Metallurgical Structures of As-Cast and Heat-Treated High-Palladium Dental Alloys

Scanning electron microscope observations and energy-dispersive spectroscopic analyses have been performed on two first-generation and two second-generation high-palladium dental casting alloys. A specimen design simulating a maxillary central incisor coping was employed to conserve metal, while providing thin and thick sections to yield a range of solidification rates. The alloys were centrifugally cast in air, following standard dental laboratory techniques; three castings were prepared for each alloy. Each casting was sectioned to produce two mirror-image specimens, and one specimen received the appropriate oxidation heat treatment, followed by a simulated full porcelain firing sequence. After metallographic polishing, specimens were examined with a scanning electron microscope. The as-cast alloys displayed multi-phase microstructures which could be explained by the rapid solidification conditions and the relevant phase diagrams. The simulated porcelain firing heat treatment caused a variety of bulk microstructural changes in the coping sections, along with formation of complex subsurface oxidation regions which were less thick for the second-generation alloys. Elemental compositions of the palladium solid solution matrix in the heat-treated alloys were in good agreement with nominal alloy compositions provided by the manufacturers. Ruthenium-rich particles found in the microstructures of three alloys are consistent with a proposed mechanism for grain refinement

Metallurgical Structures of As-Cast and Heat-Treated High-Palladium Dental Alloys

Scanning electron microscope observations and energy-dispersive spectroscopic analyses have been performed on two first-generation and two second-generation high-palladium dental casting alloys. A specimen design simulating a maxillary central incisor coping was employed to conserve metal, while providing thin and thick sections to yield a range of solidification rates. The alloys were centrifugally cast in air, following standard dental laboratory techniques; three castings were prepared for each alloy. Each casting was sectioned to produce two mirror-image specimens, and one specimen received the appropriate oxidation heat treatment, followed by a simulated full porcelain firing sequence. After metallographic polishing, specimens were examined with a scanning electron microscope. The as-cast alloys displayed multi-phase microstructures which could be explained by the rapid solidification conditions and the relevant phase diagrams. The simulated porcelain firing heat treatment caused a variety of bulk microstructural changes in the coping sections, along with formation of complex subsurface oxidation regions which were less thick for the second-generation alloys. Elemental compositions of the palladium solid solution matrix in the heat-treated alloys were in good agreement with nominal alloy compositions provided by the manufacturers. Ruthenium-rich particles found in the microstructures of three alloys are consistent with a proposed mechanism for grain refinement

Room Temperature Aging of Pd-Cu-Ga Dental Alloys

Specimens of three Pd-Cu-Ga dental alloys cast five years ago and subsequently stored at room temperature were reexamined and observed to have lower amounts of the eutectic constituents in the near-surface region than originally present, along with other microstructural changes. This previously unreported room temperature aging behavior of these alloys is attributed to the presence of high-diffusivity paths in the non-equilibrium ascast eutectic structures and to the essential role of the surface for the vacancy diffusion mechanism. These results may have important clinical significance for the ill vivo corrosion resistance and long-term biocompatibility of the Pd-Cu-Ga alloys

Thromboembolism After Intramedullary Nailing for Metastatic Bone Lesions.

BACKGROUND: The risk of venous thromboembolism (VTE) in patients undergoing intramedullary nailing for skeletal metastatic disease is currently undefined. The purpose of our study was to determine the risk of thromboembolic events, to define the risk factors for VTE, and to define the rate of wound complications in this population. METHODS: A retrospective review of surgical databases at three National Cancer Institute (NCI)-designated cancer centers identified 287 patients with a total of 336 impending or pathologic long-bone fractures that were stabilized with intramedullary nailing between February 2001 and April 2013. Statistical analysis was performed utilizing multivariable logistic regression and Fisher exact tests. RESULTS: The overall rate of VTE was twenty-four (7.1%) of the 336; thirteen (3.9%) were pulmonary embolism (PE), and eleven (3.3%), deep venous thrombosis (DVT). In two patients, adequate anticoagulation data were not available. We found no significant relationship between the type of anticoagulant used and VTE. There was a significant positive correlation found between lung-cancer histology and the development of VTE (p \u3c 0.001) or PE (p \u3c 0.001). The absence of radiation therapy approached significance (p = 0.06) with respect to decreased overall VTE risk. Wound complications were documented for 11 (3.3%) of the operations. CONCLUSIONS: There is a high rate of VTE among those with skeletal metastatic disease who undergo intramedullary nailing, even while receiving postoperative thromboembolic prophylaxis. Current anticoagulation protocols may be inadequate. Wound-complication risk with anticoagulant use in this population is low and should not be a deterrent to adequate anticoagulant use for this population

Social Security Research at the University of Michigan Retirement and Disability Research Center

In 1998, the Social Security Administration established the Retirement Research Consortium to encourage research on topics related to Social Security and the well-being of older Americans, and to foster communication between the academic and policy communities. The Michigan Retirement Research Center (MRRC) participated in the Consortium from its inception until 2019, when the MRRC expanded and became the Michigan Retirement and Disability Research Center. This article surveys a selection of the MRRC’s output over its second 10 years (2008–2017), summarizes its innovative use of new data sources, and highlights several key themes in the center’s research contributions

Rasch analysis of the hospital anxiety and depression scale (hads) for use in motor neurone disease

<p>Abstract</p> <p>Background</p> <p>The Hospital Anxiety and Depression Scale (HADS) is commonly used to assess symptoms of anxiety and depression in motor neurone disease (MND). The measure has never been specifically validated for use within this population, despite questions raised about the scale's validity. This study seeks to analyse the construct validity of the HADS in MND by fitting its data to the Rasch model.</p> <p>Methods</p> <p>The scale was administered to 298 patients with MND. Scale assessment included model fit, differential item functioning (DIF), unidimensionality, local dependency and category threshold analysis.</p> <p>Results</p> <p>Rasch analyses were carried out on the HADS total score as well as depression and anxiety subscales (HADS-T, D and A respectively). After removing one item from both of the seven item scales, it was possible to produce modified HADS-A and HADS-D scales which fit the Rasch model. An 11-item higher-order HADS-T total scale was found to fit the Rasch model following the removal of one further item.</p> <p>Conclusion</p> <p>Our results suggest that a modified HADS-A and HADS-D are unidimensional, free of DIF and have good fit to the Rasch model in this population. As such they are suitable for use in MND clinics or research. The use of the modified HADS-T as a higher-order measure of psychological distress was supported by our data. Revised cut-off points are given for the modified HADS-A and HADS-D subscales.</p

Effects of a pragmatic lifestyle intervention for reducing body mass in obese adults with obstructive sleep apnoea: a randomised controlled trial

This study investigated the effects of a pragmatic lifestyle intervention in obese adults with continuous positive airway pressure-treated obstructive sleep apnoea hypopnoea syndrome (OSAHS). Sixty patients were randomised 1 : 1 to either a 12-week lifestyle intervention or an advice-only control group. The intervention involved supervised exercise sessions, dietary advice, and the promotion of lifestyle behaviour change using cognitive-behavioural techniques. Outcomes were assessed at baseline (week 0), intervention end-point (week 13), and follow-up (week 26). The primary outcome was 13-week change in body mass. Secondary outcomes included anthropometry, blood-borne biomarkers, exercise capacity, and health-related quality of life. At end-point, the intervention group exhibited small reductions in body mass (−1.8 [−3.0, −0.5] kg; P = 0.007) and body fat percentage (−1 [−2, 0]%; P = 0.044) and moderate improvements in C-reactive protein (−1.3 [−2.4, −0.2] mg·L−1; P = 0.028) and exercise capacity (95 [50, 139] m; P <0.001 ). At follow-up, changes in body mass (−2.0 [−3.5, −0.5] kg; P = 0.010), body fat percentage (−1 [−2, 0]%; P = 0.033), and C-reactive protein (−1.3 [−2.5, −0.1] mg·L−1; P = 0.037 ) were maintained and exercise capacity was further improved (132 [90, 175] m; P <0.001). This trial is registered with ClinicalTrials.gov NCT01546792

Identifying preferred features of weight loss programs for adults with or at risk of type 2 diabetes: a discrete choice experiment with 3,960 adults in the U.K.

OBJECTIVE: To understand preferences for features of weight loss programs among adults with or at risk of type 2 diabetes in the U.K. RESEARCH DESIGN AND METHODS: We conducted a discrete choice experiment with 3,960 U.K. adults living with overweight (n = 675 with type 2 diabetes). Preferences for seven characteristics of weight loss programs were analyzed. Simulations from choice models using the experimental data predicted uptake of available weight loss programs. Patient groups comprising those who have experience with weight loss programs, including from minority communities, informed the experimental design. RESULTS: Preferences did not differ between individuals with and without type 2 diabetes. Preferences were strongest for type of diet. Healthy eating was most preferred relative to total diet replacement (odds ratio [OR] 2.24; 95% CI 2.04–2.44). Individual interventions were more popular than group interventions (OR 1.40; 95% CI 1.34–1.47). Participants preferred programs offering weight loss of 10–15 kg (OR 1.37; 95% CI 1.28–1.47) to those offering loss of 2–4 kg. Online content was preferred over in-person contact (OR 1.24; 95% CI 1.18–1.30). There were few differences in preferences by gender or ethnicity, although weight loss was more important to women than to men, and individuals from ethnic minority populations identified more with programs where others shared their characteristics. Modeling suggested that tailoring programs to individual preferences could increase participation by ∼17 percentage points (68% in relative terms). CONCLUSIONS: Offering a range of weight loss programs targeting the preferred attributes of different patient groups could potentially encourage more people to participate in weight loss programs and support those living with overweight to reduce their weight

Peptidomic discovery of short open reading frame-encoded peptides in human cells

The amount of the transcriptome that is translated into polypeptides is of fundamental importance. We developed a peptidomic strategy to detect short ORF (sORF)-encoded polypeptides (SEPs) in human cells. We identified 90 SEPs, 86 of which are novel, the largest number of human SEPs ever reported. SEP abundances range from 10-1000 molecules per cell, identical to known proteins. SEPs arise from sORFs in non-coding RNAs as well as multi-cistronic mRNAs, and many SEPs initiate with non-AUG start codons, indicating that non-canonical translation may be more widespread in mammals than previously thought. In addition, coding sORFs are present in a small fraction (8/1866) of long intergenic non-coding RNAs (lincRNAs). Together, these results provide the strongest evidence to date that the human proteome is more complex than previously appreciated

Circulating CD34+ Cell Count is Associated with Extent of Subclinical Atherosclerosis in Asymptomatic Amish Men, Independent of 10-Year Framingham Risk

Background Bone-marrow derived progenitor cells (PCs) may play a role in maintaining vascular health by actively repairing damaged endothelium. The purpose of this study in asymptomatic Old Order Amish men (n = 90) without hypertension or diabetes was to determine if PC count, as determined by CD34+ cell count in peripheral blood, was associated with 10-year risk of cardiovascular disease (CVD) and measures of subclinical atherosclerosis. Methods and Results CD34+ cell count by fluorescence-activated cell sorting, coronary artery calcification (CAC) by electron beam computed tomography, and CVD risk factors were obtained. Carotid intimal-medial thickness (CIMT) also was obtained in a subset of 57 men. After adjusting for 10-year CVD risk, CD34+ cell count was significantly associated with CAC quantity ( p =0.03) and CIMT ( p < 0.0001). A 1-unit increase in natural-log transformed CD34+ cell count was associated with an estimated 55.2% decrease (95% CI: −77.8% to −9.3%) in CAC quantity and an estimated 14.3% decrease (95% CI: −20.1% to −8.1%) in CIMT. Conclusions Increased CD34+ cell count was associated with a decrease in extent of subclinical atherosclerosis in multiple arterial beds, independent of 10-year CVD risk. Further investigations of associations of CD34+ cell count with subclinical atherosclerosis in asymptomatic individuals could provide mechanistic insights into the atherosclerotic process