Identifying components of recovery capital that support substance use disorder treatment completion.

Purpose: Individuals who do not complete substance use disorder treatment (SUDT) have similar outcomes to the untreated. Recovery capital (RC) is the collection of one's resources that contribute to the initiation and maintenance of sobriety. The aim of this paper was to identify individual measures of RC that are associated with SUDT completion. Methods: RC data for 69 residents from a men's recovery center was obtained from questionnaires administered to residents at intake and after SUDT graduation or dismissal. Participant data was divided into two groups, Graduates (n = 39, age 35.87±10.83) and Non-Graduates (n = 30, age 34.35±14.44), and retrospectively analyzed to compare RC between groups at various points during SUDT and which RC measures are associated with SUDT completion. Results: At baseline all participants reported limited RC and there was no significant difference in RC between groups. At graduation, Graduates reported significantly more RC in all measures when compared to baseline and Non-Graduates at dismissal. Non-Graduates reported a significant increase in Checking and Savings at dismissal but no other measure. Conclusion: Baseline levels of RC in both groups were limited and not significantly different which limited the capacity of the study to identify measures of RC associated with SUDT completion. A lack of RC at onset of SUDT did not preclude SUDT completion and obtaining RC during SUDT was associated with completion as only Graduates reported increases in RC. Future study designs should include participants with variable amounts of RC when entering SUDT.

MiR-382 targeting of kallikrein 5 contributes to renal inner medullary interstitial fibrosis.

Previously we have shown that microRNA miR-382 can facilitate loss of renal epithelial characteristics in cultured cells. This study examined the in vivo role of miR-382 in the development of renal interstitial fibrosis in a mouse model. Unilateral ureteral obstruction was used to induce renal interstitial fibrosis in mice. With 3 days of unilateral ureteral obstruction, expression of miR-382 in the obstructed kidney was increased severalfold compared with sham-operated controls. Intravenous delivery of locked nucleic acid-modified anti-miR-382 blocked the increase in miR-382 expression and significantly reduced inner medullary fibrosis. Expression of predicted miR-382 target kallikrein 5, a proteolytic enzyme capable of degrading several extracellular matrix proteins, was reduced with unilateral ureteral obstruction. Anti-miR-382 treatment prevented the reduction of kallikrein 5 in the inner medulla. Furthermore, the protective effect of the anti-miR-382 treatment against fibrosis was abolished by renal knockdown of kallikrein 5. Targeting of kallikrein 5 by miR-382 was confirmed by 3'-untranslated region luciferase assay. These data support a completely novel mechanism in which miR-382 targets kallikrein 5 and contributes to the development of renal inner medullary interstitial fibrosis. The study provided the first demonstration of an in vivo functional role of miR-382 in any species and any organ system.

A new and standardized approach for trocar placement in laparoscopic Roux-en-Y gastric bypass.

INTRODUCTION: Super-morbidly obese patients undergoing laparoscopic Roux-en-Y gastric bypass (LRYGB) present unique technical challenges. In our experience the ease of the operation and the operative time seem to be more dependent on body habitus than body mass index (BMI). We hypothesized that the distance between the xyphoid process and the umbilicus (the XU distance) correlated with surgical difficulty and described an original modification of trocar placement based on this measurement to improve the ease of the operation. METHODS: Seven hundred and seventy-four patients underwent LRYGB, and the XU distance was measured in a subset of 38 patients midway through the experience. The need for additional trocars was assessed intraoperatively and the relationship between the XU distance and the need for extra trocars was subsequently analyzed. A standardized approach for trocar placement was implemented in the second half of our series. The operative time was compared between the standardized and nonstandardized groups. RESULTS: Fifty percent of the patients required a five-trocar technique. Median XU distance in this group was 21.4 cm (range 17-25 cm). In the remaining 19 patients additional trocars were added; median XU distance was 27.3 cm (range 24-33 cm). From the 774 patients included in the study period, the operative time for the first 322 patients who were completed with a nonstandardized trocar approach was significantly longer than the subsequent 452 cases in which the standardized trocar approach was used (210 versus 173 min, p < 0.001). CONCLUSIONS: We define XU distance as the key element in determining the choice of trocar placement. When XU distance is less then 25 cm, the basic approach should be used and if it is greater than 25 cm, the advanced trocar approach is recommended. This standardized technique leads to decreased operative time and improved ease of operation.

Inductively coupled plasma-emission spectroscopy and atomic absorption for the use of elemental analysis of a root canal after lasing with a holmium:YAG laser.

It has been reported in the literature that after lasing dentin the dentin surface has a glassy or globular appearance. Many authors believe this to be recrystallized hydroxyapatite. The purpose of this elemental analysis was to see if any of the silica fiber optic was melted and deposited as these globular structures on the canal wall. Two teeth were used. One was hand-instrumented with files and used as the control, the other was lased with a holmium:YAG laser. A 245-micro low OH- fiber was used with a power setting of 0.75 W, 5 Hz, 94.2 J, and 1134 V to lase the root. The roots were microanalyzed for oxygen, phosphorus, silicon, nitrogen, hydrogen, calcium, and carbon. The percentages for all elements tested were the same for both teeth. Therefore, there was no silicon deposited onto the canal wall of the tooth that was lased. It is concluded that the low OH- silica fiber optic was not melted and deposited onto the dentinal canal wall.

Comparison instrumentation reamers and files versus a flat-sided design of conventional noninterrupted, flat-sided design.

The in vitro study measured the time required to instrument and shape canals by conventional reamers and files compared with a newly introduced reamer and file system. This experiment was divided into four groups with 10 block samples for each group. The results of instrumentation time demonstrate that the noninterrupted flat-sided design (EZ-Fill SafeSider reamers) produced the fastest times for comparably shaped canals because of reduced engagement of the instrument with the walls of the canal compared with conventional instruments. The conventional designs for both reamers and files result in increased instrumentation time compared with their EZ-Fill SafeSider counterparts.

The effects of eugenol and epoxy-resin on the strength of a hybrid composite resin.

The compatibility of different dental materials (root canal sealer and composite core build-up restoratives) is an important factor for a successful restoration. The aim of this in vitro study was to determine the effects on compressive and diametral tensile strength of a classical chemical cure composite resin (Henry Schein Composite Anterior-Posterior dental restorative) when in contact with either eugenol or an epoxy-resin (EZ-Fill) in a variety of situations: (a) eugenol or epoxy-resin added during mixing of a composite resin before curing; (b) vapor exposure to cured samples; and (c) specimens placed directly in eugenol or epoxy-resin (after curing). Compressive strengths and diametral tensile strengths were tested for each group. Only the addition of eugenol during mixing with the composite resin (directly before curing) resulted in specimens that were unable to be tested, because they did not achieve a full cure or hardness. For all other groups, there were no significant differences with respect to either compressive strength (p = 0.17) or diametral tensile strength (p = 0.39). Group 1 (mixed directly with eugenol) was found to be statistically different from groups 2 through 7.

The significance of ammonia/gamma-aminobutyric acid (GABA) ratio for normality and liver disorders.

Cohen has illustrated that extremely high Gamma-aminobutyric acid (GABA) levels in the urine and blood and high plasma ammonia were observed for an autistic male child diagnosed with infantile autism. GABA is a major inhibitory neurotransmitter of the mammalian brain and the enzyme responsible for catabolism is GABA-Transaminase (GABA-T). Elevated levels of ammonia in the plasma results in a decrease in the efficiency for the GABA-T enzyme and this results in higher GABA concentrations after regulation in the liver. It is postulated that a link between plasma ammonia and plasma GABA exists where the concentration of GABA in the plasma is directly related to the ammonia plasma concentration. A ratio of approximately 0.30 (plasma ammonia/GABA) is a consistent finding for normal subjects and for subjects with infantile autism and liver diseases such as hepatic encephalopathy.

Use of a GABA-transaminase agonist for treatment of infantile autism.

This paper describes the use of a GABA-transaminase agonist for the treatment of infantile autism. An approximate one third reduction of GABA and ammonia levels for an autistic patient with noticeable improvement of verbal/language skills and a reduction of repetitious ritualistic self-stimulatory behavior (stimming) was observed. A reduction of the plasma GABA (by administrating a GABA-T agonist, Imipramine) probably results in more axon(s)-to-oligodendrocyte signaling in the corpus callosum and it is postulated that this could result in a reduction of the autistic features for the patient.

A two-and-a-half year perspective on simplified endodontic techniques.

Simplified Endodontic Techniques (SET), along with EZ-Fill, a bidirectional spiral and epoxy root canal cement, have been used for more than 2 1/2 years. This particular sequence of instrumentation and obturation provides the dentist with predictable and easily attained success. Periapical areas demonstrate healing, and excess EZ-Fill cement is resorbing. Postoperatively, patients experience approximately 80% less pain in both occurrence and intensity. The adoption of SET, along with EZ-Fill, allows dentists to significantly increase their productivity while dramatically improving the quality of their work.

Post design and the optimally restored endodontically treated tooth.

The basics for the sound restoration of endodontically treated teeth have not changed despite the advent of new materials and techniques. Adequate retention for posts and crowns, resistance to cyclic shearing forces, minimal insertional stresses, and even distribution of functional stresses are prime requirements that cannot be compromised without jeopardizing the longevity of the final restoration.

Temperature change at the root surface when enlarging a root canal with a holmium: YAG (Ho:YAG) laser, using six different fiber-optic sizes.

This in vitro study was designed to determine if enlarging a canal with a holmium: YAG (Ho:YAG) laser (using six different-sized fiber-optic tips) would increase the change in temperature at the root surface and if fiber-optic tips spaced more closely would enlarge the canal more efficiently and consistently.

The application of batch extraction tests for the characterisation of solidified ferro alloy waste products.

Leach testing is arguably the best indicator of the effectiveness of pre-landfill treatments, including solidification/stabilisation (S/S), in reducing mobility of waste constituents. The results of leach tests can, however, also be interpreted to provide an understanding of the mechanisms via which toxic species are retained in the S/S product. An understanding of retention mechanisms contributes to the development of improved waste treatment systems. In this paper, we explore the applicability of four extraction tests, Pore Solution Expressions, the TCLP, the Equilibrium Extraction (EE) and the Sequential Chemical Extraction (SCE) for providing a description of the mechanisms of containment within an S/S product. The waste materials explored here are ferrochrome dusts with high levels of metals including Cr and Zn. The errors in results from the pore solution expressions and sequential chemical extractions were too high to draw any quantitative conclusions, although some qualitative comments could be made. The latter observations, however, were consistent with those from the other two tests, and together these build a comprehensive picture of the S/S products. For these specific products, it is suggested that a small amount (approximately 1%) of the Cr is Cr(VI) which is readily mobile, approximately 5% is Cr(III) which is mobile under acidic conditions and the remainder is a stabile chromite which is not readily mobile. For Zn, however, roughly equal proportions are contained as a species (possibly Zn(OH)2) whose release is pH dependent, and as a stable, immobile species on the surface of the dust particles.

La fuerza de fractura de tres tipos de materiales para el muñon en combinacion con tres espigas endodontiacales distintas / The fracture load for three diferent core materials supported by three different post

El propósito de este estudio fué el de determinar la carga causante de la fractura de tres tipos de materiales para el muñon, aguantado por tres sistemas distintos de espigas. El estudio se separó en nueve grupos distintos, conteniendo, cada uno, 10 muestras. Los especímenes se colocaron en una guía especial de sujección com un ángulo de 45 grados y luego se obtuvieron, com el aparato universal de examinación, los valores de la carga que causaron la fractura. Se utilizó un análisis factorial de variación de 3 x 3 (p<.0408) para examinar los efectos que tenían en la resistencia a la fractura el tipo de material del muñon y la clase de espiga. Los valores de la carga causante de la fractura de midieron en Libras, y los resultados fueron los siguientes: La espiga de Flexi-Post/Ti-Core, 204.9:la espiga de Vlok/Ti-Core, 218.8; la espiga de Parapost/Ti-Core, 164.8; la espiga de Flexi-Post/Tytin, 156.0; la espiga de Vlok/Tytin, 100.6; la espiga de Parapost/Tytin, 134.6; la espiga de Flexi-Post/Ketac-Silver, 69.4; la espiga de Vlok/Ketac-Silver, 50.4; y la espiga de Parapost/Ketac-Silver 37.7. El compuesto de titanio de Ti-Core tuvo los valores más altos de carga causante de fractura, mientras que el espécimen de ionómero de vidrio relleno de plata de Ketac-silver tuvo los más bajos. Las espigas de Flexi-Post y las microhiladas de Vlok obtuvieron los valores más altos de carga de fractura y las de Flexi-Post tuvo los más bajos. La espigas de Flexi-Post y las de Vlok tienen cabezas grandes y abultadas, lo que aparentemente facilitó la sujección del material del muñon a la espiga

Comparacion de las resistencias a las fuerzas opuestas ejercidas sobre los puntos de union de la dentina, que llevan un material de resina con un compuesto de titanio y agentes de enlace a la dentina, a los cementos de ionomeros de vidrio / A comparative study of the \"in vitro\" shear bond strength of an autopolymerizing composite resin system with two third-generation dentinal bonding agents to glass ionomer cements

Este estudio compara la resistencia a las fuerzas opuestas ejercidas in vitro sobre puntos de union a la dentina de un sistema de resina de compueso autopolimerizado (SRCA) (Ti-Core) que contiene dos agentes de tercera generacion de enlace a la dentina (AED) (Tenure y Scotchbond 2), a cementos de ionomero de vidrio (CIV) (Ketac-Silver, cemento de Vidrio (CV) Miracle Mix, y Ketac-Cem). El experimento se dividio en cinco partes. Se evaluaron en tres intervalos diferentes y con un aparato universal de examinacion las fuerzas opuestas ejercidas sobre los puntos de union a la dentina: intervalos de 15 minutos, 24 horas, y siete dias. Estadisticamente hablando, (analisis de variacion), las resistencias a las fuerzas opuestas ejerciads sobre los puntos de union a la dentina fueron, de mayor a menor: Ti-Core SRCA con tenure AED>Ti-Core SRCA with Scotchbond 2 AED > Ketac-Silver CIV, CV Miracle Mix CIV>Ketac-Cem CIV. No hubieron diferencias que dependieran del factor tiempo, y no existieron interacciones entre los grupos y el factor tiempo. La resistencia ofrecida ante las fuerzas opuestas ejercidas sobre los puntos de union a la dentina de Tenure AED con Ti-Core SRCA fueron de dos a tres veces mayores que las de los ionomeros de vidrio con relleno de plata, Ketac-Silver CIV y CV Miracle Mix CIV. Las de Tenure AED con TI-Core SRCA fueron mayores que las de Scotchbond 2 AED con Ti-Core SRCA. Esta tendencia fue en acuerdo con similares estudios realizados

Examen de la fatiga clínica de seis sistemas de espigas endodontiacales / Test of clinical stress of six endodonties prefabricated post systems

Este estudio examino la fatiga clinica comparativa de seis sistemas de espigas prefabricadas; Espigas Flexi-Post (Essential Dental Systems, South Hackensack, N.J>), Flexi-Flange (Essential Dental Systems), Vlock (Brasseler USA, Inc, Savannah, GA) Parapost (Whadedent/Coltene, New York, N.Y.), Cytco (L.D. Caulk, Milford, DE), y espigas AccessPost (Essential Dental Systems). Los metodos de examinacion de la fatiga clinica se consiguieron in vitro gracias a una maquina de fatiga que simulaba las condiciones clinicas de fatiga. Una fuerza instantanea de 5 libras se aplicaba a cada especimen de espiga y se hicieron anotaciones una vez que la espiga sufriese una ruptura. Si ningun tipo de ruptura ocurria, el examen se daba por terminado despues de 2,000,000 repeticiones. Los unicos disenos de espigas que no pasaron este tipo de prueba fueron el de Cytko y el de Vlock. Los disenos de espigas de Flexi-Post, Flexi-Flange, Parapost y AccessPost demonstraron tener una mayor resistencia al no mostrar problemas en este tipo de prueba de fatiga clinica. Este diseno experimental puede simular fuerzas de mordida y otros tipos de esfuerzos o estreses a los que una espiga se ve sometida en situaciones clinica