This CME activity will enable doctors to recognize when risks of chronic opioid therapy outweigh benefits, and how to safely and compassionately taper patients off of chronic opioid therapy (including the use of buprenorphine to make this transition). A real life patient case scenario will be used to illustrate these principles in practice, including what to say to patients to communicate risks and provide support through the difficult period of withdrawal. When to refer for addiction treatment will also be discussed.

For me macros do a lot of this. I am pretty happy with using alias for fast or repetitive workflow/command parameters. Besides I am sure that there are some that absolutely could not live without the taper command.


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One of the most vexing problems for athletes is figuring out how to time their heat adaptation prior to a competition, without messing up their taper, their travel plans, and perhaps their final stint of altitude training.

This microphone is fine-tuned to capture spoken word and voice at a production-level standard, and it exhibits a high presence bump in the upper midrange with a gradual downward taper until its response drops significantly at the low end.

the above example only works, if the deformed mesh resides in the world center (0,0,0)

i made some tests with a referenced mesh box which was moved outside the world center. then i used a bounding box and a point component to put the start of the taper axis where i think it should be and attached a worldXY-plane and a worldYZ-plane to this start point (the planes are visualised via circles). at last i generated axes from these two different planes and used these axes for the taper. allthough the two axes are in two different planes, they give the same result (THE TAPERING SHOULD BE VISIBLE IN TOP VIEW, top and bottom of the meshbox should stay parallel to worldXY, the two smaller sides should stay parallel to worldXZ)

Hey everyone! I'm new to Fusion 360 (normally I work in 3ds max) so I don't know where everything is right now or the capabilities of the program but I'm trying to make a tapered box. What is the best way to do this? Normally I would just soft select one end and scale it to make a quick taper but when I use the scale in the modeling mode it just scales the whole form.

I'm trying to merge a [tapered] cube with a [different taper] cylinder, to create a coffee mug with circular top and square base. Double walled coffee mug, so needs to be hollow and a cone insert to complete the model .

If you have used a sketch to define the square on which the tapered cube is based, and you are in history based modeling, you can simply edit the dimensions of the original sketch to change the dimensions of the cube. If you extruded with a taper angle then you can alter that in the same way, by returning to that action in the timeline. You can't have this level of control if you used the primitive generation tools to make the initial cube. Working from sketches in general gives you a lot more flexibility to change parameters down the line.

I started with a cube, 7.5x7.5x20, with a taper [1.73209 degrees, from memory]. Then I added a cone, 20cm high, and specified an upper and lower radius. I then tried to merge / union these objects, and ran into troubles [can't select either target body] so time to assess what I'm doing wrong.

Patients receiving long-term opioid therapy for chronic pain and interested in tapering their opioid dose were randomly assigned to a 22-week taper support intervention (psychiatric consultation, opioid dose tapering, and 18 weekly meetings with a physician assistant to explore motivation for tapering and learn pain self-management skills) or usual care (N = 35). Assessments were conducted at baseline and 22 and 34 weeks after randomization. Using an intention to treat approach, we constructed linear regression models to compare groups at each follow-up. At 22 weeks, adjusted mean daily morphine-equivalent opioid dose in the past week (primary outcome) was lower in the taper support group, but this difference was not statistically significant (adjusted mean difference = -42.9 mg; 95% confidence interval, -92.42 to 6.62; P = .09). Pain severity ratings (0-10 numeric rating scale) decreased in both groups at 22 weeks, with no significant difference between groups (adjusted mean difference = -.68; 95% confidence interval, -2.01 to .64; P = .30). The taper support group improved significantly more than the usual care group in self-reported pain interference, pain self-efficacy, and prescription opioid problems at 22 weeks (all P-values < .05). This taper support intervention is feasible and shows promise in reducing opioid dose while not increasing pain severity or interference.

Perspective:  In a pilot randomized trial comparing a prescription opioid taper support intervention to usual care, lower opioid doses and pain severity ratings were observed at 22 weeks in both groups. The groups did not differ significantly at 22 weeks in opioid dose or pain severity, but the taper support group improved significantly more in pain interference, pain self-efficacy, and perceived opioid problems. These results support the feasibility and promise of this opioid taper support intervention.

Aim:  To evaluate the effect of root canal taper on irrigant flow inside a prepared root canal during final irrigation with a syringe and two types of needles, using a Computational Fluid Dynamics (CFD) model.

Methodology:  A validated CFD model was used to simulate irrigant flow from either a side-vented or a flat 30G needle positioned inside size 30, .02 taper, 30, .04, 30, .06, ProTaper F3 or size 60, .02 taper root canals, at 3 mm short of working length (WL). Velocity, pressure and shear stress in the root canal were evaluated.

Results:  The side-vented needle could not achieve irrigant replacement to the WL in any of the cases. Significant irrigant replacement was evident further than 2 mm apically to the tip of the flat needle in the size 30, .06 taper, F3 and size 60, .02 taper canal. A wider distribution of wall shear stress was noted as the canal taper increased but the maximum shear stress decreased. The flat needle led to higher mean pressure at the apical foramen. Both needles showed a similar gradual decrease in apical pressure as the taper increased, but the least pressure was calculated in the size 60, .02 taper canal.

Conclusions:  An increase in root canal taper improved irrigant replacement and wall shear stress whilst reducing the risk for irrigant extrusion. Irrigant flow in a minimally tapered root canal with a large apical preparation size also improved irrigant replacement and wall shear stress and reduced the risk for irrigant extrusion, compared to the tapered root canals with a smaller apical preparation size.

The Morse Taper was invented in 1864 by Stephen A. Morse, an enterprising mechanic, who developed it to reliably join two rotating machine components. The orthopaedic industry has adapted these tapers, under the generic name of Morse tapers, as a means of reliably joining modular components of total joints directly on the operation table. The principle of the Morse taper is that of the cone in the cone. The trunnion (the male portion) and the bore (the female portion) are both uniformly tapered. When the bore in the femoral head is tapped onto the trunnion of the femoral stem they come into intimate contact. The conical femoral taper compresses the walls in the bore as it expands. Thus, the stresses inside the materials keep both components fixed together.

Stephen A. Morse, an enterprising mechanic, developed a new and better way to drill a hole in 1864 when he invented the twist drill. Machine tool operators must be able to install or remove tool bits quickly and easily. A lathe, for example, has a rotating spindle in its headstock, to which one may want to mount a spur drive or work in a collet. Another example is a drill press, to which an operator may want to mount a bit directly, or by using a drill chuck. Virtually all milling machines, from the oldest, manual machines up to the most modern machines use tooling that is guided on a tapered surface. The machine taper is a simple, low-cost, highly repeatable, and versatile tool mounting system that uses tool bits (or holders) with gradually tapered shanks and a matching hollowed-out spindle.

For light loads (such as encountered by a lathe tailstock), tools are simply slipped onto or into the spindle; the pressure of the spindle against the workpiece drives the tapered shank tightly into the tapered hole. The friction across the entire surface area of the interface provides a large amount of torque transmission, so that splines or keys are not required. The tapered interference fits are used commonly in engineering practice such as Morse tapers, used to engage lathe bits.

With a new patent and a stockholder investment of $30,000, he opened the Morse Twist Drill and Machine Company in New Bedford Massachusetts in 1864. Recognising the need for a way to drive his twist drill, Morse created the taper shank series. Two sets of master gages were made up; one, sent to the Bureau of Standards in Washington, D.C., was accepted as a National Standard. The other remains with the Morse Company.

The orthopaedic industry has now adapted these tapers for metal head, under the generic name of Morse tapers, as a means of reliably joining modular components at the operating table. They are now available in femoral and acetabutar component designs, in humeral head component designs, and even as intramedullary rods.

Morse tapers are not standardised in the orthopaedic industry; they vary from company to company. Thus, the trunion (male portion) and the bore (female portion) may appear to be compatible but might be totally incompatible. Extreme care must be taken in the use of these tapers at the time of revision procedures to be sure that products from different manufacturers are not mixed, as this may lead to dissociation. 2351a5e196

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