Effects of concentration of sodium hypochlorite as an endodontic irrigant on the mechanical and structural properties of root dentine: A laboratory study

alexandrossfakianakis shared this article with you from Inoreader Effects of concentration of sodium hypochlorite as an endodontic irrigant on the mechanical and structural properties of root dentine: A laboratory study via International Endodontic Journal Abstract Aim The use of high-concentration sodium hypochlorite (NaOCl) as an endodontic irrigant remains controversial because of its potential impact on the fracture strength of endodontically-treated teeth. This study evaluated the effects of using different NaOCl concentrations, with 2-min-ethylenediaminetetraacetic acid (EDTA) as the final active irrigant, on the biomechanical and structural properties of root dentine. Methodology A new test method, which is more clinically relevant, was utilized to calculate the fracture strength of root dentine. Bovine incisors were used to obtain root dentine discs. The root canals were enlarged to mean diameter of 2.90 mm with a taper of 0.06. The resulting discs were divided into 5 groups (n=20) and treated with different concentrations of NaOCl (5.25%, 2.5%, and 1.3%) for 30 min plus 17% EDTA for 2 min. The discs were then loaded to fracture by a steel rod with the same taper through the central hole. The fractured specimens were examined by scanning electron microscopy to evaluate changes in the dimensions of the remaining intertubular dentine and the tubular radius. Micro-hardness was also measured with a Knoop diamond indenter along a radius to determine the depth of dentine eroded by the irrigation. Results were analyzed by one-way ANOVA and the Tukey test. The level of significance was set at α = 0.05. Results The damage by NaOCl increased with its concentration. 5.25% NaOCl greatly reduced the fracture strength of root dentine from 172.10±30.13 MPa to 114.58±26.74 MPa. The corresponding reduction in micro-hardness at the root canal wall was 34.1%. The damages reached a depth of up to 400 μm (p < 0.05). Structural changes involved degradation of the intratubular wall leading to enlarged dentinal tubules and the loss of intertubular dentine. Changes in the microstructural parameters showed positive linear relationships with the fracture strength. Conclusions With the adjunctive use of EDTA, NaOCl caused destruction to the intratubular surface near the root canal and, consequently, reduced the root dentine's mechanical strength. The higher the concentration of NaOCl, the greater the effect. Therefore, endodontists should avoid using overly high concentration of NaOCl for irrigation to prevent potential root fracture in endodontically-treated teeth. View on Web

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Nutrition Education: Optimizing Preparation and Recovery for Benign Esophageal Surgery

alexandrossfakianakis shared this article with you from Inoreader Nutrition Education: Optimizing Preparation and Recovery for Benign Esophageal Surgery via Journal of Human Nutrition and Dietetics Abstract Background Patients requiring upper gastrointestinal surgery for benign esophageal conditions are at nutrition risk before and after surgery. There is a dearth of published evidence guiding clinicians on effective collaboration with patients to mitigate perioperative nutritional challenges. We conducted a qualitative study to explore patients' perioperative food, nutrition, and educational experiences to guide future care. Methods Adult patients who had undergone elective, benign esophageal surgery were invited to participate in semi-structured interviews within 3 weeks of hospital discharge. Interviews were transcribed and analyzed with a reflexive form of inductive thematic analysis in addition to synthesized member checking. Results Interviews with 12 patients identified three major themes. First, nutrition education fosters a better surgical recovery experience: patients expressed a desire to be prepared for their upcoming surgery a nd engage in the recovery process with informed food choices. Most patients preferred preoperative education given limited capacity for learning during hospital admission. Second, patients have priorities for nutrition information: patients expressed that educational material should be printed, comprehensive, practical, include familiar foods, and focus on managing postoperative physical symptoms. Third, food impacts social and emotional experiences of surgery: resumption of a normal diet was a sign of recovery that enabled social reintegration. Identified themes resonated with Knowles' six-core principles of andragogy. Conclusions Patients with benign esophageal conditions perceived nutrition education to be a vital aspect of surgical preparation and recovery. Re-designing perioperative education with patient input has the potential to improve outcomes and experiences. This article is protected by copyright. All rights reserved. View on Web

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Response to a novel, weight self‐awareness plan used in a multi‐component lifestyle intervention programme to reduce breast cancer risk factors in older women – secondary analysis from The ActWELL trial

alexandrossfakianakis shared this article with you from Inoreader Response to a novel, weight self‐awareness plan used in a multi‐component lifestyle intervention programme to reduce breast cancer risk factors in older women – secondary analysis from The ActWELL trial via Journal of Human Nutrition and Dietetics Abstract Background The ActWELL RCT assessed the effectiveness of a weight management programme delivered by volunteer lifestyle coaches (LC) in women attending breast clinics. The intervention focused on caloric intake and physical activity, utilising behavioural change techniques including a weight awareness plan (WAP). The current work is a secondary analysis of the ActWELL data and aims to examine the response to the weight self-awareness plan (used as part of the intervention programme). Methodology The LCs invited participants (n=279) to undertake an implementation intention discussion to formulate a self-weighing (SW) plan. Bodyweight scales were offered, and recording books provided. The PA intervention focused on a walking plan assessed by accelerometers. The LCs contacted participants by telephone monthly and provided personalised feedback. Mann-Whitney tests and chi-squared analysis were used to examine the effect of SW on weight change. A qualitative evaluation utilising semi-structured interviews was also undertaken. Results Most participants (96.4%) agreed to set a weekly SW goal and 76 (27%) requested scales. At 12 months, 226 (81%) returned for follow up. The median (IQR) weight change for those who self- reported at least one weight (n=211) was -2.3kg (-5.0, 0.0) compared to -1.2kg (-5.0, 0.03) in those who did not (n=14). Participants who reported weights on >8 occasions (39%) were significantly more likely (p=0.012) to achieve 5% weight loss compared to those who weighed less often. Low numbers of accelerometers were returned which did not allow for significance testing. Qualitative data (n=24) indicated that many participants found the WAP helpful and motivating. Principal Conclusion Greater adherence to the WAP initiated by volunteer coaches is associated with achieving 5% weight loss. This article is protected by copyright. All rights reserved. View on Web

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The deciphering of the immune cells and marker signature in COVID‐19 pathogenesis: An update

alexandrossfakianakis shared this article with you from Inoreader The deciphering of the immune cells and marker signature in COVID‐19 pathogenesis: An update via Journal of Medical Virology Abstract The precise interaction between the immune system and severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) is critical to deciphering the pathogenesis of Coronavirus disease 2019 (COVID-19) and is also vital for developing novel therapeutic tools, including monoclonal antibodies, antivirals drugs, and vaccines. Viral infections need innate and adaptive immune reactions since the various immune components like neutrophils, macrophages, CD4+ T, CD8+ T, and B lymphocytes play different roles in various infections. Consequently, the characterization of innate and adaptive immune reactions toward SARS-CoV-2 is crucial to defining the pathogenicity of COVID-19. In this study, we explain what is currently understood concerning the conventional immune reactions to SARS-CoV-2 infection to shed light on the protective and pathogenic role of immune response in this case. Also, in particular, we investigate the in-depth roles of other i mmune mediators, including neutrophil elastase, serum amyloid A, and Syndecan, in the immunopathogenesis of COVID-19. This article is protected by copyright. All rights reserved. View on Web

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Interpretation of Mendelian randomization using a single measure of an exposure that varies over time

alexandrossfakianakis shared this article with you from Inoreader Interpretation of Mendelian randomization using a single measure of an exposure that varies over time via International Journal of Epidemiology - Advance Access Abstract BackgroundMendelian randomization (MR) is a powerful tool through which the causal effects of modifiable exposures on outcomes can be estimated from observational data. Most exposures vary throughout the life course, but MR is commonly applied to one measurement of an exposure (e.g. weight measured once between ages 40 and 60 years). It has been argued that MR provides biased causal effect estimates when applied to one measure of an exposure that varies over time. Methods We propose an approach that emphasizes the liability that causes the entire exposure trajectory. We demonstrate this approach using simulations and an applied example. Results We show that rather than estimating the direct or total causal effect of changing the exposure value at a given time, MR estimates the causal effect of changing the underlying liability for the exposure, scaled to the effect of the liability on the exposure at that time. As such, results from MR conducted at different time points are expected to differ (unless the effect of the liability on exposure is constant over time), as we illustrate by estimating the effect of body mass index measured at different ages on systolic blood pressure. Conclusion Univariable MR results should not be interpreted as time-point-specific direct or total causal effects, but as the effect of changing the liability for the exposure. Estimates of how the effects of a genetic variant on an exposure vary over time, together with biological knowledge that provides evidence regarding likely effective exposure periods, are required to interpret time-point-specific causal effects. View on Web

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Depatuxizumab-mafodotin in EGFR-amplified newly diagnosed glioblastoma: a phase III randomized clinical trial

alexandrossfakianakis shared this article with you from Inoreader Depatuxizumab-mafodotin in EGFR-amplified newly diagnosed glioblastoma: a phase III randomized clinical trial via Neuro-Oncology Advance Access Abstract Background Approximately 50% of newly diagnosed glioblastomas (GBMs) harbor EGFR gene amplification (EGFR-amp). Preclinical and early phase clinical data suggested efficacy of depatuxizumab mafodotin (depatux-m), an antibody drug conjugate (ADC) comprised of a monoclonal antibody that binds activated EGFR (overexpressed wild-type and EGFRvIII-mutant) linked to a microtubule-inhibitor toxin in EGFR-amp GBMs. Methods In this phase III trial, adults with centrally confirmed, EGFR-amp, newly diagnosed GBM were randomized 1:1 to radiotherapy, temozolomide, and depatux-m/placebo. Corneal epitheliopathy (CE) was treated with a combination of protocol-specified prophylactic and supportive measures. There was 85% power to detect a Hazard Ratio (HR) ≤0.75 for survival (OS) at a 2.5% one-sided significance level (i.e., traditional two-sided p ≤0.05) by log-rank testing. Results There were 639 randomized patients (median age 60, range 22-84; 62% men). Pre-specified interim analysis found no improvement in OS for depatux-m over placebo (median 18.9 vs. 18.7 months, HR 1.02, 95% CI 0.82-1.26, one-sided p= 0.63). Progression-free survival was longer for depatux-m than placebo (median 8.0 vs. 6.3 months; HR 0.84, 95% CI 0.70-1.01, p=0.029), particularly among those with EGFRvIII mutant (median 8.3 vs. 5.9 months, HR 0.72, 95% CI 0.56-0.93, p=0.002 one sided) or MGMT unmethylated (HR 0.77, 95% CI 0.61-0.97; p=0.012 one-sided) tumors but without an OS improvement. CE occurred in 94% of depatux-m treated patients (61% grade 3-4), causing 12% to discontinue. Conclusions Interim analysis demonstrated no OS benefit for depatux-m in treating EGFR-amp newly diagnosed GBM. No new important safety risks were identified. View on Web

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Current trends in carotid body tumors: Comprehensive review

alexandrossfakianakis shared this article with you from Inoreader Current trends in carotid body tumors: Comprehensive review via Head & Neck Abstract Background Carotid body tumor (CBT) is a rare neoplasm that has been increasingly studied during the last decades; nevertheless, it continues to be a topic of controversy. This review aims to provide an update on the general features of CBT and particularly review different treatment strategies and primary outcomes. Methods Data for this literature review were identified by PubMed, Scopus, and Medline. 93 articles from the initial search were included, as well as 28 relevant studies utilizing the snowballing method; totaling 121 articles about CBT. Results Main features such as anatomy, embryology, genetics, clinical presentation, and diagnosis of CBT are presented, followed by evidence of different treatment strategies such as radiotherapy, preoperative embolization, vascular resection, and vascular reconstruction. Main complications are also discussed. Conclusion This review summarizes the most critical aspects regarding CBT. Future studies should compare different treatments to attain the best surgical results with lower morbidity rates. View on Web

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Latent class analysis to characterize neonatal risk for neurodevelopmental differences

alexandrossfakianakis shared this article with you from Inoreader Latent class analysis to characterize neonatal risk for neurodevelopmental differences via Journal of Child Psychology and Psychiatry Background Neonatal risk factors, such as preterm birth and low birth weight, have been robustly linked to neurodevelopmental deficits, yet it is still unclear why some infants born preterm and/or low birth weight experience neurodevelopmental difficulties while others do not. The current study investigated this heterogeneity in neurodevelopmental abilities by examining additional neonatal morbidities as risk factors, utilizing latent class analysis to classify neonates into groups based on similar neonatal risk factors, and including neonates from the full spectrum of gestational age. Methods Neonates who received neonatal care at an academic public hospital during an almost 10-year period (n = 19,951) were included in the latent class analysis, and 21 neonatal indicators of health were used. Neonatal class, sex, and the interaction between neonatal class and sex were used to examine differences in neurodevelopment at 18 months of age in a typically developing population. Results The best fitting model included five infant classes: healthy, hypoxic, critically ill, minorly ill, and complicated delivery. Scores on the parent-rated neurodevelopmental measure differed by class such that infants in the critically ill, minorly ill, and complicated delivery classes had lower scores. There was no main effect of sex on the neurodevelopmental measure scores, but the interaction between sex and neonatal class was significant for three out of five neurodevelopmental domains. Conclusions The current study extends the understanding of risk factors in neurodevelopment by including several neonatal medical conditions that are often overlooked and by using a person-centered, as opposed to variable-centered, approach. Future work should continue to examine risk factors, such as maternal health during pregnancy and medical interventions for newborns, in relation to neonatal risks and neurodevelopment by using a person-centered approach. View on Web

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Ferulic Acid Mitigates Diabetic Cardiomyopathy via Modulation of Metabolic Abnormalities in Cardiac tissues of Diabetic Rats

alexandrossfakianakis shared this article with you from Inoreader Ferulic Acid Mitigates Diabetic Cardiomyopathy via Modulation of Metabolic Abnormalities in Cardiac tissues of Diabetic Rats via Fundamental & Clinical Pharmacology Abstract Background Cardiovascular abnormalities have been reported as a major contributor of diabetic mortality. The protective effect of ferulic acid on diabetic cardiomyopathy in fructose-streptozotocin induced type 2 diabetic (T2D) rat model was elucidated in this study. Methods T2D rats were treated by oral administration of low (150 mg/kg b.w) and high (300 mg/kg b.w) doses of ferulic acid. Metformin was used as the antidiabetic drug. Rats were humanely euthanized after 5 weeks of treatment and their blood and hearts were collected. Results Induction of T2D depleted the levels of reduced glutathione, glycogen, HDL-cholesterol and the activities of superoxide dismutase, catalase, ENTPDase and 5'Nucleotidase. It simultaneously triggered marked increase in levels of malondialdehyde, total cholesterol, triglyceride, LDL-cholesterol, creatinine kinase-MB as well as activities of acetylcholinesterase, ACE, ATPase, Glucose-6-phopsphatase, fructose-1,6-bisphophatase, glycogen phosphorylase and lipase. T2D induction further revealed obvious degeneration of cardiac muscle morphology. However, treatment with ferulic acid markedly reversed the levels and activities of these biomarkers with concomitant improvement in myocardium structural morphology, which had favourable comparison with the standard drug, metformin. Additionally, T2D induction led to depletion of 40, 75, and 33% of fatty acids, fatty esters, and steroids, respectively with concomitant generation of eicosenoic acid, gamolenic acid and vitamin E. Ferulic acid tre atment restored eicosanoic acid, 2-hydroxyethyl ester, with concomitant generation of 6-Octadecenoic acid, (Z)-, cis-11-Eicosenoic acid, tridecanedioic acid, octadecanoic acid, 2-hydroxyethyl ester, ethyl 3-hydroxytridecanoate, dipalmitin, cholesterol isocaproate, cholest-5-ene, 3-(1-oxobuthoxy)-, cholesta-3,5-diene. Conclusion These results suggest the cardioprotective potential of ferulic acid against diabetic cardiomyopathy. View on Web

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Empagliflozin has favourable effect on frontal plane QRS‐T angle in diabetic patients with cardiovascular disease

alexandrossfakianakis shared this article with you from Inoreader Empagliflozin has favourable effect on frontal plane QRS‐T angle in diabetic patients with cardiovascular disease via Journal of Clinical Pharmacy and Therapeutics Empagliflozin treatment is associated with a significant decrease in the frontal plane QRS-T angle (fQRST) in patients with diabetes mellitus (DM). However, despite similar antihyperglycemic effect with empagliflozin treatment in patients with and without cardiovascular disease (CVD), the significant decrease in fQRST angle was observed only in patients with CVD and no significant decrease was observed in fQRST angle in patients without CVD. Therefore, as a sign of ventricular repolarization heterogeneity that can be easily measured from a standard 12-lead electrocardiography (ECG), fQRST angle may be a useful ECG parameter in the monitoring of cardiovascular effects of empagliflozin in type 2 DM patients with CVD. Abstract What is Known and Objective Empagliflozin treatment is significantly associated with lower risk of cardiovascular events in patients with diabetes mellitus (DM) independent of its antihyperglycemic effect. However, little is known regarding the impact of empagliflozin on electrocardiography (ECG) parameters. This study aimed to investigate whether empagliflozin has favourable effect on frontal plane QRS-T (fQRST) angle, which is an ECG sign of ventricular repolarization heterogeneity, in patients with type 2 DM. Methods We prospectively enrolled 111 patients with known diagnosis of type 2 DM who newly prescribed empagliflozin on top of their standard anti-diabetic therapy. Patients were divided into two groups according to presence or absence of cardiovascular disease (CVD) at baseline and followed-up for 6 months. The impact of empagliflozin treatment on fQRST angle was investigated and patient groups were compared regarding the pre- and post-treatment fQRST angle. Results and Discussion Among 111 patients, 32 (28.8%) had CVD and 79 (71.2%) had no CVD. Empagliflozin treatment lead a significant decrease in the mean fQRST angle throughout the study period and mean fQRST angle was significantly lower at 3- and 6-month follow-up visits compared to baseline values (62° ± 17.4° vs. 57.2° ± 14.8° vs. 50.5° ± 13.6°, p < 0.001 for all dual comparisons). However, despite similar antihyperglycemic effect with empagliflozin treatment in patients with and without CVD, the significant decrease in the mean fQRST angle was observed only in patients with CVD and no significant decrease was observed in the mean fQRST angle in patients without CVD. What is New and Conclusion Empagliflozin leads a significant narrowing in the fQRST angle in type 2 DM patients with known CVD. View on Web

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