Longevity of immediate rehabilitation with direct metal-wire reinforced composite fixed partial dentures.

OBJECTIVES This study aimed to analyze the longevity of direct metal-wire reinforced composite fixed partial dentures (MRC-FPD) and factors influencing their survival and success. METHODS Within one private practice 513 MRC-FPD were directly applied. The preparation of a proximal cavity in abutment teeth was not limited. MRC-FPD were reinforced by one to three metal-wires. At the last follow-up MRC-FPD were considered successful, if they were still in function without any need of therapy. MRC-FPD were considered as survived, if they were repaired or replaced. Multi-level Cox proportional hazard models were used to evaluate the association between clinical factors and time. RESULTS Mean follow-up period (range) was 59(2-249) months. Seventy-three bridges did not survive (cumulative survival rate(CSR):86%) and further 129 bridges had received a restorative follow-up treatment (CSR:61%). AFR was 2.2% for survival and 8.6% for success. In multivariate analysis MRC-FPD with> 1 wire showed a up to 2.3x higher failure rate than MRC-FPD with one wire(p ≤ 0.023). Dentist's experience in designing MRC-FDP (p ≤ 0.017), patient's caries risk (p ≤ 0.040) and bruxism (p = 0.033) significantly influenced the failure rate: the more experience, the lower caries risk and bruxism, the lower the failure rate. SIGNIFICANCE For directly prepared metal-wire reinforced composite bridges high survival and moderate success rates were observed. MRC-FPD might, thus, be an immediate, short- and medium-term solution for replacing missing teeth. However, several factors on the levels of practice (dentist's experience in designing MRC-FDP), patient (bruxism, caries risk) and restoration (number of wires) were identified as significant predictors for the failure rate. The study was registered in the German Clinical Trials Register (DRKS-ID: DRKS00021576)

Minimax Estimation of Nonregular Parameters and Discontinuity in Minimax Risk

When a parameter of interest is nondifferentiable in the probability, the existing theory of semiparametric efficient estimation is not applicable, as it does not have an influence function. Song (2014) recently developed a local asymptotic minimax estimation theory for a parameter that is a nondifferentiable transform of a regular parameter, where the nondifferentiable transform is a composite map of a continuous piecewise linear map with a single kink point and a translation-scale equivariant map. The contribution of this paper is two fold. First, this paper extends the local asymptotic minimax theory to nondifferentiable transforms that are a composite map of a Lipschitz continuous map having a finite set of nondifferentiability points and a translation-scale equivariant map. Second, this paper investigates the discontinuity of the local asymptotic minimax risk in the true probability and shows that the proposed estimator remains to be optimal even when the risk is locally robustified not only over the scores at the true probability, but also over the true probability itself. However, the local robustification does not resolve the issue of discontinuity in the local asymptotic minimax risk

Preliminary analysis of fluctuations in the received uplink-beacon-power data obtained from the GOLD experiments

Uplink data from recent free-space optical communication experiments carried out between the Table Mountain Facility and the Japanese Engineering Test Satellite are used to study fluctuations caused by beam propagation through the atmosphere. The influence of atmospheric scintillation, beam wander and jitter, and multiple uplink beams on the statistics of power received by the satellite is analyzed and compared to experimental data. Preliminary analysis indicates the received signal obeys an approximate lognormal distribution, as predicted by the weak-turbulence model, but further characterization of other sources of fluctuations is necessary for accurate link predictions

Adherence and Acceptability of Telehealth Appointments for High Risk Obstetrical Patients During the COVID-19 Pandemic.

Background:Telehealth has been successfully implemented for the delivery of obstetrical care. However, little is known regarding the attitudes and acceptability of patients and providers in high risk obstetrics and if implementation improves access to care in non-rural settings. Objective:The study aims to: 1) Describe patient and provider attitudes toward telehealth for delivery of high risk obstetrical care in a large health care system with both urban and suburban settings. 2) Determine if implementation of a telehealth model improves patient adherence to scheduled appointments in this patient population.Study DesignTwo self-administered surveys were designed. The first survey was sent to all high-risk obstetrical patients who received a telehealth visit between March 1, 2020 and May 30, 2020. The second survey was designed for providers who participated in these visits. We also compared the attended, cancelled and no show visit rates before (March 1-May 30, 2019) and after (March 1-May 30, 2020) telehealth implementation, as well as telehealth versus in person visits in 2020. We reviewed scheduled high-risk prenatal care appointments, diabetes education sessions, and genetic counseling and Maternal- Fetal Medicine consultations. Results:A total of 91 patient surveys and 33 provider surveys were analyzed. Overall, 86.9% of patients were satisfied with the care they received and 78.3% would recommend telehealth visits to others. 87.8% of providers reported having a positive experience using telehealth, and 90.9% believed that telehealth improved patients\u27 access to care. When comparing patient and provider preference regarding future obstetrical care after experiencing telehealth, 73.8% of patients desired a combination of in person and telehealth visits during their pregnancy. However, a significantly higher rate of providers preferred in-person visits (56% vs 23% respectively). When comparing visits between 2019 and 2020, there was a significantly lower rate of no-show appointments, patient-cancelled appointments, and patient same-day cancellations with the implementation of telehealth. There was also a significantly lower rate of patient-cancelled appointments, and patient same-day cancellations with those receiving telehealth visits compared to in person visits in 2020. Conclusion:Implementation of telehealth in high risk obstetrics has the potential to improve access to high risk obstetrical care, by reducing the rate of missed appointments. Both patients and providers surveyed expressed a high rate of satisfaction with telehealth visits and a desire to integrate telehealth into the traditional model of high risk obstetrical care

The unstable coastline: navigating dispossession and belonging in Colombo

This article explores how residents of a small coastal fishing enclave in Colombo live with cumulative waves of dispossession brought on by exclusionary projects of urban development. Drawing on ethnographic fieldwork, I introduce the analytic of navigation to describe how people move, plan and live with both present and future threats of dispossession. Navigation offers a unique perspective on questions of agency and resistance in oppressive conditions. Rather than framing subjects as “resisting” projects of world-class city-making, this analysis shows that urban residents instead engage in complex and occasionally contradictory modes of living with uncertainty. I complicate existing understandings of the term “navigation” by describing how questions of nation and belonging are crucial to comprehending how people navigate. Ultimately, I suggest that expressions of belonging and obligation to an imagined community might not only be strategic, but instead reflect some of the broader social forces which structure possibilities for action

Bub1 mediates cell death in response to chromosome missegregation and acts to suppress spontaneous tumorigenesis

The physiological role of the mitotic checkpoint protein Bub1 is unknown. To study this role, we generated a series of mutant mice with a gradient of reduced Bub1 expression using wild-type, hypomorphic, and knockout alleles. Bub1 hypomorphic mice are viable, fertile, and overtly normal despite weakened mitotic checkpoint activity and high percentages of aneuploid cells. Bub1 haploinsufficient mice, which have a milder reduction in Bub1 protein than Bub1 hypomorphic mice, also exhibit reduced checkpoint activity and increased aneuploidy, but to a lesser extent. Although cells from Bub1 hypomorphic and haploinsufficient mice have similar rates of chromosome missegregation, cell death after an aberrant separation decreases dramatically with declining Bub1 levels. Importantly, Bub1 hypomorphic mice are highly susceptible to spontaneous tumors, whereas Bub1 haploinsufficient mice are not. These findings demonstrate that loss of Bub1 below a critical threshold drives spontaneous tumorigenesis and suggest that in addition to ensuring proper chromosome segregation, Bub1 is important for mediating cell death when chromosomes missegregate

Maximum likelihood drift estimation for a threshold diffusion

We study the maximum likelihood estimator of the drift parameters of a stochastic differential equation, with both drift and diffusion coefficients constant on the positive and negative axis, yet discontinuous at zero. This threshold diffusion is called drifted Oscillating Brownian motion.For this continuously observed diffusion, the maximum likelihood estimator coincide with a quasi-likelihood estimator with constant diffusion term. We show that this estimator is the limit, as observations become dense in time, of the (quasi)-maximum likelihood estimator based on discrete observations. In long time, the asymptotic behaviors of the positive and negative occupation times rule the ones of the estimators. Differently from most known results in the literature, we do not restrict ourselves to the ergodic framework: indeed, depending on the signs of the drift, the process may be ergodic, transient or null recurrent. For each regime, we establish whether or not the estimators are consistent; if they are, we prove the convergence in long time of the properly rescaled difference of the estimators towards a normal or mixed normal distribution. These theoretical results are backed by numerical simulations