Accidental Ingestion of Endodontic File: A Case Report

Ingestion of the endodontic instrument during root canal treatment is rare but can result in serious complications. The present paper reports a case in which endodontic file was accidentally swallowed by the patient undergoing root canal therapy, which entered digestive tract and passed uneventfully

Access to Oral Health Care in Nebraska

Oral health contributes to overall health; therefore, it is important to understand the level of access to oral health care in Nebraska. Our analysis of the most recently available data in Nebraska on access to oral health care and on the oral health workforce indicates that in 2010, 68.4% of Nebraskans aged 18 years and older visited a dentist within the past year. The total number of dentists practicing in Nebraska in 2012 was 1,028, compared to 1,017 in 2008; however, the number of dentists per 100,000 population decreased by 2.85% between 2008 and 2012, and the number of dentists older than 60 years increased by 39.29%, raising concerns about the retiring dental workforce. Also, in 2012, 53.6% of dentists practicing in Nebraska were practicing part-time, and only 39.2% practiced in rural areas. Twenty Nebraska counties were without a dentist in 2012. The State of Nebraska designates 44 counties as general dentistry shortage areas, and the Health Resources and Services Administration designates 72 dental Health Professional Shortage Areas in Nebraska. To meet the oral health objectives outlined in Healthy People 2020 and to provide services to the additional children who will have dental coverage under the Affordable Care Act, access to care and dental workforce needs in Nebraska will require the attention of both policymakers and providers.https://digitalcommons.unmc.edu/coph_policy_reports/1001/thumbnail.jp

Autogenous Brachial—Brachial Fistula for Vein Access. Haemodynamic Factors Predicting Outcome and 1 Year Clinical Data

AbstractTwo-stage autogenous brachial vein–brachial artery access (ABBA) has been proposed as an option where adequate superficial vein is not available for the creation of conventional haemodialysis fistulae.MethodsThis report depicts the clinical outcome of a series of 17 consecutive patients who underwent ABBA in a single centre. Of the 17 patients, nine had had at least one previous arterioventricular (AV) fistula or graft, and eight were new to haemodialysis. Patencies were assessed using the Kaplan–Meier survival analysis.ResultsIn 14 patients, the brachial vein was transposed (82%) and the time to transposition ranged from 4 to 26 weeks (median time: 6 weeks). The functional patency rate was 45.75% at 12 months. After stage one, all fistulas that went on to develop well had a brachial vein flow of at least 900mlmin−1, and this was significantly higher than in fistulas that failed to develop (p=0.005). The maturation rate in our study was 65% and the median time to cannulation of the fistula was 8weeks from the stage 1. Of the 17 patients, 12 (71%) experienced at least one complication. Ten (59%) demonstrated moderate-to-severe stenoses; eight of which necessitated angioplasty and/or percutaneous mechanical thrombolysis.ConclusionsABBA was characterised by a high incidence of complications and a long period to achieve maturation. Despite close monitoring and a high rate of secondary interventions, the patency rate was low. With this experience, we now only consider it an alternative in patients without adequate superficial veins, who have had failed grafts or where there is a very high risk of infection

Software architecture for YOLO, a creativity-stimulating robot

YOLO is a social robot designed and developed to stimulate creativity in children through storytelling activities. Children use it as a character in their stories. This article details the artificial intelligence software developed for YOLO. The implemented software schedules through several Creativity Behaviors to find the ones that stimulate creativity more effectively. YOLO can choose between convergent and divergent thinking techniques, two important processes of creative thought. These techniques were developed based on the psychological theories of creativity development and on research from creativity experts who work with children. Besides promoting creativity, this software allows the creation of Social Behaviors that enable the robot to behave as a believable character. We built 3 main social behavior parameters: Exuberant, Aloof, and Harmonious. These behaviors are meant to ease immersive play and the process of character creation. The 3 social behaviors were based on psychological theories of personality and developed using children's input during co-design studies. Overall, this work presents the design, development, and usage of social robots that might nurture intrinsic human abilities, such as the ability to be creative.info:eu-repo/semantics/publishedVersio

Remarkable variation in the informativeness of RFLP markers linked to hemophilia B locus in Indian population groups: implication in the strategy for carrier detection

Hemophilia B, an X-linked recessive bleeding disorder, is caused by heterogeneous mutations in the factor IX (F9) gene. Hence, carriers of the disease are usually detected by F9 gene linked RFLP analysis. We aimed to test a set of RFLP markers (DdeI, XmnI, MnlI, TaqI & HhaI), used worldwide for carrier detection, to estimate its heterozygosity in different population groups of India, and identify additional single nucleotide polymorphisms (SNPs) if necessary. A total of 8 population groups encompassing different regions of India, consisting of 107 unrelated normal females without any history of hemophilia B in the family and 13 unrelated obligate carriers were recruited in the study. Regions of F9 gene were amplified by PCR from genomic DNA of the donors followed by restriction enzyme digestion and/or sequencing as appropriate. Combined informativeness for the markers varied between 52-86% among normal females belonging to different geographical locations of India. Haplotype analysis revealed that the most prevalent haplotype lacked the restriction sites for all five RFLP markers. Screening regions of F9 gene that harbor 10 SNPs reported in dbSNP yielded only two SNPs, which increased the overall informativeness in each population group and heterozygosity in the obligate carriers for the disease from 38% to 69%. Our data show that heterozygosity of commonly used RFLP markers is remarkably variable across different regions of India. Thus prudent selection of the markers based on specific population groups including usage of additional markers is recommended for efficient carrier detection

Design and development of the ‘POD Adventures’ smartphone game: a blended problem-solving intervention for adolescent mental health in India

Introduction: Digital technology platforms offer unparalleled opportunities to reach vulnerable adolescents at scale and overcome many barriers that exist around conventional service provision. This paper describes the design and development of POD Adventures, a blended problem-solving game-based intervention for adolescents with or at risk of anxiety, depression and conduct difficulties in India. This intervention was developed as part of the PRemIum for ADolEscents (PRIDE) research programme, which aims to establish a suite of transdiagnostic psychological interventions organised around a stepped care system in Indian secondary schools. Methods and materials: Intervention development followed a person-centered approach consisting of four iterative activities: (i) review of recent context-specific evidence on mental health needs and preferences for the target population of school-going Indian adolescents, including a multiple stakeholder analysis of school counselling priorities and pilot studies of a brief problem-solving intervention; (ii) new focus group discussions with N=46 student participants and N=8 service providers; (iii) co-design workshops with N=22 student participants and N=8 service providers; and (iv) user-testing with N=50 student participants. Participants were aged 12-17 years and recruited from local schools in New Delhi and Goa, including a subgroup with self-identified mental health needs (N=6). Results: Formative data from existing primary sources, new focus groups and co-design workshops supported a blended format for delivering a brief problem-solving intervention, with counsellors supporting use of a game-based app on ‘offline’ smartphones. User-testing with prototypes identified a need for simplification of language, use of concrete examples of concepts and practice elements to enhance engagement. There were also indications that participants most valued relatability and interactivity within real-world stories with judicious support from an in-app guide. The final prototype comprised a set of interactive and gamified vignettes and a structured set of problem-solving questions to consolidate and generalise learning while encouraging real-world application. Discussion: Findings shaped the design of POD Adventures and its delivery as an open-access blended intervention for secondary school students with a felt need for psychological support, consistent with an early intervention paradigm. A randomised controlled trial is planned to evaluate processes and impacts of POD Adventures when delivered for help-seeking students in low-resource school settings

The Cancer Care Workforce in Nebraska

Although cancer is the leading cause of death in Nebraska, the adequacy of Nebraska’s cancer care workforce to care for the cancer population is unknown. Therefore, we used workforce survey data for 2008-2012 from the Health Professions Tracking Service to analyze the cancer care workforce supply in Nebraska. We found that from 2008 to 2012, the cancer care workforce for adults outpaced cancer prevalence. We outline several policy options to improve Nebraska’s cancer care workforce capacity, and we consider the effect the Affordable Care Act may have on Nebraska’s cancer care workforcehttps://digitalcommons.unmc.edu/coph_policy_reports/1005/thumbnail.jp

Learning to speak on behalf of a group: medium access control for sending a shared message

The rapid development of Internet of Things (IoT) technologies has not only enabled new applications, but also presented new challenges for reliable communication with limited resources. In this work, we define a novel problem that can arise in these scenarios, in which a set of sensors need to communicate a joint observation. This observation is shared by a random subset of the nodes, which need to propagate it to the rest of the network, but coordination is complex: as signaling constraints require the use of random access schemes over shared channels, sensors need to implicitly coordinate, so that at least one transmission gets through without collisions. Unlike the majority of existing medium access schemes, the goal is to make sure that the shared message gets through, regardless of the sender. We analyze this coordination problem theoretically and provide low-complexity solutions. While a clustering-based approach is near-optimal if the sensors have prior knowledge, we provide a distributed multi-armed bandit (MAB) solution for the more general case and validate it by simulation

Razvoj matriksnih sustava za transdermalnu isporuku pentazocina: In vitro/in vivo ispitivanje

The present study aimed to develop hydroxypropyl methylcellulose based transdermal delivery of pentazocine. In formulations containing lower proportions of polymer, the drug released followed the Higuchi kinetics while, with an increase in polymer content, it followed the zero-order release kinetics. Release exponent (n) values imply that the release of pentazocine from matrices was non-Fickian. FT-IR, DSC and XRD studies indicated no interaction between drug and polymer. The in vitro dissolution rate constant, dissolution half-life and pharmacokinetic parameters (Cmax, tmax, AUC(s), t1/2, Kel, and MRT) were evaluated statistically by two-way ANOVA. A significant difference was observed between but not within the tested products. Statistically, a good correlation was found between per cent of drug absorbed from patches vs. Cmax, and AUC(s). A good correlation was also observed when per cent drug released was correlated with the blood drug concentration obtained at the same time point. The results of this study indicate that the polymeric matrix films of pentazocine hold potential for transdermal drug delivery.U radu je opisan razvoj transdermalnih sustava na bazi hidroksipropil metilceluloze za isporuku pentazocina. U pripravcima koji sadrže manje udjele polimera, otpuštanje lijeka slijedilo je Higuchijevu kinetiku. Međutim, ako je udio polimera veći oslobađanje je najbolje odgovaralo kinetici nultog reda. Vrijednost eksponenta n implicira da oslobađanje pentazocina iz matriksa nije po Fickovom zakonu. FT-IR, DSC i X RD studije ukazuju da nema interakcije između ljekovite tvari i polimera. In vitro konstanta oslobađanja, poluvrijeme oslobađanja i farmakokinetički parametri (Cmax, tmax, AUC(s), t1/2, Kel, i MRT) procijenjeni su statistički koristeći ANOVA program. Značajna razlika primijećena je između, ali ne i unutar testiranih pripravaka. Pronađena je dobra korelacija između lijeka apsorbiranog iz flastera i Cmax i AUC(s) te oslobođenog lijeka i koncentracije lijeka u krvi. Rezultati ukazuju da su polimerni matriksni filmovi pentazocina potencijalno dobri sustavi za transdermalnu primjenu lijeka

Differential placental methylation and expression of VEGF, FLT-1 and KDR genes in human term and preterm preeclampsia

BACKGROUND: Preeclampsia, a pregnancy complication of placental origin is associated with altered expression of angiogenic factors and their receptors. Recently, there is considerable interest in understanding the role of adverse intrauterine conditions in placental dysfunction and adverse pregnancy outcomes. Since we have observed changes in placental global DNA methylation levels in preeclampsia, this study was undertaken to examine gene promoter CpG methylation and expression of several angiogenic genes. We recruited 139 women comprising, 46 normotensive women with term delivery (≥37 weeks), 45 women with preeclampsia delivering preterm (<37 weeks) and 48 women with preeclampsia delivering at term. Expression levels and promoter CpG methylation of VEGF, FLT-1 and KDR genes in placentae from respective groups were determined by Taqman-based quantitative real time PCR and by the Sequenom® EpiTYPER™ technology respectively. RESULTS: We observed several differentially methylated CpG sites in the promoter regions of VEGF, FLT-1 and KDR between the normotensive and preeclampsia groups. We specifically observed hypomethylated CpGs in the promoter region and an increased expression of VEGF gene between term and preterm preeclampsia. However, mean promoter CpG methylation could not account for the higher expression of FLT-1 and KDR in preterm preeclampsia as compared to normotensive group. CONCLUSIONS: Our data indicates altered DNA methylation patterns in the VEGF, FLT-1 and KDR genes in preeclampsia as compared to the normotensive group, which could be involved in the pathophysiology of preeclampsia. Hypomethylation of VEGF promoter and consequent upregulation of VEGF mRNA levels could be a compensatory mechanism to restore normal angiogenesis and blood flow in preterm preeclampsia. This study suggests a role of altered DNA methylation in placental angiogenesis and in determining adverse pregnancy outcomes