Median mental sinus in twins

Sinus on the chin can be the result of a chronic apical abscess due to pulp necrosis of a mandibular anterior tooth. The tooth is usually asymptomatic, and a dental cause is therefore not apparent to the patient or the unsuspecting clinician. Not infrequently, the patient may seek treatment from a dermatologist or general surgeon instead of a dentist. Excision and repair of the fistula may be carried out with subsequent breakdown because the dental pathology is not removed. This paper reports the presence of median mental sinus of dental origin in twins. One case healed following root canal therapy while the other required both root canal therapy and surgery to eliminate the infection

Accreditation Engineering Scenario and Future of Engineering Education in Malaysia

Engineering education in Malaysia is a strong and vibrant enterprise. Malaysia government is projecting to produce 222,000 engineering graduates in the next 9 years. This number of engineers is needed to ensure the development industries, infrastructures and general well-being of Malaysia are carried out as planned. However, since Malaysia has engineers in various fields, engineers have provided the driving forces behind high technology services and products to enhance the Malaysia economy growth locally and internationally. It is also cited that there are 33 accredited engineering programmes in Malaysia universities and colleges. Engineering degree is the common degree entry to the engineering profession nowadays, such as civil engineering, electrical engineering, electronics engineering and mechanical engineering. The Malaysia engineering degree requires a completion of four years full time study. For an engineering degree programme to be recognize, all the engineering degrees in Malaysia are governed by Engineering Accreditation Council (EAC). EAC ensure all the engineering degree programmes that are offered by Malaysian universities are subjected to the minimum academic requirements for registration as a graduate engineer with the Board of Engineers Malaysia (BEM). BEM is representing Malaysia in Washington Accord since 2009, engineering education in Malaysia took on a broader international aspect and agreed to achieve equivalent standard with the other 14 signatories’ countries. Due to the upcoming challenges of the future, it is ideated that Malaysia engineers must progress working hard with all the necessary technical competencies in engineering science. This role is very important so that they will be flexible enough to be involved in multidisciplinary engineering tasks in Malaysia and around the world. Globalization is a trend that affects humanities, cultures, traditions and history of a country. Globalisation is defined as “the flow of people, culture, ideas, values, knowledge, technology, and economy across borders facilitating a more interconnected and interdependent world”. Engineering graduates are facing fierce challenges and competition not only locally but also internationally. Due to the global challenges and competition, local engineering graduates need to equip themselves with flexibility, ethics, professionalism, knowledge and skill in facing the global challenges. Government, educational institutions and industry plays an important role to upgrade the quality of local engineering education. The modern engineering profession deals constantly with uncertainty, incomplete data and competing (often conflicting) demands from clients, governments, environmental groups and the public. It requires technical competent and professionalism skill, as well as to be exposed to the global scenarios, current trend and future requirements. Whilst trying to incorporate more “humanity” skill into their knowledge base and professional practice, today’s engineers must also cope with continual technological and organizational changes in the workplace. In addition they must cope with the commercial realities of industrial practice in the modern world, as well as the legal consequences of every professional decision they make. The challenge for engineering education in Malaysia is to improve the current engineering education system so that the Malaysia engineering graduates are recognized internationally. Nevertheless, engineering education in Malaysia is constantly reviewed together with the professional members from the industries and education departmental. This study is expected to provide the current scenario of engineering education which later will foresee effect and the future design of accreditated engineering curriculum in Malaysia. This aim of this paper is to describe the modelled current scenario of accreditated engineering education and the accreditation process on future engineering education in Malaysia

The Sustainable Technological Innovation among SMEs in South East Asia Countries: A Case Study

South East Asia (SEA) region is characterized by economies of vast disparities in natural resources, capabilities and development levels. Key issues for Small and Medium Enterprises (SMEs) in globalizing economies in the region continue to financing, marketing, technology, human resource and external environment including policy framework. SMEs are currently going through a transition phase and process of restructuring for competitive growth, in the fast technological changes, among other factors. The increasing influx of transnational corporations (TNCs) and foreign direct investment (FDI) in manufacturing and services in the region have opened up large business opportunities and also threats, needing more advanced technological inputs, and absorptive and innovative capabilities for enhancing and efficiency of SMEs. This paper describes the technological innovation, provide information, and discuss the technological innovation issues in selected SEA countries

Status of PEM-based polarimetric MSE development at KSTAR

A multi-chord PEM (photo elastic modulator)-based polarimetric motional Stark effect (MSE) system is under development for the KSTAR tokamak. The conceptual design for the front optics was optimized to preserve not only the polarization state of the input light for the MSE measurements but also the signal intensity of the existing charge exchange spectroscopy (CES) system that will share the front optics with the MSE. The optics design incorporates how to determine the number of channels and the number of fibers for each channel. A dielectric coating will be applied on the mirror to minimize the relative reflectivity and the phase shift between the two orthogonal polarization components of the incident light. Lenses with low stress-birefringence constants will be adopted to minimize non-linear and random changes in the polarization through the lenses, which is a trade-off with the rather high Faraday rotation in the lenses because the latter effect is linear and can be relatively easily calibrated out. Intensive spectrum measurements and their comparisons with the simulated spectra are done to assist the design of the bandpass filter system that will also use tilting stages to remotely control the passband. Following the system installation in 2014, the MSE measurements are expected to be performed during the 2015 KSTAR campaign

Influence of abutment design on clinical status of peri-implant tissues

Objective: To compare the clinical soft tissue responses around implant tooth-supported 3-unit bridges using tapered abutments with those using butt-joint abutments. Methods: In a split-mouth design study, 8 mm Ankylos (Dentsply Friadent, Germany) implants were placed in the second mandibular molar region of 8 adult Macaca fascicularis monkeys about I month after extraction of all mandibular molars. After 3 months of submerged healing, 3-unit metal bridges were constructed. Clinical data was collected by the author who was blind to the abutment selections. Implants were clinically evaluated using Waite plaque index, sulcus bleeding index, probing pocket depth (PPD), probing attachment loss (PAL), and width of keratinized mucosa at baseline (BL) and 3-month and 6-month intervals. Stability of the implant was assessed using Periotest device at BL and after 6 months. Results: At BL, all the clinical variables did not differ statistically between the tapered and the butt-joint groups except for PPD (P < 0.05), where the meat? PPD was greater in the butt-joint group (2.75 +/- 1.02 mm) as compared with the tapered group (1.97 +/- 0.65 mm). At the 3-month assessment, there was no difference in all clinical variables. After 6-month loading, no significant difference between these 2 groups was detected in all these variables, with the exception of PAL (P = 0.05) where mean PAL was greater for implants with the butt-joint abutments (0.91 +/- 0.86 mm) in comparison with the tapered abutments (0.50 +/- 0.88 mm), and mean Periotest values (PTVs) that indicate the tapered-abutment implants (PTV = -4.5 +/- 1.60) were more stable than butt-joint-abutment implants (PTV = -1.5 +/- 3.59) with P < 0.05. Conclusions: The differences in these mucogingival responses between these 2 groups at BL (during seating of abutments, especially of butt-joint abutments) and after 6-month loading indicated enhanced peri-implant soft tissue stability around the tapered abutments of this system. There was also enhanced-PTV in the test group for clinical mobility assessment after 6-month loading. (Implant Dent 2009; 18:438-446

Discontinuation, suboptimal adherence, and reinitiation of oral HIV pre-exposure prophylaxis: a global systematic review and meta-analysis

Background: Poor adherence to oral HIV pre-exposure prophylaxis (PrEP) diminishes its clinical and public health benefits. This study synthesises evidence regarding discontinuation, adherence, and reinitiation of PrEP among geographically diverse PrEP users. Methods: We did a systematic review and meta-analysis evaluating studies published in MEDLINE, Embase, and Cochrane Central Register of Controlled Trials from inception to Dec 18, 2020. We included longitudinal studies that presented data for PrEP discontinuation, defined as investigator-reported loss to follow-up or participant self-reported PrEP stoppage. Data were extracted from published reports and assessed for risk of bias. We used a random-effects meta-analysis to pool estimates of discontinuation and I2 and τ2 to evaluate heterogeneity. This study is registered with PROSPERO, CRD42020155675. Findings: We identified 4129 records, of which 59 articles were included (n=43 917 participants). 41·0% (95% CI 18·8–63·5) of participants discontinued PrEP within 6 months, with the highest rates in observational studies. The discontinuation rate in sub-Saharan Africa (47·5%, 95% CI: 29·4–66·4%) was higher than in other regions (p&lt;0·001). Discontinuation rates were lower in studies with adherence interventions than in those without (24·7% vs 36·7%, p=0·015). Gay or bisexual men who have sex with men and transgender women offered daily or non-daily dosing options had lower discontinuation rates than those offered daily dosing alone (21·6% vs 31·5%; p&lt;0·001). The pooled suboptimal adherence within 6 months was 37·7% (95% CI 8·4–66·9). Among people who discontinued PrEP, 47·3% (95% CI 31·5–63·2) reinitiated PrEP within 1 year of PrEP initiation. The included studies had poor quality in terms of study design, with a moderate risk of bias. Interpretation: Strategies to encourage reinitiating PrEP for new or persistent risk should be a focus of future PrEP implementation strategies. Funding: National Institutes of Health and Nature Science Foundation of China

Genome-Wide Association Study in BRCA1 Mutation Carriers Identifies Novel Loci Associated with Breast and Ovarian Cancer Risk

BRCA1-associated breast and ovarian cancer risks can be modified by common genetic variants. To identify further cancer risk-modifying loci, we performed a multi-stage GWAS of 11,705 BRCA1 carriers (of whom 5,920 were diagnosed with breast and 1,839 were diagnosed with ovarian cancer), with a further replication in an additional sample of 2,646 BRCA1 carriers. We identified a novel breast cancer risk modifier locus at 1q32 for BRCA1 carriers (rs2290854, P = 2.7×10-8, HR = 1.14, 95% CI: 1.09-1.20). In addition, we identified two novel ovarian cancer risk modifier loci: 17q21.31 (rs17631303, P = 1.4×10-8, HR = 1.27, 95% CI: 1.17-1.38) and 4q32.3 (rs4691139, P = 3.4×10-8, HR = 1.20, 95% CI: 1.17-1.38). The 4q32.3 locus was not associated with ovarian cancer risk in the general population or BRCA2 carriers, suggesting a BRCA1-specific associat

The Influence of Age and Sex on Genetic Associations with Adult Body Size and Shape : A Large-Scale Genome-Wide Interaction Study

Genome-wide association studies (GWAS) have identified more than 100 genetic variants contributing to BMI, a measure of body size, or waist-to-hip ratio (adjusted for BMI, WHRadjBMI), a measure of body shape. Body size and shape change as people grow older and these changes differ substantially between men and women. To systematically screen for age-and/or sex-specific effects of genetic variants on BMI and WHRadjBMI, we performed meta-analyses of 114 studies (up to 320,485 individuals of European descent) with genome-wide chip and/or Metabochip data by the Genetic Investigation of Anthropometric Traits (GIANT) Consortium. Each study tested the association of up to similar to 2.8M SNPs with BMI and WHRadjBMI in four strata (men 50y, women 50y) and summary statistics were combined in stratum-specific meta-analyses. We then screened for variants that showed age-specific effects (G x AGE), sex-specific effects (G x SEX) or age-specific effects that differed between men and women (G x AGE x SEX). For BMI, we identified 15 loci (11 previously established for main effects, four novel) that showed significant (FDR= 50y). No sex-dependent effects were identified for BMI. For WHRadjBMI, we identified 44 loci (27 previously established for main effects, 17 novel) with sex-specific effects, of which 28 showed larger effects in women than in men, five showed larger effects in men than in women, and 11 showed opposite effects between sexes. No age-dependent effects were identified for WHRadjBMI. This is the first genome-wide interaction meta-analysis to report convincing evidence of age-dependent genetic effects on BMI. In addition, we confirm the sex-specificity of genetic effects on WHRadjBMI. These results may providefurther insights into the biology that underlies weight change with age or the sexually dimorphism of body shape.Peer reviewe

Repositioning of the global epicentre of non-optimal cholesterol

High blood cholesterol is typically considered a feature of wealthy western countries1,2. However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world3 and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health4,5. However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol—which is a marker of cardiovascular risk—changed from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million–4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.</p