Search

Background: Traditionally, pediatric endodontics lacked access to the full potential of rotary instruments. These instruments, designed for the permanent root canal system, often presented limitations when used in primary teeth. To address this, exclusive pediatric rotary files with regular improvements have been introduced, featuring superior cutting efficiency with a focus on precise alignment. This design offers the advantage of reduced risk of ledges, perforations, instrument separation, and canal transportation. This study aimed to compare and evaluate the effectiveness of Pro AF Baby Gold and Kedo-S rotary files in preparing primary tooth root canals during pulpectomy procedures through a meta-analysis. Methodology: The review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. The review searched electronic databases from 2000 to February 2024 for studies evaluating the efficacy of Pro AF Baby Gold and Kedo-S files in terms of canal instrumentation, transportation, and centering ratio. The Cochrane risk of bias (ROB)-2 tool assessed quality, with analyses conducted using RevMan software version 5.3. The standardized mean difference (SMD) served as the summary with a random effects model (P < 0.05). Results: Out of the five studies identified through the eligibility criteria, three were deemed suitable for a meta-analysis, while all five were included in a qualitative synthesis. The quality assessment revealed a presence of moderate-to-low ROB. The pooled analysis using SMD did not show any statistically significant differences between the files, except for the centering ratio in the mesiobuccal canal, where the Kedo-S file performed slightly better. In addition, the absence of any significant asymmetry in the funnel plot suggests that there is likely no publication bias present in the data. Conclusion: Pro AF Baby Gold files can be used as an alternative adjunct in pediatric endodontics to Kedo-S files and manual files. Prospero Registration: CRD42023469406.

This data article presents tensile properties of about 1200 single carbon fibres (PYROFIL™ TRW40 50L) tested at eight different gauge lengths in the range of L0∈ [20; 80] mm with approximately 150 tested fibres for each length. The equivalent fibre diameter distribution is presented, and the mean and standard deviation are found to be df=(7.37 ± 0.34) µm. The obtained stress-strain curves are analysed by a second-order polynomial fitting method. The initial modulus, E0= (220 ± 3) GPa, and the curvature coefficient α=(3600 ± 250) GPa are determined. The failure stress distribution is analysed by the Weibull model. A Weibull parameter of m¯=6.7±0.8 is determined, and the characteristic (σ0), median (σ˜) and mean (σ¯) failure stresses are found to scale linearly with the gauge length. A length scale independent stress-length factor of σ0m¯L0=(560±60)GPam¯m is determined. The fibre properties determined in this work can be used as parameters to model the mechanical behaviour of carbon fibre composites by Weibull scaling, as done in [1] and [2].

Peripartum cardiomyopathy and hypertensive disorders of pregnancy are not very uncommon in routine practice, but when associated with abruptio placentae and significant hypotension, survival of both child and mother becomes challenging. We report a case of a 20-year-old primigravida who presented in the gynecology emergency unit of our hospital with an ejection fraction of < 20%, severe preeclampsia with abruptio placentae leading to fetal demise, and renal failure in the immediate postoperative period. Challenges faced during decision making regarding the mode of delivery and grave concerns during intraoperative and postoperative periods are discussed. In this case, prompt termination of pregnancy, various point-of-care sonographic measurements, and post-operative emergency dialysis played vital roles in the complete recovery of this patient with a failing heart and grossly jeopardized hemodynamics. Hence, multidisciplinary team-based management is crucial for managing such cases to prevent maternal mortality and morbidity.

Superior Mesenteric Artery Syndrome (SMAS) is a rare but potentially life-threatening condition caused by the compression of the duodenum by the superior mesenteric artery. We report a case of an 11-year-old male who complaint of abdominal pain and intermittent vomiting for last 3 weeks. Diagnosis of SMAS was made with the help of radiological findings. The patient was managed conservatively with nutritional support, prokinetic agents, and stomach decompression. After 2 weeks of treatment, the patient’s symptoms improved, and he was discharged from the hospital.

Irrespective of men and women, colorectal cancer (CRC), is the third most common cancer in the population with more than 1.85 million cases annually. Fewer than 20% of patients only survive beyond five years from diagnosis. CRC is a highly preventable disease if diagnosed at the early stage of malignancy. Several screening methods like endoscopy (like colonoscopy; gold standard), imaging examination [computed tomographic colonography (CTC)], guaiac-based fecal occult blood (gFOBT), immunochemical test from faeces, and stool DNA test are available with different levels of sensitivity and specificity. The available screening methods are associated with certain drawbacks like invasiveness, cost, or sensitivity. In recent years, computer-aided systems-based screening, diagnosis, and treatment have been very promising in the early-stage detection and diagnosis of CRC cases. Artificial intelligence (AI) is an enormously in-demand, cost-effective technology, that uses various tools machine learning (ML), and deep learning (DL) to screen, diagnose, and stage, and has great potential to treat CRC. Moreover, different ML algorithms and neural networks [artificial neural network (ANN), k-nearest neighbors (KNN), and support vector machines (SVMs)] have been deployed to predict precise and personalized treatment options. This review examines and summarizes different ML and DL models used for therapeutic intervention in CRC cancer along with the gap and challenges for AI.

Tuberculosis (TB) is still one of the major health care problems in many developing countries. Among various forms of TB, central nervous system (CNS) TB causes significant morbidity and mortality. CNS TB can present in various forms: cerebritis, abscess, meningitis, tuberculoma, calcified granuloma, meningitis, or hydrocephalus. But subdural empyema is a very rare form of presentation. Very few cases have been reported till now in the literature. So, high level of suspicion, thorough microbiological and histological investigations to diagnosis, and early and timely inception of anti-TB medication are keys in its management. Here, we are presenting a case of tubercular subdural empyema that was successfully treated with surgical evacuation and anti-TB medication.

ABSTRACTHypoxia results from an insufficient supply of oxygen, which results in physiological stress in biological systems. Cells respond to this unfavorable condition by reducing critical cellular functions, which include replication, transcription, and translation. Oncogenic Kaposi sarcoma-associated virus (KSHV) undergoes lytic reactivation in hypoxic conditions. Furthermore, reactivation requires the synthesis of specific viral proteins, both structural and non-structural. Therefore, the virus manipulates the cellular microenvironment to ensure efficient functioning of the cellular transcription machinery, including RNA polymerase II (Pol II), by protecting it from hypoxia-mediated degradation. In this study, we demonstrated that hypoxia induces degradation of RNA Pol II via ubiquitination mediated by the NEDD4 E3 ligase, which results in transcription inhibition. However, in KSHV-infected cells during hypoxia, the virus-encoded latency-associated nuclear antigen interacts with NEDD4, inhibiting its E3 ubiquitin ligase activity and requires complex formation with hypoxia inducible factor HIF1α. This activity inhibits the polyubiquitination of RNA Pol II to maintain steady transcription levels necessary for the synthesis of the essential viral genes needed for successful lytic reactivation.IMPORTANCEHypoxia can induce the reactivation of Kaposi sarcoma-associated virus (KSHV), which necessitates the synthesis of critical structural proteins. Despite the unfavorable energetic conditions of hypoxia, KSHV utilizes mechanisms to prevent the degradation of essential cellular machinery required for successful reactivation. Our study provides new insights on strategies employed by KSHV-infected cells to maintain steady-state transcription by overcoming hypoxia-mediated metabolic stress to enable successful reactivation. Our discovery that the interaction of latency-associated nuclear antigen with HIF1α and NEDD4 inhibits its polyubiquitination activity, which blocks the degradation of RNA Pol II during hypoxia, is a significant contribution to our understanding of KSHV biology. This newfound knowledge provides new leads in the development of novel therapies for KSHV-associated diseases.

Abstract The MECHANISMS study investigates how social norms for adolescent smoking and vaping are transmitted through school friendship networks, and is the first study to use behavioral economics methodology to assess smoking-related social norms. Here, we investigate the effects of selection homophily (the tendency to form friendships with similar peers) and peer influence (a social process whereby an individual’s behavior or attitudes are affected by peers acting as reference points for the individual) on experimentally measured smoking and vaping norms, and other smoking outcomes, in adolescents from high and middle-income settings. Full school year groups in six secondary schools in Northern Ireland (United Kingdom) and six secondary schools in Bogotá (Colombia) participated (n = 1344/1444, participation = 93.1%, target age 12–13 years). Over one semester, pupils received one previously tested school-based smoking prevention program (ASSIST or Dead Cool). Outcomes included experimentally measured smoking/vaping norms, self-report and objectively measured smoking behavior, and self-report smoking norms, intentions, susceptibility, attitudes, and psycho-social antecedents. We investigated selection homophily and peer influence using regressions and SIENA modeling. Regression results demonstrate lagged and contemporaneous selection homophily (odds ratios [ORs] = 0.87–1.26, p ≤ 0.01), and peer influence effects for various outcomes from average responses of friends, school classes, or school year groups (standardized coefficients [βs] = 0.07–0.55, ORs = 1.14–1.31, p ≤ 0.01). SIENA models showed that comparable proportions of smoking/vaping-based similarity between friends were due to selection homophily (32.8%) and peer influence (39.2%). A higher percentage of similarity between friends was due to selection homophily and/or peer influence for ASSIST schools compared to Dead Cool. Selection homophily was also more important in Bogotá, whilst peer influence was stronger in Northern Ireland. These findings support using social norms strategies in adolescent smoking prevention interventions. Future research should consider selection homophily and social influence jointly, and examine whether these findings translate to other high and low-middle-income settings with varying cultures and norms.

Abstract Emerging pollutants and a large volume of unused dyes from the textile industry have been contaminating water bodies. This work introduces a scalable approach to purifying water by the adsorption of Acid green 25 (AG), Crystal Violet (CV), and Sulfamethoxazole (SMA) from an aqueous solution by graphene oxide (GO) doped modified silica aerogel (GO-SA) with supercritical fluid deposition (SFD) method. Characterization of GO-SA using X-ray diffraction (XRD), Fourier-transform infrared spectroscopy (FTIR), high-resolution scanning electron microscopy (HR-SEM), thermogravimetric analysis (TGA), and Brunauer–Emmett–Teller (BET) adsorption isotherms revealed the improvement in the adsorbent surface area, and its textural properties. The high removal percentages observed in most of the experimental runs provide evidence of the excellent performance of the adsorbent towards the anionic and cationic dyes along with the antibiotic. The adsorption isotherm and kinetics showed that the Langmuir isotherm and pseudo-second-order kinetic models could explain adsorption. The adsorbent holds a higher adsorption capacity for SMA (67.07 mg g−1) than for CV (41.46 mg g−1) and AG (20.56 mg g−1) due to the higher hydrophobicity that interacts with the hydrophobic adsorbent. The GO-SA successfully removed AG, CV, and SMA with removal percentages of 98.23%, 98.71%, and 94.46%, respectively. The parameters were optimized using Central Composite Design (RSM-CCD). The prepared aerogel showed excellent reusability with a removal efficiency of > 85% even after 5 cycles. This study shows the potential of GO-SA adsorbent in textile and other wastewater purification.

Abstract Background Concurrent existence of lncRNA and circular RNA at both nucleus and cytosol within a cell at different proportions is well reported. Previous studies showed that circular RNAs are synthesized in nucleus followed by transportation across the nuclear membrane and the export is primarily defined by their length. lncRNAs primarily originated through inefficient splicing and seem to use NXF1 for cytoplasm export. However, it is not clear whether circularization of lncRNA happens only in nucleus or it also occurs in cytoplasm. Studies indicate that circular RNAs arise when the splicing apparatus undergoes a phenomenon of back splicing. Minor spliceosome (U12 type) mediated splicing occurs in cytoplasm and is responsible for the splicing of 0.5% of introns of human cells. Therefore, possibility of cRNA biogenesis mediated by minor spliceosome at cytoplasm cannot be ruled out. Secondly, information on genes transcribing both circular and lncRNAs along with total number of RBP binding sites for both of these RNA types is extractable from databases. This study showed how these apparently unconnected pieces of reports could be put together to build a model for exploring biogenesis of circular RNA. Results As a result of this study, a model was built under the premises that, sequences with special semantics were molecular precursors in biogenesis of circular RNA which occurred through catalytic role of some specific RBPs. The model outcome was further strengthened by fulfillment of three logical lemmas which were extracted and assimilated in this work using a novel data analytic approach, Integrated Cellular Geography. Result of the study was found to be in well agreement with proposed model. Furthermore this study also indicated that biogenesis of circular RNA was a post-transcriptional event. Conclusions Overall, this study provides a novel systems biology based model under the paradigm of Integrated Cellular Geography which can assimilate independently performed experimental results and data published by global researchers on RNA biology to provide important information on biogenesis of circular RNAs considering lncRNAs as precursor molecule. This study also suggests the possible RBP-mediated circularization of RNA in the cytoplasm through back-splicing using minor spliceosome.

Abstract BackgroundPromoting cognitive health is key to maintaining cognitive and everyday functions and preventing the risk of cognitive impairment or dementia. Existing scientific evidence shows the benefits of various training modalities on cognition. One way to promote cognitive health is through engagement in cognitive activities (eg, board and video games). ObjectiveThis study aims to investigate the benefits of dynamic adaptive casual puzzle games on cognitive function and well-being in healthy adults and older people. MethodsA total of 12 adults and older people (female participants: n=6; mean age 58.92, SD 10.28 years; range 46-75 years) were included in this pilot randomized controlled trial. This study used a crossover design with two phases (8 weeks each) and three measurement waves (pretest, midtest, and posttest). The participants were randomly allocated either to the control or experimental group. In the control group, participants read newspapers between the pre- and midtest, then switched to cognitive training with puzzle games. In the experimental group, the interventions were reversed. Baseline measurements (pretest) were collected before the intervention. The interventions were delivered on tablet computers and took place unsupervised at participants’ homes. ResultsThe outcome measures included global cognitive function, higher cognitive function, and emotional well-being at 3 time points (pretest, midtest, and posttest) using standardized neuropsychological tests. The participants showed improvements in their visual attention and visuospatial measures after the puzzle game intervention. ConclusionsThe study showed that digital games are a feasible way to train cognition in healthy adults and older people. The algorithm-based dynamic adaption allows accommodations for persons with different cognitive levels of skill. The results of the study will guide future prevention efforts and trials in high-risk populations.

Biomaterials are widely used for various medical purposes, for instance, implants, tissue engineering, medical devices, and drug delivery systems. Natural biomaterials can be obtained from proteins, carbohydrates, and cell-specific sources. However, when these biomaterials are introduced into the body, they trigger an immune response which may lead to rejection and failure of the implanted device or tissue. The immune system recognizes natural biomaterials as foreign substances and triggers the activation of several immune cells, for instance, macrophages, dendritic cells, and T cells. These cells release pro-inflammatory cytokines and chemokines, which recruit other immune cells to the implantation site. The activation of the immune system can lead to an inflammatory response, which can be beneficial or detrimental, depending on the type of natural biomaterial and the extent of the immune response. These biomaterials can also influence the immune response by modulating the behavior of immune cells. For example, biomaterials with specific surface properties, such as charge and hydrophobicity, can affect the activation and differentiation of immune cells. Additionally, biomaterials can be engineered to release immunomodulatory factors, such as anti-inflammatory cytokines, to promote a tolerogenic immune response. In conclusion, the interaction between biomaterials and the body’s immune system is an intricate procedure with potential consequences for the effectiveness of therapeutics and medical devices. A better understanding of this interplay can help to design biomaterials that promote favorable immune responses and minimize adverse reactions.

Background A spinal epidural arachnoid cyst (SEAC) is a rare clinical entity. We performed a systematic review of the literature to obtain information regarding demographics, clinical presentation, treatment modalities, and outcome of SEACs. Methods A literature search was performed by using the databases PubMed/Medline, PubMed Central, Embase, Cochrane Library, Ovid MEDLINE, and Ovid Medline In-Process. A total of 170 articles were found on literature search. We found 575 cases of SEAC since 1904 for inclusion in the review including three cases which were operated by us. We studied the patient characteristics, clinical features, and management strategies, and evaluated their outcome. Results The average age of presentation was 30 years with a male:female ratio of 1.03:1. They are commonly seen in the thoracic region (42.3%). The length of cyst was more than two vertebral levels in 85.81%. Mean symptom duration was 29 months, with most common presentation being that of compressive myelopathy. A good clinical outcome was present in symptomatic patients who had a shorter symptom duration and underwent complete surgical excision of the SEAC. Age, sex, length of lesion, and presence of dural defect did not have a bearing on the surgical outcome. Conclusion For thoracic compressive myelopathy in a young patient, SEAC should be kept as a differential diagnosis. Surgical complete excision of the cyst with meticulous closure of the dural defect is the standard in management for a good clinical outcome.

We want to highlight a simple technique for performing smaller craniotomies, using a marker computed tomography scan, which does not require any special equipment, training or cost and is not time-consuming. Pictorial description of two such cases have been provided.

In this article, we formulate the concept of generalize bonvexity/pseudobonvexity functions. We formulate duality results for second-order fractional symmetric dual programs of G-Wolfe-type model. In the next section, we explain the duality theorems under generalize bonvexity/pseudobonvexity assumptions. We identify a function lying exclusively in the class of generalize pseudobonvex and not in class of generalize bonvex functions. Our results are more generalized several known results in the literature.

Background: In hospitalized seizure patients and during clinical seizure emergencies, parenteral administration of antiepileptic therapy (AED) is primary treatment modality. Appropriate selection and administration of AED is essential for immediate seizure control. The purpose of this study was to evaluate the safety, tolerability, and efficacy of lacosamide injection in adult patients with focal onset seizures (FOS) with or without secondary generalized tonic-clonic seizures or focal to bilateral tonic-clonic seizures. Methods: In this Phase 3 study, we enrolled 60 patients (≥18 years) with FOS and maintained on stable doses of oral lacosamide. Patients were switched to intravenous ( i.v.) lacosamide (10 mg/ml); daily i.v. dosage and frequency were kept equivalent to oral lacosamide per patient. Lacosamide was infused intravenously over for 30 to 60 minutes at 12 hourly intervals for five consecutive days. Primary outcome was evaluating the safety and secondary outcome included measuring the seizure frequency during the treatment (day 1- 5) and at follow-up (day 12). Results: All patients enrolled completed the study. No significant changes in vital signs, or laboratory parameters, were observed at the end of treatment or follow-up when compared to baseline. The frequency analysis for all the components of electrocardiogram (ECG) was within the normal limits at all times. There were no serious adverse events (AEs) reported in this study. Overall, 26.66% of patients had mild to moderate AE intensity that resolved spontaneously without any other intervention. Most common AEs (frequency=5%) were abdominal pain upper, injection site pruritus, and nausea. The anti-seizure activity for lacosamide was maintained despite oral to i.v. switch of lacosamide. Conclusions: The study showed that i.v. lacosamide is a safe and effective strategy in patients with FOS and can be co-administered with other anti-epileptic drugs (AEDs), especially in acute settings with primary generalized tonic-clonic seizures. Registration: CTRI ( CTRI/2011/07/001888; 14 th July 2011).

Background: Twenty-four-hour heart rate (HR) integrates multiple physiological and psychological systems related to health and well-being, and can be continuously monitored in high temporal resolution over several days with wearable HR monitors. Using HR data from two independent datasets of cancer patients and their caregivers, we aimed to identify dyadic and individual patterns of 24 h HR variation and assess their relationship to demographic, environmental, psychological, and clinical variables of interest. Methods: a novel regularized approach to high-dimensional canonical correlation analysis (CCA) was used to identify factors reflecting dyadic and individual variation in the 24 h (circadian) HR trajectories of 430 people in 215 dyads, then regression analysis was used to relate these patterns to explanatory variables. Results: Four distinct factors of dyadic covariation in circadian HR were found, contributing approximately 7% to overall circadian HR variation. These factors, along with non-dyadic factors reflecting individual variation exhibited diverse and statistically robust patterns of association with explanatory variables of interest. Conclusions: Both dyadic and individual anomalies are present in the 24 h HR patterns of cancer patients and their caregivers. These patterns are largely synchronous, and their presence robustly associates with multiple explanatory variables. One notable finding is that higher mood scores in cancer patients correspond to an earlier HR nadir in the morning and higher HR during the afternoon.