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Background/purpose: Overlay restorations can be used clinically as a treatment option to preserve natural dentine. However, whether the residual enamel thickness and overlay thickness affect the adhesion between the restoration and tooth is still unknown. This study was to investigate effects of the overlay thickness and residual enamel thickness on bonding strength. Overlays of different thicknesses were prepared with natural teeth which had 2, 4, and 6 mm of occlusal reduction (n = 10). Specimens were subjected to 10,000 cycles in water at 5–55 °C, and finally compressive strength tests were used to evaluate the bonding strength. All groups showed good bond strength (P > 0.05). The overlay restorations of different thicknesses reduced the preparation amount by 30.3%–7.2% and significantly preserved more of the tooth structure (P < 0.005). Compared to the control group, the overlay restoration increased the marginal fitness by about 0.67–0.88 times. The thermal cycling indicated that the decrease in the maximum bearing stress was due to the aging of the ceramic itself. Therefore, the thickness of the overlay had a greater influence on the compressive strength than the bond strength. Based on the above this study recommends an overlay thickness of at least 2 mm in clinical practice. The aging test confirmed that adhesion between the overlay and teeth was quite firm and stable. This shows that a stable adhesive effect of the overlay can be used as a treatment option for preserving a greater amount of a tooth's structure. [ABSTRACT FROM AUTHOR]

Objective: Bereavement care is one of the major components of hospice palliative care. Previous studies revealed the barriers to the success of the system, including lack of time or support from mental health professionals. Few studies have explored the intrapersonal barriers to bereavement care by clinical staff. The aims of the study were to explore (1) the emotional and cognitive barriers of bereavement care by hospice palliative care staff and (2) the demographic and work characteristics related to these emotional and cognitive barriers.Method: The participants were clinical staff (n = 301) who were working in hospice palliative care units, including hospice wards, home care, and hospital-based palliative care teams. Their professional backgrounds included physicians (n = 12), nurses (n = 172), social workers (n = 59), psychologists (n = 34), spiritual care specialists (n = 15), and others (n = 9). A cross-sectional design was used and a standardized questionnaire including emotional and cognitive barriers was developed. Information on demographic and work characteristics was also collected. Content validity index, an exploratory factor analysis, and multiple regression analysis were conducted.Results: One emotional barrier, "negative emotional reactions" (13 items, Cronbach's α = 0.92), and three cognitive barriers, "lack of ability" (7 items, Cronbach's α = 0.85), "belief in avoidance" (5 items, Cronbach's α = 0.86), and "outcome expectancy" (4 items, Cronbach's α = 0.85) were identified. Clinical staff who had higher working stress, lower self-rated ability for bereavement care, and higher negative impact from major life loss tended to have higher emotional and cognitive barriers.Significance Of Results: Clinical staff should be aware of intrapersonal barriers to bereavement care. Educational programs should be developed to improve the ability to engage in bereavement care. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the relationship between health-related quality of life (HRQoL) and different cutoff value of low level of high-density lipoprotein cholesterol (HDL-C) in Taiwanese women with different definition of obesity. Methods: Prospective observational study in women with central obesity was conducted in Taipei City Hospital. A total of 572 women were screened at our clinic, and 227 of them with a body mass index ≧27 kg/m defined by the Department of Health in Taiwan and weight circumference ≧80 cm were eligible for the study. We defined two groups as group A-low HDL (HDL-C < 40 mg/dL) and group B-high HDL (HDL-C < 50 mg/dL) according to different definition of hypoalphalipoproteinemia in obese women. Results: Significantly reduced HRQoL score was noted in group A-low HDL compared to group A-high HDL (HDL-C ≧ 40 mg/dL), but not between group B-low HDL and group B-high HDL (HDL-C ≧ 50 mg/dL). Positively correlation was noted between HDL-C level and physical domain of HRQoL score. HDL-C contributes independently to physical domain of HRQoL score after controlling for other factors. Decreased leptin and adiponectin level were noted in hypoalphalipoproteinemia groups. Conclusion: Taiwanese obese women with hypoalphalipoproteinemia have adverse impact on HRQoL, especially when the HDL-C level is lower than 40 mg/dL. Both hypoalphalipoproteinemia and hypertension accounted for a great variance to lower scores of physical domain of HRQoL with positively correlation with HDL-C level observed. Decreased leptin and adiponectin were also observed in hypoalphalipoproteinemia group, which implied increased cardiovascular risk. HDL-C level may deem as another indicator for HRQoL in women with central obesity. [ABSTRACT FROM AUTHOR]

Abstract: The behavioral modeling of active devices using pathological nullor–mirror elements has shown advantages comparing with their representations using nullor elements only. In order to model the terminal characteristic of active devices containing current or voltage differencing properties, the pathological representations of current and voltage differencing cells are presented. Each proposed model includes the non-ideal effects of input and output parasitics and transfer characteristics. They are used to model some active devices with the consideration of their non-ideal effects. Symbolic nodal analyses (NA) using the non-ideal models of active devices are given to demonstrate the usefulness of the proposed models. [Copyright &y& Elsevier]

Simple Summary: This study is the first to estimate the impact of smoking-related chronic obstructive pulmonary disease (COPD) in patients with rectal adenocarcinoma undergoing curative resection. In these patients, current smokers with smoking-related COPD had worse survival outcomes than nonsmokers without COPD. Moreover, hospitalization for COPD with acute exacerbation within 1 year before diagnosis was an independent risk factor for OS in these patients, with a higher number of hospitalizations being associated with poorer survival. Purpose: The survival effect of current smoking-related chronic obstructive pulmonary disease (COPD) and COPD with acute exacerbation (COPDAE) is unclear for patients with rectal adenocarcinoma undergoing curative resection. Methods: We recruited patients with clinical stage I–IIIC rectal adenocarcinoma from the Taiwan Cancer Registry Database who had received surgery. The Cox proportional hazards model was used to analyze all-cause mortality. We categorized the patients into two groups by using propensity score matching based on COPD status to compare overall survival outcomes: Group 1 (current smokers with COPD) and Group 2 (nonsmokers without COPD). Results: In the multivariate Cox regression analyses, the adjusted hazard ratio (aHR; 95% confidence interval (CI)) of all-cause mortality for Group 1 compared with Group 2 was 1.25 (1.04–1.51). The aHRs (95% cis) of all-cause mortality for frequency of ≥1 hospitalizations for COPDAE or ≥2 hospitalizations within 1 year before diagnosis were 1.17 (1.05–1.51) and 1.48 (1.03–2.41) compared with no COPDAE in patients with rectal adenocarcinoma undergoing curative resection. Conclusion: In patients with rectal adenocarcinoma undergoing curative resection, being a current smoker with COPD (Group 1) was associated with worse survival outcomes than being a nonsmoker without COPD (Group 2). Being hospitalized at least once for COPDAE within 1 year before the diagnosis of rectal adenocarcinoma is an independent risk factor for poor overall survival in these patients, and a higher number of hospitalizations for COPDAE within 1 year before diagnosis was associated with poorer survival. [ABSTRACT FROM AUTHOR]