Τρίτη 10 Νοεμβρίου 2020

In Vitro Infrared Thermographic Assessment of Temperature Change in the Pulp Chamber during Provisionalization: Effect of Remaining Dentin Thickness

alkiviadis.1961 shared this article with you from Inoreader

jhe.banner.jpg

Interim crowns and partial fixed dental prosthesis materials generate exothermic heat during polymerization. The amount of heat transmitted to the pulp chamber can be a function of several factors, including the thickness and quality of the remaining dentin after crown preparation. The aim of this in vitro study was to measure with infrared thermography the temperature changes on the adjacent surface of the chamber roof of premolar teeth extracted from young and old patients (having different thicknesses of remaining dentin after crown preparation) during fabrication of provisional resinous restorations. Twenty extracted human first and second maxillary premolar teeth (10 from young patients, with a relatively large pulp chamber, and 10 from older patients, with a relatively small pulp chamber) were used. The roots were sectioned to expose the inner side of the chamber roof, and the crowns were provisionalized after preparation for a metal-ceramic crown. Two provisional materials, Turbo Temp 2 and Luxatemp Fluorescence, were used. Temperature changes on the inner side of the chamber roof were measured at 2-second intervals using an infrared thermal imaging camera. After completion of the temperature recordings, the teeth were sectioned and the remaining dentin thickness was determined. The older group (mean thickness: 2.82 mm) and younger group (mean thickness: 1.9 mm) differed significantly in dentin thickness (). The mean greatest temperature increases recorded on the chamber roof of teeth with less remaining dentin were 4.07°C for Turbo Temp 2 and 3.94°C for Luxatemp Fluorescence, while increases in the premolars with greater dentin thickness were 1.69°C for Turbo Temp 2 and 1.64°C for Luxatemp Fluorescence. Significant interactions were found between tooth groups (for Turbo Temp 2 and for Luxatemp Fluorescence). No significant differences were found between assessed materials regardless of the thickness of the remaining dentin (for the older group and for the younger group). Dentin had a significant effect in limiting the temperature increase generated during polymerization of provisional materials, indicating good thermal insulating properties of this tissue. A remaining dentin thickness of 1.9 mm or more is sufficient to protect the pulp from any temperature increase during provisionalization using tested materials.
View on the web

Improving Stem Cell Clinical Trial Design and Conduct: Development of a Quality Assessment Tool for Stem Cell Clinical Trials

alkiviadis.1961 shared this article with you from Inoreader

sci.banner.jpg

Background. Clinical trials are at the cornerstone of evidence-based stem cell therapies, but the quality assessment for designing and conduct these sometimes-complex studies are scarce of evidence. This study is aimed at developing a handy quality assessment tool for stem cell clinical trials, enhancing capacity of the self-regulate overall quality, and participating protection. Methods. The framework of quality assessment tool was based on the PQRS (progress-quality-regulation-scientific) quality assessment tool, and detailed quality indicators were developed by leader group discussion, expert consulting, and literature review. Stem cell clinical trials were retrieved from the International Clinical Trials Registry Platform, and corresponding quality indicators were assessed and extracted. The validity and feasibility of conceptual quality assessment tool were further evaluated by using structural equation modeling. Results. The quality assessment tool for stem cell clinical trials contains four critical quality attributes, including participant protection, scientific value, quality control, and stem cell products, and 9 observed quality indicators. From 11 primary clinical trial registries in the International Clinical Trials Registry Platform, 9410 stem cell trial registrations were identified, and 1036 studies were eligible for publications and protocols screening. After reviewed full text, 37 studies were included in the validity and feasibility evaluation: 32 studies were completed, and 3 studies terminated early. Most of the studies (83.79%) were in the early phase, and 63.16% of the studies were investigator-initiated trial. To further tested for validity, the critical quality attributes and quality indicators (QIs) between expertise further validated by the SEM method, which s howed a good fit for the model (;;;;). Compared with exploratory trials, evaluating using the quality assessment tool, confirmatory trials performed similarly in participant protection, scientific value, and quality control, but lower in stem cell products. Conclusions. The results of critical quality attributes and quality indicators between expertise and confirmatory validation analysis are basically consistent, indicating the feasibility and validity of applying this quality assessment tool for overall quality evaluation of stem cell trials.
View on the web

Carbamazepine-Induced Toxic Epidermal Necrolysis Managed by Mobile Teledermatology in COVID-19 Pandemic in Rural Nepal

alkiviadis.1961 shared this article with you from Inoreader

cridm.banner.jpg

Toxic epidermal necrolysis is a life-threatening dermatological emergency with high mortality if not treated in time. Here we report a case of toxic epidermal necrolysis due to carbamazepine in rural Nepal in COVID-19 pandemic who was successfully treated with the help of mobile teledermatology. The clinical impression of toxic epidermal necrolysis was made from "WhatsApp" video calls using a smart phone. The supportive features were the history of starting of carbamazepine 2 weeks prior for seizure disorder, clinical findings in serial photographs of skin with 40 percent body surface area involvement of necrotic skin lesions and bulla, and involvement of oral mucosa and eyes. The patient was immediately asked to stop carbamazepine and was treated with intravenous fluids and systemic steroids along with symptomatic management. As the whole world was suffering from lockdown due to COVID-19 crisis, it was impossible for the rural area patient to visit a dermatologist. Thus, with the help of paramedics staff in a community health center and mobile teledermatology, the patient was diagnosed as carbamazepine-induced toxic epidermal necrolysis and treated successfully with good outcome.
View on the web

Verification of the Efficacy and Safety of Qi-Replenishing Chinese Medicine in Treating Prediabetes: A Meta-Analysis and Literature Review

alkiviadis.1961 shared this article with you from Inoreader

ecam.banner.jpg

Background. Qi-replenishing Chinese medicines (QCMs) are used for treating prediabetes in the traditional Chinese medicine (TCM) clinical practice. The aims of this meta-analysis were to (i) verify the efficacy and safety of QCMs in treating prediabetes and (ii) investigate the clinical outcomes between the trials complying with and not complying with the principle of "syndrome differentiation." Methods. We included only randomized controlled clinical trials (RCTs) whose Jadad scores were not less than 4. The overall clinical outcomes, including the incidence rate of diabetes, normalization of blood glucose, changes in fasting blood glucose (FBG), 2 h postprandial blood glucose, HbA1c, and occurrence of adverse events, were evaluated. Subgroup analyses were performed. Results. A total of 11 RCTs that e nrolled 2210 patients with prediabetes were included. We observed that overall treatment with QCMs significantly ameliorated the clinical outcomes of prediabetes without increasing incidence of adverse events. The results of subgroup analyses revealed that prescribing QCMs complying with syndrome differentiation ameliorated all the clinical indices, whereas prescribing not complying with syndrome differentiation could not achieve significant amelioration in FBG and HbA1c levels. Furthermore, the subgroup with syndrome differentiation reported more adverse events. Conclusions. The overall results suggested that QCMs are effective and safe in treating prediabetes. Results of subgroup analyses indicated that the groups with syndrome differentiation presented better efficacy but had a higher occurrence of adverse events. This study indicated the important role of the principle of syndrome differentiation in TCM and that the adverse events of QCMs cannot be ignored in TCM clinical practi ce.
View on the web

Random Network Transmission and Countermeasures in Containing Global Spread of COVID-19-Alike Pandemic: A Hybrid Modelling Approach

alkiviadis.1961 shared this article with you from Inoreader

complexity.banner.jpg

Since the outbreak of the novel coronavirus disease (COVID-19) at the beginning of December 2019, there have been more than 28.69 million cumulative confirmed cases worldwide as of 12th September 2020, affecting over 200 countries and regions with more than 920,463 deaths. The COVID-19 pandemic has been sweeping worldwide with unexpected rapidity. In this paper, a hybrid modelling strategy based on tessellation structure- (TS-) configured SEIR model is adopted to estimate the scale of the pandemic spread. Building on the data pertaining to the global pandemic transmission over the last six months around the world, key impact factors in the transmission and control procedure have been analysed, including isolation rate, number of the infected cases before taking prevention measures, degree of contact scope, and medical level, so as to capture the fundamental factor influencing the pandemic. The quantitative evaluation allowed us to illustrate the magnitude of risks of pandemic and to recommend appropriate national health policy of prevention measures for effectively controlling both intra- and interregional pandemic spread. Our modelling results clearly indicate that the early-stage preventive measures are the most effective action to be taken to contain the pandemic spread of the highly contagious nature of the COVID-19.
View on the web

Foreign Body Granuloma in the Tongue by a Pequi Spine

alkiviadis.1961 shared this article with you from Inoreader

crid.banner.jpg

Substances considered foreign to the human organism can penetrate it due to local trauma, initially causing an acute inflammatory response against these substances, involving a neutrophilic infiltrate that, when it fails to deal with these foreign bodies, ends up generating a granulomatous inflammatory response. Granuloma formation has been associated with a variety of conditions. The correct clinical and imaging diagnoses are extremely important for the dentist to choose an appropriate therapeutic approach, aiming at the best possible treatment. This work is aimed at describing a case report of a foreign body granuloma, formed on the tongue, from the penetration of a pequi spine, in a 76-year-old patient, in whom, after an imaging diagnosis with ultrasound, surgical removal of the lesion was performed, an d the piece was sent for histopathological examination, which confirmed the initial diagnostic hypothesis of a foreign body granuloma. The initial diagnosis of foreign body granulomas is challenging. For this reason, more sophisticated means of diagnosis such as tomography and magnetic resonance become important in the diagnosis, as they can show with greater clarity and reliability the nature of the lesion and its relationship with adjacent anatomical structures. In the case in question, an ultrasound examination was chosen, which was extremely important as an aid to diagnosis, considerably improving surgical planning. In addition, after surgical removal, the result of the histopathological analysis is essential to determine the definitive diagnosis, as it determines the granulomatous characteristic of the lesion.
View on the web

How to Stop Restaurants from Driving COVID Infections

alkiviadis.1961 shared this article with you from Inoreader

Message:


In cities worldwide, coronavirus outbreaks have been linked to restaurants, cafes and gyms. Now, a new model using mobile-phone data to map people's movements suggests that these venues could account for most COVID-19 infections in US cities.

The model, published in Nature today, also reveals how reducing occupancy in venues can significantly cut the number of infections.

The model "has concrete pointers as to what may be cost-effective measures to contain the spread of the disease, while at the same time, limiting the damage to the economy", says Thiemo Fetzer, an economist at the University of Warwick in Coventry. "This is the policy sweet spot."


ADVERTISEMENT
MOBILITY DATA
To predict how people's movements might affect viral transmission, the research team input anonymized location data from mobile-phone apps into a simple epidemiological model that estimated how quickly the disease spreads. The location data, collected by SafeGraph, a company based in Denver, Colorado, came from 10 of the largest US cities, including Chicago, Illinois; New York; and Philadelphia, Pennsylvania. It mapped how people moved in and out of 57,000 neighbourhoods to points of interest, such as restaurants, churches, gyms, hotels, car dealers and sporting-goods stores for 2 months starting in March.

When the team compared the model's number of infections in Chicago neighbourhoods between 8 March and 15 April with the number of infections officially recorded in those neighbourhoods a month later, they found that the model had accurately predicted confirmed case numbers.

"We are able to faithfully estimate the contact network between 100 million people for every hour of the day. That is the secret ingredient we have," says Leskovec.

VENUE HOT SPOTS
The team then used the model to simulate different scenarios, such as reopening some venues while keeping others closed. They found that opening restaurants at full capacity led to the largest increase in infections, followed by gyms, cafes and hotels and motels. If Chicago had reopened restaurants on 1 May, there would have been nearly 600,000 additional infections that month, while Opening gyms would have produced 149,000 extra infections. If all venues were open, the model predicts that there would have been 3.3 million additional cases.

But capping occupancy for all venues at 30% would reduce the number of additional infections to 1.1 million, the model estimated. If occupancy was capped at 20%, new infections would be reduced by more than 80% to about 650,000 cases.


ADVERTISEMENT
"The study highlights how real-time big data on population mobility offers the potential to predict transmission dynamics at unprecedented levels of spatial granularity," says Neil Ferguson, an epidemiologist at Imperial College London.

The mobility data also suggests why people from poorer neighbourhoods are more likely to get COVID-19: because they are less able to work from home, and the stores they visit for essential supplies are often more crowded than in other areas. The average grocery store in poorer neighbourhoods had 59% more hourly visitors per square foot, and visitors stayed on average 17% longer than at stores outside those areas. Leskovec says that people living in these areas probably have limited options to visit less crowded stores, and as a result, a shopping trip is twice as risky as it is for someone from a wealthier area.

But Christopher Dye, an epidemiologist at the University of Oxford, says these mobility patterns need to be validated with real-world data. "It is an epidemiological hypothesis that remains to be tested. But it is a hypothesis that is well worth testing," he says.

newsletter promo
Read Our Latest Issue

Read Now
GLOBAL TREND
Broadly speaking, Fetzer says, the modelling study corroborates much of what has been learnt from contact-tracing studies worldwide, which have identified restaurants, gyms, choir practices, nursing homes and other crowded indoor venues as locations of superspreader events, where many people are infected at one time.

Last month, Fetzer published a report showing how a UK government programme called Eat Out to Help Out, in which restaurant meals were subsidized during August, led to a huge surge in restaurant visits and accounted for up to 17% of new COVID-19 infections that month.


ADVERTISEMENT
But restaurants might not be hot spots everywhere. Contact-tracing data from Germany has found that restaurants were not the primary source of infection in that country, says Moritz Kraemer, who models infectious diseases at the University of Oxford, UK. That might be because it can be difficult to identify the source of an infection using contact-tracing data. Although the model's prediction of overall infection rates in cities was validated with real-world data, Kraemer says more detailed contact-tracing data will be required to test whether the model correctly identified the actual location of infections.

Leskovec says that all models have some amount of error. But as many of its predictions align with observational data, he adds, there is no reason to think that it wouldn't work at smaller scales.

If the model is found to accurately predict the risk of visiting specific locations, health officials could use it to fine-tune social-distancing policies, says Ferguson.

This article is reproduced with permission and was first published on November 10 2020.

F672C42D-12B6-4629-B3F0B32F6DFF0275.jpg

Mobile phone data suggests restaurants, gyms and cafes can be COVID hotspots—and reveals strategies for limiting spread

-- Read more on ScientificAmerican.com
Attachments:
View on the web

Laparoscopic Distal Pancreatectomy Following Prior Upper Abdominal Surgery (Pancreatectomy and Prior Surgery)

alkiviadis.1961 shared this article with you from Inoreader

Abstract

Background and Purpose

Previous abdominal surgery can be a risk factor for perioperative complications in patients undergoing laparoscopic procedures. Today, distal pancreatectomy is increasingly performed laparoscopically. This study investigates the consequences of prior upper abdominal surgery (PUAS) for laparoscopic distal pancreatectomy (LDP).

Methods

Patients who had undergone LDP from April 1997 to January 2020 were included. Based on the history and type of PUAS, these were categorized into three groups: minimally invasive (I), open (II), and no PUAS (III). To reduce possible confounding factors, the groups were matched in 1:2:4 fashion based on age, sex, body mass index (BMI) and American Society of Anesthesiology grade.

Results

After matching, 30, 60, and 120 patients were included in the minimally invasive, open and no PUAS groups, respectively. No statistically significant differences were found in terms of intraoperative outcomes. Postoperative morbidity, mortality and length of hospital stay were similar. Open PUAS was associated with higher Comprehensive Complication Index (33.7 vs 20.9 vs 26.2, p = 0.03) and greater proportion of patients with ≥ 2 complications (16.7 vs 0 vs 6.7%, p = 0.02) compared with minimally invasive and no PUAS. Male sex, overweight (BMI 25–29.9 kg/m2), diagnosis of neuroendocrine neoplasia, and open PUAS were risk factors for severe morbidity in the univariable analysis. Only open PUAS was statistically significant in the multivariable model.

Conclusions

PUAS does not impair the feasibility and safety of LDP as its perioperative outcomes are largely comparable to those in patients without PUAS. However, open PUAS increases the burden and severity of postoperative complications.

View on the web

Vitamin D, Omega-3s, and Strength-Training May Offer No Benefit in Healthy Older Adults

alkiviadis.1961 shared this article with you from Inoreader
Among adults aged 70 or older with no major comorbidities, treatment with vitamin D, omega-3s, or strength-training exercise does not seem to improve...
View on the web

Zebra Coloration Messes With Fly Eyes

alkiviadis.1961 shared this article with you from Inoreader

88C819BA-4EF8-47B0-9801ADEF4B0A39D7.jpg

Horseflies misjudge landing on zebra patterns compared with solid grey or black surfaces, which provides evidence for why evolution came up with the black and white pattern.

-- Read more on ScientificAmerican.com
Attachments:
View on the web

Αρχειοθήκη ιστολογίου