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INTRODUCTION: Understanding how different countries have responded to mitigate the risk of severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) transmission in dental offices is important. This article describes the different approaches taken towards optimal fallow periods in Canadian jurisdictions. METHODS: We searched publicly available information from dentist and dental hygiene regulator websites across the 10 provinces and 3 territories in Canada. We also searched for guidance documents on dental associations' websites or through personal communication with government officials. We extracted and tabulated information on fallow period recommendations or guidance, when available. RESULTS: Nine jurisdictions (6 provinces and all 3 territories) acknowledge or provide guidance on fallow periods following aerosol-generating procedures. Among those who have provided guidance regarding a fallow period, recommendations follow the Centers for Disease Control and Prevention guidance if the air changes per hour (ACH) in the dental operatory is known. CONCLUSION: The evidence for deciding on optimal fallow period is limited and still being explored, resulting in substantial variation across Canadian jurisdictions. A focus on developing scientific evidence relevant to dentistry and assimilating existing science is crucial to establishing consistency and uniformity in information to deliver safe oral health care services.

ObjectiveTo describe the process of revising the Pain Medicine Milestones 1.0 and implementing changes into the Pain Medicine Milestones 2.0 along with implications for pain medicine trainees.BackgroundCompetency-based medical education has been implemented in graduate medical education, including pain medicine. Milestones 1.0, introduced by the Accreditation Council for Graduate Medical Education (ACGME), has been used to assess learners in six competencies and respective sub-competencies. Recognizing areas for improvement in Milestones 1.0, the ACGME initiated the process of Milestones 2.0 and a working group was created to execute this task for pain medicine. The working group discussed revisions; consensus was sought when changes were introduced. Final milestones were agreed upon and made available for public comment prior to publication.ResultsRedundant sub-competencies were either merged or eliminated, reducing the number of sub-competencies. A maximum of three rows representing skill, knowledge, behavior and attitude were included for each sub-competency. Harmonized Milestones, aligning with other specialties in a predetermined ACGME framework, were adopted and modified to meet the needs of pain medicine. A supplemental guide was developed to assist educators in implementation of Milestones 2.0 and assessment of trainees.ConclusionsThe intent of the Milestones 2.0 was to create an improved tool that is comprehensive, easier to utilize, and of increased value for pain medicine training programs. It is expected that implementation of Milestones 2.0 will streamline pain medicine trainee assessments by educators and prepare trainees for the future practice of pain medicine while serving to be the foundation of an iterative process to match the evolution of the specialty.

OBJECTIVE Chronic overlapping pain conditions (COPCs) represent a co-aggregation of widespread pain disorders. We characterized differences in physical and psychosocial functioning in patients with chronic migraine (CM) and those with CM and COPCs. BACKGROUND Patients with CM and COPCs have been identified as a distinct subgroup of patients with CM, and these patients may be vulnerable to greater symptom severity and burden. METHODS Data were extracted from Collaborative Health Outcomes Information Registry (an open-source learning health-care system), completed at the patients' first visit at a large tertiary care pain management center and electronic medical records. In 1601 patients with CM, the number of non-cephalic areas of pain endorsed on a body map was used to examine the differences in pain, physical and psychosocial function, adverse life experience, and health-care utilization. RESULTS Patients endorsing more body map regions reported significantly worse symptoms and function across all domains. Scored on a t-score metric (mean = 50, SD = 10), endorsement of one additional body map region corresponded with a 0.69-point increase in pain interference (95% CI = 0.55, 0.82; p

BACKGROUND Anesthesiology education has undergone profound changes over the past century, from a pure clinical apprenticeship to novel comprehensive curricula based on andragogic learning theories. Combined with institutional and regulatory requirements, these new curricula have propagated professionalization of the clinician-educator role. A significant number of clinician-educator anesthesiologists, often with support from department chairs, pursue formal health professions education (HPE) training, yet there are no published data demonstrating the benefits or costs of these degrees to educational leaders. OBJECTIVE This study aims to collect the experiences of anesthesiologists who have pursued HPE degrees to understand the advantages and costs of HPE degrees to anesthesiologists. METHODS Investigators performed a qualitative study of anesthesiologists with HPE degrees working at academic medical centers. Interviews were thematically analyzed via an iterative process. They were coded using a team-based approach, and representative themes and exemplary quotations were identified. RESULTS Seven anesthesiologists were interviewed, representing diverse geographic regions, subspecialties, and medical institutions. Analyses of interview transcripts resulted in the following 6 core themes: outcomes, extrinsic motivators, intrinsic motivators, investment, experience, and recommendations. The interviewees noted the advantages of HPE training for those wishing to pursue leadership or scholarship in medical education; however, they also noted the costs and investment of time in addition to preexisting commitments. The interviewees also highlighted the issues faculty and chairs might consider for the optimal timing of HPE training. CONCLUSIONS There are numerous professional and personal benefits to pursuing HPE degrees for faculty interested in education leadership or scholarship. Making an informed decision to pursue HPE training can be challenging when considering the competing pressures of clinical work and personal obligations. The experiences of the interviewed anesthesiologists offer direction to future anesthesiologists and chairs in their decision-making process of whether and when to pursue HPE training.

Objective Given there are conflicting recommendations for the perioperative management of buprenorphine, we conducted a retrospective cohort study of our surgery patients on buprenorphine whose baseline dose had been preoperatively continued, tapered, or discontinued. Materials and methods We reviewed charts of patients on buprenorphine who had received elective surgery at Stanford Healthcare from January 1, 2013 to June 30, 2016. Our primary outcome of interest was the change in pain score, defined as mean postoperative pain score-preoperative pain score. We also collected data on patients' tapering procedure and any postoperative nonbuprenorphine opioid requirements. Results Out of ∼1200 patients on buprenorphine, 121 had surgery of which 50 were admitted and included in the study. Perioperative continuation of transdermal buprenorphine resulted in a significantly lower change in pain score postoperatively (0.606±0.878) than discontinuation (4.83±1.23, P=0.012). Among sublingual patients, there was no statistically significant difference in the change in pain score between those who were tapered to a nonzero dose versus discontinued (P=0.55). Continuation of sublingual buprenorphine resulted in fewer nonbuprenorphine scheduled opioid prescriptions than its taper or discontinuation (P=0.028). Finally, tapers were performed with great variability in the tapering team and rate of taper. Discussion On the basis of our findings, we implemented a policy at our institution for the continuation of perioperative buprenorphine whenever possible. Our work reveals crucial targets for the education of perioperative healthcare providers and the importance of coordination among all perioperative services and providers.

Perioperative pain management is a unique challenge in patients undergoing spine surgery due to the increased incidence of both pre-existing chronic pain conditions and chronic postsurgical pain. Peri-operative planning and counseling in spine surgery should involve an interdisciplinary approach that includes consideration of patient-level risk factors, as well as pharmacologic and non-pharmacologic pain management techniques. Consideration of psychological factors and patient focused education as an adjunct to these measures is paramount in developing a personalized perioperative pain management plan. Understanding the currently available body of knowledge surrounding perioperative opioid management, management of opioid use disorder, regional/neuraxial anesthetic techniques, ketamine/lidocaine infusions, non-opioid oral analgesics, and behavioral interventions can be useful in developing a comprehensive, multi-modal treatment plan among patients undergoing spine surgery. Although many of these techniques have proved efficacious in the immediate postoperative period, long-term follow-up is needed to define the impact of such approaches on persistent pain and opioid use. Future techniques involving the use of precision medicine may help identify phenotypic and physiologic characteristics that can identify patients that are most at risk of developing persistent postoperative pain after spine surgery.

Buprenorphine is a partial μ-opioid receptor agonist that is commonly used to treat chronic pain and opioid addiction as part of opioid maintenance therapy (OMT). Buprenorphine uniquely augments the clinician’s pharmacological arsenal through its partial agonism and long duration of action resulting in an increased safety profile. Unfortunately, clinical application of buprenorphine has been limited by misconceptions about its pharmacodynamic and pharmacokinetic characteristics and poses unique challenges for anesthesiologists. For example, due to its reputation for causing analgesic ceiling effects, many anesthesiologists are wary of continuing buprenorphine in the perioperative period; however, buprenorphine has been shown to be safe and effective in the perioperative setting and should be continued in most patients who are receiving OMT. In addition, buprenorphine offers an attractive option for chronic opioid therapy in suitable patients with chronic pain.

Basidiobolus ranarum is an environmental saprophytic fungus which is found across the globe, predominantly in the regions with arid climate. It resides in the intestine of amphibians, fishes, and insectivorous bats and can be found in the soil also. Inoculation of this pathogen in an open wound or after a trivial trauma or insect bite is a proposed mechanism of its infection in humans. It is a potentially pathogenic fungus that usually leads to chronic subcutaneous swelling in immunocompetent individuals; intra-abdominal extension of this infection is extremely rare. Even in abdominal basidiobolomycosis, description of few cases of bowel wall thickening and intra-abdominal masses is there. However, presentation of basidiobolomycosis as retroperitoneal fibrosis has never been reported till date. A 19-year-old female presented in our emergency block with anasarca, anuria, and right-sided flank pain since 3 days. She had thickening with induration and discoloration of the skin over the abdominal and chest wall on right side. An ultrasound followed by MRI was done; which revealed mild right-sided hydronephrosis with a large T2W hypointense mass in abdomen (involving the right kidney, perinephric space, retroperitoneum, and right adnexa). Biopsy was taken from the abdominal mass which came out to be Basidiobolomycosis. We, herein report an extremely rare case of abdominal basidiobolomycosis, presenting with renal involvement and secondary retroperitoneal fibrosis along with intra-abdominal masses which has never been reported till date.

BackgroundEffective analgesia is essential in managing traumatic rib fractures. Intravenous lidocaine (IVL) is effective in treating perioperative pain, acute pain in the emergency department, cancer pain in hospice, and outpatient chronic neuropathic pain. Our study examined the associations between IVL versus epidural analgesia (EA) and pain for the treatment of acute rib fracture in the inpatient setting.MethodsWe performed a retrospective study involving adults admitted to an academic level I trauma center from June 1, 2011 to June 1, 2016 with consults to the pain service for acute rib fracture pain. Eighty-nine patients were included in the final analysis (54 IVL and 35 EA patients). Both groups had usual access to opioid medications. The primary outcome was absolute change in numeric pain scores during 0–24 and 24–48 hours after initiating IVL or EA, compared with baseline. Secondary outcomes include opioid consumption, incentive spirometry, supplemental oxygens, pneumonia, endotracheal intubation and length of hospital stay.ResultsNumeric pain scores differed at baseline (mean 5.6 for IVL vs 4.5 for EA, p=0.01), while age, injury severity, and number of fractured ribs were similar. IVL and EA were associated with similar reductions in numeric pain scores within 0–24 and 24–48 hours (mean −2.9 for IVL vs −2.3 for EA during both periods, p=0.19 and p=0.17 respectively) . There was greater non-neuraxial opioid consumption with IVL compared with EA (98.6 vs 22.3 mg morphine equivalents (MME) at 0–24 hours, p=0.0005; 105.6 vs 18.9 MME at 24–48 hours, pConclusionOur results suggest that IVL is similar to EA in numeric pain score reduction, and that IVL may have an opioid sparing effect when taking neuraxial opioids into account. IVL may be an effective alternative to epidurals for the treatment of rib fracture pain. It should be considered for patients who have contraindications to epidurals or are unable to receive an epidural in a timely manner.

Mechanical properties of a nanomechanical resonator significantly impact the performance of a resonant Nano-electromechanical system (NEMS) device. We study the mechanical properties of suspended membranes fabricated out of low-pressure chemical vapor deposited silicon nitride thin films. We fabricated doubly-clamped membranes of silicon nitride with thickness less than 50 nm and length varying from 5 to 60 μm. The elastic modulus and stress in the suspended membranes were measured using Atomic Force Microscope (AFM)-based nanomechanical spectroscopy. The elastic moduli of the suspended membranes are significantly higher than those of corresponding on-substrate thin films. We observed a reduction in net stress after the fabrication of suspended membrane, which is explained by estimating the thermal stress and intrinsic stress. We also use a mathematical model to study the stress and thickness-dependent elastic modulus of the ultrathin membranes. Lastly, we study the capillary force-gradient between the SiNxsuspended membrane-Si substrate that could collapse the suspended membrane.

As part of a national effort to combat the current US opioid epidemic, use of currently Food and Drug Administration-approved drugs for the treatment of opioid use disorder/opioid addiction (buprenorphine, methadone, and naltrexone) is on the rise. To provide optimal pain control and minimize the risk of relapse and overdose, providers need to have an in-depth understanding of how to manage these medications in the perioperative setting. This article reviews key principles and discusses perioperative considerations for patients with opioid use disorder on buprenorphine, methadone, or naltrexone.

A majority of physicians feel poorly trained in the treatment of chronic pain and addiction. As such, it is critical that medical students receive appropriate education in both pain management and addiction. The purpose of this study was to assess the pre-clinical curriculum in pain medicine and addiction from the perspective of students after they had completed their pre-clinical training and to assess what they perceived as the strengths and weaknesses of their training. The authors conducted focused interviews among clinical medical students who had completed at least 6 months of clerkships. The interviews targeted the students’ retrospective opinions about the pre-clinical curriculum and their preparedness for clinical encounters with either pain or addiction-related issues during their rotations. Coders thematically analyzed the de-identified interview transcripts, with consensus reached through discussion and code modification. Themes that emerged through the focused interviews included: fragmented curricular structure (and insufficient time) for pain and addiction medicine, not enough specific treatment strategies for pain or addiction, especially for complex clinical scenarios, and lack of a trained work-force to provide guidance in the management of pain and addiction. This study demonstrated the feasibility of gathering student perspectives to inform changes to improve the pre-clinical curriculum in pain and addiction medicine. Students identified multiple areas for improvement at the pre-clerkship level, which have informed updates to the curriculum. More research is needed to determine if curricular changes based on student feedback lead to improved learning outcomes.

We have studied the ability of urinary molecules in altering the precipitation of kidney stone-related calcium oxalate monohydrate (COM) crystals and correlated the resulting morphologies with those of idiopathic COM kidney stones. We found that weakly acidic but highly glycosylated polyelectrolytes (Tamm Horsfall protein (THP), fetuinA, hyaluronic acid) do not significantly affect crystallization, and that THP and fetuinA show the tendency to aggregate in the presence of nascent crystals. It is proposed that highly glycosylated polyelectrolytes encapsulate nascent urinary crystals, prevent their aggregation, and thus act supportive in crystal excretion. Strong effects on crystallization were observed in the presence of the highly acidic molecules osteopontin (OPN), citrate, and the non-urinary glycosaminoglycans heparin and dextran sulfate. OPN formed non-structured concretions comparable with those found in the core of stones, while citrate formed platelets closely resembling crystal shapes found in the mantle region. However, it is unclear how the columnar growth in the mantle takes place. It is assumed that changing polyelectrolyte compilations/concentrations affect stone forming processes (e.g. equilibria, enhanced self-assembly), perhaps resulting in these structures. We have indeed shown that peptides can induce the formation of such structures. Moreover, heparin and dextran sulfate inhibited COM formation; implicating that these molecules could assist OPN, citrate but also THP in preventing stone formation.

Anesthesia in infancy impairs performance in recognition memory tasks in mammalian animals, but it is unknown if this occurs in humans. Successful recognition can be based on stimulus familiarity or recollection of event details. Several brain structures involved in recollection are affected by anesthesia-induced neurodegeneration in animals. Therefore, we hypothesized that anesthesia in infancy impairs recollection later in life in humans and rats. Twenty eight children ages 6-11 who had undergone a procedure requiring general anesthesia before age 1 were compared with 28 age- and gender-matched children who had not undergone anesthesia. Recollection and familiarity were assessed in an object recognition memory test using receiver operator characteristic analysis. In addition, IQ and Child Behavior Checklist scores were assessed. In parallel, thirty three 7-day-old rats were randomized to receive anesthesia or sham anesthesia. Over 10 months, recollection and familiarity were assessed using an odor recognition test. We found that anesthetized children had significantly lower recollection scores and were impaired at recollecting associative information compared with controls. Familiarity, IQ, and Child Behavior Checklist scores were not different between groups. In rats, anesthetized subjects had significantly lower recollection scores than controls while familiarity was unaffected. Rats that had undergone tissue injury during anesthesia had similar recollection indices as rats that had been anesthetized without tissue injury. These findings suggest that general anesthesia in infancy impairs recollection later in life in humans and rats. In rats, this effect is independent of underlying disease or tissue injury.

Our aim was to compare the use of a conventional rotary handpiece and a Piezosurgical unit for extraction of lower third molars. We studied 40 patients, who were allocated alternately to have the third molar removed with either the handpiece or the Piezosurgical unit. Pain, trismus, and oedema were evaluated at baseline and then postoperatively, together with paraesthesiae, on postoperative days 1, 3, 5, 7, and 15. Damage to surrounding tissue was checked on the same day whereas dry socket was evaluated from postoperative day 3 onwards. More patients complained of pain in the conventional group, they also required more analgesics, and they developed trismus more often than in the Piezosurgery group. There was also significantly more postoperative swelling in the conventional group. Patients were also evaluated using the subjective Postoperative Symptom Severity (PoSSe) scale. Our results suggest that apart from some inherent limitations with the Piezotome, it is a valuable alternative for extraction of third molars.

In the last three decades, polyetheretherketone (PEEK) has been increasingly employed as a biomaterial for orthopedic and spinal implants. PEEK dental implants have shown equal promise and are currently being used and investigated in many parts of the world. While their osseointegration capacity has been established beyond doubt, it is not clear whether these implants are suitable for specific situations with low functional and high esthetic demands or as completely viable alternatives to titanium in all situations. We present a brief introduction to the PEEK implants, a representative system and kit and the advantages and disadvantages as compared to titanium implants. It is our observation that PEEK implants function well in anterior as well as posterior regions and when loaded immediately (one week after placement). Their use in the esthetic zone can be of significant advantage to the surgeon as well as patient. However, diminished radiopacity and limitation of available sizes may be causes for concern.

Introduction: With the ever increasing success rate of dental implants, researchers and clinicians have turned their minds towards making the duration of treatment shorter and more comfortable. Many studies have been conducted using various graft materials in conjunction with implants for initial stability in immediate placement.Materials and Methods: In this study, we have included the patients from our local area Delhi NCR and 20 implants were used, out of which 10 were wetted and covered with PRGF and remaining were placed without any similar adjunct. The patients were prospectively evaluated for implant stability clinically, radiographically and using radiofrequency devices.Results: It was observed that patients in the PRGF group reported lesser pain and swelling at the site of implantation. The soft tissue healing in PRGF group was exemplary in experimental group. In the experimental group the stability values showed an early recovery from the remodeling phase between 2nd and 4th weeks postoperatively. In our study, stability values after 12 to 24 weeks were approximately same for both the groups.Conclusion: As an outcome of this study, we can recommend PRGF as an adjunct with implants, placed in fresh extraction sockets, as it may improve the success rate and decrease the treatment duration.

Yttria-tetragonal zirconia polycrystal (Y-TZP) is a difficult substrate to bond to due to the absence of a glass phase and the material’s chemical inertness. This study evaluated the effect of two monomers for metal, MDP (10-methacryloyloxydecyl dihydrogen phosphate) and VBATDT (6-(4-vinylbenzyl-n-propyl)amino-1,3,5-trizaine-2,4-dithiol) on bond strength to Y-TZP. Seven combinations with different concentrations of MDP and VBATDT-monomers (0.0, 0.1, 0.5, or 1.0 wt %) in acetone solution were developed and applied to the surface of Y-TZP slabs, which were bonded to composite resin substrates using a resin cement under standard loading. Non-primed samples were used as controls. Bonded specimens were cut for microtensile testing and tested after either 48 h or 180 days in water storage at room temperature. All samples from control group (no primer) and MV5 group (0% MDP/0.5% VBATDT) debonded spontaneously. Two-way ANOVA showed that the primer had a significant effect (p < 0.001) on bond strength to zirconia, whilst storage time did not (p = 0.203). Tukey HSD (honest significant difference) test indicated that groups with at least 0.5% of each monomer resulted in higher initial bond strength values. Although chemical bonding to zirconia is credited to MDP, a correct balance between MDP and VBATDT may imply in better bond strength results. The minimum concentration of each monomer should not be lower than 0.5 wt %.

Background: Superficial tinea infections are some of the most common dermatological conditions in children. Recently, few studies done showed abrupt increase in dermatophytic infection in adults; however, similar recent studies describing clinicoepidemiological pattern in pediatric population are lacking. Aims and Objectives: The aims and objectives of this study are to identify the epidemiological profile of the dermatophytoses among pediatric population. Materials and Methods: Pediatric patients with suspected tinea infections presenting in the Department of Dermatology at a tertiary care medical college hospital in Northern India from April 2016 to 2017 were evaluated for inclusion in this study. Samples were collected in two parts; if first part was found to be potassium hydroxide (KOH) positive for septate hyphae, the second part was sent for fungal culture subsequently. Statistical Analysis Used: SPSS version 20 was used for statistical analysis. Results: Out of 235 patients, 152 were male and 83 were female. Only 200/235 (85.1%) KOH positive enrolled patients yielded positive fungal culture. Most common species identified on culture was Trichophyton mentagrophytes, followed by Trichophyton rubrum, and Trichophyton violaceum. Trunk was the most common site affected in 29.4% patients, palms and soles were least affected. Conclusion: More number of patients applied topical steroid for a longer period of time in patients with extensive disease as compared to limited disease. The present study provides evidence that dermatophytosis in pediatric patients is following the pattern of adult dermatophytosis clinically and microbiologically now.

Endosseous implants can be placed following either two-stage technique requiring second-stage surgery or one-stage technique, which does not involve a second surgical intervention.The present study was undertaken to evaluate and compare the changes in crestal bone level when two-piece implants were placed in posterior mandibular region following one-stage and two-stage surgical protocol.A parallel group randomized prospective study was designed in which 20 two-piece implants were placed in the posterior mandibular region of 16 partially edentulous healthy patients following either one-stage (Group I) or a two-stage surgical protocol (Group II). Alterations in crestal bone level were assessed with the help of DentaScan at baseline, that is, at the time of implant placement, third month and sixth month.Nonsignificant differences were seen in both groups in terms of changes in crestal bone level at the final evaluation.Hence, it could be concluded that two-piece implants can be placed following one-stage surgical protocol as predictably as when two-stage surgical technique is followed.

Medical students have been shown to have high levels of psychological distress, including self-stigmatization and unwillingness to seek care. The authors hypothesized that a student-led curriculum involving personal mental illness experience, given during the first-year neuroscience course, and titled “Mental Illness Among Us (MIAU), ” would reduce stigma of mental illness. In 2010 and 2011, students completed voluntary pre- and post-MIAU surveys measuring attitudes regarding mental illness in relation to MIAU. Also, in 2011, the authors categorized topics mentioned in student responses to an open-ended, free-response question on the course final examination. Of 298 enrolled students, 250 submitted surveys that were matched pre- and post-intervention. Participants in the curriculum showed a significant difference in Social Distance, indicating an increased willingness to interact with individuals with mental illness, and a significant difference in the Mental Illness: Clinicians’ Attitudes (MICA) score representing a stronger agreement with positive statements regarding mental illness. The non-participants’ scores showed no changes in measures from pre-to post. Respondents most frequently reported that the neuroscience course prepared them to be a physician because it taught about compassion and the importance of treating the whole patient. The results indicate that participation in MIAU leads to a decrease in stigmatization of mental illness and a greater sense of compassion among UCSF medical students. This finding is consistent with previous research suggesting social and cognitive congruence among peers and peer-teachers can result in meaningful learning experiences. MIAU may represent a sustainable model to supplement current systems to promote well-being of medical trainees.

Transplant candidate caregivers (TCCs) are an under-utilized but potentially devoted pool of advocates who themselves may be recruited to register for deceased organ donation.The purpose of this study was to assess and compare recruitment barriers to deceased donor registration efforts in TCCs and health fair attendees (HFAs).A 42-item questionnaire assessing willingness to register as an organ donor and perceptions and knowledge about organ donation was administered to 452 participants (174 in Denver, 278 in San Francisco). Logistic regression, stratified by study site, was used to assess associations between explanatory variables and willingness to register as an organ donor.In Denver, 83 % of TCCs versus 68 % of HFAs indicated a willingness to register (p = 0.03). Controlling for study group (TCC vs HFA), predictors of willingness to register were female gender [odds ratio (OR) 2.4], Caucasian race (OR 2.3), college graduate (OR 11.1), married (OR 2.4) and higher positive perception of organ donation (OR 1.2), each p0.05. In San Francisco, 58 % of TCCs versus 70 % of HFAs indicated a willingness to register (p = 0.03). Controlling for study group (TCC vs HFA), predictors of willingness to register were Caucasian race (OR 3.5), college graduate (OR 2.2), married (OR 1.9), higher knowledge (OR 1.6) and higher positive perception of organ donation (OR 1.2), each p0.05. In both locales, Caucasians were more likely to have positive perceptions about organ donation and were more willing to register.Demographic characteristics, not personal connection to a transplant candidate, explain willingness to register as an organ donor.

In this paper, we present some new results of our work in a novel polymerization process (called the free-radical retrograde precipitation polymerization, or FRRPP, process) that occurs at temperatures above the lower critical solution temperature. Our polymerization experiments basically involve the methacrylic acid–poly(methacrylic acid)–water system. Experimental results indicate a gradual increase in conversion with time after what seemingly is the onset of phase separation. In an equivalent solution polymerization system, conversion of methacrylic acid reaches almost 100% at a much shorter time than in the FRRPP system. Molecular weights of poly(methacrylic acid) at different times for the FRRPP system are not dramatically different from those obtained in the solution system. However, the FRRPP system yields a relatively narrow molecular weight distribution at a wide range of conversion compared to that obtained in the equivalent solution system. The unique characteristics of the FRRPP process is shown in the asymptotic time behavior of the free-radical concentration compared to the decay behavior in other polymerization systems. © 1996 John Wiley & Sons, Inc.

A new method of collision free motion path planning using Non uniform rational B- Spline curves for mobile robots is addressed in this paper. Obstacles of polygonal nature are used and the navigation occurs in a dynamic environment. Mathematical Modeling with vector addition technique is used to compute the set of points which will form the final path. NURBS technique is applied on the computed set of points which results in smooth curve as the final path, giving the advantage of more efficient motion. NURBS offsets of the computed NURBS path have been defined to avoid collision. Number of obstacles is not a constraint in the model presented. Number and position of obstacles can be changed dynamically which will be encountered by the robot and the path computed will be updated accordingly ensuring the shortest path.

Oral care is critical from the stand point of systemic health. No health preventive strategy is complete without taking into cognizance the significance of subgingival microbiota in causation of a number of systemic conditions. Clinical studies and etiopathogenetic models substantiate a distinct connect between chronic periodontitis and a host of cardiovascular, respiratory, endocrine, musculoskeletal, and reproductive system pathologies. A potent source of contagion, subgingival microbiota associated with periodontitis may act as a significant risk factor in atherosclerotic coronary disease, carotid atheromas, chronic obstructive pulmonary disease, rheumatoid arthritis, systemic osteoporosis, diabetes mellitus, premature labor and birth of preterm babies, head and neck squamous cell carcinomas, and a myriad of other conditions.

In this paper we focus on the special problem encountered during the damping of structurally stiff automotive sheet metal panes. These structurally stiff panels exhibit high amplitude low frequency vibrations along with medium frequency damping problem. Due to the wide frequency range desired for vibration suppression, passive damping is considered for these stiff panels. A classical automotive sheet panel is forced to vibrate by a shaker and the frequency-response-function (FRF) between the frame and the sheet panel is measured. The low-frequency FRFs along with the overall damping loss for the medium frequency range are presented. Unlike conventional damping materials, the new 'structural damping layer' (SDL) utilizes the inelastic collision and friction damping mechanisms, SDL exhibits comparable or better damping performance over the extensional dampers on structurally stiff sheet panels. Moreover, these SDL materials exhibit interesting temperature and acceleration dependence characteristics.