VALUES ARE Research Articles

A Lower Remote Dielectric Sensing Value Was Associated with Hypovolemia and Worse Clinical Outcomes.

Background: Remote dielectric sensing (ReDS) systems can estimate the amount of lung fluid non-invasively and easily without expert techniques. The correlation between the elevated ReDS value and other modalities that estimate pulmonary congestion has been validated. The clinical implications of lower ReDS values, which may indicate hypovolemia, remain unknown. Methods: A total of 138 patients who were hospitalized for various cardiovascular-related problems and underwent ReDS value measurements at the index discharge in a blinded manner to the attending clinicians were eligible for inclusion. Patients with ReDS values > 30%, indicating the presence of pulmonary congestion, were excluded. The prognostic impact of lower ReDS values on all-cause readmission after index discharge was evaluated. Results: A total of 97 patients were included. The median age was 78 years, and 48 were men. The median ReDS value at index discharge was 26% (23%, 27%). A lower ReDS value correlated with smaller inferior vena cava maximum diameters (r = 0.46, p < 0.001) and higher blood urea nitrogen/creatinine ratios (r = -0.35, p < 0.001). A lower ReDS value (≤25%) was associated with a risk of all-cause readmissions with an unadjusted hazard ratio of 2.68 (95% confidence interval 1.09-6.59, p = 0.031) and an adjusted hazard ratio of 2.30 (95% confidence interval 0.92-5.78, p = 0.076). Its calculated cutoff of 25% significantly stratified the cumulative incidence of the primary outcome (36% versus 17%, p = 0.038). Conclusions: A lower ReDS value may indicate hypovolemia and be associated with the risk of all-cause readmission in patients hospitalized for cardiovascular diseases.

Effectiveness Of Administering Olive Oil Against Diaper Rash In Babies Aged 0-36 Months At Pmb Cahyati Bogor, West Java, 2023

Background: In The World, It Is Estimated That Skin Irritation (Diaper Rash) Occurs In Babies In 25% Of The 6,840,507,000 Babies Born. The Prevalence Of Babies Affected By Diaper Rash In West Java In 2020 Was 52.7%. Diaper Rash Can Cause Red Spots, Itching, Skin Irritation, And Discomfort In Sensitive Areas Of Toddlers. Usually Caused By Humidity, Fungus And Bacteria That Develop In These Sensitive Areas. The Aim Of This Research Is To Find Out How Effective The Use Of Olive Oil Is In Treating Diaper Rash. Research Method: The Research Used Was Pre-Experimental Using A One Group Pretest-Posttest Design, And With A Prospective Approach. This Research Was Conducted At Pmb Cahyati Bogor, West Java. The Research Sample Was 30 Respondents Taken Using Total Sampling Technique. Research Results: Based On The Results Of Non-Parametric Statistical Tests, The Significance Value Was 0.000 &lt; 0.005, It Can Be Concluded That There Is An Effect Of Giving Olive Oil On Diaper Rash In Toddlers At Pmb Cahyati, Bogor, West Java In 2023. Suggestion: It Is Hoped That Respondents Can Use Extra Virgin Olive Oil As A Medicine To Treat Diaper Rash In Toddlers Who Experience Diaper Rash And Can Be Used For Other Health Needs.

Reducing and Delaying Nitrogen Recommended by Leaf Critical SPAD Value Was More Suitable for Nitrogen Utilization of Spring Wheat under a New Type of Drip-Irrigated System

Timely and accurate judgment of the nitrogen nutritional status of crops is the key to develop an optimal nitrogen application strategy. However, the evaluation criteria of nitrogen nutrition and nitrogen application strategies at each growth stage of wheat are not clear for the new type of drip-irrigated spring wheat system, TR6S (where one drip tube serves six rows of wheat, with a row spacing (RS) of 10 cm, inter-block space (IBS) of 25 cm and the lateral spacing (LS) of 80 cm, which achieved a lower drip-tube input and higher profit compared with the traditional planting system in Xinjiang). Therefore, we studied the recommendation mechanism of nitrogen fertilizer in different growth stages of wheat based on the critical SPAD values of leaves under TR6S. We set four nitrogen treatments (N1 (300 kg ha−1), N2 (270 kg ha−1), N3 (240 kg ha−1) and N4 (0 kg ha−1)) during two spring wheat growth seasons. The results revealed that the correlation coefficient (r2) between SPAD (soil plant analysis development) value and plant nitrogen content in the middle of first top leaf (L1-M) of wheat was higher than that in other leaf types and leaf positions under TR6S. A quadratic function relationship existed between a SPAD value of L1-M and grain yield. The critical SPAD values at the jointing, booting, anthesis, early milk, and late milk stages were 37.34, 39.40, 42.25, 45.57, and 35.91, respectively. In addition, through the establishment of the nitrogen application recommendation model for various wheat growth stages based on the critical SPAD value, the recommended optimal nitrogen application rates at jointing, booting, anthesis, early milk, and late milk stages were observed to be 69.4, 80.0, 90.8, 44.0, and 6.0 kg ha−1, respectively. This recommended nitrogen application strategy exhibited a better parallel relationship with the nitrogen nutrition index (NNI) of each growth period than the conventional nitrogen application strategy. Therefore, it was more in line with the actual absorption and utilization of nitrogen in wheat of TR6S. In conclusion, the SPAD values of L1-M could be relatively more accurate to evaluate the nitrogen nutrition status of wheat. Compared to traditional nitrogen application strategy, reducing and delaying nitrogen application, recommended based on the leaf SPAD model, was more suitable for nitrogen utilization under TR6S. The results can be applied in other arid and semiarid regions.

Testing a Feedback‐controlled Heated Vest to Treat Thermoregulatory Dysfunction in Persons with Spinal Cord Injury

Study ObjectiveAfter spinal cord injury (SCI), The ability to maintain a constant core body temperature (Tcore) is compromised. Persons with higher levels of SCI (Hi‐SCI: above the first thoracic vertebrae) are far more vulnerable to hypothermia (Tcore &lt;35°C) when exposed to cool ambient temperatures. A decrease in Tcore in persons with Hi‐SCI has been associated with impaired cognitive performance after limited exposure to cool environmental conditions (2 hours at 18°C). The objective of this pilot study is to determine the efficacy of a feedback‐controlled heated vest (HV) to minimize the decrease in Tcore and associated cognitive impairment in persons with Hi‐SCI when exposed to cool ambient conditions.MethodsThree participants with Hi‐SCI (C4‐C7, AIS A‐B) were recruited to study under two conditions [HV and non‐heated vest (NHV)] in random order on 2 separate visits when exposed to a cool challenge (CC). To obtain Tcore in a continuous manner, participants ingested a CorTempR capsule 1‐3 hours before initiation of the study. Abdominal (Tabd) and distal (Tdsk) skin temperatures were measured. Fifteen minutes of baseline (BL) data were collected while seated at thermoneutral (25°C). At the end of BL, a cognitive battery that consisted of the Montreal Cognitive Assessment (MoCA) and Stroop Color and Word Test (SCWT) was administered. Participants were then fitted with either HV or NHV and transferred into an 18°C room for 2 hours, after which the cognitive battery was once again administered.Results: During Cool Challenge (values are expressed as BL‐ CC): The decrease in Tcore was less when wearing the HV (‐0.22°C) than when wearing the NHV (‐0.54°C). The increase in Tabd was greater when wearing the HV (4.34°C) than when wearing the NHV (0.90°C). When wearing the HV, Tdsk of the fingers was higher (6.48°C HV vs. 4.20°C NHV), but not of the toes (6.46°C HV vs. 7.92°C NHV). The decrease in performance for the MoCA was less when wearing the HV (‐8.33%) than when wearing the NHV (‐43.33%). The decrease in score for the Stroop word test was less when wearing the HV (‐0.17%) than when wearing the NHV (‐3.32%). Of note, the Stroop Color and Color‐Word score increased when wearing the HV (10.12% and 5.73%, respectively) but decreased when wearing the NHV (‐0.97% and ‐4.9%, respectively).ConclusionIn persons with Hi‐SCI, our preliminary findings demonstrate the ability of the HV to minimize the expected decline in Tcore when exposed to the CC and decreased the decline in cognitive performance. While our results are quite encouraging, they require confirmation in a larger number of participants. However, once confirmed, our HV may offer persons with Hi‐SCI protection against adverse declines in Tcore when exposed to cool environmental conditions.

BOLLYWOOD MOVIES AND INDIAN DIASPORA HOW INDIAN VALUES ARE RECONSTRUCTED?

The word of ‘diaspora’ that refers to the dispersal of population to other places due to various reasons started in India with the sending of ‘indentured labor’ identified as ‘new slavery’ to the plantation regions under the administration of British Empire. It became possible to observe that Indian diaspora has transformed with the contribution of developments in both within the country and out of country. One of the most remarkable developments has been the period of globalization. This is because; globalization became the manifestation of cultural flow between homeland and the diaspora who had to migrate or preferred to migrate. Along with the development both information and communication technologies with globalization, Bollywood movies as an example of glocalization which brought together global with local became the most influential instrument of providing linkage between diaspora and homeland and reconstruction of the culture and values of India over Indian diasporas. Starting from this, this study will try to expose how Bollywood movie reconstruct Indian values for Indian diaspora. It also will be demonstrated how Bollywood cinema has an effect on both connecting with the homeland for diasporic Indian society and protecting and maintaining of the Indian customs and values with the help of three Indian movies.

The Effect of BP Measurement Velocity on Noninvasive BP Measurement Value Was Studied by Establishing the Blood Pressure Measurement Running Model

Objective Through the establishment of blood pressure measurement running model, the relationship between the blood pressure measurement velocity and the noninvasive blood pressure measurement value was calculated, then the accuracy of noninvasive blood pressure measurement was evaluated. Methods First, the basis of establishing the blood pressure measurement running model: the origin and nature of the blood pressure auscultation sound (BPAS) which was also confirmed as the main component of Korotkoff-sound was determined by the resonance theory of blood pressure measurement and its confirming experiments from the perspective of evidence-based medicine. The BPAS was a vibration sound which coming from the vibration of closing mitral valve and being homologous with the first heart sound and also possessing resonant nature. It was located between the first heart sound and the second heart sound on the synchronization graph of artery and heart, this meant that the Korotkoff-sound was a sound of systolic period in cardiac cycle; Second, establishing the blood pressure measurement running model: the cardiac cycle was divided into 6 equal parts in which 3 ones were in systolic period and another 3 ones were in diastolic period, then 6 pressure measurement lines were imagined and the speed that the gas flow out of the cuff was in control from 1-10mmHg/per beating and the systolic pressure measurement value was calculated using mathematical methods, the principle of value reading was to use round figure; In final, setting up the ideal tested individuals: imagining the individual's systolic pressure of each beating was always 130mmHg, the heart rate was 60/min. Results When the blood pressure measurement velocity was 1mmHg/per beating, two numbers of 130 and 129mmHg were calculated; when the velocity was 2 to 3mmHg/per beating, three numbers of 130,129 and 128mmHg were calculated; when the velocity was 4 to 5mmHg/per beating, five numbers from 130 to 126mmHg were calculated; when the velocity was 10mmHg/per beating, nine numbers from 130 to 122mmHg were calculated; Conclusion The faster the blood pressure measurement velocity was, the wider the range of blood pressure measurement value was, and then the greater the measurement error was. The blood pressure measurement velocity can greatly affect the systolic blood pressure measurement value ,and this is also an important factor of fluctuation in blood pressure.

Study on Fatigue Property of Cracked Steel Plate Strengthened by CFRP

This paper presents fatigue property of CFRP-strengthened cracked steel plate. Firstly, the finite element model of CFRP-strengthened cracked steel plate is established by using the cohesive zone model. With the finite element model, stress intensity factor of the crack-tipis calculated. Then, it gives the fatigue tests of cracked steel plate. According to the experimental data, the material constants C and n value sare obtained. The prediction fatigue life is calculated by the finite element model and Paris function and verified by the experimental data. The results show that the prediction fatigue life, calculated by the finite element model and the Paris formula, is consistent with the experimental fatigue life, which verifies the accuracy of our prediction model with finite element model and the Paris function.

Crosswalk algorithms for the conversion of mean EQ-5D indices calculated with different value sets.

The EQ-5D questionnaire of EuroQol is an important tool, not only for researchers, but also for quality registers. Until 2013, Sweden did not have a country-specific value set to convert the EQ-5D health states into a single index. Commonly, the UK time trade-off (UK TTO) value set has been used. The study reported here aimed to establish an easy to use tool for the bidirectional crosswalk of the mean EQ-5D values based on two different value sets: the UK TTO and the Swedish TTO value sets. Using an artificial data set encompassing all possible EQ-5D outcomes, we calculated the EQ-5D index using both the UK TTO and Swedish TTO value sets. Thereafter we modelled the relationship between the two indices using least-squares regression and major axis regression. A series of simulations was run to assess the feasibility of the obtained crosswalk algorithms. Major axis regression was superior to ordinary least-squares regression. Converting the mean EQ-5D values from the UK TTO scale to the Swedish TTO scale was more accurate than the inverse conversion. Values close to the floor and ceiling of the EQ-5D index were more challenging to crosswalk. CONCLUSIONS WE ESTABLISHED ALGORITHMS BASED ON MAJOR AXIS REGRESSION TO CROSSWALK EQ-5D VALUES BASED ON THE UK TTO AND THE SWEDISH TTO VALUE SETS THE PRESENTED ALGORITHM MAY FACILITATE COMPARISONS OF EQ-5D VALUES WHEN ONLY MEAN VALUES ARE AVAILABLE THE EXISTENCE OF A CROSSWALK ALGORITHM WILL EASE THE TRANSITION FROM THE UK TTO TO THE SWEDISH TTO VALUE SET.

Influence of the implant-abutment connection design and diameter on the screw joint stability.

PURPOSEThis study was conducted to evaluate the influence of the implant-abutment connection design and diameter on the screw joint stability.MATERIALS AND METHODSRegular and wide-diameter implant systems with three different joint connection designs: an external butt joint, a one-stage internal cone, and a two-stage internal cone were divided into seven groups (n=5, in each group). The initial removal torque values of the abutment screw were measured with a digital torque gauge. The postload removal torque values were measured after 100,000 cycles of a 150 N and a 10 Hz cyclic load had been applied. Subsequently, the rates of the initial and postload removal torque losses were calculated to evaluate the effect of the joint connection design and diameter on the screw joint stability. Each group was compared using Kruskal-Wallis test and Mann-Whitney U test as post-hoc test (α=0.05).RESULTSThe postload removal torque value was high in the following order with regard to magnitude: two-stage internal cone, one-stage internal cone, and external butt joint systems. In the regular-diameter group, the external butt joint and one-stage internal cone systems showed lower postload removal torque loss rates than the two-stage internal cone system. In the wide-diameter group, the external butt joint system showed a lower loss rate than the one-stage internal cone and two-stage internal cone systems. In the two-stage internal cone system, the wide-diameter group showed a significantly lower loss rate than the regular-diameter group (P<.05).CONCLUSIONThe results of this study showed that the external butt joint was more advantageous than the internal cone in terms of the postload removal torque loss. For the difference in the implant diameter, a wide diameter was more advantageous in terms of the torque loss rate.

Correlação tomográfica da técnica de magerl para artrodese C1-C2 na artrite reumatoide

OBJECTIVE: To use the tomographic analysis of C1 and C2 vertebrae to assess the possibility of using Magerl's technique in patients with rheumatoid arthritis. Other objectives were to obtain anatomical data for the choice of the surgical technique in general, to establish safety parameters and obtain epidemiological data of the population in question. METHODS: We retrospectively reviewed the CT scans of 20 patients with rheumatoid arthritis of the Outpatient Spine Group, IOT-HCFMUSP. Data were analyzed statistically to obtain the mean values and the variance of each measurement: the length of the C2 pedicle to the C1 lateral mass, the thickness of the pedicle and the angle of attack of the screw in the isthmus of C2 to the horizontal. RESULTS: The mean values were, respectively: right 23.08 mm and left 23.16 mm, right 6.46 mm and left 6.50 mm, right 44.50o and left 44.95o. Discussion: The leading screw's manufacturers have implants compatible with the anatomical measurements found in this work. Considering the wide diffusion and mastery of Magerl's technique in our country and around the world, this is a safe surgical option that provides mechanical stability. CONCLUSION: Magerl's technique, according to tomographic analysis, can be used in patients with rheumatoid arthritis. Levels of Evidence IV,Case Series.

Legitimization and delegitimization strategies on terrorism

This article examines the role of Building Metaphors in the political discourse of the former Spanish president José Luis Rodríguez Zapatero. More specific, it analyzes how Building Metaphors serve as legitimization and delegitimization strategies used by the Government and its anti-terrorist plight. The corpus of investigation comprises all political speeches on terrorism during Zapatero’s two terms in office (from April 2004 to December 2011). I argue that the use of Building Metaphors is a strategy of Zapatero’s whereby the solid ground of the Government’s anti-terrorist initiative is juxtaposed with terrorism’s lack of foundation. Findings suggest that the following conceptual metaphors are used as framing devices: POLITICS IS BUILDING, POLITICAL ENTITIES ARE BUILDINGS, THE GOVERNMENT IS THE BUILDER, TERRORISM IS THE DESTROYER, DEMOCRACY IS A STANDING BUILDING WITH SOLID FOUNDATIONS, TERRORISM IS A BUILDING WITH NO FOUNDATIONS, DEMOCRATIC VALUES ARE CONNECTORS, and TERRORIST VALUES ARE OBSTRUCTORS.

The effect of a diode laser and traditional irrigants on the bond strength of self-adhesive cement

PURPOSEThe purpose of this study was to compare the effect of a diode laser and traditional irrigants on the bond strength of self-adhesive cement.MATERIALS AND METHODSFifty-five incisors extracted due to periodontal problems were used. All teeth were instrumented using a set of rotary root canal instruments. The post spaces were enlarged for a No.14 (diameter, 1.4 mm) Snowlight (Abrasive technology, OH, USA) glass fiber reinforced composite post with matching drill. The teeth were randomly divided into 5 experimental groups of 11 teeth each. The post spaces were treated with the followings: Group 1: 5 mL 0.9% physiological saline; Group 2: 5 mL 5.25% sodium hypochlorite; Group 3: 5 mL 17% ethylene diamine tetra acetic acid (EDTA), Group 4: 37% orthophosphoric acid and Group 5: Photodynamic diode laser irradiation for 1 minute after application of light-active dye solution. Snowlight posts were luted with self-adhesive resin cement. Each root was sectioned perpendicular to its long axis to create 1 mm thick specimens. The push-out bond strength test method was used to measure bond strength. One tooth from each group was processed for scanning electron microscopic analysis.RESULTSBond strength values were as follow: Group 1 = 4.15 MPa; Group 2 = 3.00 MPa; Group 3 = 4.45 MPa; Group 4 = 6.96 MPa; and Group 5 = 8.93 MPa. These values were analysed using one-way ANOVA and Tukey honestly significant difference test (P<.05). Significantly higher bond strength values were obtained with the diode laser and orthophosphoric acid (P<.05). There were no differences found between the other groups (P>.05).CONCLUSIONOrthophosphoric acid and EDTA were more effective methods for removing the smear layer than the diode laser. However, the diode laser and orthophosphoric acid were more effective at the cement dentin interface than the EDTA, Therefore, modifying the smear layer may be more effective when a self-adhesive system is used.

Prevalence, clinical and biochemical profile of subclinical hypothyroidism in normal population in Mumbai

Background:Subclinical Hypothyroidism (ScHt) affects 3–15% of the adult population. It's clinical and biochemical profile is not well defined, especially in Indian scenario. Our study aimed at screening normal population to define normative ranges of thyroid hormones and Serum thyroid stimulating hormone (S.TSH) and prevalence of ScHt and thyroid autoimmunity.Materials and Methods:Two-hundred thirty-seven normal subjects without family history of thyroid disease were evaluated for symptoms and laboratory tests for thyroid dysfunction and autoimmunity.Results:The thyroid function tests were as follows:Euthyroid Group:Mean values were: T3: 1.79 ± 0.42 ng/mL, T4: 10.23 ± 2.25 μg/dL, FT3: 1.88 ± 0.19 pg/mL, FT4: 1.12 ± 0.21 ng/dL, S.TSH: 2.22 ± 1.06 μlu/mL. 10.2% of euthyroid subjects had antimicrosomal antibodies (AMA) +ve (mean titer 1:918) and 23.6% were anti-thyroid peroxidase autoantibody (anti-TPO) +ve (mean titer 15.06 Au/mL). The euthyroid outlier range for S.TSH was 0.3–4.6 μlu/mL. The values were comparable in both the sexes. Those with S.TSH ≥ 5 μlu/mL were defined to have ScHt.ScHt Group:Prevalence of ScHt was 11.3% (M:F ratio 1:3.7). 74% belonged to 35–54 years age group and prevalence increased with age (post-menopausal females: prevalence 20%). S.TSH was 9.8 ± 7.22 μlu/mL, mean S.AMA was 1:5079 (40.7% positivity) and mean S.anti-TPO was 260 Au/mL (47.6% positivity). Majority were agoitrous (74%), and stage I goiter was seen in 26% of this population. Symptom score of 5–8 was seen in 55% ScHt subjects versus 35% normal subjects.Conclusion:Mean S.TSH in our population was 2.22 μlu/mL (euthyroid outliers: 0.3–4.6 μlu/mL); hence, S.TSH above 4.6 μlu/mL should be considered as abnormal. The prevalence of thyroid autoimmunity increases after age of 35 years. ScHt presents mainly in agoitrous form and with positive antibodies, suggesting autoimmunity as the cause.

Análise tomográfica para colocação de parafusos em C2 nos pacientes com artrite reumatoide

ObjectiveA morphological analysis of the bone structure of C2 in patients with rheumatoid arthritis in order to enhance the security of the stabilization procedures for this vertebra.MethodsWe retrospectively analyzed 20 CT scans of the cervical spine performed in patients with rheumatoid arthritis; the following parameters were measured: spinolaminar angle, thickness and length of C2 lamina.ResultsThe mean values are: 5.92mm and 5.87mm for thickness of right and left laminae retrospectively, 27.75mm for right lamina length and 27.94mm for left lamina length, and 44.7º for spinolaminar angle.ConclusionThe values obtained are consistent with studies in normal subjects published by other groups, with no apparent need for change in the screw placement technique. Level of Evidence IV, Case Series.

Screening for Cushing’s Syndrome in Obese Patients

OBJECTIVES:The aim of this study was to examine the frequency of Cushing’s syndrome (CS) in obese patients devoid of specific clinical symptoms of Cushing’s syndrome.METHODS:A total of 150 obese patients (129 female, 21 male; mean age 44.41 ± 13.34 yr; mean BMI 35.76 ± 7.13) were included in the study. As a first screening step, we measured 24-h urinary free cortisol (UFC). An overnight 1-mg dexamethasone suppression test was also performed on all patients. Urinary free cortisol levels above 100 μg/24 h were considered to be abnormal. Suppression of serum cortisol <1.8 μg/dL after administration of 1 mg dexamethasone was the cut-off point for normal suppression. The suppression of the serum cortisol levels failed in all of the patients.RESULTS:Measured laboratory values were as follows: ACTH, median level 28 pg/ml, interquartile range (IQR) 14–59 pg/ml; fasting glucose, 100 (91–113) mg/dL; insulin, 15.7 (7.57–24.45) mU/ml; fT4, 1.17 (1.05–1.4) ng/dL; TSH, 1.70 (0.91–2.90) mIU/L; total cholesterol, 209 (170.5–250) mg/dL; LDL-c, 136 (97.7–163) mg/dL; HDL-c, 44 (37.25–50.75) mg/dL; VLDL-c, 24 (17–36) mg/dL; triglycerides, 120.5 (86–165) mg/dL. The median UFC level of the patients was 30 μg/24 h (IQR 16–103). High levels of UFC (>100 μg/24 h) were recorded in 37 patients (24%). Cushing’s syndrome was diagnosed in 14 of the 150 patients (9.33%). Etiologic reasons for Cushing’s syndrome were pituitary microadenoma (9 patients), adrenocortical adenoma (3 patients), and adrenocortical carcinoma (1 patient).CONCLUSION:A significant proportion (9.33%) of patients with simple obesity were found to have Cushing’s syndrome. These findings argue that obese patients should be routinely screened for Cushing’s syndrome.

The effect of mechanical and chemical polishing techniques on the surface roughness of denture base acrylic resins

Smooth polished surface of dental prostheses is important to prevent bacterial colonization and plaque accumulation. The acrylic base of prosthodontic appliances needs to be adjusted by grinding which often alters the surface of the denture base. It is therefore important to know how different polishing techniques affect surface roughness of acrylic resin. The aim of this study was to evaluate the effect of mechanical polishing (MP) and chemical polishing (CP) on the surface roughness of heat cured (HC) and auto cured (AC) denture base acrylic resins. Sixty acrylic resin specimens (30×15×3mm) were made for each of the two types of acrylic resins. Thirty HC specimens received mechanical conventional lathe polishing using cone with pumice slurry and soft brush with chalk powder. The other thirty HC specimens received chemical polishing by immersing in methyl-methacrylate monomer heated to 75°C±1°C for 10s. The sixty AC specimens received mechanical and chemical polishing in the same manner. Surface roughness was measured using surface analyzing instrument in microns. The data were statistically analyzed by two-way analysis of variance (ANOVA) followed by post hoc Tukey's test (α=0.05). THE SURFACE ROUGHNESS MEAN IN MICRONS IN ORDER OF DECREASING VALUES WERE: CP-HC: 1.4132μm; CP-AC: 1.3494μm; MP-AC: 0.7364μm and MP-HC: 0.6333μm. Two-way ANOVA revealed that the MP-HC was significantly different from CP-HC and CP-AC (P<0.05). The MP-AC is also significantly different from CP-HC and CP-AC (P<0.05). There was no significant difference between MP and CP of HC and AC acrylic resin groups. It can be concluded that MP produced significantly smoother surfaces than CP. The surface roughness obtained by MP was not influenced by acrylic resin type where as this was not true for CP.

Usefulness of inspiratory capacity measurement in COPD patients in the primary care setting

To determine if inspiratory capacity (IC) assessment could be useful for chronic obstructive pulmonary disease (COPD) patient management in the primary care setting. A descriptive cross-sectional study was conducted in 93 patients diagnosed with COPD according to Spanish Thoracic Society (SEPAR) criteria. Patients were recruited in eight primary care centers in Andalusia, Spain. Anthropometric, sociodemographic, resting lung function (forced expiratory volume in one second [FEV(1)], forced vital capacity, synchronized vital capacity, IC), and quality of life data based on the Spanish version of Saint George's Respiratory Questionnaire (SGRQ) were obtained. LUNG FUNCTION RESULTS EXPRESSED AS PERCENTAGES OF THE PREDICTED VALUES WERE AS FOLLOWS: FEV(1), 49.04 (standard deviation [SD]: 16.23); IC, 61.73 (SD: 15.42). The SGRQ mean total score was 47.5 (SD 17.98). The Spearman's Rho correlation between FEV(1) and SGRQ was r = -0.36 (95% confidence interval [CI]: -0.529 to -0.166), between IC and SGRQ was r = -0.329 (95% CI -0.502 to -0.131), and between FEV(1) and IC was r = -0.561. Measurement of IC at rest could be used as a complementary functional exploration to forced spirometry in the monitorization of patients with COPD in the primary care setting. We found a poor correlation between IC and quality of life at the same level as in FEV(1).

Whither Family History? A Road Map from Latin America

FAMILY VALUES ARE BACK with a vengeance. As pundits pontificate and spin doctors strategize, historians of family have periodically joined in fray. Scholars have appeared in popular media offering historical perspectives on marriage and divorce, childhood, cohabitation, working mothers, child custody, and same-sex unions. The family is an institution peculiarly subject to mythification, and more often than not, historians have sought to set record straight about the way we never were.l Meanwhile, historical perspectives on family have found their way into legal reasoning. In Halpern v. Canada, landmark 2005 decision that paved way for same-sex marriage in Canada, both sides marshaled historical evidence in an effort to bolster their claims.2 Prominent historians of gender, sexuality, and family have also filed amicus briefs in cases involving same-sex marriage in U.S. state courts and in Lawrence v. Texas, 2003 Supreme Court case that struck down Texas's anti-sodomy law.3 If family history reverberates in public discourse, its resonance in contemporary

The Quality Oncology Practice Initiative (QOPI): Understanding and improving “Best Practices” by a community of oncologists

6023 Background: One goal of the QOPI project is to provide tools for practitioners to implement “best practices.” In an effort to provide comparative data regarding best practices, QOPI has developed a set of evidence and consensus-based measures. Concordance is assessed through a structured chart review that allows numeric scoring and generation of practice reports. Results can be compared over time and among practices. Methods: 23 practices of various sizes from across the U.S. were invited to participate. Measures relate to ASCO practice guidelines, national standards, or expert consensus. 2,410 charts have been abstracted to date. Observations and comparisons among groups are analyzed by construction of 95% confidence intervals (CI). Conclusions: We observed a clinically meaningful and statistically significant variation in achieving quality measures in oncology practices. The QOPI process provides a mechanism for documenting concordance with quality measures, testing interventions and documenting improvement. Measure N Mean %Yes 95% CI Lowest Ob- served Value Highest Ob- served Value Was pain addressed on the visit prior to death? 394 65.0% 55–75% 15.0% 92.9% Were granulocytic growth factors given per guideline? 203 30.6% 34–50% 0% 100% Were serotonin antagonist antiemetics given per guideline? 1160 97.0% 96–98% 84.1% 100% Were corticosteroids added per guideline? 1102 97.9% 97–99% 90.3% 100% Were erythroid growth factors given per guideline? 824 72.7% 68–77% 36.7% 94.7% Was a pathology report available in the chart? 2410 97.1% 96–98% 88.2 % 100% Was staging completed prior to definitive therapy? 2159 96.1% 94–98% 70.2% 100% Were flow sheets used when chemotherapy was given? 1997 99.8% 99–100% 97.3% 100% Was a signed consent for non-protocol chemotherapy in the chart? 1997 39.5% 28–51% 0% 100% Was verbal consent for chemotherapy documented? 692 88.7% 80–96% 73.6% 100% Was adjuvant chemotherapy given to breast cancer patients per NICCQ specifications? 131 100% N/A N/A N/A Was adjuvant chemotherapy given to colorectal cancer patients per NICCQ specifications? 270 99.2% 99–100% 91.7% 100% No significant financial relationships to disclose.

Academic medicine's core values: what do they mean?

When I visit academic medical centers (AMCs) across the country, I not infrequently find my colleagues, especially the young people, eager to talk about academic medicine’s heritage—what it stands for, what it should embody at its deepest level. Frequently these conversations get into core values, those handful of guiding tenets that define how we live as we carry out our missions and strive to achieve our goals. The fact that more and more people today want to talk about academic medicine’s core values is both a good and a bad sign. On the one hand, it suggests that there is a lack of clarity about what our core values are and what they actually mean. When there is no rudder, there is no means of steering the ship. On the other hand, it indicates that people are looking for something more permanent, more substantive than the same old hectic pace, with its constant focus on producing more with less at almost any cost [1]. “It’s easy to get caught up in the rat race and wake up a decade later and wonder where time went,” someone recently said. Core values are the organization’s essential and enduring principles and most fundamental beliefs—they require no external justification [2]. They powerfully shape organizational culture but are not to be confused with operating practices or group norms. A core value is one we would hold even if the marketplace penalized us (financially or otherwise) for holding it. Organizations that live out their core values are more gratifying places to work. WHICH VALUES ARE MOST CORE?