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Longevity of posterior direct versus indirect composite restorations: A systematic review and meta-analysis.
Get PDFOBJECTIVES
The goal of this systemic review and meta-analysis was to compare the longevity of direct and indirect composite restorations in posterior teeth.
DATA
Randomized controlled trials (RCT) investigating direct and indirect composite restorations in permanent posterior teeth.
SOURCES
Three electronic databases (PubMed, CENTRAL (Cochrane) and Embase) were screened. No language or time restrictions were applied. Study selection, data extraction and quality assessment were done in duplicate. Risk of bias and level of evidence was graded using Risk of Bias 2.0 tool and Grade Profiler 3.6.
RESULTS
A total of 3056 articles were found by electronic databases. Finally, five RCTs were selected. Overall, 627 restorations of which 323 were direct and 304 indirect composite restorations have been placed in 279 patients (age: 28-81 years). The highest annual failure rates (AFR) were found for indirect restorations ranging from 0 % to 15.5 %. Lower AFR were found for direct restorations ranging from 0 % to 5.4 %. The most frequent failures were found to be chipping and fracture of the restoration followed by caries. Meta-analysis revealed that the failure rate for direct restorations was significantly lower than for indirect restorations (Risk Ratio (RR) [95 %CI] = 0.61 [0.47; 0.79]; very low level of evidence). Furthermore, all studies showed a high risk of bias.
CONCLUSION
Direct and indirect composite restorations can be recommended for large class II cavities including cusp coverage in posterior teeth for single tooth restoration. Meta-analysis revealed significantly lower relative risk to fail for direct composite restorations than for indirect restorations but results are with high risk of basis
Shaping the Debate on Land Policies in Europe - Progress of the ARL International Working Group on Land Policies in Europe
Get PDFOne-Month Dual Antiplatelet Therapy in High Bleeding Risk Asian Patients Undergoing Percutaneous Coronary Intervention - Onyx ONE Clear 2-Year Results.
Get PDFBACKGROUND
One-month dual antiplatelet therapy (DAPT) in high bleeding risk (HBR) patients undergoing percutaneous coronary intervention (PCI) with the Resolute OnyxTM zotarolimus-eluting stents (ZES) is safe and effective. Asian patients have a unique ischemia/bleeding risk profile. Here, we compare the outcomes between Asian and non-Asian patients after PCI and 1-month DAPT.
METHODS AND RESULTS
Onyx ONE Clear was a prospective, multicenter study enrolling HBR patients undergoing PCI with the Resolute Onyx ZES (ClinicalTrials.gov identifier NCT03647475). Event-free patients after 1-month DAPT transitioned to single antiplatelet therapy. Clinical outcomes between 1 month and 2 years were compared between patients from Asian and non-Asian countries after 1 : 1 propensity score matching accounting for baseline differences. Patients from Asian countries represented 18% (n=273) of the study group (n=1,507). Non-Asian patients had greater clinical complexity; however, these differences were minimal after matching. There were no significant differences in ischemic outcomes between matched cohorts from 1 month to 2 years, including the primary composite endpoint of cardiac death or myocardial infarction (12% vs. 12%; P>0.99). However, there were significantly fewer Bleeding Academic Research Consortium types 3-5 bleeding events in the Asian vs. non-Asian cohort (4% vs. 9%; P=0.007), despite similar bleeding risk profiles after matching.
CONCLUSIONS
After propensity score matching, HBR patients from Asian countries undergoing PCI treated with 1-month DAPT had similar ischemic outcomes but fewer bleeding events between 1 month and 2 years compared with patients from non-Asian countries
Electrographic seizures during low-current thalamic deep brain stimulation in mice.
Get PDFBACKGROUND
Deep brain stimulation of central thalamus (CT-DBS) has potential for modulating states of consciousness, but it can also trigger electrographic seizures, including poly-spike-wave trains (PSWT).
OBJECTIVES
To report the probability of inducing PSWTs during CT-DBS in awake, freely-moving mice.
METHODS
Mice were implanted with electrodes to deliver unilateral and bilateral CT-DBS at different frequencies while recording EEG. We titrated stimulation current by gradually increasing it at each frequency until a PSWT appeared. Subsequent stimulations to test arousal modulation were performed at the current one step below the current that caused a PSWT during titration.
RESULTS
In 2.21% of the test stimulations (10 out of 12 mice), CT-DBS caused PSWTs at currents lower than the titrated current, at currents as low as 20 μA.
CONCLUSION
Our study found a small but significant probability of inducing PSWTs even after titration and at relatively low currents. EEG should be closely monitored for electrographic seizures when performing CT-DBS in both research and clinical settings
Self-directed learning among general practitioners in the German-speaking part of Switzerland: a qualitative study using semi-structured interviews.
Get PDFAIMS OF THE STUDY
This research aimed to investigate the self-directed learning (SDL) habits of Swiss general practitioners from the German-speaking part of Switzerland, understanding how they acquire new knowledge, exploring the impact of the COVID-19 pandemic on these habits and identifying optimisation strategies for their future self-directed learning.
METHODS
We employed a qualitative study design, conducting semi-structured interviews with 16 general practitioners from 30 May 2022 to 06 July 2022. Thematic analysis based on a mixed deductive/inductive approach was used to gain insight into the learning activities and self-directed learning practices of the practitioners.
RESULTS
The interviewed general practitioners demonstrated a versatile approach to self-directed learning, where peer communication emerged as the most predominant learning method. It is noteworthy that the younger generation in particular showed a strong inclination for peer learning and is well prepared for the integration of advanced digital solutions for peer communication. Furthermore, a significant shift was observed in media-based self-directed learning, especially since the COVID-19 pandemic. Digital platforms and repositories for practical learning were mentioned as educational mainstays by many interviewees, reflecting a profound technological shift observed over the past 25 years and especially since the pandemic. The primary motivation for pursuing new knowledge remains patient care, although personal development and staying up-to-date with medical and technological advancements are also key motivators. Although the pandemic has undeniably accelerated the transition towards digital learning, it has also brought with it challenges such as information overload and technical difficulties. There was an evident decline in formal learning venues and physical presence during the pandemic, yet the reported value of in-person interactions remains high. Suggestions for optimising self-directed learning included enhancing digital offerings, fostering stronger peer networks and integrating more practical content.
CONCLUSIONS
The COVID-19 pandemic has catalysed a transformation in the self-directed learning practices of general practitioners in the German-speaking part of Switzerland, underlining the importance of a balanced approach between digital and traditional learning methods. As the digital realm of self-directed learning grows, it is essential to address existing challenges and capitalise on potential advantages. Both individual networking efforts like general practitioner quality circles and initiatives from official authorities like informal self-test opportunities can play pivotal roles in refining self-directed learning practices. The findings from this study offer valuable insights for enhancing learning resources and environments that align with general practitioners' needs and preferences. Future research should investigate the ongoing impact of advanced digital technologies on self-directed learning to understand the evolving landscape in a post-pandemic world
Heterozygous DSP in-frame deletion in a poodle with syndromic ichthyosis involving additional hair and tooth abnormalities.
Get PDFIchthyoses comprise a large heterogeneous group of skin disorders, characterized by generalized scaly and hyperkeratotic skin. We investigated a miniature poodle with early onset generalized scaling, dry and irregularly thickened skin, paw pad hyperkeratosis and abnormalities in hair and teeth. The clinical signs of ichthyosis were confirmed by histopathological examination, which revealed mild epidermal hyperplasia and lamellar orthokeratotic hyperkeratosis. A hereditary condition was suspected and a genetic investigation was initiated. We sequenced the whole genome of the affected dog and searched for potentially causative variants in functional candidate genes for the observed phenotype. The analysis revealed a heterozygous in-frame deletion in DSP, NC_049256.1:g.8804542_8804544del resulting from a de novo mutation event as evidenced by genotyping leukocyte DNA from both parents. The 3 bp deletion is predicted to remove one aspartic acid without disrupting the open reading frame (XM_038584124.1:c.1821_1823del, XP_038440052.1:p.(Asp608del)). The DSP gene encodes desmoplakin, a desmosomal plaque protein, responsible for cell-cell adhesion to provide resistance to mechanical stress in epidermal and cardiac tissues. We hypothesize that the deletion of one amino acid in the N-terminal globular head domain acts in a dominant negative manner and thus impairs the proper connection with other proteins. Several variants in DSP in humans and cattle have been described to result in different phenotypes associated with hair and skin abnormalities, sometimes in combination with variable cardiac and/or dental manifestations. In conclusion, we characterized a new syndromic ichthyosis phenotype in a dog and identified a de novo 3 bp deletion in the DSP gene as causal variant
Magnetic resonance imaging pattern recognition of metabolic and neurodegenerative encephalopathies in dogs and cats.
Get PDFMetabolic/neurodegenerative encephalopathies encompass a wide list of conditions that share similar clinical and magnetic resonance imaging (MRI) characteristics, challenging the diagnostic process and resulting in numerous tests performed in order to reach a definitive diagnosis. The aims of this multicentric, retrospective and descriptive study are: (I) to describe the MRI features of dogs and cats with metabolic/neurodegenerative encephalopathies; (II) to attempt an MRI recognition pattern classifying these conditions according to the involvement of grey matter, white matter or both; and (III) to correlate the MRI findings with previous literature. A total of 100 cases were recruited, comprising 81 dogs and 19 cats. These included hepatic encephalopathy (20 dogs and three cats), myelinolysis (five dogs), intoxications (seven dogs and one cat), thiamine deficiency (two dogs and seven cats), hypertensive encephalopathy (three dogs and two cats), neuronal ceroid lipofuscinosis (11 dogs and one cat), gangliosidosis (three dogs and two cats), fucosidosis (one dog), L-2-hydroxyglutaric aciduria (13 dogs and one cat), Lafora disease (11 dogs), spongiform leukoencephalomyelopathy (one dog) and cerebellar cortical degeneration (four dogs and two cats). None of the hepatic encephalopathies showed the previously described T1-weighted hyperintensity of the lentiform nuclei. Instead, there was involvement of the cerebellar nuclei (8/23), which is a feature not previously described. Dogs with myelinolysis showed novel involvement of a specific white matter structure, the superior longitudinal fasciculus (5/5). Thiamine deficiency affected numerous deep grey nuclei with novel involvement of the oculomotor nuclei (3/9), thalamic nuclei, subthalamus and cerebellar nuclei (1/9). Cats with hypertensive encephalopathy had a more extensive distribution of the white matter changes when compared to dogs, extending from the parietal and occipital lobes into the frontal lobes with associated mass effect and increased brain volume. Lysosomal storage disease showed white matter involvement only, with neuronal ceroid lipofuscinosis characterised by severe brain atrophy when compared to gangliosidosis and fucosidosis. All patients with L-2-hydroxyglutaric aciduria had a characteristic T2-weighted hyperintense swelling of the cerebral and cerebellar cortical grey matter, resulting in increased brain volume. Lafora disease cases showed either normal brain morphology (5/11) or mild brain atrophy (6/11). Dogs with cerebellar cortical degeneration had more marked cerebellar atrophy when compared to cats. This study shows the important role of MRI in distinguishing different metabolic/neurodegenerative encephalopathies according to specific imaging characteristics
Framework and effects of the life story work based group intervention ANKOMMEN for adolescents in residential care in Germany. A qualitative analysis of interviews with participants
Get PDFAdolescents in out-of-home care are a high-risk population due to their accumulation of adverse childhood experiences. Furthermore, out-of-home placement itself is a critical life event. Life story work (LSW) is a method for coping with critical life events. However, the need for a high amount of resources makes its implementation in care settings difficult. To improve the accessibility of LSW in residential care, the ANKOMMEN (English “Arriving”) intervention was developed as a manualized and cost-efficient group intervention. This study aims to explore the experiences of adolescents who took part in the intervention in order to examine how participation benefited them and what contributed to these beneficial effects. For this reason, we analyzed n = 48 individual interviews with adolescents after completing the intervention. The focused interview analysis method was used to transcribe and code the interviews. The qualitative analyses revealed that the framework of the intervention helped the participants to open up and to process parts of their history within the group. Moreover, the group setting was a major contributory factor to the positive effects of the intervention by encouraging the participants to exchange their experiences, through mutual peer support and the normalization of adverse thoughts and feelings. Furthermore, participation in the intervention increased self-esteem and self-efficacy in some participants. It contributed to the improvement of positive relationships, helped clarify placement associated events, thoughts and feelings, and improved the acceptance of the placement. Further research is needed to validate these findings and thus widen the range of application of LSW
From Nigeria to New Friendships in the Soviet Union: Educational Mobility during the Cold War (1960-1991)
No full textBetween 1960 and the dissolution of the Soviet Union in 1991, more than 43,500 students from Sub-Saharan Africa graduated from Soviet universities, with Nigerians comprising approximately 12 percent. Their Soviet-sponsored studies constituted a crucial component of the educational "charm offensive," playing a pivotal role in Moscow’s cultural diplomacy. The overreaching goal was to establish a socialist and Soviet-friendly intelligentsia in postcolonial Sub-Saharan Africa. Despite three decades of educational mobility from the South to the East, the perspectives and agency of Nigerian students have received little attention. In particular, there exists a noticeable research gap regarding cultural encounters, such as friendships or experiences of racism. For the Workshop at the Institute of Contemporary History in Ljubljana, I will examine the developed friendships for Nigerians with Soviet and other international students. The daily lives of Nigerian students were intricately woven with interpersonal encounters, driven by housing arrangements and language barriers. Placement in student residences made contacts inevitable, and the deepening of Russian language skills was vital for living and learning behind the Iron Curtain. Consequently, international friendships have developed. To capture the personal experiences of former Nigerian students in the Soviet Union, I use conducted oral history interviews about their memories of interpersonal encounters and the dynamics of (absent) friendships. This comparative micro-level approach will offer new insights into the significance and limitations of international friendships forged behind the Iron Curtain
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