Suppression of decoherence tied to electron-phonon coupling in telecom-compatible quantum dots: low-threshold reappearance regime for quantum state inversion.

We demonstrate suppression of dephasing tied to deformation potential coupling of confined electrons to longitudinal acoustic (LA) phonons in optical control experiments on large semiconductor quantum dots (QDs) with emission compatible with the low-dispersion telecommunications band at 1.3 µm. By exploiting the sensitivity of the electron-phonon spectral density to the size and shape of the QD, we demonstrate a fourfold reduction in the threshold pulse area required to enter the decoupled regime for exciton inversion using adiabatic rapid passage (ARP). Our calculations of the quantum state dynamics indicate that the symmetry of the QD wave function provides an additional means to engineer the electron-phonon interaction. Our findings will support the development of solid-state quantum emitters in future distributed quantum networks using semiconductor QDs.

Relationship of Functional Reach Test scores and falls in Special Olympics athletes.

BACKGROUND: The Functional Reach Test is used to assess balance of Special Olympic athletes as part of the FUNfitness screens held at Special Olympics games. However, it is unknown if the Functional Reach Test is an accurate assessment of balance in this population. The objective of this study was to explore the relationship between Functional Reach Test scores and falls in Special Olympic athletes. METHODS: Data were collected as a part of the FUNfitness screens during Arizona Special Olympics games. The Functional Reach Test scores of 272 Special Olympic athletes were recorded. Athletes were asked to report the number of falls they experienced in the last 12 months. RESULTS: A two-tailed Kendall tau test revealed little to no relationship between number of falls and Functional Reach Test scores of either the left upper extremity (n = 263, τ = -0.063, P = 0.202) or the right upper extremity (n = 263, τ = -0.107, P = 0.030). Sensitivity of the Functional Reach Test to identify fallers was 28.8%, and specificity was 83.5%. CONCLUSIONS: Scores of the Functional Reach Test did not correlate with actual falls. The relatively high specificity indicates the assessment is good at identifying non-fallers, while the low sensitivity results in a high number of fallers not being recognised as such. Therefore, the cut-off scores used for the Functional Reach Test in FUNfitness screenings may need to be altered to more accurately identify balance deficits in this population. FUNfitness screens need to be quick, efficient and accurate. As such, selection of the most appropriate assessment tools is essential. Consideration should be given on how to make the Functional Reach Test the most beneficial as a FUNfitness screen.

Projecting the Supply and Demand for Certified Genetic Counselors: a Workforce Study.

As of May 2017, there were 4242 Certified Genetic Counselors (CGC) (American Board of Genetic Counseling, Inc. 2017) and 41 graduate-level genetic counseling training programs (Accreditation Council for Genetic Counseling 2017) in North America, and the demand for CGCs continues to increase. In the Fall of 2015 the Genetic Counselor Workforce Working Group, comprised of representatives from the American Board of Genetic Counseling (ABGC), the Accreditation Council for Genetic Counseling (ACGC), the Association of Genetic Counseling Program Directors (AGCPD), the American Society of Human Genetics (ASHG), and the National Society of Genetic Counselors (NSGC) commissioned a formal workforce study to project supply of and demand for CGCs through 2026. The data indicate a shortage of genetic counselors engaged in direct patient care. Assuming two scenarios for demand, supply is expected to reach equilibrium between 2024 and 2030. However, given the rate of growth in genetic counseling training programs in the six months since the study was completed, it is reasonable to expect that the number of new programs may be higher than anticipated by 2026. If true, and assuming that growth in programs is matched by equivalent growth in clinical training slots, the supply of CGCs in direct patient care would meet demand earlier than these models predict.

Optimizing Connective Tissue Integration on Laser-Ablated Implant Abutments.

Focused Clinical Question: The integration of connective tissue (CT) to a laser-ablated abutment with a microgrooved surface at the apical millimeter (LL) has been documented in both animal and human studies. How should the healing be influenced to optimize the CT integration on abutment surfaces? Summary: When smooth machined titanium (ST) abutments were placed, epithelial attachment was found on abutments, but no CT integration was noted. On LL abutments, a zone of epithelial attachment and CT integration was noted. When an ST abutment was switched for an LL abutment, the soft tissue was inconsistent; however, when an LL abutment was placed after the removal of a prior LL abutment, CT integration was observed. Conclusions: Consistent CT integration was observed on LL abutment surfaces after implant placement. Switching LL abutments with new LL abutments consistently led to CT integration. This was not consistent when an ST abutment was switched for an LL abutment. Plaque and gingival indices were comparable between teeth and abutments. Probing depth (PD) was lower around teeth. There was no difference in PD between abutments. CT integration on LL abutments was optimized by initial healing occurring on an LL abutment or by creation of a CT wound before insertion of the abutment.

In vivo characterization of the highly selective monoacylglycerol lipase inhibitor KML29: antinociceptive activity without cannabimimetic side effects.

BACKGROUND AND PURPOSE: Since monoacylglycerol lipase (MAGL) has been firmly established as the predominant catabolic enzyme of the endocannabinoid 2-arachidonoylglycerol (2-AG), a great need has emerged for the development of highly selective MAGL inhibitors. Here, we tested the in vivo effects of one such compound, KML29 (1,1,1,3,3,3-hexafluoropropan-2-yl 4-(bis(benzo[d][1,3]dioxol-5-yl)(hydroxy)methyl)piperidine-1-carboxylate). EXPERIMENTAL APPROACH: In the present study, we tested KML29 in murine inflammatory (i.e. carrageenan) and sciatic nerve injury pain models, as well as the diclofenac-induced gastric haemorrhage model. KML29 was also evaluated for cannabimimetic effects, including measurements of locomotor activity, body temperature, catalepsy, and cannabinoid interoceptive effects in the drug discrimination paradigm. KEY RESULTS: KML29 attenuated carrageenan-induced paw oedema and completely reversed carrageenan-induced mechanical allodynia. These effects underwent tolerance after repeated administration of high-dose KML29, which were accompanied by cannabinoid receptor 1 (CB1 ) receptor desensitization. Acute or repeated KML29 administration increased 2-AG levels and concomitantly reduced arachidonic acid levels, but without elevating anandamide (AEA) levels in the whole brain. Furthermore, KML29 partially reversed allodynia in the sciatic nerve injury model and completely prevented diclofenac-induced gastric haemorrhages. CB1 and CB2 receptors played differential roles in these pharmacological effects of KML29. In contrast, KML29 did not elicit cannabimimetic effects, including catalepsy, hypothermia and hypomotility. Although KML29 did not substitute for Δ(9) -tetrahydrocannabinol (THC) in C57BL/6J mice, it fully and dose-dependantly substituted for AEA in fatty acid amide hydrolase (FAAH) (-/-) mice, consistent with previous work showing that dual FAAH and MAGL inhibition produces THC-like subjective effects. CONCLUSIONS AND IMPLICATIONS: These results indicate that KML29, a highly selective MAGL inhibitor, reduces inflammatory and neuropathic nociceptive behaviour without occurrence of cannabimimetic side effects. LINKED ARTICLES: This article is part of a themed section on Cannabinoids 2013. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2014.171.issue-6.

Blockade of endocannabinoid-degrading enzymes attenuates neuropathic pain.

Direct-acting cannabinoid receptor agonists are well known to reduce hyperalgesic responses and allodynia after nerve injury, although their psychoactive side effects have damped enthusiasm for their therapeutic development. Alternatively, inhibiting fatty acid amide hydrolase (FAAH) and monoacylglycerol lipase (MAGL), the principal enzymes responsible for the degradation of the respective endogenous cannabinoids, anandamide (AEA) and 2-arachydonylglycerol (2-AG), reduce nociception in a variety of nociceptive assays, with no or minimal behavioral effects. In the present study we tested whether inhibition of these enzymes attenuates mechanical allodynia, and acetone-induced cold allodynia in mice subjected to chronic constriction injury of the sciatic nerve. Acute administration of the irreversible FAAH inhibitor, cyclohexylcarbamic acid 3'-carbamoylbiphenyl-3-yl ester (URB597), or the reversible FAAH inhibitor, 1-oxo-1-[5-(2-pyridyl)-2-yl]-7-phenylheptane (OL-135), decreased allodynia in both tests. This attenuation was completely blocked by pretreatment with either CB(1) or CB(2) receptor antagonists, but not by the TRPV1 receptor antagonist, capsazepine, or the opioid receptor antagonist, naltrexone. The novel MAGL inhibitor, 4-nitrophenyl 4-(dibenzo[d][1,3]dioxol-5-yl(hydroxy)methyl)piperidine-1-carboxylate (JZL184) also attenuated mechanical and cold allodynia via a CB(1), but not a CB(2), receptor mechanism of action. Whereas URB597 did not elicit antiallodynic effects in FAAH(-/-) mice, the effects of JZL184 were FAAH-independent. Finally, URB597 increased brain and spinal cord AEA levels, whereas JZL184 increased 2-AG levels in these tissues, but no differences in either endo-cannabinoid were found between nerve-injured and control mice. These data indicate that inhibition of FAAH and MAGL reduces neuropathic pain through distinct receptor mechanisms of action and present viable targets for the development of analgesic therapeutics.

Discordant tuberculin skin and interferon-gamma tests during contact investigations: a dilemma for tuberculosis controllers.

Current recommendations conflict over the appropriate use of interferon-gamma whole blood assays to screen for tuberculosis (TB) infection in contact investigations. We report here on a worksite TB contact investigation in which tuberculin skin test (TST) and QuantiFERON-TB Gold (QFT-G) were both used to identify infection among 61 co-workers. Of the 27 (44%) who had a TST > or =15 mm, 11 (41%) had negative QFT-G, raising concerns that QFT-G may not be sufficiently sensitive when used alone in contact investigations. The questionable performance of QFT-G in this setting is not unexpected, as the negative predictive value of a test decreases with increasing prevalence.

A prospective, randomized, controlled comparison of platform-switched and matched-abutment implants in short-span partial denture situations.

Recent observations suggest that less bone loss may result from placing a more medialized abutment on an implant (platform switching). The objective of this study was to measure the radiographic crestal bone loss and biologic width around conventional and platform-switched implants. Implants were randomly assigned into conventional or switched categories within the same prosthesis. Twenty-five implants were placed and observed in the mandibles of 10 patients for 2 years. A regression analysis demonstrated a significant difference between groups (P < or = .0001). These findings suggest that less crestal bone loss occurs around a platform-switched dental implant versus a conventional implant.

Initial clinical efficacy of 3-mm implants immediately placed into function in conditions of limited spacing.

PURPOSE: The objective of this study was to determine changes in interdental papillae, alveolar bone loss, esthetics, and initial healing survival when 1-piece narrow-diameter implants were immediately loaded in sites with limited tooth-to-tooth spacing. MATERIALS AND METHODS: One-piece titanium alloy implants with a maximum diameter of 3.0 mm and a resorbable blast surface texture on a square-thread form were evaluated. Digital photographs were made at each clinical visit to assess soft tissue healing. Interproximal soft tissue fill of the embrasure was assessed with a modified Jemt index. Standardized radiographs were made at baseline (implant placement) and at 6 and 12 months postsurgery. Radiographic bone height was measured from a consistent landmark on the implant. A 1-sided t test was used to determine statistical differences of bone height. RESULTS: Thirty-one implants were placed in 17 subjects. One implant had clinical mobility and was removed, for an overall survival rate of 96.7%. Mean bone height on the day of placement and restoration was 2.33 + 0.73 mm above the first thread. Mean bone height was 1.75 +/- 0.78 mm at 6 months postrestoration and 1.63 +/- 0.81 mm at 12 months postrestoration. There was a statistically significant loss of bone support over the initial 6 months (0.58 mm; P < .01), with no significant progression thereafter (0.12 mm; NS). Complete fill of papillae was found in 92% of maxillary lateral incisor sites and 60% of mandibular incisor sites. CONCLUSION: The use of 1-piece narrow-diameter immediately loaded implants appears to be an effective prosthetic treatment for areas of limited space.

Low-cost implant overdenture option for patients treated in a predoctoral dental school curriculum.

In an effort to make the implant overdenture more affordable for patients, a pricing package at the University of Alabama at Birmingham School of Dentistry was established. This package includes two implants, two dentures (upper and lower), and two implant abutments, all for $975. It is known as the "2-2-2" implant program. One concern regarding the program was whether patients would complete overdenture treatment or simply receive implants at this relatively low cost and have the implants restored outside the school. The purpose of this retrospective chart review was to determine how many patients in 2004 received implants as part of this program and how many of these patients completed overdenture treatment. Other data (age, distance from school, number of teeth at start of treatment, and gender) were collected to identify variables that might be associated with greater likelihood of completing overdenture treatment. In 2004, fifty-one patients received 102 implants as part of this program. Two patients had a failed implant prior to restoration (two of 102 implants), and one patient was referred to graduate prosthodontics for restoration. Of the remaining forty-eight patients, forty-one completed overdenture treatment (85 percent), and seven (15 percent) were lost to follow-up. The mean age of patients receiving this treatment was 60.7 years. The mean distance traveled to the school was 70.7 miles. While no variables showed significant predictive value, point estimates (estimate of the odds ratio) suggest that older patients and patients who travel greater distance to the school were less likely to complete treatment. The low-cost implant overdenture has been an important addition to our curriculum. The majority of patients who receive implants as part of this program complete overdenture treatment.

Using chaos theory to understand a community-built occupational therapy practice.

SUMMARY Community-built occupational therapy programs interact with a wide range of systems. This interaction does not occur in an orderly manner, but in an unpredictable fashion. The use of chaos theory may help program developers understand actual and potential interactions that may occur. To illustrate the use of chaos theory, a case study is presented.

Dental erosion and aspirin headache powders: a clinical report.

The causes of tooth erosion are varied, but all are associated with a chemical attack on the teeth and resulting loss of tooth structure. Etiologic factors related to erosion cited in the literature include bulimia, eating acidic foods, soft drink consumption, acid reflux, and swimming, among others. This clinical report suggests that chronic use of headache powders can also be a factor leading to tooth erosion.

Ligament tissue engineering using synthetic biodegradable fiber scaffolds.

Tissue engineering offers the possibility of replacing damaged human ligaments with engineered ligament tissues. Hence, we attempted to culture in vitro ligament tissues by seeding human anterior cruciate ligament (ACL) and medial collateral ligament (MCL) cells onto synthetic biodegradable polymer fiber scaffolds. The ACL and MCL cells readily attached to the scaffold fibers. These cells and their secreted matrix soon surrounded the scaffold fibers and bridged the gaps in between. Beginning at 2 weeks, portions of the scaffolds were completely filled with tissue matrix. By 5 weeks, the scaffolds became single bundles of tissue. Thus the cell/fiber system appears to be a viable system for culturing ligament tissues. Additionally, cell proliferation under mechanical and biochemical stimuli was studied for up to 4 days. Whereas mechanical stimulus and transforming growth factor enhanced proliferation, inflammatory agents (lipopolysaccharide and complement C5a) had a negative effect. This work can thus contribute to a sound strategy for culturing replacement ligament tissues in vitro.

A study of physician reactions to the Medicare cost containment pilot program in the State of Georgia.

Having reduced the unit cost of physician fees during the 1980s, the federal government set up a Medicare pilot study in the state of Georgia in 1989 to test the impact of its cost containment strategies aimed at reducing volume of services. This research has attempted not only to clarify the nature of physician reaction to the Medicare pilot study and to quantify the level of the dissatisfaction, but also to provide a richer understanding of the dynamic meaning of the dissatisfaction that Georgia physicians feel.

A mobile clinic experience: nurse practitioners providing care to a rural population.

Improving access to health care for rural underserved populations is a growing concern. This article reviews the advantages of mobile clinics and describes a collaborative model for a nurse practitioner-operated mobile clinic that has provided cost education, early detection, and referral for low-income, rural populations. Examples of health care provided to a rural population in South Carolina are described. This approach to improving access to health care for underserved populations has implications for nursing practice in other rural areas.

Biologic and clinical evaluation of Syntac and Variolink systems for cohesive pretreatment of hypersensitivity and definitive cementation.

Adhesive resin systems have become increasingly popular as they have been demonstrated to infiltrate conditioned vital dentin to cohesively hybridize the biologically altered substrates for adhesive bonding. This paper is a review of the biologic and clinical use of Syntac (Ivoclar Vivadent) and Variolink (Ivoclar Vivadent) adhesive systems for cohesive hybridization of vital dentin to prevent patient postoperative hypersensitivity and bacterial microleakage following clinical preparation.

Evaluating interfacial gaps for esthetic inlays.

Because of some inadequacies associated with the direct fill posterior composite resin, the inlay/onlay form of the same material or ceramic agents has been introduced. This clinical investigation measured the wear rate of several types of luting agents with both resin and ceramic restorative systems and identified several factors related to wear of the cementing agent.

QA, CQI, TQM: what's the difference?

Total Quality Management (TQM) is not a program, but a process. It is a major cultural change of healthcare organizations. TQM should not be embraced as a "short term fix," but as the long term solution to the shortcomings in the delivery of patient care.