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There is a critical need to generate age- and sex-specific survival curves to characterize chronological aging consistently across nonhuman primates (NHP) used in biomedical research. Accurate measures of chronological aging are essential for inferences into genetic, demographic, and physiological variables driving differences in NHP lifespan within and between species. Understanding NHP lifespans is relevant to public health because unraveling the demographic, molecular, and clinical bases of health across the life course in translationally relevant NHP species is fundamentally important to the study of human aging. Data from more than 110,000 captive individual NHP were contributed by 15 major research institutions to generate sex-specific Kaplan-Meier survival curves using uniform methods in 12 translational aging models: Callithrix jacchus (common marmoset), Chlorocebus aethiops sabaeus (vervet/African green), Macaca fascicularis (cynomolgus macaque), M. fuscata (Japanese macaque), M. mulatta (rhesus macaque), M. nemestrina (pigtail macaque), M. radiata (bonnet macaque), Pan troglodytes spp. (chimpanzee), Papio hamadryas spp. (baboon), Plecturocebus cupreus (coppery titi monkey), Saguinus oedipus (cotton-top tamarin), and Saimiri spp. (squirrel monkey). After employing strict inclusion criteria, primary analysis results are based on 12,269 NHP that survived to adulthood and died of natural/health-related causes. A secondary analysis was completed for 32,616 NHP that died of any cause. For the primary analyses, we report ages of 25th, 50th, 75th, and 85th percentiles of survival, maximum observed ages, rates of survivorship, and sex-based differences captured by quantile regression models and Kolmogorov-Smirnov tests. Our findings show a pattern of reduced male survival among catarrhines (African and Asian primates), especially macaques, but not platyrrhines (Central and South American primates). For many species, median lifespans were lower than previously reported. An important consideration is that these analyses may offer a better reflection of healthspan than lifespan. Captive NHP used in research are typically euthanized for humane welfare reasons before their natural end of life, often after diagnosis of their first major disease requiring long-term treatment with reduced quality of life (e.g., endometriosis, cancer, osteoarthritis). Supporting the idea that these data are capturing healthspan, for several species typical age at onset of chronic disease is similar to the median lifespan estimates. This data resource represents the most comprehensive characterization of sex-specific lifespan and age-at-death distributions for 12 biomedically relevant species, to date. The results clarify the relationships among NHP ages and will provide a valuable resource for the aging research community, improving human-NHP age equivalencies, informing investigators of the expected survival rates of NHP assigned to studies, providing a metric for comparisons in future studies, and contributing to our understanding of the factors that drive lifespan differences within and among species.
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The integration of artificial intelligence (AI) in healthcare has seen significant advancements, particularly in areas requiring image interpretation. Endodontics, a specialty within dentistry, stands to benefit immensely from AI applications, especially in interpreting radiographic images. However, there is a knowledge gap among endodontists regarding the fundamentals of machine learning and deep learning, hindering the full utilization of AI in this field. This narrative review aims to: (A) elaborate on the basic principles of machine learning and deep learning and present the basics of neural network architectures; (B) explain the workflow for developing AI solutions, from data collection through clinical integration; (C) discuss specific AI tasks and applications relevant to endodontic diagnosis and treatment. The article shows that AI offers diverse practical applications in endodontics. Computer vision methods help analyse images while natural language processing extracts insights from text. With robust validation, these techniques can enhance diagnosis, treatment planning, education, and patient care. In conclusion, AI holds significant potential to benefit endodontic research, practice, and education. Successful integration requires an evolving partnership between clinicians, computer scientists, and industry.
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Artificial intelligence (AI) is emerging as a transformative technology in healthcare, including endodontics. A gap in knowledge exists in understanding AI's applications and limitations among endodontic experts. This comprehensive review aims to (A) elaborate on technical and ethical aspects of using data to implement AI models in endodontics; (B) elaborate on evaluation metrics; (C) review the current applications of AI in endodontics; and (D) review the limitations and barriers to real-world implementation of AI in the field of endodontics and its future potentials/directions. The article shows that AI techniques have been applied in endodontics for critical tasks such as detection of radiolucent lesions, analysis of root canal morphology, prediction of treatment outcome and post-operative pain and more. Deep learning models like convolutional neural networks demonstrate high accuracy in these applications. However, challenges remain regarding model interpretability, generalizability, and adoption into clinical practice. When thoughtfully implemented, AI has great potential to aid with diagnostics, treatment planning, clinical interventions, and education in the field of endodontics. However, concerted efforts are still needed to address limitations and to facilitate integration into clinical workflows.
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OBJECTIVES: This study aimed to investigate the influence of access cavity designs on the mechanical properties of a single-rooted mandibular first premolar tooth under various static loads using a finite element analysis. MATERIALS AND METHODS: 3-dimensional FEA designs were modeled according to the access cavity designs: an intact tooth (control), traditional access cavity (TEC-I), traditional access cavity with Class-II mesio-occlusal cavity design (TEC-II), conservative access cavity (CEC), ninja access cavity (NEC), caries-driven access cavity (Cd-EC), buccal access cavity (BEC) and bucco-occlusal access cavity (BOEC). After the simulated access cavity preparations, root canal treatment was simulated and three different static loads which mimicked oblique and vertical mastication forces were applied to the models. The stress distribution and maximum Von Misses stress values were recorded. The maximum stress values were obtained on both enamel and dentin under multi-point vertical loads. RESULTS: The maximum stress values were obtained on both enamel and dentin under multi-point vertical loads. Under all load types, the minimum stress distribution was observed in the control group, followed by CEC, NEC and BEC designs. The highest stress concentration was detected in Cd-EC and TEC-II designs. Under single-point vertical loading, the stress was mostly concentrated in the lingual PCD area, while under multi-point vertical loading, the entire root surface was stress-loaded except for the lingual apical third of the root. CONCLUSION: Preserving tooth tissue by simulating CEC, NEC and BEC access cavities increased the load capacity of a single-rooted mandibular first premolar following simulated endodontic treatment.
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Diente Premolar , Análisis del Estrés Dental , Análisis de Elementos Finitos , Mandíbula , Humanos , Preparación de la Cavidad Dental/métodos , Fenómenos Biomecánicos , Estrés Mecánico , Preparación del Conducto Radicular/métodosRESUMEN
INTRODUCTION: The evidence hierarchy in public health emphasizes longitudinal studies, whereas social media monitoring relies on aggregate analyses. Authors propose integrating longitudinal analyses into social media monitoring by creating a digital cohort of individual account holders, as demonstrated by a case study analysis of people who vape. METHODS: All English language X posts mentioning vape or vaping were collected from January 1, 2017 through December 31, 2020. The digital cohort was composed of people who self-reported vaping and posted at least 10 times about vaping during the study period to determine the (1) prevalence, (2) success rate, and (3) timing of cessation behaviors. RESULTS: There were 25,112 instances where an account shared at least 10 posts about vaping, with 619 (95% CI=616, 622) mean person-days and 43,810,531 cumulative person-days of observation. Among a random sample of accounts, 39% (95% CI=35, 43) belonged to persons who vaped. Among this digital cohort, 27% (95% CI=21, 33) reported making a quit attempt. For all first quit attempts, 26% (95% CI=19, 33) were successful on the basis of their subsequent vaping posts. Among those with a failed first cessation attempt, 13% (95% CI=6, 19) subsequently made an additional quit attempt, of whom 36% (95% CI=11, 61) were successful. On average, a quit attempt occurred 531 days (95% CI=474, 588) after their first vaping-related post. If their quit attempt failed, any second quit attempt occurred 361 days (95% CI=250, 474) after their first quit attempt. CONCLUSIONS: By aligning with standard epidemiologic surveillance practices, this approach can greatly enhance the usefulness of social media monitoring in informing public health decision making, such as yielding insights into the timing of cessation behaviors among people who vape.
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BACKGROUND: Major depressive disorder (MDD) is a debilitating condition that affects more than 300 million people worldwide. Current treatments are based on a trial-and-error approach, and reliable biomarkers are needed for more informed and personalized treatment solutions. One of the potential biomarkers, gamma-frequency (30-80 Hz) brainwaves, are hypothesized to originate from the excitatory-inhibitory interaction between the pyramidal cells and interneurons. The imbalance between this interaction is described as a crucial pathological mechanism in neuropsychiatric conditions, including MDD, and the modulation of this pathological interaction has been investigated as a potential target. Previous studies attempted to induce gamma activity in the brain using rhythmic light and sound stimuli (GENUS - Gamma Entrainment Using Sensory stimuli) that resulted in neuroprotective effects in Alzheimer's disease (AD) patients and animal models. Here, we investigate the antidepressant, cognitive, and electrophysiological effects of the novel light therapy approach using 40 Hz masked flickering light for patients diagnosed with MDD. METHODS AND DESIGN: Sixty patients with a current diagnosis of a major depressive episode will be enrolled in a randomized, double-blinded, placebo-controlled trial. The active treatment group will receive 40 Hz masked flickering light stimulation while the control group will receive continuous light matched in color temperature and brightness. Patients in both groups will get daily light treatment in their own homes and will attend four follow-up visits to assess the symptoms of depression, including depression severity measured by Hamilton Depression Rating Scale (HAM-D17), cognitive function, quality of life and sleep, and electroencephalographic changes. The primary endpoint is the mean change from baseline to week 6 in depression severity (HAM-D6 subscale) between the groups.
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Trastorno Depresivo Mayor , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Trastorno Depresivo Mayor/terapia , Método Doble Ciego , Electroencefalografía/métodos , Ritmo Gamma/fisiología , Fototerapia/métodos , Resultado del Tratamiento , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
OBJECTIVE: The use of propolis-based materials within endodontics to promote pulp wound healing or disinfect the root canal system has been a recent focus of scientists and clinicians. This is mainly because of the well-documented antimicrobial, anti-inflammatory, immunomodulatory and wound healing properties of propolis. This scoping review critically appraises the literature on the clinical applications of propolis-based compounds during endodontic therapy of primary and permanent teeth. METHODS: An electronic literature search was performed in Scopus, PubMed, and Web of Science up to and including October 2023 to identify studies assessing the use of propolis during endodontic therapy of primary and permanent teeth. A combination of relevant MeSh terms and keywords was used. Only human clinical studies written in English were included. The identified manuscripts were screened and assessed for inclusion by two independent authors. Eligible manuscripts were then subjected to critical appraisal and data extraction with the information being summarised according to their clinical application. RESULTS: A total of 26 human clinical studies were identified and included in the analysis. Propolis was investigated for use in the primary and permanent dentitions as a direct pulp capping or pulpotomy material as well as in root canal disinfection and root filling of teeth with non-vital pulps. Overall, the studies reported that the use of propolis was associated with promising outcomes in terms of efficacy to control inflammation, enhance tissue repair, and disinfection of the root canal system. However, a critical appraisal of the studies revealed a range of methodological and reporting deficiencies, resulting in unreliable results and conclusions in terms of the clinical outcomes reported. CONCLUSION: Although the studies on the use of propolis-based materials in endodontics reported promising clinical outcomes, they had a range of methodological and reporting flaws. Further well-designed and properly reported controlled clinical studies are essential to derive sound evidence-based conclusions on propolis-based materials. Furthermore, guidelines for quality assurance and safe use of propolis-based materials are necessary to enhance their production for commercial use in endodontics.
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Própolis , Diente Primario , Própolis/farmacología , Humanos , Dentición Permanente , Tratamiento del Conducto Radicular/métodos , Recubrimiento de la Pulpa Dental/métodos , Pulpotomía/métodos , Estudios Clínicos como AsuntoRESUMEN
AIM: Adolescent mental ill-health is a common international challenge affecting both high- and lower-middle-income countries. The Republic of the Philippines enacted its first mental health law in 2019, underlining the importance of the promotion of adolescent mental health education in schools. In Japan, course instructions about mental ill-health were formulated in a Course of Study that reflects governmental curriculum guidelines. Embedded since 2022, the Course of Study aimed to promote an understanding of current issues of adolescent health. The National Center for Global Health and Medicine in Japan has been sharing experience of promoting public health practices and advancing medical technology in low- and middle-income countries, especially in the Western Pacific region. This paper describes the development process and content of these resources by an interdisciplinary team from Japan and the Philippines. METHODS: The interdisciplinary team created an embedded mental health education programme using animated videos for the Philippine school curriculum to improve mental health literacy in adolescents. RESULTS: Two six-minute animated videos of age-relevant stories were created. The animation scenarios illustrate: 1) mental health problems and recovery; and 2) major symptoms of mental illnesses, including depression, anxiety, and schizophrenia. Each animated video presents several items for discussion among students and/or teachers, both in class and online for students unable to attend school. CONCLUSION: Our efforts may provide good opportunities for enhancing adolescents' mental health activities in the Philippines. In the following steps, we should investigate the effectiveness of school-based MHL using these animated videos with rigorous evaluation methods.
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This article seeks to enhance the theoretical understanding of discrimination perception, especially in contexts with relevant statistical information. Previous research has provided important insights into the perception of single, ambiguous instances of discrimination. However, the generalizability of these insights to scenarios involving multiple, repeated instances of discrimination remains unclear. The current research aims to reduce this uncertainty by investigating whether three key determinants of discrimination perception in single instances - perpetrators' prototypicality, victims' control, and system-justifying beliefs (SJB) - also influence observers' perceptions of repeated discrimination. In Experiments 1 and 2, participants perceived stronger discrimination when perpetrators were prejudiced members of the advantaged group. In Experiments 3 and 4, perceived discrimination intensified when victims had low control, a trend significantly noted in tabular presentations but not in sequential ones. In Experiments 5 and 6, a negative correlation between SJB and discrimination perception was observed. The theoretical and practical implications of these results, as well as open questions, are discussed. Overall, these studies advance our knowledge of discrimination perception in multiple instances. They highlight the intricate interplay between statistical data, moral judgements, and individual belief systems, paving the way for a more nuanced exploration of the underlying psychological processes of discrimination perception.
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The manipulation of T cell metabolism to enhance anti-tumor activity is an area of active investigation. Here, we report that activating the amino acid starvation response in effector CD8+ T cells ex vivo using the general control non-depressible 2 (GCN2) agonist halofuginone (halo) enhances oxidative metabolism and effector function. Mechanistically, we identified autophagy coupled with the CD98-mTOR axis as key downstream mediators of the phenotype induced by halo treatment. The adoptive transfer of halo-treated CD8+ T cells into tumor-bearing mice led to robust tumor control and curative responses. Halo-treated T cells synergized in vivo with a 4-1BB agonistic antibody to control tumor growth in a mouse model resistant to immunotherapy. Importantly, treatment of human CD8+ T cells with halo resulted in similar metabolic and functional reprogramming. These findings demonstrate that activating the amino acid starvation response with the GCN2 agonist halo can enhance T cell metabolism and anti-tumor activity.
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Linfocitos T CD8-positivos , Neoplasias , Humanos , Animales , Ratones , Inmunoterapia Adoptiva/métodos , Neoplasias/patología , Inmunoterapia , AminoácidosRESUMEN
BACKGROUND: Dengue has become a major health issue in tropical regions as the numbers of reported cases and estimated infections continuously increase. In the Philippines, many challenges remain in preventing and controlling the disease amidst all the mitigation efforts of the government. This study sought to measure the health literacy of Filipino teachers and determine the associations among teachers' knowledge, attitudes, and selected practices (KAP) against dengue. METHODS: Elementary and secondary school teachers from the consistently declared dengue hotspots in the City of San Fernando, Pampanga, Philippines, from the years 2017 to 2019 were selected as target participants in this cross-sectional study. A self-administered online survey tool was used in this study for both screening of participants and the KAP survey proper. STATA, descriptive statistics, and multiple logistic regression were used for the data analysis. Odds Ratios (ORs) and 95% confidence intervals (CIs) were reported. RESULTS: The study comprised 604 participants whose mean age was 38.4 years. Television was determined as the top media source of information, and various health staff were the most trusted and common source of information. Good knowledge on dengue treatment (OR = 1.81; 95% CI 1.18-2.78) and dengue prevention (OR = 1.85; 95% CI 1.26-2.71) were positively associated with having good practices on protection against mosquito bites. Good knowledge on dengue signs and symptoms (OR = 1.56; 95% CI 1.02-2.37) and dengue prevention (OR = 2.38; 95% CI 1.59-3.58) were positively associated with having good practices on preventing breeding sites. Those with positive perceived susceptibility to dengue had lower odds of having good practices on protection against mosquito bites (OR = 0.64; 95% CI 0.41-0.99) and of having good practices on preventing breeding sites (OR = 0.46; 95% CI 0.26-0.81). CONCLUSION: Even with the existing dengue policies, programs, and strategies, and the high disease literacy rate of Filipinos, dengue remains a struggle with an increasing case rate. Therefore, specific concepts should be emphasized, and interventions should be fine-tuned to better reach and influence the target population to attain a dengue-free Philippines.
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Immunotherapies targeting PD-1/PD-L1 are now widely used in the clinic to treat a variety of malignancies. While most of the research on T cell exhaustion and PD-1 blockade has been focused on conventional αß T cells, the contribution of innate-like T cells such as γδ T cells to anti-PD-1/PD-L1 mediated therapy is limited. Here we show that tumor reactive γδ T cells respond to PD-1 blockade in a Merkel cell carcinoma (MCC) patient experiencing a complete response to therapy. We find clonally expanded γδ T cells in the blood and tumor after pembrolizumab treatment, and this Vγ2Vδ1 clonotype recognizes Merkel cancer cells in a TCR-dependent manner. Notably, the intra-tumoral γδ T cells in the MCC patient are characterized by higher expression of PD-1 and TIGIT, relative to conventional CD4 and CD8 T cells. Our results demonstrate that innate-like T cells could also contribute to an anti-tumor response after PD-1 blockade.
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Carcinoma de Células de Merkel , Neoplasias Cutáneas , Humanos , Receptor de Muerte Celular Programada 1/metabolismo , Antígeno B7-H1 , Linfocitos T CD8-positivos/metabolismo , Neoplasias Cutáneas/patologíaRESUMEN
Introduction: This study investigated the health effects of two different architectural glass types: A two-layered low-iron high transmittance glass and a three-layered low energy glass with lower transmittance. The study investigated how these glass types affected daylight conditions in 72 residential apartments, as well as health and satisfaction of the residents.Methods: The study installed high transmittance glass (light transmittance LT:0.82) in 36 apartments and low transmittance (LT:0.74) in 36 identical apartments. The study then analyzed the light transmittance of each glass type in the laboratory and analyzed the indoor environmental quality (IEQ) in eight representative apartments before and after renovation. Self-reported questionnaires were handed out and collected before and after renovation.Results: The results showed that the glass types differed significantly in measured daylight transmittance. The two-layered high transmittance glass transmitted 15% more visual light (380-750 nm) and 20% more light in the spectral range (460-480 nm), stimulating ipRGCs and circadian rhythm, when compared to three-layered low energy glass. In addition, significant differences were observed in the UV-B spectrum (280-315 nm). While two-layered high transmittance glass transmitted UV-B, three-layered low transmittance glass did not. During the 12-month study period, residents in apartments with three-layered low energy glass reported more difficulties sleeping (p = 0.05), higher satisfaction with daylight (p = 0.03) and higher satisfaction with ventilation (p = 0.04). Residents in apartments with three-layered low energy glass experienced fewer days with too cold indoor temperatures (p = 0.02), compared to residents with two-layered low-iron glass. The results of energy consumption for heating showed that two-layered low-iron glass reduced the energy consumption by 11.0%, while three-layered low energy glass reduced the energy consumption by 9.4%, compared to the year prior to renovation.Conclusion: The results contribute to a discussion about potential energy savings on one hand and potential non-energy benefits, such as daylight quality, overall health, and total economy/life cycle assessment of the built environment on the other hand. The results suggest further research performed in randomized large-scale studies.
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Ritmo Circadiano , Sueño , Humanos , Autoinforme , Encuestas y Cuestionarios , HierroRESUMEN
Propolis is a resinous substance produced naturally by bees, and it consists of the exudates of plants mixed with enzymes, wax, and pollen. Propolis continues to gain considerable scientific interest due to its potential health benefits. The modern-day use of propolis in pharmaceutical preparations, such as toothpastes, mouthwashes, chewable tablets, mucoadhesive gels, and sprays, is increasing. However, the effectiveness of using propolis-containing pharmaceuticals in dentistry is not clear. The present paper aims to review the literature on the dental applications of propolis in preventive dentistry, periodontics, oral medicine, and restorative dentistry and discuss its clinical effectiveness. A literature search was conducted using Scopus, PubMed, and Web of Science databases. In total, 104 studies were included, of which 46 were laboratory studies, 5 animal studies, and 53 human clinical studies. Overall, the laboratory studies revealed a range of antimicrobial effects of propolis on oral pathogens. Clinical investigations of propolis in biofilm and dental caries control as well as adjuvant periodontal therapies reported positive outcomes in terms of plaque control, pathogenic microbial count reduction, and periodontal tissue inflammation control. Additional investigations included the use of propolis for the management of recurrent aphthous stomatitis, oral mucositis, and cavity disinfection after caries removal as well as the development of a range of restorative dental materials. Based on the reported outcomes of the studies, the clinical usage of propolis has potential. However, the majority of the evidence is derived from studies with flaws in their methodological design, making their results and conclusions questionable. As a consequence, properly designed and well-reported clinical studies are required to affirm the effectiveness of propolis for dental applications. Additionally, the safety of propolis and the optimal concentrations and extraction methods for its clinical use warrant further investigation. Utilisation of standardised propolis extracts will help in quality control of propolis-based products and lead to the achievement of reproducible outcomes in research studies.
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Própolis , Própolis/uso terapéutico , Humanos , Caries Dental/prevención & control , Antiinfecciosos/uso terapéutico , Animales , Odontología Preventiva , Biopelículas/efectos de los fármacos , Estomatitis Aftosa/tratamiento farmacológico , Estomatitis Aftosa/prevención & controlRESUMEN
Alzheimer's disease (AD) is associated with electrophysiological changes in the brain. Pre-clinical and early clinical trials have shown promising results for the possible therapy of AD with 40 Hz neurostimulation. The most notable findings used stroboscopic flicker, but this technique poses an inherent barrier for human applications due to its visible flickering and resulting high level of perceived discomfort. Therefore, alternative options should be investigated for entraining 40 Hz brain activity with light sources that appear less flickering. Previously, chromatic flicker based on red, green, and blue (RGB) have been studied in the context of brain-computer interfaces, but this is an incomplete representation of the colours in the visual spectrum. This study introduces a new kind of heterochromatic flicker based on spectral combinations of blue, cyan, green, lime, amber, and red (BCGLAR). These combinations are investigated by the steady-state visually evoked potential (SSVEP) response from the flicker with an aim of optimising the choice of 40 Hz light stimulation with spectrally similar colour combinations in BCGLAR space. Thirty healthy young volunteers were stimulated with heterochromatic flicker in an electroencephalography experiment with randomised complete block design. Responses were quantified as the 40 Hz signal-to-noise ratio and analysed using mixed linear models. The size of the SSVEP response to heterochromatic flicker is dependent on colour combinations and influenced by both visual and non-visual effects. The amber-red flicker combination evoked the highest SSVEP, and combinations that included blue and/or red consistently evoked higher SSVEP than combinations only with mid-spectrum colours. Including a colour from either extreme of the visual spectrum (blue and/or red) in at least one of the dyadic phases appears to be more important than choosing pairs of colours that are far from each other on the visual spectrum. Spectrally adjacent colour pairs appear less flickering to the perceiver, and thus the results motivate investigations into the limits for how alike the two phases can be and still evoke a 40 Hz response. Specifically, combining a colour on either extreme of the visual spectrum with another proximal colour might provide the best trade-off between flickering sensation and SSVEP magnitude.
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Ámbar , Interfaces Cerebro-Computador , Humanos , Estimulación Luminosa/métodos , Potenciales Evocados Visuales , Electroencefalografía/métodos , EncéfaloRESUMEN
AIM: There are currently no high-quality studies comparing the static navigation technique with conventional methods of fibre post removal. The aim of this ex vivo study was to compare the effectiveness of fibre post removal between a static navigation technique and a conventional freehand technique using ultrasonics by experienced and inexperienced operators. METHODOLOGY: Forty-eight extracted single-rooted human premolars were root-filled. A fibre post was cemented in all 48 teeth, which were then divided randomly into the following groups: static navigation group using burs; static navigation-ultrasonic group; and non-guided group using ultrasonic tips. The following parameters were evaluated for both experienced operators and inexperienced operators: reaching the gutta-percha root filling successfully, the time required to remove the entire post, the occurrence of lateral root perforations, and the amount of root dentine removed. The Kolmogorov-Smirnov test was used to examine the normality of the data; the anova test was used to compare the significant differences among groups; and Tukey tests were used for all two-by-two comparisons. The significance level was set at 0.05. RESULTS: In the static navigation group, the gutta-percha was reached significantly more frequently than in the non-guided group (p < .05). The static navigation approach required significantly less time than the non-guided approach to reach the gutta-percha (p < .05). The total removal of posts was significantly different between groups (p < .05), but there was no significant difference between experienced and inexperienced operators in the static navigation group (p > .05). More perforations were associated with the non-guided group than with the other two groups. The total mean loss of dentine in the non-guided group in all directions was 0.39 (±0.17) mm, with 0.25 (±0.09) mm for experienced, and 0.42 (±0.16) mm for inexperienced operators. CONCLUSION: When compared to a conventional ultrasonic technique for the removal of fibre posts, the static navigation method using burs resulted in less dentine removal, more rapid access to the gutta-percha root filling, less overall time to remove the posts, and fewer complications. When using static navigation, there was no difference in performance between experienced and inexperienced operators.
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Gutapercha , Materiales de Obturación del Conducto Radicular , Humanos , Ultrasonido , Preparación del Conducto Radicular/métodos , Obturación del Conducto RadicularRESUMEN
AIMS: High-sensitivity cardiac troponin (hs-cTn) assays are used for detection of myocardial infarction (MI). Ninety-ninth percentiles show wide inter-assay variation. The use of sex-specific cut-offs is recommended as definitory cut-off for MI. We compared diagnostic performance and prognostic value of sex-specific 99th percentiles of four hs-cTn assays in patients with suspected MI. METHODS AND RESULTS: Concentrations of four hs-cTn assays were measured at presentation and after 3â h in patients with suspected MI. Final diagnoses were adjudicated according to the 4th Universal Definition of MI. Unisex and sex-specific 99th percentiles were evaluated as diagnostic cut-offs following the ESC 0/3â h algorithm. These cut-offs were used in Cox-regression analyses to investigate the association with a composite endpoint of MI, revascularization, cardiac rehospitalization, and death. Non-ST-elevation MI was diagnosed in 368 of 2718 patients. Applying the unisex 99th percentile, Elecsys hs-cTnT provided highest negative predictive value (NPV) of 99.7 and a positive predictive value (PPV) of 75.9. The analysed hs-cTnI assays showed slightly lower NPVs and comparable PPVs [Architect (NPV 98.0, PPV of 71.4); Atellica (NPV 97.7, PPV of 76.1); Pathfast (NPV 97.7, PPV of 66.6)]. Application of sex-specific 99th percentiles did not significantly affect diagnostic performance. Concentrations above 99th percentile were independent predictors for impaired long-term outcome (hazard ratios 1.2-1.5, P < 0.001). CONCLUSION: We describe a good diagnostic accuracy of four hs-cTn assays using the assay-specific 99th percentile for detection of MI. Application of sex-specific 99th percentiles did neither affect diagnostic performance nor prognostic value significantly. Finally, values above the 99th percentile were associated with poor long-term outcome.
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Infarto del Miocardio , Troponina T , Masculino , Femenino , Humanos , Pronóstico , Biomarcadores , Infarto del Miocardio/diagnóstico , Infarto del Miocardio/complicaciones , Troponina IRESUMEN
OBJECTIVES: Chikungunya virus (CHIKV), a reemerging global public health concern, which causes acute febrile illness, rash, and arthralgia and may affect both mothers and infants during pregnancy. Mother-to-child transmission (MTCT) of CHIKV in Africa remains understudied. METHODS: Our cohort study screened 1006 pregnant women with a Zika/dengue/CHIKV rapid test at two clinics in Nigeria between 2019 and 2022. Women who tested positive for the rapid test were followed through their pregnancy and their infants were observed for 6 months, with a subset tested by reverse transcription-polymerase chain reaction (RT-PCR) and neutralization, to investigate seropositivity rates and MTCT of CHIKV. RESULTS: Of the 1006, 119 tested positive for CHIKV immunoglobulin (Ig)M, of which 36 underwent detailed laboratory tests. While none of the IgM reactive samples were RT-PCR positive, 14 symptomatic pregnant women were confirmed by CHIKV neutralization test. Twelve babies were followed with eight normal and four abnormal outcomes, including stillbirth, cleft lip/palate with microcephaly, preterm delivery, polydactyly with sepsis, and jaundice. CHIKV IgM testing identified three possible antepartum transmissions. CONCLUSION: In Nigeria, we found significant CHIKV infection in pregnancy and possible CHIKV antepartum transmission associated with birth abnormalities.
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Fiebre Chikungunya , Virus Chikungunya , Labio Leporino , Fisura del Paladar , Dengue , Infección por el Virus Zika , Virus Zika , Lactante , Recién Nacido , Humanos , Femenino , Embarazo , Virus Chikungunya/genética , Mujeres Embarazadas , Estudios de Cohortes , Nigeria/epidemiología , Labio Leporino/complicaciones , Transmisión Vertical de Enfermedad Infecciosa , Fisura del Paladar/complicaciones , Fiebre Chikungunya/diagnóstico , Fiebre Chikungunya/epidemiología , Fiebre Chikungunya/complicaciones , Infección por el Virus Zika/diagnóstico , Infección por el Virus Zika/epidemiología , Mortinato , Inmunoglobulina MRESUMEN
With the ever-increasing understanding of tooth anatomy, there is a renewed focus on the pulp chamber as an important component of the root canal system. For example, the pulp chamber is of critical relevance during diagnostic procedures such as pulp sensibility tests, deep caries removal, vital pulp treatments, access cavity preparation, tooth whitening, tooth restoration as well as methods for examining the floor of the pulp chamber to aid the detection of root canal orifices or the presence of perforations and cracks. The more recent concept of minimal invasive endodontics has also created a need to understand better the anatomy of the pulp chamber. The purpose of this article is to discuss the research methods used to study pulp chamber anatomy and the significance of the pulp chamber in endodontic research and clinical practice. In addition, directions for future research are emphasised.