Radiologic evaluation of associated symptoms and fractal analysis of unilateral dens invaginatus cases.

OBJECTIVE: The aim of this study is to determine the age-based prevalence of dens invaginatus cases and to learn the radiologic findings. In addition, fractal analysis of the periapical regions of unilateral dens invaginatus cases and contralateral teeth was performed to determine the effect of possible microleakage on fractal dimension. METHODS: A total of 136 patients (170 teeth) identified in panoramic radiographs taken for diagnostic purposes between January 2018 and December 2023 at our Department of Oral and Maxillofacial Radiology were included in the study. Data were analysed using IBM SPSS V23. The Chi-square test was used for comparing categorical variables between groups. The relationship between the FD values calculated around the apexes of the teeth with unilateral dens invaginatus and the contralateral teeth was analyzed by paired t test. A significance level of p < 0.050 was adopted. RESULTS: The mean age of the cases was calculated as 28.1 (8-63) years. 66 (48.5%) of the cases were female, and 70 (51.1%) were male. The lateral incisor was the most affected tooth among these cases. Bilateral cases were observed in 34 patients. Type 2 was detected in 93 patients, Type 1 in 35 patients, and Type 3 dens invagination in 8 patients. Dens invaginatus cases were observed in 134 maxillary and 2 mandibular teeth. Periapical lesions were seen in 22 of these cases. CONCLUSIONS: Dens invaginatus cases are a congenital anomaly encountered at any age. Early diagnosis is crucial to prevent the loss of pulp vitality due to these invaginations. It should be noted that these invaginations can affect both jaws. However, due to the prevalence of occurrence in the maxillary anterior teeth and asymptomatic nonvitality, particular attention should be paid to evaluating this region. Powered by.

Modulation of Decellularized Lacrimal Gland Hydrogel Biodegradation by Genipin Crosslinking.

Purpose: Hydrogels derived from decellularized tissues are promising biomaterials in tissue engineering, but their rapid biodegradation can hinder in vitro cultivation. This study aimed to retard biodegradation of a hydrogel derived from porcine decellularized lacrimal glands (dLG-HG) by crosslinking with genipin to increase the mechanical stability without affecting the function and viability of lacrimal gland (LG)-associated cells. Methods: The effect of different genipin concentrations on dLG-HG stiffness was measured rheologically. Cell-dependent biodegradation was quantified over 10 days, and the impact on matrix metalloproteinase (MMP) activity was quantified by gelatin and collagen zymography. The viability of LG epithelial cells (EpCs), mesenchymal stem cells (MSCs), and endothelial cells (ECs) cultured on genipin-crosslinked dLG-HG was assessed after 10 days, and EpC secretory activity was analyzed by ß-hexosaminidase assay. Results: The 0.5-mM genipin increased the stiffness of dLG-HG by about 46%, and concentrations > 0.25 mM caused delayed cell-dependent biodegradation and reduced MMP activity. The viability of EpCs, MSCs, and ECs was not affected by genipin concentrations of up to 0.5 mM after 10 days. Moreover, up to 0.5-mM genipin did not negatively affect EpC secretory activity compared to control groups. Conclusions: A concentration of 0.5-mM genipin increased dLG-HG stiffness, and 0.25-mM genipin was sufficient to prevent MMP-dependent degradation. Importantly, concentrations of up to 0.5-mM genipin did not compromise the viability of LG-associated cells or the secretory activity of EpCs. Thus, crosslinking with genipin improves the properties of dLG-HG for use as a substrate in LG tissue engineering.

Enhancement of lacrimal gland cell function by decellularized lacrimal gland derived hydrogel.

Sustainable treatment of aqueous deficient dry eye (ADDE) represents an unmet medical need and therefore requires new curative and regenerative approaches based on appropriatein vitromodels. Tissue specific hydrogels retain the individual biochemical composition of the extracellular matrix and thus promote the inherent cell´s physiological function. Hence, we created a decellularized lacrimal gland (LG) hydrogel (dLG-HG) meeting the requirements for a bioink as the basis of a LG model with potential forin vitroADDE studies. Varying hydrolysis durations were compared to obtain dLG-HG with best possible physical and ultrastructural properties while preserving the original biochemical composition. A particular focus was placed on dLG-HG´s impact on viability and functionality of LG associated cell types with relevance for a futurein vitromodel in comparison to the unspecific single component hydrogel collagen type-I (Col) and the common cell culture substrate Matrigel. Proliferation of LG epithelial cells (EpC), LG mesenchymal stem cells, and endothelial cells cultured on dLG-HG was enhanced compared to culture on Matrigel. Most importantly with respect to a functionalin vitromodel, the secretion capacity of EpC cultured on dLG-HG was higher than that of EpC cultured on Col or Matrigel. In addition to these promising cell related properties, a rapid matrix metalloproteinase-dependent biodegradation was observed, which on the one hand suggests a lively cell-matrix interaction, but on the other hand limits the cultivation period. Concluding, dLG-HG possesses decisive properties for the tissue engineering of a LGin vitromodel such as cytocompatibility and promotion of secretion, making it superior to unspecific cell culture substrates. However, deceleration of biodegradation should be addressed in future experiments.

Analysis of type 2 diabetes heterogeneity with a tree-like representation: insights from the prospective German Diabetes Study and the LURIC cohort.

BACKGROUND: Heterogeneity in type 2 diabetes can be represented by a tree-like graph structure by use of reversed graph-embedded dimensionality reduction. We aimed to examine whether this approach can be used to stratify key pathophysiological components and diabetes-related complications during longitudinal follow-up of individuals with recent-onset type 2 diabetes. METHODS: For this cohort analysis, 927 participants aged 18-69 years from the German Diabetes Study (GDS) with recent-onset type 2 diabetes were mapped onto a previously developed two-dimensional tree based on nine simple clinical and laboratory variables, residualised for age and sex. Insulin sensitivity was assessed by a hyperinsulinaemic-euglycaemic clamp, insulin secretion was assessed by intravenous glucose tolerance test, hepatic lipid content was assessed by 1 H magnetic resonance spectroscopy, serum interleukin (IL)-6 and IL-18 were assessed by ELISA, and peripheral and autonomic neuropathy were assessed by functional and clinical measures. Participants were followed up for up to 16 years. We also investigated heart failure and all-cause mortality in 794 individuals with type 2 diabetes undergoing invasive coronary diagnostics from the Ludwigshafen Risk and Cardiovascular Health (LURIC) cohort. FINDINGS: There were gradients of clamp-measured insulin sensitivity (both dimensions: p<0·0001) and insulin secretion (pdim1<0·0001, pdim2=0·00097) across the tree. Individuals in the region with the lowest insulin sensitivity had the highest hepatic lipid content (n=205, pdim1<0·0001, pdim2=0·037), pro-inflammatory biomarkers (IL-6: n=348, pdim1<0·0001, pdim2=0·013; IL-18: n=350, pdim1<0·0001, pdim2=0·38), and elevated cardiovascular risk (nevents=143, pdim1=0·14, pdim2<0·00081), whereas individuals positioned in the branch with the lowest insulin secretion were more prone to require insulin therapy (nevents=85, pdim1=0·032, pdim2=0·12) and had the highest risk of diabetic sensorimotor polyneuropathy (nevents=184, pdim1=0·012, pdim2=0·044) and cardiac autonomic neuropathy (nevents=118, pdim1=0·0094, pdim2=0·06). In the LURIC cohort, all-cause mortality was highest in the tree branch showing insulin resistance (nevents=488, pdim1=0·12, pdim2=0·0032). Significant gradients differentiated individuals having heart failure with preserved ejection fraction from those who had heart failure with reduced ejection fraction. INTERPRETATION: These data define the pathophysiological underpinnings of the tree structure, which has the potential to stratify diabetes-related complications on the basis of routinely available variables and thereby expand the toolbox of precision diabetes diagnosis. FUNDING: German Diabetes Center, German Federal Ministry of Health, Ministry of Culture and Science of the state of North Rhine-Westphalia, German Federal Ministry of Education and Research, German Diabetes Association, German Center for Diabetes Research, European Community, German Research Foundation, and Schmutzler Stiftung.

Evaluation of container port sustainability using WASPAS technique using on type-2 neutrosophic fuzzy numbers.

According to the common opinion in the literature, the sustainability of container ports is a tremendously complex topic owing to the maritime sector's excessively dynamic form and many highly complex, predictable and unpredictable uncertainties in this industry. The current paper proposes two powerful, practical, inspiring approaches to fill these gaps. It proposes a novel type-2 neutrosophic fuzzy numbers (T2NFNs) based Delphi method to determine the criteria logically and optimal and extends the WASPAS technique based on the T2NFNs for evaluating the alternatives. The current paper presents practical managerial implications that many stakeholders can consider, such as port authorities, ship owners, logistics service providers, governments, and local authorities, when making strategic and managerial decisions. In addition, the results of a comprehensive sensitivity analysis performed to test the robustness and applicability of the model approve the validity of the proposed T2NFN-based integrated approach.

Evaluation of changes in the maxillary sinus of orthodontic patients with maxillary molar distalization using cone-beam computed tomography.

INTRODUCTION: This study aimed to evaluate the possible effects of maxillary molar distalization on maxillary sinus mucosa thickness and sinus volume in 3-dimensions. METHODS: The study was conducted with 46 patients: 73.9% (n = 34) females and 26.1% (n = 12) males. The patients had a mean age of 27.89 ± 6.62 years, ranging from 18 to 45 years. The study included patients who were admitted to the Faculty of Dentistry at Van Yüzüncü Yil University between 2010 and 2021 and underwent cone-beam computed tomography (CBCT) before and after orthodontic treatment for various reasons. The CBCT scans of patients were divided into 2 groups: the first group underwent orthodontic treatment and maxillary molar distalization with Class II elastic, whereas the second group consisted of patients who did not get orthodontic treatment (control). In CBCTs, sinus mucosa thickness was measured on the anterior, posterior, medial, lateral, superior, and inferior walls of the maxillary right and left sinuses. Three-dimensional volume calculations were made using CBCT images taken before and after the treatment of both orthodontic treatment patients and control patients. Statistical significance was set at P <0.05. RESULTS: The orthodontic treatment group had a mean distalization of 2.86 ± 0.27 mm. The mean distalization time was 8.01 ± 0.64 months. When the differences between the pretreatment and posttreatment CBCT scans were examined in terms of sinus mucosa thickness in the anterior, posterior, medial, lateral, and superior walls of the right and left sinuses, there was no statistically significant difference between treatment and control groups (P >0.05). The change in sinus mucosa thickness in the right and left sinus inferior wall from T1 to T2 was significantly higher in the control group than treatment group (P <0.05). In addition, the increase in maxillary sinus volume was statistically significantly higher in the treatment group than in the control group (P <0.05). CONCLUSIONS: We observed that maxillary molar distalization caused an increase in maxillary sinus volume. The change in sinus mucosa thickness in the right and left sinus inferior wall was lower in the maxillary molar distalization group.

Rational and design of the REMOTE trial: An exploratory, pilot study to analyze REtinal MicrOcirculaTion in wEightlessness.

BACKGROUND: "Spaceflight associated neuro-ocular syndrome" (SANS) represents a challenging health condition in modern space medicine. Forty-eight percent of astronauts are diagnosed with SANS after long-term space missions. The pathophysiological mechanism seems to be multifactorial, and yet remains unknown. In this proof-of-concept study we plan to investigate retinal microcirculatory changes in weightlessness and aim to identify their role in the development of SANS. METHODS AND DESIGN: Healthy individuals will take part in a parabolic flight campaign, which recreates fractioned total weightlessness periods. The airplane is specifically equipped, and designed for the execution of parabolic flight maneuvers and scientific research in microgravity. Retinal microcirculation will be assessed with a modified fundus camera, which allows dynamic vessel analysis. We will additionally measure intra-ocular pressure and hemodynamic changes during each phase of the flight. Blood samples will be analyzed at baseline, one hour and 24 hours after exposure to weightlessness. CONCLUSIONS: This pilot study aims to investigate the feasibility of retinal microcirculation assessment during varying gravity. Results of this study may generate insights whether venous stasis in the eye, surrogated by the dilatation of retinal vessels and increase in intraocular pressure as signs of venous insufficiency, may potentially contribute to the development of SANS.

A novel two-phase group decision-making model for circular supplier selection under picture fuzzy environment.

Circular supply chain management (CSCM), which incorporates circular thinking into supply chain management, promotes supply chain sustainability by offering a novel and compelling viewpoint. In the CSCM, supplier selection is crucial in establishing a competitive edge among businesses by decreasing environmental degradation and related supply chain expenses. This paper aims to propose a novel two-phase group decision-making approach, which combines the picture fuzzy Analytical Hierarchical Process (PF-AHP) and grey Measurement of Alternatives and Ranking According to Compromise Solution (MARCOS-G) model to select railway material suppliers within the scope of circular economy perspective. In group decision-making, a picture fuzzy number-based approach aggregates individual decision makers'(DMs) opinions and provides a lower level of computing complexity and a higher level of performance. The PF-AHP has been used to produce the weights of the criteria, and the MARCOS-G technique has been used to rank the suppliers and choose the most appropriate one. The results and verification of the novel method are carried out throughout a comprehensive sensitivity analysis. For this purpose, 50 scenarios with changes in the weight values of criteria were developed. In the validation analysis, a comparison with other grey COPRAS, TOPSIS, ARAS and WASPAS methods were performed. Due to the ranking results obtained from Spearman's correlation analyses, the MARCOS-G is almost consistent and it can be seen that the A4 remains the top supplier in all 50 scenarios.

Is there an association between proton pump inhibitors and radiomorphometric parameters of the mandible? A preliminary study.

OBJECTIVES: This study aimed to analyze the association between the use of proton pump inhibitors (PPIs) and radiomorphometric parameters of trabecular and cortical bone of the mandible. METHODS: A total of 64 patients (37 females and 27 males) using PPIs (PPI group) and 64 age- and gender-matched healthy individuals (control group) were included in this study. The analyzed radiomorphometric parameters were fractal dimension (FD), mandibular cortical width (MCW), and mandibular cortical index (MCI). RESULTS: There were no significant differences in the mean FDs of selected regions and MCW between the two groups (p > 0.05). The mean MCW was 1.95 mm in the PPI group and 2 mm in the control group. The MCI C3 category, which represents the most porous state of the mandibular cortex, was 2.5 times more frequent in the PPI group (p = 0.002). PPI use duration did not correlate with FD or MCW. No significant differences were observed in FD, MCW, and MCI distribution according to PPI type (p > 0.05). CONCLUSIONS: Although not all radiomorphometric parameters indicated osteoporotic effects of PPI use, the mandibular cortex of PPI users is prone to erosive defects.

Towards the circular economy: Analysis of barriers to implementation of Turkey's zero waste management using the fuzzy DEMATEL method.

Zero waste has an important position in the circular economy model in terms of manufacturing recyclable products instead of products to be consumed quickly, reducing the amount of waste, developing and implementing recycling/reuse technologies, and thus ensuring resource efficiency. A zero-waste strategy is one of the basic steps to achieve the goal of the circular economy. The number of studies conducted on Turkey's zero waste management strategies referring to the circular economy is quite limited. To fill this gap in the literature, this study aims to identify the potential barriers which have an important role in zero waste management practices in Turkey. Through a broad literature review and expert opinions, 12 key barriers for zero waste implementation in Turkey have been defined in view of circular economy principles. Then, fuzzy DEMATEL methodology is employed to examine which is the most influential barrier affecting zero waste management success and to identify the interdependence of these barriers. The results indicate that uncertainty of the goals and tactics relevant to the circular economy and lack of financial and economic aid are key causal barriers that affect Turkey's zero waste management.

Prevalence of foramen Huschke: evaluation of the association between mastoid pneumatization volume and the existence of foramen Huschke using cone beam computed tomography.

PURPOSE: The study examined the association between mastoid pneumatization (MP) volume and the existence of foramen Huschke (FH). METHODS: Cone beam computed tomography (CBCT) images of 1117 patients (2234 mastoid regions) were analyzed. The prevalence of FH was calculated. The association of MP volume calculated in 83 patients (48 women, 35 men) with sex, side, and the existence of FH analyzed. T test and Pearson's Chi-square test were used for statistical analyses. RESULTS: FH was observed in 223 (20%) patients. FH was unilateral in 141 (63.7%) patients (74 left-sided, 68 right-sided) and bilateral in 81 (36.3%) patients. Six patients with FH had herniation into the external auditory canal. MP volume was significantly greater in females (p = 0.016). Additionally, MP volume was significantly greater in patients having FH (p = 0.009). CONCLUSION: It is possible to speculate that the volume of MP, which is in close neighborhood with the external auditory canal, somehow affects the existence of FH located in the tympanic segment.

Three-Dimensional Analysis of Impacted Maxillary and Mandibular Canines and Evaluation of Factors Associated With Transmigration on Cone-Beam Computed Tomography Images.

PURPOSE: The aim of this study was to determine the prevalence of canine transmigration in the maxilla and mandible and to perform a 3-dimensional examination of impacted canines (ICs) on cone-beam computed tomography (CBCT) images. MATERIALS AND METHODS: CBCT images of 35 transmigrated and 35 nontransmigrated canines (control group) were analyzed. Associations between gender, jaw, dental anomalies associated with ICs, adjacent lateral status, the status of deciduous canine, contact of the apical region with the cortex, contact of the crown with the cortex, canine location, resorption of adjacent teeth and severity, periodontal contour of adjacent teeth, odontoma, root status of the canine, cyst formation, and age groups of patients with transmigration were evaluated. RESULTS: The prevalence of unilateral canine transmigration was 1.14%. Unilateral canine transmigration was less common in the mandible (0.52%) than in the maxilla (0.62%). ICs were significantly more frequently located on the lingual side. Resorption, the absence of contact between permanent and deciduous canines, and older age were significantly associated with transmigration. Resorption of adjacent teeth did not show significant differences according to transmigration status and gender, whereas nontransmigrated canines were significantly more commonly associated with periodontal destruction. CONCLUSIONS: The status of associated deciduous canines, location on the lingual side, and older age may be associated with transmigration of ICs. Conversely, transmigration is not significantly associated with the destruction of adjacent structures. CBCT is a valuable tool for comprehensive evaluations of impacted and transmigrated teeth.

Is it possible to estimate volume of bone defects formed on dry sheep mandibles more practically by secondarily reconstructing section thickness of cone beam computed tomography images?

OBJECTIVES: The purpose of this study was to evaluate the effect of section thickness on volume estimations of bone defects scanned using cone beam computed tomography (CBCT). METHODS: 25 bone defects were prepared on sheep mandibles and scanned using a KaVo 3D eXam (KaVo Dental, Biberach, Germany) CBCT device. Section thickness of images were reconstructed at 0.25, 0.5, and 0.75 mm to estimate the volume of these defects using the semiautomatic segmentation method. The volume averages obtained using microcomputed tomography and Archimedes' method served as reference values. The estimated volumes at each section thickness were compared with the actual volumes using the Friedman test. The accuracy of volume estimation was determined by the percentage error with respect to the reference values, and the mean absolute error (MAE) was calculated. RESULTS: Volumetric values of bone defects obtained with CBCT at section thicknesses up to 0.5 mm were compatible with the actual volumes (p > 0.05). The percentage errors at section thicknesses of 0.25, 0.5, and 0.75 mm were -5.4%, -7.3%, and -13.1%, respectively. The mean absolute errors were 13.6 mm3, 15.7 mm3, and 18.2 mm3, respectively. CONCLUSIONS: The section thickness values of CBCT images can be increased to a reasonable level to obtain accurate volume estimation results and save time. The semiautomatic segmentation method can be used reliably for volume estimations of bone defects.

Poor glycemic control impairs the cardioprotective effects of red blood cells on myocardial ischemia/reperfusion injury.

Red blood cells (RBCs) play an important role in the cardiac ischemia/reperfusion (I/R) injury. Cardiovascular risk factors impair the RBC function in an endothelial nitric oxide synthase (eNOS) dependent manner. However, it is unclear whether the protective role of RBCs can be rescued by modifying cardiovascular risk factors or by pharmacologic intervention. RBCs obtained from elderly patients with or without diabetes as well as from young volunteers were treated with vehicle, eNOS inhibitor l-NAME and/or arginase inhibitor nor-NOHA before loading to the coronary system of isolated murine hearts in a Langendorff system before 40 min of global ischemia. RBCs from young and healthy volunteers as well as from aged persons and elderly diabetes patients with satisfying blood glucose control improved left ventricular function upon 60 min of reperfusion with Krebs-Henseleit buffer and reduced the infarct size compared to buffer treated controls. This cardioprotective effect was abolished in RBCs from aged diabetes patients with poor blood glucose control. Treatment of RBCs from elderly diabetes patients with nor-NOHA partly rescued the cardioprotective function. Thus, effective glucose control in aged diabetes patients rescues RBC-dependent cardioprotection in an ex-vivo model of myocardial I/R injury.

A Model of Blood Component-Heart Interaction in Cardiac Ischemia-Reperfusion Injury using a Langendorff-Based Ex Vivo Assay.

INTRODUCTION: Myocardial infarction is one of the leading causes of morbidity and mortality worldwide. Cellular interactions of red blood cells (RBCs) and platelets with endothelial cells and cardiomyocytes play a crucial role in cardiac ischemia/reperfusion (I/R) injury. However, addressing the specific impact of such cell-to-cell interactions in commonly employed in vivo models of cardiac I/R injury is challenging due to overlap of neuronal, hormonal, and immunological pathways. This study aimed to refine a Langendorff-based ex vivo transfer model to evaluate the impact of specific blood components on cardiac I/R injury. MATERIAL AND METHODS: Murine whole blood, defined murine blood components (RBCs, platelet-rich plasma [PRP], and platelet-poor plasma [PPP], respectively) as well as human RBCs were loaded to the coronary system of isolated murine hearts in a Langendorff system before initiating global ischemia for 40 minutes. Following 60 minutes of reperfusion with Krebs Henseleit Buffer, left ventricular function and coronary flow were assessed. Infarct size was determined by specific histological staining following 120 minutes of reperfusion. RESULTS: Loading of murine whole blood to the coronary system of isolated murine hearts at the beginning of 40 minutes of global ischemia improved left ventricular function after 60 minutes of reperfusion and reduced the infarct size in comparison to buffer-treated controls. Similarly, isolated murine RBCs, PRP, and PPP mediated a protective effect in the cardiac I/R model. Furthermore, human RBCs showed a comparable protective capacity as murine RBCs. CONCLUSION: This Langendorff-based transfer model of cardiac I/R injury is a feasible, time-, and cost-effective model to evaluate the impact of blood components on myocardial infarction. The presented method facilitates loading of blood components of genetically modified mice to murine hearts of a different mouse strain, thus complementing time- and cost-intensive chimeric models and contributing to the development of novel targeted therapies.

Analysis of human microcirculation in weightlessness: Study protocol and pre-study experiments.

BACKGROUND: In weightlessness, alterations in organ systems have been reported. The microcirculation consists of a network of blood vessels with diameters of a few µm. It is considered the largest part of the circulatory system of the human body and essential for exchange of gas, nutrients and waste products. An investigation of the microcirculation in weightlessness seems warranted but has not yet been performed. OBJECTIVE: In this paper, we outline a study in which we will investigate the possible interrelations between weightlessness and microcirculation. We will induce weightlessness in the course of parabolic flight maneuvers, which will be conducted during a parabolic flight campaign. In this study protocol also an evaluation of a possible influence of parabolic flight premedication on microcirculation will be described. METHODS: The microcirculation will be investigated by sublingual intravital measurements applying sidestream darkfield microscopy. Parameters of macrocirculation such as heart rate, blood pressure and blood oxygenation will also be investigated. RESULTS: In our pre-study experiments, neither dimenhydrinate nor scopolamine altered microcirculation. CONCLUSIONS: As the application of motion sickness therapy did not alter microcirculation, it will be applied during the parabolic flight maneuvers of the campaign. Our results might deepen the understanding of microcirculation on space missions and on earth.