Prenatal Screening and Genetics

Although the term 'genetic screening' has been used for decades, this paper discusses how, in its most precise meaning, genetic screening has not yet been widely introduced. 'Prenatal screening' is often confused with 'genetic screening'. As we show, these terms have different meanings, and we examine definitions of the relevant concepts in order to illustrate this point. The concepts are i) prenatal, ii) genetic screening, iii) screening, scanning and testing, iv) maternal and foetal tests, v) test techniques and vi) genetic conditions. So far, prenatal screening has little connection with precisely defined genetics. There are benefits but also disadvantages in overstating current links between them in the term genetic screening. Policy making and professional and public understandings about screening could be clarified if the distinct meanings of prenatal screening and genetic screening were more precisely observed

Dental implant treatment for two adjacent missing teeth in the maxillary aesthetic zone:a comparative pilot study and test of principle

Aim The aim of this prospective comparative pilot study was to evaluate hard and soft peri-implant tissues in patients with a missing adjacent central and lateral upper incisor treated with either one implant and an implant crown with a cantilever or two implants with solitary implant crowns up to 1 year after functional loading. Material and methods In the "Implant-cantilever group", five patients were treated with one dental implant in the region of the central incisor (NobelReplace Groovy Regular Platform). In the "Implant-implant group", five patients were treated with two adjacent dental implants: at the position of the central incisor (NobelReplace Groovy Regular Platform) and at the position of the lateral incisor (NobelReplace Groovy Narrow Platform). Implant survival, pocket probing depth, papilla index, marginal bone level and patient satisfaction were assessed during a 1-year follow-up period. Results No implants were lost during the 1-year follow-up. Mean pocket probing values of the implants were comparable between the two groups. Papilla index scores in both groups were relatively low, pointing towards a compromised papilla. Marginal bone loss was minimal and comparable between the groups. Patient satisfaction was very high in both groups. Conclusion In this 1-year prospective comparative study, no large differences in hard- and soft-tissue levels could be shown between patients with a missing central and lateral upper incisor treated with either one implant and an implant crown with a cantilever or two implants with solitary implant crowns. To cite this article:Tymstra N, Raghoebar GM, Vissink A, Meijer HJA. Dental implant treatment for two adjacent missing teeth in the maxillary aesthetic zone: a comparative pilot study and test of principle.Clin. Oral Impl. Res. 22, 2011; 207-213.doi: 10.1111/j.1600-0501.2010.02017.x

Spring wildfires in Alberta and opportunities for enhanced wildfire preparedness

Wildfire management agencies are at a tipping point as wildfire disasters, particularly in western Canada increase in frequency. Climate change impacts, and competing values and assets on the landscape are challenging suppression effectiveness. Semi-structured interviews with Canadian wildfire management agencies were conducted to understand the strategies, policies and preparedness procedures these agencies use to manage wildfires and prepare for a future with more wildfires. These interviews revealed considerable differences in how wildfire management agencies determine their agency preparedness level, and the level of decision support (tools) they use to make these determinations. A future path is proposed to address a double wildfire paradox and ensure Canadians are able to co-exist with wildfire. Alberta has experienced more disastrous wildfire seasons, particularly during the spring, than any other agency across Canada. Spring wildfire preparedness is critical in Alberta. Wildfires starts in May alone account for 23% of all wildfires but are responsible for 55% of the total area burned. Initial attack (IA) and being held (BH) escape surveillance charts with statistical peak over thresholds were developed for enhanced situational awareness in near-real time of spring wildfire activity. Early surveillance of December sea surface temperature anomalies in the Pacific Ocean were also investigated for use as an indicator of the potential persistence of spring wildfire activity. Surface and upper synoptic weather patterns, and fire weather indices from the Canadian Forest Fire Danger Rating System were evaluated for 80 large wildfires in Alberta that started in May and grew to over 1,000 ha during the 1990 – 2019 period. Pre-frontal and frontal passage activity was the predominant feature associated with 48% of the calendar spread day events during the first four days of wildfire activity. Strong south-southeast winds from a surface high centered east of Alberta and west of Hudson Bay and supported by an upper ridge, and a surface low located southwest of the ridge, occurred on 26% of the calendar spread day events. The spring season in Alberta is an ISI driven fire regime, characterized by very high to extreme FFMC and ISI values. For Alberta, this means large wildfires in the spring can occur after only a few days of dry, windy weather. Opportunities for enhanced wildfire preparedness include night time surveillance, stronger integration of weather and wildfire behavior forecasting, innovative statistical data visualization for decision support, precision preparedness, and the strategic use of prevention regulatory tools

Levels of State and Trait Anxiety in Patients Referred to Ophthalmology by Primary Care Clinicians: A Cross Sectional Study

Purpose There is a high level of over-referral from primary eye care leading to significant numbers of people without ocular pathology (false positives) being referred to secondary eye care. The present study used a psychometric instrument to determine whether there is a psychological burden on patients due to referral to secondary eye care, and used Rasch analysis to convert the data from an ordinal to an interval scale. Design Cross sectional study. Participants and Controls 322 participants and 80 control participants. Methods State (i.e. current) and trait (i.e. propensity to) anxiety were measured in a group of patients referred to a hospital eye department in the UK and in a control group who have had a sight test but were not referred. Response category analysis plus infit and outfit Rasch statistics and person separation indices were used to determine the usefulness of individual items and the response categories. Principal components analysis was used to determine dimensionality. Main Outcome Measure Levels of state and trait anxiety measured using the State-Trait Anxiety Inventory. Results State anxiety scores were significantly higher in the patients referred to secondary eye care than the controls (p0.1). Rasch analysis highlighted that the questionnaire results needed to be split into “anxiety-absent” and “anxiety-present” items for both state and trait anxiety, but both subscales showed the same profile of results between patients and controls. Conclusions State anxiety was shown to be higher in patients referred to secondary eye care than the controls, and at similar levels to people with moderate to high perceived susceptibility to breast cancer. This suggests that referral from primary to secondary eye care can result in a significant psychological burden on some patients

On deciding to have a lobotomy:either lobotomies were justified or decisions under risk should not always seek to maximise expected utility

In the 1940s and 1950s thousands of lobotomies were performed on people with mental disorders. These operations were known to be dangerous, but thought to offer great hope. Nowadays, the lobotomies of the 1940s and 1950s are widely condemned. The consensus is that the practitioners who employed them were, at best, misguided enthusiasts, or, at worst, evil. In this paper I employ standard decision theory to understand and assess shifts in the evaluation of lobotomy. Textbooks of medical decision making generally recommend that decisions under risk are made so as to maximise expected utility (MEU) I show that using this procedure suggests that the 1940s and 1950s practice of psychosurgery was justifiable. In making sense of this finding we have a choice: Either we can accept that psychosurgery was justified, in which case condemnation of the lobotomists is misplaced. Or, we can conclude that the use of formal decision procedures, such as MEU, is problematic

Patient-reported outcome measures focusing on aesthetics of implant- and tooth-supported fixed dental prostheses:A systematic review and meta-analysis

Objectives: The aim of this systematic review and meta-analysis was to summarize the existing evidence on patient-reported aesthetic outcome measures (PROMs) of implant-supported, relative to tooth-supported fixed dental prostheses. Material and Methods: In April 2017, two reviewers independently searched the Medline (PubMed), EMBASE, and Cochrane electronic databases, focusing on studies including patient-reported aesthetic outcomes of implant- and tooth-supported fixed dental prostheses (FDPs). Human studies with a mean follow-up period of at least 1 year, a minimum of ten patients, and English, German, or French publication were included. For the comparison of subgroups, random-effects meta-regression for aggregate-level data was used. Results: The systematic search for implant-supported prostheses focusing on patient-reported outcomes identified 2,675 titles, which were screened by two independent authors. Fifty full-text articles were analyzed, and finally, 16 publications (including 19 relevant study cohorts) were included. For tooth-supported prostheses, no studies could be included. A total of 816 implant-supported reconstructions were analyzed by patients. Overall aesthetic evaluation by the patients’ visual analogue scale (VAS) rating was high in implant-supported FDPs (median: 90.3; min–max: 80.0–94.0) and the surrounding mucosa (median: 84.7; min–max: 73.0–92.0). Individual restorative materials, implant neck design (i.e., tissue or bone level type implants), and the use of a fixed provisional had no effect on patients’ ratings of the definitive implant-supported FDPs. Conclusions: Aesthetics is an important patient-reported measure, which lacks in standardized methods; however, patients’ satisfaction was high for implant- supported FDPs and the surrounding mucosa

Physics-based model of wildfire propagation towards faster-than-real-time simulations

This paper presents the mathematical formulation, numerical solution, calibration and testing of a physics-based model of wildfire propagation aimed at faster-than-real-time simulations. Despite a number of simplifying assumptions, the model is comprehensive enough to capture the major phenomena that govern the behaviour of a real fire –namely the pyrolysation of wood; the combustion of a mono-phase medium composed of premixed gas of fuel and air; and the heat transferred by conduction, convection, radiation, mass diffusion and transport due to atmospheric wind. The model consists of a system of coupled partial differential equations, one ensuring the balance of enthalpy, and a set of equations representing the mass formation of each chemical species involved in the combustion. Dimensionality reduction is sought by modelling these three-dimensional phenomena in a two-dimensional space, which has been achieved by means of heat-sources and heat-sinks to account for the third dimension in the energy balance equation. Once calibrated with a widely used non-physics-based commercial wildfire simulator, the proposed Fire Propagation Model for Fast simulations (FireProM-F) is tested, returning similar predictions in terms of the size and shape of the burnt area although similarity deteriorates for windy conditions. FireProM-F has the added benefit of being both physics-based and computationally inexpensive so that its interaction with fire suppressants may also be modelled in the future and simulated in real time