The Institute for European Hospice Partnerships: Idea, vision, mission, and first steps of its development

Against the background of a European research study in the field of palliative care lasting several months and the experiences of a five-year international hospice partnership, the founding idea for an Institute dedicated to the presentation and promotion of bilateral cooperations of specialized services in palliative care emerged. The goals, as well as the vision, mission and tasks of this Institute for European Hospice Partnerships are described and the significance of a research project important for its development is named

Postgraduate palliative care education and curricular issues in Central Asia, Eastern and South-Eastern Europe: Results from a quantitative study

Introduction. The WHO Europe Office, together with the European Association for Palliative Care, issupporting the development of an interdisciplinary core curriculum for health care professionals in theEuropean Region, which is to be given to the countries as a recommendation.Material and methods. Between April and September 2018, a research journey to Central Asia, Easternand South-Eastern Europe took place. It covered two main tasks: collecting quantitative data using a surveyand collecting qualitative data by conducting on-site interviews. This article contains the quantitativepart. Experts in palliative care education in 23 countries were invited to fill out a questionnaire. The datareceived from 23 questions were statistically evaluated by IBM SPSS Statistics 25.Results. 27 surveys received from 21 countries were evaluated. In one-third of the surveyed countries, thereis still no postgraduate training in palliative care. The main barriers to the development of educational workare limited political interest, followed by limited educational structures, missing curricula, lack of trainersand the limited healthcare system. For 92.6% of all respondents, a WHO-recommended interdisciplinarypostgraduate core curriculum would help promote palliative care in their country.Conclusion. There is a high need for postgraduate education in general and the intended core curriculumin particular. The results of the survey, along with those from the interviews in a later second part of thepublication, are essential for the development of a core curriculum

One century of hydrological monitoring in two small catchments with different forest coverage

Long-term data on precipitation and runoff are essential to draw firm conclusions about the behavior and trends of hydrological catchments that may be influenced by land use and climate change. Here the longest continuous runoff records from small catchments (<1km2) in Switzerland (and possibly worldwide) are reported. The history of the hydrological monitoring in the Sperbel- and Rappengraben (Emmental) is summarized, and inherent uncertainties in the data arising from the operation of the gauges are described. The runoff stations operated safely for more than 90% of the summer months when most of the major flood events occurred. Nevertheless, the absolute values of peak runoff during the largest flood events are subject to considerable uncertainty. The observed differences in average, base, and peak runoff can only partly be attributed to the substantial differences in forest coverage. This treasure trove of data can be used in various ways, exemplified here with an analysis of the generalized extreme value distributions of the two catchments. These distributions, and hence flood return periods, have varied greatly in the course of one century, influenced by the occurrence of single extreme events. The data will be made publicly available for the further analysis of the mechanisms governing the runoff behavior of small catchments, as well as for testing stochastic and deterministic model

The effect of connective tissue graft or a collagen matrix on epithelial differentiation around teeth and implants: a preclinical study in minipigs.

OBJECTIVES This study aimed to histologically evaluate the healing at 8 weeks after coronally advanced flap (CAF) with either a superficial (SCTG) or deep palatal connective tissue graft (DCTG), or a collagen matrix (CM) to cover recession defects at teeth and implants. MATERIAL AND METHODS One mandibular side of 6 miniature pigs received each 3 titanium implants 12 weeks after extraction. Eight weeks later, recession defects were created around implants and contralateral premolars and 4 weeks later randomly subjected to CAF + SCTG, CAF + DCTG, or CAF + CM. After 8 weeks, block biopsies were histologically analyzed. RESULTS For the primary outcome, i.e., keratinization of the epithelium, all teeth and implants exhibited a keratinized epithelium with no histological differences among them also not in terms of statistically significant differences in length (SCTG 0.86 ± 0.92 mm, DCTG 1.13 ± 0.62 mm, and Cm, 1.44 ± 0.76 mm). Pocket formation was histologically seen at all teeth, around most implants with SCTG and DCTG, however not in the CM implant group. The connective tissue grafts showed hardly signs of degradation, whereas the CM was partly degraded and integrated in connective tissue. The mean gain in gingival height was similar in all experimental groups (SCTG 3.89 ± 0.80 mm, DCTG 4.01 ± 1.40 mm, CM 4.21 ± 0.64 mm). Statistically significant differences were found in the height of the junctional epithelium between the control teeth and the connective tissue groups (p = 0.009 and 0.044). CONCLUSIONS In this animal model, the use of either a superficial or deep connective tissue graft or a collagen membrane did not seem to have any impact on the epithelial keratinization around both teeth and implants. All procedures (CAF + SCTG/DCTG/CM) resulted in a long JE that was even longer at implants. CLINICAL RELEVANCE Deep/superficial palatal connective tissue graft yielded similar keratinization around teeth/implants. Given the absence of pocket formation and inflammatory processes at implants when using a CM, CAF + CM might bear potential clinical benefits

The effect of connective tissue graft or a collagen matrix on epithelial differentiation around teeth and dental implants: a preclinical study in minipigs

This study aimed to histologically evaluate the healing at 8 weeks after coronally advanced flap (CAF) with either a superficial (SCTG) or deep palatal connective tissue graft (DCTG), or a collagen matrix (CM) to cover recession defects at teeth and implants.One mandibular side of 6 miniature pigs received each 3 titanium implants 12 weeks after extraction. Eight weeks later, recession defects were created around implants and contralateral premolars and 4 weeks later randomly subjected to CAF + SCTG, CAF + DCTG, or CAF + CM. After 8 weeks, block biopsies were histologically analyzed.For the primary outcome, i.e., keratinization of the epithelium, all teeth and implants exhibited a keratinized epithelium with no histological differences among them also not in terms of statistically significant differences in length (SCTG 0.86 ± 0.92 mm, DCTG 1.13 ± 0.62 mm, and Cm, 1.44 ± 0.76 mm). Pocket formation was histologically seen at all teeth, around most implants with SCTG and DCTG, however not in the CM implant group. The connective tissue grafts showed hardly signs of degradation, whereas the CM was partly degraded and integrated in connective tissue. The mean gain in gingival height was similar in all experimental groups (SCTG 3.89 ± 0.80 mm, DCTG 4.01 ± 1.40 mm, CM 4.21 ± 0.64 mm). Statistically significant differences were found in the height of the junctional epithelium between the control teeth and the connective tissue groups (p = 0.009 and 0.044).In this animal model, the use of either a superficial or deep connective tissue graft or a collagen membrane did not seem to have any impact on the epithelial keratinization around both teeth and implants. All procedures (CAF + SCTG/DCTG/CM) resulted in a long JE that was even longer at implants.Deep/superficial palatal connective tissue graft yielded similar keratinization around teeth/implants. Given the absence of pocket formation and inflammatory processes at implants when using a CM, CAF + CM might bear potential clinical benefits

A simple coronary CT angiography-based jeopardy score for the identification of extensive coronary artery disease: Validation against invasive coronary angiography

PURPOSE The invasive British Cardiovascular Intervention Society Jeopardy Score (iBCIS-JS) is a simple angiographic scoring system, enabling quantification of the extent of jeopardized myocardium related to clinically significant coronary artery disease (CAD). The purpose of this study was to develop and validate the coronary CT angiography-based BCIS-JS (CT-BCIS-JS) against the iBCIS-JS in patients with suspected or stable CAD. MATERIALS AND METHODS Patients who underwent coronary CT angiography followed by invasive coronary angiography, within 90 days were retrospectively included. CT-BCIS-JS and iBCIS-JS were calculated, with a score ≥ 6 indicating extensive CAD. Correlation between the CT-BCIS-JS and iBCIS-JS was searched for using Spearman's coefficient, and agreement with weighted Kappa (κ) analyses. RESULTS A total of 122 patients were included. There were 102 men and 20 women with a median age of 62 years (Q1, Q3: 54, 68; age range: 19-83 years). No differences in median CT-BCIS-JS (4; Q1, Q3: 0, 8) and median iBCIS-JS (4; Q1, Q3: 0, 8) were found (P = 0.18). Extensive CAD was identified in 53 (43.4%) and 52 (42.6%) patients using CT-BCIS-JS and iBCIS-JS, respectively (P = 0.88). CT-based and iBCIS-JS showed excellent correlation (r = 0.98; P < 0.001) and almost perfect agreement (κ = 0.93; 95% confidence interval: 0.90-0.97). Agreement for identification of an iBCIS-JS ≥ 6 was almost perfect (κ = 0.94; 95 % confidence interval: 0.87-0.99). CONCLUSION The CT-BCIS-JS represents a feasible, and accurate method for quantification of CAD, with capabilities not different from those of iBCIS-JS. It enables simple, non-invasive identification of patients with anatomically extensive CAD

A Fractal Approach to Model Soil Structure and to Calculate Thermal Conductivity of Soils

Heat transport in soils depends on the spatial arrangement of solids, ice, air and water. In this study, we present a modified fractal approach to model the pore structure of soils and to describe its influence on the thermal conductivity. Three different fractal generators were sequentially applied to characterize a wide range of particle- and pore-size distributions. The given porosity and particle-size distribution of a clay, clay loam, silt loam and loamy sand were successfully modeled. The thermal conductivity of the fractal soil model was calculated using a network of resistors. We applied a renormalization approach to include the effects of smaller scale structures. The predictions were compared with the empirical Johansen' model (Johansen, 1975), that postulates a simple linear relationship between ice content and thermal conductivity. For high ice-saturated conditions, the calculated thermal conductivity agrees well with the empirical model. To describe partial ice saturation, we assumed that some pores were coated by ice films enclosing the air-filled center. In addition, we introduced a reduced heat exchange coefficient of the particles for unsaturated conditions. The ice-saturated and -unsaturated thermal conductivity calculated with this approach was very similar to that estimated by the empirical model. The variation of the thermal conductivities for different spatial arrangements of pores and particles in the prefractals were determined. Extreme values deviate more than 50% from the mean values.ISSN:0169-3913ISSN:1573-163

Quercetin in the Prevention of Induced Periodontal Disease in Animal Models: A Systematic Review and Meta-Analysis.

BACKGROUND Periodontitis is an inflammatory condition initiated by oral bacteria and is associated with several systemic diseases. Quercetin is an anti-inflammatory and anti-bacterial poly-phenol present in various foods. The aim of this meta-analysis was the evaluation of the effects of quercetin administration in animal models of experimental periodontitis. METHODS A systematic search was performed in electronic databases using the following search terms: "periodontitis" or "periodontal disease" or "gingivitis" and "quercetin" or "cyanidanol" or "sophoretin" or "pentahydroxyflavone". In vivo preclinical animal models of experimental periodontal disease with a measurement of alveolar bone loss were included in the analysis. The risk of bias of the included studies was assessed using the SYRCLE tool. RESULTS The systematic search yielded 335 results. Five studies were included, four of them qualified for a meta-analysis. The meta-analysis showed that quercetin administration decreased alveolar bone loss (τ2 = 0.31, 1.88 mm 95%CI: 1.09, 2.67) in experimental periodontal disease animal models. However, the risk of bias assessment indicated that four SYRCLE domains had a high risk of bias. CONCLUSIONS Quercetin diminishes periodontal bone loss and prevents disease progression in animal models of experimental periodontal disease. Quercetin might facilitate periodontal tissue hemostasis by reducing senescent cells, decreasing oxidative stress via SIRT1-induced autophagy, limiting inflammation, and fostering an oral bacterial microenvironment of symbiotic microbiota associated with oral health. Future research will show whether and how the promising preclinical results can be translated into the clinical treatment of periodontal disease