Abstract
Since its introduction in 1998, alveolar ridge preservation has become a popular technique, currently accounting for approximately 29% of all procedures involving bone substitute materials. ...The global cost of bone substitute materials for alveolar ridge preservation is estimated at $190 million annually and is expected to rise by approximately 11.4% per year.
Numerous randomised controlled trials have compared alveolar ridge preservation to extraction alone. A recent Cochrane review reported that, in terms of socket dimensional change, the mean difference between alveolar ridge preservation and extraction alone is 1.18 mm horizontally and 1.35 mm vertically. The clinical impact of this is uncertain, for there is no significant difference in the need for graft procedures at implant placement between ridge preservation and extraction alone. There are no randomised controlled trials comparing aesthetic or functional outcomes.
A systematic review of the histological outcomes of ridge preservation demonstrates that, compared to extraction alone, many bone substitute materials can significantly delay the bone healing process. No bone substitute material achieves statistically more new bone formation than extraction alone and many commonly used materials achieve significantly less bone formation. Grafted sites can demonstrate high levels of residual graft and granulation tissue.
In the absence of good-quality clinical evidence to support alveolar ridge preservation, the technique must be questioned as the treatment of choice at extraction sites. This paper assesses recent systematic reviews and presents two case reports of late graft failure.
Paths of fire Adams, Robert McC
1996., 20120917, 2012, 1996, 1997-01-01, 19960101
eBook
Technology, perhaps the most salient feature of our time, affects everything from jobs to international law yet ranks among the most unpredictable facets of human life. Here Robert McC. Adams, ...renowned anthropologist and Secretary Emeritus of the Smithsonian Institution, builds a new approach to understanding the circumstances that drive technological change, stressing its episodic, irregular nature. The result is nothing less than a sweeping history of technological transformation from ancient times until now. Rare in antiquity, the bursts of innovations that mark the advance of technology have gradually accelerated and now have become an almost continuous feature of our culture. Repeatedly shifting in direction, this path has been shaped by a host of interacting social, cultural, and scientific forces rather than any deterministic logic. Thus future technological developments, Adams maintains, are predictable only over the very short term.
Adams's account highlights Britain and the United States from early modern times onward. Locating the roots of the Industrial Revolution in British economic and social institutions, he goes on to consider the new forms of enterprise in which it was embodied and its loss of momentum in the later nineteenth century. He then turns to the early United States, whose path toward industrialization initially involved considerable "technology transfer" from Britain. Propelled by the advent of mass production, world industrial leadership passed to the United States around the end of the nineteenth century. Government-supported research and development, guided partly by military interests, helped secure this leadership.
Today, as Adams shows, we find ourselves in a profoundly changed era. The United States has led the way to a strikingly new multinational pattern of opportunity and risk, where technological primacy can no longer be credited to any single nation. This recent trend places even more responsibility on the state to establish policies that will keep markets open for its companies and make its industries more competitive. Adams concludes with an argument for active government support of science and technology research that should be read by anyone interested in America's ability to compete globally.
Quality assurance, especially in adhesive bonding Adams, Robert. D.
Proceedings of the Institution of Mechanical Engineers. Part D, Journal of automobile engineering,
11/2023, Letnik:
237, Številka:
13
Journal Article
Recenzirano
Odprti dostop
With the increased use of adhesives in industrial applications, there is a need to consider not only strength and stiffness, but also how bonded joints will perform in the long term. In aerospace and ...automotive applications, this means at least 10 years. In buildings and civil engineering structures, much greater timescales are needed. All classes of bond are important whether they be structural or for ‘less important’ applications such as trim, sound deadening. Vehicles which become ‘shabby’ with trim beginning to detach may not lead to warranty claims, but can easily cause loss of reputation. The objective of this paper is to illustrate some of the traps into which a designer might fall and how to avoid them. For a given configuration and expected set of loads, this involves correct choice of the adhesive, specification of the surfaces and some means of checking consistency of the adhesives on delivery to the client, together with the processes used in production.
Recent studies suggest that obstructive sleep apnea (OSA) severity can vary markedly from night to night, which may have important implications for diagnosis and management.
This study aimed to ...assess OSA prevalence from multinight in-home recordings and the impact of night-to-night variability in OSA severity on diagnostic classification in a large, global, nonrandomly selected community sample from a consumer database of people that purchased a novel, validated, under-mattress sleep analyzer.
A total of 67,278 individuals aged between 18 and 90 years underwent in-home nightly monitoring over an average of approximately 170 nights per participant between July 2020 and March 2021. OSA was defined as a nightly mean apnea-hypopnea index (AHI) of more than 15 events/h. Outcomes were multinight global prevalence and likelihood of OSA misclassification from a single night's AHI value.
More than 11.6 million nights of data were collected and analyzed. OSA global prevalence was 22.6% (95% confidence interval, 20.9-24.3%). The likelihood of misdiagnosis in people with OSA based on a single night ranged between approximately 20% and 50%. Misdiagnosis error rates decreased with increased monitoring nights (e.g., 1-night F1-score = 0.77 vs. 0.94 for 14 nights) and remained stable after 14 nights of monitoring.
Multinight in-home monitoring using novel, noninvasive under-mattress sensor technology indicates a global prevalence of moderate to severe OSA of approximately 20%, and that approximately 20% of people diagnosed with a single-night study may be misclassified. These findings highlight the need to consider night-to-night variation in OSA diagnosis and management.
Despite its widespread clinical use, there is little data available from population-based studies on the determinants of serum sex hormone binding globulin (SHBG). We aimed to examine multifactorial ...determinants of circulating SHBG levels in community-dwelling men. Study participants comprised randomly selected 35-80 y.o. men (n = 2563) prospectively-followed for 5 years (n = 2038) in the Men Androgen Inflammation Lifestyle Environment and Stress (MAILES) study. After excluding men with illness or medications known to affect SHBG (n = 172), data from 1786 men were available at baseline, and 1476 at follow-up. The relationship between baseline body composition (DXA), serum glucose, insulin, triglycerides, thyroxine (fT4), sex steroids (total testosterone (TT), oestradiol (E2)), and pro-inflammatory cytokines and serum SHBG level at both baseline & follow-up was determined by linear and penalized logistic regression models adjusting for age, lifestyle & demographic, body composition, metabolic, and hormonal factors. Restricted cubic spline analyses was also conducted to capture possible non-linear relationships. At baseline there were positive cross-sectional associations between age (β = 0.409, p<0.001), TT (β = 0.560, p<0.001), fT4 (β = 0.067, p = 0.019) and SHBG, and negative associations between triglycerides (β = -0.112, p<0.001), abdominal fat mass (β = -0.068, p = 0.032) and E2 (β = -0.058, p = 0.050) and SHBG. In longitudinal analysis the positive determinants of SHBG at 4.9 years were age (β = 0.406, p = <0.001), TT (β = 0.461, p = <0.001), and fT4 (β = 0.040, p = 0.034) and negative determinants were triglycerides (β = -0.065, p = 0.027) and abdominal fat mass (β = -0.078, p = 0.032). Taken together these data suggest low SHBG is a marker of abdominal obesity and increased serum triglycerides, conditions which are known to have been associated with low testosterone and low T4.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The Men Androgen Inflammation Lifestyle Environment and Stress (MAILES) Study was established in 2009 to investigate the associations of sex steroids, inflammation, environmental and psychosocial ...factors with cardio-metabolic disease risk in men. The study population consists of 2569 men from the harmonisation of two studies: all participants of the Florey Adelaide Male Ageing Study (FAMAS) and eligible male participants of the North West Adelaide Health Study (NWAHS). The cohort has so far participated in three stages of the MAILES Study: MAILES1 (FAMAS Wave 1, from 2002-2005, and NWAHS Wave 2, from 2004-2006); MAILES2 (FAMAS Wave 2, from 2007-2010, and NWAHS Wave 3, from 2008-2010); and MAILES3 (a computer-assisted telephone interview (CATI) survey of all participants in the study, conducted in 2010). Data have been collected on a comprehensive range of physical, psychosocial and demographic issues relating to a number of chronic conditions (including cardiovascular disease, diabetes, arthritis and mental health) and health-related risk factors (including obesity, blood pressure, smoking, diet, alcohol intake and inflammatory markers), as well as on current and past health status and medication.
Sex hormone-binding globulin (SHBG) levels are associated with cardiovascular disease (CVD) risk factors. However, prospective data on the association between SHBG levels and CVD events are sparse, ...with conflicting results.
To examine associations between serum SHBG, total testosterone (TT), and incident CVD and CVD-related mortality in middle-aged to elderly men.
Data on 2563 community-dwelling men (35 to 80 years) were obtained from participants in the Men Androgen Inflammation Lifestyle Environment and Stress cohort. The analytic sample included 1492 men without baseline (2002 to 2007) CVD and with fasted morning serum SHBG and TT available at both baseline and follow-up (2007 to 2010) and without medications affecting TT or SHBG. Associations of baseline SHBG and TT, with incident CVD and CVD mortality, were analyzed using logistic regression for incident CVD and Cox proportional hazard regression for CVD mortality, adjusting for established CVD risk factors.
In multivariable models, elevated baseline SHBG and lower baseline TT were independently associated with incident CVD (SHBG: OR, 1.54; 95% CI, 1.15 to 2.06 per SD increase in SHBG, P = 0.003; TT: OR, 0.71; 95% CI, 0.52 to 0.97 per SD decrease in TT; P = 0.03). A decrease in TT between time points was associated with incident CVD (OR, 0.72; 95% CI, 0.56 to 0.92; P = 0.01). Neither SHBG nor TT was significantly associated with all-age CVD mortality hazard ratio (HR), 0.69; 95% CI, 0.29 to 1.63; P = 0.40; and HR, 0.60; 95% CI, 0.28 to 1.26; P = 0.18, respectively.
Among all men and men >65 years, elevated SHBG and lower TT were independently associated with both a greater risk of CVD and an increased CVD mortality risk.
A central plank of health care reform is an expanded role for educated consumers interacting with responsive health care teams. However, for individuals to realize the benefits of health education ...also requires a high level of engagement. Population studies have documented a gap between expectations and the actual performance of behaviours related to participation in health care and prevention. Interventions to improve self-care have shown improvements in self-efficacy, patient satisfaction, coping skills, and perceptions of social support. Significant clinical benefits have been seen from trials of self-management or lifestyle interventions across conditions such as diabetes, coronary heart disease, heart failure and rheumatoid arthritis. However, the focus of many studies has been on short-term outcomes rather that long term effects. There is also some evidence that participation in patient education programs is not spread evenly across socio economic groups. This review considers three other issues that may be important in increasing the public health impact of patient education. The first is health literacy, which is the capacity to seek, understand and act on health information. Although health literacy involves an individual's competencies, the health system has a primary responsibility in setting the parameters of the health interaction and the style, content and mode of information. Secondly, much patient education work has focused on factors such as attitudes and beliefs. That small changes in physical environments can have large effects on behavior and can be utilized in self-management and chronic disease research. Choice architecture involves reconfiguring the context or physical environment in a way that makes it more likely that people will choose certain behaviours. Thirdly, better means of evaluating the impact of programs on public health is needed. The Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework has been promoted as one such potential approach.
Abstract
Mental health conditions confer considerable global disease burden in young adults, who are also the highest demographic to work shifts, and of whom 20% meet criteria for a sleep disorder. ...We aimed to establish the relationship between the combined effect of shift work and sleep disorders, and mental health. The Raine Study is the only longitudinal, population-based birth cohort in the world with gold-standard, Level 1 measurement of sleep (polysomnography, PSG) collected in early adulthood. Participants (aged 22y) underwent in-laboratory PSG and completed detailed sleep questionnaires. Multivariable adjusted robust linear regression models were conducted to explore associations with anxiety (GAD7) and depression (PHQ9), adjusted for sex, health comorbidities, and work hours/week. Data were from 660 employed young adults (27.3% shift workers). At least one clinically significant sleep disorder was present in 18% of shift workers (day, evening and night shifts) and 21% of non-shift workers (
p
= 0.51); 80% were undiagnosed. Scores for anxiety and depression were not different between shift and non-shift workers (
p
= 0.29 and
p
= 0.82); but were higher in those with a sleep disorder than those without (
Md(IQR)
anxiety: 7.0(4.0–10.0) vs 4.0(1.0–6.0)), and depression: (9.0(5.0–13.0) vs 4.0(2.0–6.0)). Considering evening and night shift workers only (i.e. excluding day shift workers) revealed an interaction between shift work and sleep disorder status for anxiety (
p
= 0.021), but not depression (
p
= 0.96), with anxiety scores being highest in those shift workers with a sleep disorder (
Md(IQR)
8.5(4.0–12.2). We have shown that clinical sleep disorders are common in young workers and are largely undiagnosed. Measures of mental health do not appear be different between shift and non-shift workers. These findings indicate that the identification and treatment of clinical sleep disorders should be prioritised for young workers as these sleep disorders, rather than shift work per se
,
are associated with poorer mental health. These negative mental health effects appear to be greatest in those who work evening and/or night shift and have a sleep disorder.
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