An investigation into the effects of two bioceramics on rat mandibular bone

The aim of this study was to evaluate the effects of both dense hydroxyapatite and ß tricalcium phosphate on mandibular bone, in an attempt to offer guidelines for their use. The importance of these guidelines is that although both of these bioceramics have been used in clinical studies there are no established guidelines to indicate which clinical situation is best served by either dense hydroxyapatite or ß tricalcium phosphate. This is evidenced by the fact that many materials have been used as dental implants and that many shapes and forms of implants have been used in an attempt either to stabilise dentures or to restore facial form.In vitro and in vivo investigations are included in this study. The in vivo investigation, on 231 male Sprague-Dawley rats contained controlled studies on weakened and unweakened mandibular bone; cryosurgery was used to weaken bone in this investigation as previous studies demonstrated significant reduction in bone strength after cryosurgery. The in vivo studies were assessed in two ways; first, mechanical assessments of fracture strengh were determined by three-point bending tests. Second, histological examination of mandibular bone was performed in parallel to the mechanical evaluation, in an attempt to interpret fracture test results from histological findings.The investigations in this thesis indicated, for the first time, that both materials result in significant increased fracture strength of mandibular bone. The histological findings indicated that these increases in fracture strength were biologically significant.The results presented in this thesis suggest that both materials are biocompatible and that g tricalcium phosphate is more ideally used in unweakened bone whereas dense hydroxyapatite, gives its optimal effect on weakened bone, although it gives more rapid early increases in strength than does g tricalcium phosphate. It is suggested that those biomaterials may be of benefit in those clinical situations where surgery on mandibular bone may render it prone to fractur

The Heidelberg Catechism: An Ecumenical Confession

This booklet prints the Founders\u27 Day address delivered by Dr. James Iley McCord at Ursinus College on November 4, 1962. The speech details the distinguishing characteristics of the Heidelberg Catechism. The booklet also contains an outline of Zacharias Ursinus\u27 educational career as well as a history of educational institutions in Collegeville.https://digitalcommons.ursinus.edu/founders_programs/1069/thumbnail.jp

A proposal for a SPARK Park site selection process in East Baton Rouge Parish

A Proposal for a SPARK Park Site Selection Process in East Baton Rouge Parish is the topic of this study to assist Parish schools and local governmental agencies in creating community parks. The SPARK Park program uses underutilized municipal properties to create community-use parks in lower-income urban areas. SPARK Parks originated in Houston, Texas. The Houston SPARK Park process was adapted for developing a site selection process for East Baton Rouge Parish. East Baton Rouge Parish dedicated their first SPARK Park in 2000. The park was built in an attempt to reduce the Parish’s open space deficit. Many more parks are needed for any significant reduction of the deficit. A prioritization process of need for park development is required since most Parish communities qualify as SPARK Park candidates. The proposed site selection process will expedite the park acquisition process and objectively locate those sites of greatest need for park development in the Parish. An easy-to-use checklist and a site selection prioritization map are the two tools created for the proposed site selection process. They were designed to involve a school and the surrounding community early in the park development process, save vital resources of local agencies so several parks can be built simultaneously, and be a model for similar park initiatives, other agencies, and school grant writing

Rapid Acute Coronary Syndrome Evaluation Over One Hour With High-Sensitivity Cardiac Troponin I:A United States-Based Stepped-Wedge, Randomized Trial

STUDY OBJECTIVE: The real-world effectiveness and safety of a 0/1-hour accelerated protocol using high-sensitivity cardiac troponin (hs-cTn) to exclude myocardial infarction (MI) compared to routine care in the United States is uncertain. The objective was to compare a 0/1-hour accelerated protocol for evaluation of MI to a 0/3-hour standard care protocol.METHODS: The RACE-IT trial was a stepped-wedge, randomized trial across 9 emergency departments (EDs) that enrolled 32,609 patients evaluated for possible MI from July 2020 through April 2021. Patients undergoing high-sensitivity cardiac troponin I testing with concentrations less than or equal to 99th percentile were included. Patients who had MI excluded by the 0/1-hour protocol could be discharged from the ED. Patients in the standard care protocol had 0- and 3-hour troponin testing and application of a modified HEART score to be eligible for discharge. The primary endpoint was the proportion of patients discharged from the ED without 30-day death or MI.RESULTS: There were 13,505 and 19,104 patients evaluated in the standard care and accelerated protocol groups, respectively, of whom 19,152 (58.7%) were discharged directly from the ED. There was no significant difference in safe discharges between standard care and the accelerated protocol (59.5% vs 57.8%; adjusted odds ratio (aOR)=1.05, 95% confidence interval [CI] 0.95 to 1.16). At 30 days, there were 90 deaths or MIs with 38 (0.4%) in the standard care group and 52 (0.4%) in the accelerated protocol group (aOR=0.84, 95% CI 0.43 to 1.68).CONCLUSION: A 0/1-hour accelerated protocol using high-sensitivity cardiac troponin I did not lead to more safe ED discharges compared with standard care.</p

A survey of dentists? practice in the restoration of the shortened dental arch

Objectives: The aim of this survey was to determine how a sample of dentists working in general dental practice in the UK sought to restore the mouths of patients who had shortened dental arches (SDAs). Study design: A survey was conducted over a period of six months on four commercial dental laboratories. Cases of SDAs comprising the anterior teeth and 2 to 4 premolars were examined; dental prescriptions were scrutinized and a special data collection form was completed accordingly. Results: A total of 140 SDA cases were examined. Most of these cases were for mandibular SDAs (88.6%). Of the recorded SDA cases, 67.2% were restored by cobalt-chromium based removable partial dentures (RPD); 25.7% were extended by acrylic-resin based RPDs; implants were provided to restore 8 SDA cases (5.7%); and only two SDA cases (1.4%) were extended by cantilevered fixed bridges. Neither the gender of the patient ([Chi (2)= 4.19, p>0.05) nor the length of the SDA ([Chi (2) = 6.51, p>0.05) influenced the choice of prosthesis to be implemented. Conclusions: It would appear from the results of this survey that among the different restorative treatment options for SDA, the RPD was the most popular treatment option for dentists surveyed in this UK study. Extending the SDA by either an implant-supported prosthesis or cantilevered fixed bridges did not appear to be a popular choice of treatment

Suicide Screening in Primary Care: Use of an Electronic Screener to Assess Suicidality and Improve Provider Follow-Up for Adolescents

Purpose The purpose of this study was to assess the feasibility of using an existing computer decision support system to screen adolescent patients for suicidality and provide follow-up guidance to clinicians in a primary care setting. Predictors of patient endorsement of suicidality and provider documentation of follow-up were examined. Methods A prospective cohort study was conducted to examine the implementation of a CDSS that screened adolescent patients for suicidality and provided follow-up recommendations to providers. The intervention was implemented for patients aged 12–20 years in two primary care clinics in Indianapolis, Indiana. Results The sample included 2,134 adolescent patients (51% female; 60% black; mean age = 14.6 years [standard deviation = 2.1]). Just over 6% of patients screened positive for suicidality. A positive endorsement of suicidality was more common among patients who were female, depressed, and seen by an adolescent−medicine board-certified provider as opposed to general pediatric provider. Providers documented follow-up action for 83% of patients who screened positive for suicidality. Documentation of follow-up action was correlated with clinic site and Hispanic race. The majority of patients who endorsed suicidality (71%) were deemed not actively suicidal after assessment by their provider. Conclusions Incorporating adolescent suicide screening and provider follow-up guidance into an existing computer decision support system in primary care is feasible and well utilized by providers. Female gender and depressive symptoms are consistently associated with suicidality among adolescents, although not all suicidal adolescents are depressed. Universal use of a multi-item suicide screener that assesses recency might more effectively identify suicidal adolescents

Hydrological Analysis of Conjunctive Management Approaches to Increase Freshwater Supplies on the Lower South Platte River, Colorado

This paper describes conjunctive surface water – groundwater management approaches to water allocation and administration on the South Platte in Colorado, focusing in particular on the hydrologic evaluation of the efficacy of the various conjunctive operations proposed to increase supplies

CONNECTION MATRICES AND TRANSITION MATRICES

This paper is an introduction to connection and transition matrices in the Conley index theory for flows. Basic definitions and simple examples are discussed