Modeling the Flow and Diffusion of Lidocaine Through Tooth and Gum

The movement of anesthesia around and through the tooth and gum was modeled in order to design a novel procedure to effectively anesthetize a single tooth with minimal side effects. This model includes the injection of lidocaine into the gum near the tooth, and the ensuing diffusion of anesthesia through the tooth and gum. The geometry of the tooth and gum has been drawn in two dimensions in COMSOL. The Brinkman’s equations were used to model the fluid flow resulting from the initial injection through the porous media, and the mass transfer equation was used to model how the anesthesia flows through the tooth and gum after the completion of the injection through the coupling of the velocities calculated by the Brinkman’s equations. The concentration of anesthesia in this region was calculated, in order to determine the amount of time the tooth is numb and the distance the anesthesia has travelled. The model showed that the optimum procedure for numbing the tooth has a long injection time of five minutes dispensing lidocaine at a slower velocity, specifically 0.018 mol/m3. This is an important process to model because with the longer injection time the patient’s discomfort can be decreased, numbness can be quickly achieved and anesthesia can last for the entirety of an average dental procedure protecting the patient from unnecessary pain

Post-Permanency: An Assessment for Families’ Needs for Services and Supports

This article reports the results of a qualitative study that sought the perspectives of birth parents and adoptive parents following reunification or adoption of children from foster care. Using a participatory action design that actively involved young adults formerly in foster care and parents in the design and implementation of the study, the study focused on the consumers’ perspectives on several issues related to permanency. The article reports findings from interviews with a subset of 27 birth and adoptive families in New York City who were asked about their post-permanency experiences and from interviews with 38 child welfare professionals who were asked to respond to the parents’ perspectives. The article offers directions for child welfare practice and program development

Perspectives on Psychotropic Medication Treatment Among Young Adults Formerly Served in Public Systems of Care: A Thematic and Narrative Analysis

This study examines the perspectives of psychotropic medications held by young adults with mood disorder diagnoses. This article presents an analysis of qualitative interviews with 52 young adults who had been involved with public systems of care during adolescence and had used psychiatric medications. A concatenated analytic approach was used. First, we used a thematic analysis across cases, then a narrative analysis within selected cases. Two main themes emerged from the thematic analysis that captured aspects of the experience of taking medication. First, young adults described the effects of the medications and how they thought the medications were working. They described the impact on their moods, thinking, bodies, and functioning, and the ways in which these effects related to their lives. Second, the process of taking medications emerged as an important aspect of the medication treatment experience, including the trial-and-error nature of treatment and interactions with psychiatrists. The narrative analysis within cases identified that some youth created a medication narrative composed of three elements: why medications were needed, what medications do, and participants’ outlook on future medication use. These narratives are helpful in understanding prior patterns of service use and are instructive in framing young people’s future intentions to use medications. Findings support the importance of eliciting the perspectives of young adults about their treatment and ensuring that services are designed and delivered in developmentally appropriate ways tailored to this group

Knowledge of and Attitudes toward Behavioral Health Services among Older Youth in the Foster Care System

This study examined knowledge of and attitudes toward services among 268 17-year olds with psychiatric diagnoses preparing to exit foster care. A structured interview assessed knowledge of services with vignette scenarios and attitudes with a standardized scale. Descriptive statistics described the extent of knowledge and attitudes among this population and regression analyses examined predictors of these dimensions of literacy. Most youth suggested a help source, but responses often lacked specificity. Gender and depression were the strongest predictors of knowledge and attitudes, respectively. Knowing which aspects of literacy are low, and for whom, can inform education efforts to improve access to care in adulthood

Mitochondrial respiration variability and simulations in human skeletal muscle: The Gene SMART study

Mitochondrial respiration using the oxygraph‐2k respirometer (Oroboros) is widely used to estimate mitochondrial capacity in human skeletal muscle. Here, we measured mitochondrial respiration variability, in a relatively large sample, and for the first time, using statistical simulations, we provide the sample size required to detect meaningful respiration changes following lifestyle intervention. Muscle biopsies were taken from healthy, young men from the Gene SMART cohort, at multiple time points. We utilized samples for each measurement with two technical repeats using two respirometer chambers (n = 160 pairs of same muscle after removal of low‐quality samples). We measured the Technical Error of measurement (TEM) and the coefficient of variation (CV) for each mitochondrial complex. There was a high correlation between measurements from the two chambers (R > 0.7 P 15% for all complexes. We performed statistical simulations of a range of effect sizes at 80% power and found that 75 participants (with duplicate measurements) are required to detect a 6% change in mitochondrial respiration after an intervention, while for interventions with 11% effect size, ~24 participants are sufficient. The high variability in respiration suggests that the typical sample sizes in exercise studies may not be sufficient to capture exercise‐induced changes

Impaired left atrial mechanical function after cardioversion: Relation to the duration of atrial fibrillation

AbstractObjectives. We hypothesized that the time course of the recovery of atrial systolic function may be related to the duration of atrial fibrillation before cardioversion and sought to study noninvesively the recovery of left atrial mechanical function utilizing serial transthoracic Doppler studies.Background. Recovery of atrial mechanical function may be delayed for several weeks after successful cardioversion of atrial fibrillation to sinus rhythm.Methods. After successful cardioversion, 60 patients with atrial fibrillation of brief (≤2 week, 17 patients), moderate (>2 to 6 weeks, 22 patients) or prolonged (>6 weeks, 21 patients) duration were followed up with serial transmitral pulsed Doppler echocardiography immediately (60 patients) and at 24 h (45 patients), 1 week (41 patients), 1 month (31 patients) and >3 months (30 patients) after cardioversion.Results. Atrial mechanical function is greater immediately and at 24 h and 1 week after cardioversion in patients with “brief” compared with “prolonged” atrial fibrillation. In all groups, atrial mechanical function increases over time, ultimately achieving similar levels. Full recovery of atrial mechanical function, however, is achieved within 24 h in patients with brief atrial fibrillation, within 1 week in patients with moderate-duration atrial fibrillation and within 1 month in patients with prolonged atrial fibrillation.Conclusions. Recovery of left atrial mechanical function is related to the duration of atrial fibrillation before cardioversion. These findings have important implications for assessing the early hemodynamic benefit of successful cardioversion