Incorporation of Hydroxyapatite (HA) and Calcium Triphosphate (TCP) in the Epoxy Resin-Based Sealer

Objective This study aims to assess and compare the influence of hydroxyapatite (HA) and tricalcium phosphate (TCP) nanoparticles on a commercially available epoxy resinbased sealer, focusing on porosity and push-out bond strength. Materials and Methods This work was classified into a control group and two experimental groups. In each experimental group, the sealer was mixed with 2.5 wt.% of HA and TCP nanoparticles. Thirty extracted single-rooted teeth were utilized. After sectioning the crowns, the remaining roots of 15 teeth were used, up to 40 to 0.06, using a K3 rotary system. Smear layers were removed with 3 mL of 17% EDTA applied for 60 seconds. Then, the canals were irrigated with 3 mL of 2.25% NaOCl and 5 mL of distilled water. The strength of push-out bonds was tested via an Instron universal testing machine on a 2 mm section acquired from obturated canals. Data were assessed using one-way ANOVA and post hoc tests at a significance level of p < 0.05. Results A nonsignificant difference (p > 0.05) was evident when the three groups were crosschecked in terms of void volume and bond strength. Micro-CT evaluations revealed the lowest volume of voids to be 0.1152 mm3 (2.69%) for the HA group compared with the control group 0.1818 mm3 (3.9%) and the TCP group 0.2194 mm3 (4.33%). Mean bond strength values were 4.18 ± 1.77 MPa for group 1 (control), 4.19 ± 1.54 MPa for group 2 (HA 2.5%) and 3.76 ± 1.95 MPa for group 3 (TCP 2.5%). Groups 1 and 3 showed both cohesive and a mixed type of failure, while group 2 showed adhesive and a mixed type of bond failure. Conclusion Within the limitations of the study, incorporation of 2.5 wt% HA and TCP nanoparticles into AH Plus did not significantly affect the percentage volume of voids and the bond strength negatively.

Extraction vs. Nonextraction on Soft-Tissue Profile Change in Patients with Malocclusion: A Systematic Review and Meta-Analysis

Objectives. We aimed to summarize the current evidence regarding the impact of extraction vs. nonextraction in orthodontic treatment on patients’ soft-tissue profile with malocclusion. Methods. Between April 30th and November 30th, 2020, we searched PubMed and SCOPUS for published papers from inception to November 2020 using “orthodontic,” “extraction,” “nonextraction,” and “Malocclusion.” Included studies were summarized, and relevant data were extracted and analyzed using Review Manager 5.4. Results. Pooled data from four controlled trials demonstrated a nonsignificant difference between extraction and nonextraction in terms of SNA ( MD = 0.50 , 95% CI: -0.37, 1.38; p = 0.26 ), SNB ( MD = 0.11 , 95% CI: -1.23, 1.44; p = 0.88 ), FMA ( MD = 1.82 , 95% CI: -2.39, 6.02; p = 0.40 ), IMPA ( MD = 0.06 , 95% CI: -8.83, -8.94; p = 0.99 ), overjet ( MD = − 1.47 , 95% CI: -6.21, 3.26; p = 0.54 ), and overbite ( MD = 0.50 , 95% CI: -1.40, 2.40; p = 0.60 ). On the other hand, the extraction method significantly increased the ANB compared with the nonextraction group ( MD = 0.78 , 95% CI: 0.25, 1.31; p = 0.004 ). Conclusion. The current evidence demonstrated that nonextraction protocols for orthodontic treatment are a safe and effective alternative to extraction protocols; individually tailored treatment strategies should be applied. More randomized controlled trials are critically needed to safely make an evidence-based treatment conclusion.

PERFORMANCE ASSESSMENT OF CROSSES BETWEEN GADAM AND HARDCORE TANNIN SORGHUM IN HYBRID LINES PRODUCTION

Gadam cultivar of sorghum has been characterized by low yields compared to the international yield levels of sorghum. In this research, Gadam was crossed with Serena, Seredo, and Kari/Mtama-1 in an attempt to increase yield through heterosis. The objective of this study was to determine the level of compatibility and heterosis in crosses between Gadam and the three sorghum lines in a reciprocal crossing. Gadam was crossed with the three lines and their reciprocals to make six treatments that were subjected to compatibility and heterosis tests. The F1 hybrid lines and their parental controls were sown in a randomized complete block design in three replicates. Compatibility and heterosis data variances were analyzed using R statistical software. The cross between Gadam x Serena, Serena x Gadam and the parent Gadam exhibited moderate mean plant height ranging from 99.5 cm to 120.5 cm. The cross Gadam x Serena recorded a desirable negative mid-parent heterosis of -19.89 and -16.16 for plant height and days to maturity respectively. All F1 hybrids recorded positive mid-parent heterosis for the panicle length, the number of reproductive tillers, a thousand seed weight, and the number of tillers per plant. The crosses Gadam x Seredo, Seredo x Gadam, Gadam x Serena and Kari/Mtama-1 x Gadam recorded significantly lower grain filling percentages compared to their parents. In conclusion, the F1 hybrids differed significantly from their reciprocal crosses especially in days of heading, flowering, and maturity indicating a significant maternal influence in these traits. Also, the mid-parent and better parent heterosis had a nonsignificant difference in quantitative traits assessed except for the plant height and grain filling percentage.

Descriptive Comparative Analysis of Patients With Cancer Referring to the Emergency Department of an Italian University Hospital Across the Severe Acute Respiratory Syndrome Coronavirus 2 Waves

PURPOSE: COVID-19 cancer patients (C19-CP) represent a population at high risk for mortality, whose clinical characteristics are still unknown in the second SARS-CoV-2 wave. The aim of this retrospective study was to compare epidemiology and clinical presentation of C19-CP referring to the emergency department (ED) of our institution (San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy), in a 3-week observation period of the first and second COVID-19 waves, starting from the introduction of the corresponding national lockdowns. METHODS: We retrieved ED admissions from March 9 to 29, 2020, for the first wave, and from October 24 to November 13, 2020, for the second wave. We collected clinical characteristics of consecutive patients with molecularly confirmed SARS-CoV-2 infection. We also considered untested or SARS-CoV-2–negative cancer patients referring to the ED in the reference time frames. RESULTS: C19-CP in the second wave exceeded those in the first wave despite the nonsignificant difference (39 of 576 v 8 of 163; P = .5). Compared with nononcological patients, C19-CP were older (median age 70 years [interquartile range 61-77] v 60 years [interquartile range 45-73]; P = .02) and presented more often with ≥ 2 comorbidities (40.4% v 24.3%; P = .02). Compared with nononcological patients, in C19-CP, respiratory failure (29 of 47 v 321 of 692; P = .049) and hospitalization (37 of 47 v 363 of 692; P = .0004) were higher, with comparable frequencies across the waves. Five of 24 and 10 of 27 hospitalized cancer patients in the first and second waves developed SARS-CoV-2 infection during hospitalization. CONCLUSION: C19-CP were a vulnerable population, irrespective of the COVID-19 waves. This highlights the need to prioritize vaccinations in oncological patients to safeguard and guarantee optimal anticancer care.

One-Year Clinical Performance of the Fast-Modelling Bulk Technique and Composite-Up Layering Technique in Class I Cavities

The aim of this study was to assess the one year clinical performance of a new application method, the Fast-Modelling Bulk Technique (FMBT), in comparison to the Composite-Up Layering Technique (CULT) in posterior cavities. Thirty patients with two class I cavities on permanent human molars were enrolled in the present study. A total of sixty class I cavities were prepared and randomly divided according to the restoration technique used: 30 cavities restored by incremental layering technique and modelling of the last layer with Composite-Up Technique (CUT) using the composite Filtek Z250XT (3M ESPE; St. Paul, MN, USA) and the other 30 restored by Bulk Filling technique and modelling of the last layer by Fast-Modelling Technique (FMT) using the composite Filtek Bulk Fill Posterior Restorative (3M ESPE; St. Paul, MN, USA). Restorations were evaluated for up to one year by two observers according to Federation Dentaire Internationale (FDI) criteria, through clinical and radiological exams. Exact Fisher tests were used for statistical analysis. (p ≤ 0.05). From a biological perspective, at baseline, teeth restored with both techniques did not reveal any postoperative sensitivity. However, with time, FMBT showed less postoperative sensitivity and therefore more desirable results than CULT with a nonsignificant difference after one year (p > 0.05). Concerning secondary caries, fracture of the material, and marginal adaptation, no significant difference was noted between both techniques (p > 0.05). Regarding marginal staining, CULT resulted in more staining with a significant difference, as compared to FMBT (p < 0.05). Upon radiological examination, FMBT showed a good marginal fit during the first year, whereas CULT showed small empty voids from baseline with a nonsignificant difference (p = 1.00). After one year of clinical function, both techniques showed promising results. The present study indicates that the new FMBT could have a positive effect on the marginal staining of resin composite.

Development, Characterization and Comparative Phar-macokinetic Evaluation of Ritonavir Nanosuspension, with a Model Nanoemulsion and Coarse Suspension for Improved Oral Delivery

Ritonavir (RV) is an antiretroviral drug, classified as BCS class II pharmaceutical active.It has limited bioavailability due to poor aqueous solubility and first pass metabolism. The purpose of this investigation was to develop optimal nanosuspension and to compare with a model nanoemulsion of RV for improved oral delivery. DSC studies showed good compatibility of excipients with drug. Nanosuspension was prepared by high pressure homogenization, while nanoemulsion was prepared by hot homogenization followed by ultrasonication. All prepared RV formulations were characterized and optimal system was selected and in vivo evaluated. Nanosuspension (F1) formulation containing 0.5% SLS showed homogeneity with least particle size was optimized and compared with coarse (powder) suspension. SEM studies on lyophilized nanosuspension revealed the absence of needle shaped drug crystals, indicating the loss of crystallinity. Prepared a model lipid nanoemulsion. It was having the size, PDI, ZP, EE and assay of 193.14 ± 12.66nm, 0.311 ± 0.04, -27.6 ± 1.184mV, 90.79 ± 0.319% and 99.57 ± 1.25% respectively. Next, a comparative pharmacokinetic study of RV nanosuspenison with respect to lipid nanoemulsion and coarse suspension was performed in male wistar rats. The Cmax of nanosuspension was significantly more when compared to that of NE or coarse drug suspension. The tmax was similar in case of both nanodelivery systems and significantly less when compared to that of coarse suspension. About 1.36 and 1.27 fold improvements in relative bioavailability (BA) of ritonavir via lipid nanoemulsion and nanosuspension were found when compared to coarse suspension. The study results revealed nominal but nonsignificant difference in oral bioavailability for the two nanodelivery systems. Taken together, this study confirmed the potential of nanosuspension and nanoemulsion systems in improving the bioavailability of ritonavir.

Outcomes of Palliative Radiotherapy in Metastatic Epidural Spinal Cord Compression in Lung Cancer—A Prospective Observational Study from Tata Memorial Hospital

Background Metastatic epidural spinal cord compression (MESCC) secondary to lung cancer (LC) is a debilitating complication associated with poor prognosis and is commonly treated with radiotherapy (RT). There is no consensus for RT dose fractionation in spinal cord compression. Methods Forty consecutive patients of LC with radiological evidence of MESCC treated with palliative RT were evaluated for functional outcomes (pain, ambulation, and sphincter function) at 2-, 4-, and 24-week post RT completion. Pain assessment was done using visual analogue scale (VAS) and response was categorized according to international consensus criteria, ambulation status (AS) using Tomita’s scale, and sphincter function by the presence or absence of a catheter. Overall survival (OS) was assessed using Kaplan-Meier method and compared using log-rank test. Impact of potential prognostic factors on survival was also analyzed and p-value ≤0.05 was considered significant. Results Sixteen, 22, and two patients received 8 Gy single fraction (SF), 20 Gy in five fractions (20/5), and 30 Gy in 10 fractions (30/10), respectively. At 2 weeks, overall response (OR) rates of pain, ambulation, and sphincter control were 73, 81, and 81%, respectively. At 4 and 24 weeks, 93.7, 84.3, 87.5% and 88, 94, 76.5% had OR, respectively. Median OS was 4 months. Six- and 12-months OS was 50 and 37.5%. Nonsignificant difference in OS was seen between SF and 20/5 fractions (median 2.2 vs. 7.1 months, p = 0.39). Age ≤50 years was the only significant factor (p <0.05) in univariate analysis for OS. Conclusion Radiotherapy provided equivalent pain control, ambulation, and sphincter function compared with reported literature in MESCC. Nonsignificant difference in OS exists between SF and multifraction RT regimens.

Bond Strength and Microleakage of Different Designs of Occlusal Veeners

The purpose of this study was to investigate fracture strength of different lithium disilicate occlusal veneers designs with different tooth preparations. Material and method: Fifty-six extracted human mandibular molars were collected with relatively comparable size and standardization done by diamond saw and it will receive. 6mm lithium disilicate occlusal veneers. Specimens will be divided into two main groups, each of these groups contains 28 samples (group A&B), the first group represents occlusal veneers with 1.0 ml with radial shoulder finish line design includes axial surfaces for a2 ml length, while the second group represents occlusal veneers preparation without finish line. Each main group will be subdivided into 2 subtypes groups (A1, A2, B1, B2), each subtype group contains 14 samples, the first subtype group will receive a buccal groove, while the second subgroup will be without grooves. Each subgroup will be divided into 2 classes (7 samples) according to the type of test it will be subjected to: microleakage, bond strength. Results: The fracture strength is (mean value+ standard deviation) in plain occlusal reduction without vs with buccal groove(890.36±42.51N), (865.69±36.79N). The fracture strength is (mean value ± standard deviation) in occlusal reduction with radial shoulder, without or with buccal groove (835.36±42.51N), (820.69±36.79N), with nonsignificant difference p value <0.05. Conclusions: All tested occlusal veneer designs proved to withstand normal and parafunctional masticatory forces with non-significant statistical difference.

Renting Poorer Housing: Ecological Relationships Between Tenure, Dwelling Condition, and Income and Housing-Sensitive Hospitalizations in a Developed Country

Background Previous research has shown two-way associations between rental tenure, poorer housing quality, and health outcomes, but little research has looked at relative housing contributions to health outcomes. Aims We investigated whether tenure and/or dwelling condition were associated with housing-sensitive hospitalizations and whether any association differed by income. Method Using a data set of housing characteristics matched to hospitalization records, rental tenure data, and income quintiles, we modeled differences in housing-sensitive hospitalization rates by ecological-level tenure and housing condition, controlling for age-group and mean temperatures. Results There were clear associations between income, tenure, and house condition, and winter-associated hospitalization risk. In the adjusted model, the largest risk differences were associated with neighborhoods with low income (risk ratio [ RR] = 1.48) and high rental tenure ( RR = 1.41). There was a nonsignificant difference for housing condition ( RR = 1.04). Discussion Rental tenure and poor housing condition were risks for housing-sensitive hospitalization, but the association with income was stronger. Higher income households may be better able to offset quality and tenure-related health risks. This research illustrates the inverse housing law: Those most vulnerable, with most need for good-quality housing, are least likely to have it. Income inequity is inbuilt in tenure, quality, and health burden relationships. Conclusion These findings suggest that measures to address health inequities should include improvements to both tenure security and housing quality, particularly in low-income areas. However, policymakers aiming to reduce overall hospitalization rates should focus their efforts on reducing fuel poverty and improving the affordability of quality housing.

Evaluation of the Symmetry of the Levator Veli Palatini Muscle and Velopharyngeal Closure Among a Noncleft Adult Population

Purpose: The goal of this study is to determine the typical range of asymmetry between the length and thickness of the levator veli palatini muscle and to explore the impact of the observed asymmetry on velopharyngeal closure. A second objective is to report normative length and thickness of the levator veli palatini muscle among adults with typical velopharyngeal anatomy. Method: Magnetic resonance imaging (MRI) data and Amira 5.5 Visualization software were used to evaluate the levator veli palatini muscle among 89 participants with typical velopharyngeal anatomy. Flexible nasopharyngoscopy was used to determine the function of velopharyngeal closure among 39 of the 89 participants with typical velopharyngeal anatomy to examine the functional impact of observed asymmetry. Results: Matched paired t tests demonstrated a nonsignificant difference between the length and thickness of the right and left levator muscle. The mean difference between the right and left length of the levator muscle was 2.28 mm but ranged from 0.09 mm to 10.37 mm. In all cases where individuals displayed asymmetry in the levator muscle through MRI, there was no observed impact on the symmetry of velopharyngeal closure. Discussion: This study suggest that differences in the right and left levator veli palatini muscle are not significant among individuals without cleft palate. However, among individual cases where asymmetry was sizeable, there was no direct impact on the closure pattern. This may suggest there are multiple factors that contribute to asymmetrical velopharyngeal closure that are beyond the level of the levator veli palatini muscle.