Root Canal Instrumentation: Current Trends and Future Perspectives.

The evolution of root canal instrumentation techniques has significantly impacted the field of endodontics, enhancing both the efficiency and outcomes of treatments. This review outlines the transition from manual to mechanical and rotary instruments, highlighting the role of nickel-titanium (NiTi) alloys and smart technologies in advancing procedural precision and reducing patient discomfort. Key historical developments and technological innovations, such as digital imaging and navigation systems, are explored for their contributions to improved clinical outcomes and patient satisfaction. Additionally, the review addresses the challenges presented by the complex anatomy of the root canal system and the advent of current instrumentation techniques. The potential of emerging trends, including artificial intelligence and advances in materials science, is discussed in the context of future endodontic practices. Despite the progress, challenges related to using advanced instrumentation methods, ethical considerations, and the cost factor of new technologies persist. The present review underscores the ongoing need for research and development to further refine root canal instrumentation techniques, ensuring that advancements in endodontic care remain patient-centered and accessible.

Brain tumor detection with integrating traditional and computational intelligence approaches across diverse imaging modalities - Challenges and future directions.

Brain tumor segmentation and classification play a crucial role in the diagnosis and treatment planning of brain tumors. Accurate and efficient methods for identifying tumor regions and classifying different tumor types are essential for guiding medical interventions. This study comprehensively reviews brain tumor segmentation and classification techniques, exploring various approaches based on image processing, machine learning, and deep learning. Furthermore, our study aims to review existing methodologies, discuss their advantages and limitations, and highlight recent advancements in this field. The impact of existing segmentation and classification techniques for automated brain tumor detection is also critically examined using various open-source datasets of Magnetic Resonance Images (MRI) of different modalities. Moreover, our proposed study highlights the challenges related to segmentation and classification techniques and datasets having various MRI modalities to enable researchers to develop innovative and robust solutions for automated brain tumor detection. The results of this study contribute to the development of automated and robust solutions for analyzing brain tumors, ultimately aiding medical professionals in making informed decisions and providing better patient care.

Coumarin-transition metal complexes with biological activity: current trends and perspectives.

Coumarin (2H-1-benzopyran-2-one) presents the fundamental structure of an enormous class of biologically active compounds of natural, semi-synthetic, and synthetic origin. Extensive efforts are continually being put into the research and development of coumarin derivatives with medicinal properties by the broad scientific community. Transition metal coordination compounds with potential biological activity are a "hot topic" in the modern search for novel drugs. Complexation with transition metals can enhance the physiological effect of a molecule, modify its safety profile, and even imbue it with novel attributes of interest in the fields of medicine and pharmacy. The present review aims to inform the reader of the latest developments in the search for coumarin transition metal complexes with biological activity, their potential applications, and structure-activity relationships, where such can be elucidated. Each section of the present review addresses a certain kind of biological activity (antiproliferative, antioxidant, antimicrobial, etc.), explores the most recent discoveries in the field, and, at the same time, tries to offer useful perspectives for potential future investigations.

Comparing "Meaningful Use" of Health Information Technology in Pennsylvania: Electronic Prescription Rates of Metropolitan and Rural Counties.

The Health Information Technology for Economic and Clinical Health Act incentivized the adoption of electronic health records (EHRs). Health systems looked to leverage technology to assist in serving populations in health professional shortage areas. Qualitative research points to EHR usability as a source of health inequities in rural settings, making the challenges of EHR usage a subject of interest. Pennsylvania offers a model for investigating rural health infrastructure with it having the third largest rural population in the United States. This study analyzed the adoption of Electronic Prescribing in the 67 Pennsylvania (PA) counties. Physician adoption and usage data for PA and the United States were compared using a t-test to establish a basis for comparison. PA counties were categorized using the United States Department of Agriculture (USDA)'s Rural-Urban Commuting Areas (RUCAs) system. Surescript use percentages were plotted against the RUCA scores of each PA county to create a polynomial regression model. PA office-based physicians, on average, utilize e-prescription tools at the same rate as the national average with 59% of practices utilizing Surescripts as of 2013. There was no significant correlation between Surescript usage and the rural/urban classification of counties in Pennsylvania (R-squared value of 0.06). Pennsylvania was able to adopt health information technology (HIT) infrastructure at the same rate as the national average. Rural and metropolitan definitions do not correlate to meaningful use of HIT, thus usability of HIT cannot be tied to health outcomes. Future studies looking at specific forms of HIT and their ability to decrease the burden of administrative work for clinicians.

Current Trends In Complete Denture Education In Undergraduate Dental Colleges Of Pakistan.

Objective: To determine the current trends in complete denture education in undergraduate dental colleges. METHODS: The survey-based study was conducted in April and May 2020 at undergraduate dental colleges of Pakistan, and comprised heads of the Prosthodontics Department at all dental colleges across Pakistan having at least one batch of final year dental students. Data was collected using an online predesigned questionnaire that explored theoretical and practical teaching patterns of complete denture prosthodontics in the undergraduate years, and the materials and practices of students when constructing complete dentures in the clinics. The participants were given the option of choosing more than one option where needed. Data was analysed using SPSS 23. RESULTS: Of the 49 subjects approached, 40(81.6%) returned the forms duly filled; 11(27.5%) from public-sector institutions and 29(72.5%) from the private sector. There were 26(65%) institutions which required that their undergraduate students fabricate 2-4 conventional complete dentures. In all 40(100%) colleges, faculty gave live clinical demonstrations before students fabricated conventional complete dentures in the outpatient departments. Teaching strategy included small group discussions in 25(62.5%) institutions. Green stick 40(100%), zinc oxide eugenol 40(100%) and impression compound 39(97.2%) were the materials of choice for various steps of impression making. In all the 40(100%) institutions, students fabricated conventional complete dentures during their prosthodontics rotation. Immediate, copy and overdentures were constructed by students in 8(20%), 3(7.5%) and 8(20%) institutions, respectively. Conclusion: Majority of the dental schools used similar impression materials and techniques for fabricating conventional complete dentures. Didactic teaching of conventional and unconventional complete dentures was being carried out at a huge majority of the dental institutions studied.

Erratum: Editorial: Immuno-diagnosis of active tuberculosis; are we making progress?

[This corrects the article DOI: 10.3389/fimmu.2023.1092651.].

Current trends and research topics regarding liver 3D bioprinting: A bibliometric analysis research.

Introduction: Over recent years, 3D bioprinting has changed dramatically. The articles related to liver 3D bioprinting have not been quantitatively analyzed. In this article, we screen all articles related to liver 3D bioprinting until January 2022 and analyzed them using bibliometric citation analysis to characterize the current trends in liver 3D bioprinting. Methods: The articles were identified and analyzed from the Clarivate Analytics Web of Science Core Collection database. Results: Until 1 January 2022, 71 articles focusing on liver 3D bioprinting were identified. There was an increase in the number of articles in 2015. Most articles came from the USA (n = 27), followed by South Korea (n = 22), China (n = 16), and Japan (n = 5). The printing technology of liver 3D printing was the most studied topic (n = 29). Biofabrication published the highest number of papers (n = 16) with 1,524 total citations. Conclusion: Based on bibliometric analysis of the articles until January 2022, a comprehensive analysis of the liver 3D bioprinting articles highlighted the current trends and research topics of this field. The data should provide clinicians and researchers insight into future directions relative to the liver 3D bioprinting.

The Impact of the COVID-19 Pandemic on Orthopaedic Knee Procedures: A National Multicentered Analysis.

INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic strained the United States healthcare system, and associated policies resulted in the postponement or cancellation of many elective surgeries. While most orthopaedic surgeons are aware of how the pandemic affected their patients' care, broader national trends in the operative treatment of orthopaedic knee pathology are poorly characterized. Therefore, the purpose of this study was to identify trends in orthopaedic knee procedures during the COVID-19 pandemic. METHODS: The TriNetX database was queried for orthopaedic knee procedures performed from March 2018 to May 2021. Procedures were classified as arthroplasty (total knee arthroplasty (TKA), revision total knee arthroplasty) or non-arthroplasty (tendon or ligament repair, fracture fixation). Procedural volume per healthcare organization was determined over five seasons from March 2020 to May 2021 and compared to overlapping pre-pandemic periods from March 2018 to May 2019. Descriptive analysis was performed, and comparisons were made using a Student's T-test. RESULTS: Compared to the pre-pandemic period, there were significant decreases in primary TKA (p=0.016), femoral or entire tibial component revision TKA (p=0.005), and open treatment of femoral shaft fractures (p=0.007) in spring 2020. Procedural volume returned to baseline in summer 2020 through winter 2021. In spring 2021, primary TKA (p=0.017) and one component revision TKA (p=0.003) increased compared to the pre-pandemic period. CONCLUSION: The greatest decrease in knee procedures occurred early in the pandemic. Rates of these procedures have since rebounded, with some exceeding pre-pandemic levels. Hospitals are now better able to accommodate orthopaedic surgical volume while continuing to care for patients with COVID-19.

Recent trends in nitrogen cycle and eco-efficient nitrogen management strategies in aerobic rice system.

Rice (Oryza sativa L.) is considered as a staple food for more than half of the global population, and sustaining productivity under a scarcity of resources is challenging to meet the future food demands of the inflating global population. The aerobic rice system can be considered as a transformational replacement for traditional rice, but the widespread adaptation of this innovative approach has been challenged due to higher losses of nitrogen (N) and reduced N-use efficiency (NUE). For normal growth and developmental processes in crop plants, N is required in higher amounts. N is a mineral nutrient and an important constituent of amino acids, nucleic acids, and many photosynthetic metabolites, and hence is essential for normal plant growth and metabolism. Excessive application of N fertilizers improves aerobic rice growth and yield, but compromises economic and environmental sustainability. Irregular and uncontrolled use of N fertilizers have elevated several environmental issues linked to higher N losses in the form of nitrous oxide (N2O), ammonia (NH3), and nitrate (NO3 -), thereby threatening environmental sustainability due to higher warming potential, ozone depletion capacities, and abilities to eutrophicate the water resources. Hence, enhancing NUE in aerobic rice has become an urgent need for the development of a sustainable production system. This article was designed to investigate the major challenge of low NUE and evaluate recent advances in pathways of the N cycle under the aerobic rice system, and thereby suggest the agronomic management approaches to improve NUE. The major objective of this review is about optimizing the application of N inputs while sustaining rice productivity and ensuring environmental safety. This review elaborates that different soil conditions significantly shift the N dynamics via changes in major pathways of the N cycle and comprehensively reviews the facts why N losses are high under the aerobic rice system, which factors hinder in attaining high NUE, and how it can become an eco-efficient production system through agronomic managements. Moreover, it explores the interactive mechanisms of how proper management of N cycle pathways can be accomplished via optimized N fertilizer amendments. Meanwhile, this study suggests several agricultural and agronomic approaches, such as site-specific N management, integrated nutrient management (INM), and incorporation of N fertilizers with enhanced use efficiency that may interactively improve the NUE and thereby plant N uptake in the aerobic rice system. Additionally, resource conservation practices, such as plant residue management, green manuring, improved genetic breeding, and precision farming, are essential to enhance NUE. Deep insights into the recent advances in the pathways of the N cycle under the aerobic rice system necessarily suggest the incorporation of the suggested agronomic adjustments to reduce N losses and enhance NUE while sustaining rice productivity and environmental safety. Future research on N dynamics is encouraged under the aerobic rice system focusing on the interactive evaluation of shifts among activities and diversity in microbial communities, NUE, and plant demands while applying N management measures, which is necessary for its widespread adaptation in face of the projected climate change and scarcity of resources.

Disparities in Telehealth Utilization in a Population of Publicly Insured Children During the COVID-19 Pandemic.

Telehealth became a crucial vehicle for health care delivery in the United States during the COVID-19 pandemic. However, little research exists on inequities in telehealth utilization among the pediatric population. This study examines disparities in telehealth utilization in a population of publicly insured children. This observational, retrospective study used administrative data from Alabama's stand-alone Children's Health Insurance Program, ALL Kids. Rates of any telehealth use for March to December 2020 were examined. In addition-to capture lack of health care utilization-rates of having no medical claims were examined and compared with March to December 2019 and 2018. Multinomial logit models were estimated to investigate how telehealth use and having no medical claims (reference category: having medical claims but no telehealth) were associated with race/ethnicity, rural-urban residence, and family income. Of the 106,478 enrollees over March to December 2020, 13.4% had any telehealth use and 24.7% had no medical claims. The latter was greater than no medical claims in 2019 (19.5%) and 2018 (20.7%). Black and Hispanic children had lower odds of any telehealth use (odds ratio [OR]: 0.81, P < 0.01; OR: 0.68, P < 0.01) and higher odds of no medical claims (OR: 1.11, P < 0.05; OR: 1.73, P < 0.05) than non-Hispanic White children. Rural residents had lower odds of telehealth use than urban residents. Those in the highest family income-based fee group had higher odds of telehealth use than the lowest family income-based fee group. As telehealth will likely continue to play an important role in health care delivery, additional efforts/investments are required to ensure telehealth does not further exacerbate inequities in pediatric health care access.

Current trends in removable partial prosthodontics education in dental colleges of Pakistan.

OBJECTIVE: The objective of this study was to investigate the current trends in undergraduate teaching of removable partial prosthodontics in various dental colleges of Pakistan. METHODOLOGY: A cross-sectional study was conducted in which a questionnaire was sent by email to head of Prosthodontics department of thirty-one dental institutes of Pakistan. The survey included multiple questions regarding current trends in removable partial prosthodontics education in undergraduate dental colleges. RESULTS: Out of thirty-one questionnaires, twenty-six were completely filled and returned. In 19 (73%) dental colleges, removable partial denture is taught over a period of at least two years of undergraduate education. Students of only six dental colleges fabricate 10-12 removable partial dentures during their Prosthodontic rotation. Lectures and live clinical demonstration for construction of removable acrylic dentures are reported to be carried out in all the dental schools. Simple hinge articulator is the articulator of choice in 22 (84.6%) colleges. Even though twenty-four out of twenty-six colleges (92.3%) teach fabrication of cast partial dentures in lectures, none of the student fabricate these dentures during their Prosthodontic rotation. CONCLUSION: This survey is the first to comprehensively report the teaching practices of removable denture Prosthodontics in undergraduate dental colleges of Pakistan. Faculty of all twenty-six colleges give clinical demonstrations of acrylic partial denture construction before students start working in the dental OPD. Most of the dental colleges report use of similar impression materials and techniques in removable partial denture fabrication. More than 90% of dental colleges teach cast partial dentures theoretically, but their construction is grossly neglected in all the dental colleges. It is important that this skill is taught and practised by students in order to have the necessary skill set, so they can provide comprehensive treatment to partially dentate patients once they graduate.

Trends in Clinical Trials for Spinal Cord Stimulation.

BACKGROUND: Spinal cord stimulation (SCS) is a neuromodulation technology widely used in the treatment of intractable chronic pain syndromes. SCS is now being applied more broadly as a possible therapy for a range of indications, including neurological, cardiac, and gastrointestinal disorders. Ongoing research in this field is critical in order to gain further insights into the mechanisms of SCS, determine its role in new indications, and refine programming techniques for the optimization of therapeutic outcomes. OBJECTIVE: To assess the state of SCS-related human research by cataloging and summarizing clinical trials that have been recently completed or are currently underway in this field. METHODS: A search was conducted for clinical trials pertaining to SCS using the ClinicalTrials.gov database. Trials were analyzed to generate a detailed overview of ongoing SCS-related research. Specifically, trials were categorized by intervention, trial start date, study completion status, clinical phase, projected subject enrollment, condition, country of origin, device manufacturer, funding source, and study topic. RESULTS: In total, 212 relevant clinical trials were identified. 175 trials (82.5%) involved invasive SCS, while the remaining 37 trials (17.5%) used noninvasive forms of spinal stimulation. Most trials examined the efficacy of SCS for chronic pain syndromes or new indications, while others assessed different stimulation parameters. The studies spanned >27 different disorders, with almost 20% of trials pertaining to conditions other than chronic pain syndromes. The majority of SCS trials were US-based (55.7% of studies), but many countries (e.g., Belgium and UK) are becoming increasingly active. The ratio of investigator-sponsored to industry-sponsored trials was 2:1. Emphasizing the need to optimize therapeutic outcomes of SCS, one-quarter of trials predominantly focused on the assessment of alternative stimulation parameters such as burst or high-frequency stimulation. CONCLUSIONS: A large number of clinical trials of SCS are underway. Improvements in the treatment of pain and novel indications for SCS constitute the majority of studies. This overview of SCS-related clinical trials provides a window into future new indications, novel stimulation techniques, and a heightened understanding of the mechanisms of action.

Therapeutic Alliance in Cognitive Behavioural Therapy in Child and Adolescent Mental Health-Current Trends and Future Challenges.

This extended literature review proposes to present the trends in the therapeutic alliance, outcomes, and measures in the last decade within the premises of individual cognitive behaviour therapy (CBT) and its innovations, used as an interventional measure in the context of child and adolescent mental health setting. A brief background of the rationale for conducting this literature search is presented at the start. This is followed by the methodology and design which incorporates the inclusion and exclusion criteria and the basis for the same. The critical appraisal of the primary studies is presented in the literature review section with a brief description of the summary features of the studies in the study tables followed by the results and discussion of the study findings. To summarise, the literature review of primary studies conducted in the last decade demonstrates the need for further research to be conducted both in the field of CBT in children and therapeutic alliance, competence, and therapy outcomes, integrating perspectives in child development, carer alliance, and the social construct theory in children, to allow for further innovations in CBT in the context of increasing challenges in the current times of exponentially developing technology and its utility without compromising the quality of therapy. In conclusion, recommendations are made as a guideline for future studies and research in this field.

Managing bone defects in primary total knee arthroplasty: options and current trends.

While tackling with bone deficiencies in the context of total knee arthroplasty, it is imperative for the arthroplasty surgeon to arm himself with an in-depth knowledge on the various management options available and to use the right option for the right type of defect in the right patient. Aim of this review paper is to focus on the various options available and discuss the evolving concepts and recent trends with regard to the implications and treatment of bone deficiencies, in primary total knee arthroplasty. Relevant literature is evaluated with specific focus on the modality used for managing a defect, their clinical and radiological outcomes and failure rates. Out of various classifications described, Anderson Orthopaedic Research Institute (AORI) system is universally employed to classify the bone defects. The currently available management options include more tibial resection, the use of bone cement to fill the defect, with or without augmentation with screws, bone grafting which may be autograft or allograft, metal augments, metaphyseal cones and sleeves. There is no single option which can be applied universally; each has its own advantages, disadvantages and specific indications with regard to application in specific types of defects, in specific patients as outlined in this article.

Current trends and prospects of tidal energy technology.

Generation of energy across the world is today reliant majorly on fossil fuels. The burning of these fuels is growing in line with the increase in the demand for energy globally. Consequently, climate change, air contamination, and energy security issues are rising as well. An efficient alternative to this grave hazard is the speedy substitution of fossil fuel-based carbon energy sources with the shift to clean sources of renewable energy that cause zero emissions. This needs to happen in conjunction with the continuing increase in the overall consumption of energy worldwide. Many resources of renewable energy are available. These include thermal, solar photovoltaic, biomass and wind, tidal energy, hydropower, and geothermal. Notably, tidal energy exhibits great potential with regard to its dependability, superior energy density, certainty, and durability. The energy mined from the tides on the basis of steady and anticipated vertical movements of the water, causing tidal currents, could be converted into kinetic energy to produce electricity. Tidal barrages could channel mechanical energy, while tidewater river turbines can seize the energy from tidal currents. This study discusses the present trends, ecological effects, and the prospects for technology related to tidal energy.

Dieulafoy's Lesion: Decade-Long Trends in Hospitalizations, Demographic Disparity, and Outcomes.

Background Dieulafoy's lesion is a relatively rare, but potentially life-threatening, condition where a tortuous arteriole, most commonly in the stomach, may bleed and lead to significant gastrointestinal hemorrhage. Limited epidemiological data exist on patient characteristics and the annual number of hospitalizations associated with such lesions. The aim of our study is to determine the inpatient burden of Dieulafoy's lesion. Methods We analyzed the National Inpatient Sample (NIS) database for all subjects with a discharge diagnosis of Dieulafoy's lesion of the stomach, duodenum, and colon using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes 537.84 and 569.86 as the primary or secondary diagnosis during the period from 2002 to 2011. Statistical significance of variation in the number of hospital discharges and demographics during the study period was achieved using the Cochrane-Armitage trend test. Results In 2002, there were 1,071 admissions with a discharge diagnosis of Dieulafoy's lesion as compared to 7,414 in 2011 (p < 0.0001). Dieulafoy's lesion was found to be most common in the age group of 65-79 years (p < 0.0001). Overall, it was found to be more common in males as compared to females (p = 0.0261). The white race was most commonly affected amongst all the races. The average cost of care per hospitalization increased from $14,992 in 2002 to $25,594 in 2011 (p < 0.0001). Conclusion There has been a steady rise in the number of inpatient admissions with Dieulafoy's lesions. Advances in diagnostic techniques likely play a key role in the higher detection rates along with the possible involvement of other unknown factors. Men, in the age group of 65 to 79 years, and Whites were found to have significantly higher admission rates than all other groups, with a significant increase in the cost of care.

Immunosuppression in Visceral Transplantation: Current Trends and Future Perspectives.

Visceral transplant represents an immunologic challenge due to high intestinal graft immunogenicity. Over the last 20 years, significant advances in immunosuppression regimens have resulted in excellent short-term outcomes. Currently, visceral transplant is the standard of care for patients with gut failure having life-threatening complications and complex abdominal pathology. In this review, we describe immunosuppressive strategies in the visceral transplant field.

[Reconstructive surgery of deep veins in post-thrombotic disease: possibilities and perspectives]. / Rekonstruktivnaia khirurgiia glubokikh ven pri posttromboticheskoi bolezni: vozmozhnosti i perspektivy.

This article is a review of the literature related to the possibilities and perspectives of reconstructive operations on deep veins for post-thrombotic disease (with the data retrieved from such databases as the PubMed, Scopus, Medline and EMBASE). The most optimal variants of performing reconstructive operations on deep veins are described, accompanied and followed by analysing their outcomes with the discussion of approaches to determining the indications for these interventions. Also considered are the perspectives of bettering the results of reconstructive operations at the expense of modernizing the technologies of diagnosis and surgical treatment.