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Objectives: This study aimed to synthesize and characterize an environmentally friendly nanohydroxyapatite (n-HA) and evaluate its impact on enamel mineral content when incorporated into a Pistachio oleo gum resin (Saqqez) bio-chewing gum for in-situ models. We compared the effects of this green nano-hydroxyapatite (G n-HA) with those of a commercially available synthetic nano-hydroxyapatite (S n-HA)., Methods: Various analytical techniques were employed including XRD, FESEM, FT-IR, EDX/SEM and TGA/DTA to characterize the crystallinity, size and composition of the G n-HA powder. Three chewing gum groups were formulated: (1) Saqqez gum containing 10% wt G n-HA, (2) Saqqez gum containing 10% wt S n-HA, and (3) pure Saqqez gum. In order to evaluate the impact of these chewing gums on enamel, intraoral appliances were fabricated, each containing six enamel specimens. Participants were instructed to chew the gums while wearing these appliances. The calcium (Ca +2 ) and phosphorus (P) levels in enamel specimens, both with and without exposure to an acid challenge, were quantified using EDX/SEM. FE-SEM was employed to capture the microstructure of the enamel surface. In terms of the statistical analysis, one-way ANOVA and Tukey's post hoc tests were utilized to compare the data, where the significance level (α) was set at 0.05., Results: The characterization tests confirmed the successful synthesis of G n-HA. Furthermore, EDX/SEM analysis of the enamel specimens from the intraoral appliance revealed significant variations in calcium (Ca +2 ) content among the enamel specimens (P = 0.000). The S n-HA group, in particular, exhibited the highest Ca +2 content, while the pure Saqqez group displayed the lowest. Nonetheless, there was no statistically significant differences in phosphorus (P) content observed among the three groups (P = 0.27)., Conclusions: Saqqez gum can be considered a wholesome natural chewing gum that serves, as a carrier for delivering remineralization agents to the tooth surfaces. This was evident in the groups containing n-HA, exhibiting elevated Ca +2 levels. It's noteworthy that G n-HA demonstrated less efficacy in enamel remineralization compared to S n-HA., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

The present analysis examined the test-retest reliability of the Epworth Sleepiness Scale in participants with excessive daytime sleepiness associated with narcolepsy or obstructive sleep apnea in three clinical trials. Intraclass correlation coefficient estimates for Epworth Sleepiness Scale scores from two solriamfetol 12-week placebo-controlled trials (one narcolepsy, one obstructive sleep apnea) and one long-term open-label extension trial (narcolepsy or obstructive sleep apnea) were calculated using postbaseline time-point pairs for the overall population in each trial, by treatment, and by primary obstructive sleep apnea therapy adherence. In the 12-week narcolepsy trial, intraclass correlation coefficients (95% confidence intervals) were 0.83 (0.79, 0.87) for weeks 4 and 8 (n = 199), 0.87 (0.83, 0.90) for weeks 8 and 12 (n = 196), and 0.81 (0.76, 0.85) for weeks 4 and 12 (n = 196). In the 12-week obstructive sleep apnea trial, intraclass correlation coefficients (95% confidence intervals) were 0.74 (0.69, 0.78) (n = 416), 0.80 (0.76, 0.83) (n = 405), and 0.74 (0.69, 0.78) (n = 405), respectively. In the open-label extension trial, intraclass correlation coefficients (95% confidence intervals) were 0.82 (0.79, 0.85) for weeks 14 and 26/27 (n = 495), 0.85 (0.82, 0.87) for weeks 26/27 and 39/40 (n = 463), and 0.78 (0.74, 0.81) for weeks 14 and 39/40 (n = 463). Placebo/solriamfetol treatment or adherence to primary obstructive sleep apnea therapy did not affect reliability. In conclusion, across three large clinical trials of participants with narcolepsy or obstructive sleep apnea, Epworth Sleepiness Scale scores demonstrated a robust acceptable level of test-retest reliability in evaluating treatment response over time., (© 2021 The Authors. Journal of Sleep Research published by John Wiley & Sons Ltd on behalf of European Sleep Research Society.)

In this study, the auto-combustion sol-gel method was used to prepare novel Tb 2 FeMnO 6 (TFMO) double perovskite nanoparticles. Chemical and natural fuels were used to achieve these particles with appropriate size. The resulting particles were examined via X-ray powder diffraction (XRD) and scanning electron microscopy (SEM) techniques. Rietveld analysis was also performed to confirm the crystallinity and lattice parameters of the formed particles. The particles obtained in the presence of maleic acid were selected as the optimal sample (S4), and the particles obtained in the presence of pomegranate paste were chosen as the non-optimal sample (S8) in terms of size and morphology. Both particles were used to investigate the photocatalytic activity. Fourier transform infrared spectroscopy (FTIR), UV-Vis diffuse reflectance spectroscopy (DRS), and vibrating sample magnetometer (VSM) analyses and N 2 adsorption/desorption isotherms were performed for both samples and the results were compared. Erythrosine and malachite green dyes in aqueous solutions were used as contaminants in the photocatalysis process. The results showed 22% and 20% discoloration for S4 and 41% and 30% discoloration for S8 in the presence of erythrosine and malachite green under visible light irradiation. The photocatalytic activity was investigated under UV light for S4, which showed 80% and 50% discoloration for erythrosine and malachite green, respectively. Investigating the photocatalytic activity of TFMO double perovskite nanoparticles showed that these nanoparticles could be a desirable option for mitigating water pollution., Competing Interests: The authors declare that there are no conflicts of interest regarding the publication of this manuscript., (This journal is © The Royal Society of Chemistry.)

Background: Solriamfetol, a dopamine-norepinephrine reuptake inhibitor, is approved in the United States to improve wakefulness in adults with excessive daytime sleepiness (EDS) associated with OSA (37.5-150 mg/d)., Research Question: Does solriamfetol have differential effects on EDS based on adherence to primary OSA therapy and does solriamfetol affect primary OSA therapy use?, Study Design and Methods: Participants were randomized to 12 weeks of placebo or solriamfetol 37.5, 75, 150, or 300 mg/d (stratified by primary OSA therapy adherence). Coprimary end points were week 12 change from baseline in 40-min Maintenance of Wakefulness Test (MWT) and Epworth Sleepiness Scale (ESS) in the modified intention-to-treat population. Primary OSA therapy use (hours per night, % nights) and safety were evaluated., Results: At baseline, 324 participants (70.6%) adhered to OSA therapy (positive airway pressure use ≥ 4 h/night on ≥ 70% nights, surgical intervention, or oral appliance use on ≥ 70% nights) and 135 participants (29.4%) did not adhere. Least squares (LS) mean differences from placebo in MWT sleep latency (minutes) in the 37.5-, 75-, 150-, and 300-mg/d groups among adherent participants were 4.8 (95% CI, 0.6-9.0), 8.4 (95% CI, 4.3-12.5), 10.2 (95% CI, 6.8-13.6), and 12.5 (95% CI, 9.0-15.9) and among nonadherent participants were 3.7 (95% CI, -2.0 to 9.4), 9.9 (95% CI, 4.4-15.4), 11.9 (95% CI, 7.5-16.3), and 13.5 (95% CI, 8.8-18.3). On ESS, LS mean differences from placebo in the 37.5-, 75-, 150-, and 300-mg/d groups among adherent participants were -2.4 (95% CI, -4.2 to -0.5), -1.3 (95% CI, -3.1 to 0.5), -4.2 (95% CI, -5.7 to -2.7), and -4.7 (95% CI, -6.1 to -3.2) and among nonadherent participants were -0.7 (95% CI, -3.5 to 2.1), -2.6 (95% CI, -5.4 to 0.1), -5.0 (95% CI, -7.2 to -2.9), and -4.6 (95% CI, -7.0 to -2.3). Common adverse events included headache, nausea, anxiety, decreased appetite, nasopharyngitis, and diarrhea. No clinically meaningful changes were seen in primary OSA therapy use with solriamfetol., Interpretation: Solriamfetol improved EDS in OSA regardless of primary OSA therapy adherence. Primary OSA therapy use was unaffected with solriamfetol., Trial Registry: ClinicalTrials.gov; No.: NCT02348606; URL: www.clinicaltrials.gov; EU Clinical Trials Register; No.: EudraCT2014-005514-31; URL: www.clinicaltrialsregister.eu., (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)

Study Objectives: Solriamfetol, a dopamine/norepinephrine reuptake inhibitor, is approved in the United States and European Union to treat excessive daytime sleepiness in patients with obstructive sleep apnea (OSA) (37.5-150 mg/day) and narcolepsy (75-150 mg/day). This analysis evaluated solriamfetol's efficacy in subgroups of participants with OSA who were adherent or nonadherent to primary OSA therapy at baseline and examined whether solriamfetol affected the use of primary therapy in an open-label extension trial., Methods: Participants with OSA who completed prior solriamfetol studies received solriamfetol 75, 150, or 300 mg/day for ≤ 52 weeks. The main efficacy outcome was the Epworth Sleepiness Scale score. Primary therapy use was summarized as the percentage of nights, the number of hours/night, and the percentage of nights with use ≥ 50%/night (%). Efficacy and primary therapy use are reported for participants who directly enrolled from a previous 12-week study and had ≤ 40 weeks of open-label treatment (n = 333). Safety data are reported for all participants (n = 417)., Results: Mean ESS scores in adherent (n = 255) and nonadherent (n = 78) subgroups, respectively, were 15.0 and 15.8 at baseline (of 12-week study) and 6.5 and 6.8 at week 40. For participants using an airway therapy, mean use at baseline was 90% of nights, 6.6 hours/night, and use ≥ 50%/night on 90% of nights; changes from baseline to week 40 were minimal (0.9%, -0.8 hours, and 6.5%, respectively). Common adverse events (both subgroups) included headache, nasopharyngitis, insomnia, dry mouth, nausea, anxiety, and upper respiratory tract infection., Conclusions: Long-term efficacy and safety of solriamfetol were similar regardless of adherence to primary OSA therapy. Solriamfetol did not affect primary therapy use., Clinical Trial Registration: Registry: ClinicalTrials.gov; Name: A Long-Term Safety Study of JZP-110 in the Treatment of Excessive Sleepiness in Subjects with Narcolepsy or OSA; URL: https://clinicaltrials.gov/ct2/show/NCT02348632; Identifier: NCT02348632 and Registry: EU Clinical Trials Register; Identifier: 2014-005489-31; URL: https://www.clinicaltrialsregister.eu/ctr-search/search?query=2014-005489-31.., (© 2021 American Academy of Sleep Medicine.)

Water contamination has turned into a critical global concern that menaces the entire biosphere and has a notable effect on the lives of living beings and humans. As a proper and environmentally friendly solution, visible-light photocatalysis technology has been offered for water contamination removal. There is a strong interest in the design of the efficient catalytic materials that are photoactive with the aid of visible light. Herein, to fabricate a highly efficient photocatalyst for removal of organic pollution in water, a facile and swift sonochemical route employed for creation of the spindle shaped PbWO 4 nanostructure with the aid of an environmentally friendly capping agent (maltose) for the first time. To optimize the efficiency, dimension and structure of lead tungstate, various effective factors such as time, dose of precursors, power of ultrasound waves and kind of capping agents were altered. The attributes of PbWO 4 samples were examined with the aid of diverse identification techniques. The produced lead tungstate samples in role of visible-light photocatalyst were applied to remove organic pollution in water. The kinds of pollutants, dose and type of catalyst were examined as notable factors in the capability to eliminate contaminants. Very favorable catalytic yield and durability were demonstrated by spindle-shaped PbWO 4 nanostructure (produced at power of 60 W for 10 min and with usage of maltose). Usage of ultrasonic irradiation could bring to improvement of catalytic yield of PbWO 4 to 93%. Overall, the outcomes could introduce the spindle-shaped PbWO 4 nanostructure as an efficient substance for eliminating water contamination under visible light., (Copyright © 2020 The Author(s). Published by Elsevier B.V. All rights reserved.)

Study Objectives: To evaluate the clinical relevance of solriamfetol in treating excessive daytime sleepiness in participants with narcolepsy or obstructive sleep apnea (OSA)., Methods: This posthoc analysis includes data from two 12-week, randomized phase 3 studies in participants with narcolepsy or OSA treated with once-daily placebo or solriamfetol 37.5 mg (OSA only), 75 mg, 150 mg, or 300 mg. Excessive daytime sleepiness was assessed with the Epworth Sleepiness Scale (ESS) at baseline and at week 12. Cumulative distribution function plots were generated using a last-observation-carried-forward approach to determine the percentage of participants who achieved ESS scores ≤ 10, within the normal range, and the percentage who achieved a reduction (improvement) in ESS ≥ 25% relative to baseline. Safety was also assessed., Results: In narcolepsy (n = 231), 30.5%-49.2% of participants treated with solriamfetol (across doses) reported ESS scores ≤ 10 and 44.1%-62.7% achieved a ≥ 25% decrease from baseline in ESS scores at week 12, compared with 15.5% and 27.6%, respectively, of placebo recipients. In OSA (n = 459), 51.8%-73.0% of participants treated with solriamfetol (across doses) reported ESS scores ≤ 10 and 50.0%-81.9% achieved a ≥ 25% decrease from baseline in ESS scores at week 12, compared with 37.7% and 36.8%, respectively, of placebo recipients. Results were generally dose-dependent, with more responders at higher solriamfetol doses. Common treatment-emergent adverse events (≥ 5% of solriamfetol recipients in either study) were headache, nausea, decreased appetite, nasopharyngitis, dry mouth, and anxiety., Conclusions: A greater percentage of participants treated with solriamfetol achieved normal ESS scores (≤ 10) or clinically meaningful improvements on the ESS compared with those receiving placebo. The safety profile was similar between participants with narcolepsy and those with OSA., Clinical Trial Registrations: Registry: ClinicalTrials.gov. Names: TONES 2 and TONES 3. URLs: https://www.clinicaltrials.gov/ct2/show/NCT02348593 and https://www.clinicaltrials.gov/ct2/show/NCT02348606. Identifiers: NCT02348593, NCT02348606. Registry: European Union Drug Regulating Authorities Clinical Trials. Names: TONES 2 and TONES 3. URL: https://www.eudract.ema.europa.eu. Identifiers: EudraCT 2014-005487-15, EudraCT 2014-005514-31., (© 2021 American Academy of Sleep Medicine.)

Background: Proton pump inhibitors (PPIs) are among the most commonly used medications by patients due to its availability over the counter and frequent prescribing by physicians to treat and alleviate symptoms of gastroesophageal reflux disease. Recently, the FDA issued a warning with respect to the utilization of PPIs and risk of developing Clostridium difficile infections (CDI). The most commonly known medications to cause CDI are antibiotics. However, available studies suggest an association and increase in risk for CDI with PPI use as well., Objective: The purpose of this research is to review and summarize data currently available on the association between PPIs and CDI., Methods: To search for eligible studies, EBSCO engines were investigated using proton pump inhibitors or PPIs and Clostridium difficile or C. diff. as search terms. Meta analyses and systematic reviews published between 2000 and 2020 on adult patients were considered., Results: Eight meta-analyses and systematic reviews met the inclusion criteria. They included studies conducted in the US, Europe, Asia and Canada on inpatient and outpatient adults. The final result for all 8 studies showed a statistically significant association between PPIs and CDI ranging from mild to high risk., Conclusion: Currently available data suggest a positive association between PPIs and CDI., Competing Interests: Conflict of interest: None, (© Individual authors.)

Recently, nanocomposite photocatalysts based on semiconductors have drawn consideration due to their suitable bandgap. Combination of tow of several semiconductors can slow down the electron-hole recombination. For this purpose, we have introduced DyMnO 3 /Fe 2 O 3 nanocomposite as a novel and efficient catalyst for water purification. For this regard, DyMnO 3 /Fe 2 O 3 nanocomposite has been fabricated by a simple and green sol-gel auto-combustion technique. The impact of calcination temperature, time, and types of fuel was investigated on morphology, structure, and purity of the products. The samples were identified by XRD, FTIR, FESEM, HRTEM, BET, and DRS. The bandgap was calculated by DRS to be 3.20 and 3.28 eV for Fe 2 O 3 and DyMnO 3 . Due to the appropriate bandgap, DyMnO 3 /Fe 2 O 3 degraded 80% of methylene blue under UV light. The future aspects of the DyMnO 3 /Fe 2 O 3 application can be applied in thermoelectric materials, solid fuel cells, electrochemical gas sensors, and electrochemical biosensors.

In this work, new double perovskite Tb 2 ZnMnO 6 nanoparticles were successfully synthesized by a sol-gel auto combustion method. To synthesize these nanoparticles, three known sugars, lactose, fructose, and maltose, and liquorice powder, which contains quantities of sugar and other organic compounds, were used as fuel. Images obtained from Scanning Electron Microscopy (SEM) analysis implied that maltose-based nanoparticles are homogenous and less in particle size. Further, different maltose ratios were applied to get the best size and morphology. The optimum sample was used to continue the other analysis to check other features of the nanoparticles. Also, the optimum sample was used for the removal of dye contamination under the photocatalytic process. Photocatalytic tests were performed in neutral and alkaline pH conditions under UV-light irradiation. It has been found that the decolorization percent for methyl orange was about 35% and for methyl violet about 55% at neutral pH. Also, this value for methyl violet was about 90% at pH = 8. The results obtained from the study of photocatalytic properties introduce these nanoparticles as a desirable option for removing dye contaminants from aqueous media., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Study Objectives: To evaluate long-term safety and maintenance of efficacy of solriamfetol treatment for excessive daytime sleepiness in narcolepsy and obstructive sleep apnea (OSA)., Methods: Participants with narcolepsy or OSA who completed a prior solriamfetol study were eligible. A 2-week titration period was followed by a maintenance phase (up to 50 weeks). Efficacy was assessed by Epworth Sleepiness Scale (ESS) and Patient and Clinical Global Impression of Change (PGI-C and CGI-C, respectively). After approximately 6 months of treatment, a subgroup entered a 2-week placebo-controlled randomized withdrawal (RW) phase. Change in ESS from beginning to end of the RW phase was the primary endpoint; PGI-C and CGI-C were secondary endpoints. Safety was assessed throughout the study., Results: In the maintenance phase, solriamfetol-treated participants demonstrated clinically meaningful improvements on ESS, PGI-C, and CGI-C. In the RW phase, least squares mean change on ESS was 1.6 in participants continuing solriamfetol versus 5.3 in participants switched to placebo (p < .0001). For both secondary endpoints, higher percentages of participants receiving placebo were reported as worse at the end of the RW phase versus solriamfetol (p < .0001). Common treatment-emergent adverse events (TEAEs) with solriamfetol were headache, nausea, nasopharyngitis, insomnia, dry mouth, anxiety, decreased appetite, and upper respiratory tract infection; 27 (4.2%) participants experienced at least one serious TEAE, and 61 (9.5%) withdrew because of TEAEs., Conclusions: This study demonstrated long-term maintenance of efficacy of solriamfetol under open-label and double-blind, placebo-controlled conditions. Safety profile of solriamfetol was consistent with previous 12-week studies; no new safety concerns were identified., Trial Registration: NCT02348632., (© Sleep Research Society 2019. Published by Oxford University Press [on behalf of the Sleep Research Society].)

Herein, successful synthesis of pure Dy 2 ZnMnO 6 nanoparticles as a new double perovskite was reported. The samples were prepared using various base and surfactants under ultrasound waves (30 W and 20 kHz). The effects of base type and surfactant type as effective parameters on morphology and size of products and the roles of calcination temperature and sonication as operative procedures on purity of products were investigated. According to the results tepa was chosen as favorite base to produce the smallest particles with the most homogeneity and T ≥ 900 °C was considered as desirable calcination temperature for synthesis of pure product. It seemed that high temperature of ultrasound waves can decrease the required calcination temperature, so facilitates the achievement of pure product. Moreover, photocatalytic performance of the prepared product was examined by decolorization of three dyes including Eriochrome Black T, Methyl orange and Methyl violet under UV irradiation. The most and the least percent of degradation were assigned to Methyl violet (90.44%) and Methyl orange (48.39%), respectively. Paramagnetic property of this product was considered as the other advantage for its photocatalytic performance because of it can be easily separated by magnetic field and recycles again., (Copyright © 2019 Elsevier B.V. All rights reserved.)