Heat production during different ultrasonic and conventional osteotomy preparations for dental implants

Objectives: The purpose of this study was to evaluate the intraosseous temperature changes during ultrasonic and conventional implant site preparation in vitro with respect to the effect of load and irrigation volume. Material and methods: Implant sites were prepared using two different ultrasonic devices (Piezosurgery, Mectron Medical Technology and VarioSurg, NSK) and one conventional device (Straumann) at loads of 5, 8, 15 and 20 N and with irrigation volumes of 20, 50 and 80 ml/min. During implant site preparation, temperatures were measured in fresh, equally tempered bovine ribs using two thermocouples placed at a distance of 1.5 mm around the drilling site in cortical and cancellous bone. The preparation time was recorded. Results: The heat production and time required for implant site preparation using both ultrasonic devices were significantly higher than those for conventional drilling (P<0.01). Increased loading had no effect on heat production. A higher irrigation volume was associated with a diminished temperature increase in the cortical bone for ultrasonic but not for conventional drilling, which resulted in significantly lower temperatures in cortical as compared with cancellous bone during ultrasonic implant site preparation. Conclusions: Ultrasonic implant site preparation is more time consuming and generates higher bone temperatures than conventional drilling. However, with the levels of irrigation, ultrasonic implant site preparation can be an equally safe method. To cite this article:
Rashad A, Kaiser A, Prochnow N, Schmitz I, Hoffmann E, Maurer P. Heat production during different ultrasonic and conventional osteotomy preparations for dental implants.
Clin. Oral Impl. Res. xx , 2011; 000–000.
doi: 10.1111/j.1600‐0501.2010.02126.x     

Community Needs,Concerns, and Perceptions About Health Research: Findings From the Clinical and Translational Science Award Sentinel Network

Objectives. We used results generated from the first study of the National Institutes of Health Sentinel Network to understand health concerns and perceptions of research among underrepresented groups such as women, the elderly, racial/ethnic groups, and rural populations.Methods. Investigators at 5 Sentinel Network sites and 2 community-focused national organizations developed a common assessment tool used by community health workers to assess research perceptions, health concerns, and conditions.Results. Among 5979 individuals assessed, the top 5 health concerns were hypertension, diabetes, cancer, weight, and heart problems; hypertension was the most common self-reported condition. Levels of interest in research participation ranged from 70.1% among those in the “other” racial/ethnic category to 91.0% among African Americans. Overall, African Americans were more likely than members of other racial/ethnic groups to be interested in studies requiring blood samples (82.6%), genetic samples (76.9%), or medical records (77.2%); staying overnight in a hospital (70.5%); and use of medical equipment (75.4%).Conclusions. Top health concerns were consistent across geographic areas. African Americans reported more willingness to participate in research even if it required blood samples or genetic testing.Although more than 80 000 clinical trials are conducted each year in the United States, less than 1% of the population participates in these studies.1 Women, the elderly, members of racial/ethnic minority groups, and rural populations are often underrepresented in research,2,3 leading to findings that do not account for genetic, cultural, linguistic, racial/ethnic, gender, and age differences. A representative population sample in clinical trials is important both from an ethical perspective and to ensure external validity of findings.3–5The community health worker (CHW) intervention model could help eliminate this discrepancy. CHWs are lay community members who share a common language and culture with the people they serve.6 CHWs primarily deliver interventions, navigate patients through cancer treatment, educate patients about their diverse conditions, and facilitate connections to hidden populations. The value of the CHW in research is increasingly recognized; some states now certify CHWs to further professionalize their role.7,8 In fact, the American Journal of Public Health devoted its December 2011 issue to work associated with CHWs.7,9Recognizing this potential, the Clinical and Translational Science Award (CTSA) Strategic Goal 4 Committee (Enhancing the Health of Our Communities and the Nation) of the National Institutes of Health (NIH) established the CTSA Community Engagement Resource Development Workgroup. This group subsequently received an American Reinvestment and Recovery Act supplemental grant in 2009 to collaborate across 5 CTSA sites and 2 community-focused national organizations to develop procedures to increase community participation in research, build the capacity of CHWs to expand their role in research by increasing the rigor of health evaluation metrics in the field, and establish a sustainable network, the Sentinel Network, to provide ongoing, real-time assessments of top health and neighborhood needs, concerns, and research perceptions. The data could then be immediately shared with NIH-CTSA sites, and local communities to increase the representativeness and relevance of research by facilitating community participation.The Sentinel Network is built on an interactive community program called HealthStreet, founded by the lead author (L. B. C.) when she was at Washington University in St. Louis. HealthStreet uses CHWs for 4 aims: to assess the medical problems and health concerns of community residents, to engage in bidirectional sharing of information between the community and research investigators, to link community residents to medical and social services, and to provide community members with opportunities to participate in research.HealthStreet builds trust between the research community and the general public6,10 by directly engaging individual residents (the program’s first aim) rather than focusing on agencies, providers, and organizations as partners, as is more typical in community engagement research.6 This strategy ensures that HealthStreet’s efforts do not bypass the input of community members or inadvertently privilege the perceptions of community leaders and service providers.11–13Community members often perceive research as primarily meeting the needs of the researcher.14,15 Recognition of these and other issues has led to an increasingly robust literature on methods to engage the community in research.10,14,16,17 In line with HealthStreet’s second aim to engage in bidirectional sharing of information between communities and researchers, this literature stresses the need for community members to provide meaningful input into study content. With the discrepancy between participants enrolled in research studies and the populations to whom findings relate, efforts are needed that effectively link people to desired medical and social services (the third aim) and that use this exchange to inform individuals of opportunities for relevant research (the fourth aim).Past studies evaluating barriers to research participation indicate that members of underrepresented groups have concerns with respect to inconvenience of study times, other logistical burdens, and fears about being a guinea pig.12,18,19 That mistrust, directed at researchers and health professionals, is decreasing as a result of new community engaged research efforts.20,21 Programs such as the CTSA Sentinel Network and HealthStreet can help change these perceptions.Here we report findings generated from the Sentinel Network’s first study on the assessment of health needs and concerns at 5 diverse CTSA sites. We describe the Sentinel Network study protocol, assessment, and results from the first phase of the collaboration.     

Feasibility and Effectiveness of HIV Prevention Among Wives of Heavy Drinkers in Bangalore,India

Few studies have examined the effectiveness of community based HIV interventions for monogamous married women. We examined prevalence of risky behaviors and effectiveness of a Western intervention on increased knowledge and reductions in risky behaviors among wives of heavy drinkers in an urban slum in Bangalore, India. Household enumeration was conducted on 509 households; wives of the youngest married man 18–50 years of age who scored 8+ on the Alcohol Use Disorder Identification Test (AUDIT) were selected (N = 100) and assessed with Indian adaptations of the Substance Abuse Module (SAM), the Washington University Risk Behavior Assessment for Women (WU-RBA-W), the Violence Exposure Questionnaire (VEQ), the CES-D, the Diagnostic Interview Schedule (DIS-IV), and a Proxy AUDIT. After random assignment to either the Standard (Pre-post HIV counseling; N = 50) or the Enhanced Intervention (Standard + Body Wise Intervention; N = 50), women were re-assessed at 2 months; a 100% follow-up rate was achieved. Though no major intervention effects were found, at follow-up women were less likely to report victimization and perpetrated violence, more likely to feel empowered to make decisions about birth control, and were more knowledgeable about how to protect themselves from STDs and HIV. The findings have implications for HIV prevention among at risk monogamous women in community settings.     

Variability of non-response to aspirin in patients with peripheral arterial occlusive disease during long-term follow-up

Non-responsiveness to aspirin as detected by laboratory tests may identify patients at high risk for future vascular events. The aim of this prospective study was to evaluate whether non-responsiveness to aspirin is stable over time. Ninety-eight patients with stable peripheral arterial occlusive disease (PAOD) treated with 100 mg/d aspirin were followed over a median timeframe of 17 months. Platelet function tests were performed initially and at follow-up using arachidonic acid-induced light transmittance aggregometry (LTA) in native platelet-rich plasma with the Behring Coagulation Timer® and by measuring the collagen?epinephrine closure time (CT) on a Platelet Function Analyzer (PFA-100®). When determining platelet function using LTA, four patients (4.1%) had residual platelet function (i.e., MaxAggr ≥78%) despite aspirin treatment, whereas, according to the PFA-100® results, 12 patients (12.2%) were identified as non-responders (i.e., CT <192 s). Fifty-seven patients who were still under treatment with 100 mg/d aspirin at the time of follow-up provided a second blood sample. Further platelet function tests with the PFA-100® system identified a persistent non-responsiveness to aspirin over time in three patients (5.3%) whereas four (7.0%) and 15 (26.3%) patients had changes in response status when platelet function was assessed by LTA and on the PFA-100®, respectively. We conclude that true non-responsiveness to aspirin is a rare phenomenon in stable PAOD patients. Furthermore, we conclude that in a number of patients, aspirin non-responsiveness is not stable over time.     

Substance use,victimization, HIV/AIDS risk,and recidivism among females in a therapeutic justice program

This analysis examines the association between crack/cocaine use only and the SAVA syndemic (any substance use, being exposed to violence, having HIV/AIDS risk behaviors) at baseline and any felony, misdemeanor, or municipal violations by an 8-month follow-up. Data comes from 317 women recruited from a Municipal Drug Court System in the Midwest. Among the sample, 45% of the women had at least one felony, misdemeanor, or a municipal violation at the 8-month follow-up (felony: 20%; misdemeanor or municipal violation 25%). Multinomial regression revealed that crack/cocaine use and SAVA at baseline were associated specifically with misdemeanors OR 2.21 (95% CI: 1.21, 4.04) and OR 3.60 (95% CI: 1.23, 10.56), respectively, no increases in odds of felonies were evident. Women with a higher number of lifetime arrests were also significantly more likely to have a greater number of offenses postbaseline, while black women were considerably less likely to be charged with misdemeanors. Recent crack/cocaine use with or without the mutually reinforcing issues of victimization, and HIV/AIDS risk behaviors significantly increased the odds of a misdemeanors/municipal violation. However, significant increases in odds of more severe offenses (felonies) were not evident. Interventions aimed to reduce offenses should offer additional support for crack/cocaine users.     

Rice Husk Ash to Stabilize Heavy Metals Contained in Municipal Solid Waste Incineration Fly Ash: First Results by Applying New Pre-treatment Technology

A new technology was recently developed for municipal solid waste incineration (MSWI) fly ash stabilization, based on the employment of all waste and byproduct materials. In particular, the proposed method is based on the use of amorphous silica contained in rice husk ash (RHA), an agricultural byproduct material (COSMOS-RICE project). The obtained final inert can be applied in several applications to produce “green composites”. In this work, for the first time, a process for pre-treatment of rice husk, before its use in the stabilization of heavy metals, based on the employment of Instant Pressure Drop technology (DIC) was tested. The aim of this work is to verify the influence of the pre-treatment on the efficiency on heavy metals stabilization in the COSMOS-RICE technology. DIC technique is based on a thermomechanical effect induced by an abrupt transition from high steam pressure to a vacuum, to produce changes in the material. Two different DIC pre-treatments were selected and thermal annealing at different temperatures were performed on rice husk. The resulting RHAs were employed to obtain COSMOS-RICE samples, and the stabilization procedure was tested on the MSWI fly ash. In the frame of this work, some thermal treatments were also realized in O₂-limiting conditions, to test the effect of charcoal obtained from RHA on the stabilization procedure. The results of this work show that the application of DIC technology into existing treatment cycles of some waste materials should be investigated in more details to offer the possibility to stabilize and reuse waste.     

Simkania negevensis and acute cellular rejection in lung transplant recipients

Simkania negevensis infection has been hypothesized to play a role in lung transplant rejection. The incidence of S. negevensis infection and its association with acute cellular rejection (ACR) were determined in a prospective cohort study of 78 lung transplant recipients (LTRs) in Toronto, Canada, and Pittsburgh, USA, from July 2007 to January 2010. Simkania negevensis testing was detected by quantitative polymerase chain reaction (PCR) on bronchoalveolar lavage fluid. The relationship between S. negevensis and ACR was examined using Cox proportional hazards models and generalized linear and latent mixed models. Cumulative incidence estimates for time‐to‐ACR in S. negevensis PCR‐positive vs. PCR‐negative LTRs were 52.7% vs. 31.1% at six months and 68.9% vs. 44.6% at one yr, respectively. Although not statistically significant, there was a trend toward a higher risk of ACR among S. negevensis PCR‐positive vs. PCR‐negative LTRs in all statistical models.     

Reflections on the need for geropsychiatric management in a rural district

It is reported about results of a pilot study to the investigation of the geropsychiatric care demand for the district Haldensleben and conclusions to the geronto-psychiatric care structure of organization are added.     

Social Context,Gender Identity and Eating Disorders in Western and Eastern Europe: Preliminary Results of a Comparative Study

The present paper reports preliminary results of a pilot study carried out on two samples of females living in two different European countries. The onset of eating disorders is considered to result from females' difficulties in developing a gender-specific identity in a specific social context that provides and supports certain ideals, interpersonal relationships, and attitudes toward them. Thirty-five German females and 20 Bulgarians have been questioned about the way they perceive themselves, the social ideal, the attractivity in women, the problem of individuation and separation, autonomy and social relationship in general. The results indicate that certain social models are more likely to induce identity conflicts in the German sample than in the Bulgarian one.