An estimated carbon footprint of NHS primary dental care within England. How can dentistry be more environmentally sustainable?

Introduction National Health Service (NHS) England dental teams need to consider from a professional perspective how they can, along with their NHS colleagues, play their part in reducing their carbon emissions and improve the sustainability of the care they deliver. In order to help understand carbon emissions from dental services, Public Health England (PHE) commissioned a calculation and analysis of the carbon footprint of key dental procedures.Methods Secondary data analysis from Business Services Authority (BSA), Health and Social Care Information Centre (HSCIC) (now called NHS Digital, Information Services Division [ISD]), National Association of Specialist Dental Accountants (NASDA) and recent Scottish papers was undertaken using a process-based and environmental input-output analysis using industry established conversion factors.Results The carbon footprint of the NHS dental service is 675 kilotonnes carbon dioxide equivalents (CO2e). Examinations contributed the highest proportion to this footprint (27.1%) followed by scale and polish (13.4%) and amalgam/composite restorations (19.3%). From an emissions perspective, nearly 2/3 (64.5%) of emissions related to travel (staff and patient travel), 19% procurement (the products and services dental clinics buy) and 15.3% related to energy use.Discussion The results are estimates of carbon emissions based on a number of broad assumptions. More research, education and awareness is needed to help dentistry develop low carbon patient pathways.

Modeling the flow in diffuse interface methods of solidification.

Fluid dynamical equations in the presence of a diffuse solid-liquid interface are investigated via a volume averaging approach. The resulting equations exhibit the same structure as the standard Navier-Stokes equation for a Newtonian fluid with a constant viscosity, the effect of the solid phase fraction appearing in the drag force only. This considerably simplifies the use of the lattice Boltzmann method as a fluid dynamics solver in solidification simulations. Galilean invariance is also satisfied within this approach. Further, we investigate deviations between the diffuse and sharp interface flow profiles via both quasiexact numerical integration and lattice Boltzmann simulations. It emerges from these studies that the freedom in choosing the solid-liquid coupling parameter h provides a flexible way of optimizing the diffuse interface-flow simulations. Once h is adapted for a given spatial resolution, the simulated flow profiles reach an accuracy comparable to quasiexact numerical simulations.

Phase-field modeling of grain-boundary premelting using obstacle potentials.

We investigate the multiorder parameter phase field model of Steinbach and Pezzolla [Physica D 134, 385 (1999)] concerning its ability to describe grain boundary premelting. For a single order parameter situation solid-melt interfaces are always attractive, which allows us to have (unstable) equilibrium solid-melt-solid coexistence above the bulk melting point. The temperature-dependent melt layer thickness and the disjoining potential, which describe the interface interaction, are affected by the choice of the thermal coupling function and the measure to define the amount of the liquid phase. Due to the strictly finite interface thickness the interaction range also is finite. For a multiorder parameter model we find either purely attractive or purely repulsive finite-ranged interactions. The premelting transition is then directly linked to the ratio of the grain boundary and solid-melt interfacial energy.

Stability and dynamics of droplets on patterned substrates: insights from experiments and lattice Boltzmann simulations.

The stability and dynamics of droplets on solid substrates are studied both theoretically and via experiments. Focusing on our recent achievements within the DFG-priority program 1164 (Nano- and Microfluidics), we first consider the case of (large) droplets on the so-called gradient substrates. Here the term gradient refers to both a change of wettability (chemical gradient) or topography (roughness gradient). While the motion of a droplet on a perfectly flat substrate upon the action of a chemical gradient appears to be a natural consequence of the considered situation, we show that the behavior of a droplet on a gradient of topography is less obvious. Nevertheless, if care is taken in the choice of the topographic patterns (in order to reduce hysteresis effects), a motion may be observed. Interestingly, in this case, simple scaling arguments adequately account for the dependence of the droplet velocity on the roughness gradient (Moradi et al 2010 Europhys. Lett. 89 26006). Another issue addressed in this paper is the behavior of droplets on hydrophobic substrates with a periodic arrangement of square shaped pillars. Here, it is possible to propose an analytically solvable model for the case where the droplet size becomes comparable to the roughness scale (Gross et al 2009 Europhys. Lett. 88 26002). Two important predictions of the model are highlighted here. (i) There exists a state with a finite penetration depth, distinct from the full wetting (Wenzel) and suspended (Cassie-Baxter, CB) states. (ii) Upon quasi-static evaporation, a droplet initially on the top of the pillars (CB state) undergoes a transition to this new state with a finite penetration depth but then (upon further evaporation) climbs up the pillars and goes back to the CB state again. These predictions are confirmed via independent numerical simulations. Moreover, we also address the fundamental issue of the internal droplet dynamics and the terminal center of mass velocity on a flat substrate.

Multiphase-field approach for multicomponent alloys with extrapolation scheme for numerical application.

A multiphase-field model previously proposed by the authors is reformulated in a thermodynamically consistent form and extended to multicomponent systems. The phase-field and diffusion equations, derived from a free energy functional, are compared to those postulated in the previous model in the limit of a binary alloy. The constraint of local quasiequilibrium, which is equivalent to the postulate of equal diffusion potentials for coexisting phases, is deduced from a variational principle. Solute partitioning and evaluation of the thermodynamic driving force for phase transformation are done by numerical minimization of the free energy of the multiphase system using the Calphad approach. A local extrapolation scheme which enhances the computational efficiency for complex numerical simulations of technical alloys is presented. It is shown that this extrapolation scheme, used in a "multibinary" approximation, reproduces the former model without restriction to dilute solutions.

Cognitive dedifferentiation in eidetics and synaesthesia: hunting for the ghost once more.

Both synaesthesia and eidetics have a common characteristic of cognitive dedifferentiation. Synaesthesia (e.g. colour-hearing) entails the dedifferentiation of the sensory modalities, while eidetic imagery entails the dedifferentiation of imagery and perception. One can profitably gain by investigating both within the same study. Moreover, some of the same issues have arisen in these, hitherto, separate research literatures. This behoves a common framework for analysis and investigation. We applied a technique previously used for identifying child eidetikers, for screening the adult population, looking at both phenomena in the same sample. After screening, we selected a total of twenty-nine individuals for controlled testing of both phenomena and their variants (structural eidetic imagery, typographic eidetic imagery, colour-hearing synaesthesia, colour-mood synaesthesia). Our participants also completed a number of questionnaires of relevance (absorption, dissociation, and hallucination). We found that the personality trait of absorption underlies the commonality of experience tapped by both typographic and structural eidetic imagery. Furthermore, the latter phenomena were found to have a common pseudohallucinatory experiential base. For subjects scoring relatively high on the absorption scale, there is a negative correlation between structural eidetic imagery and colour-mood synaesthetic differentiation, replicating to a degree results reported earlier.

Fetal liver transplantation in the dog. I. Restoration of hemopoiesis with cryopreserved fetal liver cells from DLA-identical siblings.

Fetal liver cells (FLC) were obtained from beagle fetuses 52 days postconception, and were cryopreserved prior to transplantation into ten sibling recipients that had previously been exposed to total-body irradiation delivered in 3 fractions of 6 Gy each at 4 days, 2 days, and 2 hr before grafting. Donors and hosts were genotypically identical for dog leukocyte antigens (DLA)-A, B, and D. A rapid and lasting engraftment was achieved in all animals following the transfer of 0.2 X 10(8) to 1.6 X 10(8) mononuclear FLC/kg body weight, which were equivalent to 0.9 X 10(4) to 19.8 X 10(4) granulocyte/macrophage progenitor cells (CFU-GM)/kg. Between days 14 and 20 posttransplant pretreatment levels were detected for blood granulocytes, between days 23 and 28 for circulating platelets, and between days 35 and 40 for the erythrocyte count and hemoglobin concentration. Increasing the number of CFU-GM transfused resulted in an accelerated granulocyte and platelet recovery. Bone marrow cells were of donor origin throughout the observation interval, but declining proportions of host lymphocytes circulated in the peripheral blood during the initial recovery phase. In two dogs, skin alterations that might indicate slight graft-versus-host disease (GVHD) were noted following days 20 and 70, respectively. Six recipients had to be sacrificed due to inanition, probably secondary to radiation-induced pancreatic insufficiency two to three months after grafting. The results of this study indicate that cryopreserved FLC are highly effective in restoring hemopoiesis in DLA-compatible sibling dogs. Transplantation of canine FLC may prove valuable in analyzing mechanisms pathogenetically related to graft rejection or to the development of GVHD following the transfer of T-cell-depleted hemopoietic grafts at a preclinical stage.

Stem cells from peripheral blood and bone marrow: a comparative evaluation of the hemopoietic potential in the dog.

The kinetics and pattern of hemopoietic recovery after supralethal total-body irradiation (TBI) were compared after transfusion of cryopreserved autografts derived from peripheral blood and bone marrow. Fractionated TBI was given in three doses of 6 Gy each at intervals of 48 h. Grafts of peripheral blood mononuclear cells (MNC) were collected by means of continuous-flow centrifugation and by using the mobilizing agent, dextran sulphate. Autografts were adjusted to contain equal numbers of committed progenitor cells (CFU-GM). Dogs grafted with blood-derived MNC (group A) and with MNC from bone marrow (group B) all received about 1 X 10(5) CFU-GM per kg body weight. In all dogs consistent hemopoietic engraftment was achieved. Comparing the pattern of regeneration of the granulocytes, group A dogs showed a significant regeneratory advantage over group B dogs, particularly during the first 20 days after transplantation. Lymphoid recovery was more rapid in group A until day 14. In both groups, blood lymphocytes remained below normal values beyond day 100. The regeneration patterns of the platelets and reticulocytes revealed no significant differences. These results are in agreement with the hypothesis that there are differences in the relationship between CFU-GM content and hemopoietic potential of autografts from different sources.

[Conversation contents in person centered conversation groups and their relationship with process variables in non-clients]. / Gesprächsinhalte in personenzentrierten Gesprächsgruppen und ihr Zusammenhang mit Prozessvorgängen bei Nicht-Klienten.

UNLABELLED: 90 persons of different professions and ages (18 to 85 years old) took part in a total of 9 person-centered encounter groups of 2 1/2 days each. The groups were completely tape-recorded (163 hours) and rated by experts into 7 categories of "contents-of-talking". These categories were correlated with process-variables (talking behaviour and individual problems of the participants). MAIN RESULTS: For 26% of the total time of these groups the participants talked about their problems about interpersonal relations. After these groups the participants stated that they had experienced relief in their dissatisfaction with own behaviour and emotional problems. They experienced this relief although they had talked relatively little about these problems.

Albumin density gradient purification of canine hemopoietic blood stem cells (HBSC): long-term allogeneic engraftment without GVH-reaction.

Long-term repopulation of the blood-forming organs of dogs, conditioned by wholebody X-irradiation (1200 R midplane dose), was achieved by transfusion of cryopreserved allogeneic blood mononuclear cells (MNC) without causing graft-versus-host-reaction (GVH-R). Donor and recipient dogs were DL-A identical, MLC-negative, no siblings, non-related. The blood stem cells (CFUc) were procured by a 3- to 4-hour continuous-flow leukapheresis. To increase the CFUc concentration in the peripheral blood, dextran sulfate (DS) was administered intravenously beforehand. About 1 x 10(10) MNC, among them about 1 x 10(7) CFUc, were collected and further segregated using a discontinuous albumin density gradient. Less dense cells were to be found in the upper part of the gradient (fraction 2). These cells included most of the CFUc, enriched by a factor of between 275 and 1730 compared to their concentration in the peripheral blood beforehand. After cryopreservation, these cells, when transfused into lethally irradiated dogs, completely repopulated the marrow and lymph nodes, caused no GVH-R and allowed long-term survival. These dogs received no immunosuppressive therapy, either before or after transfusion. More dense MNC were to be found in fraction 3; their transfusion caused a severe GVH-R, followed quickly by death. Fraction 4 was rich in lymphocytes and poor in CFUc. The transfusion of these cells produced a selective plasma-cell hyperplasia of the lymph nodes but failed to repopulate permanently the marrow. The reappearance of the different cell lineages in the marrow and in the peripheral blood after conditioning and transfusion of these cells produced a selective plasma-cell hyperplasia of the lymph nodes but failed to repopulate permanently the marrow. The reappearance of the different cell lineages in the marrow and in the peripheral blood after conditioning and transfusion of the segregated MNC is described in detail.

Morphologic alterations in canine marrow of long-term survivors after 1200 R whole-body x-irradiation and autologous blood leukocyte engraftment.

The marrow matrix of total-body x-irradiated dogs (1200 R midline dose) was able to support effective hemopoiesis for several hundred days if the animals were transfused with their own mononuclear leukocytes collected from the blood prior to irradiation and preserved at ultralow temperatures. However, a lesion developed in the marrow, consisting of a fibrosis originating in conjunction with or from the endosteum. The fibrotic tissue substantially reduced the available marrow space in dogs with advanced lesions. The number of autologous, cryopreserved mononuclear leukocytes transfused ranged from 0.32 X 10(9) to 1.63 X 10(9)/kg body weight. The observation period extended to a maximum of 898 days after irradiation.

[Psychic help for aged people of day-care-centers by attending person-centered encounter groups (author's transl)]. / Psychische Hilfe für Besucher von Altentagesstätten durch Teilnahme an personenzentrierten Encountergruppen.

UNLABELLED: 45 old people (Average age 72 years) took part in 9 person-centered encounter groups together with younger people (Average age 32 years). Psychological changes of the old people were collected by questionaires and compared to a control group of 38 old people who subsequently took part in 4 encounter groups without younger people. Excerpts from the encounter talks were rated in certain variables. MAIN RESULTS: delta The old people of the mixed aged encounter groups showed constructive psychological changes after participation, for example reduced feelings of loneliness, reduced stress with emotional problems, and they see ageing less resignative. The mixed aged encounter groups were more helpful for the old people than the groups without younger people. The old people of the mixed group were more emotionally occupied by their own person, they showed more self-exploration and self-acceptance, they talked with more emotional engagement about their experiences and were more genuine; 3 months later their self-disclosure in an interview with a stranger was higher.