Reinventing postgraduate training in the plant sciences: T-training defined through modularity, customization, and distributed mentorship.

The Plant Science Research Network (PSRN) comprises scientific societies and organizations with a mission to build and communicate a consensus vision of the future of plant science research, education, and training. This report enumerates a set of far-reaching recommendations for postgraduate training that emerged from workshops held in October 2016 and September 2017. These recommendations broaden and deepen the T-training concept presented in the Decadal Vision for Plant Science, which emphasizes experiential learning beyond the traditional disciplinary focus. Both workshops used the scenarios developed in Imagining Science in 2035 as a mechanism to encourage out-of-the-box thinking, an approach that led to the innovative recommendations and solutions described here. At the heart of our recommendations is the empowerment of trainees, who should be enabled to customize and take ownership of their training experiences. This fundamental concept is embodied in five principles: (a) Trainees should be provided guidance and resources needed to define and pursue career objectives within and beyond academia, conferring to them greater independence and responsibility in shaping their own future. (b) Learning should be flexible, adaptable, and distributed. Training should combine traditional and modular coursework to encompass both technical and professional skills. Guidance from diverse mentoring teams will support and tailor training toward diverse, personalized career paths. (c) Scientific research experiences should be broad and question-driven, whether motivated by basic discovery or seeking solutions to societal challenges. Trainees should continue to gain mastery of one or a few core scientific disciplines and their key tools and approaches. (d) Trainees should be skilled in science communication and incentivized to engage with and learn from the broader public community, helping to maintain an active dialogue among public, private, and academic sectors. (e) Training programs should foster and facilitate the inclusion of individuals with a diverse range of life experiences and should prioritize trainee well-being. The report recommendations call for a profound cultural shift, one that embraces and extends educational delivery trends toward self-learning and distance learning, considers trainee well-being as an essential requirement for success, and acknowledges the importance of effective two-way communication with the public. This shift is intended to broaden participation in the plant science workforce, both in terms of diversity and numbers, while maintaining excellence in core scientific training. Cultural change takes time, but among academic institutions the need for significant change and innovation in postgraduate training is increasingly pressing. As such, the immediate intent is for these recommendations to catalyze pilot programs and also build on emergent prototypes that exist globally while creating momentum for larger scale changes over longer time periods.

Insights into fast-track colon surgery: a plea for a tailored program.

BACKGROUND: This retrospective study compared the fast-track colon surgery program to conventional perioperative care and assessed factors that influence postoperative length of stay. DESIGN: This retrospective study included 124 fast-track and 119 conventional care colon surgical patients. Exclusion criteria were primary rectal disease, stoma, American Society of Anesthesiologists score IV, and Association Française de Chirurgie index 3 or 4. Laparoscopy was the preferred approach. Variables influencing length of stay were analyzed by multivariate linear and logistic regression. RESULTS: Overall mortality and complication rates were not significantly different between groups (fast-track vs. controls 0 vs. 0.8 %, 30.6 vs. 38.6 % respectively). As expected, median length of stay was significantly reduced in fast-track patients (3 vs. 6 days, p < 0.001), but emergency readmission rate was higher (16.9 vs. 7.6 %, p = 0.026), although rehospitalization rates were similar (8 vs. 4.2 %, not significant). Independent risk factors of increased length of stay were identified as age >69 years (p = 0.001), laparotomy (p = 0.011), and conventional perioperative care (p < 0.001). CONCLUSIONS: The introduction of a fast-track program reduced postoperative length of stay without increasing complication rate. This study proposes a modulation of the program according to patient age and surgical approach.

Total perineal reconstruction after abdominoperineal excision for rectal cancer: long-term results of dynamic graciloplasty with Malone appendicostomy.

AIM: This study aimed to assess long-term function after total perineal reconstruction (TPR) with dynamic graciloplasty (DG) and systematic Malone appendicostomy (MA) adjunction after abdominoperineal excision (APR) for rectal cancer. METHOD: From 1999 to 2004, TPR using DG and MA was performed in 10 patients [seven women; median age 40 (range 28-55) years] after APR for rectal cancer (cT2 in one patient, cT3 in six patients and cT4 in three patients). We prospectively recorded early and late morbidity, mortality, oncological outcome, functional results (using the modified Working Party on Anal Sphincter Replacement 'WPASR' scoring system) and quality of life (QoL; using the European Organisation for Research and Treatment of Cancer 'EORTC' QLQ-C30 and QLQ-CR38 questionnaires). RESULTS: There was no procedure-related mortality. One patient required intra-abdominal re-operation. Nine patients required local and multiple revisions [there was one coloperineal anastomosis (CPA) stenosis, five CPA mucosal prolapse, three stenosis related to graciloplasty, two MA stenosis and one MA reflux]. After a median follow up of 78 months, there was no local recurrence and six patients were alive and disease-free. Regarding the functional results, the median modified WPASR score, of 8, after a follow up of 78 months, was good. The overall QoL scores remained stable over time. CONCLUSION: In carefully selected patients who want to avoid definitive abdominal colostomy after APR for rectal cancer, reconstruction involving MA and DG after APR for low rectal cancer is followed by good long-term function and QoL.

Beliefs and practices to prevent drowning among Vietnamese-American adolescents and parents.

OBJECTIVE: To determine the beliefs, attitudes and practices regarding water safety among Vietnamese-Americans through focus group interviews. PARTICIPANTS: 15 teenagers (aged 15-19 years) and 20 parents participated, and reported similar attitudes, beliefs and practices regarding water activities. Participants identified a lack of familiarity with water activities and few swimming skills, noting that these activities are not perceived as recreational sports among the Vietnamese. They reported recreating at open water sites because they are free and available, and attributed drowning to fate. Vietnamese youth swim unsupervised, responding to peer pressure despite lack of skills. Participants had negative attitudes toward life jackets using, swimming pools and lessons, because of the costs, but would attend lessons in Vietnamese. They identified schools and Vietnamese media as means of delivering injury-prevention messages. CONCLUSIONS: Decreasing drowning among Vietnamese-Americans requires changing the knowledge, attitudes and safety practices with programs and messages in Vietnamese, as well as targeting the dominant culture.

Booster seats for child passengers: lessons for increasing their use.

OBJECTIVE: To explore parental knowledge, attitudes, beliefs, and barriers to use of booster seats in cars for 4-8 year old children. METHODS: Three focus groups conducted by a professional marketing firm. Results-Many parents were confused about the appropriate weight and age of children who should be in booster seats; most parents incorrectly identified the age at which it was safe to use a lap-shoulder belt. Legislation was viewed as a positive factor in encouraging use. Cost of seats was frequently cited as a barrier to ownership, as were child resistance, peer pressure from older children, the need to accommodate other children in the vehicle, and the belief that a lap belt was adequate. Messages from health care providers, emergency medical services, or law enforcement personnel were believed to be most effective. CONCLUSION: Campaigns to promote booster seat use should address issues of knowledge about appropriate age and size of the child, cost, inadequacy of lap belts, and resistance to use by the child.

Dental luting agents: A review of the current literature.

STATEMENT OF PROBLEM: The practice of fixed prosthodontic has changed dramatically with the introduction of innovative techniques and materials. Adhesive resin systems are examples of these changes that have led to the popularity of bonded ceramics and resin-retained fixed partial dentures. Today's dentist has the choice of a water-based luting agent (zinc phosphate, zinc polycarboxylate, glass ionomer, or reinforced zinc oxide-eugenol) or a resin system with or without an adhesive. Recent formulations of glass ionomer luting agents include resin components (resin-modified glass ionomers), which are increasingly popular in clinical practice. PURPOSE: This review summarizes the research on these systems with the goal of providing information that will help the reader choose the most suitable material. MATERIAL: The scientific studies have been evaluated in relation to the following categories: (1) biocompatibility, (2) caries or plaque inhibition, (3) microleakage, (4) strength and other mechanical properties, (5) solubility, (6) water sorption, (7) adhesion, (8) setting stresses, (9) wear resistance, (10) color stability, (11) radiopacity, (12) film thickness or viscosity, and (13) working and setting times. In addition, guidelines on luting-agent manipulation are related to available literature and include: (1) temporary cement removal, (2) smear layer removal, (3) powder/liquid ratio, (4) mixing temperature and speed, (5) seating force and vibration, and (6) moisture control. Tables of available products and their properties are also presented together with current recommendations by the authors with a rationale.

The full veneer as an alternative to the full crown.

The use of ceramic veneers on the facial and incisal surfaces of teeth has become an integral part of our esthetic armamentarium. The success rate on these restorations has led to increased optimism and expanded applications. The full veneer uses bonded ceramic veneers to restore additional tooth surfaces. The result is a highly esthetically pleasing restoration that is functional and very conservative compared with traditional crowns.

Full veneers: the functional and esthetic application of bonded ceramics.

Esthetic restorative practices have used bonded ceramic facial veneers to replace or augment defective, discolored, or missing enamel. These restorations have proved to be highly esthetic and extremely durable. Sometimes it is necessary to extend the veneers onto occlusal, lingual, or proximal surfaces to cover defective tooth structure. This article will define "full veneers," present indications, show preparation designs, and present clinical cases where full veneers have been used.

Expanding the application of facial ceramic veneers.

"Full veneers," restorations similar in depth to ceramic veneers but extending over the lingual or occlusal surface as well as the facial surface, are a conservative option to conventional crowns. They have been used successfully at the UCLA Center for Esthetic Dentistry for three years. Indications, technique and a patient study are presented.

Resin bonding to various substrates.

The use of bonding adhesive techniques in dentistry in general and in esthetic dentistry in particular has expanded significantly. As techniques, materials, and results improve, adhesive procedures are substantially modifying many traditional approaches to treating dental problems. More esthetic and less invasive techniques are becoming routine as adhesive materials and techniques become tested and understood. This paper reviews several important areas that affect our understanding and application of adhesive dentistry. With the many material categories, materials in categories, and varieties of bonding surfaces, the subject is extremely complicated. An attempt has been made to divide the past year's literature into sections and to review each section as a separate component of this complex subject.

Computerized design and manufacturing of esthetic dental restorations.

The "high-tech race" in restorative and esthetic dentistry is underway. The Cerec System, which currently leads the race, is reviewed. Other systems, which soon will be available, are discussed briefly. New and innovative technologies are sure to become a significant part of dentistry, both today and in the future. Many traditional methodologies and materials will be replaced by these new developments.

A longitudinal clinical study of bonded fixed partial dentures: the first 5 years.

Etched-metal, composite resin-bonded, fixed partial dentures, as described in the early 1980s, gained an immediate application and popularity in restorative dentistry. This initial report presents the results of the first 5 years of a 10-year longitudinal study of these restorations. A total of 71 fixed partial dentures, ranging in use from 13 to 65 months, that were placed at the University of California, Los Angeles, School of Dentistry using consistent design parameters and restorative techniques have been analyzed. The results of this initial report indicate: (1) bonded fixed partial dentures are technique-sensitive; (2) optimal success requires meticulous attention to procedural detail; (3) anterior bonded fixed partial dentures do not appear to need routine 180-degree-plus circumferential retainer preparation for predictable success; (4) posterior bonded fixed partial dentures appear to require 180-degree-plus circumferential preparation for predictable success; (5) for single-tooth posterior replacements or single-to-double tooth anterior replacements, bonded fixed partial dentures are a viable alternative to conventional fixed partial dentures when intact abutments exist; and (6) most failures occurred within the first year.

Effect of porcelain crown substructures on visually perceivable value.

Factors that will affect the potential color of ceramic restorations must be understood to control variables that exist. Clinical observations of porcelain restorations lead to the hypothesis that certain substructures tend to produce crowns with a lower than expected Value (brightness). This study was done to determine whether a visually perceivable difference could be detected between groups of ceramic crowns with different substructures. Two test groups of crown types with four different porcelain substructures were compared. In the first group, metal ceramic crowns made with either Galaxy or Rexillium III alloys were compared. In the second group, aluminous porcelain jacket crowns with and without a tin-plated, bonded platinum foil internally were compared. Visual analysis showed that (1) in the metal ceramic group, the crowns with the Rexillium III substructure were scored as more often having a lower significant Value, and (2) in the aluminous porcelain jacket group the crowns with the tin-plated, bonded platinum substructures were scored as more often having a lower significant Value.

Relative color stability of ceramic stains subjected to glazing temperatures.

Ceramic stains are routinely used to modify Hue or characterize ceramic dental restorations. Subjective opinion has led to the hypothesis that certain stains are not color stable when subjected to glazing temperatures. This study tested the individual stains in nine different ceramic staining kits for color stability when subjected to glazing temperatures. Ceramic disks were made with gingival porcelain and coated with individual stains. Colorimetric recordings were made before and after glazing and the color difference (delta E) was calculated. Significant color changes were noted for specific individual stains from each of the ceramic staining kits tested.

Effect of different metal ceramic alloys on the color of opaque and dentin porcelain.

Certain metal ceramic alloys alter the final color of bonded porcelain. Contradicting results, inconsistent test designs, and incomplete alloy selections have led to some confusion. In this study, differential colorimetric analysis was done at the opaque and dentin porcelain stages with five major types of metal ceramic alloys. The color stability of the porcelain on the high-noble metal alloys was found to be excellent. The palladium-silver and nickel-chromium alloys resulted in significant color changes of the dentin porcelain only. The greatest changes in color were found with the palladium-silver alloy, which resulted in a higher yellow-green saturation. The nickel-chromium alloy also produced a color change, although not as severe, resulting in a porcelain shade with a reduced Value or lightness.

The effect of ion exchange on the flexural strength of feldspathic porcelains.

The use of ceramic restorative materials is becoming more widely accepted by the dental profession. Concern over the inherent problems related to failure through the propagation of cracks has led to the development of new reinforced ceramics. Ion exchange is a simple, relatively low-temperature process that can have a substantial effect on the flexural strength of feldspathic dental porcelains. This study would support the use of such a material to reinforce dental ceramic restorations.