The influence of resin coating on the shear punch strength of a high strength auto-cure glass ionomer.

OBJECTIVES: The aim of this study is to examine the influence of early water contact on the shear punch strength of a modern, high strength, auto-cure glass ionomer (Fuji IX GP). METHODS: Specimens, 8.0mm in diameter and approximately 1.25mm thick, were prepared in metal washers, and allowed to remain covered by polyester strips for 7min, to ensure completion of the initial set. A minimum of 32 specimens was prepared for each set of experiments and they were divided into two equal groups. Following removal of the strips, the surfaces of the specimens in Group 1 were immediately coated on both sides with Fuji Coat LC and light cured for 10s. In Group 2 the specimens were left uncoated. All specimens were then placed in distilled water at 37 degrees C, and stored for periods of 24h, 1, 2, 5, or 8 weeks. The strength of the specimens was measured at each time interval in the shear mode by a punch test in a universal testing machine. RESULTS: The mean strength of the coated specimens in Group 1, which had been protected against exposure to water, increased significantly on ageing from 67.1 (24h) to 78.0MPa (1 week), with no further significant change in strength. The mean strength of the specimens in Group 2 increased significantly from 75.7 (24h) to 83.3 (1 week) and 91.9MPa (2 weeks), with no further significant change in strength. Uncoated specimens were stronger at all points of time. The difference was statistically significant at 24h, 2, 5, and 8 weeks (P<0.05), but not at 1 week (P=0.061). Significance. The results suggest that, contrary to the usual instructions for placement of glass ionomer, early access to water will positively influence the shear punch strength of Fuji IX GP.     

Renal calcification in mice homozygous for the disrupted type IIa Na/Pi cotransporter gene Npt2.

Mice homozygous for the disrupted renal type IIa sodium/phosphate (Na/Pi) cotransporter gene (Npt2-/-) exhibit renal Pi wasting, hypophosphatemia, and an adaptive increase in the serum concentration of 1,25-dihydroxyvitamin D with associated hypercalcemia and hypercalciuria. Because hypercalciuria is a risk factor for nephrocalcinosis, we determined whether Npt2-/- mice form renal stones. Analysis of renal sections by von Kossa staining and intact kidneys by microcomputed tomography revealed renal calcification in adult Npt2-/- mice but not in Npt2+/+ littermates. Energy-dispersive spectroscopy and selected-area electron diffraction indicated that the calcifications are comprised of calcium and Pi with an apatitic mineral phase. To determine the age of onset of nephrocalcinosis, we examined renal sections of newborn and weanling mice. At both ages, mutant but not wild-type mice display renal calcification, which is associated with renal Pi wasting and hypercalciuria. Immunohistochemistry revealed that osteopontin co-localizes with the calcifications. Furthermore, renal osteopontin messenger RNA abundance is significantly elevated in Npt2-/- mice compared with Npt2+/+ mice. The onset of renal stones correlated developmentally with the absence of Npt2 expression and the expression of the genes responsible for the renal production (1alpha-hydroxylase) and catabolism (24-hydroxylase) of 1,25-dihydroxyvitamin D. In summary, we show that Npt2 gene ablation is associated with renal calcification and suggest that mutations in the NPT2 gene may contribute to nephrocalcinosis in a subset of patients with familial hypercalciuria.     

Assessment of Respondent Driven Sampling for Recruiting Female Sex Workers in Two Vietnamese Cities: Reaching the Unseen Sex Worker

Respondent driven sampling (RDS) is a relatively new method to sample hard-to-reach populations. Until this study, female sex workers (FSWs) in Vietnam were sampled using a variety of methods, including time location sampling (TLS), which may not access the more hidden types of FSWs. This paper presents an analysis from an HIV biological and behavioral surveillance survey to assess the feasibility and effectiveness of RDS to sample FSWs, to determine if RDS can reach otherwise inaccessible FSWs in Vietnam and to compare RDS findings of HIV risk factors with a theoretical TLS. Through face-to-face interviews with FSWs in Ho Chi Minh City (HCMC) and Hai Phong (HP), data were collected about the venues where they most often solicit their clients. These data were used to create three variables to assess whether FSWs solicit their clients in locations that are visible, semi-visible and non-visible. For this analysis, the visible group simulates a sample captured using TLS. Survey results in HIV prevalence and related risk factors and service utilization, adjusted for sampling methodology, were compared across each of the three FSW visibility groups to assess potential bias in TLS relative to RDS. The number of self-reported visible FSWs (HCMC: n=311; HP: n=162) was much larger than those of the semi-visible (HCMC: n=65; HP: n=43) and non-visible (HCMC: n=37; HP: n=10) FSWs in HCMC and HP. Non-visible FSWs in both cities were just as likely as visible and semi-visible FSWs to be HIV positive (HCMC: visible 14.5%, semi-visible 13.8%, non-visible 13.5%, p value = 0.982; HP: visible 35.2%, semi-visible 30.2%, non-visible 30.0%, p value = 0.801), to practice behaviors that put them at risk for contracting and transmitting HIV (injecting drug use—HCMC: visible 13.8%, semi-visible 12.3%, non-visible 5.4%, p value = 0.347; HP: visible 38.9%, semi-visible 23.3%, non-visible 30.0%, p value = 0.378, to have no condom use in the past month —HCMC only: visible 52.7%, semi-visible 63.1%, non-visible 48.6%, p value = 0.249) and to have symptoms of a sexually transmitted infection (STI) in the past year (HCMC: visible 16.1%, semi-visible 12.3%, non-visible 16.2%, p value = 0.742; HP: visible 13.6%, semi-visible 18.6%, non-visible 20.0%, p value = 0.640). There was a difference found among the visible, semi-visible and non-visible groups in HP for no past month condom use (visible 53.1%, semi-visible 79.1%, non-visible 60.0%, p value = 0.009). This study found that RDS was successful at recruiting hidden types of FSWs in Vietnam. Past reports of FSWs in Vietnam have assessed the more visible FSWs as being the most vulnerable and at risk for HIV. Although the number of visible FSWs is much higher than those of the semi and non-visible groups, this study found that the non-visible FSWs are very vulnerable to HIV infection. If prevention programs are targeting and responding to those who are most likely to be assessed (e.g., more visible types of FSWs) then this analysis indicates that a significant proportion of the FSW population at risk for HIV may not be receiving optimal HIV information and services.     

The Effect of Education and Self-monitoring of Blood Glucose on Glycosylated Hemoglobin in Type I Diabetes

ABSTRACT The influence on glycosylated hemoglobin (HbA₁) of formal education as compared with self-monitoring of blood glucose (SMBG) was studied in a randomized 18-month trial. All adult type I diabetics in a community were identified. Forty-one of these patients had had diabetes for 20 years or less. Thirty-seven patients were included in the study and finally randomized into four groups. Ten patients received individual formal education followed by SMBG, eight patients were instructed in SMBG without pre-education, nine patients were given only formal education and 10 patients made up a reference group. Education did not improve the mean HbA₁ values. SMBG resulted in a decrease by 2% in HbA₁ from 12 to 10% (p<0.05). The final HbA₁ level, however, did not differ significantly between any of the groups. SMBG was accepted by 80% of the patients. The liability to hypoglycemia was about equal in the four groups. It was concluded that SMBG, but not education, improved metabolic control to a certain degree.     

Atypical antipsychotic medications and risk of falls in residents of aged care facilities

OBJECTIVES: To determine whether use of atypical antipsychotics (olanzapine and risperidone) is associated with lower risk of falls than use of typical antipsychotics. DESIGN: Prospective cohort study with 1-month follow-up. SETTING: Residential aged care facilities in Sydney, Australia. PARTICIPANTS: Two thousand five people aged 65 to 104 (mean age 86). MEASUREMENTS: Medication use at baseline was collected from medical records. Data on potential confounders were collected at interview and physical examination and from medical records. The outcome was accidental falls (one or more). RESULTS: One thousand one hundred seven subjects (55%) used at least one type of psychotropic medication, with 289 (14%) using an antipsychotic. There were 82 olanzapine users, 38 risperidone users, and 181 users of typical antipsychotics. Eleven percent of subjects (n=226) had at least one fall during follow-up. After adjusting for a comprehensive range of falls risk factors, hazard ratios (HRs) for falls were 1.35 (95% confidence interval (CI)=0.87-2.09) for typical antipsychotics, 1.32 (95% CI=0.57-3.06) for risperidone, and 1.74 (95% CI=1.04-2.90) for olanzapine. Antidepressants were also associated with falls (adjusted HR=1.45, 95% CI=1.09-1.93). CONCLUSION: Despite fewer extrapyramidal side effects, atypical antipsychotic medications are not associated with fewer falls than the older, more-established antipsychotics.     

Host susceptibility and clinical outcomes in toll-like receptor 5-deficient patients with typhoid fever in Vietnam

Toll-like receptor 5 (TLR5) mediates innate immune responses to bacterial pathogens by binding to flagellin. A polymorphism in the TLR5 gene introduces a premature stop codon (TLR5(392STOP)) that is associated with susceptibility to legionnaires disease. Here we investigated whether TLR5(392STOP) was associated with typhoid fever. The frequency of TLR5(392STOP) was not significantly different in 565 patients with typhoid fever and 281 ethnically matched control subjects. Furthermore, TLR5 deficiency had no measurable effect on a number of clinical parameters associated with typhoid fever, including fever clearance time, pathogen burden, disease severity, or age at acquisition of disease. TLR5 may not play an important role in TLR-stimulated innate immune responses to human infection with Salmonella enterica serovar Typhi. Initiation of these responses may rely on other TLRs that recognize different bacterial ligands.