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Background and objectivesThis study examined the associations between homelessness and clinical outcomes of CKD among adults from the urban healthcare safety net.Design, setting, participants, & measurementsThis retrospective cohort study examined 15,343 adults with CKD stages 3-5 who received ambulatory care during 1996-2005 from the Community Health Network of San Francisco. Main outcome measures were time to ESRD or death and frequency of emergency department visits and hospitalizations.ResultsOverall, 858 persons (6%) with CKD stages 3-5 were homeless. Homeless adults were younger, were disproportionately male and uninsured, and suffered from far higher rates of depression and substance abuse compared with adults with stable housing (P

The prospect of modifying the surface properties of the substrate (or base) material to enhance its corrosion and wear resistance as well as its reliability, performance, and more importantly its bioactivity is made possible using nanocoatings. An effective technique of synthesizing high purity nanocoatings in addition to nanopowders and fibers is to utilize the sol‐gel approach. It is an attractive and versatile method that can be carried out with relative ease. Ceramic coatings, such as hydroxyapatite (HAp), can be fabricated through chemical means from solutions and consequently complex shapes can be coated economically. Given the fact that mixing takes place on the atomic scale, one of the key advantages of the sol‐gel technique is its capacity to produce homogeneous materials, and it has been shown that the mechanical properties of sol‐gel coatings are enhanced due to the presence of nanocrystalline grain structures. This review covers a brief insight into the recent application of HAp nanocoatings derived from sol‐gel technique. [ABSTRACT FROM AUTHOR]

Nanomaterials such as nanostructured scaffolds in tissue engineering and nanoparticles in drug delivery systems are associated with many applications within the biomedical and dental arenas. Furthermore, nanotechnology has also played an important role in the modifications of surface properties of surgical-grade materials and implants to achieve improvements in in vivo performance and reliability. The utilizations of nanocoatings, nanocomposite coatings, and nanolaminates are also intended to enhance osseointegration and improved protection from the release of unnecessary or even harmful metal ions. Due to their nanocrystalline structure and increase surface area, they become more reactive and hence they can also be synthesized to deliver faster tissue bonding properties and exceptional bioactivity. These new generation nanocoatings based on inorganic and biological materials such as proteins and peptides are currently being developed and investigated. This review aims to give an overview into the recent advances in nanocoatings containing biological materials being applied in medicine. [ABSTRACT FROM AUTHOR]

This study developed a behavioral model of intentions to purchase aviation carbon offsets, and tested the model through structural equation models. The model draws on the established hierarchical models of human behavior to hypothesize relationships between general and specific attitudes as predictors of offsetting intentions. The New Ecological Paradigm scale, the theory of planned behavior and variables from past literature were employed to measure general environmental attitudes, intermediate beliefs, and behavior-specific attitudes and norms. The current research represents a first attempt to build a theoretical model that helps to understand the relationships between factors that determine whether people will purchase aviation carbon offsets. The results show that a more positive orientation toward the environment could be an important predictor of environmental intentions operating both directly on intentions as well as guiding beliefs that relate to intentions. Policy implications of the findings are discussed, encouraging greater voluntary climate action. [ABSTRACT FROM AUTHOR]

During the last two decades although many calcium phosphate based nanomaterials have been proposed for both drug delivery, and bone regeneration, their coating applications have been somehow slow due to the problems related to their complicated synthesis methods. In order to control the efficiency of local drug delivery of a biomaterial the critical pore sizes as well as good control of the chemical composition is pertinent. A variety of calcium phosphate based nanocoated composite drug delivery systems are currently being investigated. This review aims to give an update into the advancements of calcium phosphate nanocoatings and thin film nanolaminates. In particular recent research on PLA/hydroxyapatite composite thin films and coatings into the slow drug delivery for the possible treatment of osteomyelitis is covered. [ABSTRACT FROM AUTHOR]

As Australia recently introduced a mandatory carbon price, this paper provides a rare perspective of how such institutional changes influence consumer preferences for voluntary climate action. When examined using three contingent valuation questions, the results show that the compliance mechanism induces a substantial reduction in the number of air travellers who are willing to pay extra for voluntary carbon offsets and in the payment amount, although the crowding-out effect is incomplete. A disproportionately larger welfare benefit is attached to the carbon offsets for a domestic flight than its international counterpart. Overall empirical findings advocate the continued role of voluntary programmes. [ABSTRACT FROM AUTHOR]

A number of materials have been applied as implant coatings and as tissue regeneration materials. Calcium phosphate holds a special consideration, due to its chemical similarity to human bone and, most importantly, its dissolution characteristics, which allow for bone growth and regeneration. The applications of molecular and nanoscale-based biological materials have been and will continue to play an ever increasing role in enhancing and improving the osseointegration of dental and orthopedic implants. More recently, extensive research efforts have been focused on the development and applications of fluorescent nanoparticles and nanocoatings for in vivo imaging and diagnostics as well as devising methods of adding luminescent or fluorescent capabilities to enhance the in vivo functionality of calcium phosphate-based biomedical materials. [ABSTRACT FROM AUTHOR]

Although voluntary carbon offsets have played a key role in the response to addressing climate change in the aviation sector, little is known about consumer preferences for such offsets and their offsetting behaviour in Australia. This paper developed and applied a choice modelling study to measure the economic values of aviation carbon mitigation and to identify major factors influencing air travellers' voluntary climate action. Results show that respondents have a mean willingness to pay (WTP) of AU$21.38 per tonne of CO2 reduced in the form of voluntary carbon offsets per person. Female travellers might have a higher economic value of carbon mitigation than male counterparts while climate sceptics who are less likely to be carbon offsetters might in fact hold a higher WTP value than non-sceptical travellers. The findings suggest that in terms of WTP the best profile of offset projects might be renewable energy projects in developing countries, of which resulting carbon credits can reduce company legal liabilities. Positive support was found for mitigation measures by airlines, with technological efficiencies more strongly supported than operational practices and biofuels. This paper challenges previous understandings of environmentally motivated behaviour, and notes that behaviour profiles are still evolving. [ABSTRACT FROM AUTHOR]

This article aims to provide a brief background to the current applications of finite-element analysis (FEA) in nanomedicine and dentistry. FEA was introduced in orthopedic biomechanics in the 1970s in order to assess the stresses and deformation in human bones during functional loadings and in the design and analysis of implants. Since then, it has been applied with great frequency in orthopedics and dentistry in order to analyze issues such as implant design, bone remodeling and fracture healing, the mechanical properties of biomedical coatings on implants and the interactions at the bone-implant interface. More recently, FEA has been used in nanomedicine to study the mechanics of a single cell and to gain fundamental insights into how the particulate nature of blood influences nanoparticle delivery. [ABSTRACT FROM AUTHOR]

Objective. This investigation aims to evaluate the changes in stress magnitudes and distributions on Partially Stabilized Zirconia (PS-ZrO2) dental implants and bridges and on the mandible caused by fibrous encapsulations during clenching. Materials and methods. Four 3.26 mm diameter PS-ZrO2 dental implants with lengths of 12 mm were modelled and placed in the second premolar and first molar region on both sides of the mandible model. A rigid zirconia bridge with a thickness of 0.5 mm connects the PS-ZrO2 dental implants placed in the second premolar and first molar. Four periodontal ligament (PDL) case studies were examined: PDL in the second premolars; PDL in the first molars; PDL in both the second premolars and first molars; and no PDL present. Results. The results reveal the magnitudes and distributions of stresses on the dental implants and connecting bridges were governed by the PDLs. A significant drop in stress levels were recorded when the PDL encapsulates the roots of the dental implants. Of the four PDL case studies, it was found that when the PDLs are present in both the second premolars and first molars the lowest stress magnitudes are generated. The analysis also revealed that, during the healing process after implant insertion and the result of fibrous encapsulation, the dental implant system will experience a varying amount of stress levels. Conclusion. This study was intended to produce more insight into the influence of the PDL on the changes in stress distribution on the dental implant system during clenching. [ABSTRACT FROM AUTHOR]

Objective. The purpose of this paper is to compare the differences in stress between Ti-6Al-4V and PS-ZrO2 dental implant during clenching and whether these changes are clinically significant to limit the use of zirconia in oral implantology. Materials and methods. The model geometry was derived from position measurements taken from 28 diamond blade cut cross-sections of an average size human adult edentulous mandible and generated using a special sequencing method. Data on anatomical, structural, functional aspects and material properties were obtained from measurements and published data. Ti-6Al-4V and PS-ZrO2 dental implants were modelled as cylindrical structure with a diameter of 3.26 mm and length of 12.00 mm was placed in the first molar region on the right hemimandible. Results. The analysis revealed an increase of 2-3% in the averaged tensile and compressive stress and an increase of 8% in the averaged Von Mises stress were recorded in the bone-implant interface when PS-ZrO2 dental implant was used instead of Ti-6Al-4V dental implant. The results also revealed only relatively low levels of stresses were transferred from the implant to the surrounding cortical and cancellous bone, with the majority of the stresses transferred to the cortical bone. Conclusion. Even though high magnitudes of tensile, compressive and Von Mises stresses were recorded on the Ti-6Al-4V and PS-ZrO2 dental implants and in the surrounding osseous structures, the stresses may not be clinically critical since the mechanical properties of the implant material and the cortical and cancellous bone could withstand stress magnitudes far greater than those recorded in this analysis. [ABSTRACT FROM AUTHOR]

Background/Aims: Although HIV-infected persons are at higher risk for acute kidney injury (AKI) during hospitalization compared with their uninfected counterparts, risk factors for AKI are not well-defined. We aimed to describe the evolving incidence of AKI among HIV-infected individuals and to identify important AKI risk factors. Methods: We conducted a prospective cohort study of 56,823 HIV-infected persons in the Department of Veterans Affairs Clinical Case Registry. Outcomes were: AKI (acute in-hospital serum creatinine increase of ≥0.3 mg/dl, or a relative increase by 50% or greater), and dialysis-requiring AKI. We used proportional hazards regressions to identify risk factors. Results: From its peak in 1995 at 62 per 1,000 person-years, the incidence of AKI declined after the introduction of highly active antiretroviral therapy (HAART) in 1996 to a low point of 25 per 1,000 person-years in 2006. Incidence of dialysis-requiring AKI declined in the early 1990s, but doubled between 2000 and 2006. Using multivariate proportional hazard regression, we identified the following strong risk factors for AKI: chronic kidney disease (eGFR <60 ml/min/1.73 m2) (5.38, 95% CI: 5.11-5.67), proteinuria (1.78, 1.70-1.87), low serum albumin (<3.7 mg/dl) (5.24, 4.82-5.71), low body mass index (<18.5 kg/m2) (1.69, 1.54-1.86), cardiovascular disease (1.77, 1.66-1.89), low CD4 count (<200 cells/mm3) (2.54, 2.33-2.77), and high viral load (≥100,000 copies/ml) (2.51, 2.28-2.75). In addition, there was substantial heterogeneity in the strengths of risk factors for dialysis-requiring AKI before and after the introduction of HAART. Conclusions: Although AKI incidence has decreased during the HAART era, it remains common in HIV-infected persons and appears attributable to both kidney- and HIV-related factors. Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

The article highlights a study which examined trends in the timing of chronic dialysis initiation in the U.S. between 1997 and 2007. The results of the study found that the initiation of chronic dialysis seems to be earlier in the course of kidney disease in 2007 as compared to 1997. The initiation of chronic dialysis in 2007 was a mean of 147 days earlier.

Background/aims: Reduced kidney function and albuminuria are associated with higher risk for cardiovascular disease (CVD) and mortality in HIV-infected individuals. We investigated whether reduced estimated glomerular filtration rate (eGFR) and albuminuria are associated with subclinical vascular disease, as assessed by carotid intima-medial thickness (cIMT).Methods: Cross-sectional analysis of 476 HIV-infected individuals without clinical evidence of CVD enrolled in the Fat Redistribution and Metabolic Change in HIV infection (FRAM) study, using multivariable linear regression. eGFR(Cys) and eGFR(Cr) were calculated from cystatin C and creatinine levels. Albuminuria was defined as a positive urine dipstick (≥ 1+) or urine albumin-to-creatinine ratio ≥ 30 mg/g. Common and internal cIMT were measured by high-resolution B-mode ultrasound.Results: In unadjusted analyses, eGFR(Cys) and eGFR(Cr) were strongly associated with com- mon and internal cIMT. Each 10 ml/min/1.73 m2 decrease in eGFR(Cys) and eGFR(cr) was associated with a 0.008 mm higher common cIMT (p = 0.003, p = 0.01) and a 0.024 and 0.029 mm higher internal cIMT (p = 0.003), respectively. These associations were eliminated after adjustment for age, gender, and race. Albuminuria showed little association with common or internal cIMT in all models.Conclusions: In HIV-infected individuals without prior CVD, reduced kidney function and albuminuria were not independently associated with subclinical vascular disease, as assessed by cIMT. These results suggest that research should focus on searching for novel mechanisms by which kidney disease confers cardiovascular risk in HIV-infected individuals. [ABSTRACT FROM AUTHOR]

The article presents a study which aims to determine the association of inflammatory markers, fibrinogen and C-reactive protein (CRP) with 5-year mortality risk among HIV-infected patients. It mentions that the vital status of 922 HIV-positive participants from the Study of Fat Redistribution and Metabolic Change in HIV infection were examined. The authors concluded that fibrinogen and CRP are strong and independent predictors of mortality among HIV-infected adults.

Despite growing attention by researchers and policy makers on the economic value of cultural heritage sites, debate surrounds the use of adequate methods. Although choice modeling techniques have been applied widely in the environmental economics field, their application in tourism and cultural economics has been much more limited. This paper contributes to the knowledge on the economic valuation of cultural heritage sites through a national choice modeling study of Old Parliament House, Australia. The study sought to value marginal changes in several attributes of this site and revealed that only some of them are valued positively: extending the period of temporary exhibitions, hosting various events, and having ‘shop and café’ and ‘fine dining’. Advantages of using a mixed logit model are provided and managerial and policy implications are discussed. [Copyright &y& Elsevier]

Background. It is unknown whether chronic kidney disease (CKD) influences receipt of highly active antiretroviral therapy (HAART) among patients with the human immunodeficiency virus (HIV) and whether prescription practices contribute to excess mortality. Methods. We conducted a retrospective observational study involving HIV-infected patients with established indications for HAART and an outpatient serum creatinine level measured in the Veterans Affairs health care system. Patients were followed up for the outcomes of HAART exposure (percentage of follow-up time treated with HAART), inadequate dose adjustment of renally eliminated antiretroviral medications, and time to death. Results. A total of 1041 patients (8.5%) had CKD, defined as an estimated glomerular filtration rate (eGFR) !60 mL/min/1.73 m2. Compared with patients with an eGFR 60 mL/min/1.73 m2, HAART exposure was 14% less (95% confidence interval [CI], 2%-24% less), 24% less (95% CI, 4% more to 45% less), 64% less (95% CI, 38%-79% less), and 49% less (95% CI, 32%-61% less) in patients who had an eGFR of 30-59 mL/min/1.73 m2, 15-29 mL/min/1.73 m2, and !15 mL/min/1.73 m2 (and were not receiving dialysis) and in patients receiving longterm dialysis, respectively. At study entry, 15.4% of patients with CKD received HAART unadjusted for the level of renal function. The adjusted hazard ratio for death was 1.36 (95% CI, 1.08-1.72) for patients with an eGFR of 30-59 mL/min/1.73 m2, 2.17 (95% CI, 1.43-3.27) for patients with an eGFR of 15-29 mL/min/1.73 m2, 5.97 (95% CI, 3.18-11.19) for patients with an eGFR !15 mL/min/1.73 m2, and 1.92 (95% CI, 1.30-2.82) for dialysisdependent patients. Underexposure and inadequate dose adjustment of HAART were associated with 22.5%-35.5% of the excess mortality found among patients with different levels of CKD. Conclusions. Underexposure and inadequate dose adjustment of HAART may contribute to excess mortality among HIV-infected patients with CKD. [ABSTRACT FROM AUTHOR]

National parks are protected areas where special efforts are taken to conserve wildlife species and their habitats. However, the management of parks presents many diverse challenges. One effective mitigation strategy is understanding and improving the connections between environmental awareness and responsible behavior. This study examined this relationship by integrating the value orientations and environmental attitudes of individuals into the developmental process to understand individual conservation behavioral intentions measured as willingness to pay (WTP). The conceptual framework was constructed on the premise that the WTP is hierarchically developed: first, from value orientations and experience-use history, and, second, from attitudes toward national park management. Mt. Seorak National Park has faced diverse problems, including land use conflict from the development of cable cars and high-speed railroad tunnels through the park, and was chosen as a study site. The data were collected from 800 respondents through an online survey that considered the geographical area of residence. This study employed a confirmatory factor analysis and structural equation modeling along with a contingent valuation method to measure WTP. The findings from the study indicated that WTP was connected to specific dimensions of value orientations, attitudes, and experience-use history. The theoretical and practical implications are also discussed. [ABSTRACT FROM AUTHOR]

During the last decade, there has been a major increase in the interest of nanostructured materials in advanced technologies for biomedical and dental clinical applications. Nanostructured materials are associated with a variety of applications within the dental and biomedical field, for example nanoparticles in drug delivery systems and nanostructured scaffolds in tissue engineering. More importantly, nanotechnology has also been linked with the modification of surface properties of synthetic implants in an attempt to improve their bioactivity, reliability and protection from the release of harmful or unnecessary metal ions. This is achieved through the use of nanocoatings and nanocomposite coatings. These new-generation coatings based on inorganic materials and biological materials such as proteins and peptides are currently investigated and applied. This chapter aims to give an overview of the recent advances in nanocoatings and their composites being investigated or used in dentistry., (© 2015 S. Karger AG, Basel.)

Objectives: To determine whether ethnic differences in the incidence of albuminuria are present in patients with diabetes, and to identify social, behavioral, and provider factors that explain ethnic differences., Study Design: Survey follow-up design with a race-stratified baseline survey (2005-2006) in diabetic patients from a nonprofit, fully integrated healthcare system in Northern California. We followed the 10,596 respondents (30% whites, 20% blacks, 23% Hispanics, 14% Asians, and 13% Filipinos) without evidence of prevalent albuminuria at baseline., Methods: Incident albuminuria was defined by positive dipstick urinalysis (>1) or urine albumin to creatinine level (>30 mg/g), and confirmed with repeat testing at least 3 months later., Results: The 27,292 person-years of observation yielded 981 incident albuminuria events. Agestandardized rates of albuminuria (per 1000 person-years) ranged from 13.6 (95% confidence interval [CI] 10.5-17.0) in whites to 27.8 (CI 18.2- 38.3) in blacks. In fully adjusted Cox models, the hazard ratio for blacks (1.22, 95% CI 1.09-1.38), Asians (1.35, 95% CI 1.13-1.61), and Filipinos (1.93, 95% CI 1.61-2.32), but not Hispanics, was significantly greater than it was for whites. In some cases, point estimates changed markedly from the base model when fully adjusted for potential confounders. Moreover, adjustment for an array of potentially mediating factors explained only a small proportion of the observed ethnic disparities., Conclusions: Despite uniform medical care coverage, Filipinos, blacks, and Asians with diabetes developed albuminuria at higher rates than white and Hispanic adults.