Teleconsultation/telediagnosis using teledentistry technology: a pilot feasibility study

Abstract—This study assessed the feasibility of a teledentistry model for teleconsultation and telediagnosis in Residential Aged Care Facilities. Study feasibility was defined by the ability to develop remote treatment plans. Reliability of the remote assessments was assessed by comparing with those performed by traditional face-to-face oral examinations. An intraoral camera was operated by trained teledentistry assistants with the aim of screening residents for oral diseases and pathological conditions. The model was supported by traning and an instructional kit for the introral camera operators. The structure, content and delivery of the program, was evaluated. Residents ’ views about the structure, content and delivery of the program were also evaluated. A total of 50 residents participated in this assessment. Results indicated that the proposed teledentistry approach for oral health screening is feasible and reliable as an alternative to traditional oral health examination. Residents expressed high levels of satisfaction with the teledentistry service. This study provides an innovative solution towards closing the service delivery gap in the provision of sustainable oral health care services to underserviced populations (e.g., nursing homes, rural areas)

Влияние культуры на экологическое сознание

В работе рассматривается взаимодействие экологии и культуры, влияние искусства на человеческое сознание и формирование взгляда на природу как на самостоятельную ценность, что делает безальтернативным вариант коэволюционного развития. Показан масштаб глобального экологического кризиса, важность работ Вернадского по ноосфере, новые не только природные, но и социокультурные реальности. Рассматриваются варианты выхода из создавшейся сложной экологической ситуации.This paper considered the interaction between ecology and culture, the influence of art on human consciousness and the formation of a view of nature as an independent value that makes the only option of co-evolutional development. Shows the scale of the global environmental crisis, the importance of the work of Vernadsky on the noosphere, new not only natural but also socio-cultural reality. Discusses options for overcoming the current dangerous ecological situation

What Are The Effects On Parish Relations When Adding Digital Communication To Catholic Ministry?

This qualitative study sought to understand the effects on parish relations when those leading Catholic ministry efforts added digital communication to their programs. This study, based on Buber’s philosophy that it is a person’s full commitment and presence in a dialogue that contributes to intimacy, will aim to illustrate that the level of richness in a dialogue relies more on the quality of the information, or messages shared, than the medium used to conduct the dialogue. The study is grounded in the Social Information Processing Theory and the Social Presence Theory. The data for this study was garnered through personal interviews with priests, sisters, and lay Catholic ministers who serve parishes and congregations within the Archdiocese of Philadelphia. The results show that the ministers place the highest priority on the message that is being delivered and will utilize whatever methods of communication available to disseminate their message to as many people as possible. The results also provide insight into the positive and negative effects of digital communication along with an important commitment by the ministers to provide information in a manner that will be as accessible to as many people as possible, thus lessening concerns of a digital divide. The findings of this study will benefit Catholic ministers by providing them with a context for reviewing their core ministry message. That review will provide a basis from which to craft a strategic communications plan that supports their goals to spread the word of God to as many people as possible and to guide and support individuals in their Catholic education and faith formation

Ermüdungsfestigkeit von Stumpfnahtverbindungen größerer Blechdicke gefügt mit Hochleistungsschweißverfahren

In vielen Bereichen des Ingenieurwesens gehört das Schweißen zu den maßgebenden und am häufigsten angewendeten Verbindungstechniken. Auch für Tragstrukturen von Windenergieanlagen, zu denen u. a. Türme und Monopiles gehören, sind stumpfgestoßene, dickwandige Schweißverbindungen charakteristisch. Durch die zunehmenden Dimensionen und Beanspruchungen geraten konventionelle Hochleistungsfügeverfahren wie das Unterpulverschweißen an die Grenzen ihrer technischen Umsetzbarkeit. Gleiches gilt auch für das Design und die Bemessung dieser Verbindungen. Zum Nachweis der Ermüdungssicherheit ist bisher das Nennspannungskonzept, basierend auf experimentell ermittelten Wöhlerlinien, Stand der Technik und maßgebend in gültigen Bemessungsnormen wie dem Eurocode 3. Dieses Verfahren ist einfach in der Anwendung, bietet aber kaum Möglichkeiten, lokale Nahteigenschaften zu berücksichtigen und so zu einer individuellen Dimensionierung zu gelangen. Die vorliegende Arbeit leistet einen Beitrag zu einer zuverlässigen Lebensdauerprog-nose auf Basis lokaler Ermüdungskonzepte, indem sie die Anwendbarkeit des Zwei-Phasenmodells, d. h. einer Kombination aus Kerbdehnungs- und Rissfortschrittskonzept, für die Bemessung von dickwandigen Stumpfstößen untersucht. Wesentliche Eingangsgrößen für dieses Modell sind die aus der Nahtgeometrie resultierende, elastische Spannungserhöhung und die lokale, inhomogene Festigkeitsverteilung über den Nahtquerschnitt. In großem Umfang wurden daher die Nahtprofile der Schweißproben vor der Schwingprüfung messtechnisch erfasst und durch entsprechende Filter für die numerische Analyse der Kerbformzahlen aufbereitet. Erst durch das Filtern mit entsprechender Grenzwellenlänge werden Messdaten vereinheitlicht und grundsätzlich vergleichbar. Für das Qualitätsmanagement innerhalb der Schweißfertigung und auch den direkten Eingang in Bemessungskonzepte ist dieser Schritt essentiell. Am Ende der Untersuchung steht eine umfassende Datenbasis zur Kerbgeometrie stumpfgeschweißter Verbindungen. Diese lokalen Nahtgeometrieeigenschaften und aus der Härte umgewertete Festig-keitsverteilungen über den Querschnitt bilden nun die maßgebenden Eingangspara-meter für das Zwei-Phasenmodell. Die Validierung an experimentell ermittelten Schwingfestigkeiten zeigt die Anwendbarkeit und das Potential des Modells. Die erreichte Prognosegüte für verschiedene Stahlwerkstoffe und Randbedingungen ist hoch. Durch die große Datenbasis ist es möglich, statistische Verteilungen dieser Eingangsparameter abzuleiten und im Rahmen stochastischer Monte-Carlo-Simulationen zu untersuchen. Das Potential lokaler Nachweiskonzepte für eine wirtschaftliche und sichere Bemessung großer Stahlstrukturen kann damit eindeutig aufgezeigt werden

The Relationship Between Denial and Behavior Pattern in the Patient Experiencing Myocardial Infarction

Denial has been recognized as a possible adaptation mechanism for patients with heart disease, stroke, brain damage, cancer, emphysema, manic-depressive psychos is, and neurologic disorders. Croog and coworkers discovered that twenty percent of 345 men treated for three weeks after a first myocardial infarction denied they had even had a heart attack. The problem under investigation in this study is: What is the relationship between the use of denial as a form of adaptation and the type of behavior pattern reflected in male patients within two weeks of admission to a coronary care unit with a diagnosis of myocardial infarction? Research indicates that the use of denial as a form of adaptation by myocardial infarction patients tends to decrease mortality in the immediate, forty-eight hour post infarction period, but decreases compliance in the post-hospitalization period. Therefore, cardiovascular nurses could assume that assessment of the use of denial might be important for increasing patient compliance towards cardiac rehabilitation in the myocardial infarction patient. If nurses can determine that the use of denial is associated with a particular behavior pattern, such as the Type A behavior pattern who are at high risk for myocardial infarction, nurses can develop plans of care with those individuals which would increase compliance in post-hospitalization. The objectives of this study are the following: 1. To determine the frequency of denial used by the male patient experiencing myocardial infarction according to the response to the Hackett-Cassem Denial Scale. 2. To determine whether the Type A behavior pattern or the Type B behavior pattern is reflected by the male patient experiencing myocardial infarction according to the response to the Jenkins Activity Survey. 3. To determine if there is a relationship between the use of denial as a form of adaptation and the type of behavior pat tern reflected by the male patient experiencing myocardial infarction

Determination of Loading and Residual Stresses on Offshore Jacket Structures by X-ray Diffraction

As basements of offshore wind turbines (OWTs) in deep water (>50 m), jacket structures are an economic alternative to monopiles. For this reason, the structural durability of jackets has become more important. In such structures, welded tubular joints are weak points for fatigue design. The harmful effect of tensile residual stresses in welding joints is well known. For these reasons, the residual stresses and the loading stresses of offshore jacket structures were determined by X-ray diffraction (XRD) using a mobile diffractometer. This allows us to directly determine the load stress at the fatigue-critical locations, namely at the weld toe at the testing rig. High tensile residual stresses up to 250 MPa were determined in a welded (and unloaded) condition. At a loaded structure (10,000 load cycles), a lower residual stress level was determined. During loading, a local increase in the stress at the welded joint that is between 1.4 and 4 times higher than the applied nominal stress was determined. Furthermore, it is shown that additional treatment (grinding and clean blasting) influences the local stress state significantly

Alienation in the narrative of Mireya Robles

Mireya Robles\u27 narrative works explore the problem of alienation in our contemporary world. On the one hand, her narrative portrays the lives of individuals who are trapped in a socially limiting and fragmented existence. As a result, they are incapable of understanding themselves and others. At the same time, Robles documents men\u27s and women\u27s basic need to transcend their isolation and to gain a deeper understanding of their destiny in this world. The texts analyzed for this study are Robles\u27 two unpublished collections of short stories, Trisagio de la muerte and Frigorífico del este, and her novel Hagiografía de Narcisa La Bella published in 1985. Regarding Trisagio de la muerte. the stories selected demonstrate Robles\u27 interest in investigating the origin of alienation as she explores the conflict between the individual and society. In the stories analyzed from Frigorífico del este, Robles uses the ideas of rebirth and reincarnation to describe the impoverished spiritual condition of men and women and their efforts to transcend their alienation through the recovery of their past. Finally, in Hagiografía de Narcisa La Bella, as Robles parodies a traditional hagiography, she subverts the idea of a spiritual rebirth and thereby reveals the extreme alienation of a Cuban family in the 1940s. This exploration of her Cuban past is an integral part of Robles\u27 incessant search for a greater understanding of the human condition. Although she frequently portrays pessimistically her characters\u27 struggles for self-realization, there is always a sense of hope. Robles implicitly. at least, suggests to her readers that her fictional world is made up of individuals who refuse to abandon their efforts to achieve self-discovery

Anemos : development of a next generation wind power forecasting system for the large-scale integration of onshore & offshore wind farms

International audienceThis paper presents the objectives and the research work carried out in the frame of the ANEMOS project on short-term wind power forecasting. The aim of the project is to develop accurate models that substantially outperform current state-of-the-art methods, for onshore and offshore wind power forecasting, exploiting both statistical and physical modeling approaches. The project focus on prediction horizons up to 48 hours ahead and investigates predictability of wind for higher horizons up to 7 days ahead useful i.e. for maintenance scheduling. Emphasis is given on the integration of highresolution meteorological forecasts. For the offshore case, marine meteorology is considered as well as information by satellite-radar images. An integrated software platform, ‘ANEMOS', is developed to host the various models. This system will be installed by several utilities for on-line operation at onshore and offshore wind farms for prediction at a local, regional and national scale. The applications include different terrain types and wind climates, on- and offshore cases, and interconnected or island grids. The on-line operation by the utilities will allow validation of the models and an analysis of the value of wind prediction for a competitive integration of wind energy in the developing liberalized electricity markets in the EU

Monitoring guidance for patients with hypophosphatasia treated with asfotase alfa.

Hypophosphatasia (HPP) is a rare, inherited, systemic, metabolic disorder caused by autosomal recessive mutations or a single dominant-negative mutation in the gene encoding tissue-nonspecific alkaline phosphatase (TNSALP). The disease is associated with a broad range of signs, symptoms, and complications, including impaired skeletal mineralization, altered calcium and phosphate metabolism, recurrent fractures, pain, respiratory problems, impaired growth and mobility, premature tooth loss, developmental delay, and seizures. Asfotase alfa is a human, recombinant enzyme replacement therapy that is approved in many countries for the treatment of patients with HPP. To address the unmet need for guidance in the monitoring of patients receiving asfotase alfa, an international panel of physicians with experience in diagnosing and managing HPP convened in May 2016 to discuss treatment monitoring parameters. The panel discussions focused on recommendations for assessing and monitoring patients after the decision to treat with asfotase alfa had been made and did not include recommendations for whom to treat. Based on the consensus of panel members, this review provides guidance on the monitoring of patients with HPP during treatment with asfotase alfa, including recommendations for laboratory, efficacy, and safety assessments and the frequency with which these should be performed during the course of treatment. Recommended assessments are based on patient age and include regular monitoring of biochemistry, skeletal radiographs, respiratory function, growth, pain, mobility and motor function, and quality of life. Because of the systemic presentation of HPP, a coordinated, multidisciplinary, team-based, patient-focused approach is recommended in the management of patients receiving asfotase alfa. Monitoring of efficacy and safety outcomes must be tailored to the individual patient, depending on medical history, clinical manifestations, availability of resources in the clinical setting, and the clinician's professional judgment

Effective NSAID treatment indicates that hyperprostaglandinism is affecting the clinical severity of childhood hypophosphatasia

BACKGROUND: Hypophosphatasia (HP) is an inborn error of bone metabolism characterized by a genetic defect in the gene encoding the tissue-nonspecific alkaline phosphatase (TNSALP). There is a lack of knowledge as to how the variability and clinical severity of the HP phenotype (especially pain and walking impairment) are related to metabolic disturbances or impairments, subsequent to the molecular defect. METHODS: We analyzed the changes in clinical symptoms and the prostaglandin (PG) metabolism in response to treatment with non-steroidal anti-inflammatory drugs (NSAIDs) in six children affected by childhood HP. In addition, by exposing HP fibroblasts to pyridoxal phosphate and/or calcium pyrophosphate in vitro, we analyzed whether the alterations in PG levels are sequelae related to the metabolic defect. RESULTS: Childhood HP patients, who often complain about pain in the lower limbs without evident fractures, have systemic hyperprostaglandinism. Symptomatic anti-inflammatory treatment with NSAIDs significantly improved pain-associated physical impairment. Calcium pyrophosphate, but not pyridoxal phosphate, induced cyclooxygenase-2 (COX-2) gene expression and PG production in HP and normal fibroblasts in vitro. CONCLUSION: Clinical features of childhood HP related to pain in the lower legs may be, at least in part, sequelae related to elevated PG levels, secondary to the primary metabolic defect. Consequently, NSAID treatment does improve the clinical features of childhood HP