Few prospective trials of implant-retained mandibular dentures have evaluated the increase and duration of patient satisfaction, costs of denture maintenance in relation to different methods of ...attaching overdentures to implants, or the use of a reinforced framework.
This report evaluates subjects' satisfaction and prosthodontic maintenance during a 3-year randomized clinical trial of implant-retained mandibular complete dentures, whether reinforced or not with a cast framework, and attached by bar-clip or 2.25-mm ball-spring matrices to endosteal dental implants.
One hundred edentulous subjects, each having at least 1 year's experience with conventional complete dentures, were selected from respondents to a university dental clinic's request for volunteers. Candidates were examined to verify adequate mandibular bone and medical suitability for implants. Subjects then received 2 implants in the anterior mandible before being stratified by mandibular bone height and gender and assigned randomly to 1 of 4 treatment groups. Every subject received a new maxillary complete denture in addition to an implant-supported mandibular complete denture, with or without a reinforcing framework, connected to implants by either a bar-clip or a ball-spring patrix and matrix. The dentures were adjusted and repaired as needed. Subjects indicated on a visual analogue scale (VAS) satisfaction with conventional dentures prior to the study and then with new dentures at 1 month, 1 year, and 2 years. The results reported here are from the first 68 subjects observed for 3 years after receiving new dentures (19 subjects received new dentures less than 3 years before this analysis, and another 13 subjects were lost to follow-up). VAS scores are presented in simple tables and graphs, and results for different groups were compared using 2-sided nonparametric rank tests and repeated measures ANOVA. With respect to costs and maintenance,
t tests were used to compare group means. Sample size and other design considerations used a .05 significance level.
After receiving new dentures with mandibular implant supports, improved satisfaction “within subject” was prompt, durable, substantial, and statistically significant, regardless of the attachment mechanism, and with or without a reinforcing framework. In contrast, there were no notable satisfaction differences between the 2 attachment mechanisms, or with the presence or absence of a reinforcing framework, either at specific intervals after receiving the new dentures, or in repeated measures ANOVA. For both attachment groups, most denture adjustments occurred during the first year. This accounted for 81% of total adjustments during 3 years, when the 34 subjects in the ball-spring group and the 34 in the bar-clip group were combined. The mean numbers of adjustments per subject and associated clinical times did not differ significantly between the 2 groups. Conversely, denture repairs declined more slowly than adjustments. Almost all repairs (90%) occurred in the ball-spring group to correct problems with the attachments, 39% in the first year, and tapering off only slightly in the following 2 years. Over 3 years of follow-up, mean numbers of repairs per subject differed significantly between groups: 6.7 repairs per person in the ball-spring group, compared to 0.8 in the bar-clip group (
P<.001), and mean time per appointment was greater for repairs in the ball-spring group: 18.9 minutes compared to 16.9 (
P<.01). The cast framework had no influence on the satisfaction expressed or on adjustments and repairs.
Subjects were very satisfied with the new dentures, although the ball-spring attachment tested in this trial required substantially more repairs.
Vanillin (4-hydroxy-3-methoxybenzaldehyde) is an important flavour and aroma molecule, but is also of interest because of its biogenetic relationship to the phenylpropanoid pathway and to other ...molecules of physiological significance, notably salicylate. Recent progress towards characterisation of the biosynthesis of vanillin is reviewed. In
Vanilla, there is some evidence that the route to vanillin-β-
d-glucoside may proceed from 4-coumaric acid via 4-hydroxybenzaldehyde, with glucoside formation occurring not necessarily as the final step, and possibly with the involvement of 4-hydroxybenzyl alcohol β-
d-glucoside tartrate bis-esters as “shunt” metabolites. This appears to be given tentative support by the recent partial characterisation of a 4-hydroxybenzaldehyde synthase from
Vanilla. On the other hand, a well-characterised, CoA-dependent, non-oxidative chain-shortening mechanism to produce vanillin from ferulic acid, occurring as part of a pathway of hydroxycinnamate degradation in
Pseudomonas, may not be representative of hydroxycinnamate chain-shortening mechanism(s) occurring in
Vanilla and other plants. Nevertheless, by expression of the
Pseudomonas enzyme 4-hydroxycinnamoyl-CoA hydratase/lyase (HCHL), attempts have been made to introduce a direct capacity for vanillin formation into model plants by diversion of the phenylpropanoid pathway. The results obtained have emphasised the obstacles to achieving the desired oxidation level (aldehyde) and ring substitution (4-hydroxy-3-methoxyphenyl), even when a substantial metabolic diversion is successfully achieved. Finally, the significance of the latest biosynthetic and biotechnological developments is reviewed briefly in relation to authentication of vanillin.
Graphic
Objectives
To determine the diagnostic yield of analysing biparametric (T2‐ and diffusion‐weighted) magnetic resonance imaging (B‐MRI) for prostate cancer detection compared with standard digital ...rectal examination (DRE) and prostate‐specific antigen (PSA)‐based screening.
Patients and Methods
Review of patients who were enrolled in a trial to undergo multiparametric‐prostate (MP)‐MRI and MR/ultrasound fusion‐guided prostate biopsy at our institution identified 143 men who underwent MP‐MRI in addition to standard DRE and PSA‐based prostate cancer screening before any prostate biopsy. Patient demographics, DRE staging, PSA level, PSA density (PSAD), and B‐MRI findings were assessed for association with prostate cancer detection on biopsy.
Results
Men with detected prostate cancer tended to be older, with a higher PSA level, higher PSAD, and more screen‐positive lesions (SPL) on B‐MRI. B‐MRI performed well for the detection of prostate cancer with an area under the curve (AUC) of 0.80 (compared with 0.66 and 0.74 for PSA level and PSAD, respectively). We derived combined PSA and MRI‐based formulas for detection of prostate cancer with optimised thresholds. (i) for PSA and B‐MRI: PSA level + 6 x (the number of SPL) > 14 and (ii) for PSAD and B‐MRI: 14 × (PSAD) + (the number of SPL) >4.25. AUC for equations 1 and 2 were 0.83 and 0.87 and overall accuracy of prostate cancer detection was 79% in both models.
Conclusions
The number of lesions positive on B‐MRI outperforms PSA alone in detection of prostate cancer. Furthermore, this imaging criteria coupled as an adjunct with PSA level and PSAD, provides even more accuracy in detecting clinically significant prostate cancer.
Values‐affirmation interventions have the potential to improve students’ experience and achievement in school. Researchers have proposed that these benefits are greatest when affirmation exercises ...are delivered by teachers (versus researchers). The current research provides an experimental test of whether describing affirmation activities as provided by teachers increases students’ engagement with the activities and students’ positive perceptions of their teachers. In a 2×2 field experiment, delivered to students during their first year of high school, students completed either an affirmation or matched control activity purportedly provided by either teachers or researchers. We found that describing affirmation activities as provided by teachers led students to perceive that teachers at their school were more interested in students’ broader lives outside of school and provided marginally more care and support to students, as compared to the same affirmation exercise described as provided by researchers and control activities attributed to either source. In addition, teacher‐provided affirmation activities prompted students to write more during the activities. The present study provides initial evidence that affirmation interventions can improve students’ perceptions of their relationship with their teachers—a potent driver of student success—but only when affirmation activities are seen as coming from and of interest to teachers.
We present NuSTAR observations of the bright Seyfert 2 galaxy NGC 2110 obtained in 2012, when the source was at the highest flux level ever observed, and in 2013, when the source was at a more ...typical flux level. We include archival observations from other X-ray satellites, namely XMM–Newton, Suzaku, BeppoSAX, Chandra and Swift. Simultaneous NuSTAR and Swift broad-band spectra (in the 3–80 keV range) indicate a cutoff energy E
c > 210 keV, with no detectable contribution from Compton reflection. NGC 2110 is one of the very few sources where no evidence for distant Compton-thick scattering is found and, by using temporal information collected over more than a decade, we investigate variations of the iron Kα line on time-scales of years. The Fe Kα line is likely the sum of two components: one constant (originating from distant Compton-thick material) and the other one variable and linearly correlated with the source flux (possibly arising from Compton-thin material much closer to the black hole).
A promising way to mitigate inequality is by addressing students' worries about belonging. But where and with whom is this social-belonging intervention effective? Here we report a team-science ...randomized controlled experiment with 26,911 students at 22 diverse institutions. Results showed that the social-belonging intervention, administered online before college (in under 30 minutes), increased the rate at which students completed the first year as full-time students, especially among students in groups that had historically progressed at lower rates. The college context also mattered: The intervention was effective only when students' groups were afforded opportunities to belong. This study develops methods for understanding how student identities and contexts interact with interventions. It also shows that a low-cost, scalable intervention generalizes its effects to 749 4-year institutions in the United States.
ABSTRACT Hot dust-obscured galaxies (hot DOGs), selected from Wide-Field Infrared Survey Explorer's all-sky infrared survey, host some of the most powerful active galactic nuclei known and may ...represent an important stage in the evolution of galaxies. Most known hot DOGs are located at , due in part to a strong bias against identifying them at lower redshift related to the selection criteria. We present a new selection method that identifies 153 hot DOG candidates at , where they are significantly brighter and easier to study. We validate this approach by measuring a redshift z = 1.009 and finding a spectral energy distribution similar to that of higher-redshift hot DOGs for one of these objects, WISE J1036+0449 ( ). We find evidence of a broadened component in Mg ii, which would imply a black hole mass of and an Eddington ratio of . WISE J1036+0449 is the first hot DOG detected by the Nuclear Spectroscopic Telescope Array, and observations show that the source is heavily obscured, with a column density of . The source has an intrinsic 2-10 keV luminosity of , a value significantly lower than that expected from the mid-infrared/X-ray correlation. We also find that other hot DOGs observed by X-ray facilities show a similar deficiency of X-ray flux. We discuss the origin of the X-ray weakness and the absorption properties of hot DOGs. Hot DOGs at could be excellent laboratories to probe the characteristics of the accretion flow and of the X-ray emitting plasma at extreme values of the Eddington ratio.
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