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To assess the overall impact of chlorhexidine, when used as an endodontic irrigant/medicament, on post-obturation pain following endodontic treatment by the application of Bayes methods of meta-analysis. This study aimed to combine recently documented evidence using rigorous and specific search criteria. The available data were analyzed using Bayesian methods, which have the advantage of accounting for uncertainties in estimates. This is in contrast to commonly used frequentist meta-analysis methods, which are not able to model uncertainties as effectively, particularly when there is heterogeneity present. A preliminary search was conducted in the Pubmed, Cochrane, and Scielo databases using appropriate keywords. The search aimed to identify human randomized clinical studies that evaluated post-operative endodontic pain and involved the use of chlorhexidine as an endodontic irrigant or medicament. The preliminary Bayesian meta-analysis produced a more accurate estimate compared to a frequentist random effect meta-analysis model, with a narrower credible interval. The frequentist model demonstrated a detrimental impact of chlorhexidine on post-obturation pain, while the Bayesian model indicated a somewhat favorable effect of chlorhexidine on post-obturation pain. Based on the scope of this investigation, it can be inferred that a Bayesian random effects meta-analysis model demonstrated a somewhat favorable impact of chlorhexidine on post-endodontic pain, which carries significant therapeutic significance.

Introduction: Root canal debridement, irrigation and a microorganism-free environment are key factors in the success of root canal treatment. Intracanal medicaments are used to enhance root canal disinfection. Simvastatin is derived from lovastatin and is a semisynthetic medication. This study compares and evaluates the effect of simvastatin and double antibiotic paste (DAP) as an intracanal medicament in single-rooted teeth with apical periodontitis using colony-forming units (CFUs)/ml. Materials and Methods: Twenty-eight patients with single-rooted teeth diagnosed with apical periodontitis were selected. Under aseptic conditions, patency was gained, sterile saline solution was deposited in the canal and the first sample (S1) was collected. Cleaning and shaping were then carried out following an appropriate technique depending on the configuration of the canal. After irrigation and biomechanical preparation, teeth were randomly assigned to two different groups, and the test intracanal medicament was applied to the root canals. Coronal openings were sealed with temporary restorative cement. The second sample (S2) was collected after 7 days. The samples obtained were checked for a reduction in the bacterial load. They were incubated aerobically for 48 h, and the CFUs were calculated. The Mann–Whitney U and Wilcoxon's signed-rank tests were used to analyse the results statistically. Results: A significant reduction in bacterial count was present after administration of the intracanal medicament. On intergroup comparison, there was no statistically significant difference in bacterial decrease between the two groups. Comparatively, the mean reduction in the bacterial count was higher in the DAP group. Conclusion: It can be concluded that DAP and simvastatin were effective in the reduction of the bacterial count in single-rooted teeth diagnosed with apical periodontitis. However, DAP demonstrated a better performance in the reduction of bacterial counts.

During the past few years, the social interactions of students have been limited. The act of social distancing has not only exacerbated developmental gaps in social and emotional learning (SEL) (Vaillancourt et al. 2021) but also interrupted mathematics instruction (Lewis et al. 2021). Teachers are searching for strategies that promote mathematical problem solving, while also fostering a sense of community that maximizes SEL development. One strategy that Kathryn Lavin Brave and Jillian Miller have found to be particularly effective involves the use of Fermi Questions. Fermi Questions, also referred to as "back-of-the-envelope calculations" (Kenyon 2008/2009), were named after Nobel Prize-winning physicist Enrico Fermi, who was lauded for both his theoretical and practical achievements and was also known for his ability to make reasonable estimates with limited data. The following article describes how the authors used Fermi Questions to illuminate the connections between the Standards for Mathematical Practice (SMP; NGA Center and CCSSO 2010) and the SEL competencies. In the subsequent sections, they recount their experiences with Fermi Investigations, specifically with a collaborative group of third- and fifth-grade students. They also provide snapshots of student performance during the course of the investigation to describe how the implementation of Fermi Questions promotes arithmetical expertise and a sense of community in the mathematics classroom.

Purpose – This study examines the moderating role of information sharing on the effect of lead-time management on the performance of firms in the Zimbabwean motor industry. Design/methodology/approach – Data were collected using Likert-based structured questionnaires from a sample of 105 employees in Zimbabwe. In addition, Pearson Correlation, Linear Regression and Moderation Regression analysis were employed to test the relationship between study variables. Findings – The study found that fixed lead time, preprocessing lead time, processing lead time and postprocessing lead time significantly influence the performance of firms in the motor industry. The results also demonstrate that information sharing moderates the effect of lead-time management on firm performance in the motor industry. Practical implications – Firms in the motor industry should establish long-term relationships with their suppliers and implement effective communication channels for timely and frequent information exchange regarding production schedules, inventory levels, quality standards and potential disruptions. Originality/value – The current study aims to contribute to the scientific discourse on lead-time management, information sharing and performance in the motor industry. Furthermore, it extends knowledge on the performance of the motor industry in the African region.

The SARS-CoV-2 Omicron variant has had strong effects on the COVID-19 pandemic. New Omicron subvariants have emerged over time and those subvariants have increased capacity to evade neutralizing antibody responses [...]

Introduction: Our study aimed to determine 1) the association between time spent in the emergency department (ED) hallway and the development of delirium and 2) the hospital location of delirium development.Methods: This single-center, retrospective chart review included patients 18+ years old admitted to the hospital after presenting, without baseline cognitive impairment, to the ED in 2018. We identified the Delirium group by the following: key words describing delirium; orders for psychotropics, special observation, and restraints; or documented positive Confusion Assessment Method (CAM) screen. The Control group included patients not meeting delirium criteria. We used a multivariable logistic regression model, while adjusting for confounders, to assess the odds of delirium development associated with percentage of ED LOS spent in the hallway.Results: A total of 25,156 patients met inclusion criteria with 1920 (7.6%) meeting delirium criteria. Delirium group vs. Control group patients spent a greater percentage of time in the ED hallway (median 50.5% vs 10.8%, P

Abstract New potent vaccine adjuvants are desirable for increasing the efficacy of novel vaccine modalities such as DNA and peptides. We therefore tested if syngeneic erythrocytes could serve as delivery vectors for selected HIV peptides and compared the potency of these constructs to immunization with peptides in phosphate buffered saline or in incomplete Freunds adjuvant. Immunization of mice with peptides in a low dose (5 ng) coupled to erythrocytes induced a weak immune response in mice. These peptides alone (5 μg) gave no immune responses, while formulating the peptides (50 μg) in IFA induced strong homologous immunity as well as prominent cross reactivity to a related mutant epitope. Thus, vaccine delivery using syngeneic erythrocytes, although attractive for clinical use, might be of limited value due to the low amount of antigen that can be loaded per erythrocyte.

BACKGROUND:Approximately half of hospitalized patients suffer functional decline due to spending the vast majority of their time in bed. Previous studies of early mobilization have demonstrated improvement in outcomes, but the interventions studied have been resource-intensive. We aimed to decrease the time hospital inpatients spend in bed through a pragmatic mobilization protocol. METHODS:This prospective, non-blinded, controlled clinical trial assigned inpatients to the study wards per routine clinical care in an urban teaching hospital. All subjects on intervention wards were provided with a behavioral intervention, consisting of educational handouts, by the nursing staff. Half of the intervention wards were supplied with recliner chairs in which subjects could sit. The primary outcome was hospital length of stay. The secondary outcome was the '6-Clicks' functional score. RESULTS:During a 6-month study period, 6082 patient encounters were included. The median length of stay was 84 hours (IQR 44-175 hours) in the control group, 80 hours (IQR 44-155 hours) in the group who received the behavioral intervention alone, and 88 hours (IQR 44-185 hours) in the group that received both the behavioral intervention and the recliner chair. In the multivariate analysis, neither the behavioral intervention nor the provision of a recliner chair was associated with a significant decrease in length of stay or increase in functional status as measured by the '6-Clicks' functional score. CONCLUSION:The program of educational handouts and provision of recliner chairs to discourage bed rest did not increase functional status or decrease length of stay for inpatients in a major urban academic center. Education and physical resources must be supplemented by other active interventions to reduce time spent in bed, functional decline, and length of stay. TRIAL REGISTRATION:ClinicalTrials.gov, HS-16-00804.

During a time when students are accessing instruction virtually because of COVID-19, reflecting on the sixth of the Standards for Mathematical Practice (SMP 6) is a vital step for educators to take. Although the Common Core State Standards for Mathematics (NGA Center and CCSSO 2010) identifies SMP 6 as Attend to precision, associated expertise includes more than "calculating accurately and efficiently" (p. 7). SMP 6 also states that mathematically proficient students "communicate precisely to others," using "clear definitions in discussion with others and in their own reasoning" (NGA Center and CCSSO 2010, p. 7). Applying exact terminology allows students not only to form and support conjectures but also to engage in mathematical discourse. This, in turn, results in enhanced conceptual understanding because mathematical discourse has been linked to the unveiling of concepts and the debunking of misconceptions (Thompson and Gay 2020). This article describes an eye-opening experience, during which the authors realized that their methods of vocabulary instruction in the virtual environment needed to be revised. Data were collected in the third author's fourth-grade virtual classroom from January through February 2021. The first and third authors were co-teachers, whereas the second author assisted with instructional planning. All students were native English speakers; however, featured practices may also support the cognitive academic language proficiency development of English language learners in a virtual setting.

The use of mixed frequency data is now common in many applications, ranging from the analysis of high frequency financial time series to large cross-sections of macroeconomic time series. In this article, we show how state space methods can easily facilitate both estimation and inference in these settings. After presenting a unified treatment of the state space approach to mixed frequency data modeling, we provide a series of applications to demonstrate how our MATLAB toolbox can make the estimation and post-processing of these models straightforward.

Abstract Background Literature shows that newly qualified nurse-midwives face challenges integrating into the workforce during their transition period from education to practice. However, little is known about the needs and challenges of Malawian nurse-midwives during their transition from education to practice. The aim of the study was to explore the transition experiences of newly qualified nurse-midwives working in selected midwifery units in Northern Malawi. Methodology A qualitative descriptive approach was used. Data were collected through in-depth interviews using semi-structured interview guides from a purposive sample of 19 participants (13 newly qualified nurse-midwives and 6 key informants). The researchers developed two interview guides; one for the newly qualified nurse-midwives and another one for the key informants. The interview guides had questions related to newly qualified nurse-midwives experiences of transitioning to practice and the support they received. Participants were from three selected hospitals in the Northern part of Malawi that have maternity units. Data were analysed manually using thematic analysis. Findings Five themes related to challenges faced by newly qualified nurse-midwives during their transition to practice in midwifery units emerged from the thematic analysis of the data. These included (1) Theory—practice gap, (2) Lack of confidence and skills, (3) Inadequate resources, (4) Transition support system, and (5) Workplace conflict. Conclusion Newly qualified nurse-midwives in Malawi encounter many challenges while transitioning from education to practice. The study findings underscore the need to develop a national framework support system that could not only help newly qualified midwives adjust positively to their new role but also create more opportunities for learning and developing and strengthening a collaborative partnership between colleges and hospitals.

Abstract The data demands during the pandemic heightened the need to blend information from numerous sources to get a more timely and granular picture of economic developments. Ongoing efforts include [...]

A complex network of molecular chaperones and proteolytic machinery safeguards the proteins which comprise the proteome, from the time they are synthesized on ribosomes to their destruction via proteolysis. Impaired protein quality control results in the accumulation of aberrant proteins, which may undergo unwanted spurious interactions with other proteins, thereby interfering with a broad range of cellular functions. To protect the cellular environment, such proteins are degraded or sequestered into inclusions in different subcellular compartments. Recent findings demonstrate that aberrant or mistargeted proteins from different cytoplasmic compartments are removed from their environment by transporting them into the nucleus. These proteins are degraded by the nuclear ubiquitin–proteasome system or sequestered into intra-nuclear inclusions. Here, we discuss the emerging role of the nucleus as a cellular quality compartment based on recent findings in the yeast Saccharomyces cerevisiae. We describe the current knowledge on cytoplasmic substrates of nuclear protein quality control, the mechanism of nuclear import of such proteins, as well as possible advantages and risks of nuclear sequestration of aberrant proteins.

Voluntary medical male circumcision (VMMC) has primarily been promoted for HIV prevention. Evidence also supports that male circumcision offers protection against other sexually transmitted infections. This analysis assessed the effect of circumcision on syphilis, hepatitis B virus (HBV) infection and HIV. Data from the 2015 to 2019 Population-based HIV Impact Assessments (PHIAs) surveys from Rwanda, Tanzania, Uganda, Zambia, and Zimbabwe were used for the analysis. The PHIA surveys are cross-sectional, nationally representative household surveys that include biomarking testing for HIV, syphilis and HBV infection. This is a secondary data analysis using publicly available PHIA data. Univariate and multivariable logistic regression models were created using pooled PHIA data across the five countries to assess the effect of male circumcision on HIV, active and ever syphilis, and HBV infection among sexually active males aged 15-59 years. Circumcised men had lower odds of syphilis infection, ever or active infection, and HIV, compared to uncircumcised men, after adjusting for covariates (active syphilis infection = 0.67 adjusted odds ratio (aOR), 95% confidence interval (CI), 0.52-0.87, ever having had a syphilis infection = 0.85 aOR, 95% CI, 0.73-0.98, and HIV = 0.53 aOR, 95% CI, 0.47-0.61). No difference between circumcised and uncircumcised men was identified for HBV infection (P = 0.75). Circumcised men have a reduced likelihood for syphilis and HIV compared to uncircumcised men. However, we found no statistically significant difference between circumcised and uncircumcised men for HBV infection.

Emerging data show a rapid increase in the prevalence of SARS-CoV-2 infection linked to an increase in COVID-19 cases, which is being driven by the SARS-CoV-2 Omicron variant. Compared with [...]

rDNA repeats residing in the nucleolus must be released to the nucleoplasm to allow repair by homologous recombination. Here the authors reveal insights into the molecular mechanism proposing that phosphorylation and SUMOylation of the rDNA-tethering complex facilitate the nucleolar release of damaged repeats to maintain genome integrity.