The impact of orthodontic treatment on a young person's quality of life, esthetics, and self-esteem in hypodontia: A longitudinal study.

INTRODUCTION: This research aimed to evaluate the impact of orthodontic treatment on a young person's oral health-related quality of life, self-esteem, and esthetics concerning hypodontia. METHODS: A prospective longitudinal hospital-based study recruited 97 participants with hypodontia, aged 11-18 years. Forty-one participants (42%) originally planned to have space closure and the remainder space opening, with subsequent prosthetic replacement. The following questionnaires were completed before and after orthodontic treatment: the child perception questionnaire, Bristol condition-specific questionnaire for hypodontia (BCSQ), the child health questionnaire, and the Oral Aesthetic Subjective Impact Scale (OASIS). The Wilcoxon and matched pairs t tests approach was applied to compare before and after orthodontic treatment for significant testing (P <0.05). RESULTS: Fifteen participants were lost to follow-up, resulting in 82 participants completing orthodontic treatment, with an average age of 13.8 ± 1.71 years. A total of 282 teeth were missing in the sample. Treatment resulted in significantly lower indexes (P <0.001) to overall BCSQ, OASIS, appearance, and how others would treat them. In comparing the 2 subgroups, those treated with space closure had significantly reduced functional limitations (child perception questionnaire), appearance concerns, self-esteem (child health questionnaire), OASIS, and overall BCSQ scores. CONCLUSIONS: Orthodontic treatment in participants with hypodontia appears to significantly impact a range of psychological and esthetic scales. In particular, space closure appears to significantly improve the quality of life of participants compared with those undergoing space opening

In defence of the bioethics scoping review:largely systematic literature reviewing with broad utility

There is growing interest in the possible role of systematic methods of reviewing literature in bioethics. This has arisen alongside the growth of empirical bioethics and a general push towards introducing some level of rigour and reproducibility into scholarship in the field. However, there remain a range of approaches to reviewing literature utilized in bioethics, which vary significantly in their 'systematicness' and suitability for different purposes. In this article, we first detail a taxonomy of various existing reviews used in bioethics and how scholars have defended and critiqued them, presenting them relationally along axes of 'systematic' and 'critical'. Considering the suitability of these reviews, we then explore the inherent differences between normative and empirical literature in relation to how they can be reviewed. In particular, we highlight the challenges in reviewing both normative and empirical literature in a single review. As something of an answer to these challenges, we introduce and defend the scoping review as, in many ways, a method of reviewing literature with wide-ranging utility in bioethics. Demonstrating the many benefits of the scoping review, we then position it within the existing taxonomy of reviews, ultimately arguing that its combination of systematic and critical, inclusive of a reasonable degree of flexibility, makes it deserving of increased attention and use in bioethics

Best Interests v Resource Allocation:Could COVID-19 cloud decision-making for the cognitively impaired?

The COVID-19 pandemic is putting the NHS under unprecedented pressure, requiring clinicians to make uncomfortable decisions they would not ordinarily face. These decisions revolve primarily around intensive care and whether a patient should undergo invasive ventilation. Certain vulnerable populations have featured in the media as falling victim to an increasingly utilitarian response to the pandemic-primarily those of advanced years or with serious existing health conditions. Another vulnerable population potentially at risk is those who lack the capacity to make their own care decisions. Owing to the pandemic, there are increased practical and normative challenges to following the requirements of the Mental Capacity Act 2005. Both capacity assessments and best interests decisions may prove more difficult in the current situation. This may create a more paternalistic situation in decisions about the care of the cognitively impaired which is at risk of taking on a utilitarian focus. We look to these issues and consider whether there is a risk of patients who lack capacity to make their own care decisions being short-changed

Symptomatic scrotoliths in a child

Amelanotic/hypomelanotic variant of cellular blue naevus (CBN) can present a challenge for the clinician and histopathologist. We report a case of amelanotic/hypomelanotic variant of CBN that presented as a painless scrotal swelling in a child. We review the literature on amelanotic/hypomelanotic CBN, the key histological features and important differential diagnoses

National Vascular Registry: 2015 Annual Report.

The National Vascular Registry is commissioned by the Healthcare Quality Improvement Partnership (HQIP) to measure the quality and outcomes of care for patients who undergo major vascular surgery in NHS hospitals in England and Wales. It aims to provide comparative information on the performance of NHS vascular units and thereby support local quality improvement as well as inform patients about major vascular interventions delivered in the NHS. As such, all NHS hospitals in England, Wales, Scotland and Northern Ireland are encouraged to participate in the Registry. The measures used to describe the patterns and outcomes of care are drawn from various national guidelines including: the “Provision of Services for Patients with Vascular Disease” document and the Quality Improvement Frameworks published by the Vascular Society, and the National Institute for Health and Care Excellence (NICE) guidelines on stroke and peripheral arterial disease. This report provides a description of the care provided by NHS vascular units, and contains information on the process and outcomes of care for: (i) patients undergoing abdominal aortic aneurysm (AAA) repair, (ii) patients undergoing carotid endarterectomy, (iii) patients undergoing a revascularisation procedure (angioplasty/stent or bypass) or major amputation for lower-limb peripheral arterial disease (PAD). In addition, the report presents the findings of an organisational audit conducted in August 2015

Performance Evaluation of Multiple Differential Detection for Third Generation Mobile Communication System

Third generation mobile communication system is widely used nowadays. One of its parameter standard, which is QPSK modulation has been adopted by International Telecommunication Union (ITU) to be used in IMT-2000. However, due to amplitude variations introduced in QPSK, a rather robust and reliable data modulation technique, namely the p/4-shift Differential QPSK is proposed. For detection purposes, two types of detectors are evaluated for their performance in AWGN and Rayleigh fading channels.A differential detection technique called multiple differential detection technique which uses maximumlikelihood sequence estimation (MLSE) of the transmitted phases is compared with conventional differential detection which uses symbol-by-symbol detection. By using some of the IMT-2000 standard parameters, the simulation results show that multiple differential detection scheme performs much better than conventional differential detection scheme

Geometry of escort distributions

Given an original distribution, its statistical and probabilistic attributs may be scanned by the associated escort distribution introduced by Beck and Schlogl and employed in the formulation of nonextensive statistical mechanics. Here, the geometric structure of the one-parameter family of the escort distributions is studied based on the Kullback-Leibler divergence and the relevant Fisher metric. It is shown that the Fisher metric is given in terms of the generalized bit-variance, which measures fluctuations of the crowding index of a multifractal. The Cramer-Rao inequality leads to the fundamental limit for precision of statistical estimate of the order of the escort distribution. It is also quantitatively discussed how inappropriate it is to use the original distribution instead of the escort distribution for calculating the expectation values of physical quantities in nonextensive statistical mechanics.Comment: 12 pages, no figure

National Vascular Registry: 2014 Progress Report.

The National Vascular Registry is commissioned by the Healthcare Quality Improvement Partnership (HQIP) to measure the quality and outcomes of care for patients who undergo major vascular surgery in NHS hospitals in England and Wales. It aims to provide comparative information on the performance of NHS hospitals and thereby support local quality improvement as well as inform patients about the care delivered in the NHS. As such, all NHS hospitals in England, Wales, Scotland and Northern Ireland are encouraged to participate in the Registry. The measures used to describe the patterns and outcomes of care are drawn from various national guidelines including: the “2014 The Provision of Services for Patients with Vascular Disease” and the Quality Improvement Frameworks published by the Vascular Society, and the National Institute for Health and Care Excellence (NICE) guidelines on stroke and peripheral arterial disease. In 2014, the Registry published NHS trust and surgeon-level information for elective infrarenal Abdominal Aortic Aneurysm (AAA) repair and carotid endarterectomy on the Registry website. From 28 October, information on both procedures has been available on the www.vsqip.org.uk website for all UK NHS trusts that currently perform them. For English NHS trusts, the same information was published for individual consultants, as part of NHS England’s “Everyone Counts: Planning for Patients 2013/4” initiative. Consultant-level information was also published for NHS hospitals in Wales, Scotland and Northern Ireland for consenting surgeons. This progress report aims to complement that information by (1) providing an overview of care delivered by the NHS at a national level, and (2) describing various developments within the National Vascular Registry. The Registry will publish its next annual report on major vascular surgery in November 2015

Wideband 5.8 GHz Radio Frequency Amplifier with 3 dB Π- Network Attenuator Isolation

This paper presents a design of radio frequency amplifier (RFA), which operates at 5.8 GHz frequency for WiMAX application. The RFA designed used T-matching network consisting of lump reactive elements, 3 dB attenuator and microstrip line at the input and output impedance. The RFA developed in this project contribute a gain of 15.6 dB with overall noise figure of 2.4 dB. The overall measured bandwidth measures is 1.240 GHz with S parameters S11, S12 and S22 measured are -12.4 dB, -25.5 dB and -12.3 dB respectively. The RFA used FET transistor EPA018A from Excelics Semiconductor Inc