Tooth wear prevention: A quantitative and qualitative in vitro study

The document attached has been archived with permission from the Australian Dental Association. An external link to the publisher’s copy is included.Background: Management of tooth wear from grinding presents a significant clinical challenge. Acrylic nightguards are often used to protect the teeth, but many patients still grind with these appliances. This study aimed to test the effectiveness of three lubricants in reducing enamel wear by using an electro-mechanical machine under controlled conditions, with a view to undertaking a subsequent longitudinal clinical study. Methods: Sectioned tooth specimens were worn against each other under different loads and with the addition of three different lubricants: calcium fluoride (CaF) powder, olive-oil, and a combination of calcium fluoride with olive-oil in the form of a slurry. Wear rates of enamel only were quantified by weighing the specimens, and resin replicas of the worn tooth surfaces were made for examination under a scanning electron microscope. Results: All three lubricants reduced the amount of enamel wear significantly compared with wearing specimens without adding lubricants. Wear rate was influenced by the type of lubricant and the load applied. Wear rates were significantly less for olive-oil and the olive-oil/CaF slurry compared with CaF alone. The microwear detail differed between the three lubricants. Conclusions: This study has shown that enamel wear can be reduced using dry or wet lubricants between opposing teeth that are worn under controlled conditions. Further research is required to clarify their possible clinical applications.JA Kaidonis, J Gratiaen, N Bhatia, LC Richards, GC Townsen

Mix methods approach to explore patients' perspectives on the acceptability of a urinary biomarker test in replacement of cystoscopy in bladder cancer surveillance

OBJECTIVE: To determine the minimal accepted sensitivity (MAS) of a urine biomarker that patients are willing to accept to replace cystoscopy and to qualitatively assess their views and reasons. PATIENT AND METHODS: Patients were part of a prospective multi-center observational study recruiting patients with bladder cancer for a urine biomarker study (DETECT II; ClinicalTrials.gov: NCT02781428). A mix methods approach comprising of 1) Questionnaire to assess patients' experience with cystoscopy and patients' preference for cystoscopy vs urinary biomarker and 2). Semi-structured interviews to understand patient views, choice and reasons for their preference. RESULTS: A urine biomarker with MAS of 90% would be accepted by 75.8% of patients. This is despite a high self-reported prevalence of hematuria (51.0%), dysuria/ lower urinary tract symptoms (69.1%) and urinary tract infection requiring antibiotics (25.8%). There was no association between MAS with patient demographics, adverse events experienced, cancer characteristics and distance of patients' home to hospital. Qualitative analysis suggest that patients acknowledge that cystoscopy is invasive, embarrassing and associated with adverse events but are willing to tolerate the procedure due to a high sensitivity. Patients have confidence in cystoscopy and appreciate the visual diagnosis of cancer. Both low and high-risk patients would consider a biomarker with a reported sensitivity similar to cystoscopy. CONCLUSION: Patients value the high sensitivity cystoscopy accords despite the reported discomfort and adverse events experienced following cystoscopy. The sensitivity of a urinary biomarker must be close to cystoscopy before patients' acceptance

Exploring patients’ experience and perception of being diagnosed with bladder cancer: A mixed methods approach

OBJECTIVE: To determine patient experience and perception following a diagnosis of non-muscle invasive bladder cancer (NMIBC). PATIENT AND METHODS: Patients were part of a prospective multi-centre observational study recruiting patients with NMIBC for a urine biomarker study (DETECT II; ClinicalTrials.gov: NCT02781428). A mix methods approach comprising 1) the Brief Illness Perception Questionnaire (Brief IPQ) and 2) semi-structured interviews to explore patients' experience of experiencing haematuria, initial and subsequent experience with NMIBC diagnosis. Both assessments were completed at 6 months following NMIBC diagnosis. RESULTS: A total of 213 patients completed the Brief IPQ. Patients felt that they had minimal symptoms (median [IQR: 2 [0-5]) and were not particularly affected emotionally (3 [1-6]) with a minimal effect to their daily life (2 [0-5]). However, they remained concern about their cancer diagnosis (5 [3-8]) and felt that they had no personal control over the cancer (2 [2-5]) and believed that their illness would affect them for some time (6 [3-10]). A significant association with a lower personal control of the disease (p70 years of age. A high number of patients were uncertain about the cause of their bladder cancer diagnosis. Qualitative analysis found that at initial presentation of haematuria, most patients were not aware of the risk of bladder cancer. Patients were most anxious and psychologically affected between the interval of cystoscopy diagnosis and transurethral resection of bladder tumour (TURBT). Following TURBT, most patients were positive about their cancer prognosis. CONCLUSION: NMIBC patients have a poor perception of disease control and believe that their disease will continue over a prolonged period of time. This is particularly more pertinent in the elderly. Patients are most psychologically affected during the interval between cancer diagnosis following cystoscopy and tumour resection at TURBT. Further, health awareness about the causes of bladder cancer remained poor with a significant number of patients unaware of the cause of bladder cancer. Psychological support and prompt TURBT following bladder cancer diagnosis would help improve the mental health of patients with NMIBC

Rotating black rings on Taub-NUT

In this paper, we construct new solutions describing rotating black rings on Taub-NUT using the inverse-scattering method. These are five-dimensional vacuum space-times, generalising the Emparan-Reall and extremal Pomeransky-Sen'kov black rings to a Taub-NUT background space. When reduced to four dimensions in Kaluza-Klein theory, these solutions describe (possibly rotating) electrically charged black holes in superposition with a finitely separated magnetic monopole. Various properties of these solutions are studied, from both a five- and four-dimensional perspective.Comment: 33 pages, 3 figures, LaTe

Teaching Medicine to Non-English Speaking Background Learners in a Foreign Country

Teaching abroad exposes medical educators to unfamiliar teaching methods and learning styles that can enhance their overall teaching repertoire. Based on the author’s experience teaching residents for one month at a community hospital in Japan and a review of the non-English speaking background (NESB) educational literature, pedagogical principles and lessons for successful international NESB instruction are outlined. These methods include understanding the dissimilar linguistic, cultural, and academic backgrounds of the learners, emphasizing pace and clarity of speech, presenting a conceptual framework instead of detailed discourse on subjects, and regular visual reinforcement of spoken words. The limitations introduced by the language barrier and the use of interpreters are briefly discussed. As society and institutions of higher learning become more global and multicultural, clinician–educators may benefit from teaching in other countries in order to enhance their teaching skills with NESB learners, both abroad and in their own institutions

Balanced electric-magnetic dihole in Kaluza-Klein theory

We present a four-dimensional double-black-hole (or dihole) solution in Kaluza-Klein theory, describing a superposition of an electrically charged and a magnetically charged black hole. This system can be balanced for appropriately chosen parameters, and the resulting space-time is completely regular on and outside the event horizons. This solution was constructed using the inverse-scattering method in five-dimensional vacuum gravity, in which it describes a rotating black ring surrounding a static black hole on a Taub-NUT background space. Various properties of this solution are studied, from both a four- and five-dimensional perspective.Comment: 33 pages, 6 figures; v2: expanded discussion of phase space, published versio

Multi-scalar tachyon potential on non-BPS domain walls

We have considered the multi-scalar and multi-tachyon fields living on a 3d domain wall embedded in a 5d dimensional Minkowski spacetime. The effective action for such a domain wall can be found by integrating out the normal modes as vibrating modes around the domain wall solution of a truncated 5d supergravity action. The multi-scalar tachyon potential are good enough to modeling assisted inflation scenario with multi-tachyon fields. The tachyon condensation are also briefly addressed.Comment: version to appear in JHEP, 18 pages, 3 figure

Development of an IS change reason - IS change type combination matrix

Firms change their information systems (IS) for various reasons, ranging from compliance with government regulations to the development of new capabilities. When making these changes a firm can choose between four different IS change types: IS introduction, IS extension, IS replacement, and IS merger. This paper proposes that change reasons and change types are interrelated, and that certain reason-type combinations are more likely than others to result in a successful IS change. To identify these combinations, an IS change reason–IS change type matrix is developed. While the matrix is created from prior IS research, we conducted a focus group study of IS professionals to further explore and refine the matrix. The findings from the focus group study reveal that some IS change reason–IS change type combinations are more appropriate than others to carry out the IS change project successfully. We also present three examples of IS change projects to illustrate the use and value of the matrix in practice

Reproductive Schedules in Southern Bluefin Tuna: Are Current Assumptions Appropriate?

Southern bluefin tuna (SBT) appear to comprise a single stock that is assumed to be both mixed across its distribution and having reproductive adults that are obligate, annual spawners. The putative annual migration cycle of mature SBT consists of dispersed foraging at temperate latitudes with migration to a single spawning ground in the tropical eastern Indian Ocean. Spawning migrations have been assumed to target two peaks in spawning activity; one in September-October and a second in February-March. SBT of sizes comparable to that of individuals observed on the spawning ground were satellite tagged in the Tasman Sea region (2003–2008) and demonstrated both migrations to the spawning grounds and residency in the Tasman Sea region throughout the whole year. All individuals undertaking apparent spawning migrations timed their movements to coincide with the second recognised spawning peak or even later. These observations suggest that SBT may demonstrate substantial flexibility in the scheduling of reproductive events and may even not spawn annually as currently assumed. Further, the population on the spawning grounds may be temporally structured in association with foraging regions. These findings provide new perspectives on bluefin population and spatial dynamics and warrant further investigation and consideration of reproductive schedules in this species

De novo mutations in SMCHD1 cause Bosma arhinia microphthalmia syndrome and abrogate nasal development

Bosma arhinia microphthalmia syndrome (BAMS) is an extremely rare and striking condition characterized by complete absence of the nose with or without ocular defects. We report here that missense mutations in the epigenetic regulator SMCHD1 mapping to the extended ATPase domain of the encoded protein cause BAMS in all 14 cases studied. All mutations were de novo where parental DNA was available. Biochemical tests and in vivo assays in Xenopus laevis embryos suggest that these mutations may behave as gain-of-function alleles. This finding is in contrast to the loss-of-function mutations in SMCHD1 that have been associated with facioscapulohumeral muscular dystrophy (FSHD) type 2. Our results establish SMCHD1 as a key player in nasal development and provide biochemical insight into its enzymatic function that may be exploited for development of therapeutics for FSHD