Bone apposition to titanium implants biocoated with recombinant human bone morphogenetic protein 2 (rhBMP-2). A pilot study in dogs

The aim of the present study was to investigate bone formation to recombinant human bone morphogenetic protein-2 (rhBMP-2)-biocoated and rhBMP-2-nonbiocoated titanium implants after implantation in dogs. Implantation of sand-blasted and acid-etched (C), chromosulfuric acid surface-enhanced (CSA), and rhBMP-2-biocoated CSA [BMP-A: noncovalently immobilized rhBMP-2 (596 ng/cm(2)), BMP-B: covalently immobilized rhBMP-2 (819 ng/cm(2))] implants was performed in both the mandible and tibia of dogs. After 4 weeks of healing, the percentage of direct bone to implant contact (BIC) and the induced bone density (BD) at a distance of less than and greater than 1 mm adjacent to each implant was assessed. Histomorphometric analysis of implants inserted in the mandible and tibia revealed that BIC values appeared to be highest in the BMP-B group, followed by BMP-A, CSA, and C. BD as measured at a distance of <1 mm revealed obvious differences between groups: BMP-B>BMP-A>CSA>C. However, no differences between groups were observed at a distance of >1 mm. Within the limits of the present study, it may be concluded that rhBMP-2 immobilized by covalent and noncovalent methods on CSA-treated implant surfaces seemed to be stable and promoted direct bone apposition in a concentration-dependant manner

Monte Carlo vs. Pencil Beam based optimization of stereotactic lung IMRT

<p>Abstract</p> <p>Background</p> <p>The purpose of the present study is to compare finite size pencil beam (fsPB) and Monte Carlo (MC) based optimization of lung intensity-modulated stereotactic radiotherapy (lung IMSRT).</p> <p>Materials and methods</p> <p>A fsPB and a MC algorithm as implemented in a biological IMRT planning system were validated by film measurements in a static lung phantom. Then, they were applied for static lung IMSRT planning based on three different geometrical patient models (one phase static CT, density overwrite one phase static CT, average CT) of the same patient. Both 6 and 15 MV beam energies were used. The resulting treatment plans were compared by how well they fulfilled the prescribed optimization constraints both for the dose distributions calculated on the static patient models and for the accumulated dose, recalculated with MC on each of 8 CTs of a 4DCT set.</p> <p>Results</p> <p>In the phantom measurements, the MC dose engine showed discrepancies < 2%, while the fsPB dose engine showed discrepancies of up to 8% in the presence of lateral electron disequilibrium in the target. In the patient plan optimization, this translates into violations of organ at risk constraints and unpredictable target doses for the fsPB optimized plans. For the 4D MC recalculated dose distribution, MC optimized plans always underestimate the target doses, but the organ at risk doses were comparable. The results depend on the static patient model, and the smallest discrepancy was found for the MC optimized plan on the density overwrite one phase static CT model.</p> <p>Conclusions</p> <p>It is feasible to employ the MC dose engine for optimization of lung IMSRT and the plans are superior to fsPB. Use of static patient models introduces a bias in the MC dose distribution compared to the 4D MC recalculated dose, but this bias is predictable and therefore MC based optimization on static patient models is considered safe.</p

Personality traits and mental disorders

Peer reviewe

Organisatorische Planung für die Marktausweitung der smart GmbH auf den USamerikanischen Automobilmarkt mit dem Schwerpunkt relevanter After Sales Prozesse.

In der vorliegenden Arbeit wird die Problematik einer Marktausweitung, unterBerücksichtigung der organisatorischen Planung des After Sales Bereichs, amBeispiel der smart GmbH auf dem US-amerikanischen Automobilmarkt aufgezeigt.Dabei wird insbesondere die Positionierung der smart GmbH innerhalbder DaimlerChrysler AG berücksichtigt, sowie dem komplexen Markt als auchden Wettbewerbern Rechnung getragen.Die von der smart GmbH angewandte Autonomiestrategie, nach dem Stufenmodellvon Ansoff, verfolgt die anspruchsvolle Marktausweitung auf den USamerikanischenMarkt, durch die Verfolgung einer Diversifikationsstrategie. Ummit den Modell „formore“, dieselbe Kundengruppe wie auf den bestehendenMärkten ansprechen und sich gleichzeitig gegenüber den Hauptwettbewerbernbehaupten zu können, ist eine umfangreiche und spezifische, strategische wieauch operative Planung vor der Einführung notwendig.Unter Berücksichtigung des Fit- sowie des situativen Organisationsansatzes,wird die strategische Planung der smart GmbH unter dem Aspekt einer ganzheitlichenBetrachtungsweise aufgezeigt. Diese sollte in erster Linie den Ausbaueiner starken Marke vor Augen haben und unter Berücksichtigung des gegebenenUmfeldes gute Bedingungen für eine hohe und langfristige Kundenbindunggewährleisten. Dies betrifft insbesondere die Gestaltung des AfterSales Bereichs in seiner Brückenfunktion zwischen Produkt und Kunde. BesondereGesichtspunkte sind dabei die Garantiefindung, sowie des Vertriebs- undKundendienstnetzes.Die vorliegende Arbeit zeigt hierzu verschiedene Vertriebsmodelle und Garantiepläneauf und geht auf diese, auch im Vergleich zu MB und den Wettbewerbernin kritischer Weise ein.Im Anschluss an die strategischen Überlegungen wird die operative Planungdes After Sales Bereichs in theoretischer und optimaler Weise dargelegt. Kritikpunktean der realen praktischen Umsetzung sowie Empfehlungen bezüglichder operativen Planung des Verfassers schließen die Arbeit ab.The present thesis deals with the problems of market extension, in particular the after sales, especially in case of the smart Ltd. in the USA. Beside the position of smart within the DaimlerChrysler Corp. the important point of interest is the complexity of the wide new market and their competitors. Following the stepwise model of Ansoff, the strategy of smart how to enter this specific new market is the strategy of diversification. To reach the same target customers as in the other markets and to succeed against the main competitors BMW with Mini and Toyota with Scion, especially strategic and operative planning has to be very specific concerning the characteristics of this region. Regarding the principles of the best strategy by Fit and the rule of situative organization, the smart company has firstly to look at the national characteristics. In this regard the importance of the after sales service as a bridge between customer and product, for example warranty and sales service, has to be considered keenly. Beside the presentation of the sales models (shop-in-shop, built-on-shop, stand-alone-shop) and the comparison of the special warranties of MB and their competitors, this diploma thesis shows how to develop the best possible way of the operative planning including work packages and milestones. This dissertation ends up with critical and recommending statements to optimize the after sales service with main focus on customer contentment

Ubiquitination of endogenous calmodulin in rabbit tissue extracts

AbstractPreviously we were able to show that purified calmodulins from vertebrates, plants (spinach) and the mold Neurospora crassa can be covalently conjugated to ubiquitin in a Ca2+-dependent manner. It was therefore pertinent to answer the question if a tissue extract contains all the components necessary for the endogenous synthesis of ubiquityl calmodulin (uCaM). Therefore [125I]ubiquitin, ATP/Mg2+ and Ca2+ were added to tissue extracts enriched by a single ion exchange step. In such extracts of red blood cells, skeletel muscle and testis a novel ubiquitin conjugate of 27–29 kDa is formed. This novel band could be identified as ubiquityl-calmodulin by the following methods: (i) identical R1-value of novel conjugate and standard uCaM in SDS-PAGE; (ii) Ca2+-dependent conjugate formation; (iii) Ca2+-dependent adsorption to fluphenazine-Sepharose; (iv) Ca2+-dependent mobility change of the novel conjugate during SDS-PAGE; and (v) inhibition of conjugate band formation by phosphorylate kinase. These experiments clearly demonstrate that ubiquityl calmodulin can be endogenously generated in enriched cellular extracts and strongly indicate that this reaction is of importance in vivo

Protecting ultra- and hyperhydrophilic implant surfaces in dry state from loss of wettability

Ultrahydrophilic titanium miniplates with sandblasted and acid etched (SLA) surfaces were protected from loss of hydrophilicity by an exsiccation layer of salt and stored in a dry state. Various salts in different concentrations were tested in respect to their conservation capacity and optical appearance. Potassium phosphate buffer in a specified composition appeared to be optimal. This optimal system was applied in a long time storage experiment showing no loss of hydrophilicity over years. It was also transferred with success to hyperhydrophilic dental implants

Yield of a public health screening of children for islet autoantibodies in Bavaria, Germany

Importance: Public health screening for type 1 diabetes in its presymptomatic stages may reduce disease severity and burden on a population level. Objective: To determine the prevalence of presymptomatic type 1 diabetes in children participating in a public health screening program for islet autoantibodies and the risk for progression to clinical diabetes. Design, Setting, and Participants: Screening for islet autoantibodies was offered to children aged 1.75 to 5.99 years in Bavaria, Germany, between 2015 and 2019 by primary care pediatricians during well-baby visits. Families of children with multiple islet autoantibodies (presymptomatic type 1 diabetes) were invited to participate in a program of diabetes education, metabolic staging, assessment of psychological stress associated with diagnosis, and prospective follow-up for progression to clinical diabetes until July 31, 2019. Exposures: Measurement of islet autoantibodies. Main Outcomes and Measures: The primary outcome was presymptomatic type 1 diabetes, defined by 2 or more islet autoantibodies, with categorization into stages 1 (normoglycemia), 2 (dysglycemia), or 3 (clinical) type 1 diabetes. Secondary outcomes were the frequency of diabetic ketoacidosis and parental psychological stress, assessed by the Patient Health Questionnaire-9 (range, 0-27; higher scores indicate worse depression; ≤4 indicates no to minimal depression; &gt;20 indicates severe depression). Results: Of 90 632 children screened (median [interquartile range {IQR}] age, 3.1 [2.1-4.2] years; 48.5% girls), 280 (0.31%; 95% CI, 0.27-0.35) had presymptomatic type 1 diabetes, including 196 (0.22%) with stage 1, 17 (0.02%) with stage 2, 26 (0.03%) with stage 3, and 41 who were not staged. After a median (IQR) follow-up of 2.4 (1.0-3.2) years, another 36 children developed stage 3 type 1 diabetes. The 3-year cumulative risk for stage 3 type 1 diabetes in the 280 children with presymptomatic type 1 diabetes was 24.9% ([95% CI, 18.5%-30.7%]; 54 cases; annualized rate, 9.0%). Two children had diabetic ketoacidosis. Median (IQR) psychological stress scores were significantly increased at the time of metabolic staging in mothers of children with presymptomatic type 1 diabetes (3 [1-7]) compared with mothers of children without islet autoantibodies (2 [1-4]) (P = .002), but declined after 12 months of follow-up (2 [0-4]) (P &lt; .001). Conclusions and Relevance: Among children aged 2 to 5 years in Bavaria, Germany, a program of primary care-based screening showed an islet autoantibody prevalence of 0.31%. These findings may inform considerations of population-based screening of children for islet autoantibodies