Clinicians' perspectives on race-specific guidelines for hypertensive treatment.

Despite the general consensus that there is no biological basis to race, racial categorization is still used by clinicians to guide diagnosis and treatment plans for certain diseases. In medicine, race is commonly used as a rough proxy for unmeasured social, environmental, and genetic factors. The American College of Cardiology's Eighth Joint National Committee's (JNC 8) guidelines for the treatment of hypertension provide race-specific medication recommendations for Black versus non-Black patients, without strong evidence for race-specific physiological differences in drug response. Clinicians practicing family or geriatric medicine (n = 21) were shown a video of a mock hypertensive patient with genetic ancestry test results that could be viewed as discordant with their phenotype and self-identified race. After viewing the videos, we conducted in-depth interviews to examine how clinicians value and prioritize different cues about race -- namely genetic ancestry data, phenotypic appearance, and self-identified racial classifications - when making treatment decisions in the context of race-specific guidelines, particularly in situations when patients claim mixed-race or complex racial identities. Results indicate that clinicians inconsistently follow the race-specific guidelines for patients whose genetic ancestry test results do not match neatly with their self-identified race or phenotypic features. However, many clinicians also emphasized the importance of clinical experience, side effects, and other factors in their decision making. Clinicians' definitions of race, categorization of the patient's race, and prioritization of racial cues greatly varied. The existence of the race-specific guidelines clearly influences treatment decisions, even as clinicians' express uncertainty about how to incorporate consideration of a patient's genetic ancestry. In light of widespread debate about removal of race from medical diagnostics, researchers should revisit the clinical justification for maintaining these race-specific guidelines. Based on our findings and prior studies indicating a lack of convincing evidence for biological differences by race in medication response, we suggest removing race from the JNC 8 guidelines to avoid risk of perpetuating or exacerbating health disparities in hypertension.

Compassion and equity-focused clinical genomics training for health professional learners.

There remains an urgent need for expanded genomics training in undergraduate medical education, especially as genetic and genomic assessments become increasingly important in primary care and routine clinical practice across specialties. Physician trainees continue to report feeling poorly prepared to provide effective consultation or interpretation of genomic test results. Here we report on the development, pilot implementation, and evaluation of an elective offering for pre-clinical medical students called the Sanford Precision Health Scholars Immersive Learning Experience (PHS), which was designed leveraging genetic counseling expertise as one means to address this need. This 9-week course, piloted in Fall 2021 at UC San Diego, afforded students the opportunity to build technical skills and competencies in clinical genomics while identifying, addressing, and engaging with pervasive health disparities in genomics. Interactive exercises focused students' learning on strategies for empathic and compassionate patient interactions while supporting the application of concepts and knowledge to future practice. Upon completion of the course, participants reported increases in confidence related to skills required for clinical genomics practice. Drawing on learnings from this pilot implementation, recommendations for refining the program include deepening pedagogical engagement with ethical issues, expanding the offering to trainees across health professions, including pharmacy students, and incorporating an optional experiential learning component. Educational offerings, like PHS, that are designed with the input of genetic counseling expertise may ease pressures on the genetic counseling profession by building a more genomic-literate healthcare workforce that can better support efforts to expand access for patients.

Fabrication and characterization of fish gelatin-based magnetic nanocomposite for biomedical applications.

Bionanocomposite is considered an advanced way to bridge the gap between the structural and functional material and achieve the desired properties in the nanocomposite. This present study highlighted the synthesis of fish gelatin-based magnetic nanocomposite (GMNC) using three different concentrations of gelatin (6% w/v, G12% w/v, and 18% w/v) individually, through the in situ coprecipitation method. The effect of gelatin concentration on the structural, functional, magnetic properties, and biocompatibility of the GMNC was studied successfully. This variation reduces the crystallite size from 20.8 to 12.2 nm. GMNC obtained at minimum gelatin concentration (6% w/v) produced well-dispersed sphere-shaped magnetite nanoparticles with an average particle size of 33 nm without aggregation. All three reported superparamagnetic behavior at 293 K. It also noted the highly biocompatible and biodegradable nature of GMNC with a high magnetic response at a low magnetic field. This study reported the perspective of this functionalization method for biomedical applications, as GMNC is a potential carrier material that is easily attached to drug molecules through the free functional residues of gelatin molecules. The present study also performed the in vitro drug release behavior of 5'Fluorouracil-loaded GMNC (GF) at physiological conditions (pH 7.4 and 37 °C). It indicates the prepared GF exhibits a sustained drug-release profile for up to 48 h. Hence, these results strongly supported that the functionalized GMNC would be a potential carrier material for advanced drug delivery applications.

BBD optimized antioxidants of Crotalaria candicans and its nanoconjugates, exert potent in vivo anti-biofilm effects against MRSA.

Crotalaria genus is extensively dispersed in tropical and subtropical provinces, and it is found to harbor antioxidant flavonoids. Response surface methodology-based optimization was carried out for the purpose of efficient extraction involving a suitable solvent which can maximize the yield along with higher total phenolic content and total flavonoid content (TFC). Optimization conditions for extraction of C.candicans flavonoids (CCF) based on variables such as solvent, solid-solvent ratio and extraction temperature were evaluated. The optimized conditions were found as Solvent i.e., Aqueous-ethanol (53.42%), Solid-solvent ratio (1:15.83 w/v) and temperature (44.42 °C) and resulted to obtain the TFC as 176.23 mg QRET/g C. candicans extract with the yield 27.42 mg CCF/g (C. candicans dry weight). LC-MS analysis of CCF, revealed the presence of seven major flavonoids. The antioxidant flavonoids were further used to functionalize the zero-valent silver (ZVAgF) and copper (ZVCuF) nanoparticles. The ZVAgF and ZVCuF were investigated using UV-Vis spectrophotometry, FT-IR spectroscopy and X-ray diffractometry to confirm the presence of the zero valent metals and possible functional groups which capped the elemental metal. Further transmission electron microscopy, dynamic light scattering method and zeta-potential studies were done to understand their respective structural and morphological properties. The efficacy of the as-prepared ZVAgF/ZVCuF as antibiofilm agents on Methicillin-resistant Staphylococcus aureus (MRSA) with the mechanism studies have been explored. The MRSA-colony count from the infection zebrafish (in vivo) model, portrayed a reduction of > 1.9 fold for ZVCuF and > twofold for ZVAgF, with no alteration in liver morphology when treated with ZVAgF, implying that the nanoparticles were safe and biocompatible.

Incorporating oregano (Origanum vulgare L.) Essential oil onto whey protein concentrate based edible film towards sustainable active packaging.

The study's objectives were to develop a packaging film incorporating oregano essential oil, and evaluate the antioxidant, antibacterial, mechanical, and physicochemical activities of the film toward grapes packaging. The films were developed by casting method, after adding nano-emulsion of essential oil into WPC-glycerol film forming solution. The effects of the Oregano Essential Oil (OEO) at different concentrations of 1, 2, 3, and 4% (w/w) in the WPC edible films were studied. The light transmittance, colour aspects, water aspects, mechanical, antioxidant, antimicrobial activities, FTIR, SEM microstructure, and biodegradability of the film were studied. Acidity, weight, TSS, pH and 9-point hedonic sensory analysis of grapes packed in WPC-OEO film were evaluated. Results showed that 3% OEO incorporated WPC film displayed positive inhibition towards pathogenic bacteria; Staphylococcus aureus and Escherichia coli (25.36 ± 0.52-28.0 ± 0.5 mm), the antioxidant activity of 86.89 ± 0.087% and 51.24 ± 0.031% for DPPH, FRAP respectively and degradation after 10 days. The film displayed reduced light transmittance, lower water solubility (44.04 ± 2.361%) and prominent surface characteristics in SEM microstructure and FTIR spectra. The grapes packed in WPC-3% OEO film were firmer, had less surface colour change and showed negligible change in weight, pH, acidity, and Brix value throughout the storage period. Thus, the developed film displayed excellent antibacterial and antioxidant properties that potentially extended the quality of fresh grapes during refrigerated storage. Supplementary Information: The online version contains supplementary material available at 10.1007/s13197-023-05763-7.

Bifunctional electrode of bismuth tungsten for electrochemical sensing applications.

A co-precipitation technique has been used to prepare Bismuth tungstate nanoparticles (Bi2WO6) for electrochemical capacitors and electrochemical sensing of Ascorbic acid (AA). Using a scanning rate of 10 mV s -1, the electrode was performed as the pseudocapacitance behavior and the specific capacitance to be up to 677 Fg -1 at 1 A/g. Bi2WO6 versus Glassy carbon electrode (GCE) was also used to study the behavior of the Bi2WO6 modified electrodes in detecting ascorbic acid. This electrochemical sensor shows excellent electrocatalytic performance when ascorbic acid is present, as determined by differential pulse voltammetry. In solution, ascorbic acid diffuses to an electrode surface and controls its surface properties. Based on the results from the investigation, the sensor showed a detection sensitivity of 0.26 mM/mA, and a limit of detection (LOD) of 77.85 mM. It is clear from these results that Bi2WO6 may find application as an electrode material for supercapacitors and glucose sensors.

Compassion as a tool for allyship and anti-racism.

Racist systems, policies, and institutions subvert the quality of life for minoritized individuals and groups, across all indicators, from education and employment, to health, to community safety. Reforms to address systemic racism may be accelerated with greater support from allies who identify with the dominant groups that derive advantage from such systems. Although enhancing empathy and compassion for impacted individuals and groups may foster greater allyship with and support of minoritized communities, little work to date has assessed the relationships among compassion, empathy, and allyship. After reviewing current work in the area, this perspective offers insights into the utility and specific components of a compassion-based framework that can be used to combat racism, using findings from a survey study in which we investigated the relationship between validated psychometric measures of compassion and allyship with minoritized communities. Several subdomains of compassion, as measured among individuals identifying as non-Black, correlate significantly with levels of felt allyship with Black or African American communities. These findings inform recommendations for compassion-focused research, including development and testing of interventions to promote allyship, advocacy, and solidarity with minoritized groups, and support efforts to undo longstanding structural racisms that have patterned inequality in the United States.

Fabrication of an effectual, stable and reusable Mg-doped CdAl2O4 nanoparticles for photodegradation of toxic pollutants under visible light illumination.

The water contamination caused by discharging extensive organic dyes stuff into water bodies is one of the utmost significant concerns disturbing the environment and human life. CdAl2O4 spinel materials have been excellent in the elimination of emerging pollutants by the photocatalysis route. These materials, when altered through methods namely doping with Mg ions, have benefits over CdAl2O4, especially reduced energy gap and light absorbed in the visible region. The XRD established the creation of space group R 3‾ with no other phase step being found. The photoluminescence outcomes indicated that Mg-doped CdAl2O4 nanoparticles had the preventing e--h+ recombination possibility, which was favorable for the photocatalytic process. The Mg (0.075 M)-doped CdAl2O4 catalyst had higher photocatalytic performance with 94 and 96% removal of two azo (BB and BG) dyes under a mere 90 min visible light irradiation, which indicated enhanced Photodegradation behaviors when compared to other Mg (0.025, 0.050 M)-doped and pure CdAl2O4 materials. More interestingly, pH 5 was optimum for the Mg (0.075 M)-doped CdAl2O4 samples photodegradation of both dyes, and the optimum catalyst amount was 5 mg/100 mL. The doped Mg ions influenced the elimination of both dyes by inducing the manufacture of more active species. The Mg (0.075 M)-doped CdAl2O4 samples is reusable and highly stable with only a 5% reduction in degradation rate after six cycles. Based on the quencher and ESR investigations, the .OH- and h+ are described as active species in the removal reaction. We hope our present examinations highlight the possibility of using Mg (0.075 M)-doped CdAl2O4 product for a broad range of photodegradation applications, also it may be applied for several ecological remediations, surface cleaning devices, foods and pharmaceutical industry applications.

Strategies for ameliorating the photodegradation efficiency of Mn-doped CdAl2O4 nanoparticles for the toxic dyes under visible light illumination.

Worldwide environmental issues have been escalating with the growth of the global economy and become a vital problem. To solve the problems, we require an eco-friendly and sustainable binary catalyst for the degradation of Azo dye pollutants. In this work, magnetically reusable, multifunctional novel Mn-doped CdAl2O4 nanoparticles were effectively fabricated by the co-precipitation approach. It was utilized for the degradation of two Azo dyes, exhibiting 96 and 98% Mn (0.050 M)-doped CdAl2O4 removal rates under visible light illumination, and presenting improved photocatalytic capability than that of pure and other dopants. More notably, the Mn (0.050 M)-doped CdAl2O4 catalyst was recycled using centrifuges without major loss and displays almost similar photodegradation behaviors for six successive runs. According to the ESR measurements, outcome and quenching tests affirmed that .OH- and h+ radicals were better reactive species responsible for Azo dyes removal. A possible photodegradation reaction mechanism underlying the elimination of Azo dyes by Mn (0.050 M)-doped CdAl2O4 catalyst is also proposed. Elaborated analyzes by variable reaction parameters such as the role of reactive species and catalyst dosage, pH, COD and irradiation time in the degradation route was also discussed. We assume that our outcomes will provide novel insights into using a highly effectual Mn (0.050 M)-doped CdAl2O4 catalyst, with possible applications in the treatment of both industrial and domestic wastewater.

Preparation and characterization of a novel cobalt-substitution cadmium aluminate spinel for the photodegradation of azo dye pollutants.

Modern-year organic contaminants have been highly observed in ecosystems since they are not removed entirely and remain dangerous. Semiconductor binary oxide photocatalysts have been well accredited as capable technology for ecological contaminants degradation in the existence of visible irradiation. In this research, novel Co ions doped CdAl2O4 materials were fabricated by a facile co-precipitation approach. The fabricated pure and Co-doped CdAl2O4 exhibited the typical peaks of CdAl2O4 with the Eg of 3.66, 3.24, 2.57, and 2.41 eV respectively. The HR-TEM microstructures revealed that the Co (0.075 M) doped CdAl2O4 has rod-like morphology, and some places are spherical with particle sizes reaching 21 nm. The PL peaks of the Co (0.075 M)-CdAl2O4 are much lesser than that of the other dopant and pure CdAl2O4, representing much more effectual separation of generated e- and h+ at the interface which in fact outcomes in superior expected photodegradation behaviours. The Co (0.075 M)-CdAl2O4 catalyst demonstrated the highest performances of 92 and 94% toward the degradation of both dyes, respectively, owing to the lowest e- and h+ recombination rate. The Co (0.075 M) doped CdAl2O4 photocatalyst revealed outstanding reusability and stability under visible irradiation, retaining the performance of about 83 and 86% after the fifth consecutive run of BB and BG elimination. A probable photodegradation mechanism of Co (0.075 M) doped CdAl2O4 was suggested since the photoexcited h+, OH- and O2- species contributed to the removal process, and that was affirmed by the scavenging test and ESR analysis. This research offers new ways to improve the photodegradation performance of the Co-doped CdAl2O4 catalyst that will be employed in pharmaceutical applications and wastewater treatment.

A critical review on recent research progress on microplastic pollutants in drinking water.

Plastic pollution is an emerging issue in recent days. Persistent plastic particles reach the atmosphere, land and water by multiple pathways. Research has confirmed that the existence of plastic particles is found surprisingly everywhere, from the Artic to the Antarctic region. The probability of ingestion of plastic by all living forms is quite natural, as the whole planet's environment is polluted with microplastic particles. The bioaccumulation of microplastics is a threat and the consequences for living beings are yet to be explored. Microplastics present in different drinking water sources like rivers, lakes, treatment units etc. are studied by several researchers, covering various aspects. Research carried out by various scientists on the microplastics in different drinking water sources is highlighted in this review. In view of the previous research carried out on various aspects of microplastic particles, the necessity of a uniform protocol for qualitative and quantitative analysis of microplastic is ascertained. Microplastic pollution is an ongoing environmental concern, it must be addressed and research should be expanded.

A synergistic consequence of catalyst dosage, pH solution and reactive species of Fe-doped CdAl2O4 nanoparticles on the degradation of toxic environmental pollutants.

Industrial wastewater treatment techniques are one of the biggest challenges of the scientific community that necessitate an increased consciousness to address water scarcity worldwide. Herein, an eco-friendly and cost-effective process was demonstrated to cope with tannery, textile and pharmaceutical dye wastes through the co-precipitation of highly reusable Fe-doped CdAl2O4 samples. The XRD studies exposed the space group R 3‾ with no secondary phase step being found for all samples. The outcomes of optical absorbance spectra demonstrate that Fe doping diminished the energy gap from 3.66 to 1.67 eV. HR-TEM images of existing spherical particles and some of the particles' rod-like structures with little agglomeration were found for Fe (0.075 M) doped CdAl2O4 nanoparticles. The PL emission outcomes show that Fe doping effectively prevented the charge carrier's recombination in CdAl2O4 during photocatalysis. All Fe-doped CdAl2O4 samples demonstrated higher photodegradation behaviors towards the effectual degradation of both dye solutions as compared to pure CdAl2O4 samples. Particularly, Fe (0.075 M)-doped CdAl2O4 samples exhibited improved photodegradation performance of 93 and 95% for both dye solutions. The amount of photodegradation was noticed to rely on dye pH, irradiation time, catalyst dosage, initial dye amount, and reactive species. The recyclability of the Fe (0.075 M) doped CdAl2O4 nanoparticles denotes that 78 and 82% of BB and BG were removed up to the 6th run of usage. The outcomes of trapping tests,.OH- and h+ radicals were the major Scavenging in the photodegradation reaction. COD studies affirmed the whole mineralization of BB and BG dye molecules. It is expected that our present examination could offer to improve various spinal oxide materials for the photodegradation activity of pharmaceutical contaminants and environmental issues and can also resolve energy storage applications.

Experimental investigation of the electrochemical detection of sulfamethoxazole using copper oxide-MoS2 modified glassy carbon electrodes.

An electrochemical sensor detection of sulfamethoxazole was performed using a copper oxide Molybdenum sulfide modified glassy carbon electrode using Molybdenum sulfide (CuO/MoS2) functionalization. As part of the characterization process, materials were characterized via cyclic voltammetry (CV), Square wave voltammetry (SWV), Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), X-ray diffraction (XRD) and scanning electron microscopy (SEM). To optimize the performance of the experiment, parameters like the scan rate and pH, the electrolytes study, the stability, the comparative study and repeatability were optimized. In comparison to CuO, MoS2 and bare Glassy carbon electrode (GCE), an electrochemical sensor that incorporated CuO/MoS2 exhibited exceptional electrochemical performance. CuO/MoS2 modified electrodes showed a higher peak current for oxidation compared with bare, CuO and MoS2 modified electrodes, which demonstrated enhanced electrochemical conductivity for detection of SMX by minimizing oxidation potential from +0.18 V to +0.10 V. In the range of 100-800 µl SMX concentrations, the peak current linearly correlated with the concentration of SMX. In the calibration plot, the modified electrode showed linearity under ideal circumstances for SMX concentrations starting at 0.3 µM. This study investigated the presence of SMX with a detection limit of 0.34 Pg/L. CuO/MoS2 based electrochemical sensor, according to our analysis, are potentially useful in applications requiring the detection of trace amounts of SMX.

A recent advancement on the applications of nanomaterials in electrochemical sensors and biosensors.

Industrialization and globalization, both on an international and local scale, have caused large quantities of toxic chemicals to be released into the environment. Thus, developing an environmental pollutant sensor platform that is sensitive, reliable, and cost-effective is extremely important. In current years, considerable progress has been made in the expansion of electrochemical sensors and biosensors to monitor the environment using nanomaterials. A large number of emerging biomarkers are currently in existence in the biological fluids, clinical, pharmaceutical and bionanomaterial-based electrochemical biosensor platforms have drawn much attention. Electrochemical systems have been used to detect biomarkers rapidly, sensitively, and selectively using biomaterials such as biopolymers, nucleic acids, proteins etc. In this current review, several recent trends have been identified in the growth of electrochemical sensor platforms using nanotechnology such as carbon nanomaterials, metal oxide nanomaterials, metal nanoparticles, biomaterials and polymers. The integration strategies, applications, specific properties and future projections of nanostructured materials for emerging progressive sensor platforms are also observed. The objective of this review is to provide a comprehensive overview of nanoparticles in the field of electrochemical sensors and biosensors.

A raw data article on the physico-chemical properties of soil from six firkas in Dharmapuri district, Tamil Nadu, India.

The present study was aimed to assess the physical and chemical characteristics of soil belonging to six firkas covering three blocks of Dharmapuri district. A total of 125 samples were collected by means of Global Positioning System (GPS). The processed soil samples were analyzed for pH, Electrical conductivity (EC), soil separates, Bulk density (BD), Water holding capacity (WHC), organic carbon (OC), calcium carbonate (CaCO3), available nitrogen (AVN), available phosphorus (AVP), and available potassium (AVK). Extreme value in the data set was removed by outlier removal algorithm. Spatial variability maps were prepared using the kriging method using ArcGIS 10.4 . The best fitted semi variance model for pH, EC, AVK and CaCO3 was spherical; BD, sand, silt, and OC was circular; a Gaussian model was best fitted for WHC and AVN, while clay and AVP were exponential. The data presented in this study will help farmers, land managers, and policymakers to mitigate land degradation, and other environmental issues, thereby helping to increase land productivity.

A review on recent advancements in bioenergy production using microbial fuel cells.

The generation of energy and its efficient use in industries and agriculture are critical to any country's growth. A country like India, which is still developing, faces a major challenge in terms of generating adequate electricity. With the current crisis and environmental concerns, the government must look past carbon-based energy sources and into long-term energy sources. Microbial fuel cells (MFCs) are a form of technology that can be used to both treat wastewater and generate electricity on a large scale. Researchers play a critical role in making this technology practical and effective enough to be implemented. However, since the charge of building microbial fuel cells is superior than the cost of fossil fuels, it is unlikely that power production will continually be aggressive with existing energy generation approaches. However, improvements in power densities and lower material expenses could render microbial fuel cells a viable option for energy making in the future. Following a thorough literature review, the analysis resumes the role of micro-organisms and substrates in the anode chamber. Microbial fuel cells are discussed in terms of their forms, materials, mechanism, and activity. This analysis discusses the various factors that influence microbial fuel cells, as well as contemporary challenges and applications in the development of sustainable electrical power.

Colorism and employment bias in India: an experimental study in stratification economics.

In this paper, we examine whether the prevalence of colorism in India can be linked to discrimination in hiring for people with darker skin shades. Colorism or preference for lighter skin tones has a long history primarily linked to colonialism in parts of Asia and Africa. More recently, this preference for lighter skin has become amplified by growing and global whitening product industries dominated by multinational corporations. In India, the industry has tried to link lighter skin to economic success, specifically labor market success. However, the existence of such a link is yet to be explored given the lack of skin tone-specific data in the global context. We implemented an experimental survey design in India to overcome this lack of data. Participants in our study were asked to evaluate job candidates on the basis of unchanging resumes paired with photographs manipulated to vary skin tones. We did not find a statistically significant bias in favor of resumes paired with lighter-skinned photographs. Overall, participants tended to evaluate both lighter-skinned and darker-skinned candidates similarly. Our findings suggest that colorism in India cannot be easily linked to direct instances of hiring discrimination. Differential outcomes due to preference for skin color though might operate in other economic contexts beyond entry into employment. It may also exist in social contexts like marriage and family or health outcomes and in situations where beauty ideals are more relevant. Our findings provide an important counter-narrative to the skin whitening industry's worrisome efforts to expand their consumer base by linking lighter skin to economic success. Our methodology also provides new directions for future research on colorism, an important new global frontier in stratification economics.

Longevity of Crown Margin Repairs Using Glass Ionomer Cement: A Retrospective Study.

OBJECTIVE: The objective of this study was to determine the survival time of crown margin repairs (CMRs) with glass ionomer and resin-modified glass ionomer cements on permanent teeth using electronic dental record (EDR) data. METHODS: We queried a database of EDR (axiUm; Exan Group, Coquitlam, BC, Canada) in the Indiana University School of Dentistry (IUSD), Indianapolis, IN, USA, for records of patients who underwent CMRs of permanent teeth at the Graduate Operative Dentistry Clinic. Two examiners developed guidelines for reviewing the records and manually reviewed the clinical notes of patient records to confirm for CMRs. Only records that were confirmed with the presence of CMRs were retained in the final dataset for survival analysis. Survival time was calculated by Kaplan-Meier statistics, and a Cox proportional hazards model was performed to assess the influence of age, gender, and tooth type on survival time (a<0.05). RESULTS: A total of 214 teeth (115 patients) with CMR were evaluated. Patient average age was 69.4 ± 11.7 years old. Posterior teeth accounted for 78.5% (n=168) of teeth treated. CMRs using glass ionomer cements had a 5-year survival rate of 62.9% and an annual failure rate (AFR) of 8.9%. Cox proportional-hazards model revealed that none of the factors examined (age, gender, tooth type) affected time to failure. CONCLUSION: The results indicate the potential of CMRs for extending the functional life of crowns with defective margins, thus reducing provider and patient burden of replacing an indirect restoration. We recommend future studies with a larger population who received CMR to extend the generalizability of our findings and to determine the influence of factors such as caries risk and severity of defects on survival time.