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Mechanical properties, cytotoxicity, and protein adsorption of three-dimensionally printable hybrid resin containing zwitterionic polymer and silicate-based composites for dental restorations.
No full textOBJECTIVE
To evaluate the mechanical and biological properties of three-dimensionally (3D) printable resins filled with 2-methacryloyloxyethyl phosphorylcholine (MPC) and silicate-based composites and compare with those of a commercially available 3D-printable resin for definitive restorations.
METHODS
A group of 3D-printable hybrid resins (HRs) filled with 6 wt% MPC and three different compositions of silicate-based composites (barium silicate to zirconium silicate ratios: 1.50:1 for HR1, 0.67:1 for HR2, and 0.25:1 for HR3) were prepared. The HR groups were compared with the commercially available unfilled 3D-printable resin (CR) marketed for definitive restorations in terms of flexural strength and modulus, fracture toughness, surface roughness, Vickers hardness, light transmittance (all, n=15), cytotoxicity, and protein adsorption (both, n=3). All data were analyzed by using non-parametric Kruskal-Wallis and Dunn's tests (α=.05).
RESULTS
The HR groups had significantly higher flexural strength, modulus, fracture toughness, and hardness values than the CR (P<0.001). HR3 had the highest surface roughness and light transmittance among the groups (P≤0.006). None of tested resins showed cytotoxicity. Both HR2 and HR3 showed significantly lower protein adsorption than the CR, with a difference of approximately 60% (P≤0.026).
CONCLUSION
Both HR2 and HR3 exhibited superior mechanical properties (flexural strength, flexural modulus, fracture toughness, and Vickers hardness), light transmittance, and protein-repellent activity than the CR, with no impact on cytotoxicity.
CLINICAL SIGNIFICANCE
The MPC/silicate-based composite-filled resins may be a suitable alternative for definitive restorations, given their higher mechanical properties and promising biological properties to prevent microbial adhesion and subsequent biofilm formation, as well as their non-cytotoxic properties
Dual spatio-temporal regulation of axon growth and microtubule dynamics by RhoA signaling pathways.
No full textRhoA plays a crucial role in neuronal polarization, where its action restraining axon outgrowth has been thoroughly studied. We now report that RhoA has not only inhibitory but also a stimulatory effect on axon development depending on when and where exerts its action and the downstream effectors involved. In cultured hippocampal neurons, FRET imaging revealed that RhoA activity selectively localizes in growth cones of undifferentiated neurites, while in developing axons it displays a biphasic pattern, being low in nascent axons and high in elongating ones. RhoA-Rho kinase (ROCK) signaling prevents axon initiation but has no effect on elongation, while formin inhibition reduces axon extension without significantly altering initial outgrowth. Besides, RhoA-mDia promotes axon elongation by stimulating growth cone microtubule stability and assembly, as opposed to RhoA-ROCK that restrains growth cone microtubule assembly and protrusion
Optical coherence tomography angiography in neovascular age-related macular degeneration: comprehensive review of advancements and future perspective.
No full textOptical coherence tomography angiography (OCTA) holds promise in enhancing the care of various retinal vascular diseases, including neovascular age-related macular degeneration (nAMD). Given nAMD's vascular nature and the distinct vasculature of macular neovascularization (MNV), detailed analysis is expected to gain significance. Research in artificial intelligence (AI) indicates that en-face OCTA views may offer superior predictive capabilities than spectral domain optical coherence tomography (SD-OCT) images, highlighting the necessity to identify key vascular parameters. Analyzing vasculature could facilitate distinguishing MNV subtypes and refining diagnosis. Future studies correlating OCTA parameters with clinical data might prompt a revised classification system. However, the combined utilization of qualitative and quantitative OCTA biomarkers to enhance the accuracy of diagnosing disease activity remains underdeveloped. Discrepancies persist regarding the optimal biomarker for indicating an active lesion, warranting comprehensive prospective studies for validation. AI holds potential in extracting valuable insights from the vast datasets within OCTA, enabling researchers and clinicians to fully exploit its OCTA imaging capabilities. Nevertheless, challenges pertaining to data quantity and quality pose significant obstacles to AI advancement in this field. As OCTA gains traction in clinical practice and data volume increases, AI-driven analysis is expected to further augment diagnostic capabilities
[Lessons from the COVID-19-Pandemic : Experiences of critical care nurses during the COVID-19 pandemic: a qualitative explorative study].
No full textBACKGROUND
When the workload for critical care nurses becomes too high, this can have consequences for both personal health as well as patient care. During the COVID-19 pandemic, critical care nurses were confronted with new and dynamic changes.
OBJECTIVE
The aim of this study was to describe the experiences of critical care nurses regarding the ad hoc measures taken and the perceived physical and psychological burden experienced during the coronavirus disease 2019 (COVID-19) pandemic.
METHODS
This was a cross-sectional study conducted at two hospitals using an online survey. The open questions addressing the challenges faced during the COVID-19 pandemic were subjected to content analysis according to Mayring.
RESULTS
A total of 179 critical care nurses participated in the online survey. From the results, the following four categories were developed: "not meeting one's own quality of care requirements," "uncertainties in everyday professional and private life," "increased responsibility with lack of relief," and "insufficient coping strategies for physical and psychological burden."
CONCLUSION
Critical care nurses require structures and processes which support them in situations of high workload. The focus should be on the self-imposed requirements of quality of care as well as potentially relieving measures
Perioperative hyperoxia- impact on myocardial biomarkers, strain and outcome in high-risk patients undergoing non-cardiac surgery: Protocol for a prospective randomized controlled trial.
No full textBACKGROUND
Supplemental oxygen is used during every general anesthesia. However, for the maintenance phase of a general anesthesia, in most cases the longest part of anesthesia, only scarce evidence of dosing supplemental oxygen exists. Oxygen is a well-known coronary vasoconstrictor and thus may contribute to cardiovascular complications especially in vulnerable high-risk patients with coronary artery disease undergoing major non-cardiac surgery. Myocardial biomarkers are early indicators of myocardial injury. Oxygen supply demand mismatches due to coronary artery disease aggravated by hyperoxia might be displayed by changes from the biomarker's baseline-values. This study is designed to detect changes in myocardial biomarkers levels associated with perioperative hyperoxia.
METHODS
This prospective randomized controlled interventional trial investigates the impact of maintaining perioperative high oxygen supplementation in high-risk patients undergoing non-cardiac vascular surgery on cardiac biomarkers, myocardial strain and outcome in 110 patients. Patients are allocated to be supplemented with either 0.3 (normal) or 0.8 (high) fraction of inspired oxygen (FiO2) perioperatively. Included is a short crossover phase during which transesophageal echocardiography is used to evaluate myocardial function at FiO2 0.3 and 0.8 by strain analysis in each patient. Patients will be followed up for complications at 30 days and 1 year.
CONCLUSION
The trial is designed to evaluate perioperative changes from baseline myocardial biomarkers associated with perioperative FiO2. Furthermore, exploration and correlation of changes in biomarkers, acute early changes in myocardial function and clinical outcomes induced by different FiO2 may be possible
Trends in mortality in people with HIV from 1999 to 2020: a multi-cohort collaboration.
No full textBACKGROUND
Mortality among people with HIV declined with the introduction of combination antiretroviral therapy. We investigated trends over time in all-cause and cause-specific mortality in people with HIV from 1999-2020.
METHODS
Data were collected from the D:A:D cohort from 1999 through January 2015 and RESPOND from October 2017 through 2020. Age-standardized all-cause and cause-specific mortality rates, classified using Coding Causes of Death in HIV (CoDe), were calculated. Poisson regression models were used to assess mortality trends over time.
RESULTS
Among 55716 participants followed for a median of 6 years (IQR 3-11), 5263 participants died (crude mortality rate [MR] 13.7/1000 PYFU; 95%CI 13.4-14.1). Changing patterns of mortality were observed with AIDS as the most common cause of death between 1999- 2009 (n = 952, MR 4.2/1000 PYFU; 95%CI 4.0-4.5) and non-AIDS defining malignancy (NADM) from 2010 -2020 (n = 444, MR 2.8/1000 PYFU; 95%CI 2.5-3.1). In multivariable analysis, all-cause mortality declined over time (adjusted mortality rate ratio [aMRR] 0.97 per year; 95%CI 0.96, 0.98), mostly from 1999 through 2010 (aMRR 0.96 per year; 95%CI 0.95-0.97), and with no decline shown from 2011 through 2020 (aMRR 1·00 per year; 95%CI 0·96-1·05). Mortality due all known causes except NADM also declined over the entire follow-up period.
CONCLUSION
Mortality among people with HIV in the D:A:D and/or RESPOND cohorts decreased between 1999 and 2009 and was stable over the period from 2010 through 2020. The decline in mortality rates was not fully explained by improvements in immunologic-virologic status or other risk factors
Sex differences in chronic kidney disease-related complications and mortality across levels of glomerular filtration rate.
No full textBACKGROUND AND HYPOTHESIS
Chronic kidney disease (CKD) is a growing global health concern. Recent research has indicated sex disparities in CKD-related complications, yet the impact of sex differences on critical kidney function levels that trigger these complications and mortality remains inadequately documented.
METHODS
We investigated sex-specific disparities in CKD-related complications and mortality according to eGFR levels. We analyzed NHANES data spanning from 1999 to 2018, including adult participants with an eGFR of 15-150 ml/min per 1.73m². The outcomes were CKD-related complications (hypertension, anaemia, CV diseases, acidosis, hyperphosphatemia, hyperparathyroidism) and all-cause and cause-specific mortality (CV mortality and non-CV mortality). Sex-stratified multivariable logistic and Cox regression models yielded odds ratios (ORs) and hazard ratios (HRs) for the relationship between eGFR categories and outcomes. Sex-stratified natural splines were used to explore the relationship between continuous eGFR and outcomes and identified eGFR thresholds of statistical significance.
RESULTS
The study included 49 558 participants (50.3% women, 49.7% men). Multivariable logistic regression demonstrated a significant eGFR association with all CKD-related complications, exhibiting a linear trend across eGFR categories. Modelling eGFR as a natural spline revealed varied significance thresholds between sexes for anaemia and hyperparathyroidism. Additionally, the eGFR-hyperphosphatemia association was more pronounced in men. We observed substantial but not statistically significant differences between men and women in the thresholds of statistical significance for CV (significance appeared at a higher eGFR in men) and non-CV mortality (significance appeared at a higher eGFR in women).
CONCLUSIONS
Research shows sex disparities in most CKD-related complications. Men develop anaemia and hyperparathyroidism earlier, women show steeper anaemia increase. Men have higher CV mortality risk. As eGFR decreased, men faced a higher risk of CV mortality at a higher eGFR threshold than women
Impact of the superimposition methods on accuracy analyses in maxillary complete-arch digital implant investigation.
No full textOBJECTIVES
To measure the impact of the superimposition method on accuracy analyses in digital implant research using an ISO-recommended 3-dimensional (3D) metrology-grade inspection software (Geomagic Control X; 3D Systems; Rock Hill, South Carolina; USA).
MATERIALS AND METHODS
A six-implant edentulous maxillary model was scanned using a desktop scanner (7Series; DentalWings; Montreal, Canada) and an intraoral scanner (TRIOS 4; 3Shape; Copenhagen, Denmark) to generate a reference and an experimental mesh. Thirty experimental STL files were superimposed onto the reference model's STL using the core features of six superimposition methods: initial automated pre-alignment (GI group), landmark-based alignment (G1 group), partial area-based alignment (G2 group), entire area-based alignment (G3 group), and double alignment combining landmark-based alignment with entire model area-based alignment (G4 group) or the scan bodies' surface (G5 group). The groups underwent various alignment variations, resulting in sixteen subgroups (n=30). The alignment accuracy between experimental and reference meshes was quantified by using the root mean square (RMS) error as trueness and its fluctuation as precision. The Kruskal-Wallis test with a subsequent adjusted post-hoc Dunn's pairwise comparison test was used to analyze the data (α = .05). The reliability of the measurements was assessed using the intraclass correlation coefficient (ICC).
RESULTS
Four hundred and eighty superimpositions were used. No significant differences were found in trueness and precision among the groups (p>.05), except for partial area-based alignment (p.05). Double alignments did not improve alignment accuracy (p>.05). The entire area-based alignment of the scan bodies' surface had the least effect on accuracy analyses.
CONCLUSIONS
Digital oral implant investigation remains unaffected by the superimposition method when ISO-recommended 3D metrology-grade inspection software is used. At least two scan bodies are needed when considering partial area-based alignments.
CLINICAL SIGNIFICANCE
The superimposition method choice within the tested ISO-recommended 3D inspection software did not impact accuracy analyses in digital implant investigation
Policy Entrepreneurs, Entrepreneurial Strategies, and Institutional Contexts in Interreg Europe
No full textIn their efforts to affect policy change, policy entrepreneurs employ a series of strategies, which have been well documented in the literature. However, little is known regarding the relationship between the type of strategies policy entrepreneurs use and the institutional contexts in which they operate. The Interreg Europe programme aims to promote policy changes and thus offers a space for policy learning and experimentation to policy entrepreneurs. Using a mixed methodology that includes a survey addressed to the 65 Interreg Europe projects in research and innovation during the programming period 2014-2020 and 12 follow-up semi-structured interviews, this article explores the strategies used by policy entrepreneurs in different institutional contexts. The study, rare in the policy entrepreneurship scholarship with its quantitative aspects, highlights the most widely used strategies by policy entrepreneurs in research and innovation policy changes. Findings suggest that the strategy of storytelling is more widely used in high innovator regions than in low innovator regions as well as in Northern European compared to Southern European regions. Moreover, there are significant differences between the use of the strategy of storytelling with the perceived ease of policy entrepreneurs to introduce a policy change
Endovascular repair of pararenal and thoracoabdominal aortic aneurysms with inner and outer off-the shelf-multibranched endografts. A systematic review and meta-analysis.
No full textBACKGROUND
During the last years a great progress has been noted in device technology and operator experience in treating complex aortic aneurysms. Fenestrated and branched custom-made devices require detailed preoperative planning and production time that can take up to 12 weeks. During this awaiting period, the aortic related mortality is being increased. To overcome this limitation, off-the shelf standardized multibranched devices were launched in the market for the treatment of pararenal and thoracoabdominal aortic aneurysms (TAAA). Our aim was to systematically evaluate all the published studies of off-the shelf endografts for the treatment of pararenal and thoracoabdominal aortic aneurysms.
METHODS
We performed a systematic review to identify all the eligible studies that reported outcomes to the off-the-shelf with inner or outer multibranched devices and then conducted a qualitative synthesis and meta-analysis of the results. The main outcomes were technical success, mortality, target visceral vessel (TVV) instability, major adverse events and reintervention rate. We estimated pooled proportions and 95% confidence intervals (CIs).
RESULTS
A total of 1605 study titles were identified by the initial search strategy, of which 13 (8=t-Branch/ 3=E-nside/1=We-Flow/1=TAMBE) were considered eligible for inclusion in the meta-analysis. A total of 595 patients (70% male) were identified among the eligible studies. In terms of procedures, 64.4% were elective, 19.2% (13.4% outer-multibranched group (OMG); 6.1% inner-multibranched group (IMG) were emergent, and 16.4% (15.6% OMG; 0.8% IMG) were urgent. The pooled technical success was 92.1% (95%, CI, 83.8-96.4%) and 96.9% (95%, CI, 92.5-98.8%) for the outer- and inner-multibranched endograft, respectively. The pooled 30-day mortality was 10.4 % (95%, CI, 6.6-16.1%,) and 4.2% (95%, CI, 2.0-8.6%) for the outer and inner branched group respectively. The pooled 30-day and late TVV instability for the outer-branched group was 3.5% (95%, CI, 2.0-6.1%) and 6.2% (95%, CI, 4.7-8.0%) and for the inner branched group 10.4% (95%, CI, 4.5-22.5%) and 1.6% (95%, CI, 0.7-3.3%) respectively.
CONCLUSIONS
This pooled analysis indicated good technical success and mortality rate, for both devices despite the high rate of urgent procedures. Pararenal and thoracoabdominal aortic aneurysms can be safely treated using the included devices. However, further studies are required to draw additional conclusions for the inner group due to the small sample size
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