Testing a consensus conference method by discussing the management of traumatic dental injuries in Tanzania

Objectives: To test the recommended consensus conference methods in Tanzania by discussing the management of traumatic dental injuries, and to reach consensus on the feasibility of the treatment modalities of traumatic dental injuries recommended in western countries in theTanzanian situation.Study participants: Fifteen dentists as representatives of the profession and two lay people as representative of potential consumers.Interventions: Presentation of treatment modalities for traumatic dental injuries recommended in western countries.Main outcome measure: Consensus on the feasibility of the recommended treatment modalities of traumatic dental injuries in the Tanzanian situation.Results: For most types of injuries, consensus on the feasibility of the recommended treatment methods for Tanzania was reached immediately. More time was spent to discuss management of some injuries where the members felt that the recommended managementregimes for these injuries are not feasible in the current Tanzanian situation. Panel members made three recommendations. First, parents and teachers should be provided with guidelines or instructions about self-care following trauma. Second, teaching on the management oftraumatic dental injuries at training institutions should be emphasised and third, dental practitioners at dental clinics in the country should get continuing education about the management of traumatic dental injuries.Conclusion: The methods for achieving consensus were useful in the Tanzanian dental situation, therefore it is recommended that the methods be adopted to reach consensus on other oral health issues

Editing to a planar graph of given degrees.

We consider the following graph modification problem. Let the input consist of a graph G=(V,E), a weight function w:V∪E→N, a cost function c:V∪E→N0 and a degree function δ:V→N0, together with three integers kv,ke and C . The question is whether we can delete a set of vertices of total weight at most kv and a set of edges of total weight at most ke so that the total cost of the deleted elements is at most C and every non-deleted vertex v has degree δ(v) in the resulting graph G′. We also consider the variant in which G′ must be connected. Both problems are known to be NP-complete and W[1]-hard when parameterized by kv+ke. We prove that, when restricted to planar graphs, they stay NP-complete but have polynomial kernels when parameterized by kv+ke

Scenarios as the basis for assessment of mitigation and adaptation

The possibilities and need for adaptation and mitigation depends on uncertain future developments with respect to socio-economic factors and the climate system. Scenarios are used to explore the impacts of different strategies under uncertainty. In this chapter, some scenarios are presented that are used in the ADAM project for this purpose. One scenario explores developments with no mitigation, and thus with high temperature increase and high reliance on adaptation (leading to 4oC increase by 2100 compared to pre-industrial levels). A second scenario explores an ambitious mitigation strategy (leading to 2oC increase by 2100 compared to pre-industrial levels). In the latter scenario, stringent mitigation strategies effectively reduces the risks of climate change, but based on uncertainties in the climate system a temperature increase of 3oC or more cannot be excluded. The analysis shows that, in many cases, adaptation and mitigation are not trade-offs but supplements. For example, the number of people exposed to increased water resource stress due to climate change can be substantially reduced in the mitigation scenario, but even then adaptation will be required for the remaining large numbers of people exposed to increased stress. Another example is sea level rise, for which adaptation is more cost-effective than mitigation, but mitigation can help reduce damages and the cost of adaptation. For agriculture, finally, only the scenario based on a combination of adaptation and mitigation is able to avoid serious climate change impacts

Overkappingsprothese op implantaten versus volledige prothese zonder en met mondbodemvestibulumplastiek:Een prospectief onderzoek van 10 jaar

Samenvatting: Het doel van dit gerandomiseerd klinisch onderzoek was om gedurende 10 jaar klinische resultaten, tevredenheid en subjectief kauwvermogen te evalueren na 3 behandelmethoden bij een edentate onderkaak. Deze methoden waren: een overkappingsprothese op 2 implantaten in de onderkaak (IMP-groep, 61 patiënten), een conventionele volledige prothese (VP-groep, 60 patiënten) en een volledige prothese vervaardigd na uitvoering van een mondbodemvestibulumplastiek (MVP-groep, 28 patiënten). Geconcludeerd werd dat 2 enossale implantaten in een edentate onderkaak, als retentie voor een overkappingsprothese, na 10 jaar een hoog overlevingspercentage hebben (93%). De tevredenheid van de VP-groep en de MVP-groep blijft lager dan van de IMP-groep. Versch. in: NTVT januari 2005; 112: 7-1

Implant-retained overdentures compared with complete dentures with or without preprosthetic surgery. Satisfaction and subjective chewing capabilities

The aim of this prospective randomized clinical trial was to evaluate and compare a set of clinical items and satisfaction of a group of edentulous patients during a 5-year follow-up. They were treated according to one of the following modalities: 61 patients with a mandibular overdenture on two implants (IMP-group), 60 patients with a conventional complete denture (VP-group) and 28 patients with a complete denture after preprosthetic surgery (MVP-group). It can be concluded that endosseous implants, serving as retention for a mandibular overdenture, have a high survival rate after 5 years of follow-up (93%). The mean satisfaction score of the VP-group was lower than of the IMP-group. The mean satisfaction score of the MVP-group is lower than of the IMP-group.</p

Bivalirudin started during emergency transport for primary PCI.

BACKGROUND: Bivalirudin, as compared with heparin and glycoprotein IIb/IIIa inhibitors, has been shown to reduce rates of bleeding and death in patients undergoing primary percutaneous coronary intervention (PCI). Whether these benefits persist in contemporary practice characterized by prehospital initiation of treatment, optional use of glycoprotein IIb/IIIa inhibitors and novel P2Y12 inhibitors, and radial-artery PCI access use is unknown. METHODS: We randomly assigned 2218 patients with ST-segment elevation myocardial infarction (STEMI) who were being transported for primary PCI to receive either bivalirudin or unfractionated or low-molecular-weight heparin with optional glycoprotein IIb/IIIa inhibitors (control group). The primary outcome at 30 days was a composite of death or major bleeding not associated with coronary-artery bypass grafting (CABG), and the principal secondary outcome was a composite of death, reinfarction, or non-CABG major bleeding. RESULTS: Bivalirudin, as compared with the control intervention, reduced the risk of the primary outcome (5.1% vs. 8.5%; relative risk, 0.60; 95% confidence interval [CI], 0.43 to 0.82; P=0.001) and the principal secondary outcome (6.6% vs. 9.2%; relative risk, 0.72; 95% CI, 0.54 to 0.96; P=0.02). Bivalirudin also reduced the risk of major bleeding (2.6% vs. 6.0%; relative risk, 0.43; 95% CI, 0.28 to 0.66; P<0.001). The risk of acute stent thrombosis was higher with bivalirudin (1.1% vs. 0.2%; relative risk, 6.11; 95% CI, 1.37 to 27.24; P=0.007). There was no significant difference in rates of death (2.9% vs. 3.1%) or reinfarction (1.7% vs. 0.9%). Results were consistent across subgroups of patients. CONCLUSIONS: Bivalirudin, started during transport for primary PCI, improved 30-day clinical outcomes with a reduction in major bleeding but with an increase in acute stent thrombosis. (Funded by the Medicines Company; EUROMAX ClinicalTrials.gov number, NCT01087723.)

Genetic convergence of industrial melanism in three geometrid moths

The rise of dark (melanic) forms of many species of moth in heavily coal-polluted areas of nineteenth- and twentieth-century Britain, and their post-1970s fall, point to a common selective pressure (camouflage against bird predators) acting at the community level. The extent to which this convergent phenotypic response relied on similar genetic and developmental mechanisms is unknown. We examine this problem by testing the hypothesis that the locus controlling melanism in Phigalia pilosaria and Odontopera bidentata, two species of geometrid moth that showed strong associations between melanism and coal pollution, is the same as that controlling melanism in Biston betularia, previously identified as the gene cortex. Comparative linkage mapping using family material supports the hypothesis for both species, indicating a deeply conserved developmental mechanism for melanism involving cortex. However, in contrast to the strong selective sweep signature seen in British B. betularia, no significant association was detected between cortex-region markers and melanic morphs in wild-caught samples of P. pilosaria and O. bidentata, implying much older, or diverse, origins of melanic morph alleles in these latter species