Periodontal Disease, Bone Loss, and Anti-Androgen Therapy

Periodontitis is a multifactorial disease with microbial dental plaque as the etiological agent. The manifestation and progress of periodontitis is influenced by a wide variety of determinants and factors, including subject characteristics, social and behavioral factors, systemic factors, genetic factors, the microbial composition of dental plaque, and others. The pathogenesis of periodontal disease results in resorption of alveolar bone and loss of the attachment apparatus to the teeth. There is a biological potential that periodontal destruction may be influenced by systemic bone loss. Since alveolar bone loss is a prominent feature of periodontal disease, disturbances in bone mineral density (BMD), especially in the jaws, are suspected of being an aggravating factor in periodontal disease. In previously published research, the severity of osteoporosis may be related to tooth loss in post-menopausal women. Considering the relationship among bone mineral density, osteoporosis, and periodontitis in men, it is known that men completing androgen ablation therapy for control of prostate cancer are at higher risk for osteoporosis. As androgen deprivation therapy is the recommended treatment for men with metastatic or locally-advanced nonmetastatic prostate carcinoma, and as prostate carcinoma is the most common visceral malignancy and the second leading cause of death from cancer in men, the relationship between androgen deprivation therapy and loss of bone mineral density is a matter of public health importance.This dissertation assesses the association between bone mineral density, the presence of periodontal disease, and the possible subsequent onset of clinical osteoporosis, as seen among a population of older women followed longitudinally; a set of men with prostate carcinoma undergoing androgen ablation therapy; and those men in the same set not receiving androgen ablation for prostate cancer. We believe our research, using the model of periodontal bone density and oral bone loss, shows additional clear empirical evidence pointing to a cause-and-effect relationship between androgen deprivation therapy and loss of bone mineral density

Differential construct definitions of six change score models within a correlational research context

Six change score models were comparatively evaluated within the correlational research context. The models compared included raw change, corrections of raw change for unreliability in x, correction of raw change for unreliability in both x and y, a regression correction, the raw residual model, and the base-free measure of change. The data were simulated for nine different parameter conditions. The manipulated parameter values were reliability coefficient values for x, y and w where x and y were the components of change and w was an outside variable, relative variability of x and y, colinearity between x and y, and relative validity coefficients for x and y. A set of true and two sets of observed change scores (total of 18 models) were generated for 2000 cases under each condition. Correlations among scores between models within and across conditions were generated. A principal component analysis was used to investigate the commonality of the change score models regarding the construct definition of change when w was considered and when w was partialed from the change score models. The latter analysis investigated the possible differential impact of w on the construct definition of change. The findings revealed that model differences do exist between the change scores under most of the parameter conditions, particularly for \sigma\sb{x} = \sigma\sb{y} where \rho\sb{xy} \sigma\sb{x} where \rho\sb{xy} = 0.75 when \rho \sb{xx\prime} \not= \rho\sb{yy\prime}. Selected parameter conditions had differential impact on discrepancy models versus residual models. Discrepancy models were more susceptible to manipulations of x and y variability, while the base-free measure of change was most affected by different reliability levels and colinearity coefficients. Removal of w had differential impact on the change score models. The results of this study lead to a conclusion that change scores in the form of any of the models are not sufficiently stable across research conditions to provide confidence in their use. Those conditions most favorable to change scores are rare in practice and use of a single variable (y) will result in an equal amount of information

A Joint Model for Definition Extraction with Syntactic Connection and Semantic Consistency

Definition Extraction (DE) is one of the well-known topics in Information Extraction that aims to identify terms and their corresponding definitions in unstructured texts. This task can be formalized either as a sentence classification task (i.e., containing term-definition pairs or not) or a sequential labeling task (i.e., identifying the boundaries of the terms and definitions). The previous works for DE have only focused on one of the two approaches, failing to model the inter-dependencies between the two tasks. In this work, we propose a novel model for DE that simultaneously performs the two tasks in a single framework to benefit from their inter-dependencies. Our model features deep learning architectures to exploit the global structures of the input sentences as well as the semantic consistencies between the terms and the definitions, thereby improving the quality of the representation vectors for DE. Besides the joint inference between sentence classification and sequential labeling, the proposed model is fundamentally different from the prior work for DE in that the prior work has only employed the local structures of the input sentences (i.e., word-to-word relations), and not yet considered the semantic consistencies between terms and definitions. In order to implement these novel ideas, our model presents a multi-task learning framework that employs graph convolutional neural networks and predicts the dependency paths between the terms and the definitions. We also seek to enforce the consistency between the representations of the terms and definitions both globally (i.e., increasing semantic consistency between the representations of the entire sentences and the terms/definitions) and locally (i.e., promoting the similarity between the representations of the terms and the definitions)

For fibromyalgia, which treatments are the most effective?

There is no single most effective modality for the treatment of fibromyalgia syndrome, and no objective comparison of the results from the different studies is available. Low-dose tricyclic antidepressants (TCAs) improve sleep quality and global well-being and have a moderate beneficial effect on tenderness and stiffness (strength of recommendation [SOR]: A, based on a systematic review of randomized controlled trials [RCTs]). Selective serotonin reuptake inhibitors (SSRIs) may moderately improve fibromyalgia-related symptoms (SOR: B, based on a few RCTs). The serotonin and norepinephrine reuptake inhibitors (SNRIs) duloxetine (Cymbalta) and milnacipran (Ixel, not currently available in the US) improve pain and other symptoms (SOR: B, based on single RCTs). Tramadol (Ultram) improves pain and other outcomes (SOR: A, based on a few RCTs). Cyclobenzaprine (Flexeril) improves both pain and sleep quality (SOR: A, based on a systematic review of RCTs). Aerobic exercise improves overall functional capacity and sense of well-being for patients with fibromyalgia (SOR: A, based on a systematic review of RCT). Cognitive behavioral therapy improves patients' self-reported symptoms (SOR: A, based on RCTs)

PARAMETERS AFFECTING THE STRUCTURAL ANALYSIS OF A TUNNEL STRUCTURE EXPOSED TO FIRE

Behaviour of cut-and-cover tunnels exposed to fire should be analysed by using a realistic structural model that takes account of mechanical and thermal effects on the structure. This has been performed with the aid of Finite Element (FE) software package called SOFiSTiK in parallel, for two types of elements as a scope of research project financed by the German Bundesanstalt für Straßenwesen BAST. Since the stiffness of the structure at elevated temperatures is highly affected, a realistic model of structural behaviour of the tunnel could be only achieved by considering the nonlinear analysis of the structure. This has been performed for a 2–cell cut and cover tunnel by taking account of simultaneous reduction of stiffness and strength and the time-dependent increasing indirect effects due to axial constraints and temperature gradients induced by elevated temperatures. The thermal analyses have been performed and the effects were implemented into the structural model by the multi-layered strain model. The stress–strain model proposed by EN 1992-1-2 is implemented for the elevated temperature. Since there was sufficient amount of Polypropylene fibres in the concrete mixtures, modelling of spalling was excluded from the analysis. The critical corresponding stresses and material behaviour are compared and interpreted at different time stages. The main parameters affecting the accuracy and convergence of the results of structural analysis for the used model are identified: defining a realistic fire action, using concrete material model fulfilling the requirements of fire situation in tunnels, defining appropriate time intervals for load implementations. These parameters along with other parameters, which influence the results to a lesser degree, are identified and investigated in this paper

Analysis of the spatial distribution of health care centers of Shahrekord by geographical information system

زمینه و هدف: توسعه فیزیکی نامتناسب شهرها و عدم تخصیص مناسب امکانات شهری از جمله توزیع نامتناسب مراکز بهداشتی درمانی سبب هدر رفت منابع مادی و انسانی شده و مشکلات شهر نشینی شهروندان را به دنبال داشته است. هدف از این پژوهش شناسایی مناطق فاقد دسترسی مناسب خدمات بهداشتی جهت توزیع بهینه امکانات بهداشتی بر اساس عدالت در سلامت در تمام مناطق شهری شهرکرد بوده است. روش بررسی: پژوهش حاضر یک مطالعه توصیفی- تحلیلی مبتنی بر روش‌های پژوهش اسنادی بود. پس از تلفیق دادهای تمام ده مرکز و پایگاه‌های بهداشتی درمانی سطح شهر شهرکرد، با استفاده از سیستم اطلاعات جغرافیایی با تعیین شعاع عملکردی و دسترسی در سال 1390، پراکنش فضایی این مراکز پس از تجزیه و تحلیل با استفاده از تحلیل سلسله مراتبی داده‌ها رتبه بندی مناطق انجام گردید. یافته ها: داده‌های مراکز و پایگاه‌های بهداشتی درمانی شهر شهرکرد نشان داد که اختلاف زیادی در تمام مراکز و پایگاه‌های بهداشتی شهر شهرکرد از نظر بیشترین به کم‌ترین وسعت تحت پوشش(4/4 برابر)، تعداد جمعیت (3/2 برابر) و تراکم جمعیتی (6/2 برابر) وجود دارد. مناطق حاشیه شمال و جنوب و شرق سطح دسترسی نامناسبی نسبت به مرکز شهر داشته و70 تراکم مراکز و پایگاه‌های بهداشتی شهر شهرکرد فاقد توزیع مناسب می‌باشند. نتیجه گیری: نتایج نشان می‌دهد که تراکم مراکز و پایگاه‌های بهداشتی شهر شهرکرد فاقد توزیع مناسب بوده و پراکنش مناسبی مشاهده نگردید. توزیع غیرمنطقی و محدوده بندی نامتناسب واحدهای بهداشتی منجر به کاهش سطح دسترسی مطلوب می‌شود که احتمال افت سطح شاخص‌های عدالت در سلامت را به دنبال خواهد داشت

Prevalence of Clarithromycin-Resistant Helicobacter pylori in Patients With Chronic Tonsillitis by Allele-Specific Scorpion Real-Time Polymerase Chain Reaction Assay

Objectives/Hypothesis: To investigate the allelic prevalence of resistance to clarithromycin in the DNA of clinical isolates of Helicobacter pylori obtained from biopsy specimens of patients with chronic tonsillitis by Scorpion real-time polymerase chain reaction (PCR). Study Design: Pathologic specimens of patients with chronic tonsillitis were used for rapid urease test, and blocks of paraffin-embedded tonsillar tissue were used for McMullen staining, rapid urease test, and Scorpion real-time PCR test. Methods: A total of 103 biopsy samples were obtained from patients with chronic tonsillitis and examined for the presence of clarithromycin resistant H. pylori. Modified McMullen staining and rapid urease test were done on the all the samples. The DNA of specimens was extracted from the pathology blocks, and Scorpion real-time PCR was performed on a final volume of 25 lL. Results: Of 103 biopsy specimens, 22 samples were identified as infected by H. pylori, of which none were sensitive to clarithromycin. One had the A2143G genotype, and four had the A2142G genotype. Two had a mixed sensitive and the A2143G genotype, and five had a mixed sensitive and A2142G genotype. One strain had a mixed genotype of sensitive, A2143G, and A2142G. Conclusions: The reported rate of resistance to clarithromycin is of great variation among H. pylori strains isolated from specimens in different countries. Our study showed that the most prevalent genotypes in our H. pylori-positive specimens was A2142G followed by A2143G, which is different from reported results of allele-specific genotyping of H. pylori strains isolated from gastric biopsy and may be a result of cross-resistance to erythromycin and other macrolides. Key Words: Scorpion real-time polymerase chain reaction, chronic tonsillitis, clarithromycin