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1.
Iran Endod J ; 19(3): 189-192, 2024.
Article in English | MEDLINE | ID: mdl-39086711

ABSTRACT

Introduction: Ultrasonic vibration for metallic post removal seems to be a unanimous choice between endodontists and general practitioners for providing the best results and having the highest safety. This study compared the time required by ultrasonic vibration for removing metallic post (MP) when 1 or 2 ultrasonics devices are used. Materials and Methods: One hundred and fifteen teeth with MPs from 105 patients, indicated for nonsurgical endodontic retreatment were divided into 2 groups according to the number of ultrasonic devices used (G1-1 device) and (G2-2 devices). In G1, the MP was worn with a transmetal bur, alongside the wear of the cement line (around 2 mm deep). Then, an ultrasonic tip attached to an ultrasonic unit, with a power of 100% was activated at the level of the post, with constant water spray at a level of 1 mm above the axial surface of the tooth. The position of the tip was changed between buccal and lingual surfaces every 10 seconds until the MP was removed. In G2 the same procedures were performed as described in G1, but two ultrasonic tips were activated simultaneously at buccal and lingual surfaces until the MP was removed. The vibration time necessary for removing each MP was recorded using a chronometer. Results: The mean time was 131.10±29.68 seconds (mean±standard error of the mean) for MP removal using one ultrasonic device, and 24.86±6.88 seconds for two devices. The time required for MP removal using two ultrasonic devices was significantly less than when using one ultrasonic device (P<0.001). Conclusion: The technique with 2 ultrasonic devices proved to be more efficient than the one using only 1 ultrasonic device.

2.
J Mol Evol ; 92(4): 467-487, 2024 Aug.
Article in English | MEDLINE | ID: mdl-39017924

ABSTRACT

In the present work, we carried out a comparative genomic analysis to trace the evolutionary trajectory of the bacterial species that make up the Liquorilactobacillus genus, from the identification of genes and speciation/adaptation mechanisms in their unique characteristics to the identification of the pattern grouping these species. We present phylogenetic relationships between Liquorilactobacillus and related taxa such as Bacillus, basal lactobacilli and Ligilactobacillus, highlighting evolutionary divergences and lifestyle transitions across different taxa. The species of this genus share a core genome of 1023 genes, distributed in all COGs, which made it possible to characterize it as Liquorilactobacillus sensu lato: few amino acid auxotrophy, low genes number for resistance to antibiotics and general and specific cellular reprogramming mechanisms for environmental responses. These species were divided into four clades, with diversity being enhanced mainly by the diversity of genes involved in sugar metabolism. Clade 1 presented lower (< 70%) average amino acid identity with the other clades, with exclusive or absent genes, and greater distance in the genome compared to clades 2, 3 and 4. The data pointed to an ancestor of clades 2, 3 and 4 as being the origin of the genus Ligilactobacillus, while the species of clade 1 being closer to the ancestral Bacillus. All these traits indicated that the species of clade 1 could be soon separated in a distinct genus.


Subject(s)
Fermentation , Genome, Bacterial , Phylogeny , Adaptation, Physiological/genetics , Evolution, Molecular , Bacillus/genetics , Bacillus/metabolism
3.
Physiol Rep ; 12(14): e16155, 2024 Jul.
Article in English | MEDLINE | ID: mdl-39039617

ABSTRACT

Numerous body locations have been utilized to obtain an accurate body temperature. While some are commonly used, their accuracy, response time, invasiveness varies greatly, and determines their potential clinical and/or research use. This review discusses human body temperature locations, their accuracy, ease of use, advantages, and drawbacks. We explain the concept of core body temperature and which of the locations achieve the best correlation to this temperature. The body locations include axilla, oral cavity, rectum, digestive and urinary tracts, skin, tympanic, nasopharynx, esophagus, and pulmonary artery. The review also discusses the latest temperature technologies, heat-flux technology and telemetric ingestible temperature pills, and the body locations used to validate these devices. Rectal and esophageal measurements are the most frequently used.


Subject(s)
Body Temperature , Humans , Body Temperature/physiology , Thermography/methods , Thermography/instrumentation , Thermometry/methods , Thermometry/instrumentation
4.
Article in English | MEDLINE | ID: mdl-39075825

ABSTRACT

In this contribution, nanocatalysts with rather diverse architectures were designed to promote different intimacy degrees between Cu and SiO2 and consequently tune distinct Cu-SiO2 interactions. Previously synthesized copper nanoparticles were deposited onto SiO2 (NPCu/SiO2) in contrast to ordinarily prepared supported Cu/SiO2. NPCu@SiO2 and SiO2@Cu core-shell nanocatalysts were also synthesized, and they were all bulk and surface characterized by XRD, TGA, TEM/HRTEM, H2-TPR, XANES, and XPS. It was found that Cu0 is the main copper phase in NPCu/SiO2 while Cu2+ rules the ordinary Cu/SiO2 catalyst, and Cu0 and electron-deficient Cuδ+ species coexist in the core-shell nanocatalysts as a consequence of a deeper metal-support interaction. Catalytic performance could not be associated with the physical properties of the nanocatalysts derived from their architectures but was associated with the more refined chemical characteristics tuned by their design. Cu/SiO2 and NPCu/SiO2 catalysts led to the formation of furfuryl alcohol, evidencing that catalysts holding weak or no metal-support interaction have no significant impact on product distribution even in the aqueous phase. The establishment of such interactions through advanced catalyst architecture, allowing the formation of electron-deficient Cuδ+ moieties, particularly Cu2+ and Cu+ as unveiled by spectroscopic investigations, is critical to promoting the hydrogenation-ring rearrangement cascade mechanism leading to cycloketones.

5.
J Therm Biol ; 123: 103907, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38950497

ABSTRACT

Recent heatwaves have highlighted the importance of accurate and continuous core temperature (TCORE) monitoring in sports settings. For example, accentuated rises in TCORE caused by physical exercises under environmental heat stress increase the risk of heat illnesses. Thus, using valid and reproducible devices is essential to ensure safe sports practice. In this study, we assessed the validity and reproducibility of the Calera Research Sensor (CRS) in estimating the TCORE of male and female participants during cycling exercise in a hot environment. Seven male (age: 36.2 ± 10.1 years) and eight female cyclists (age: 30.1 ± 5.0 years) underwent two identical cycling trials in a dry-bulb temperature of 32 °C and relative humidity of 60%. The protocol consisted of an initial 10-min rest followed by a 60-min exercise comprising 10 min at 20%, 25 min at 55%, and 25 min at 75% of maximal aerobic power, and an additional 25 min of post-exercise recovery. TCORE was recorded simultaneously every minute using a gastrointestinal capsule (TGi) and the CRS (TSENSOR). Bland-Altman analysis was performed to calculate bias, upper (LCS) and lower (LCI) concordance limits, and the 95% confidence interval (95%CI). The maximum acceptable difference between the two devices was predetermined at ±0.4 °C. A mixed linear model was used to assess the paired differences between the two measurement systems, considering the participants, trials, and environmental conditions as random effects and the cycling stages as fixed effects. An intra-class correlation coefficient (ICC) of 0.98 was recorded when analyzing data from the entire experiment. A non-significant bias value of 0.01 °C, LCS of 0.38 °C, LCI of -0.35 °C, and CI95% of ±0.36 °C were found. When analyzing data according to the participants' sex, CRS reproducibility was high in both sexes: ICC values of 0.98 and 0.99 were reported for males and females, respectively. CI95% was 0.35 °C in experiments with males and 0.37 °C with females, thereby falling within the acceptable margin of difference. Therefore, CRS was considered valid (compared to TGi) and reproducible in estimating TCORE in both sexes at various intensities of cycling exercise in the heat.


Subject(s)
Bicycling , Body Temperature , Hot Temperature , Humans , Male , Adult , Female , Bicycling/physiology , Reproducibility of Results , Exercise , Young Adult
6.
Pharmaceutics ; 16(7)2024 Jun 25.
Article in English | MEDLINE | ID: mdl-39065553

ABSTRACT

Core-shell micro/nanomotors have garnered significant interest in biomedicine owing to their versatile task-performing capabilities. However, their effectiveness for photothermal therapy (PTT) still faces challenges because of their poor tumor accumulation, lower light-to-heat conversion, and due to the limited penetration of near-infrared (NIR) light. In this study, we present a novel core-shell micromotor that combines magnetic and photothermal properties. It is synthesized via the template-assisted electrodeposition of iron (Fe) and reduced graphene oxide (rGO) on a microtubular pore-shaped membrane. The resulting Fe-rGO micromotor consists of a core of oval-shaped zero-valent iron nanoparticles with large magnetization. At the same time, the outer layer has a uniform reduced graphene oxide (rGO) topography. Combined, these Fe-rGO core-shell micromotors respond to magnetic forces and near-infrared (NIR) light (1064 nm), achieving a remarkable photothermal conversion efficiency of 78% at a concentration of 434 µg mL-1. They can also carry doxorubicin (DOX) and rapidly release it upon NIR irradiation. Additionally, preliminary results regarding the biocompatibility of these micromotors through in vitro tests on a 3D breast cancer model demonstrate low cytotoxicity and strong accumulation. These promising results suggest that such Fe-rGO core-shell micromotors could hold great potential for combined photothermal therapy.

7.
Chem Biol Drug Des ; 104(1): e14578, 2024 Jul.
Article in English | MEDLINE | ID: mdl-39044291

ABSTRACT

The development of new radiopharmaceuticals for the detection of hidden infection foci has great relevance for early detection and the selection of the correct treatment, particularly in immunosuppressed patients. In that sense, the labelling of antimicrobial peptides (AMPs) that are capable of binding specifically to the pathogenic microorganism which causes the infection, should provide a sufficiently specific agent, able to distinguish an infection from a sterile inflammation. Defensins are particularly interesting molecules with antimicrobial activity, the EcgDf1 defensin was identified from the genome of a Uruguayan native plant, Erythrina crista-galli, the 'Ceibo' tree. Our group has previously reported a synthetic biologically active short analogue EcgDf21 (ERFTGGHCRGFRRRCFCTKHC) successfully labelled with 99mTc. Herein we present a shorter analogue which also preserves the γ-core domain, as a pharmacophore for a potential infection detection agent. This peptide was derivatized with the bifunctional chelating agent 1,4,7-triazacyclononane-1,4,7-triacetic acid (NOTA) through a lysine linker in the amino-terminal group (NOTA-KGHCRGFRRRC) and radiolabelled with 68Ga ([68Ga]Ga-NOTA-K-EcgDf1(10)). The [68Ga]Ga-NOTA-K-EcgDf1(10) labelling procedure rendered a product with high radiochemical purity and stability in the labelling milieu. The Log P value indicated that the complex has a hydrophilic behaviour, confirmed by the biodistribution profile. The [68Ga]Ga-NOTA-K-EcgDf1(10) complex demonstrated specific binding to cultures of Candida albicans and Aspergillus niger. Its biodistribution showed renal elimination and low accumulation in the rest of the body. It was possible to successfully differentiate sterile inflammation from infection by PET images in nude mice with a target/non-target ratio of 3.3 for C. albicans and 3.7 for A. niger, respectively.


Subject(s)
Defensins , Gallium Radioisotopes , Positron-Emission Tomography , Radiopharmaceuticals , Animals , Humans , Mice , Amino Acid Sequence , Defensins/chemistry , Gallium Radioisotopes/chemistry , Peptides/chemistry , Positron-Emission Tomography/methods , Radiopharmaceuticals/chemistry , Tissue Distribution , Organotechnetium Compounds/chemistry
8.
J Environ Manage ; 366: 121671, 2024 Aug.
Article in English | MEDLINE | ID: mdl-39003910

ABSTRACT

Biosphere Reserves (BR) manage large territories with diverse natural covers and land uses to preserve biodiversity, promote local development and preserve ecosystems. This study evaluated how their zoning (buffer and core) and policy timeframes (decree period, management plan period, and land planning period) influence four landscape management outcomes: deforestation, natural cover recovery, and anthropic and natural permanence. For three Mexican BR case studies, land use and cover transitions were calculated and compared to contrafactual sites. Observed rates of land cover change were marginal within all three BR zoning and across their policy timeframe (<0.02 % change rate), suggesting that BR effectively promote the permanence of both natural and anthropic covers. Nevertheless, the predicted probability of uncommon deforestation and recovery outcomes at local levels showed that the effect of a BR over its regulated landscape is not spatiotemporally static, contrasting the effect of individual allocation vs a group or network. Poverty, land tenure, agriculture aptitude and distance to markets adds to this dynamic and is modelled and discussed. This study shows that BR zoning schemes and its regulatory sequence influence the rates of land cover change and the predicted probability of landscape management outcomes across space and time.


Subject(s)
Biodiversity , Conservation of Natural Resources , Ecosystem , Agriculture , Mexico
9.
BMC Musculoskelet Disord ; 25(1): 512, 2024 Jul 03.
Article in English | MEDLINE | ID: mdl-38961358

ABSTRACT

BACKGROUND: The comprehensive core set for knee dysfunction was developed to classify the functioning of people with any knee dysfunction. To be used as a clinical instrument to measure the functioning of people with knee dysfunction, the construct validity of the core set still needs to be assessed. The purpose of this study was to analyze the construct validity of the comprehensive core set for knee dysfunction as an instrument to measure functioning. METHODS: A cross-sectional study with 200 participants with knee dysfunction with or without clinical diagnosis of knee pathology, with or without complaint of pain, with or without instability, and/or with or without knee movement restriction of any type. Participants were assessed using the comprehensive core set for knee dysfunction with 25 categories, the subjective form from the International Knee Documentation Committee scale, and measures of self-perceived general health and functioning. The construct validity of the core set was assessed by Rasch analysis, and the external construct validity was assessed by correlation between the score of the brief core set for knee dysfunction with the subjective form from the International Knee Documentation Committee scale, and scores of self-perception of health and functioning. RESULTS: Twelve categories were consistent with a unidimensional construct, with no difference in the response pattern for age, sex, educational level, and time of complaint. These categories were included in the brief core set for knee dysfunction. The mean score of the brief core set was 37 ± 21 points, a value classified as moderate impairment regarding functioning. Correlations with the subjective form from the International Knee Documentation Committee scale and scores of self-perception were adequate (p < 0.01; r > 0.5). CONCLUSION: The brief core set for knee dysfunction, a set with 12 categories, can be used as a clinical instrument to measure and score the functioning of people with knee dysfunction, aged between 18 and 89 years, with adequate construct validity.


Subject(s)
Disability Evaluation , Knee Joint , Humans , Female , Male , Middle Aged , Cross-Sectional Studies , Adult , Knee Joint/physiopathology , Aged , Reproducibility of Results , Young Adult , Adolescent , International Classification of Functioning, Disability and Health , Aged, 80 and over , Surveys and Questionnaires/standards
10.
Article in English | MEDLINE | ID: mdl-39030852

ABSTRACT

BACKGROUND: Engaging diverse stakeholders in developing core outcome sets (COSs) can produce more meaningful metrics as well as research responsive to patient needs. The most common COS prioritisation method, Delphi surveys, has limitations related to selection bias and participant understanding, while qualitative methods like group discussions are less frequently used. This study aims to test a co-creation approach to COS development for type 1 diabetes (T1DM) in Peru. METHODS: Using a co-creation approach, we aimed to prioritise outcomes for T1DM management in Peru, incorporating perspectives from people with T1DM, caregivers, healthcare professionals, and decision-makers. A set of outcomes were previously identified through a systematic review and qualitative evidence synthesis. Through qualitative descriptive methods, including in-person workshops, each group of stakeholders contributed to the ranking of outcomes. Decision-makers also discussed the feasibility of measuring these outcomes within the Peruvian healthcare system. RESULTS: While priorities varied among participant groups, all underscored the significance of monitoring healthcare system functionality over mortality. Participants recognized the interconnected nature of healthcare system performance, clinical outcomes, self-management, and quality of life. When combining the rankings from all the groups, metrics related to economic impact on the individual and structural support, policies promoting health, and protecting those living with T1DM were deemed more important in comparison to measuring clinical outcomes. CONCLUSION: We present the first COS for T1DM focused on low-and-middle-income countries and show aspects of care that are relevant in this setting. Diverse prioritisation among participant groups underscores the need of inclusive decision-making processes. By incorporating varied perspectives, healthcare systems can better address patient needs and enhance overall care quality.

11.
Heliyon ; 10(10): e31562, 2024 May 30.
Article in English | MEDLINE | ID: mdl-38826746

ABSTRACT

Background: The respiratory tract harbors a variety of microbiota, whose composition and abundance depend on specific site factors, interaction with external factors, and disease. The aim of this study was to investigate the relationship between COVID-19 severity and the nasopharyngeal microbiome. Methods: We conducted a prospective cohort study in Mexico City, collecting nasopharyngeal swabs from 30 COVID-19 patients and 14 healthy volunteers. Microbiome profiling was performed using 16S rRNA gene analysis. Taxonomic assignment, classification, diversity analysis, core microbiome analysis, and statistical analysis were conducted using R packages. Results: The microbiome data analysis revealed taxonomic shifts within the nasopharyngeal microbiome in severe COVID-19. Particularly, we observed a significant reduction in the relative abundance of Lawsonella and Cutibacterium genera in critically ill COVID-19 patients (p < 0.001). In contrast, these patients exhibited a marked enrichment of Streptococcus, Actinomyces, Peptostreptococcus, Atopobium, Granulicatella, Mogibacterium, Veillonella, Prevotella_7, Rothia, Gemella, Alloprevotella, and Solobacterium genera (p < 0.01). Analysis of the core microbiome across all samples consistently identified the presence of Staphylococcus, Corynebacterium, and Streptococcus. Conclusions: Our study suggests that the disruption of physicochemical conditions and barriers resulting from inflammatory processes and the intubation procedure in critically ill COVID-19 patients may facilitate the colonization and invasion of the nasopharynx by oral microorganisms.

12.
Prim Dent J ; 13(2): 53-57, 2024 06.
Article in English | MEDLINE | ID: mdl-38888075

ABSTRACT

A technique is outlined for utilising a polymeric composite reinforced with glass fibres in a three-dimensional mesh as a post-core in aesthetic cases. The clinical procedure involves obtaining an impression of the root canal space, scanning the definitive cast, and milling a fibre-reinforced composite post-core. Subsequently, the intra-radicular post-core is cemented using an adhesive resin cement. The use of custom-made computer-aided design-computer-aided manufacturing (CAD-CAM) fibre-reinforced composite post-core facilitates repairability, provides better adaptation to the root canal space, avoids uneven cement thickness, ensures chemical adhesion to resin cement, and promotes favourable aesthetics when combined with all-ceramic crowns.


Subject(s)
Composite Resins , Computer-Aided Design , Dental Prosthesis Design , Glass , Post and Core Technique , Humans , Composite Resins/chemistry , Glass/chemistry , Resin Cements/chemistry , Crowns , Esthetics, Dental , Dental Prosthesis Retention , Dental Materials/chemistry , Cementation
13.
Sci Rep ; 14(1): 14533, 2024 06 24.
Article in English | MEDLINE | ID: mdl-38914685

ABSTRACT

The rubber tree, Hevea brasiliensis (Willd. ex Adr. de Juss.) Muell. Arg., is the sole plant worldwide utilized for the commercial production of natural rubber. Following years of breeding, there exists a wide array of germplasm differentiation in rubber trees. The exploration of diversity and population structure within rubber tree germplasm resources, alongside the establishment of core germplasm resources, is instrumental in elucidating the genetic background and facilitating the effective utilization and management of these resources. By employing SNP molecular marker technology, 195 rubber tree resources were amplified, their genetic diversity analyzed, and a fingerprint map was subsequently constructed. Through this process, the cold-resistant core germplasm of rubber trees was identified. The results revealed that the PIC, He, and pi values ranged from 0.0905 to 0.3750, 0.095 to 0.5000, and 0.0953 to 0.5013, respectively. Both group structure analysis and cluster analysis delineated the accessions into two groups, signifying a simple group structure. A core germplasm bank was established with a sampling ratio of 10%, comprising 21 accessions divided into two populations. Population G1 consists of 20 accessions, while population G2 comprises 1 accession. The research findings have led to the creation of a molecular database that is anticipated to contribute to the management and subsequent breeding applications of rubber tree accessions.


Subject(s)
Genetic Variation , Hevea , Polymorphism, Single Nucleotide , Seed Bank , Hevea/genetics , Cold Temperature , Phylogeny
14.
Psychother Res ; : 1-13, 2024 May 23.
Article in English | MEDLINE | ID: mdl-38781596

ABSTRACT

OBJECTIVE: To examine the psychometric properties of the Spanish version of the 34-item Clinical Outcomes in Routine Evaluation-Outcome Measure questionnaire (CORE-OM). METHOD: Psychometric exploration was conducted in two samples: non-clinical (n = 706) and clinical (n = 420) participants. The non-clinical sample comprised a subgroup of community members (n = 308) and students (n = 398). The clinical sample consisted of self-reported patients (n = 209) and outpatients (n = 211). The analysis included both internal and test-retest reliability, convergent validity, and principal component analysis. A reliable change index and clinical cut-off scores were established for assessing clinically significant change. RESULTS: The Spanish CORE-OM demonstrated good internal consistency and test-retest reliability, along with satisfactory convergent validity against the 45-item Outcome Questionnaire (OQ-45.2). There were strong differentiations between the clinical and non-clinical samples and the four sample subsets. The outpatient group reported the highest scores, while the community group exhibited the lowest scores. There were no marked gender effects. All observed patterns aligned closely with the established Spanish referential data. CONCLUSION: Our findings provide support for the utilization of the Spanish CORE-OM as a measure for tracking psychotherapeutic progress in the context of Chile.

15.
Sensors (Basel) ; 24(10)2024 May 10.
Article in English | MEDLINE | ID: mdl-38793882

ABSTRACT

In this work, we experimentally analyzed and demonstrated the performance of an in-line Mach-Zehnder interferometer in the visible region, with an LED light source. The different waist diameter taper and asymmetric core-offset interferometers proposed used a single-mode fiber (SMF). The visibility achieved was V = 0.14 with an FSR of 23 nm for the taper MZI structure and visibilities of V = 0.3, V = 0.27, and V = 0.34 with FSRs of 23 nm, 17 nm, and 8 nm and separation lengths L of 2.5 cm, 4.0 cm, and 5.0 cm between the core-offset structure, respectively. The experimental investigation of the response to the temperature sensor yielded values from 50 °C to 300 °C; the sensitivity obtained was 3.53 a.u./°C, with R2 of 0.99769 and 1% every 1 °C in the transmission. For a range of 50 °C to 150 °C, 20.3 pm/°C with a R2 of 0.96604 was obtained.

16.
FEMS Microbiol Ecol ; 100(6)2024 May 14.
Article in English | MEDLINE | ID: mdl-38734895

ABSTRACT

It is widely assumed that a taxonomic core community emerges among microbial communities from similar habitats because similar environments select for the same taxa bearing the same traits. Yet, a core community itself is no indicator of selection because it may also arise from dispersal and neutral drift, i.e. by chance. Here, we hypothesize that a core community produced by either selection or chance processes should be distinguishable. While dispersal and drift should produce core communities with similar relative taxon abundances, especially when the proportional core community, i.e. the sum of the relative abundances of the core taxa, is large, selection may produce variable relative abundances. We analyzed the core community of 16S rRNA gene sequences of 193 microbial communities occurring in tiny water droplets enclosed in heavy oil from the Pitch Lake, Trinidad and Tobago. These communities revealed highly variable relative abundances along with a large proportional core community (68.0 ± 19.9%). A dispersal-drift null model predicted a negative relationship of proportional core community and compositional variability along a range of dispersal probabilities and was largely inconsistent with the observed data, suggesting a major role of selection for shaping the water droplet communities in the Pitch Lake.


Subject(s)
Bacteria , Lakes , Microbiota , RNA, Ribosomal, 16S , RNA, Ribosomal, 16S/genetics , Trinidad and Tobago , Lakes/microbiology , Bacteria/genetics , Bacteria/classification , Bacteria/isolation & purification , Ecosystem , Petroleum , Phylogeny , DNA, Bacterial/genetics , Water Microbiology
17.
J Evid Based Med ; 17(2): 317-328, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38572835

ABSTRACT

AIM: To determine the comparative effectiveness of fluid schemes for children with diabetic ketoacidosis (DKA). METHODS: We conducted a systematic review with an attempt to conduct network meta-analysis (NMA). We searched MEDLINE, EMBASE, CENTRAL, Epistemonikos, Virtual Health Library, and gray literature from inception to July 31, 2022. We included randomized controlled trials (RCTs) in children with DKA evaluating any intravenous fluid schemes. We planned to conduct NMA to compare all fluid schemes if heterogeneity was deemed acceptable. RESULTS: Twelve RCTs were included. Studies were heterogeneous in the population (patients and DKA episodes), interventions with different fluids (saline, Ringer's lactate (RL), and polyelectrolyte solution-PlasmaLyte®), tonicity, volume, and administration systems. We identified 47 outcomes that measured clinical manifestations and metabolic control, including single and composite outcomes and substantial heterogeneity preventing statistical combination. No evidence was found of differences in neurological deterioration (main outcome), but differences were found among interventions in some comparisons to normalize acid-base status (∼2 h less with low vs. high volume); time to receive subcutaneous insulin (∼1 h less with low vs. high fluid rate); length of stay (∼6 h less with RL vs. saline); and resolution of the DKA (∼3 h less with two-bag vs. one-bag scheme). However, available evidence is scarce and poor. CONCLUSIONS: There is not enough evidence to determine the best fluid therapy in terms of fluid type, tonicity, volume, or administration time for DKA treatment. There is an urgent need for more RCTs, and the development of a core outcome set on DKA in children.


Subject(s)
Diabetic Ketoacidosis , Fluid Therapy , Humans , Diabetic Ketoacidosis/therapy , Fluid Therapy/methods , Child , Randomized Controlled Trials as Topic
18.
J Esthet Restor Dent ; 36(9): 1281-1300, 2024 Sep.
Article in English | MEDLINE | ID: mdl-38563466

ABSTRACT

OBJECTIVE: This systematic review aimed to analyze the clinical (survival rate, failure risk, or fracture) and laboratory performance (fracture mode or failure) of rehabilitations of endodontically treated teeth, with and without posts. MATERIALS AND METHODS: A systematic search was conducted in the Pubmed, Scopus, Web of Science, Embase, Cochrane Library, and OpenGrey databases up to March 2023, according to PRISMA guidelines. In vitro and clinical studies that compared the clinical and laboratory performance of endodontically treated teeth with and without intraradicular posts were included. Studies selection, data extraction, and risk of bias analysis were performed. RESULTS: Thirty-one in vitro and 7 clinical studies were included. For in vitro studies, fiberglass post (n = 24) was the most mentioned. The follow-up time of the clinical studies ranged from 1 to 17 years, with the fiber-reinforced composite post (n = 3) being the most evaluated, and only failure risk proved to be more favorable for using intraradicular posts. CONCLUSION: Rehabilitations of endodontically treated teeth with and without intraradicular retainers showed no difference in fracture resistance and failure mode, evaluated by in vitro studies. Clinical studies showed no difference in survival rate, but failure risk proved to be more favorable for the use of posts. CLINICAL SIGNIFICANCE: This analysis revealed significant variability between results, however, most laboratory and clinical studies revealed no difference with using the post. Furthermore, it is important to emphasize the need to evaluate the coronary remnant and the general characteristics of the tooth in each situation.


Subject(s)
Tooth, Nonvital , Humans , Post and Core Technique , Dental Restoration Failure , Tooth Fractures
20.
Sports (Basel) ; 12(4)2024 Apr 18.
Article in English | MEDLINE | ID: mdl-38668579

ABSTRACT

The effect of electromyographic (EMG) activity on agonist muscles during exercises performed on stable and unstable surfaces remains uncertain. We aimed to review the literature regarding the comparison of the EMG activity of the agonist muscles of exercises performed on stable and unstable surfaces. Eighty-six studies that evaluated the EMG activity of 1783 individuals during exercises for the lower limbs, upper limbs, and core were included. The EMG activities of the pectoralis major (SMD = 0.28 [95% CI 0.09, 0.47]) and triceps brachii muscles (SMD = 0.45 [95% CI 0.25, 0.66]) were significantly increased when the unstable device was added to the exercise. Likewise, the EMG activity of all core muscles showed a significant increase with the unstable surface during the exercises, such as the rectus abdominis (SMD = 0.51 [95% CI 0.37, 0.66]), external oblique (SMD = 0.44 [95% CI 0.28, 0.61]), internal oblique (SMD = 1.04 [95% CI 0.02, 2.07]), erector spinae (SMD = 0.37 [95% CI 0.04, 0.71]), and lumbar multifidus (SMD = 0.35 [95% CI 0.08, 0.61]). However, the lower limb muscles did not show greater EMG activity during the exercise with unstable surfaces compared to the stable surface. In conclusion, unstable conditions increase the EMG activity of some upper limb and core muscles compared to a stable surface.

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