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Background: The aim of this in vitro study was to reveal in a time-dependent manner the effect of received irradiance produced by different light-emitting-diode (LED) lamps on the surface microhardness of composite material used in the restoration of posterior teeth. Methods and Results: A single nanofilled resin composite, Estelite Posterior (Toquyama Dental Corp, Japan) shade PA3, was used to perform this in vitro study. Ninety cylindrical filling samples were made with the help of plastic ring molds and plates to obtain flat surfaces. The mean diameter and height of prepared specimens were 5.5±0.05mm and 2.5±0.1mm, respectively. For the polymerization of the composite, two different types of light-curing units (LCU) were selected for this study: Valo X (Ultradent Products, Inc., USA) operated in a “standard” mode, and Bluephase 20i (Ivoclar Vivadent, Liechtenstein) ran in a “high” mode. Photoactivation was done with the light tips fixed parallel to the surface of the filling material and above it at a distance level of 1 mm, 4 mm, and 8 mm. The radiant power (mW) of each LCU was registered in a PL-MW2000 Optical power meter (Beijing Perfectlight Technology Co., Ltd., China). A total of 18 groups, with five filling samples in each, were formed and processed. Upon the completion of light treatment, by the ISO-4049 protocol, each specimen was immersed in water and stored at 37°C for 24 hours in a lightproof container. After this period, samples were washed and tested for the hardness of top surfaces using a “ПMT-3” Vickers hardness tester. The means of light intensities of two LCUs in the study were significantly different at 4 mm and 8 mm tip distances in 1.26 and 2 times, respectively. Analysis of hardness values did not reveal significant differences in the light-curing efficacy of two LED lamps. The differences in VHN values were obvious among the 10- and 40-second time exposure groups when the photoactivation was carried out at an 8mm tip distance. Conclusion: The effective polymerization of composite restorations with poor accessibility is still a matter of time, not the power of LCU.

The present review was intended to provide several important biological insights into the practice of implant dentistry. Despite many benefits, it’s clear that a dental implant does not share the features of a dentoperiodontal unit, and alveolar bone tolerates an implant, as far as its physiology goes, within the range of adequate response to direct masticatory load. The importance of a gingival tight seal around the transmucosal part of an implant cannot be overestimated from both biological and esthetic aspects. Considering the multifactorial nature of bone augmentation, the successful outcome of this type of surgery is still a matter of chance.

BackgroundIndividuals with co-occurring posttraumatic stress disorder (PTSD) and HIV are at high-risk for negative HIV-related outcomes, including low adherence to antiretroviral therapy, faster disease progression, more hospitalizations, and almost twice the rate of death. Despite high rates of PTSD in persons with HIV (PWH) and poor HIV-related health outcomes associated with PTSD, an effective evidence-based treatment for PTSD symptoms in PWH does not exist. ObjectiveThis study aimed to describe the adaptation and theater testing of an evidence-based intervention designed for people with co-occurring PTSD and HIV. MethodsThe Assessment, Decision, Adaptation, Production, Topical experts-integration, Training, and Testing (ADAPT-ITT) framework guided the formative process used to modify an evidence-based PTSD treatment (cognitive processing therapy; CPT) to meet the unique needs of PWH experiencing PTSD. With the integration of Life-Steps for Medication Adherence (Life-Steps), the adapted protocol (CPT-Life-Steps for integration of adherence; CPT-L) targeted HIV-related stigma and HIV medication adherence within a trauma-informed framework. Theater testing was completed with 7 participants to evaluate acceptability of CPT-L for PWH. The qualitative data (N=54 recordings) used to evaluate and adapt CPT-L emerged from individual interviews conducted with participants after each therapy session as well as exit interviews conducted at posttreatment data collection. ResultsAfter challenging stigma-related appraisals, participants expressed feeling less constrained by maladaptive thoughts. These shifts translated to increased self-efficacy with both HIV-related care and mental health. ConclusionsThese results indicate that trauma-informed work with PWH should consider the impact of HIV on trauma-related stuck points, intersecting identities (including living with HIV), and challenging internalized stigma. Findings provide evidence that CPT-L is acceptable and effective in addressing internalized HIV stigma that impacts PTSD symptom maintenance and HIV treatment engagement. Trial RegistrationClinicalTrials.gov; NCT05275842; https://clinicaltrials.gov/study/NCT05275842?id=NCT05275842&rank=1 International Registered Report Identifier (IRRID)RR2-10.1016/j.conctc.2023.101150

Background: This study aimed to reveal the effect of preheating on the surface microhardness and shear strength of composite materials used in the restoration of posterior teeth. Methods and Results: There were 3 composite materials under the study: Estelite Posterior, Harmonize and Filtek Z550. To make static and dynamic tests of them, 120 filling samples were prepared. Of those, 60 samples were for surface hardness measurements and 60 samples were used to evaluate the shear strength of composite materials. We formed 12 study groups with 10 filling samples in each. Samples made off Estelite Posterior, Harmonize™, and Filtek™ were designated with E, H, and F capital letters, respectively; the "VH" abbreviation indicated static Vickers hardness testing and "SS" was assigned for dynamic shear testing; mark (°) was used when preheating was applied. Filling samples were made of heated (up to 60°C) and room-temperature (23-25°C) composite materials. The filling samples of EVH, EºVH, HVH, HºVH, FVH, and FºVH groups were subjected to a surface microhardness test. The samples of ESS, EºSS, HSS, HºSS, FSS, and FºSS groups were subjected to shear-strength assessment of materials. The surface microhardness of filling samples was measured using a ПMT-3 Vickers hardness tester and the Vickers hardness number (VHN) was calculated. Dynamic tests were carried out using an UltraTester machine (Ultradent, Inc., USA) and shear test method until the shear-strength (SS) filling sample had completely failed. After analysis of the obtained results, it was found that preheating had enhanced the surface hardness and mechanical strength of the composite materials used in the study. However, the positive influence of preheating was significant only in the EVH-EºVH, ESS-EºSS, HSS-HºSS, and FSS-FºSS groups in 1.21, 1.09, 1.33, and 1.16 times, respectively. In the HVH-HºVH and FVH-FºVH groups, the identified differences were not of significance despite the improvement in mean values at 1.08 and 1.1 times. Conclusion: Preheating of light-curing resin-based composites is not equally effective for static and dynamic mechanical properties of materials for dental restoration. Preliminary laboratory tests could have helped before their clinical use.

Background: Recently, synthetic materials based on bioactive glasses have been in special demand in dental implantology, which, according to the mechanism of their action, are not only osteo-conductors, but also osteo-inductors. Of even greater interest is the fact that the biological degradation of these materials causes alkalization of the area and inhibits the growth of many pathogens. Considering the unique properties of this group of osteoplastic fillers and the problems associated with healing after guided bone regeneration, this study aimed to compare the effectiveness of using bioactive glasses S53P4 and 45S5 when performing vertical bone augmentation in an experiment applying a rabbit tibia model. Methods and Results: Six adult outbred rabbits aged from 1.5 to 2 years and weighing from 2.5 kg to 3.2 kg were used in the study. A titanium mesh was used to perform a true vertical guided bone regeneration technique. In each animal, two titanium tents were placed: one on the left tibia and one on the right tibia. On the left limb, empty spaces were filled with bioactive synthetic bone filler NovaBone® Morsels (USA); on the right limb, we used a mixture of bioactive glass Bonalive® granules CMF (Finland) and mineralized bone MedPark Bone-D XB (Bovine Xenograft, South Korea) in a ratio of 1:1. The quantity and quality of regenerated tissues were assessed after 8-10 weeks. The NovaBone application has allowed a gain of 2.6±2.67 mm in extra-skeletal hard tissue growth. No signs of guided bone regeneration were observed in all cases of application of an osteoplastic mixture of Bonalive and Bone-D XB granules. Conclusion: Within the limits of this study, it was found that the use of a mixture of bioactive glass Bonalive (S53P4) with bovine hydroxyapatite in a 1:1 ratio was not effective in vertically guided bone regeneration, but the application of NovaBone (45S5) could promote a new bone formation.

Introduction Traditional survey-based surveillance is costly, limited in its ability to distinguish diabetes types and time-consuming, resulting in reporting delays. The Diabetes in Children, Adolescents and Young Adults (DiCAYA) Network seeks to advance diabetes surveillance efforts in youth and young adults through the use of large-volume electronic health record (EHR) data. The network has two primary aims, namely: (1) to refine and validate EHR-based computable phenotype algorithms for accurate identification of type 1 and type 2 diabetes among youth and young adults and (2) to estimate the incidence and prevalence of type 1 and type 2 diabetes among youth and young adults and trends therein. The network aims to augment diabetes surveillance capacity in the USA and assess performance of EHR-based surveillance. This paper describes the DiCAYA Network and how these aims will be achieved.Methods and analysis The DiCAYA Network is spread across eight geographically diverse US-based centres and a coordinating centre. Three centres conduct diabetes surveillance in youth aged 0–17 years only (component A), three centres conduct surveillance in young adults aged 18–44 years only (component B) and two centres conduct surveillance in components A and B. The network will assess the validity of computable phenotype definitions to determine diabetes status and type based on sensitivity, specificity, positive predictive value and negative predictive value of the phenotypes against the gold standard of manually abstracted medical charts. Prevalence and incidence rates will be presented as unadjusted estimates and as race/ethnicity, sex and age-adjusted estimates using Poisson regression.Ethics and dissemination The DiCAYA Network is well positioned to advance diabetes surveillance methods. The network will disseminate EHR-based surveillance methodology that can be broadly adopted and will report diabetes prevalence and incidence for key demographic subgroups of youth and young adults in a large set of regions across the USA.

BackgroundAs cannabis legalization continues to spread across the United States, average Δ9-tetrahydrocannabinol concentrations in recreational products have significantly increased, and no prior study has evaluated effective treatments to reduce cannabis use among high potency cannabis users. Some research has found that the non-intoxicating cannabinoid cannabidiol reduces cannabis use and cannabis use disorder-related symptoms, such as affective disturbance and withdrawal. Results of these studies are promising but limited to synthetic or isolated forms of cannabidiol.ObjectiveConduct a placebo-controlled randomized control trial comparing the effects of hemp-derived cannabidiol on reducing Δ9-tetrahydrocannabinol use in concentrate users with cannabis use disorder.MethodsDesign. Double-blind, three-arm randomized placebo-controlled trial. Setting. University in the Denver-Boulder, CO, USA area. Study population. Community members who are heavy, stable cannabis concentrate users that meet criteria for at least moderate cannabis use disorder and are seeking to decrease or stop cannabis use. Data. Self-report demographics, substance use, and mental health characteristics, blood and urine based biomarkers and anthropometrics. Outcomes. Affective, physiological, and physical withdrawal symptoms, Δ9-tetrahydrocannabinol use. Analysis. Three-group ANOVAs and χ2 tests will be used to compare baseline variables between groups. Characteristics that differ between groups will be evaluated as potential covariates in subsequent analyses. A multilevel modeling framework will be used for primary outcome analysis to account for the repeated observations nested within participants over time. Pairwise post-hoc simple effects tests will be conducted to confirm patterns of differences.Trial registrationClinicalTrials.gov NCT06107062.

Background: The aim of this research was to study the effect of air-abrasive treatment of dentin on the chemical composition of its surface and the adhesion strength of 2 self-etching adhesive systems (AS). Methods and Results: Powders based on aluminum oxide (Al2O3) (27µm) (KaVo, Biberach, Germany), sodium bicarbonate (NaHCO3) (40µm) (AIR-FlOW Classic Comfort, EMS, Nyon, Switzerland), and erythritol (14µm) (AIR-FLOW Plus, EMS, Nyon, Switzerland) were used for the air-abrasive treatment of adhesive surfaces. Bonding steps were carried out with Single Bond Universal (SBU) (3M ESPE, USA) and Bond Force 2 (BF2) (Toquyama, Japan). The adhesion strength of composite to dentin was evaluated on 80 samples prepared in accordance with the Ultradent Shear Bond Strength test. All samples were divided into 4 groups depending on the method of dentin surface processing. In the samples of Group 1 (n=20), aluminum oxide was used for the air-abrasive treatment of dentin. In Group 2 (n=20) and Group 3 (n=20), samples were treated using powders based on sodium bicarbonate and erythritol, respectively. Group 4 (control, n=20) included tooth samples in which the dentin surface was not air-abraded after preparation with carbide burs. Then, each group was divided into 2 subgroups (Sub-A and Sub-B) depending on the type of adhesive system used. Adhesive resin was applied and polymerized in accordance with the manufacturer’s instructions. Single Bond Universal (SBU) was used for the samples of Sub-A, and Bond Force 2 (BF2) (Toquyama, Japan) was used for the samples of Sub-B. Scanning electron microscopy and determining the surface elemental composition of samples were carried out on an SEM-EVO MA 10 (Carl Zeiss) and energy dispersive X-ray spectrometer with EDS Aztec Energy Advanced X-Act (Oxford Instruments). It was concluded that air-abrasive treatment of the dentin surface does not enhance the adhesion strength of composite material when using self-etch AS. Also, it was noted that the pH level of self-etch AS is not a crucial feature in determining the strength of the filling-tooth interface. The resulting variations in the elemental composition of dentin surface after air-abrasion with various mixtures and their effect on the efficacy of the different AS require further in vitro studies.

The aim of this study was to determine the average amount of silicon ions on the surface of titanium implants after air abrasion with powders based on glycine and erythritol, and to measure the content of silicon ions in separated water-insoluble fractions of these powders. Methods and Results: The study investigated 2 air-abrasive powders, one based on glycine (Air-Flow Perio, EMS, Switzerland) and another on erythritol (Air-FlowPlus, EMS, Switzerland). These abrasives were tested for solubility in water and the content of Si+ in insoluble fractions of these powders. Also, the weight percent (wt %) of Si+ was measured on the surface of failed titanium implants after air abrasion with Air-Flow Perio (Group 1) and Air-FlowPlus (Group 2). Scanning electron microscopy and determining the elemental composition of obtained samples were carried out on an SEM-EVO MA 10 (Carl Zeiss) and energy dispersive X-ray spectrometer with EDS Aztec Energy Advanced X-Act (Oxford Instruments). It was found that air-abrasive mixtures based on glycine and erythritol are not completely soluble in water due to the presumed presence of silica in them. It was also found that air-abrasive cleaning of contaminated dental implants with an erythritol-based mixture contributed to a significant increase (P=0.000) in the Si+ content on their surfaces in comparison to implants treated with glycine-based powder.

Abstract Large-scale genomic studies are beginning to identify genetic predictors of physical activity (PA). For those genetically predisposed to engage in low PA, a behavioral intervention may target a malleable factor that mediates genetic predisposition to low PA (i.e., intermediate phenotype) to mitigate the genetic influences. In a non-randomized exercise promotion pilot study, we test the feasibility of examining affective response to PA (how one feels during PA) as an intermediate phenotype between genetic variation and PA adherence. We hypothesized that three single nucleotide polymorphisms (SNPs; rs8044769 and rs3751812 in FTO; rs6265 in BDNF), identified from a prior systematic review, would be predictive of affective response to PA, and that affective response to PA would mediate the SNP-PA link. Forty five healthy, low-active adults received a 12-week print-based PA promotion program. Baseline affective response to PA was assessed using the Feeling Scale, a single-item measure of affective valence. Moderate to vigorous PA (MVPA) was assessed using accelerometers pre- and post-intervention. We examined the three SNPs in a weighted genetic score. Age, sex, body mass index, race, and neighborhood walkability were potential covariates. Affective response to PA and MVPA at follow-up (minutes/day over 4–7 days) were regressed on variation in SNPs, controlling for covariates. One unit increase in genetic score was associated with a 0.14 higher mean Feeling Scale, though was not statistically significant (p = 0.13). Among individual SNPs, having an additional FTO rs8044769 C allele was associated with a mean Feeling Scale score of 0.53 units higher (p = 0.015), which was statistically significant after applying the corrected p-value of 0.016. The genetic score or individual SNPs were not predictive of MVPA 12 weeks later, thereby mediation analyses were not performed. The preliminary findings demonstrate the promise of the intermediate phenotype approach.

The purpose of this study was to evaluate in vitro the efficacy of alumina, sodium bicarbonate and erythritol-based tooth air-abrasion on shear bond strength (SBS) of resin composite to dentin. Methods and Results: In order to assess the strength of the adhesive bond of the resin composite to tooth dentin, 50 tooth samples were prepared in accordance with the Ultradent Shear Bond Test method. All samples were divided into 5 groups. In Group 1 (n=10) and Group 2 (n=10), for air-abrasion of dentin surface 2 powders based on aluminum oxide with a particle size of 50μm and 27μm, respectively, were used (RONDOflex plus 360, KaVo, Biberach, Germany). In Group 3 (n=10) and Group 4 (n=10), other abrasive powders based on sodium bicarbonate (40μm) and erythritol (14μm), respectively, were used for a similar purpose (Air-Flow Classic comfort, Air-Flow Plus, EMS, Nyon, Switzerland). The control group (n=10) consisted of the remaining tooth samples in which the dentin surface, after preparation with a carbide bur, was not subjected to an air-abrasion.The one-day adhesive strength of bonded interfaces was evaluated on an UltraTester device (Ultradent Products Inc., USA) after resin bonding without aging simulation. The speed of movement of the test clamp with the installed sample was set to 1 mm/min. The maximal value of bonding failure was fixed in pounds (lb). The dentin surface ultrastructure was studied on 10 additional tooth samples, which were prepared for SEM analysis. It was found that the treatment of dentin surface with air-abrasive powders based on alumina (50 μm and 27 μm) and sodium bicarbonate (40 μm) did not improve the strength of the adhesive bond of resin composite to dentin. The strength of adhesion of the resin composite to dentin decreased significantly after air-abrasion of the tooth surface with erythritol-based powder.

Objective measures of adherence for antiretrovirals used as pre-exposure prophylaxis (PrEP) are critical for improving preventative efficacy in both clinical trials and real-world application. Current objective adherence measures either reflect only recent behavior (eg days for plasma or urine) or cumulative behavior (eg months for dried blood spots). Here, we measured the accumulation of the antiretroviral drug maraviroc (MVC) in hair strands by infrared matrix-assisted laser desorption electrospray ionization (IR-MALDESI) mass spectrometry imaging (MSI) to evaluate adherence behavior longitudinally at high temporal resolution. An MSI threshold for classifying daily adherence was established using clinical samples from healthy volunteers following directly observed dosing of 1 to 7 doses MVC/week. We then used the benchmarked MSI assay to classify adherence to MVC-based PrEP regimens in hair samples collected throughout the 48-week HPTN069/ACTGA5305 study. We found that only ~32% of investigated hair samples collected during the study's active dosing period showed consistent daily PrEP adherence throughout a retrospective period of 30 days, and also found that profiles of daily individual adherence from MSI hair analysis could identify when patients were and were not taking study drug. The assessment of adherence from MSI hair strand analysis was 62% lower than adherence classified using paired plasma samples, the latter of which may be influenced by white-coat adherence. These findings demonstrate the ability of MSI hair analysis to examine daily variability of adherence behavior over a longer-term measurement and offer the potential for longitudinal comparison with risk behavior to target patient-specific adherence interventions and improve outcomes.

Background: There are a large number of different types of bone-grafting materials that are used for the regeneration of atrophied alveolar ridges in order to make dental implantation possible. However, available surgical techniques and materials for bone augmentation do not contribute to the achievement of the desired reliable results and require a search for new solutions to an existing problem. A group of synthetic osteoplastic materials based on bioactive glass (BAG) may become a matter of choice in bone tissue regeneration because of special osteogenic properties. The aim of this study was to visually and histologically evaluate the behavior of an experimental BAG in rabbit tibia bone samples, which were collected from the animal 6 weeks after filling the bone defects. Methods and Results: The observation was carried out on one outbred rabbit whose tibia bone defects were filled with an experimental osteoplastic material based on the BAG. The chemical composition of the experimental osteoplastic material included SiO2 (41%), Na2O (21%), CaO (28.5%), P2O5 (6%), CaF2 (1.5%), MgO (1%), Al2O3 (1%). For histological analysis, H&E staining of paraffin-embedded tissues was performed according to the standard technique. Light microscopy of tissue samples was performed using a Leitz HM-LUX microscope (Germany). Six weeks after filling the bone defects, a strong bond between the augmented hard tissue and rabbit tibia was recognized. Also, a dense fusion of adjacent soft tissues with a newly formed bone without signs of chronic inflammation or graft particles in granular tissue was noted. Microscopic examination of the stained sections showed the presence of mature viable BT with a uniform distribution of osteocytes. Also, residual fragments of the degraded biomaterial surrounded by the fibers of a woven bone were revealed in several slices. Conclusion: In accordance with the results of this experiment, it can be concluded that the usage of BAG related to the system SiO2(41%)-Na2O(21%)-CaO(28.5%)-P2O5(6%)-CaF2(1.5%)-MgO(1%)-Al2O3(1%) may increase the volume of bone without application of barrier membrane. However, further research involving more animals needs to be done to estimate the scientific significance of the obtained data and to evaluate the mechanical properties of augmented bone.

BackgroundIn the United States, geosocial networking (GSN) apps (ie, mobile dating apps) have become central to dating and sexual interactions in recent years. Among gay, bisexual, and other men who have sex with men (GBM), these apps play an important role in reducing barriers and facilitating partner seeking. However, despite these benefits, there are concerns that these apps may facilitate risky sexual behavior and transmission of sexually transmitted infections (STIs) among GBM. ObjectiveThis study aimed to examine the association between GSN app use and sexual risk in a US sample of GBM. MethodsUsing a cross-sectional design, respondents (N=223) completed a web-based survey assessing their use of GSN apps, sexual risk and protective behaviors, HIV serostatus, and previous STI diagnoses. ResultsRespondents were aged 21-78 (mean 31.90, SD 10.06) years and 69.5% (155/223) were non-Hispanic White. The sample included respondents from 40 states and the District of Columbia. Nearly half (104/223, 47%) of the participants reported using GSN apps. GSN users were more likely to report past-year condomless anal intercourse (P.11). ConclusionsThe findings suggest that GSN apps may be a useful pathway for interventions aimed at reducing STI risk in GBM. Future prospective studies should examine how risk levels change after the initiation of GSN app use.

Abstract Rapid expansion of salmon aquaculture has resulted in high-density populations that host diverse infectious agents, for which surveillance and monitoring are critical to disease management. Screening can reveal infection diversity from which disease arises, differential patterns of infection in live and dead fish that are difficult to collect in wild populations, and potential risks associated with agent transmission between wild and farmed hosts. We report results from a multi-year infectious-agent screening program of farmed salmon in British Columbia, Canada, using quantitative PCR to assess presence and load of 58 infective agents (viruses, bacteria, and eukaryotes) in 2931 Atlantic salmon (Salmo salar). Our analysis reveals temporal trends, agent correlations within hosts, and agent-associated mortality signatures. Multiple agents, most notably Tenacibaculum maritimum, were elevated in dead and dying salmon. We also report detections of agents only recently shown to infect farmed salmon in BC (Atlantic salmon calicivirus, Cutthroat trout virus-2), detection in freshwater hatcheries of two marine agents (Kudoa thyrsites and Tenacibaculum maritimum), and detection in the ocean of a freshwater agent (Flavobacterium psychrophilum). Our results provide information for farm managers, regulators, and conservationists, and enable further work to explore patterns of multi-agent infection and farm/wild transmission risk.

Background: The aim of the present pilot study was to assess the bactericidal efficacy of a high frequency diathermy irradiation in treatment of teeth with diagnosed partial pulp necrosis. Methods and Results: The study included 83 patients aged between 22 and 54 years (mean age of 39±10 years) with irreversible pulpitis and signs of partial pulp necrosis in multi-rooted teeth (n=83). All patients were randomized in two groups in accordance with conducting therapy modes: 1) a conventional root canal treatment (Group 1, n=40); 2) a conventional treatment protocol in conjunction with a high frequency diathermy irradiation (Group 2, n=43). The postoperative sensitivity of treated teeth was assessed with the help of the Verbal Rating Scale (VRS). The quality of a root canal disinfection was evaluated by the presence of a cultural growth. The periapical index scoring system (PAI) was used for evaluation of periapical changes in every tooth after endodontic therapy. The occurrence of postoperative pain in Groups 1 and 2 demonstrated a similar reduction in toothache dynamics at all time intervals when assessments were made, and analysis of tooth radiographs in both groups of patients did not reveal a significant difference. As for the evaluation of a cultural growth, the signs of turbidity were detected in 6 samples of Group 1 and in 4 samples of Group 2. Conclusion: The possible antimicrobial efficacy of a high frequency diathermy in treatment of teeth with partial pulp necrosis was demonstrated. However, further studies should be made to confirm the results of this clinical trial.

Background: The aim of the present study was to compare the efficacy of packable and conventional composites in treatment of patients with class II caries lesions (CIICLs). Methods and Results: The clinical part of the study was conducted on patients with indications for composite restoration of at least two adjacent CIICCLs. There were 32 patients in whom 72 (36 pairs) teeth with caries pathology were treated. One tooth in every pair was randomly assigned for restoration with Filtek Z250 (Cl-Group 1, n=36) and another one with preheated Filtek-Р60 (Cl-Group 2, n=36). The mean observation time for composite restorations was 47.1±13.8 months. The modified USPHS criteria list was applied for clinical evaluation of the four following clinical parameters, which were used in the study: secondary caries, anatomy form, occlusal contact, and surface texture. The experimental study was conducted on 40 filling samples, which were made of conventional Filtek Z250 (Exp-Group 1, n=20) and packable Filtek Р60 (Exp-Group 2, n=20) with the help of a transparent plastic mold. Every experimental group was randomly divided into two subgroups (A and B): polymerized filling samples of Exp-Subgroups 1A (n=10) and 2A (n=10) were put into the test right after polymerization; samples of Exp-Subgroups 1B (n=10) and 2B (n=10) were passed through a shear-strength test after exposure to four consecutive cycles of autoclaving. Shear-strength measurements were made in an Ultratest Machine (Ultradent, USA), which was adapted to perform a proper test. The incidence of secondary caries in both clinical groups (two incidents in Gl-Group 1 and one incident in Cl-Croup 2) was very low, and comparative analysis of obtained results did not reveal any significant difference between them. In relation to criteria of anatomy form, the percentage of alpha level of tooth restorations that were done with packable Filtek P60, was 38.9%. Bravo estimates had 50% of restored teeth. Tooth restorations with conventional Filtek Z250 had alpha level in 58.3% and bravo in 41.7% of cases. Occlusal contact and surface texture, the efficacy of CIICL management was better in teeth that had been treated with packable composite. Analysis of experimental findings revealed that the mean value of shear strength for Filtek Р60 filling samples, which were tested immediately after polymerization, was lower than the same parameter for Filtek Z250 on 25.8% (P

Background Although recent epidemiological data suggest that pneumococci may contribute to the risk of SARS-CoV-2 disease, cases of coinfection with Streptococcus pneumoniae in patients with coronavirus disease 2019 (COVID-19) during hospitalization have been reported infrequently. This apparent contradiction may be explained by interactions of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and pneumococci in the upper airway, resulting in the escape of SARS-CoV-2 from protective host immune responses.Methods Here, we investigated the relationship of these 2 respiratory pathogens in 2 distinct cohorts of health care workers with asymptomatic or mildly symptomatic SARS-CoV-2 infection identified by systematic screening and patients with moderate to severe disease who presented to the hospital. We assessed the effect of coinfection on host antibody, cellular, and inflammatory responses to the virus.Results In both cohorts, pneumococcal colonization was associated with diminished antiviral immune responses, which primarily affected mucosal IgA levels among individuals with mild or asymptomatic infection and cellular memory responses in infected patients.Conclusion Our findings suggest that S. pneumoniae impair host immunity to SARS-CoV-2 and raise the question of whether pneumococcal carriage also enables immune escape of other respiratory viruses and facilitates reinfection.Trial registration ISRCTN89159899 (FASTER study) and ClinicalTrials.gov NCT03502291 (LAIV study).

IntroductionDigital health, the use of apps, text-messaging, and online interventions, can revolutionize healthcare and make care more equitable. Currently, digital health interventions are often not designed for those who could benefit most and may have unintended consequences. In this paper, we explain how privacy vulnerabilities and power imbalances, including racism and sexism, continue to influence health app design and research. We provide guidelines for researchers to design, report and evaluate digital health studies to maximize social justice in health.MethodsFrom September 2020 to April 2021, we held five discussion and brainstorming sessions with researchers, students, and community partners to develop the guide and the key questions. We additionally conducted an informal literature review, invited experts to review our guide, and identified examples from our own digital health study and other studies.ResultsWe identified five overarching topics with key questions and subquestions to guide researchers in designing or evaluating a digital health research study. The overarching topics are: 1. Equitable distribution; 2. Equitable design; 3. Privacy and data return; 4. Stereotype and bias; 5. Structural racism.ConclusionWe provide a guide with five key topics and questions for social justice digital health research. Encouraging researchers and practitioners to ask these questions will help to spark a transformation in digital health toward more equitable and ethical research. Future work needs to determine if the quality of studies can improve when researchers use this guide.

We describe a trackway (LH-Mg-10-16) occurring in laminated carbonated limestones of the Las Hoyas locality, Serranía de Cuenca, Spain. It is unmistakably a large theropod dinosaur trackway encompassing two unusual aspects, namely, wide-steps, and a set of equally deformed left footprints (with a dislocated digit). The layer also preserves other vertebrate trails (fish Undichna) and different impressions in the sediment. To address these complex settings, we devised a multidisciplinary approach, including the ichnological and taphonomical descriptions, characterisation of the rock lithofacies using thin-sections, 3D structured-light digitalisation with a high precision of 200-400 μm, and a geometric morphometric comparison with a large sample of bipedal dinosaur trackways. Sedimentary analyses showed that the trackway was produced in a humid, benthonic microbial mat, the consistency and plasticity of which enabled the preservation of the details of the movement of the animal. The results of the geometric analysis indicate that the "wide-steps" of the trackway is not unusual compared to other trackways, providing evidence that it was made by a single individual with an estimated hip height approximately 2 m. Analogous pathologies in extant archosaurs that yield the combination of wide steps and deformed digits in the same trackway were considered. All results mutually support the hypothesis that a large theropod dinosaur, with a pathological foot, generated the trackway as it crossed an area of shallow water while slowly walking towards the main water source, thus stepping steadily over the benthonic mat over which multiple fish were swimming.

Introduction The need for an efficient, low-cost, comprehensive measure to track infant/toddler development and treatment outcomes is critical, given the importance of early detection and monitoring. This manuscript describes the protocol for the development and testing of a novel measure, PediaTrac, that collects longitudinal, prospective, multidomain data from parents/caregivers to characterise infant/toddler developmental trajectories in term and preterm infants. PediaTrac, a web-based measure, has the potential to become the standard method for monitoring development and detecting risk in infancy and toddlerhood.Methods and analyses Using a multisite, prospective design, primarcaregivers will complete PediaTrac V.3.0, a survey tool that queries core domains of early development, including feeding/eating/elimination, sleep, sensorimotor, social/sensory information processing, social/communication/cognition and early relational health. Information also will be obtained about demographic, medical and environmental factors and embedded response bias indices are being developed as part of the measure. Using an approach that systematically measures infant/toddler developmental domains during a schedule that corresponds to well-child visits (newborn, 2, 4, 6, 9, 12, 15, 18 months), we will assess 360 caregiver/term infant dyads and 240 caregiver/preterm infant dyads (gestational age

Foam accumulation in swine manure deep-pits has been linked to explosions and flash fires that pose devastating threats to humans and livestock. It is clear that methane accumulation within these pits is the fuel for the fire; it is not understood what microbial drivers cause the accumulation and stabilization of methane. Here, we conducted a 13-month field study to survey the physical, chemical, and biological changes of pit-manure across 46 farms in Iowa. Our results showed that an increased methane production rate was associated with less digestible feed ingredients, suggesting that diet influences the storage pit's microbiome. Targeted sequencing of the bacterial 16S rRNA and archaeal mcrA genes was used to identify microbial communities' role and influence. We found that microbial communities in foaming and non-foaming manure were significantly different, and that the bacterial communities of foaming manure were more stable than those of non-foaming manure. Foaming manure methanogen communities were enriched with uncharacterized methanogens whose presence strongly correlated with high methane production rates. We also observed strong correlations between feed ration, manure characteristics, and the relative abundance of specific taxa, suggesting that manure foaming is linked to microbial community assemblage driven by efficient free long-chain fatty acid degradation by hydrogenotrophic methanogenesis.

There are well-known associations between stress, poor sleep, and cognitive deficits, but little is known about their interactive effects, which the present study explored in a sample of mothers of toddlers. Since certain types of cognitive decline start during the 20s and continue into later ages, we also explored whether mothers' age interacted with stress and sleep in the prediction of cognitive functioning. We hypothesized that poorer sleep [measured using one week of 24-hour wrist actigraphy data] and having more chronic stressors [e.g., life events, household chaos, work/family role conflict] would be linked with poorer cognitive performance [both executive function and standardized cognitive ability tasks], and that the interactive combination of poorer sleep and more stressors would account for the effect. We also explored whether this process operated differently for younger versus older women. In a socioeconomically and geographically diverse community sample of 227 women with toddler-age children [age, M = 32.73 yrs, SD = 5.15 yrs], poorer cognitive performance was predicted by greater activity during the sleep period, shorter sleep duration, and lower night-to-night consistency in sleep; it was not associated with higher levels of stress. The interactive effects hypothesis was supported for sleep activity [fragmented sleep] and sleep timing [when mothers went to bed]. The combination of more exposure to stressors and frequent night waking was particularly deleterious for older women's performance. For younger women, going to bed late was associated with poorer performance if they were experiencing high levels of stress; for those experiencing low levels of stress, going to bed late was associated with better performance.

Abstract HIV prevention research is focused on combining antiretrovirals (ARV) and progestin contraceptives to prevent HIV infection and pregnancy. The possibility that progestins compromise ARV anti-HIV activity prompted us to evaluate the effects of progestins on tenofovir (TFV) and TFV-alafenamide (TAF) on HIV infection and intracellular TFV-diphosphate (TFV-DP) concentrations in blood and genital CD4+ T cells. Following incubation of blood CD4+ T cells with TFV or TAF, Medroxyprogesterone acetate (MPA), but not Levonorgestrel, Norethisterone or progesterone, suppressed the anti-HIV effect of TFV by reducing intracellular TFV-DP, but had no effect on TAF inhibition of infection or TFV-DP. In contrast, with genital CD4+ T cells, MPA suppressed TAF inhibition of HIV infection and lowered of TFV-DP concentrations without affecting TFV protection. These findings demonstrate that MPA selectively compromises TFV and TAF protection in blood and genital CD4+ T cells and suggests that MPA may decrease ARV protection in individuals who use ARV intermittently for prevention.

The human gut microbiome has emerged as a potential key factor involved in the manifestation of physical and mental health. Despite an explosion of cross-disciplinary interest in researching the gut microbiome, there remains to be a gold-standard method for operationalizing gut microbiome alpha diversity. Given researchers' interest in examining the relationships among gut microbiome alpha diversity and health-related outcomes of interest, a way of operationalizing the microbiome that yields a numeric value, which could be used in common statistical approaches, is needed. Thus, the current study aims to provide methodological guidance for how to operationalize microbiome alpha diversity. Findings suggest that alpha diversity of the human gut microbiome is comprised of two sub-constructs (richness and evenness), and we propose a step-by-step method of creating alpha diversity composite measures based on this key insight. Finally, we demonstrate that our empirically derived richness and evenness composite measures are significantly associated with health-related variables of interest (alcohol use, symptoms of depression) among a human clinical sample.

IntroductionPneumococcal colonisation is regarded as a pre-requisite for developing pneumococcal disease. In children previous studies have reported pneumococcal colonisation to be a symptomatic event and described a relationship between symptom severity/frequency and colonisation density. The evidence for this in adults is lacking in the literature. This study uses the experimental human pneumococcal challenge (EHPC) model to explore whether pneumococcal colonisation is a symptomatic event in healthy adults.MethodsHealthy participants aged 18-50 were recruited and inoculated intra-nasally with either Streptococcus pneumoniae (serotypes 6B, 23F) or saline as a control. Respiratory viral swabs were obtained prior to inoculation. Nasal and non-nasal symptoms were then assessed using a modified Likert score between 1 (no symptoms) to 7 (cannot function). The rate of symptoms reported between the two groups was compared and a correlation analysis performed.ResultsData from 54 participants were analysed. 46 were inoculated with S. pneumoniae (29 with serotype 6B, 17 with serotype 23F) and 8 received saline (control). In total, 14 became experimentally colonised (30.4%), all of which were inoculated with serotype 6B. There was no statistically significant difference in nasal (p = 0.45) or non-nasal symptoms (p = 0.28) between the inoculation group and the control group. In those who were colonised there was no direct correlation between colonisation density and symptom severity. In the 22% (12/52) who were co-colonised, with pneumococcus and respiratory viruses, there was no statistical difference in either nasal or non-nasal symptoms (virus positive p = 0.74 and virus negative p = 1.0).ConclusionPneumococcal colonisation using the EHPC model is asymptomatic in healthy adults, regardless of pneumococcal density or viral co-colonisation.

Background The neosuchian crocodyliform genus Hulkepholis constitutes the longirostral lineage of the European Goniopholididae. It comprises two species ranging from the Valanginian of southern England to the lower Albian of the northern Teruel (Spain). A new species of Hulkepholis is described based on a partially complete skull from the lower Barremian Camarillas Formation. We investigate its phylogenetic position and the palatal patterns among members of Goniopholididae and the closely related Thalattosuchia and Tethysuchia. Methods Phylogenetic relationships were investigated with two matrices using a previously published dataset as the basis: the first differed only by the addition of the new species, the second had newly discovered states for 11 characters, the new species plus several additional specimens of Hulkepholis and Anteophthalmosuchus. Both matrices were processed using TNT v. 1.1, in a heuristic analysis of maximum parsimony, with tree bisection and reconnection 1,000 random addition replicates and saving the 10 most parsimonious trees per replicate, and up to 10 suboptimal trees to calculate Bremer supports. The skull geometry of nine species from Thalattosuchia, Tethysuchia and Goniopholididae was explored to test shape variation between the rostral and postrostral modules, and to visualize the differences on the secondary palate. A set of 18 landmarks was used to delimit significant anatomical features, and the skulls were isotropically scaled using Adobe Illustrator, with the longest skull (Sarcosuchus imperator) as the baseline for comparison. Results The European lineages of goniopholidids are two clades (Nannosuchus + Goniopholis) plus (Hulkepholis + Anteophthalmosuchus). The new species, Hulkepholis rori sp. nov, shares with the latter clade the following apormorphies: a long anterolateral postorbital process, postorbital process almost reaching the anterior jugal ramus, and basioccipital tubera with lateral edges turned posteriorly. Anteophthalmosuchus was found to be monophyletic, and Hulkepholis paraphyletic due to the poor preservation of H. willetti. Hulkepholis rori is distinguished by having vascular fossae and a mid-protuberance on the ventral surface of the basioccipital, and wide internal fossae in the quadrate. Among Goniopholididae differences on the secondary palate are the presence of a palatal cleft, the narrowness of the secondary choana, and a wide foramen of the median pharyngeal tube. Conclusions The new species is the earliest Hulkepholis from the Iberian Peninsula. New characters have been recognized in the organization of the palate and in the occipital region raising unexpected questions on the evolution of Goniopholididae. The set of palatal characters is discussed as part of a singular palatogenesis in Goniopholididae. The protruding occipital areas suggest that the longirostral Hulkepholis would have had an aquatic lifestyle with particular neck and skull movements.

The collapse of iconic, keystone populations of sockeye (Oncorhynchus nerka) and Chinook (Oncorhynchus tshawytscha) salmon in the Northeast Pacific is of great concern. It is thought that infectious disease may contribute to declines, but little is known about viruses endemic to Pacific salmon. Metatranscriptomic sequencing and surveillance of dead and moribund cultured Chinook salmon revealed a novel arenavirus, reovirus and nidovirus. Sequencing revealed two different arenavirus variants which each infect wild Chinook and sockeye salmon. In situ hybridisation localised arenavirus mostly to blood cells. Population surveys of >6000 wild juvenile Chinook and sockeye salmon showed divergent distributions of viruses, implying different epidemiological processes. The discovery in dead and dying farmed salmon of previously unrecognised viruses that are also widely distributed in wild salmon, emphasizes the potential role that viral disease may play in the population dynamics of wild fish stocks, and the threat that these viruses may pose to aquaculture.

Establishing the shape and determinants of trajectories of body mass index (BMI) among Soldiers is critical given the importance of weight management to military service requirements. To establish the shape and determinants of BMI trajectories among Soldiers, we aimed to (1) model the overall BMI trajectory of Soldiers, (2) find the most common trajectory groups among Soldiers, (3) investigate the relationship between BMI trajectories and sociodemographic and military-specific characteristics, and (4) determine if there were Soldiers with large fluctuations in BMI. The study population included all US Army Soldiers on active-duty between 2011 and 2014 who were age 17–62 (n = 827,126). With longitudinal data from the Stanford Military Data Repository, we used group-based trajectory modeling to identify the BMI trajectories of Soldiers and multinomial logistic regression to estimate associations between Soldier characteristics and trajectory membership. Four distinct BMI trajectory groups were found: increasing, decreasing, constant, and inconstant. The constant, increasing, and decreasing trajectories were similar in shape and percentage between men and women. The constant trajectory had the fewest Soldiers who exceeded weight standards or had duty limitations. The increasing trajectory was associated with marriage and fewer service years. The decreasing trajectory was associated with more service years and higher educational attainment. The inconstant trajectory differed in shape between men and women. Over 6% of men and 12% of women had fluctuations in BMI indicative of weight cycling. Understanding the characteristics associated with BMI trends may assist the Army in targeting resources aimed to improve Soldier health and combat readiness. Keywords: Body mass index trajectories, Longitudinal studies, Military personnel, Weight cycling, Group-based trajectory modeling, Self-monitoring

Pathogens causing acute disease and death or lasting immunity require specific spatial or temporal processes to persist in populations. Host traits, such as maternally-derived antibody (MDA) and seasonal birthing affect infection maintenance within populations. Our study objective is to understand how viral and host traits lead to population level infection persistence when the infection can be fatal. We collected data on African fruit bats and a rabies-related virus, Lagos bat virus (LBV), including through captive studies. We incorporate these data into a mechanistic model of LBV transmission to determine how host traits, including MDA and seasonal birthing, and viral traits, such as incubation periods, interact to allow fatal viruses to persist within bat populations. Captive bat studies supported MDA presence estimated from field data. Captive bat infection-derived antibody decayed more slowly than MDA, and while faster than estimates from the field, supports field data that suggest antibody persistence may be lifelong. Unobserved parameters were estimated by particle filtering and suggest only a small proportion of bats die of disease. Pathogen persistence in the population is sensitive to this proportion, along with MDA duration and incubation period. Our analyses suggest MDA produced bats and prolonged virus incubation periods allow viral maintenance in adverse conditions, such as a lethal pathogen or strongly seasonal resource availability for the pathogen in the form of seasonally pulsed birthing.

Katherine Possin and colleagues report on the implementation, development, and early findings of the Care Ecosystem, an adaptive, personalized, and scalable dementia care program.

Bats are sources of high viral diversity and high-profile zoonotic viruses worldwide. Although apparently not pathogenic in their reservoir hosts, some viruses from bats severely affect other mammals, including humans. Examples include severe acute respiratory syndrome coronaviruses, Ebola and Marburg viruses, and Nipah and Hendra viruses. Factors underlying high viral diversity in bats are the subject of speculation. We hypothesize that flight, a factor common to all bats but to no other mammals, provides an intensive selective force for coexistence with viral parasites through a daily cycle that elevates metabolism and body temperature analogous to the febrile response in other mammals. On an evolutionary scale, this host–virus interaction might have resulted in the large diversity of zoonotic viruses in bats, possibly through bat viruses adapting to be more tolerant of the fever response and less virulent to their natural hosts.