text:
|Publication number
|Publication type
|Application number
|Publication date
|Oct 3, 1995
|Filing date
|Aug 9, 1994
|Priority date
|Aug 9, 1994
|Fee status
|Publication number
|Rollin F. Christopherson
|Original Assignee
|Christopherson Group
|Export Citation
|BiBTeX, EndNote, RefMan
|Patent Citations (20), Referenced by (29), Classifications (9), Legal Events (4)
|External Links: USPTO, USPTO Assignment, Espacenet
This invention relates to a vehicle shock absorber, and particularly to a means for dampening the action of vehicle's suspension travel.
The novel concept of this invention adopts functions similar to those of the dampening shock absorber described and claimed by the present inventor in his Christopherson U.S. Pat. No. 4,736,931. As disclosed therein, the shock absorber configuration provided a retrofit of a spring assembly to a conventional gas charged or hydraulic shock or strut that involved an outer sleeve telescoped over an inner sleeve containing a piston movable against hydraulic or gaseous resistance. The patented spring assembly consists of a coil spring surrounding a tubular sleeve in telescoping relationship with a conventional tubular shock absorber configuration, a pair of oppositely disposed longitudinal grooves in the outer tubular sleeve, and oppositley disposed pairs of spring retaining clips each having inwardly projecting bosses or fingers slidably received by the respective grooves, and further including outwardly extending flanged areas arranged to receive the coil spring. Longitudinally spaced retaining rings are each secured around the inner shock absorber sleeves to act as stops for the respective spring retainer clips. Another embodiment of the patent provides an adjustable collar positioned between a retaining clip and its end of the coil spring. The spacing between retaining clips may thereby be changed to provide preload adjustment of the compressive force exerted by the coil spring against the collar.
It has been observed that the primary factor in vehicle ride control is the vehicle spring rate. Spring rate has been defined as pounds/deflected inch. Using coil suspension for purposes of illustration, a soft spring would need to be deflected more than a stiff spring to support a given vehicle weight. Consequently, a soft spring has a longer free length than a stiff spring. When two identical vehicles of equal ride height are compared, soft springs on one and stiff springs on the other, the ride height will be maintained with both vehicles being driven in a straight line on level pavement. However, under roll and pitch conditions, control would be better in the stiffly sprung vehicle, because stiff springs unload sooner.
For a better understanding, specific terminology has been used for purposes of the following discussion. "Roll" refers to tilting of the vehicle's sprung mass (passenger space and vehicle body) when cornering. Roll is caused by the extension and/or compression of the vehicle's main suspension springs above or below resting ride height (equilibrium). Equilibrium, in this case, being the neutral resting ride height resulting from the weight of the sprung mass (passenger, cargo, body, trim, etc.) as supported by suspension springs. Roll has traditionally been controlled by so-called sway bars. "Pitch" refers to rocking the vehicle front to back. This is usually caused by road anomalies. Pitch has traditionally been controlled by conventional shock absorbers. Sway bars have no effect on pitch. "Float" or "bounce" refers to undesirable extension of the suspension system past normal ride height. This condition is also caused by road anomalies. Here again, sway bars have no effect on control of the vehicle.
Standard shock absorbers without "negative boost" allow the center of gravity to shift to an angle which may cause discomfort to the driver and passengers, and materially affect control of the vehicle. This shift is particularly true during a roll while the vehicle is cornering. In a vehicle such as a van or step-van emergency medical transport, where the center of gravity is relatively high, roll may interfere with the attempts to stabilize emergency patients. Rollovers have been known to occur during cornering, where vehicle suspension has not been considered carefully. Two factors are responsible for this condition. The most obvious factor--stiff springs support more weight in a given amount of spring travel than do soft springs. This condition, for example, will occur on the outside of a turn. The less obvious factor lies in the fact that, since soft springs have a longer free length, they will continue to lift more when cornering. This condition occurs on the inside of a turn.
It will be apparent that the distance traveled by the load to reach equilibrium is greater in a soft sprung vehicle than in a stiffly sprung vehicle. The travel distance required to load the springs (suspend) is the greatest factor in most ride control problems relating to pitch, roll or float conditions.
The improved dampening shock absorber of this invention provides a neutral zone travel area affording a softer ride during straight road cruising on a level surface. The improvement also provides negative boost (pull-down) to the shock absorbers when the vehicle (sprung mass) tends to lift beyond resting ride height, i.e., during cornering wherein the inside springs unload, lifting the vehicle (sprung mass) while the outside springs compress below resting ride height. The opposite action occurs during positive boost (pushup) of the dampening feature of the invention wherein the vehicle's suspension compresses below a pre-established neutral zone travel.
Shock absorbers with dampening features further contribute towards compensation for uneven load suspension distribution caused by applying trailer hitch loads. In such case, the rear suspension is subjected to forces causing the front end of the vehicle to lift and thereby allow the front springs to lift the vehicle (sprung mass) above resting ride height. At the same time, the load on the rear wheel suspension is increased, thereby lowering the vehicle (sprung mass) to a position below resting ride height.
Advantages of providing both negative and positive boost dampening systems to conventional hydraulic and gaseous shock absorbers may be found in the novel configuration provided by this invention. The principal advantageous lies in a novel assembly which may be faciley and inexpensively manufactured and fabricated. The overall design differentiates from the past dampening systems, including the device described and claimed in the previous Christopherson patent. Christopherson U.S. Pat. No. 4,736 931 disclosed a configuration providing similar functions not entirely unlike those provided by the device of the present invention, However, dampening shock absorbers manufactured in accordance with the teachings of Christopherson presented difficulties in manufacture and fabrication. The operating parts require separate relatively complex pressing, notching and stamping techniques. Assembly also requires special forming and assembly tools. Specially designed jigs and fixtures. Are required for temporarily compressing the coil spring during insertion of spring retainers. These factors each contribute to frustration and time consuming efforts upon assembly operating personnel.
The present configuration permits convenient and facile retrofit to a conventional a tubular shock absorber. The shock absorber housing is enclosed across one end, and is partially enclosed at its opposite end to slidably receive a longitudinally extending piston rod. The present configuration provides an outer sleeve for telescoping over the tubular housing. A coil spring and a spring retainer assembly are provided, with the spring being disposed circumjacent to the tubular housing and retained at one end with a simple a cuplike spring retainer member that also surrounds the tubular housing. A flanged, washerlike retainer member serves to hold the coil spring at its opposite end. Suitable stop means are provided to limit motion of the outer sleeve and coil spring as required to provide desired compensating and dampening effects.
FIG. 1 is a graphic representation viewed from the rear end of a vehicle having a conventional shock absorber suspension system, and illustrating effects of cornering on that system.
FIG. 2 is a graphic representation also viewed from the rear end of a vehicle, and illustrating the effects of cornering after installation of a shock absorber suspension system made in accordance with the present invention.
FIG. 3 is a perspective view of the external features of a dampening shock absorber of this invention.
FIG. 4 is an exploded view, divided into three sections, and illustrating, in detail, the various interrelating components of an embodiment of a shock absorber of this invention.
FIG. 5 is a longitudinal view, partly in section, of the assembled shock absorber of FIG. 4.
FIG. 6 is a fragmentary sectional view illustrating the arrangement of components, including the cuplike spring retainer member of the embodiment of FIGS. 4 and 5.
FIGS. 7-10, inclusive, are outline representations of the dampening shock absorber of this invention, with certain details removed to more clearly illustrate the relationship of interacting components during various operating conditions affecting operation of the shock absorber of this invention.
FIG. 11 is a fragmentary sectional view of the upper end of another embodiment of this invention, and showing means of adjusting positive boost engagement point and the neutral zone which adjusts for vehicle ride stiffness.
FIG. 12 is a fragmentary longitudinal view of still another embodiment of this invention which may be used to adjust negative boost, which compensates for vehicle ride height differences, or may be combined with the embodiment of FIG. 11.
FIG. 13 is a cross sectional view taken along lines 13--13 of FIG. 12.
FIGS. 1 and 2 have been submitted as an aid in understanding the functioning of the various components of the dampening shock absorber of this invention. FIG. 1 illustrates the condition of the suspension system of a conventional motor vehicle V, as the vehicle "corners" during a left-hand turn. This condition is known as "Roll", wherein the inside springs S1 unload and lift the vehicle body, and their respective shock absorbers S3 extend. At the same time, the outside springs S2 compress along with their respective shock absorbers S4 via action of centrifugal forces exerted upon the vehicle V during cornering.
Next, referring to the view of FIG. 2, it will be observed that the vehicle V has been stabilized during cornering by the interaction of the components of the dampening shock absorbers S3 and S4, as will hereinafter be explained. That is, during cornering to the left, the roll (lift) at the left side of the vehicle V is immediately compensated by "negative boost" (pull-down) exerted by the shock absorber S3, whereas the compression on the right side of the vehicle's suspension is compensated by "positive boost" (push-up) engaging the interacting components after neutral zone travel.
The view of FIG. 3 illustrates the compact, fully assembled embodiment of the improved dampening shock absorber 10. This embodiment may be retrofitted to a conventional hydraulically or pneumatically operated shock absorber 11 terminating at its lower end mount 12. An upper mount 13 is secured to both the distal end of a reciprocating piston rod (not shown in this view) and to the upper end cap 14 of a telescoping outer protective sleeve or dust cover 15.
The interacting and operating components of the shock absorber 10 will next be described with particular attention to the views of FIGS. 3, 4 and 5. As stated previously, the components may be retrofitted to a conventional shock absorber 11, which may be either a hydraulic or gas charged device.
The shock absorber 11 contains the usual piston rod 18, shown in extended position in FIG. 5, and having its upper end secured by welding or other means to an upper mount 13. A cap 19 is also secured to the upper end of a piston rod 18 by welding, and is further secured to a partially enclosed endwall (positive boost surface) 20, as well as being secured by welding to the outer sleeve 15. The tubular outer sleeve 15 is shown with an annular cross section. However, the cross section of the sleeve 15 may be of any suitable configuration adaptable for slidably receiving the shock absorber body 16. The lower, open end of the sleeve 15 may be formed as an inwardly projecting flange 21 by either a metal spinning or metal drawing operation, and thereafter stamping and/or coining an opening 22 for slidably receiving the shock body 16. The endwall 20 serves as a stop or contact point for an upper noise dampening thrust washer 23 slideable within the telescoping, tubular outer sleeve 15 and surrounding the piston rod 18 to control and limit "positive boost", as will hereinafter be described.
A tubular intermediate sleeve (lower spring stop) 24 surrounds the shock body 16 and may be secured to the lower end thereof by means welding, crimping, sweating or similar securing means. The sleeve 24 is provided with an outwardly extending flange 25 to provide a bottom stop or rest for supporting a lower spring retainer 30. The retainer 30 is preferably fabricated from an appropriate plastic material. A lower noise dampening thrust washer member 31 is preferably disposed between the flange 25 and the lower surface of the spring retainer 30 to provide sound and impact insulation. It will be noted that the retainer 30 is provided with an aperture 32 for slidable relationship with the shock body 16, and is further formed with a shoulder portion 33 for receiving the inner diameter of the coil spring 35. The coil compression spring 35 is preferably ground flat at both ends 36, 36' to seat squarely and maintain the column traveling straight during operation thereof.
The upper end portion of the coil spring 35 surrounds a cuplike spring retainer 37, and seats against a non-metallic retainer washer 38. The compression coil spring 35 and washer 38 are retained by the outwardly extending flange 40 of the retainer 37. As shown in FIG. 5, the noise dampener washer 23 is attached against the upper surface of the flange 40. The lower end of the cuplike spring retainer 37 is flanged inwardly at 41 to define an opening for slidably receiving the shock absorber body 16. The cuplike spring retainer 37 is retained against the upper bias of the coil spring 35 by engagement of the flange 41 and an outwardly extending annular ring 42 secured by weldment 43 (See FIG. 6) to the outer surface of the body 16. It is also preferred, in this case, to provide a sound insulating washer 44 interposed between the inturned flange 41 of the upper retainer member 37 and the ring 42.
Operation of the dampening shock absorber will next be explained with reference to FIGS. 7-10, inclusive. FIG. 7 shows the assembly at rest with the components positioned relative to one another at an initial setting h, known as the "neutral zone". The height h establishes room for neutral zone travel to allow for unaffected compressive suspension travel desired during constant, minor road surface fluctuations encountered during straight ahead cruising. The initial height adjustment may be made on site, or as a retrofit, as will later be explained in connection with another embodiment of this invention. The relationship between the relative positioning of the components as shown FIGS. 7 and 8 demonstrates the shock absorber traveling through the neutral zone. The comparison further shows how the shock absorber 11 allows the vehicle a smooth ride unaffected by the coil spring 35.
FIG. 9 is illustrative of the relative position of operating components when the vehicle turns, starts, stops, or encounters a bump or pothole. Here, "positive boost" will be achieved by operation of the dampening coil spring. The piston (not shown) and its piston rod 18 of the shock absorber 11 will have previously been forced downwardly relative to the position shown in FIG. 8. Also shown in the view of FIG. 8, the upper noise dampening thrust washer 23 will be forced against the abutment provided by the endwall stop 20 of the tubular outer sleeve 15. Since the piston rod 18 is secured to the outer, telescoping sleeve 15, the sleeve 15 will be forced downwardly relative to the shock absorber body 16. Continued downward movement of the piston rod 18 and the outer sleeve 15 will provide positive boost to the vehicle by compressing the dampening coil spring 35 to the position shown view of FIG. 9. It will be further noted that the shock absorber 11 has been moved upwardly relative to the sleeve 15, with the upper noise dampening thrust washer 23 and the upper retainer member 37 being in abutting relationship with the endwall stop 20.
The view of FIG. 10 illustrates the relationship of the operating components during cornering of the vehicle, and as this action affects the suspension unloading against the inside corner sprung mass of the vehicle. The piston rod 18 and the attached outer sleeve 15 have each risen relative to the top of the flange 25 of the lower spring stop 24. This action results in a negative boost (pull-down action), which counteracts the lift of the unloading vehicle spring on the inside suspension system and pulls down on the sprung mass.
Thus, when a vehicle is placed on a flat road surface, the main vehicle supporting springs S1, S2 (See FIGS. 1 and 2) are compressed to a point where they each suspend the vehicle weight in a state of equilibrium (FIG. 7). Ride anomalies, such as pitch, roll or float, materially affect this state of equilibrium. The device of this invention opposes the lifting motion of the vehicle suspension springs in an effort to maintain level (horizontal) trim. This is accomplished by negative boost action provided by the respective coil springs in their effort to reach full length, thus opposing the lifting action upon the vehicle.
Another embodiment of the invention is exemplified with reference to the views of FIGS. 11-13, inclusive. On site positive boost adjustments and negative boost adjustments at ride height adjustment may be made with the aid of one or more camming mechanisms. These mechanisms have particular application to retrofitting existing vehicles, and to vehicles adapted, after manufacture, for application of trailer hitches and other means of change of pre-established road height parameters. In the case of using either, or both, modifications of FIGS. 11 and/or 12, it will be observed that the outer sleeve 15 is slotted to respectively provide camming ramps 46,46'.
In FIG. 11 the periphery of the sleeve 15 is provided with one or more inclined slots 46 at its upper end, each slot being arranged to receive an adjustment screw 47 threadingly engaging an internally disposed annular ring 48. The ring 48 may be moved upwardly or downwardly as the annular ring 48 is rotated. With the screw 47 in the loosened position, the screw shaft 49 acts as a cam follower riding the inclined plane or ramp provided by the inclined slot 46. The annular ring 48 thereby serves to raise or lower the stop means, formerly provided in the configuration of FIGS. 3-5, inclusive. The movement limits are shown in phantom lines in both embodiments respectively presented in the views of FIGS. 11 and 12. The camming movement provides adjustable means interposed between the original stop means provided by the endwall 20 and the noise dampening thrust washer 23. This adjustment provides readily accessible means for adjusting the positive boost at, depending upon weight of vehicle. The same type of adjustment for negative boost at ride height may be provided by positioning the inclined slot 46' in the lower end of the sleeve 15. One, or both slots 46,46' may be provided as desired.
While preferred embodiments of the present invention in a dampening shock absorber have been shown and described herein, it should be understood that this disclosure is made by way of example only. Variations to the structure of the invention and to its use are possible without departing from the subject matter coming with the scope of the following claims, which claims I regard as my invention.
|Cited Patent
|Filing date
|Publication date
|Oct 23, 1914
|Apr 4, 1916
|Joseph Jacques Jules Sauveur
|Jun 2, 1953
|Jul 24, 1956
|Girling Ltd
|Rear wheel suspensions for motorcycles
|May 25, 1964
|Nov 30, 1965
|Amsted Ind Inc
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|Apr 22, 1966
|Mar 12, 1968
|Axel Tell Sven
|Jul 7, 1969
|Sep 7, 1971
|Chapman Performance Products I
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|Feb 6, 1978
|Mar 20, 1979
|Monroe Auto Equipment Company
|Vehicle suspension device
|Oct 21, 1977
|Jan 15, 1980
|General Electric Company
|Spring buffer
|Jul 22, 1981
|Sep 20, 1983
|Oleopneumatic suspension with variable throttle orifices, especially for aircraft landing gear
|Dec 7, 1981
|Sep 27, 1983
|Sexton Enterprises, Inc.
|Safety stabilizer for vehicle steering linkage
|Mar 9, 1983
|Jun 4, 1985
|Maremont Corporation
|Series spring shock absorbers
|Oct 3, 1986
|Apr 12, 1988
|Christopherson Rollin F
|Dampening shock absorber
|Jun 10, 1987
|Jan 10, 1989
|Fritz Bauer & Sohne Ohg
|Gas spring with end position damping
|Oct 9, 1987
|Apr 4, 1989
|Paton H N
|Suspension system
|Jan 29, 1988
|Apr 18, 1989
|Sexton Enterprises, Inc.
|Single spring safety stabilizer for vehicle steering linkage
|Jun 10, 1987
|May 2, 1989
|Hollingsworth (U.K.) Limited
|Vibration damper
|Jul 29, 1985
|Dec 12, 1989
|Nhk Spring Co., Ltd.
|Vehicle suspension device with a coil spring embedded in an open cell foam
|Nov 25, 1988
|Nov 27, 1990
|Herman Hemscheidt Maschinenfabrik Gmbh & Co.
|Hydraulic shock-absorber and vibration damper with adjustable damping
|Oct 10, 1989
|Mar 5, 1991
|Dr. Ing. H.C.F. Porsche Ag
|Wheel suspension
|Title not available
|Title not available
|Citing Patent
|Filing date
|Publication date
|Jun 8, 1998
|Oct 5, 1999
|Shaffer; Theodore E.
|Vehicle shock absorber assembly having height adjustment
|May 13, 1999
|May 29, 2001
|John D. Shepherd
|Motion stabilizer
|Jan 16, 2001
|May 7, 2002
|Joe Morrow
|Apparatus for retrofitting height and load adjustable air spring to coil spring based Mac Pherson strut
|Aug 28, 2000
|Jun 25, 2002
|Allen L. Eng
|Cab suspension system for terminal tractors
|Jan 12, 1998
|Oct 7, 2003
|Colibert Enterprises
|Load leveling weight distributing hitch
|Sep 7, 2005
|May 15, 2007
|Big Shot Performance, Llc
|Protective sleeve for adjustable shock absorber
|Jan 29, 2007
|Sep 16, 2008
|Gaylen Ercanbrack
|Cushioned elliptical exerciser
|Sep 13, 2004
|Mar 24, 2009
|Colibert Enterprises
|Load-leveling, weight-distributing hitch system
|Feb 23, 2006
|Mar 16, 2010
|Barnes Group Inc.
|Force control strut
|Sep 19, 2006
|Mar 1, 2011
|Kayaba Industry Co., Ltd.
|Spring force adjusting device for a hydraulic shock absorber
|Apr 30, 2008
|Jan 3, 2012
|Moximed, Inc.
|Adjustable absorber designs for implantable device
|Aug 30, 2010
|Dec 10, 2013
|Platinum VIP, Inc.
|Cup device for additional suspension
|Nov 22, 2011
|May 6, 2014
|Douglas Hunter Powell
|Long travel shock absorber
|Aug 7, 2012
|Sep 9, 2014
|Hendrickson Usa, L.L.C.
|Cylinder shock assembly
|Mar 12, 2014
|Jan 3, 2017
|Moximed, Inc.
|Implantation approach and instrumentality for an energy absorbing system
|Aug 20, 2014
|Jun 27, 2017
|Cnh Industrial America Llc
|Spring guide
|Sep 13, 2004
|Mar 17, 2005
|Colibert Enterprises
|Load-leveling, weight-distributing hitch system
|Sep 19, 2006
|Mar 22, 2007
|Kayaba Industry Co., Ltd.
|Spring force adjusting device for a hydraulic shock absorber
|Jan 29, 2007
|May 31, 2007
|Gaylen Ercanbrack
|Cushioned elliptical exerciser
|Dec 1, 2006
|Jun 7, 2007
|Mando Corporation
|Dust cover and shock absorber having the same
|Feb 23, 2006
|Aug 23, 2007
|Barnes Group Inc., A Corporation Of Delaware
|Force control strut
|Apr 30, 2008
|Nov 6, 2008
|Exploramed Nc4, Inc.
|Adjustable absorber designs for implantable device
|Dec 11, 2008
|Apr 2, 2009
|Richard Bugaj
|Shock absorber
|Jan 25, 2010
|May 20, 2010
|Barnes Group Inc.
|Force control strut
|Aug 30, 2010
|May 3, 2012
|Hoang Minh Nguyen
|Cup device for additional suspension
|Mar 12, 2014
|Sep 18, 2014
|Moximed, Inc.
|Implantation Approach and Instrumentality for an Energy Absorbing System
|Mar 10, 2016
|May 18, 2016
|Large-tonnage elasticity-damping composite damping device
|Jun 15, 2006
|Dec 20, 2006
|WP Suspension B.V.
|Spring device for a motor vehicle, having a compression spring with a variable spring characteristic
|Feb 8, 2000
|Aug 17, 2000
|Shepherd John D
|Motion stabilizer
|U.S. Classification
|267/221, 188/322.16, 267/34, 188/322.12
|International Classification
|Cooperative Classification
|European Classification
|Jun 12, 1995
Owner name: CHRISTOPHERSON GROUP, WISCONSIN
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:CHRISTOPHERSON, ROLLIN F.;REEL/FRAME:007518/0582
Effective date: 19950524
|Apr 27, 1999
|Maintenance fee reminder mailed
|Oct 3, 1999
|Lapse for failure to pay maintenance fees
|Dec 14, 1999
|Expired due to failure to pay maintenance fee
Effective date: 19991003


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EMO Orodjarna was present at the fair Forma Tool 2011, which took place from 12/4/ to 15/4/2011 in Celje. Our showroom was visited by the Minister of the Economy, Mrs. Radič.
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Valid estimation of dental treatment needed at population level is important for service planning. In many instances, planning is informed by survey data, which provide epidemiologically estimated need from the dental fieldworkers' perspective. The aim of this paper is to determine the validity of this type of information for planning. A comparison of normative (epidemiologically estimated) need for selected treatments, as measured on a randomly-selected representative sample, is compared with treatment actually provided in the population from which the sample was drawn.
This paper compares dental treatment need-estimates, from a national survey, with treatment provided within two choice-of-dentist schemes: Scheme 1, a co-payment scheme for employed adults, and Scheme 2, a 'free' service for less-well-off adults. Epidemiologically estimated need for extractions, restorations, advanced restorations and denture treatments was recorded for a nationally representative sample in 2000/02. Treatments provided to employed and less-well-off adults were retrieved from the claims databases for both schemes. We used the chi-square test to compare proportions, and the student's t-test to compare means between the survey and claims databases.
Among employed adults, the proportion of 35-44-year-olds whose teeth had restorations was greater than estimated as needed in the survey (55.7% vs. 36.7%;p <0.0001). Mean number of teeth extracted was less than estimated as needed among 35-44 and 65+year-olds.
Among less-well-off adults, the proportion of 16-24-year-olds who had teeth extracted was greater than estimated as needed in the survey (27.4% vs. 7.9%;p <0.0001). Mean number of restorations provided was greater than estimated as needed in the survey for 16-24-year-olds (3.0 vs. 0.9; p <0.0001) and 35-44-year-olds (2.7 vs. 1.4;p <0.01).
Significant differences were found between epidemiologically estimated need and treatment provided for selected treatments, which may be accounted for by measurement differences. The gap between epidemiologically estimated need and treatment provided seems to be greatest for less-well-off adults.
Valid estimation of the dental treatment needed at population level is important for service planning. In many instances, planning is informed by survey data, which provide epidemiologically estimated need from the dental fieldworkers' perspective. The aim of this paper is to determine the validity of this type of information for planning. Normative (epidemiologically estimated) need for selected treatments, as measured on a randomly-selected representative sample, is compared with the treatment actually provided in the population from which the sample was drawn.
Commonly defined as the 'capacity to benefit' [1], need is considered a key variable in explaining differences in utilisation of health services [2]. Four models of dental needs have been suggested: professionally-defined need (normative or evaluated need), perceived need, expressed demand, and realistic need [3]. The dimension of need recorded by clinicians in epidemiological surveys is 'normative need', defined by Bradshaw (1972) as that "which the expert or professional, administrator or social scientist defines as need in any given situation. A 'desirable' standard is laid down and is compared with the standard that actually exists - if an individual or group falls short of the desirable standard then they are identified as being in need" [4]. It is regarded as most accurate when determining the need for simple dental restorations [5]. Evaluated need "represents professional judgement about people's health status and their need for medical care" [6]. Normative (epidemiologically estimated) need does not capture the patients' perspective. Translation of need to treatment provided requires action on the part of the patient. This action is the accumulation of a number of behavioural factors initiated by the patients' recognition or awareness of the problem. Perceived need, reported by individuals, explains care-seeking behaviour, while evaluated need describes the type and amount of treatment that will be provided following assessment of need by the health care provider and consultation with the patient to determine their wants [6].
The two main arrangements that exist for dental care provision for adults in Ireland are the Dental Treatment Benefit Scheme (DTBS) under the Treatment Benefit Scheme operated by the Department of Social Protection, and the Dental Treatment Services Scheme (DTSS) operated by the Health Services Executive. The DTBS, established in the 1952 Social Welfare Act, is a social insurance arrangement through which individuals make Pay-Related Social Insurance (PSRI) contributions; both the employee and employer contribute. Employed adults and retired people, who have sufficient social insurance contributions, and their spouse/partner, were, until 1st January 2010, entitled to receive an annual oral examination, and prophylaxis, every six months, free of charge. In addition, they were entitled to other treatments (such as fillings, extractions and dentures) at a subsidised rate as often as required; prices for some treatments were fixed while others were set by the dentist. The proportion of the cost paid by patients ranged from 31% for X-Rays and surgical extractions (prices set by the Department of Social Protection) to approximately 96% for crowns (prices set by the dentist). This scheme is now restricted to one free annual oral examination.
The DTSS was introduced on a phased basis between 1994 and 2000, beginning with priority for routine and denture treatment for 65+ year-olds, and emergency pain relief for all eligible adults. It provided free dental care to medical card holders until April 2010, when priority was given to emergency dental care with a focus on relief of pain and sepsis. Most individuals aged 16years or over obtain a medical card if their income is below a certain level, if the cost of meeting medical needs causes a person financial hardship, or if they have an entitlement under EU regulations. The aim of establishing the DTSS was to provide dental services to adult medical card holders to improve their oral health [7]. A greater range of treatments were provided in the DTBS (employed and retired adults) than the DTSS (less well-off adults).
One of the approaches to measuring the impact of these schemes on the oral health of the population is through periodic national surveys of adult oral health. Many surveys add a clinical estimation of treatment need to the record of oral health status, where the examiner first records the condition of the teeth and then records any treatment required (in their clinical opinion). The examining dentist does not have recourse to diagnostic aids such as radiographs to support the clinical examination. This is recognised to be an underestimate, the extent of which is unknown. Analyses of such epidemiological data are used in planning and evaluating services in many countries. Given the methodological difference in the clinical examinations, the frequently low response rate to such surveys, and the fact that evaluated need depends on service utilisation, the validation of these data in estimating treatment need should be explored.
Other studies have compared epidemiologically assessed treatment need with treatment provided within one service [8-10]. However, there are no reports of comparisons between epidemiologically estimated treatment need and treatment provided in two schemes serving different socioeconomic groups in the same population assessed in the same epidemiological survey. In this paper, need for oral health services, as estimated for a representative random sample in a national survey of adult oral health, is compared with actual treatment statistics derived from two dental schemes serving different sectors of the same population. The aim of this paper is to compare epidemiologically estimated oral health treatment need, with treatment provided, as measured from administrative databases, for selected treatments. The comparison is undertaken for two schemes targeted mainly at employed and less well-off adults. The relative relationship between epidemiologically estimated need and treatment provided for employed and less well-off adults is explored.
The Department of Social Protection maintains databases of claims for all dental treatments provided under the DTBS, and the Health Services Executive maintains a database of all dental treatments provided under the DTSS. Table1 presents the key features of each scheme. Following data cleaning and restructuring, use of these databases enabled an analysis of the treatment provided to employed (and retired adults) and less well-off adults respectively. The observations in the DTBS databases were originally arranged as one entry per claim (a dentist could claim for treatments on up to 12 teeth in one form), and the observations in the DTSS database were one entry per treatment. Prior to analysis, the databases were rearranged to create new datasets with one entry per treatment for an analysis of the proportion of users who were provided specific treatments, and one entry per person for mean number of treatments provided. To compare treatments provided in the schemes with epidemiologically estimated need, treatments were categorised as extractions, restorations, advanced restorations, and denture treatments, as described in Table1. Treatments provided between October 2000 and August 2002 were analysed, corresponding to when the survey data were collected. Ethical approval to analyse these databases was provided by the Clinical Research Ethics Committee of the Cork Teaching Hospitals.
Epidemiologically estimated need for treatment was recorded by dentists in the 2000/02 Irish national survey of adult oral health [11]. The study of a stratified random sample of 2,888 adults was conducted by the Oral Health Services Research Centre (OHSRC), University College Cork. The three age groups targeted were 16-24 (n=1,196), 35-44 (n=978) and 65+ year-olds (n=714). The sample was weighted by gender, whether or not individuals had medical cards, and age, to be representative of the population as a whole. Weighting was based on estimates of Irish population totals from the Quarterly National Household Survey in the 3rd quarter of 2001. Ethical approval to conduct the study was provided by the Clinical Research Ethics Committee of the Cork Teaching Hospitals.
The study consisted of a thorough clinical oral examination and a detailed interview pertaining to oral and general health, perception of oral health services and oral health related quality of life. The 32 clinical examiners were public service employees. Training in the clinical indices/criteria for the 32 dentists (30 teams) took place at the University Dental School and Hospital, Cork. The fieldwork was conducted between October 2000 and August 2002 in health service clinics. The standard dental operating light was used for the clinical examination, and a portable dental light was used in the case of subjects examined in their own home, however home-based examinations were the exception.
The clinical examiners assessed each subject for caries, periodontal destruction, tooth wear and denture status, and made a treatment-need decision in light of overall dental health status. They were provided with a set of 'treatment-need' codes (for the crown and root), and general guidelines on how to arrive at a decision on the treatment required. However, it was emphasised during training and calibration that many treatment plans were possible for each tooth space, and that the examiners' own clinical judgement was to be relied upon to select which treatment need score applied in individual cases. Individual variations were therefore to be expected, and it was noted that there may be consistent differences among examiners in allotment of treatment need scores.The treatments estimated as needed by the dental fieldworkers were categorised as
· Extractions (due to coronal caries, periodontal disease and root caries, or for other reasons)
· Restorations (to remove caries lesions, repair trauma or replace unsatisfactory fillings in consideration of both function and appearance, and was regardless of number of surfaces involved)
· Advanced restorations (crown, resin bonded bridge or conventional fixed bridge, pulp treatment required due to coronal caries followed by restoration with filling or crown)
· Dentures (partial denture whose major component was plastic or metal, full dentures and repair or adjustment).
'Other treatment' was also recorded in the national survey, and this score was used for any other treatment of teeth not already categorised above, and for re-contouring and repairing restorations. However, this was not directly comparable with any description of treatments provided in the claims databases for the schemes so it was excluded from the analysis.
Further information on recording of epidemiologically estimated need is available from the 2000/02 national survey report [11].
Since it was only possible to measure treatments provided to employed and less well-off adults who used the schemes, the analysis of epidemiologically estimated need only included those who were eligible for the schemes and those who said they visited the dentist regularly (as these were more likely to visit during the period of analysis). Survey respondents were asked which dental scheme they could avail of and whether they had a medical card. The estimated need of those eligible for the DTBS (Scheme 1 - employed adults) refers to those who responded "Own Pay Related Social Insurance dental benefit". Information on age was only available for eligible adults (not their spouses) in the DTBS claims database, therefore the comparison of epidemiologically estimated need and treatment provided excluded spouses who used the DTBS, and, in terms of survey data (epidemiologically estimated need), excluded adults eligible under their spouse's Pay Related Social Insurance dental benefit. Some employed adults are not eligible for dental benefit and pay privately for all dental treatment; this group were also excluded from the analysis. The estimated need of those eligible for the DTSS (Scheme 2 - less well-off adults) refers to those who said that they had a medical card. Just over three quarters (77.2%) of those who had a medical card realised that they were entitled to treatment under the scheme.
Adults were also asked how often they attended the dentist over the last few years ("every six months or more often", "every 6-12months", "every 12-24months", "every two years or less often", "occasionally" and "never"). In comparing epidemiologically estimated need with treatment provided, we included only those who responded that they attended at least every two years (i.e. regularly, a combination of the first three options) as these would have had a greater likelihood of using the schemes during the observation period (October 2000 to August 2002 – corresponding to when the survey was conducted).
Proportions and means are presented as measures of epidemiologically estimated need and treatment provided. We used the chi-square test with Yates' correction to compare the proportion of regularly-attending adults eligible for the schemes who were estimated as needing treatments, with the proportion of adults who used the schemes that were provided with these treatments. The unpaired student's t-test was used to compare mean number of teeth per person estimated as needing treatment in the survey, with mean number of teeth that were provided treatment under the schemes. Differences were considered significant at p <0.05. Results are presented by age group and type of scheme eligible for/used. The DTBS databases were cleaned using Java applications. The DTBS and DTSS databases were arranged for analysis, and output was generated, using SAS® 9.2. Tests were performed using the Graphpad QuickCalcs Website (http://www.graphpad.com/quickcalcs/contingency1.cfm and http://www.graphpad.com/quickcalcs/ttest1.cfm, accessed March 2012).
The number of adults examined in the survey, and who claimed that they attended the dentist regularly are presented in Table2, alongside the number of adults who used the schemes from October 2000 to August 2002, by age group and type of scheme eligible for/used. Among 16-24year-olds, 52.0% of those who were eligible for Scheme 1 (employed adults) said they visited the dentist regularly, compared to 39.2% of those who were eligible for Scheme 2 (less well-off adults).
The percentages of adults estimated as needing specific treatments in the national survey, and the percentages of adults who used the schemes who were provided with these treatments in 2000/02 are presented in Table3 by age group and scheme.
Among employed adults, the proportion of 35-44year-olds for whom restorations were provided was greater than the proportion estimated as needing them in the survey (55.7% vs. 36.7%; p <0.0001). The proportion of 35-44year-olds provided with advanced restorations was less than the proportion estimated as needing them in the survey (3.9% vs. 11.2%; p <0.0001), and likewise for 65+ year-olds (2.1% vs. 10.1%; p <0.05). The proportion of 35-44 year-olds and 65+ year-olds provided with denture treatments was less than the proportion estimated as needing them: (3.3% vs. 13.9%; p <0.0001) and (13.6% vs. 29.4%; p <0.001) respectively.
Among less well-off adults, the proportion of 16-24year-olds who had teeth extracted was greater than the proportion estimated as needing them in the survey (27.4% vs. 7.9%; p <0.0001). The proportion of 35-44year-olds who were provided with advanced restorations was less than the proportion estimated as needing them (3.2% vs. 12.7%; p <0.001). The proportion of 35-44 year-olds who were provided with denture treatment was less than the proportion estimated as needing them (15.2% vs. 24.3%; p <0.01).
The mean number of teeth per person with epidemiologically estimated treatment need and treatment provided for each treatment are presented in Table4 by age group and eligibility for/use of the schemes. The mean number of teeth needing treatment is dependent on the mean number of teeth present; hence, the latter is also presented for each age group for employed adults. Number of teeth present was not available from the claims database for less well-off adults.
Mean number of teeth present was similar among employed adults in the survey and claims data, for example among 35-44year-olds, mean number of teeth was 26.6 for both databases. Among employed adults, mean number of teeth extracted was less than estimated as needed for 35-44year-olds (0.2 vs. 0.4; p <0.0001) and 65+ year-olds (0.3 vs. 0.7; p <0.05). Among 35-44year-olds, mean number of restorations provided was greater than estimated as needed in the survey (1.4 vs. 0.8; p <0.0001). Mean number of advanced restorations provided was less than epidemiologically estimated as needed in all age groups.
Among less well-off adults, mean number of teeth extracted per person was greater than estimated as needed in the survey for 16-24year-olds (0.5 vs. 0.1; p <0.001), and was less than estimated as needed for those aged 65 and over (0.8 vs. 2.4; p <0.0001). Mean number of restorations provided was greater than estimated as needed in the survey for 16-24year-olds (3.0 vs. 0.9; p <0.0001), 35-44year-olds (2.7 vs. 1.4; p <0.01) and 65+ year-olds (1.4 vs. 0.8; p <0.05).
Information on the proportion of adults and mean number of teeth with estimated treatment need for extractions and restorations was obtained from a clinical examination conducted as part of an epidemiological national survey, and information on treatment provided amongst matched age groups was obtained from administrative (claims) data. An advantage of using claims databases to measure treatment provided is that the information represents real-world dentistry. Each dentist has his/her own approach to treatment, and patients have different perceived needs and lifestyle preferences. These data represent the true complexity of what occurs daily in dental surgeries [12]. The similarities in mean number of teeth present between the claims data and the survey data for employed adults instil confidence in the representativeness of the survey sample.
As in Wanman and Wigren, this was essentially an evaluation of treatment need from two points of view [10]. The first was a professional assessment on a random sample of employed and less well-off adults who claimed to attend the dentist regularly, and was based on an examination made by independent dentists (epidemiologically estimated need), where their only consideration was the subject's oral status. The second was the treatments provided to employed and less well-off adults who used the DTBS and DTSS schemes (evaluated need). For the latter, factors such as aesthetics, cost, and patients' perceived needs and preferences were also considered in treatment planning.
There was a lack of agreement between mean estimated treatment need and mean treatment provided in all age groups, especially among 16-24 and 65+ year-old less well-off adults and 35-44year-old employed adults. Although treatment provided was greater than estimated need in some cases, it is important to note that the dentist providing the service had recourse to radiographs, and could therefore offer a more thorough clinical examination than for the national survey. In the national survey, estimated need for advanced restorations included endodontics, crowns, bridges and veneers. However, the only advanced restoration covered by the DTSS (the scheme for less well-off adults) was endodontic treatment for anterior teeth. As endodontics for other teeth were not covered, these less well-off adults may have chosen extraction of compromised teeth rather than incur the expense of advanced restorations. This may explain why the proportions of less well-off 16-24 and 35-44year-olds who had teeth extracted, was greater than estimated as needed. In addition, Millar and Locker [13] found that people in low-income households were less likely than those in high-income households to mention preventive reasons for visiting a dentist. Extractions have been found to be more likely when the reason for a visit is pain [14], whereas visiting the dentist for a check-up, instead of when in need or pain, is associated with increased retention of natural teeth [15].
There are two possible measurement reasons for the gap between estimated need for restorations and the mean number of restorations provided in the schemes. First, mean need for restorations was calculated regardless of number of surfaces involved, however, patients may have been provided with restorations on different surfaces at several visits to a dentist during the period of analysis. Second, restoration repair may have been recorded as 'other' in the survey (as explained in the methods section) and as a 'restoration' in the claims databases.
Other studies also found disparities between assessment of dental treatment need and the treatment actually provided [8-10]. Nuttall [8] found a large discrepancy between need for dental treatment recorded in an epidemiological survey and the clinical treatment that was subsequently provided (for the same subjects) in the General Dental Service in Scotland. He suggests that the results "cast doubt upon the usefulness of the epidemiological survey as a tool for predicting restorative treatment" [8]. Naegele and colleagues found that more teeth were treated by fee-for-service dentists, based on a thorough routine dental check-up, than predicted as needed by salaried dentists (within six months) [9]. Wanman and Wigren [10] also question the validity of epidemiological assessment of treatment needs. They compared professionally assessed treatment need in an epidemiological survey with treatment provided in the Public Dental Service in Sweden, and found a significantly higher frequency of restorative treatments provided than the assessed need, especially among 65+ year-olds [10]. Similar results were found in this study, where more restorations were provided than estimated as needed in the survey, across all age groups.
Clarkson and colleagues suggest that the lack of agreement between what dental epidemiologists observe and the treatment that dentists provide may be due to the more complex nature of treatment decisions made by dentists compared to the diagnostic criteria used in conventional epidemiological studies [16]. According to Sheiham and colleagues, a more realistic assessment of treatment needs should include "the functional and social dimensions of dental disease, and an assessment of the social motivational factors which predispose people towards dental ill health and influence the effectiveness of treatment and health education" [5]. In evaluating need in the Irish national survey, no consideration was given to the patient's financial situation or whether he/she wanted treatment, whereas both patient and oral health factors were considered in the provision of treatment.
According to Schonfeld, gaps between treatment need and treatment provided may indicate requirements for additional manpower, an increase in productivity of existing manpower, or a change in the pattern of dental care [17]. Grembowski and colleagues suggest that under fee-for-service reimbursement, dentists' efforts to build financially successful practices may encourage over-treatment [18]. Where dental services are provided at zero monetary cost to the patient, as for less well-off adults in Ireland, there may be an incentive for patients to over-consume or dentists to over-provide treatments. According to Woods [19], if there is evidence of either over-consumption and/or over-provision of services, for particular treatments, or to certain groups, then resources should be diverted from areas of excess provision to groups with greatest need.
Although the gap between epidemiologically estimated need and treatment provided seems to be greatest for less well-off adults, we do not know if the differences are related to dentist or patient factors, and therefore we cannot determine whether over- or under-treatment occurred. As in health care generally [20], variations in dental treatment arise from the interaction between supply and demand, which depend on the preferences and perceptions of both patients and dentists; therefore, any differences are probably due to several factors.
This study is concerned with the relative validity of epidemiologically assessed treatment need for adults using two different dental care delivery schemes, one a 'free' service for less well-off adults and the other a co-payment scheme for employed adults. The differences between epidemiologically estimated need and treatment provided could also provide an indication of accessibility to dental services for the three age groups in the two schemes. However, differences by socio-economic groups do not automatically reflect inequities [2]. Those in equal need and with equal opportunities to access health care may not make equal use of those opportunities. Nonetheless, an unacceptable reason for differences in use of health care would be that some individuals may be less capable of taking advantage of health care services [21].
In accordance with traditional demand theory, demand for oral health depends on its price per unit, constraining income, the price of all other commodities, and the value people place on oral health as a source of consumption benefit [22]. Income level is associated with utilisation of dental care services [23]. Consumers must allocate their income between buying dental care and other commodities [24]. The price of dental care consists of an out-of-pocket payment and other costs such as travel costs, opportunity cost of the time devoted to dental care, and non-monetary costs (such as time and psychological costs) [25]. Sintonen and Maljanen refer to these as the 'shadow price of dental care' [22]. Although treatments are provided at a subsidised rate to employed adults in Ireland, people may still feel the cost is prohibitive, especially for advanced restorations such as crowns. This may explain why the proportion of employed adults receiving advanced restorations was significantly less than the epidemiologically estimated need for the 35-44 and 65+ age groups.
Perceived need has been found to be a stimulus for regular attendance [26]. The large gap between mean number of teeth estimated as needing extractions and teeth extracted among less well-off 65+ year-olds could reflect a difference between need and demand for treatment. People may not feel they need treatment (low perceived need), and those found as needing treatment in the survey may not have visited a dentist under the scheme during the period. According to Holm-Pedersen and colleagues, professionally assessed need for dental treatment, based solely on clinical diagnosis, often leads to an "overestimation of the true need for treatment, especially among frail and functionally dependent elderly people, some of whom do not want treatment, either because there is no perceived need or no expressed demand" [3]. Perceived need may be increased or decreased through, for example, health education programs or changing financial incentives to seek services [6]. We should encourage people to visit their dentist for a check-up rather than waiting until they feel pain. Future surveys should include questions on perceived dental treatment needs, as this would provide further insight into the gap between epidemiologically estimated need and treatment provided.
In this study, we compared adults who said they were regular users in a survey with treatment provided to those who used the schemes. Although the most recent national survey of adult oral health in the Republic of Ireland was conducted 10years ago, by comparing it with utilisation data of the same time, we feel that our findings are still relevant today. We were unable to compare treatments provided to the same people who were examined in the survey; this would have enabled us to measure whether there was unmet need or variance with provision. However, given the confidentiality issues and difficulties obtaining agreements to link survey and administrative data, we feel that the method used in this paper was a valuable alternative.
Another limitation is that we do not know why the treatments were provided, for example, whether a restoration was provided for aesthetic reasons or due to caries. The DTBS and DTSS databases could be improved by the inclusion of a field, on the claim form, for reasons for provision of treatments; this would provide a more accurate indication of dental health. Administrative databases are a largely untapped resource for analysis of treatments provided, and this study demonstrates their utility. Holtz and colleagues recommend that comparisons across survey and administrative data sources be encouraged, rewarded, and funded so that limitations can be reduced or removed [27].
In conclusion, significant differences were found between epidemiologically estimated need for dental treatments and treatment provided, as measured from administrative databases for selected treatments for services targeted mainly at employed and less well-off adults. Provision of restorations were generally greater than epidemiologically estimated as needed. These variations may be due to measurement differences between survey and administrative data.
The results of this study have implications for dental public policy. One issue is that the gap between need and utilisation seems to be greatest for less well-off adults. However, it is difficult to isolate its causes, which in turn limits the recommendation of appropriate policy responses. We recommend further research to establish the extent to which differences in utilisation between adults eligible for the two schemes are the outcome of different opportunities, or different preferences. The best way of achieving this would be to combine a future survey with administrative data.
The authors declare that they have no competing interests.
HG participated in arranging the data for analysis, performed the statistical analysis, and drafted the manuscript. PF arranged the data for analysis and helped to draft the manuscript. NW was principal investigator on the Health Research Board grant, conceived the idea for this paper, provided advice, and contributed to finalising the manuscript. HW was co-applicant on the grant, provided advice, and contributed to finalising the manuscript. All authors read and approved the final manuscript.
The pre-publication history for this paper can be accessed here:
We wish to thank the Department of Social Protection and the Department of Health and Children for providing the administrative data, and the Health Research Board for funding this project (RP/2007/293). We also wish to thank Emeritus Professor Denis O'Mullane for his invaluable feedback on the paper, and Dr. Michael Cronin for his advice on the statistical tests.
PubMed Central Canada is a service of the Canadian Institutes of Health Research (CIHR) working in partnership with the National Research Council's national science library in cooperation with the National Center for Biotechnology Information at the U.S. National Library of Medicine(NCBI/NLM). It includes content provided to the PubMed Central International archive by participating publishers.


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So I got my 1st capture card today! So I decide to play a game that I'm not so good at Super Mario Bros. on the NES!Let the lameness being! Also this was the 1st time I made it that far so I shit a brick!
I Suck @ Super Mario Bros World 1-1February 1, 2013 by hobowithcanfood
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Richard Ayotte
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Richard Ayotte has made 2 contributions to 2 codemix open source projects
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Former official node.js driver for OrientDB. Fast, lightweight, uses the binary protocol. Now deprecated.
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text: Technical Comments Response: Proteolytic Processing See allHide authors and affiliations Science 17 Oct 1986:Vol. 234, Issue 4774, pp. 369DOI: 10.1126/science.234.4774.369-a REGIS B. KELLYFind this author on Google Scholar Find this author on PubMed Search for this author on this site Article Info & Metrics eLetters PDF This is a PDF-only article. The first page of the PDF of this article appears below.


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All | Editorial | General Tech | Graphics Cards | Networking | Motherboards | Cases and Cooling | Processors | Chipsets | Memory | Displays | Systems | Storage | Mobile | Shows and Expos
The Summer of Defeat
Subject: Cases and Cooling | June 30, 2006 - 02:01 PM | Jeremy Hellstrom
Techgage will take you through the improvements offered by the summer update of Day of Defeat. Read the article while you are waiting for Steam to finish the download.
"Valve has unleashed a new DoD: Source update, and this one is a winner. Included is a brand new mode, Detonation, which will be familiar to some CS players. Two new maps and the film grain graphic effect are also included. We give our first impressions inside."
Here is some more Tech News from around the web:
Tech Talk
Four 12V rails, with 500W to split between them
Subject: Cases and Cooling | June 29, 2006 - 12:35 PM | Jeremy Hellstrom
ClubOC puts the 750W iStar TC-750PD2 to the test. With 4 rock solid 12V rails, it is perfect for quad SLI. It only has one fan, an 80mm exhaust, so you shouldn't find it terribly loud either.
Quietly cooling your HTPC
Subject: Cases and Cooling | June 28, 2006 - 05:52 PM | Jeremy Hellstrom
The nMedia Icetank is not strictly for HTPC usage, but considering how quietly it can cool, it is perfect for that type of use. It is fairly large, but designed to fit almost any processor type, which greatly helps during installation. Drop by O2 for the full review.
This case swings both ways, and likes the water ...
Subject: Cases and Cooling | June 26, 2006 - 12:31 PM | Jeremy Hellstrom
Thermaltake's Aguila is a hefty beast, that is designed to be set up either as a normal ATX system, or a BTX. It has plenty of space in HDD bays for hiding your cabling, and good airflow. On the other hand, it will be difficult to place a Bigwater 735 and a large video card into the case, at the same time.
If you want a more spacious interior, check out Lee's review of Thermaltake's new Armour Jr.
Office 2007 - Worth the time it takes to install?
Subject: Cases and Cooling | June 26, 2006 - 12:15 PM | Jeremy Hellstrom
The Inquirer starts off the week with an overview of the new Office 2007 Suite, Beta 2. More than just an aesthetic change, this Office incorporates several new ideas like ribbons. Drop by for this overview, and keep an eye open this week as they test each application individually.
AM2's secret weapon
Subject: Cases and Cooling | June 23, 2006 - 04:52 PM | Jeremy Hellstrom
The Inquirer has discovered AMD's answer to Conroe, and have posted a bit of information on what their upcoming plans may be.
If you are unfamiliar with Conroe, and the idea of IPC, read Ryan's preview, right here on PC Perspective.
The TGIF Mod Squad
Subject: Cases and Cooling | June 23, 2006 - 01:41 PM | Jeremy Hellstrom
The case mods are starting to arrive at ExtremeTech. Drop by to look at the competition, and sumbit your own if you have 'em. Don't forget we have our own Member Gallery here at PC Perspective to show off your mods too!
Look Ma! No hands!
Subject: Cases and Cooling | June 22, 2006 - 05:11 PM | Jeremy Hellstrom
Hands free input devices, such as head tracking devices are steadily improving. Drop by PDAToday to look at Natural Point's newest offering, the Track IR Pro 4, and see if you are ready to eveolve past the mouse & keyboard.
High-Powered Shoot Out
Subject: Cases and Cooling | June 22, 2006 - 02:43 PM | Jeremy Hellstrom
Legit Reviews grabbed 8 SLI/CrossFire PSUs, none less than 550W. Drop by to find out who makes the cut.
Getting the most from a lower cost video card
Subject: Cases and Cooling | June 21, 2006 - 03:39 PM | Jeremy Hellstrom
The 7300GT DDR3 from Galaxy won't be breaking any 3DMark records, but it is incredibly feature rich for a $100 VGA card. Get to Guru of 3D, and read the indepth look at this well designed mid-level card.
A different set of winners from LANWar '06
Subject: Cases and Cooling | June 21, 2006 - 12:56 PM | Jeremy Hellstrom
ThinkComputers has taken pictures of the 8 winners of the Case Contest from the Bring Your Own Computer portion of that huge LAN Party. See what they brought that stood out among all the entries.
ZoneAlarm picks a fight with Eudora and McAfee
Subject: Cases and Cooling | June 21, 2006 - 12:44 PM | Jeremy Hellstrom
CNET reports that ZoneAlarm users are having dating difficulties with Eudora, and some McAfee users are unable to install the program. The fix was released yesterday, so drop by ZoneAlarm to have your difficulties removed.
Zalman tames the AM-2
Subject: Cases and Cooling | June 19, 2006 - 04:00 PM | Jeremy Hellstrom
By copying the design for the s939 CNPS9500LED, Zalman's heatsink for AM-2 systems is bound to impress. Drop by Pro-clockers to see how well the cooling power transferred.
A closer look at nVIDIA and ATI's AM-2 offerings
Subject: Cases and Cooling | June 16, 2006 - 03:34 PM | Jeremy Hellstrom
X-Bit Labs examines 2 AM-2 boards, a reference ATI board from Sapphire called "Sturgeon" and the ASUS M2N32-SLI Deluxe. Drop by and find out what these chipsets are capable of, and the different implementations used by the two competitors.
Also check out Ryan's review of the Asus N4L-VM DH, a Core-duo motherboard.
BTX - Forgotten, but not gone?
Subject: Cases and Cooling | June 16, 2006 - 02:30 PM | Jeremy Hellstrom
The BTX form factor is taking a while to be adopted. While not too many systems are being based on it, you can still find cases that meet the new specs, like the SilverStone TJ08, reviewed by TECHGAGE.
[H]ard|OCP has lost their marbles
Subject: Cases and Cooling | June 16, 2006 - 12:15 PM | Jeremy Hellstrom
Seriously, they've posted a full reivew of Marble Blast Ultra for the XBox 360, and they loved it! I can't imagine what drove them to this level, where they describe a puzzle game involving a rolling marble as "...visually impressive and does a great job showing off the power of the Torque Shader Engine". Drop by and watch their descent into madness, and see what else they buy with accumulated Microsoft Points.
NZXT provides precise power
Subject: Cases and Cooling | June 15, 2006 - 04:00 PM | Jeremy Hellstrom
The NZXT Precise 650 Watt Power Supply that Overclockers Club reviews won't have much problems powering newer graphics cards. Over 500W is dedicated to the 2 12V lines, so even the new 7950GX2 should get enough power. It also cools well, though that makes it a little louder than other models.
I spy with my i ... something that is not an iPod
Subject: Cases and Cooling | June 15, 2006 - 12:51 PM | Jeremy Hellstrom
Drop by Think Computers to find out how unique the iRiver is. It's not very large, at only 0.5" x 2.5" x 1.75", and sports a 2.2" colour display, and a price tag under $200. Can it displace your iPod from next to your heart?
Keep your northbridge chilled quietly
Subject: Cases and Cooling | June 14, 2006 - 05:16 PM | Jeremy Hellstrom
Drop by BCCHardware to find out about a way to keep your northbridge cool, passively. The Zalman ZM-NBF47 is a passive cooler that is much quieter than any fan based solution, and it will outperform most stock coolers as well. The blue tinted aluminium construction is rather nice looking, as well.
Stable like a rock, pretty like a glow-in-the-dark butterfly
Subject: Cases and Cooling | June 13, 2006 - 06:47 PM | Jeremy Hellstrom
Having a powersupply that is stable is one thing, but having one that is as attractive as it is stable is quite another. The Kingwin Mach 1 600W PSU, as reviewed at Club OC, is exactly that. With a plentiful amount of blue LEDs, this PSU will be at home in any modded case.
Or, for a more unassuming PSU, check out Lee's review of the CoolerMaster iGreen Power 600 PSU here on PC Perspective.
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LITTLE EGG HARBOR TOWNSHIP — "Hello!" "How are you today?" "Glad you could make it!"
These greetings are often offered as throwaway salutations, but not at this party. Those extending the greetings mean them, every word. And, because this is not your typical party, many are happy just to have an opportunity to extend the greeting at all.
For the past three years, The Good Shepherd Lutheran Church on the corner of Mathistown Road and Route 9 has hosted "Saturday Night Social" — an event that gives adults with developmental disabilities or brain injuries an opportunity to break from routine and have some fun.
And every two weeks, dozens of adults pony up the 50-cent "donation" for the opportunity to play games, dance and, most importantly, meet friends.
"I have a good time here," said Theodore Cook, Jr., 50, who travels all the way from the Mays Landing section of Hamilton Township for the socials. "I like meeting new friends. … It's fun."
Mom saw son in need
Jonathan Waterson felt isolated after he graduated from the Archway Program in Waterford Township, Camden County, at age 21.
The Little Egg Harbor Township resident was born with developmental disabilities that prevented him from being able to walk, talk, hear or use his hands. But during his time at the school — which offers an array of programs for people with special needs — Waterson was able to gain these abilities, make a lot of friends and even get a girlfriend.
After he graduated, he no longer had regular contact with other people his age with similar disabilities. And making friends with the "normal" kids in town proved to be difficult, at best.
"Every parent wants their children to be happy and to have friends. And we just saw him as him," said Jonathan's mother, Leslie Waterson, 65, a retired LPN/Social Worker from the Mystic Island section of the township. "But when he left school, he had no one to socialize with. He'd spend his time playing games, watching TV or sleeping. He was very lonely. I just felt sorry for him."
After a few years of this, Leslie — a member of Good Shepherd's council — decided to try to help make her son happy again.
"We had two other people in the church with developmental disabilities, and I asked the pastor if it would be possible to start a social group so we could have parties and a place, other than the programs they all go to during the day, to have fun and meet friends," Leslie said.
She decorated the church's multi-purpose room to the hilt, but no one came.
"We were all decorated for Memorial Day weekend and I was really discouraged," she said. "One of the other members of the church stopped by and we told him 'sit down and have a cupcake! You're the first member of our group.' He was our only member."
But a short time later, she ran into Tuckerton resident Doris Farace shopping at Dollar General with some of her clients from a group home for adults with special needs. Waterson explained her idea to Farace, who immediately began promoting the event to other caregivers, parents and organizations.
"It took off from there. At our last meeting we had over 60 people here, ages 18 to 85. And now it's such a part of their routine that I don't dare skip one or I'll have to hear about it — and I do," said Waterson, who said a winter ice storm forced her to cancel one of the events and her phone rang off the hook for days. "I even feel bad when the nights end and it's time to go home, because everyone is so happy to be here."
Nan DeFilippis works at the Association for the Multiple Impaired Blind, a residential program for people with multiple disabilities that has a location in the Lanoka Harbor section of Lacey Township.
On a recent Saturday night, DeFilippis had three of her clients with her.
"They love coming here," said DeFilippis, of Lanoka Harbor, as she juggled playing multiple games of bingo at once. "They know when it is and look forward to it. Every two weeks, it's all they talk about."
Darla Kane, one of DeFilippis' clients, smiled after she won a bracelet playing bingo.
"I like it here," said Kane, 45, adding what she likes most is meeting people.
But it's not only people with special needs who attend the weekly events.
"We get some senior citizens who are not disabled at all, but who come every two weeks because they are comfortable here," Leslie Waterson said. "It really is just a warm and friendly atmosphere."
And some of the volunteers, such as 13-year-old Jonathan Episcopo, try to make it part of their routine as well.
"It makes me feel good to be able to help them out," said Episcopo, of the Parkertown section of Little Egg Harbor Township, as he helped one of DeFilippis' clients play bingo. "The people who come here, they expect to see us every two weeks. So we try to make sure we're here so they're not disappointed if they don't see us."
The socials are now a source of enjoyment for dozens of people who appreciate every minute of them. But no one appreciates them more than Jonathan Waterson.
"My mom started this, because I had a tough time making friends in the neighborhood before," said Waterson, now 26. "It touched me that she did that. It made me feel good. And now everyone here is happy because of it."
Swords, archery, bingo
Little Egg Harbor Township resident Kimberly Smith sat fixated on the numbers and letters of a bingo board early into a recent social, when the combination that she needed to win was announced.
"Bingo!" she shouted as she leaped out of her chair. "Bingo! Bingo! Bingo!"
The 23-year-old darted to the prize table, excited at the sight of what, to most adults, would seem like pile of simple items, but to her was a treasure chest.
She scanned the table and quickly snatched up a stuffed poodle, one she would hug tightly against her chest for the remainder of the evening.
"The simplest things in life make them absolutely happy — socializing, inexpensive toys, candy, having their picture taken. Simple things," said Farace, 67. "It's a simple party. But I can't explain the expression on their faces and the warmth that we, as caregivers, feel when they're happy that way."
While Waterson said the toy and food donations that are sent for the socials are always greatly appreciated, and very much needed, she said the "events" the partygoers get to attend are the biggest hit.
In addition to barbecues, game nights, and dances, "Saturday Night Social" events have also included a Medieval-themed party featuring re-enactors, sword fighting and archery, numerous birthday parties and even a wedding.
"A lot of them never get invited to birthday parties and weddings, so every month we find out whose birthday is coming up and we celebrate it," said Waterson, adding that the wedding was for a couple with special needs who renewed their vows on their 25th anniversary.
"We even had a reception afterward and everyone lined up and blew bubbles as they left the church," she said. "The funny thing is, we had everyone in the audience during the ceremony and they just sat there, without any expression on their faces. ... They were all so quiet and respectful, that we didn't think they enjoyed it. But, sure enough, it was all any of them talked about on the way home.
"I think it just meant a lot to them to finally get to go to one."
Contact Robert Spahr:


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32 Lemon Street Runcorn QLD 4113
Email Agent
GOLD MINE 835M2 BLOCK IN GREAT LOCATION.32 Lemon Street, Runcorn
In a highly-convenient and desirable location within the Warrigal Road State School catchment area, this property is only a short walk from the Fruitgrove train and bus station, offering frequent city trains and busses, as well as the Warrigal Square Shopping Centre, and is also close to several leafy public parks.
Just imagine all you could with this amazing property! Whether you want to keep the sturdy property already on the land in place and rent it out as a reliable source of rental returns, or demolish and build a fantastic new home on this large block of land, its all possible with this outstanding blank canvas.
With gorgeous timber floors throughout the interior, and with a recently renovated bathroom and kitchen, with the kitchen featuring a handy wraparound bench and an abundance of storage, this propertys low-maintenance layout is also a great option for growing families and aspirational couples looking for a spacious first home buy.
Also offering tasteful lighting throughout, as well as easy access to Sunnybank Plaza, the Garden City Shopping Centre and Brisbane City, this is the perfect place for a fantastic new development, or for first buyers to make their mark in an excellent suburban location.
Such an affordable block of prime property doesnt come along every day, so call Peter Son to make it yours before someone else does!
All information contained herein is gathered from sources we consider to be reliable. However we cannot guarantee or give any warranty about the information provided and interested parties must solely rely on their own enquiries.
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Sunnybank Hills QLD, 4109
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Central Hospital of Xinxiang
Central Hospital of Xinxiang
Li Y.,Central Hospital of Xinxiang |
Li J.-L.,Central Hospital of Xinxiang |
Zhai H.-P.,the Second Peoples Hospital of Xinxiang |
Chang F.-L.,Central Hospital of Xinxiang |
And 2 more authors.
Chinese Journal of Medical Imaging Technology | Year: 2014
Objective: To investigate the application value of echocardiography in the prenatal diagnosis of fetal simple ventricular septal defect (VSD) and the follow-up. Methods: Totally 35 fetuses with suspected VSD by prenatal echocardiography were enrolled. The fetus echocardiograph features were analyzed and the cases were followed before and after birth to observe the size of defect and the condition of closure. Results: Two fetuses were misdiagnosed. Twenty-six were non-high-risk fetuses and the other 7 were high-risk ones; 18 fetuses (18/33, 54.55%) were muscular ventricular septal defect, 13 fetuses (13/33, 39.39%) were perimembranous ventricular septal defect, 1 fetus (1/33, 3.03%) was stem-inferior ventricular septal defect, and 1 fetus (1/33, 3.03%) was sub-ralvular ventricular septal defect. One case was lost for follow-up. Two cases were naturally closed in the womb, 21 cases recovered from the defect in the three years after birth, 9 cases failed to close. The incidence of defect closure in the non-high-risk fetuses was higher than that in the high-risk fetuses (P<0.05). The incidence of muscular ventricular septal defect closure was apparently higher that of perimembranous ventricular septal defect and the other defects (all P<0.05). The closure incidence of the defect with diameter of ≤3.0 mm was apparently higher compared with the defects with diameter of 3.1-5.0 mm and >5.0 mm (all P<0.05). Conclusion: Echocardiography has an important clinical value on prenatal diagnosis, follow-up observation and chooses of treatment in simple VSD. Copyright © 2014 by the Press of Chinese Journal of Medical Imaging and Technology.
Fan W.,Central Hospital of Xinxiang |
Wang W.,Central Hospital of Xinxiang |
Wu J.,Central Hospital of Xinxiang |
Ma L.,Central Hospital of Xinxiang |
Guo J.,Zhengzhou University
Biomarkers in Medicine | Year: 2017
Aim: This study aimed to identify CD4+ T-cell-derived microparticles (MPs) and investigate their roles in rheumatoid arthritis (RA). Methods: Synovial fluids from 34 RA, 33 osteoarthritis patients and 42 healthy individuals were analyzed by flow cytometry. Human fibroblast-like synoviocytes and peripheral blood mononuclear cells were cultured with or without isolated MPs, chemokines and cytokines were measured by ELISA. Results: CD4+CD161+CD39+ and CD4+CD39+CD73+ MPs were abundantly present in RA patients, which were positively or negatively correlated with RA features, respectively. Chemokines CCL20, CCL17 and CCL22, and cytokines IL-17 and IL-10 were influenced by these MPs in human fibroblast-like synoviocytes (HFLS) or PMBCs. Conclusion: CD4+ T-cell-derived CD161+CD39+ and CD39+CD73+ MPs could serve as new reciprocal biomarkers for RA evaluation. © 2017 Future Medicine Ltd.
Wei W.,Central Hospital of Xinxiang |
Yang Y.,No150 Central Hospital Of Pla |
Yang Y.,Shanghai University |
Cai J.,No150 Central Hospital Of Pla |
And 5 more authors.
Cellular Physiology and Biochemistry | Year: 2016
Aims: MicroRNAs (miRNAs) are dysregulated in a wide range of malignant diseases, confirming their crucial role in tumor metastasis. MiRNA-30a-5p, a member of the miR-30 family, has been implicated in many types of cancers, including colorectal cancer, a leading cause of death worldwide. Methods: qRT-PCR, Western blot, Transwell assay,luciferase reporter assay were performed in the present study. Results: In this study, miR-30a-5p was found to be significantly downregulated in human colorectal cancer tissue specimens and cell lines compared with non-cancerous tissues and cells. The overexpression of miR-30a-5p inhibited the migratory and invasive abilities of colorectal cancer cells and suppressed the epithelial-mesenchymal transition, a crucial process in metastasis. Bioinformatic algorithms and luciferase reporter assays revealed that integrin β3 (ITGB3) is a direct target of miR-30a-5p. Importantly, overexpression of ITGB3 in colorectal cancer cells rescued these cells from miR-30a-5p-mediated suppression of metastasis and restored the epithelial-mesenchymal transition. Conclusion: Taken together, our study provides the first evidence that miR-30a-5p suppresses colon cancer metastasis through the inhibition of ITGB3. Thus, targeting miR-30a-5p might serve as a promising therapeutic strategy for the treatment of colorectal cancer. © 2016 The Author(s) Published by S. Karger AG, Basel.
PubMed | Xinjiang Medical University, The First Peoples Hospital of Shangqiu, Shantou University, Zhengzhou University and 43 more.
Type: Journal Article | Journal: Nature genetics | Year: 2014
We conducted a joint (pooled) analysis of three genome-wide association studies (GWAS) of esophageal squamous cell carcinoma (ESCC) in individuals of Chinese ancestry (5,337 ESCC cases and 5,787 controls) with 9,654 ESCC cases and 10,058 controls for follow-up. In a logistic regression model adjusted for age, sex, study and two eigenvectors, two new loci achieved genome-wide significance, marked by rs7447927 at 5q31.2 (per-allele odds ratio (OR) = 0.85, 95% confidence interval (CI) = 0.82-0.88; P = 7.72 10(-20)) and rs1642764 at 17p13.1 (per-allele OR = 0.88, 95% CI = 0.85-0.91; P = 3.10 10(-13)). rs7447927 is a synonymous SNP in TMEM173, and rs1642764 is an intronic SNP in ATP1B2, near TP53. Furthermore, a locus in the HLA class II region at 6p21.32 (rs35597309) achieved genome-wide significance in the two populations at highest risk for ESSC (OR = 1.33, 95% CI = 1.22-1.46; P = 1.99 10(-10)). Our joint analysis identifies new ESCC susceptibility loci overall as well as a new locus unique to the population in the Taihang Mountain region at high risk of ESCC.
Wang G.,Henan Normal University |
Li B.,Central Hospital of Xinxiang |
Hao Y.,Henan Normal University |
Hao Y.,Key Laboratory for Cell Differentiation Regulation |
And 6 more authors.
Cell Biology International | Year: 2013
To explore the relevance of non-alcoholic fatty liver disease (NAFLD) to liver regeneration (LR), rat models of non-alcoholic steatohepatitis (NASH) and LR were established, respectively, then Rat Genome 230 2.0 Array was used to detect the gene expression abundance of them, and the reliabilities of the array data were confirmed by real-time RT-PCR. As a result, the expression of 93 genes was significantly changed during NAFLD occurrence and 948 genes in LR. Hierarchical clustering indicated that the expression profiles of the above two events were quite different. K-means cluster classified their expression patterns into four clusters, and gene expression trends of clusters 1, 2 were similar in NAFLD and LR, while clusters 3, 4 were contrary with the gene expression changes of LR more abundant. DAVID classifications and functional enrichment analysis found that lipid metabolism and carbohydrate metabolism were stronger in NAFLD than in LR, but some other physiological activities including inflammation/immune response, cell adhesion, and migration, cell proliferation and differentiation in NAFLD were weaker than in LR. IPA further indicated that lipid metabolism, inflammation response, and cellular development were highly associated with NAFLD, and thus identified some potential biomarkers for NAFLD. © 2013 International Federation for Cell Biology.