Facial analysis using a new clinical device : The Kattan Facio-meter

The aim of the study was to attempt to set average faciometric standards for Egyptians using the Kattan Facio-meter. The sample consisted of 180 faculty students with age range 17-25 years. It was divided into three groups; Angle Class I, II and III. Class II was further subdivided into divisions 1 and 2. Linear and angular facial measurements in relation to K plane were taken using the Kattan facio-meter. The measurements were correlated to Angle?s classification and between genders. On comparing the different classes, Class II division 1 showed the statistically highest mean value for Orbitale-soft tissue A; p=0.042, Class II divisions 1 and 2 for Orbitale- Labrale superius; p=0.002 and soft tissue ANB; p<0.001. Females showed significantly higher mean value than males for the upper incisor/K plane; p=0.031. Males showed significantly higher mean value for the inter-incisal angle than females; p=0.001. Within the limitations of the current study, it was found that both linear and angular soft tissue measurements conformed to the antroposterior skeletal relation of the jaws and that Class II division 1 was due to protruded maxilla. Males had more prominent lips and deeper mentolabial sulcus. Egyptians had less prominent noses than Caucasians. The Kattan Facio-meter was a valuable tool for clinical analysis without the hazards of irradiation

International cooperation during volcanic crisis: an example from the Italy-El Salvador monitoring system installed at Chaparrastique volcano, El Salvador

On December 29th, 2013, after 12 years of inactivity, a new explosive eruption occurred at Chaparrastique volcano (San Miguel, el Salvador) prompting the evacuation of more than 5000 people. The new eruption that occurred at the volcano has so far been an isolated single explosion of vulcanian type, and was the first eruption since 2002, when the volcano produced a small VEI 1 eruption. The explosion produced an ash plume of considerable (5-10 km) height, generating heavy ash fall in nearby areas downwind, such as in the towns of Chinameca and San Jorge. Pyroclastic density currents also affected the flanks, damaging the coffee plantations and small inhabited areas around the volcano. On January 2014, following a request of support by the government of El Salvador, INGV (Istituto Nazionale di Geofisica e Vulcanologia), organized a task force, V-Emer (Volcano Emergency) to improve the existing monitoring network at Chaparrastque volcano. During a 10 days campaign in El Salvador a temporary network was successfully installed, and it is now run by the volcanologists of MARN (Ministerio de Medio Ambiente y Recursos Naturales, El Salvador). The network is composed of five broadband seismic stations, 3 infrasonic microphones, 2 radiometers, 10 GPS stations, 1 thermal camera, 1 DOAS and 1 multi-gas geochemical station for measurement of SO2 and CO2 fluxes, respectively. Since 27 January, significant collaborative efforts are being done between MARN and INGV for the processing and interpretation of the data collected during monitoring. For facilitating communication and exchange between the members of the cooperation, a mailing list has been created, and weekly meetings are attended by the members for the discussion on a number of scientific and technical aspects. This initiative seeks to make significant advance into volcano monitoring network and data analysis, as well as improving international cooperation during volcanic crisis management. V-EMER group: A. Bonforte, G. Giuffrida,A. La Spina, F. Montalvo, M. Liuzzo, S. Rapisarda, G. Salerno, D. Andronico, E. Biale, A. Cannata, T. Caltabiano, E. Del Bello, M. La Rocca, D. Granieri, L. Lodato, G. Giudice, F. Murè, E. Pecora, M. Prestifilippo, L. Scuderi, L. Zuccarello, G. De Natale, R. Favara, E. Privitera. MARN group: M. Diaz, D. Escobar, E. Gutierrez, D. Hernandez, G. Marroquin, C. Bolaños, L. Handal, C. Polío, B. Palacios, N. Galvez, R. Torres, E. Escobar

Boosting advice and knowledge sharing among healthcare professionals

Purpose: This study investigates the dynamics of knowledge sharing in healthcare, exploring some of the factors that are more likely to influence the evolution of idea sharing and advice seeking in healthcare. Design/methodology/approach: We engaged 50 pediatricians representing many subspecialties at a mid-size US children's hospital using a social network survey to map and measure advice seeking and idea sharing networks. Through the application of Stochastic Actor-Oriented Models, we compared the structure of the two networks prior to a leadership program and eight weeks post conclusion. Findings: Our models indicate that healthcare professionals carefully and intentionally choose with whom they share ideas and from whom to seek advice. The process is fluid, non-hierarchical and open to changing partners. Significant transitivity effects indicate that the processes of knowledge sharing can be supported by mediation and brokerage. Originality: Hospital administrators can use this method to assess knowledge-sharing dynamics, design and evaluate professional development initiatives, and promote new organizational structures that break down communication silos. Our work contributes to the literature on knowledge sharing in healthcare by adopting a social network approach, going beyond the dyadic level, and assessing the indirect influence of peers' relationships on individual networks

A simulation model of colorectal cancer surveillance and recurrence

BACKGROUND: Approximately one-third of those treated curatively for colorectal cancer (CRC) will experience recurrence. No evidence-based consensus exists on how best to follow patients after initial treatment to detect asymptomatic recurrence. Here, a new approach for simulating surveillance and recurrence among CRC survivors is outlined, and development and calibration of a simple model applying this approach is described. The model’s ability to predict outcomes for a group of patients under a specified surveillance strategy is validated. METHODS: We developed an individual-based simulation model consisting of two interacting submodels: a continuous-time disease-progression submodel overlain by a discrete-time Markov submodel of surveillance and re-treatment. In the former, some patients develops recurrent disease which probabilistically progresses from detectability to unresectability, and which may produce early symptoms leading to detection independent of surveillance testing. In the latter submodel, patients undergo user-specified surveillance testing regimens. Parameters describing disease progression were preliminarily estimated through calibration to match five-year disease-free survival, overall survival at years 1–5, and proportion of recurring patients undergoing curative salvage surgery from one arm of a published randomized trial. The calibrated model was validated by examining its ability to predict these same outcomes for patients in a different arm of the same trial undergoing less aggressive surveillance. RESULTS: Calibrated parameter values were consistent with generally observed recurrence patterns. Sensitivity analysis suggested probability of curative salvage surgery was most influenced by sensitivity of carcinoembryonic antigen assay and of clinical interview/examination (i.e. scheduled provider visits). In validation, the model accurately predicted overall survival (59% predicted, 58% observed) and five-year disease-free survival (55% predicted, 53% observed), but was less accurate in predicting curative salvage surgery (10% predicted; 6% observed). CONCLUSIONS: Initial validation suggests the feasibility of this approach to modeling alternative surveillance regimens among CRC survivors. Further calibration to individual-level patient data could yield a model useful for predicting outcomes of specific surveillance strategies for risk-based subgroups or for individuals. This approach could be applied toward developing novel, tailored strategies for further clinical study. It has the potential to produce insights which will promote more effective surveillance—leading to higher cure rates for recurrent CRC

Transitions/relaxations in polyester adhesive/PET system

The correlations between the transitions and the dielectric relaxation processes of the oriented poly(ethylene terephthalate) (PET) pre-impregnated of the polyester thermoplastic adhesive have been investigated by differential scanning calorimetry (DSC) and dynamic dielectric spectroscopy (DDS). The thermoplastic polyester adhesive and the oriented PET films have been studied as reference samples. This study evidences that the adhesive chain segments is responsible for the physical structure evolution in the PET-oriented film. The transitions and dielectric relaxation modes’ evolutions in the glass transition region appear characteristic of the interphase between adhesive and PET film, which is discussed in terms of molecular mobility. The storage at room temperature of the adhesive tape involves the heterogeneity of the physical structure, characterized by glass transition dissociation. Thus, the correlation between the transitions and the dielectric relaxation processes evidences a segregation of the amorphous phases. Therefore, the physical structure and the properties of the material have been linked to the chemical characteristics

Predicting 6-Year Mortality Risk in Patients With Type 2 Diabetes

OBJECTIVE—The objective of this study was to create a tool that predicts the risk of mortality in patients with type 2 diabetes

Long-term outcome among men with conservatively treated localised prostate cancer

Optimal management of clinically localised prostate cancer presents unique challenges, because of its highly variable and often indolent natural history. There is an urgent need to predict more accurately its natural history, in order to avoid unnecessary treatment. Medical records of men diagnosed with clinically localised prostate cancer, in the UK, between 1990 and 1996 were reviewed to identify those who were conservatively treated, under age 76 years at the time of pathological diagnosis and had a baseline prostate-specific antigen (PSA) measurement. Diagnostic biopsy specimens were centrally reviewed to assign primary and secondary Gleason grades. The primary end point was death from prostate cancer and multivariate models were constructed to determine its best predictors. A total of 2333 eligible patients were identified. The most important prognostic factors were Gleason score and baseline PSA level. These factors were largely independent and together, contributed substantially more predictive power than either one alone. Clinical stage and extent of disease determined, either from needle biopsy or transurethral resection of the prostate (TURP) chips, provided some additional prognostic information. In conclusion, a model using Gleason score and PSA level identified three subgroups comprising 17, 50, and 33% of the cohort with a 10-year prostate cancer specific mortality of <10, 10–30, and >30%, respectively. This classification is a substantial improvement on previous ones using only Gleason score, but better markers are needed to predict survival more accurately in the intermediate group of patients

Prostate Cancer Postoperative Nomogram Scores and Obesity

Nomograms are tools used in clinical practice to predict cancer outcomes and to help make decisions regarding management of disease. Since its conception, utility of the prostate cancer nomogram has more than tripled. Limited information is available on the relation between the nomograms' predicted probabilities and obesity. The purpose of this study was to examine whether the predictions from a validated postoperative prostate cancer nomogram were associated with obesity.We carried out a cross-sectional analysis of 1220 patients who underwent radical prostatectomy (RP) in southern California from 2000 to 2008. Progression-free probabilities (PFPs) were ascertained from the 10-year Kattan postoperative nomogram. Multivariable logistic regression models estimated odds ratios (ORs) and 95% confidence intervals (CIs).In the present study, aggressive prostate cancer (Gleason ≥7), but not advanced stage, was associated with obesity (p = 0.01). After adjusting for age, black race, family history of prostate cancer and current smoking, an inverse association was observed for 10-year progression-free predictions (OR = 0.50; 95% CI = 0.28–0.90) and positive associations were observed for preoperative PSA levels (OR = 1.23; 95% CI = 1.01–1.50) and Gleason >7 (OR = 1.45; 95% CI = 1.11–1.90).Obese RP patients were more likely to have lower PFP values than non-obese patients, suggesting a higher risk of experiencing prostate cancer progression. Identifying men with potentially higher risks due to obesity may improve disease prognosis and treatment decision-making