Implant-borne rehabilitation for alveolar dental cleft: Retrospective analysis of thirty-nine cases

INTRODUCTION

Dental rehabilitation of patients with alveolar-dental cleft sequelae is a crucial issue in the final stages of functional and aesthetic management of these patients. The objectives of this study are to establish the success of implant-supported rehabilitations for patients with alveolar dental cleft sequelae followed in the Department of Maxillofacial Surgery and Stomatology of Lille University Hospital and the reasons for not using this type of rehabilitation for others.

MATERIALS AND METHOD

Patients treated between January 2009 and December 2018 with implant-supported prostheses at an alveolar dental cleft site were included. Dental implants were placed after a complementary alveolar bone graft. Clinical and radiological criteria regarding periodontal, occlusal and prosthetic status were studied.

RESULTS

A total of 12 implants in 8 patients were placed. One of these implants was lost, resulting in an implant survival rate of 91.7%. All patients were able to benefit from functional rehabilitation.

DISCUSSION

The present results demonstrate the interest and reliability of implant rehabilitation in these patients. They furthermore highlight financial factors as a barrier to using this solution among the majority of patients in care.

To what extent is climate change adaptation a novel challenge for agricultural modellers?

Modelling is key to adapting agriculture to climate change (CC), facilitating evaluation of the impacts and efficacy of adaptation measures, and the design of optimal strategies. Although there are many challenges to modelling agricultural CC adaptation, it is unclear whether these are novel or, whether adaptation merely adds new motivations to old challenges. Here, qualitative analysis of modellers' views revealed three categories of challenge: Content, Use, and Capacity. Triangulation of findings with reviews of agricultural modelling and Climate Change Risk Assessment was then used to highlight challenges specific to modelling adaptation. These were refined through literature review, focussing attention on how the progressive nature of CC affects the role and impact of modelling. Specific challenges identified were: Scope of adaptations modelled, Information on future adaptation, Collaboration to tackle novel challenges, Optimisation under progressive change with thresholds, and Responsibility given the sensitivity of future outcomes to initial choices under progressive change.

Optimising finishing pig delivery weight: participatory decision problem analysis

The seemingly straightforward question of optimal pig delivery weight is more complex than meets the eye. Despite abundant research insights, the industry continues to request additional applied scientific decision support on the delivery weight problem. The current objective is to investigate whether and how the complex decision of delivery weight can be reshaped (reframed) into a more tangible and comprehensible system of factors that matter for making the right decision. We used a participatory decision problem analysis, which resulted in modelling blueprints that incorporate factors prioritised by stakeholders for determining optimal delivery weights. How to efficiently organise such a ‘problem reframing process’ is case-specific: it depends on the objective, the initial problem understanding by the stakeholders, and their learning potential. Efficient co-learning is a prerequisite for successful participatory problem analysis. Our study reveals that the first step in such a process of ‘problem reframing’ should therefore be to answer the question of how to effectively organise co-learning among stakeholders and researchers, instead of starting with a correct and detailed representation of the problem. Useful guidelines for participatory problem reframing processes are (1) providing sufficient participatory learning steps, (2) having few and clearly defined objectives per learning step, (3) providing adapted learning tools per step, (4) establishing a common language and (5) deliberately choosing stakeholders based on prior knowledge of the problem or its context, potential motivation or incentives to be part of the participatory process step and potential role in up-scaling the co-learning process to a larger group of beneficiaries.

Trained-user opinion about Welfare Quality measures and integrated scoring of dairy cattle welfare

The Welfare Quality (WQ) protocol for on-farm dairy cattle welfare assessment describes 27 measures and a stepwise method for integrating values for these measures into 11 criteria scores, grouped further into 4 principle scores and finally into an overall welfare categorization with 4 levels. We conducted an online survey to examine whether trained users' opinions of the WQ protocol for dairy cattle correspond with the integrated scores (criteria, principles, and overall categorization) calculated according to the WQ protocol. First, the trained users' scores (n = 8-15) for reliability and validity and their ranking of the importance of all measures for herd welfare were compared with the degree of actual effect of these measures on the WQ integrated scores. Logistic regression was applied to identify the measures that affected the WQ overall welfare categorization into the "not classified" or "enhanced" categories for a database of 491 European herds. The smallest multivariate model maintaining the highest percentage of both sensitivity and specificity for the "enhanced" category contained 6 measures, whereas the model for "not classified" contained 4 measures. Some of the measures that were ranked as least important by trained users (e.g., measures relating to drinkers) had the highest influence on the WQ overall welfare categorization. Conversely, measures rated as most important by the trained users (e.g., lameness and mortality) had a lower effect on the WQ overall category. In addition, trained users were asked to allocate criterion and overall welfare scores to 7 focal herds selected from the database (n = 491 herds). Data on all WQ measures for these focal herds relative to all other herds in the database were provided. The degree to which expert scores corresponded to each other, the systematic difference, and the correspondence between median trained-user opinion and the WQ criterion scores were then tested. The level of correspondence between expert scoring and WQ scoring for 6 of the 12 criteria and for the overall welfare score was low. The WQ scores of the protocol for dairy cattle thus lacked correspondence with trained users on the importance of several welfare measures.

PLAYING THE TRUMP OF DUALITY IN DISCUSS: UPGRADING POCER WITH QUESTIONNAIRE RESULTS

DISCUSS, the Dual Indicator Set for Sustainable Crop protection Sustainability Surveys, was designed to help farmers achieve more sustainable crop protection. The indicator set pairs risk indicators--POCER--, with response indicators--a management questionnaire. Both parts of DISCUSS are indicators in their own right, but the dual risk-response setup has the additional trump that the questionnaire reveals farm level information, by which POCER calculations are refined. Simulations with personal protection and drift mitigation measures illustrate how DISCUSS can be used to support the farmers' crop protection decisions.

Treatment of GI dysmotility in scleroderma with the new enterokinetic agent prucalopride

Scleroderma is a multisystem disorder frequently resulting in disturbed GI motility. Although, especially early in the disease, symptomatic improvement is achieved with prokinetic agents, more severe GI manifestations of scleroderma may be difficult to treat, leading to parenteral feeding and hospitalization. Recently, a new serotonin (5-HT4) receptor agonist prucalopride was shown to have remarkable prokinetic properties, resulting in symptomatic improvement and increased frequency of defecation in patients with chronic functional constipation. Here we report two cases of scleroderma with GI manifestation in which previous prokinetic treatment failed, but where the patients were successfully treated with prucalopride. Our data suggest that prucalopride may be a promising and effective drug to treat GI motility disorders in scleroderma. However, further placebo-controlled double blind studies are needed for full documentation of the usefulness of prucalopride in patients with scleroderma.

[Development and use of an automatic conversational system for the calculation of dose in teleradiotherapy (author's transl)]

The authors describe the equipment and methods of calculation used for a system of automatic conversational dosimetry with a mini-computer. They present the dialogue of the physician with the calculator and indicate the conditions they required of such a system: i.e. rapidity of response, simplicity of use, verification of data, precision, adaptability. Testing involved 800 dosimetric cases including 300 cases of routine clinical dosimetry.