Comparação entre técnicas de Urban e Khoury na regeneração óssea vertical e horizontal: revisão sistemática

Objetivo: Comparar as técnicas de Khoury e Urban na regeneração óssea vertical e horizontal. Materiais e Métodos: Foi desenvolvida uma pesquisa integrativa da literatura, com recurso às bases de dados PubMed e B-On. Esta pesquisa foi submetida a critérios de inclusão e exclusão. Resultados: De acordo com a pesquisa efetuada, que compreendiam os critérios de inclusão, foram selecionados 9 artigos. Dos estudos analisados, todos os estudos demostraram que as regenerações ósseas guiadas apresentam resultados significativos em ganhos ósseos, no entanto existem algumas limitações ao longo dos estudos entre as duas técnicas estudadas que podem influenciar nestes resultados. Conclusão: É necessário desenvolver mais estudos com amostras mais elevadas, com tempos de follow-up mais longos, com protocolos mais padronizados que nos permitem avaliar com mais precisão quais das técnicas cirúrgicas de regeneração óssea guiada poderão contribuir para maior ganho em volume ósseo, melhor correção dos defeitos da crista óssea e menor complicações pós-operatórias nos nossos pacientes. Contudo, de acordo com a literatura escrutinada nesta revisão sistemática, quer a técnica de regeneração óssea guiada preconizada por Istvan Urban, quer por Fouad Khoury, apresentam excelentes resultados em termos de ganhos ósseos horizontais e verticais.Objective: Compare Khoury and Urban's techniques in vertical and horizontal bone regeneration. Methods: An integrative literature search was developed, using the PubMed and B-On databases. This research was submitted to inclusion and exclusion criteria. Results: According to the research carried out, which comprised the inclusion criteria, 9 articles were selected. Of the studies analyzed, all studies showed that guided bone regeneration presents significant results in bone gains, however there are some limitations throughout the studies between the two techniques studied that may influence these results. Conclusion: It is necessary to develop more studies with higher samples, with longer follow-up times, with more standardized protocols that allow us to evaluate more accurately which of the surgical techniques of guided bone regeneration may contribute to greater gain in bone volume, better correction of bone crest defects and lower postoperative complications in our patients. However, according to the literature scrutinized in this systematic review, both the guided bone regeneration technique advocated by Istvan Urban and by Fouad Khoury present excellent results in terms of horizontal and vertical bone gains

Effects of pro-social motives and reward on children's prospective memory and inhibitory control

Prospective memory (PM) refers to the ability to remember to perform an intended action in the future whereas inhibitory control (IC) is defined as the capacity to stop a prepotent or automatic response in favour of a more correct or pertinent response in a certain situation. The main aim of the present thesis was to investigate the role of motivational factors – such as the social values of goals and presence of rewards – in children’s PM and IC abilities by using an event-based PM task (EBPM) and a RI task (Go/No-Go) modelled after Brandimonte et al. (2011). RI plays a pivotal role in executive control (e.g., Andres, 2003; Aron, 2007; Logan, 1985a; Miyake et al., 2000; Stuphorn & Schall, 2006). RI concerns the ability to withhold responses that are unsuitable or not useful, so facilitating behaviour that is both flexible and goal-orientated in constantly changing environments. RI ability is called upon frequently in everyday life to prevent us from committing potentially harmful actions, for example, from stepping into the road when a car comes around a corner without seeing you. Go/No-go task is typically used in order to measure RI ability. Only two types of stimuli are used in the conventional Go/No-go task: a Go stimulus, and a No-go stimulus. Instructions are given to participants to respond rapidly, usually by pressing a button, only when Go stimuli appear, whereas they have to refrain from pressing the button on the presentation of No-go stimuli; response inhibition refers to the ability to stop oneself responding to No-go stimuli. Usually, Go stimuli appear more frequently in this kind of task, such as to predispose a participant to responding and increase the amount of inhibitory effort needed to not respond when presented with No-go stimuli (Simmonds et al., 2008). Performance in RI paradigms can be thought of as an independent “horse race” in which there is a go process prompted by go stimuli, and a stop process prompted by No-go stimuli (Logan & Cowan, 1984; Logan, Van Zandt, Verbruggen, & Wagenmakers, 2014; Verbruggen & Logan, 2009b). RI is successful when the stop process is underway before the go process and no response is made (signal-inhibit); when the go process starts before the stop process, response inhibition is unsuccessful as a response is made inappropriately (signal-respond).This choice wase made because these two tasks mentioned above seem to involve two types of intention that differ with respect to the direction of the intended action. While both the EBPM and RI tasks require forming, maintaining, and realising delayed intentions, the EBPM task involves the overt execution of the intended action, while a response inhibition task necessitates the suppression of the predominant response (Brandimonte et al., 2011). In summary, these two tasks could be considered as being in parallel in all respects apart from the response direction, as the former consists of remembering to perform an action, whereas the latter involves refraining from acting. Of particular importance are the EF abilities needed for each task type; task-shifting abilities are predominantly required during EBPM tasks when a participant must switch from the ongoing activity to the execution of a certain action when a target cue is seen. The RI task, by contrast, principally involves inhibitory control abilities, as the participant must remember not to perform the ongoing activity when a target cue appears. Despite this contrast, switching an inhibition are not mutually exclusive; switching is still involved in an RI task, inasmuch as the participant switches from the task of performing (ongoing), to the task of not performing (RI – no response). Nevertheless, the pivotal role in the RI task is played by the active suppression of actions that would be counterproductive to the achievement of the predefined goal of the task. This comparison of RI and EBPM tasks applies particularly to these two kinds of task, as both of them involve performing two types of task simultaneously, that is the ongoing task and additionally either the PM or the RI task. However, the same comparison cannot be made between TBPM and RI tasks, since the TBPM is not based on the appearance of a target cue, which however does occur during the RI and EBPM tasks. Indeed, in TBPM tasks, intentions must be executed only after a certain period of time has passed or at a predetermined point in time in the future (Wang et al., 2008); for example, recalling the need to take medicine at a given interval, or remembering to call a friend on their birthday. By contrast, in EBPM tasks an external cue should in theory remind the participant to perform the intended action (Talbot & Kerns, 2014); examples include remembering to pass on a message to a friend when they are next seen.Overall, the present research includes three large studies testing children aged 4-5 years, 6-7 years, 7-8 years, 10-11 years, and an adult group. Specifically, the following research issues have been explored: a) whether motivational factors, such as pro-sociality and reward, can have effects on children’s memory for intentions and response inhibition (RI) and, if any, b) whether these effects differ as a function of task (PM and RI); c) whether children’s PM and RI performance differ from that of adults when pro-sociality is involved. Results highlighted a significant interaction between Pro-sociality and Task, indicating that children had worse PM performance under the condition with pro-sociality (Study 1). In contrast, pro-sociality improved adults’ but not children’s performance (Study 3), as qualified by a significant interaction between Pro-sociality and Age. Significant effects of Reward emerged when Task factor (Go/No-go task / PM task) was partialled out (Study 2), showing that children performed better in conditions with a reward but only in the Go/No-Go task. A significant effect of Task was found in Study 2 and Study 3, such that participants had higher scores in Go/No-Go than in PM tasks. In conclusion, this Ph.D. project adds to the evidence that while PM and IC may have some commonalities because they are both linked to intentions (to do something or not to do something), they seem to rely on different mechanisms as indicated by the differential effects of Task, Pro-sociality, and Reward

Effects of Policies Designed to Keep Firearms from High-Risk Individuals

This article summarizes and critiques available evidence from studies published between 1999 and August 2014 on the effects of policies designed to keep firearms from high-risk individuals in the United States. Some prohibitions for high-risk individuals (e.g., those under domestic violence restraining orders, violent misdemeanants) and procedures for checking for more types of prohibiting conditions are associated with lower rates of violence. Certain laws intended to prevent prohibited persons from accessing firearms -- rigorous permit-to-purchase, comprehensive background checks, strong regulation and oversight of gun dealers, and requiring gun owners to promptly report lost or stolen firearms -- are negatively associated with the diversion of guns to criminals. Future research is needed to examine whether these laws curtail nonlethal gun violence and whether the effects of expanding prohibiting conditions for firearm possession are modified by the presence of policies to prevent diversion

First steps towards a fast-neutron therapy planning program

<p>Abstract</p> <p>Background</p> <p>The Monte Carlo code GEANT4 was used to implement first steps towards a treatment planning program for fast-neutron therapy at the FRM II research reactor in Garching, Germany. Depth dose curves were calculated inside a water phantom using measured primary neutron and simulated primary photon spectra and compared with depth dose curves measured earlier. The calculations were performed with GEANT4 in two different ways, simulating a simple box geometry and splitting this box into millions of small voxels (this was done to validate the voxelisation procedure that was also used to voxelise the human body).</p> <p>Results</p> <p>In both cases, the dose distributions were very similar to those measured in the water phantom, up to a depth of 30 cm. In order to model the situation of patients treated at the FRM II MEDAPP therapy beamline for salivary gland tumors, a human voxel phantom was implemented in GEANT4 and irradiated with the implemented MEDAPP neutron and photon spectra. The 3D dose distribution calculated inside the head of the phantom was similar to the depth dose curves in the water phantom, with some differences that are explained by differences in elementary composition. The lateral dose distribution was studied at various depths. The calculated cumulative dose volume histograms for the voxel phantom show the exposure of organs at risk surrounding the tumor.</p> <p>Conclusions</p> <p>In order to minimize the dose to healthy tissue, a conformal treatment is necessary. This can only be accomplished with the help of an advanced treatment planning system like the one developed here. Although all calculations were done for absorbed dose only, any biological dose weighting can be implemented easily, to take into account the increased radiobiological effectiveness of neutrons compared to photons.</p

Adoptive bonds. Linking past, present and future relationships into the life paths of adopted people.

reservedNonostante l'adozione possa essere considerata come una "rinascita" per il bambino, è bene che il "prima" e il "dopo" l'evento vengano messi in relazione al fine di garantire unità alla storia della persona e permetterle di non crescere con un'identità frammentata. I genitori adottivi non devono considerare un tabù parlare delle origini e/o della famiglia biologica del bambino perché questo rischierebbe di far nascere in lui un conflitto che potrebbe persino portarlo ad idealizzare i genitori biologici e considerare negativamente quelli affidatari (in quanto l'hanno privato di un pezzo della sua storia ed identità). Privare i bambini del loro passato non garantisce loro un futuro migliore. Inoltre, vista l'età sempre maggiore con cui vengono adottati i minori, è sempre più frequente che abbiano ricordi vivi della famiglia d'origine e abbiano instaurato con i parenti (genitori/fratelli/nonni...) legami più o meno significativi, che devono essere rispettati e talvolta preservati. Risulta quindi importante prendere in considerazione l'istituto giuridico dell'adozione aperta. Nello specifico, questa tesi cerca di rispondere a tre domande: quanto è importante, per un giovane adottato, conoscere la propria storia? Quali sono gli stadi e le modalità che le ricerche sulle origini assumono? Tagliare i rapporti con i parenti del nucleo d'origine rappresenta la scelta migliore? E' importante che i servizi sappiano intervenire adeguatamente a sostegno della famiglia adottiva, soprattutto in via preventiva informando le coppie dei rischi dell'adozione, ma anche garantendo un adeguato ed efficiente servizio di supporto nel post-adozione, che può tornare utile specialmente durante il periodo pre-adolescenziale/adolescenziale del minore. Affinché ciò sia possibile, è fondamentale che i professionisti siano aggiornati e sappiano rispondere alle "nuove sfide" che interessano una famiglia adottiva (come l'utilizzo di internet, strumento che può rivelarsi un'arma a doppio taglio)

Gamma Knife radiosurgery in benign skull base tumors after planned subtotal resection: preliminary results in combined approaches

Aim: The management of large lesions of the skull base, such as vestibular schwanommas (VS), meningiomas (MEN) or pituitary adenomas (PA), is challenging, with microsurgery remaining the main treatment option. Planned subtotal resection is now being increasingly considered to reduce the risk of neurological deficits following complete resection. The residual part of the tumor can then be treated with Gamma Knife Radiosurgery (GKR) to achieve long-term growth control. Methods: This case series documents early results with planned subtotal resection followed by GKR in Lausanne University Hospital, between July 2010 and March 2012. There were 24 patients who underwent surgery, with 22 having already undergone GKR and 2 waiting for GKR. We analyzed clinical symptoms for all patients, as well as audiograms, ophthalmological and endocrinological tests, when indicated. Results: Nine patients had VS surgery (mean diameter 35 mm; range 30-44.5) through a retrosigmoid approach. There were no post-operative facial nerve deficits. Of the 3 patients whom had useful hearing pre-operatively, this improved in 2 and remained stable in 1. Four patients with clinoid MEN (mean diameter 26.5 mm; range 17-42) underwent subtotal resection of the tumor, and the component in the cavernous sinus was later treated with GKR. The visual status remained stable in 3 patients and one had complete visual recovery. 4 patients underwent subtotal resection of petro-clival MEN (mean diameter 36 mm; range 32-42): 3 had House-Brackmann (HB) grade 2 facial function that recovered completely; one continues to have HB grade 4 facial deficit following surgery. Of the 7 patients with PA (mean diameter 34.5 mm; range 20-54.5), 2 had acromegaly, the others were non functional PA. Six patients underwent trans-sphenoidal surgery, while one patient had a transcavernous sinus resection of the tumor (with prior staged trans-sphenoidal surgery). Visual status improved in 3 patients while the others remained stable. Two patients had transient diabetes insipidus following surgery. Up to now, no additional deficit or worsening has been reported after GKR. Conclusions: Our data suggest that planned subtotal resection has an excellent clinical outcome with respect to preservation of cranial nerves, and other neurological functions, and a good possibility of recovery of many of the pre-operative cranial nerve dysfunctions. The results in terms of tumor control following GKR need further long-term evaluation