Randomized controlled pilot study assessing efficacy, efficiency, and patient-reported outcomes measures of chairside and labside single-tooth restorations.

OBJECTIVES To test whether or not a chairside workflow (CHAIR) is similar to a labside workflow (LAB) in terms of efficacy (primary outcome) and efficiency (secondary outcome). MATERIAL AND METHODS Eighteen subjects in need of a single-tooth restoration in the posterior region of the maxilla or mandible were consecutively recruited and randomly assigned to the CHAIR or LAB workflow. Patient-reported outcome measures (PROMs; efficacy) were assessed using a questionnaire with visual analog scale. The white AEsthetic score (WES) was applied to evaluate the AEsthetic outcome objectively. The clinical and laboratory time (efficiency) were recorded. Nonparametric methods were applied for the group comparisons. RESULTS The overall median AEsthetic evaluation after treatment was 10 (interquartile range = IQR: 9.5-10) in group CHAIR and 10 (IQR: 9.5-10) in-group LAB (Mann-Whitney [MW] test p = 1.000). The WES amounted to 4 (IQR: 3-5) (CHAIR) and to 8 (IQR: 7-9) (LAB) (MW test p < 0.0001). The median total working time for the clinician in-group CHAIR was 49.9 min. (IQR: 40.9-63.7) and 41.4 min. (IQR: 37.2-58.2) in-group LAB (MW test p = 0.387). CONCLUSIONS Subjective PROMs of single-tooth supported restorations fabricated in a CHAIR or LAB workflow led to similar scores of patients' satisfaction and a moderate negative correlation for the objective evaluation of the clinician in the LAB workflow. CLINICAL SIGNIFICANCE PROMs can be considered a key element in the decision-making process for restoring single-tooth restorations. The patients' perception of AEsthetics was similar for the CHAIR or LAB workflows. The additional efforts undertaken with the LAB workflow did not result in a patient benefit when compared to a CHAIR workflow

Randomized controlled pilot study assessing efficacy, efficiency, and patient-reported outcomes measures of chairside and labside single-tooth restorations

OBJECTIVES To test whether or not a chairside workflow (CHAIR) is similar to a labside workflow (LAB) in terms of efficacy (primary outcome) and efficiency (secondary outcome). MATERIAL AND METHODS Eighteen subjects in need of a single-tooth restoration in the posterior region of the maxilla or mandible were consecutively recruited and randomly assigned to the CHAIR or LAB workflow. Patient-reported outcome measures (PROMs; efficacy) were assessed using a questionnaire with visual analog scale. The white AEsthetic score (WES) was applied to evaluate the AEsthetic outcome objectively. The clinical and laboratory time (efficiency) were recorded. Nonparametric methods were applied for the group comparisons. RESULTS The overall median AEsthetic evaluation after treatment was 10 (interquartile range = IQR: 9.5-10) in group CHAIR and 10 (IQR: 9.5-10) in-group LAB (Mann-Whitney [MW] test p = 1.000). The WES amounted to 4 (IQR: 3-5) (CHAIR) and to 8 (IQR: 7-9) (LAB) (MW test p < 0.0001). The median total working time for the clinician in-group CHAIR was 49.9 min. (IQR: 40.9-63.7) and 41.4 min. (IQR: 37.2-58.2) in-group LAB (MW test p = 0.387). CONCLUSIONS Subjective PROMs of single-tooth supported restorations fabricated in a CHAIR or LAB workflow led to similar scores of patients' satisfaction and a moderate negative correlation for the objective evaluation of the clinician in the LAB workflow. CLINICAL SIGNIFICANCE PROMs can be considered a key element in the decision-making process for restoring single-tooth restorations. The patients' perception of AEsthetics was similar for the CHAIR or LAB workflows. The additional efforts undertaken with the LAB workflow did not result in a patient benefit when compared to a CHAIR workflow

Das Erwachen des Bewusstseins Der Uebergang vom praeoperativen zum operativen Denken in der kognitiven Evolution; untersucht und dargelegt am Beispiel der Traumschilderungen in den Homerischen Epen Illias und Odyssee

Der vorliegende Beitrag untersucht den Uebergang vom praeoperativen zum operativen Denken in der kognitiven Evolution. Es wird gezeigt, dass dieser kognitive Uebergang in Homers 'Illias' und der 'Odyssee' zu erkennen ist, konkret in der ambivalenten Art, wie Traeume interpretiert worden sind. Nur vermuten laesst sich, dass zwischen dieser kognitiven Uebergangszone und der beispiellosen geistigen Kreativitaet in Homers Folgezeit ein kausaler Zusammenhang besteht. Fuer die Untersuchung der homerischen Traumdeutung wurde in erster Linie vom analytischen Instrumentarium der Entwicklungspsychologie Gebrauch gemacht. Entwicklungspsychologen wie Piaget gehen davon aus, dass das Kind die Entwicklung der kognitiven Faehigkeiten vom 'praeoperativen' Niveau auf das 'operative', im Alter zwischen 6 und 11 Jahren durchlebt. Hallpike gebuehrt das Verdienst, diese entwicklungspsychologischen Erkenntnisse fuer die Anthropologie und Ethnologie fruchtbar gemacht zu haben. Er hat aufgezeigt dass, was fuer die kognitive Entwicklung des Kindes zutrifft, auch fuer die kognitive Entwicklung eines Kollektivs seine Gueltigkeit hat. Die vorliegende Arbeit ist in ihren Grundannahmen diesen Thesen Hallpikes verpflichtet. Der Begriff des 'begrifflichen Realismus' wird demnach nicht nur als ein brauchbares Analyseinstrument zur Festlegung der Stufe der kognitiven Entwicklung betrachtet, auf der sich ein Individuum innerhalb unserer Gesellschaft befindet. Es wird in Anlehnung an Hallpikes Arbeiten davon ausgegangen, dass der Tatbestand des 'Begrifflichen Realismus' auch Aufschluss darueber gibt, auf welcher kognitiven Entwicklungsstufe sich ein Kollektiv befindet. Die Arbeit gliedert sich in zwei Teile. In einem ersten Teil werden kurz die Grundprinzipien der Entwicklungspsychologie und deren von Hallpike aufgezeigter Relevanz fuer evolutionstheoretische Ueberlegungen rekapituliert. Im zweiten Teil wird abgeklaert, welche Traumschilderungen in der 'Illias' und in der 'Odyssee' eher auf 'praeoperative' und welche eher auf 'operative' Denkvorgaengen schliessen lassen. (ICD)Available from http://socio.ch/evo/t zuercher.htm / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekSIGLEDEGerman

The globoside receptor triggers structural changes in the B19V capsid that facilitate virus internalization

Globoside (Gb4Cer), Ku80 autoantigen, and α5β1 integrin have been identified as cell receptors/coreceptors for human parvovirus B19 (B19V), but their role and mechanism of interaction with the virus are largely unknown. In UT7/Epo cells, expression of Gb4Cer and CD49e (integrin alpha-5) was high, but expression of Ku80 was insignificant. B19V colocalized with Gb4Cer and, to a lesser extent, with CD49e. However, only anti-Gb4Cer antibodies could disturb virus attachment. Only a small proportion of cell-bound viruses were internalized, while the majority became detached from the receptor. When added to uninfected cells, the receptor-detached virus showed superior cell binding capacity and infectivity. Attachment of B19V to cells triggered conformational changes in the capsid leading to the accessibility of the N terminus of VP1 (VP1u) to antibodies, which was maintained in the receptor-detached virus. VP1u became similarly accessible to antibodies following incubation of B19V particles with increasing concentrations of purified Gb4Cer. The receptor-mediated exposure of VP1u is critical for virus internalization, since capsids lacking VP1 could bind to cells but were not internalized. Moreover, an antibody against the N terminus of VP1u disturbed virus internalization, but only when present during and not after virus attachment, indicating the involvement of this region in binding events required for internalization. These results suggest that Gb4Cer is not only the primary receptor for B19V attachment but also the mediator of capsid rearrangements required for subsequent interactions leading to virus internalization. The capacity of the virus to detach and reattach again would enhance the probability of productive infections

Impact of physical fitness and biometric data on the quality of external chest compression: a randomised, crossover trial

<p>Abstract</p> <p>Background</p> <p>During circulatory arrest, effective external chest compression (ECC) is a key element for patient survival. In 2005, international emergency medical organisations changed their recommended compression-ventilation ratio (CVR) from 15:2 to 30:2 to acknowledge the vital importance of ECC. We hypothesised that physical fitness, biometric data and gender can influence the quality of ECC. Furthermore, we aimed to determine objective parameters of physical fitness that can reliably predict the quality of ECC.</p> <p>Methods</p> <p>The physical fitness of 30 male and 10 female healthcare professionals was assessed by cycling and rowing ergometry (focussing on lower and upper body, respectively). During ergometry, continuous breath-by-breath ergospirometric measurements and heart rate (HR) were recorded. All participants performed two nine-minute sequences of ECC on a manikin using CVRs of 30:2 and 15:2. We measured the compression and <it>de</it>compression depths, compression rates and assessed the participants' perception of exhaustion and comfort. The median body mass index (BMI; male 25.4 kg/m²and female 20.4 kg/m²) was used as the threshold for subgroup analyses of participants with higher and lower BMI.</p> <p>Results</p> <p>HR during rowing ergometry at 75 watts (HR₇₅) correlated best with the quality of ECC (<it>r </it>= -0.57, <it>p </it>< 0.05). Participants with a higher BMI and better physical fitness performed better and showed less fatigue during ECC. These results are valid for the entire cohort, as well as for the gender-based subgroups. The compressions of female participants were too shallow and more rapid (mean compression depth was 32 mm and rate was 117/min with a CVR of 30:2). For participants with a lower BMI and higher HR₇₅, the compression depth decreased over time, beginning after four minutes for the 15:2 CVR and after three minutes for the 30:2 CVR. Although found to be more exhausting, a CVR of 30:2 was rated as being more comfortable.</p> <p>Conclusion</p> <p>The quality of the ECC and fatigue can both be predicted by BMI and physical fitness. An evaluation focussing on the upper body may be a more valid predictor of ECC quality than cycling based tests. Our data strongly support the recommendation to relieve ECC providers after two minutes.</p