to In vitro degradation, all mechanical parameters decreased significantly. Highest reduction in mechanical properties was observed for Ultrapro due to the degradation of absorbable polyglecaprone and polyglactin parts of these meshes. It was observed that resterilisation by ethylene oxide did not have significant difference on the degradation characteristics and almost similar physical structures  were observed for resterilised and non-resterilised meshes. For Vypro II meshes, no significant mechanical  difference was observed between resterilised and non-resterilised meshes after degradation while resterilised Ultrapro meshes exhibited stronger characteristics than non-resterilised counterparts, after degradation

Effects of Ethylene Oxide Resterilization and In-vitro Degradation on Mechanical Properties of Partially Absorbable Composite Hernia Meshes*

Rezumat Efectele resterilizãrii cu oxid de etilen aei degradãrii in-vitro asupra proprietãåilor mecanice ale plaselor chirurgicale din material mixt paråial absorbabile Principiul aei scopul lucrãrii: Protezarea cu plase chirurgicale a herniilor de perete abdominal este o tehnicã extensiv utilizatã datoritã simplitãåii sale aei ratelor scãzute de recurenåã aferente. Cele mai utilizate materiale sunt plasele din polipropilenã, însã noi materiale mixte sunt recomandate de unele centre datoritã avantajelor pe care le prezintã. Aceste plase sunt, însã, mai costisitoare decât cele realizate exclusiv din polipropilenã. Resterilizarea unei plase de polipropilenã purã s-a dovedit a fi o procedurã destul de sigurã, iar multe centre preferã sã taie o plasã de dimensiuni mari în mai multe plase mai mici, ce pot fi folosite pentru orice tip de hernie sau orice dimensiune a defectului. Cu toate acestea, nu existã date privind gradul de siguranåã al resterilizãrii plaselor din material mixt. Studiul curent a fost desfãaeurat în vederea evaluãrii efectelor resterilizãrii aei degradãrii in-vitro cu fosfat tamponat cu soluåie salinã asupra structurii fizice aei a proprietãåilor mecanice ale plaselor chirurgicale uaeoare paråial absorbabile. Materiale aei metode: Douã tipuri de plase din material mixt au fost utilizate în acest studiu: o plasã alcãtuitã din monofilamente de polipropilenã aei monofilamente de poliglecapronã -un copolimer din glicolid aei epsilon (ε)-caprolactonã (Ultrapro®, 28 g/m 2 , Ethicon, Hamburg, Germania), iar cealaltã din multifilamente de polipropilenã aei multifilamente de poliglactinã (Vypro II®, 30 g/m 2 , Ethicon, Hamburg, Germania). Douã plase de dimensiuni mari au fost tãiate în probe rectangulare de 50x20 mm pentru testarea mecanicã aei de 20x20 mm pentru experimentele de degradare in-vitro. Plasele au fost distribuite în grupuri de control, fãrã sterilizare, aei de resterilizare cu gaz. Sterilizarea gazoasã cu oxid de etilen a fost efectiatã la 55°C timp de 4,5 ore. Câte un subgrup din fiecare grup de plase a fost supus degradãrii in-vitro cu 0,01 M fosfat tamponat cu soluåie salinã (PBS, pH 7,4) la 37 ± 1°C timp de 8 sãptãmâni. Mãsurãtorile tensiometrice aei de microscopie electronicã au fost efectuate pentru probele de control aei cele resterilizate. Rezultate: Indiferent de resterilizare, la expunerea plaselor la degradarea in-vitro, toåi parametrii mecanici au scãzut semnificativ. Cea mai mare scãdere în termeni de proprietãåi mecanice a fost observatã la plasele Ultrapro, din cauza degradãrii componentelor de poliglecapronã aei poliglactinã absorbabile ale acestor plase. S-a observat cã resterilizarea cu oxid de etilen nu a determinat diferenåe semnificative în ce Cuvinte cheie: plasã chirurgicalã, hernie, plasã din material mixt, resterilizare, degradare, proprietãåi mecanice, tensiometrie, rezistenåã la tracåiune, polipropilenã, poliglecapronã, poliglactinã Abstract Background and Aim: Prosthetic mesh repair for abdominal wall hernias is widely used because of its technical simplicity and low hernia recurrence rates. The most commonly used material is pure polypropylene mesh, although newer composite materials are recommended by some centers due to their advantages. However, these meshes are more expensive than pure polypropylene meshes. Resterilization of a pure polypropylene mesh has been shown to be quite safe, and many centers prefer slicing a large mesh into smaller pieces, suitable for any hernia type or defect size. Nevertheless there is no data about the safety after resterilization of the composite meshes. The present study was carried out to investigate the effects of resterilization and in vitro degradation in phosphate buffered saline solution on the physical structure and the mechanical properties of partially absorbable lightweight meshes. Methods: Two composite meshes were used in the study: One mesh consists of monofilament polypropylene and monofilament polyglecaprone -a copolymer of glycolide and epsilon (ε) -caprolactone -(Ultrapro®, 28 g/m 2 , Ethicon, Hamburg, Germany), and the other one consisted of multifilament polypropylene and multifilament polyglactine (Vypro II®, 30 g/m 2 , Ethicon, Hamburg, Germany). Two large meshes were cut into rectangular specimens sized 50 x 20 mm for mechanical testing and 20 x 20 mm for in vitro degradation experiments. Meshes were divided into control group with no resterilization and gas resterilization. Ethylene oxide gas sterilization was performed at 55°C for 4.5 hours. In vitro degradation in 0.01 M phosphate buffered saline (PBS, pH 7.4) solution at 37 ± 1°C for 8 weeks was applied to one subgroup in each mesh group. Tensiometric measurements and scanning electron microscopic evaluations were completed for control and resterilization specimens. Results: Regardless of resterilization, when the meshes were exposed to in vitro degradation, all mechanical parameters decreased significantly. Highest reduction in mechanical properties was observed for Ultrapro due to the degradation of absorbable polyglecaprone and polyglactin parts of these meshes. It was observed that resterilization by ethylene oxide did not determine significant difference on the degradation characteristics and almost similar physical structures were observed for resterilized and non-resterilized meshes. For Vypro II meshes, no significant mechanical difference was observed between resterilized and non-resterilized meshes after degradation while resterilized Ultrapro meshes exhibited stronger characteristics than non-resterilized counterparts, after degradation. Conclusion: Resterilization with ethylene oxide did not affect the mechanical properties of partially absorbable composite meshes. No important surface changes were observed in scanning electron microscopy after resterilization

Perception of improvement after orthognathic surgery: the important variables affecting patient satisfaction

PURPOSE: We evaluated which factors affect patient satisfaction and if patient expectations were fulfilled after orthognathic surgery. METHODS: Questionnaires consisting of 14 questions were given 1 year after bimaxillary osteotomy for class-III correction to subjects. Six questions were answered using an 11-point rating scale based on a visual analog scale (VAS; 0 = poor; 10 = excellent). Also included were seven closed-form questions with yes/no answers, as well as one open question for 'further remarks'. Sagittal and vertical cephalometric parameters were determined on postoperative cephalograms. RESULTS: Seventy-seven patients (37 females, 40 males; mean age, 23.4 +/- 4.9 (SD) years) responded. The intention to undergo surgery only for aesthetic improvement was noted in 11.9% of patients; only improvement of chewing function in 15.5%; both in 71.4%; and none/don't know in 2.6%. Postoperative satisfaction was rated (in means) with 8.13 +/- 1.97 on VAS and correlated significantly with the opinions of friends and relatives. Facial aesthetics was rated 5.6 +/- 1.2 before surgery and 8.1 +/- 1.5 after surgery (p = 0.04). Preoperative chewing function was rated 5.65 +/- 1.8 and 8.03 +/- 1.51 after surgery (p = 0.014). TMJ disorders or hypoesthesia had no negative impacts. Cephalometric analyses revealed a significantly lower SNB (75.3 degrees +/- 2.7 degrees ; p = 0.033) in patients rating lower than grade 7 for overall satisfaction. For SNA and ArGoMe, no significant differences were observed. CONCLUSION: The most distinctive factors for patient satisfaction after orthognathic surgery were chewing function and facial aesthetics with respect to the lower face. Function, aesthetics, and even psychological aspects should be considered equally when planning surgery

Spontaneous rupture of metastatic α-fetoprotein-producing gastric cancer of the liver

An 80-year-old man was admitted to our hospital because of the rupture of the liver. Laboratory data showed iron-deficiency anemia, although there was no liver dysfunction. A computed tomography scan showed large liver tumor with intraperitoneal hemorrhage, and since a serum level of α-fetoprotein (AFP) was extremely high, we initially suspected a rupture of hepatocellular carcinoma (HCC). Transarterial embolization was performed to stop bleeding from the tumor, followed by an endoscopic examination that revealed advanced gastric cancer. Histological analysis revealed that both the gastric and the hepatic tumors were moderately to poorly differentiated adenocarcinoma, as well as that both tumors were immunohistochemically positive for AFP. Finally, we diagnosed AFP-producing gastric cancer associated with liver metastasis. Rupture of metastatic liver cancer is rare, and accordingly, distinction from HCC is important, particularly for the cases of AFP-producing gastric cancer

Oral health service utilization by elderly beneficiaries of the Mexican Institute of Social Security in México city

<p>Abstract</p> <p>Background</p> <p>The aging population poses a challenge to Mexican health services. The aim of this study is to describe recent oral health services utilization and its association with socio-demographic characteristics and co-morbidity in Mexican Social Security beneficiaries 60 years and older.</p> <p>Methods</p> <p>A sample of 700 individuals aged 60+ years was randomly chosen from the databases of the Mexican Institute of Social Security (IMSS). These participants resided in the southwest of Mexico City and made up the final sample of a cohort study for identifying risk factors for root caries in elderly patients. Sociodemographic variables, presence of cognitive decline, depression, morbidity, medication consumption, and utilization of as well as reasons for seeking oral health services within the past 12 months were collected through a questionnaire. Clinical oral assessments were carried out to determine coronal and root caries experience.</p> <p>Results</p> <p>The sample consisted of 698 individuals aged 71.6 years on average, of whom 68.3% were women. 374 participants (53.6%) had made use of oral health services within the past 12 months. 81% of those who used oral health services sought private medical care, 12.8% sought social security services, and 6.2% public health services. 99.7% had experienced coronal caries and 44.0% root caries. Female sex (OR = 2.0), 6 years' schooling or less (OR = 1.4), and caries experience in more than 22 teeth (OR = 0.6) are factors associated with the utilization of these services.</p> <p>Conclusion</p> <p>About half the elderly beneficiaries of social security have made use of oral health services within the past 12 months, and many of them have to use private services. Being a woman, having little schooling, and low caries experience are factors associated with the use of these services.</p

Factors influencing patient satisfaction with dental appearance and treatments they desire to improve aesthetics

Background: We assessed factors influencing patients’ satisfaction with their dental appearance and the treatments they desired to improve dental aesthetics. Methods: A cross-sectional study was performed out among 235 adult patients who visited the Hospital Universiti Sains Malaysia dental clinic. A structured, interviewer-guided questionnaire was used to identify patient satisfaction with their general dental appearance, cosmetic elements and desired treatments. Results: The 235 patients consisted of 70 males (29.8%) and 165 females (70.2%), of mean age 31.5 years (SD 13.0). Of these patients, 124 (52.8%) were not satisfied with their general dental appearance. In addition, 132 patients (56.2%) were not happy with the color of their teeth, 76 (32.3%), regarded their teeth were poorly aligned, 62 (26.4%), as crowded and 56 (23.4%) protruded. Dissatisfaction with tooth color was significantly higher in female than in male patients (odds ratio [OR] of 1.99 (95% confidence interval [CI] 1.13-3.50). Tooth whitening was the treatment most desired by patients (48.1%). Results of multiple logistic regression analysis showed that patient dissatisfaction with general dental appearance was significantly associated with female gender (OR = 2.18; 95% CI: 1.18-4.03), unhappiness with tooth color (OR = 3.05; 95% CI: 1.74-5.34) and the opinion that their teeth protruded (OR = 2.91, 95% CI: 1.44-5.91)

An instrument to measure job satisfaction of nursing home administrators

BACKGROUND: The psychometric properties of the nursing home administrator job satisfaction questionnaire (NHA-JSQ) are presented, and the steps used to develop this instrument. METHODS: The NHA-JSQ subscales were developed from pilot survey activities with 93 administrators, content analysis, and a research panel. The resulting survey was sent to 1,000 nursing home administrators. Factor analyses were used to determine the psychometric properties of the instrument. RESULTS: Of the 1,000 surveys mailed, 721 usable surveys were returned (72 percent response rate). The factor analyses show that the items were representative of six underlying factors (i.e., coworkers, work demands, work content, work load, work skills, and rewards). CONCLUSION: The NHA-JSQ represents a short, psychometrically sound job satisfaction instrument for use in nursing homes

Using focus groups to design systems science models that promote oral health equity

Background While the US population overall has experienced improvements in oral health over the past 60 years, oral diseases remain among the most common chronic conditions across the life course. Further, lack of access to oral health care contributes to profound and enduring oral health inequities worldwide. Vulnerable and underserved populations who commonly lack access to oral health care include racial/ethnic minority older adults living in urban environments. The aim of this study was to use a systematic approach to explicate cause and effect relationships in creating a causal map, a type of concept map in which the links between nodes represent causality or influence. Methods To improve our mental models of the real world and devise strategies to promote oral health equity, methods including system dynamics, agent-based modeling, geographic information science, and social network simulation have been leveraged by the research team. The practice of systems science modeling is situated amidst an ongoing modeling process of observing the real world, formulating mental models of how it works, setting decision rules to guide behavior, and from these heuristics, making decisions that in turn affect the state of the real world. Qualitative data were obtained from focus groups conducted with community-dwelling older adults who self-identify as African American, Dominican, or Puerto Rican to elicit their lived experiences in accessing oral health care in their northern Manhattan neighborhoods. Results The findings of this study support the multi-dimensional and multi-level perspective of access to oral health care and affirm a theorized discrepancy in fit between available dental providers and patients. The lack of information about oral health at the community level may be compromising the use and quality of oral health care among racial/ethnic minority older adults. Conclusions Well-informed community members may fill critical roles in oral health promotion, as they are viewed as highly credible sources of information and recommendations for dental providers. The next phase of this research will involve incorporating the knowledge gained from this study into simulation models that will be used to explore alternative paths toward improving oral health and health care for racial/ethnic minority older adults