Linear fractional charge behavior in density functional theory through dielectric tuning of conductor-like polarizable continuum model.

A property of exact density functional theory is linear fractional charge behavior as electrons are added or removed from a molecule. Typical density functional approximations (DFAs) exhibit delocalization error, which overstabilizes this fractional charge. Conversely, solvent corrections have been shown to erroneously destabilize this fractional charge. This work will show that an implicit solvent correction with a tuned dielectric can be used as an ad hoc correction to offset the delocalizing character of DFAs and achieve linear fractional charge behavior. While desirable, in principle, we find that this linear charge behavior degrades the vertical ionization energies reported by DFAs. Our results reveal that the localizing character of the solvent correction and the Hartree-Fock (HF) exchange offset each other. This helps explain the decreased ratios of HF exchange to DFA exchange in long-range hybrid tuning studies that use a solvent correction.

Effects of caffeine supplementation on physical performance and mood dimensions in elite and trained-recreational athletes.

BACKGROUND: Caffeine supplementation (CAFF) has an established ergogenic effect on physical performance and the psychological response to exercise. However, few studies have compared the response to CAFF intake among athletes of different competition level. This study compares the acute effects of CAFF on anaerobic performance, mood and perceived effort in elite and moderately-trained recreational athletes. METHODS: Participants for this randomized, controlled, crossover study were 8 elite athletes (in the senior boxing national team) and 10 trained-recreational athletes. Under two experimental conditions, CAFF supplementation (6 mg/kg) or placebo (PLAC), the athletes completed a Wingate test. Subjective exertion during the test was recorded as the rating of perceived exertion (RPE) both at the general level (RPEgeneral) and at the levels muscular (RPEmuscular) and cardiorespiratory (RPEcardio). Before the Wingate test, participants completed the questionnaires Profiles of Moods States (POMS) and Subjective Vitality Scale (SVS). RESULTS: In response to CAFF intake, improvements were noted in Wpeak (11.22 ± 0.65 vs 10.70 ± 0.84; p = 0.003; [Formula: see text] =0.44), Wavg (8.75 ± 0.55 vs 8.41 0.46; p = 0.001; [Formula: see text] =0.53) and time taken to reach Wpeak (7.56 ± 1.58 vs 9.11 ± 1.53; p <  0.001; [Formula: see text] =0.57) both in the elite and trained-recreational athletes. However, only the elite athletes showed significant increases in tension (+ 325%), vigor (+ 31%) and SVS (+ 28%) scores after the intake of CAFF compared to levels recorded under the condition PLAC (p <  0.05). Similarly, levels of vigor after consuming CAFF were significantly higher in the elite than the trained-recreational athletes (+ 5.8%). CONCLUSIONS: CAFF supplementation improved anaerobic performance in both the elite and recreational athletes. However, the ergogenic effect of CAFF on several mood dimensions and subjective vitality was greater in the elite athletes.

The use of titanium mesh in the management of orbital trauma--a retrospective study.

This study examines the use of titanium mesh in the reconstruction of internal orbital defects. The goals of reconstruction when treating orbital fractures include restoration of internal wall continuity and provision of support to the orbital contents. In this way the untoward sequelae of post-traumatic enophthalmos and disturbance of visual acuity are avoided. Autogenous grafts have been the material of choice for most surgeons involved with treatment of these injuries. The major disadvantages of using autologous tissue are the need for a graft donor site, with attendant increases in operative time, prolonged hospitalization, increased postoperative discomfort and problems intrinsic to the donor site wound. The purpose of this report is to present the author's experience with the use of titanium alloplasts in the early repair of traumatic orbital wall fractures. Patients treated at the Townsville General Hospital from July 1, 1997-March 1, 2000 with injuries involving the orbit repaired with titanium mesh or micro-mesh were included in the study.

Effect of Japanese government policy on hospital pharmaceutical profit levels.

OBJECTIVES: Our main objective is to examine whether the Japanese government's pharmaceutical price reduction policy has reduced the size of pharmaceutical profit traditionally enjoyed by health care providers. We discuss alternative measures that the government could introduce in an attempt to control drug costs. METHODS: We review Japan's pharmaceutical reimbursement system. We then analyse published and unpublished data in an attempt to reach our main objective. Calculations are made from raw data, provided by the National Hospital Federation of Japan, in order to discover the extent to which hospitals are experiencing financial difficulties. RESULTS: Due to pharmaceutical product shifting by hospitals from older, less profitable drugs to newer, more profitable ones, drug profit margins may not have fallen to the extent that is often reported in the Japanese press. Furthermore, increased prescribing, possibly due to the ageing of the population, may have maintained the total drug profits of hospitals, to a large extent, despite any reduction in profit margins. CONCLUSIONS: Although drug price reduction policy has had some success in controlling pharmaceutical expenditure, there is little evidence to suggest that total pharmaceutical profits for the provider units have been seriously undermined, despite the prevalence of this notion among hospital administrators. Nevertheless, in order to promote the more efficient and effective manufacture and utilization of pharmaceuticals, the government should seriously consider alternative methods for controlling pharmaceutical costs.

Japan's aging population. Implications for healthcare.

In the early years of the next century, the Japanese population may well become the oldest in the world. The Japanese government's concentration on post-World War II economic expansion meant that the government only fully woke up to the financial implications of having a large elderly population when oil prices were raised in the 1970s, highlighting Japan's economic dependence on global markets. This article explains the process by which policy regarding Japan's elderly developed both before and after these oil price increases. The measures of healthcare cost containment that the government introduced in response to the increased financial pressure are described, with a particular focus on pharmaceuticals. This article shows that the government has achieved a degree of success in terms of containing pharmaceutical costs, but that future effects on the quality of healthcare are uncertain. Ultimately, a wider application of a per diem fee in place of the prevalent fee-for-service system, and the realisation of plans to improve the social service infrastructure, would be the best path for policy to follow.

A case for the adoption of pharmacoeconomic guidelines in Japan.

In recent years, more and more Japanese pharmaceutical companies have been submitting pharmacoeconomic data to the government, following the official request that such data may help in setting pharmaceutical prices. The companies have cooperated because, by doing so, they could influence pricing decisions for new products. However, the quality of these data at present is considered to be poor and heavily biased. The introduction of pharmacoeconomic guidelines that outline a set of standardised factors to be included in evaluations are necessary, so that an appropriate comparison of the cost effectiveness of the many new drugs that are introduced into the Japanese market each year can be made. In addition to supporting the development of standardised guidelines, the Ministry of Health and Welfare should clarify how pharmacoeconomic data are to be used to aid policy decisions and also mandate the publication of pharmacoeconomic data.

Primary oral squamous cell carcinoma: a review of 92 cases.

PURPOSE: This is a retrospective review of 92 cases of oral squamous cell carcinoma treated by one department of oral and maxillofacial surgery. PATIENTS AND METHODS: The medical records of 92 patients with oral squamous cell carcinoma were reviewed, and standard epidemiologic data were obtained. In addition, cases were identified as to site, stage, risk behavior, histologic classification, primary and secondary surgical treatment, adjunctive therapy, and survival rates. RESULTS: The results indicate a higher-than-predicted 2-year survival rate. The association between alcohol and tobacco consumption and incidence of disease is supported. There was a correlation between tumor size and survival rate, but no correlation between histologic classification and prognosis. CONCLUSION: Mortality increases in relation to the stage at which the diagnosis of oral squamous cell carcinoma is made. Patients with stage III or IV lesions have a much poorer prognosis than those with stage I or II lesions. However, histologic classification and prognosis were not correlated.

Varying treatment strategies for reconstruction of maxillary atrophy with implants: results in 98 patients.

This report describes the outcome of maxillary implant reconstruction in 98 consecutively treated patients assigned to three groups based on the degree of maxillary atrophy as noted on radiographic examination and method of treatment. In group 1, 33 patients had 83 implants installed following sinus and/or nasal mucosal lift procedures. In group 2, 26 patients had 56 implants placed that penetrated the sinus and/or nasal cavities. The penetrating portion of the implant was covered with autogenous particulate bone harvested from the lateral aspect of the ipsilateral sinus. In group 3, 39 patients had 152 implants fixed to autogenous mandibular bone grafts placed either in the antral and/or nasal floors and/or as an onlay over the residual alveolar ridge. The age range of the patients was 15 to 76 years, with a mean of 56 years. Follow-up periods ranged from 12 to 58 months, with a mean of 26 months. Of the 291 implants installed, 19 have been lost. The importance of considering different treatment strategies when reconstructing the edentulous maxilla is discussed.

Oral submucous fibrosis. Case report and review of the literature.

A case history and brief literature review of oral submucous fibrosis is presented. This condition is most frequently found in the Indian subcontinent and only rarely encountered elsewhere. The aetiology is considered to be related to dietary habits and customs found in the population. The condition has a known malignant potential. With increasing migration to Australia from the Indian subcontinent the condition should be known and recognized by clinicians.

Langerhans cell disease associated with pathological fracture of the mandible.

A 27-year-old male suffered a fractured mandible following extraction of a tooth. It was subsequently found that the fracture occurred in an area pathologically weakened by a localized lesion of Langerhans cell disease. Since lesions of the jaws may be seen either as the first manifestation or as a complication of widespread Langerhans cell disease, the dentist has a major role in the diagnosis and management of such cases.

Monosodium glutamate-related orofacial granulomatosis. Review and case report.

A case is reported in a 15-year-old white girl who had a swollen lower face and lips; a diagnosis of orofacial granulomatosis was made. It was suspected that her condition had an allergic basis because an increase in clinical signs and symptoms was shown to be related to the food additive monosodium glutamate. Treatment with a restricted diet resulted in resolution of the facial swelling.

An intraoral splint for the prevention of microstomia from facial burns.

Microstomia may be a disfiguring complication of severe burn injuries of the soft tissues of the face. The constriction of the perioral myocutaneous tissues following such trauma poses several problems and usually necessitates major plastic and reconstructive intervention. A novel technique is described which limited the anticipated constriction of perioral tissues in a 21-year-old female who suffered full skin thickness burns to 65 per cent of her body, including her face, following a self-induced petrol burn.

Primary angiosarcoma of the oral cavity.

Primary malignant vascular tumours of the oropharynx are rare. This report is of a 69-year-old Vietnamese female with a malignant vascular lesion involving the floor of the mouth and the pharynx.

Regional macrodontia and regional bony enlargement associated with congenital infiltrating lipomatosis of the face presenting as unilateral facial hyperplasia. Brief review and case report.

Congenital infiltrating lipomatosis of the face (CIL-F) is a rare lesion. Presented here is a review of the literature concerning this condition, with the report of a case with clinical signs indistinguishable from those of unilateral facial hyperplasia. Previously unreported clinical and radiographic features of regional bony hypertrophy and macrodontia associated with this case of CIL-F are described and the proposition raised that previously reported cases of unilateral facial hyperplasia may have been due to CIL-F. It is suggested that the clinical findings in this case of facial asymmetry associated with CIL-F, regional macrodontia and regional bony enlargement may constitute a previously undescribed syndrome.

Familial hypocomplementemic hemolytic uremic syndrome with HLA-A3,B7 haplotype.

We describe a familial, relapsing type of hemolytic uremic syndrome (HUS) that has a possible genetic origin. Three members of a family, aged between 15 months and 34 years, evidenced HUS. Histological examination disclosed thrombotic microangiopathy. Recurrences, persistent hypocomplementemia, and the HLA haplotype A3,B7 were a common factor. We studied 17 members of this family and found a low C3 level from activation of the alternative pathway in the haplotype A3,B7 carriers. These three patients with HUS probably had a congenital and hereditary condition in which immunologic factors played a role in its pathogenesis.