Non-pharmacological interventions for managing dental anxiety in children

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: This review aims to assess the effectiveness of non-pharmacological interventions for reducing dental anxiety in children

A Multiobjective Branch-and-Bound Method for Planning Wastewater and Residual Management Systems

A multiobjective branch-and-bound algorithm is proposed for use in analysing multiobjective fixed-charge network-flow problems which are found commonly in water resources planning situations. Also proposed is a multiobjective imputed value analysis which makes use of the branch-and-bound tree structure and allows the comparison of the importance of facilities in the network as represented by individual arcs or sets of arcs. The mathematical formulation and the analysis procedure of the method are described, and the potential usefulness of the method is demonstrated using two hypothetical example problems dealing with regional wastewater treatment and residual management systems. A FORTRAN program for implementing the algorithm is available from the first author

EU-Rotate_N – a decision support system – to predict environmental and economic consequences of the management of nitrogen fertiliser in crop rotations

A model has been developed which assesses the economic and environmental performance of crop rotations, in both conventional and organic cropping, for over 70 arable and horticultural crops, and a wide range of growing conditions in Europe. The model, though originally based on the N_ABLE model, has been completely rewritten and contains new routines to simulate root development, the mineralisation and release of nitrogen (N) from soil organic matter and crop residues, and water dynamics in soil. New routines have been added to estimate the effects of sub-optimal rates of N and spacing on the marketable outputs and gross margins. The model provides a mechanism for generating scenarios to represent a range of differing crop and fertiliser management strategies which can be used to evaluate their effects on yield, gross margin and losses of nitrogen through leaching. Such testing has revealed that nitrogen management can be improved and that there is potential to increase gross margins whilst reducing nitrogen losses

Desorption Behavior of Trichloroethene and Tetrachloroethene in U.S. Department of Energy Savannah River Site Unconfined Aquifer Sediments

The DOE Savannah River Site (SRS) is evaluating the potential applicability of the monitored natural attenuation (MNA) process as a contributor to the understanding of the restoration of its unconfined groundwater aquifer known to be contaminated with the chlorinated hydrocarbon compounds trichloroethylene (TCE) and tetrachloroethylene (PCE). This report discusses the results from aqueous desorption experiments on SRS aquifer sediments from two different locations at the SRS (A/M Area; P-Area) with the objective of providing technically defensible TCE/PCE distribution coefficient (Kd) data and data on TCE/PCE reversible and irreversible sorption behavior needed for further MNA evaluation

Imperfections in a two-dimensional hierarchical structure

Hierarchical and fractal designs have been shown to yield high mechanical efficiency under a variety of loading conditions. Here a fractal frame is optimized for compressive loading in a two-dimensional space. We obtain the dependence of volume required for stability against loading for which the structure is optimized and a set of scaling relationships is found. We evaluate the dependence of the Hausdorff dimension of the optimal structure on the applied loading and establish the limit to which it tends under gentle loading. We then investigate the effect of a single imperfection in the structure through both analytical and simulational techniques. We find that a single asymmetric perturbation of beam thickness, increasing or decreasing the failure load of the individual beam, causes the same decrease in overall stability of the structure. A scaling relationship between imperfection magnitude and decrease in failure loading is obtained. We calculate theoretically the limit to which the single perturbation can effect the overall stability of higher generation frames

Intravascular Lithotripsy for Treatment of Calcified Coronary Lesions: Patient-Level Pooled Analysis of the Disrupt CAD Studies.

Abstract Objectives The aim of this pooled analysis was to assess the cumulative safety and effectiveness of coronary intravascular lithotripsy (IVL). Background The clinical outcomes of IVL to opt..

Subadventitial stenting around occluded stents: A bailout technique to recanalize in-stent chronic total occlusions

To evaluate the outcomes of subadventitial stenting (SS) around occluded stents for recanalizing in-stent chronic total occlusions (IS-CTOs).There is little evidence on the outcomes of SS for IS-CTO.We examined the outcomes of SS for IS-CTO PCI at 14 centers between July 2011 and June 2017, and compared them to historical controls recanalized using within-stent stenting (WSS). Target-vessel failure (TVF) on follow-up was the endpoint of this study, and was defined as a composite of cardiac death, target-vessel myocardial infarction, and target-vessel revascularization.During study period, 422 IS-CTO PCIs were performed, of which 32 (7.6%) were recanalized with SS, usually when conventional approaches failed. The most frequent CTO vessel was the right coronary artery (72%). Mean J-CTO score was 3.1 ± 0.9. SS was antegrade in 53%, and retrograde in 47%. Part of the occluded stent was crushed in 37%, while the whole stent was crushed in 63%. Intravascular imaging was used in 59%. One patient (3.1%) suffered tamponade. Angiographic follow-up was performed in 10/32 patients: stents were patent in six cases, one had mild neointimal hyperplasia, and three had severe restenosis at the SS site. Clinical follow-up was available for 29/32 patients for a mean of 388 ± 303 days. The 24-month incidence of TVF was 13.8%, which was similar to historical controls treated with WSS (19.5%, P = 0.49).SS is rarely performed, usually as last resort, to recanalize complex IS-CTOs. It is associated with favorable acute and mid-term outcomes, but given the small sample size of our study additional research is warranted

Role of China in the Quest to Define and Control Severe Acute Respiratory Syndrome

China holds the key to solving many questions crucial to global control of severe acute respiratory syndrome (SARS). The disease appears to have originated in Guangdong Province, and the causative agent, SARS coronavirus, is likely to have originated from an animal host, perhaps sold in public markets. Epidemiologic findings, integral to defining an animal-human linkage, may then be confirmed by laboratory studies; once animal host(s) are confirmed, interventions may be needed to prevent further animal-to-human transmission. Community seroprevalence studies may help determine the basis for the decline in disease incidence in Guangdong Province after February 2002. China will also be able to contribute key data about how the causative agent is transmitted and how it is evolving, as well as identifying pivotal factors influencing disease outcome. There must be support for systematically addressing these fundamental questions in China and rapidly disseminating results