Assessment of the trueness of additively manufactured mol3% zirconia crowns at different printing orientations with an industrial and desktop 3D printer compared to subtractive manufacturing

OBJECTIVES

This study endeavours to investigate the effect of printing orientation on the trueness of additively manufactured molar zirconia crowns. The areal surface roughness and the characteristics of the marginal regions of the crowns were also considered.

METHODS

Twelve molar crowns were manufactured at 0°, 45°, and, 90° printing orientations in a Lithoz and AON zirconia printer, respectively. Twelve milled crowns were used as a comparison. Samples were scanned and analysed in metrology software to determine the trueness of the groups. Regions of interest were defined as the margins, intaglio surface and contact points. Areal surface roughness and print layer thickness were further analysed using a confocal laser scanning microscope.

RESULTS

The results indicate that there are clear differences between the investigated desktop (AON) and industrial (Lithoz) 3D printer. The 45° Lithoz group is the only sample group showing no significantly different results in trueness for all regions analysed compared to the milled group. Areal surface roughness analysis indicates that the print layers in the marginal regions are within clinically tolerable limits and surface characteristics.

CONCLUSIONS

The printing orientation for zirconia crowns is critical to trueness, and differences are evident between different AM apparatuses. Considerations for design and orientation between different apparatuses should therefore be considered when utilising direct additive manufacturing processes. The areal surface roughness of the marginal regions is within acceptable clinical limits for all manufacturing processes and print orientations considered.

CLINICAL SIGNIFICANCE

The materials and apparatuses for additive manufacturing of zirconia crowns are now clinically acceptable from the perspective of the trueness of a final crown for critical functional surfaces and areal surface roughness of the marginal regions.

Flexible Iron-On Sensor Embedded in Smart Sock for Gait Event Detection

Portable and wearable electronics for biomechanical data collection have become a growing part of everyday life. As smart technology improves and integrates into our lives, some devices remain ineffective, expensive, or difficult to access. We propose a washable iron-on textile pressure sensor for biometric data acquisition. Biometric data, such as human gait, are a powerful tool for the monitoring and diagnosis of ambulance and physical activity. To demonstrate this, our washable iron-on device is embedded into a sock and compared to gold standard force plate data. Biomechanical testing showed that our embedded sensor displayed a high aptitude for gait event detection, successfully identifying over 96% of heel strike and toe-off gait events. Our device demonstrates excellent attributes for further investigations into low-cost, washable, and highly versatile iron-on textiles for specialized biometric analysis.

Novel influenza inhibitors designed to target PB1 interactions with host importin RanBP5

In search of novel targets for influenza inhibitors, a site on PB1 was selected for its high conservation and probable interaction with a host protein, RanBP5, that is key to nuclear import of PB1, where it complexes with PB2, PA, and NP to transcribe viral RNA. Docking with libraries of drug-like compounds led to a selection of five candidates that bound tightly and with a pose likely to inhibit protein binding. These were purchased and tested in vitro, found to be active, and then one was synthetically expanded to explore the structure-activity relationship. The top candidates had a carboxylic acid converted to an ester and electron-withdrawing substituents added to a phenyl group in the original structure. Resistance was slow to develop, but cytotoxicity was moderately high. Nuclear localization of PB1 and in vitro polymerase activity were both strongly inhibited.

Patient-Reported Outcomes after Monitoring, Surgery, or Radiotherapy for Prostate Cancer

BACKGROUND

Robust data on patient-reported outcome measures comparing treatments for clinically localized prostate cancer are lacking. We investigated the effects of active monitoring, radical prostatectomy, and radical radiotherapy with hormones on patient-reported outcomes.

METHODS

We compared patient-reported outcomes among 1643 men in the Prostate Testing for Cancer and Treatment (ProtecT) trial who completed questionnaires before diagnosis, at 6 and 12 months after randomization, and annually thereafter. Patients completed validated measures that assessed urinary, bowel, and sexual function and specific effects on quality of life, anxiety and depression, and general health. Cancer-related quality of life was assessed at 5 years. Complete 6-year data were analyzed according to the intention-to-treat principle.

RESULTS

The rate of questionnaire completion during follow-up was higher than 85% for most measures. Of the three treatments, prostatectomy had the greatest negative effect on sexual function and urinary continence, and although there was some recovery, these outcomes remained worse in the prostatectomy group than in the other groups throughout the trial. The negative effect of radiotherapy on sexual function was greatest at 6 months, but sexual function then recovered somewhat and was stable thereafter; radiotherapy had little effect on urinary continence. Sexual and urinary function declined gradually in the active-monitoring group. Bowel function was worse in the radiotherapy group at 6 months than in the other groups but then recovered somewhat, except for the increasing frequency of bloody stools; bowel function was unchanged in the other groups. Urinary voiding and nocturia were worse in the radiotherapy group at 6 months but then mostly recovered and were similar to the other groups after 12 months. Effects on quality of life mirrored the reported changes in function. No significant differences were observed among the groups in measures of anxiety, depression, or general health-related or cancer-related quality of life.

CONCLUSIONS

In this analysis of patient-reported outcomes after treatment for localized prostate cancer, patterns of severity, recovery, and decline in urinary, bowel, and sexual function and associated quality of life differed among the three groups. (Funded by the U.K. National Institute for Health Research Health Technology Assessment Program; ProtecT Current Controlled Trials number, ISRCTN20141297 ; ClinicalTrials.gov number, NCT02044172 .).

Cloning and sequencing of ovine Flt3 ligand

A cDNA (879 bp) containing the complete open reading frame of ovine Fms-related tyrosine kinase 3 ligand (Flt3-L) was amplified by reverse transcriptase polymerase chain reaction (RT-PCR), cloned and sequenced. The deduced amino acid sequence has 97.6% similarity with bovine Flt3-L isoform 1 and shares the long cytoplasmic domain observed in bovine Flt3-L but not in human Flt3-L.

Multiple-dose pharmacokinetics of ritonavir in human immunodeficiency virus-infected subjects

The multiple-dose pharmacokinetics of ritonavir were investigated in four groups of human immunodeficiency virus-positive male subjects (with 16 subjects per group) under nonfasting conditions; a 3:1 ritonavir:placebo ratio was used. Ritonavir was given at 200 (group I), 300 (group II), 400 (group III), or 500 (group IV) mg every 12 h for 2 weeks. The multiple-dose pharmacokinetics of ritonavir were moderately dose dependent, with the clearance for group IV (6.8 +/- 2.7 liters/h) being an average of 32% lower than that for group I (10.0 +/- 3.2 liters/h). First-pass metabolism should be minimal for ritonavir. The functional half-life, estimated from peak and trough concentrations, were similar among the dosage groups, averaging 3.1 and 5.7 h after the morning and evening doses, respectively. The area under the concentration-time curve at 24 h (AUC24) and apparent terminal-phase elimination rate constant remained relatively time invariant, but predose concentrations decreased 30 to 70% over time. Concentration-dependent autoinduction is the most likely mechanism for the time-dependent pharmacokinetics. The Km and initial maximum rate of metabolism (Vmax) values estimated from population pharmacokinetic modeling (nonlinear mixed-effects models) were 3.43 microg/ml and 46.9 mg/h, respectively. The group IV Vmax increased to 68 mg/h after 2 weeks. The maximum concentration of ritonavir in serum (Cmax) and AUC after the evening doses were an average of 30 to 40% lower than the values after the morning doses, while the concentration at 12 h was an average of 32% lower than the predose concentration, probably due to protracted absorption. Less than 2% of the dose was eliminated unchanged in the urine. Triglyceride levels increased from the levels at the baseline, and the levels were correlated with baseline triglyceride levels and AUC, Cmax, or predose concentrations.

Expression of avrPphB, an avirulence gene from Pseudomonas syringae pv. phaseolicola, and the delivery of signals causing the hypersensitive reaction in bean

Protein production encoded by the avirulence gene avrPphB from Pseudomonas syringae pv. phaseolicola was examined. Incorporation of [35S]-labeled methionine into the AvrPphB protein indicated processing of the full-length peptide in Escherichia coli to give a major 28-kDa product. The 28-kDa native peptide was isolated from E. coli following over-expression of avrPphB and found not to elicit the hypersensitive response (HR) after infiltration into bean leaves. Antiserum raised to the 28-kDa peptide allowed expression of avrPphB and processing of AvrPphB protein to be examined in P. syringae pv. phaseolicola; immunoreactive peptides of both 35 and 28-kDa were detected in races 3 and 4 (which contain avrPphB) only after induction in minimal medium + 10 mM sucrose. Antiserum raised to a synthetic peptide, derived from the sequence of the 62 amino acids found to be cleaved from the full-length AvrPphB protein, revealed the accumulation of peptides corresponding to the smaller cleavage products, in both E. coli and P. syringae pv. phaseolicola. Biochemical localization experiments showed that all AvrPphB peptides were cytoplasmic in P. syringae pv. phaseolicola. No AvrPphB peptides were produced in a hrpL mutant unless expression of the gene was directed by a strong vector promoter; induction kinetics similar to wild type were observed in a hrpY- strain, although it also failed to cause a confluent HR. Growth of P. syringae pv. phaseolicola under inducing conditions removed the requirement for rifampicin-sensitive mRNA synthesis by bacteria to allow HR development (the induction time) in bean and lettuce leaves. Constitutive expression of hrpL reduced but did not remove the induction time. Expression of the hrp gene cluster of P. syringae pv. phaseolicola from plasmid pPPY430 in E. coli enabled phenotypic expression of avrPphE (also carried by pPPY430) and avrPphB (if over-expressed from pPPY3031). Despite constitutive expression of the hrp and avr genes in E. coli, a protein synthesis dependent induction time was still required for development of the HR in bean genotypes with matching resistance genes. The significance of processing for the function of AvrPphB peptides and the delivery of elicitors of the HR are discussed.

The stability and equivalence reliability of the functional independence measure for children (WeeFIM)

The reliability of the Functional Independence Measure for Children (WeeFIM) was examined in 37 non-disabled children and 30 children with disabilities, from 12 to 76 months of age. The WeeFIM is derived from the Functional Independence Measure (FIM) and includes 18 items involving six functional subscales. Stability was assessed by administering the WeeFIM instrument to each child's caregiver on two occasions separated by 7 to 14 days. Intraclass correlation co-efficients (ICCs) for individual items ranged from 0.90 to 0.99. The ICC for the six WeeFIM subscales ranged from 0.94 for social cognition to 0.99 for transfers and locomotion. The ICC value for total WeeFIM test-retest reliability was 0.98 for children with disabilities and 0.99 for children without disabilities. Equivalence reliability was examined by comparing ratings obtained when using personal assessment with ratings collected during a telephone interview. No statistically significant differences were found for individual items, subscale scores or total WeeFIM values.

Ordered accumulation of mutations in HIV protease confers resistance to ritonavir

Analysis of the HIV protease gene from the plasma of HIV-infected patients revealed substitutions at nine different codons selected in response to monotherapy with the protease inhibitor ritonavir. Mutants at valine-82, although insufficient to confer resistance, appeared first in most patients. Significant phenotypic resistance required multiple mutations in HIV protease, which emerged subsequently in an ordered, stepwise fashion. The appearance of resistance mutations was delayed in patients with higher plasma levels of ritonavir. Early mutants retained susceptibility to structurally diverse protease inhibitors, suggesting that dual protease inhibitor therapy might increase the duration of viral suppression.

A novel, picomolar inhibitor of human immunodeficiency virus type 1 protease

The design, synthesis, and molecular modeling studies of a novel series of azacyclic ureas, which are inhibitors of human immunodeficiency virus type 1 (HIV-1) protease that incorporate different ligands for the S1', S2, and S2' substrate-binding sites of HIV-1 protease are described. The synthesis of this series is highly flexible in the sense that the P1', P2, and P2' residues of the inhibitors can be changed independently. Molecular modeling studies on the phenyl ring of the P2 and P2' ligand suggested incorporation of hydrogen-bonding donor/acceptor groups at the 3' and 4-positions of the phenyl ring should increase binding potency. This led to the discovery of compound 7f (A-98881), which possesses high potency in the HIV-1 protease inhibition assay and the in vitro MT-4 cell culture assay (Ki = approximately 5 pM and EC50 = 0.002 microM). This compares well with the symmetrical cyclic urea 1 pioneered at DuPont Merck.

The ultimate birth center: a collaborative model for innovation

Lest these descriptions sound too good to be true, Virginia Mason Birth Center is not utopia. It is a real place with real problems and struggles. Implementing and maintaining personalized, high-quality obstetric care to the childbearing woman and her family has not come easily. Innovations continue to be developed in response to patients' and providers' desire for birth services that are flexible, sensitive, and designed around families' preferences and needs. A common philosophy continues to guide a dedicated staff, administration, and provider group within a framework of collaboration, innovation, and quality to enable a wonderful professional practice to evolve.

Modelling mood states in athletic performance

Because moods are transitory emotional states that can be influenced by a range of personality and environmental factors, the notion that elite athletes will always tend to produce a so-called iceberg profile of mood, and that less successful performers will not, is open to question. Evidence for such a claim is based principally upon descriptive studies. The present experiment used the POMS inventory as a predictor of cross-country running performance among a group of experienced male athletes. Race times from two competitive events were plotted against each of six mood factors. Using data from race 1, a multiple-regression model--incorporating the interdependence of tension, anger and depression--was able to predict rank order of finishing positions for race 2 with acceptable accuracy (rs = 0.74, P less than 0.01). The present approach differs from the traditional model of mood research in sport in that it provides a prescriptive, rather than a descriptive, focus. Although the model that has been developed appears promising, it is likely that in sports where demands on athletes are very different from those made upon cross-country runners, an alternative model may be required.

Nursing diagnoses for the postpartum woman

A descriptive, correlational study was undertaken to identify nursing diagnoses selected by mothers during the first 72 hours after birth. The convenience sample of 231 women completed questionnaires listing 34 diagnoses. On average, each mother selected nine diagnoses of concern to her since the birth. Alteration in comfort, potential for growth, alteration in body fluids, impaired mobility, and sleep pattern disturbance were the most frequently selected diagnoses. Only 34.5% of the mothers identified knowledge deficit as a concern. Parity, type of delivery, and length of postpartum time influenced the diagnoses selected. The data suggest modifications in the focus of hospital-based, postpartum nursing care.

Simplified estimation of glomerular filtration rate and effective renal plasma flow

A method is described for the determination of GFR and ERPF using a combined injection of 51Cr-EDTA and 125I-iodohippurate. Plasma samples obtained at 60 min and 150 min after administration were used to determine a flow rate F assuming a monoexponential clearance of the tracers. Empirical relationships were found between F and the true GFR and ERPF determined from multiple sampling and multi-exponential analysis of the clearance curves. The method was shown to be superior to previously published methods involving one or two samples. GFR was calculated with a standard deviation (SD) of only 3.3 ml/min when compared to the multiple sample technique (the reference method), whereas the best estimate from a single sample had a SD of 6.3 ml/min. An improvement in accuracy of ERPF estimation was achieved for values of flow of less than 200 ml/min when the SD was only 9.3 ml/min.

Two dicentric Y isochromosomes, one without and the Yqh heterochromatic segment: review of the Y isochromosomes

Two women with primary amenorrhoea and few other stigmata of Turner's syndrome were found to be chromosome mosaics: 45,X/46,X,idic(Y). In Case 1, the dicentric isochromosome Y was found to have a long-arm breakpoint of formation. This structure was interpreted as containing two Y short arms and centromeres separated by a region derived from the proximal Y long arm. One of the centromeres in the Case 1--idic(Y) was suppressed in 80% of cells in blood, and in these cells it appeared as a regular Y-shaped chromosome. In Case 2 the idic(Y) was derived by a short-arm breakpoint of formation. In all the dicentrics of this case with one primary constriction (functional monocentrics) there was a single Cd band. In the 10% of dicentrics with two primary constrictions, there were two Cd bands. It is argued that the instability of sex isochromosomes is due to this functional dicentricity in some cells. These cases are compared with 42 other Y isochromosomes with various short- and long-arm breakpoints of formation. It is suggested that some of the nonheterochromatic, nonfluorescent Y chromosomes previously reported may be explained as dicentric i(Y) with proximal long-arm breakpoints of formation and one suppressed centromere.