Micro-CT Assessment of Filling Removal Effectiveness in the Apical Third of Curved Canals with Different Types of Anatomy

Introduction: The aim of this study was to assess the effectiveness of filling removal material from the apical third of curved mesial root canals of mandibular molars. Reciprocating instrumentation followed by additional rotary instrumentation with instruments made of alloys with different heat treatments was evaluated. Materials and Methods: Thirty-six mesial roots of mandibular molars were divided into two groups: Group Class IV consisted of 16 roots with two independent canals, and Group Class II consisted of 20 roots with two canals that merged into one at their apical level. Each of these two groups were further divided into two subgroups, according to the additional rotary instrument used after the reciprocating instrumentation: Group RH and Group RM for Hyflex and Mtwo, respectively. After each procedural step, the roots were scanned by micro-tomography. After each step of filling removal, the Wilcoxon matched pair test and the Mann-Whitney test were used for the evaluation between groups. The significance level adopted was 5%. Results: Significant differences were observed between groups with different Class II and Class IV anatomies, regarding filling removal after Reciproc (P<0.05). After the use of an additional rotary instrumentation, no differences were observed between the two groups (P>0.05). Conclusions: In the apical third of mesial roots of mandibular molars with Class II anatomy, an additional rotary instrumentation was shown to be necessary for improving the removal of filling material after using the single-file reciprocating instrumentation technique

Black Grass Jelly Encapsulated Lactobacillus plantarum Mar8 in Honey and D-Allulose Beverage Enriched with Mangosteen Pericarp Extract

Abstract Background and Objective: Black grass jelly served in sweet syrup is one of the Chinese and East and Southeast Asian traditional beverages. An innovative enrichment can make it a better functional food. This study innovatively enriched the black-jelly food with formulas of probiotic Lactobacillus plantarum Mar8, honey, D-allulose and mangosteen pericarp extract. The probiotic viability, antioxidant and hypoglycemic potential were investigated as well. Material and Methods: Ready-to-drink functional beverages included mangosteen pericarp extract varied in concentrations of 0.1, 0.2 and 0.4 mg ml-1, D-allulose in honey and encapsulated probiotic Lactobacillus plantarum Mar8 in black grass jelly containing konjac and carrageenan. The probiotic viability, antioxidant activity and hypoglycemic potential were the selective parameters for the functional beverage formulas. The viability of probiotic Lactobacillus plantarum Mar8 was assessed using total plate count method. Antioxidant activity was assessed based on the reaction of 2,2-Diphenyl-1-picrylhydrazyl radical scavenging. Hypoglycemic potential was investigated by counting petite yeast cells after treating with black grass jelly formulas. Significant differences were reported using one-way analysis of variance and Duncan's test. Statistically significance included p-values≤0.05. Results and Conclusion: The probiotic Lactobacillus plantarum Mar8 encapsulated in black grass jelly survived well in the honey, D-allulose and mangosteen pericarp extract formulated beverages. Honey supported the probiotic viability better, producing further antioxidants and high potentials in hypoglycemia than that those of other formulas did. Mangosteen pericarp extract enriched the functionality of the black grass jelly probiotic beverages. However, further studies are needed to assess favorability and stability of this functional food. Conflict of interest: The authors declare no conflict of interest

Preoperative Pulmonary Function test and Pulse Oximetry among Patients Recovered from COVID-19 Who Were Candidates for Elective Surgery

Background: This descriptive study aimed to assess preoperative pulmonary function test (PFT) results and pulse oximetry readings in patients recovered from COVID-19 who were candidates for elective surgery.Materials and Methods: This is a descriptive study. A total of 110 patients (men = 51) with a mean age of 52.6 years were enrolled in the study. The study protocol was presented to the ethics committee and received approval. Participants included patients with a positive SARS-CoV-2 PCR test history, with a recovery period of at least 6-8 weeks for symptomatic patients and four weeks for asymptomatic patients. Data collection involved a random selection, obtaining informed consent, and conducting a history and physical examination. Pulmonary function capacity and oxygen saturation were assessed, and frailty was evaluated using the Edmonton Frail Scale. Echocardiography and electrocardiography were performed on all patients.Results: The study participants mainly underwent trans-ureteral lithotripsy (TUL), laparoscopic cholecystectomy (LC), and percutaneous nephrolithotomy (PCNL). Symptomatic patients exhibited lower pulse oximetry readings than asymptomatic patients (91.18% vs. 96.13%, p-value = 0.005). Although the average ejection fraction was slightly lower in symptomatic patients (44.25%) compared to asymptomatic patients (48.18%), the difference was insignificant. Symptomatic patients also had higher rates of abnormalities in chest X-rays, electrocardiograms, pulmonary function tests, and fasting blood sugar levels, as well as a higher rate of ICU admission.Conclusion: Comprehensive preoperative evaluations, including pulmonary function and oxygenation assessment, are crucial for COVID-19 survivors undergoing elective surgery. Symptomatic patients showed lower pulse oximetry readings and higher respiratory and cardiovascular abnormalities rates. These findings emphasize the importance of optimizing perioperative management and minimizing complications by thoroughly assessing patients' preoperative health status

Temperature Rise and Pain Following the Use of 810 and 980 nm Diode Lasers for Second-Stage Dental Implant Surgery: A Clinical Trial: Comparing two laser wavelengths in the second stage implant surgery

Introduction: Many surgical procedures in soft tissue are performed using diode lasers. This study aimed to assess the temperature rise and pain following the use of 810 and 980 nm diode lasers for second-stage dental implant surgery.Methods: This clinical trial was conducted on 24 osseointegrated dental implants that were randomly divided into two groups of 810 nm and 980 nm diode lasers. The temperature rise in each group was measured right after uncovering by the laser and 15 minutes later by a thermocouple, compared with the baseline temperature of gingival tissue. The level of pain was also measured at 24 hours postoperatively by using a visual analog scale. Data were analyzed by ANOVA, Tukey’s test, and t test (alpha=0.05).Results: Within-group comparisons by ANOVA showed a significant difference in tissue temperature between the three-time points in both groups (P<0.0001). Pairwise comparisons by Tukey’s test showed that the temperature at baseline (P<0.0001) and 15 seconds after uncovering was significantly lower than that immediately after uncovering in both groups (P<0.0001). The mean tissue temperature and the mean pain score in the 980 nm laser group were significantly higher than the corresponding values in the 810 nm laser group (P<0.05).Conclusion: According to the results, temperature rise in the use of the 980 nm laser was higher than the 810 nm laser. The use of 810 nm diode laser was associated with lower temperature rise and significantly lower pain score after 24 hours

Evaluation of the Effect of Photobiomodulation on Radiation-Induced Xerostomia in Head and Neck Cancer Patients: A Randomized Clinical Trial: Photobiomodulation on radiation-induced xerostomia in head and neck cancer patients

Introduction: Radiotherapy-induced xerostomia is an important side effect of head and neck cancer (HNC) treatment. Photobiomodulation (PBM) is one of the new emerging methods for preventing or reducing this problem. The aim of this study is to evaluate the effect of PBM on radiation-induced xerostomia in HNC patients.Methods: Thirty-seven patients with HNC were referred for radiotherapy to Mashhad Cancer Center. In the case group, an infrared diode laser was used in contact mode on 16 points (covering minor and major salivary glands). The device emitted a wavelength of 810 nm and operated at the power of 200 mW and continuous wave mode. Each area was irradiated for 4 seconds in contact mode with gentle pressure, and the laser energy was 0.8 J with an energy density of 2.85 J/cm2 at the surface of the probe (spot size, 0.28 cm2). The total dose was 45.6 J/cm2. The power density was 714.2 w/cm2. In the control group, the sham laser device was used. Subjective xerostomia was evaluated through the LENT SOMA scale (LSS). Stimulated and unstimulated saliva was also assessed. Data were analyzed with SPSS 22 statistical software.Results: The study included 26 men and 11 women with a mean age of 55.6±15.3 years. In the sixth week, the case group produced more stimulated saliva than the control group (P=0.006). They also had less subjective xerostomia than the control group in weeks four to six.Conclusion: In the present study, PBM had a preventive effect on stimulated saliva and subjectivexerostomia and can be recommended as an adjunctive treatment. Further studies with a highersample size and the use of a low-level laser in more sessions are needed for definitive comment

Combined Light and Thermal Stimulation of Bone Marrow Stem Cells: Cell thermo-photobiomodulation

Introduction: The purpose of this study is to achieve a significant increase in the proliferative activity of mesenchymal stem cells (MSCs) of the bone marrow (BM) at early passages after laser exposure to a suspension of these cells and to estimate the effect of light and heat components of laser radiation on the proliferation of BM MSCs.Methods: The studies were performed on rats with BM MSCs. MSC suspension was placed into the wells and heated by using laser radiation (980 nm wavelength) or a water bath at 70 °C providing similar temperature dynamics. The studies were carried out in 3 comparison groups: (1) control suspension of MSCs, which was not subjected to heating in a water bath or laser exposure; (2) MSC suspension, which was heated in a water bath; and (3) suspension of MSCs, which was subjected to laser exposure. The exposure times for the 2nd and 3rd experimental groups were 10- 50 seconds.Results: Under optimal parameters of laser action on the suspension of BM MSCs, a six-fold increase in the number of BM MSCs colonies was registered compared to the control. The role of the light and heat components of laser exposure to MSCs was determined by comparable heating of a suspension of BM MSCs in a water bath, at which only a twofold increase in the number of colonies was maximally obtained.Conclusion: The increase in the MSC proliferation activity occurs due to their ThermoPhotobiomodulation. The result obtained is important for practical use in cell transplantation in the treatment of traumatic injuries of bone, cartilage, and tendon tissues when a rapid and multiple increase in the initial number of autologous BM MSCs is required

A 980 nm Diode Laser as an Adjunctive Therapy on the Healing of Apical Periodontitis Following Endodontic Retreatment: A Randomized Controlled Clinical Trial Study: Effect of diode laser on the healing of apical periodontitis

Introduction: Apical periodontitis is one of the common dental diseases. Microorganisms are the main reasons for these lesions; irrigations are used to remove them, but because of limited penetration, the rinsing agents may not always kill the microorganisms. Laser irradiation is effective in canal disinfection. The goal of this study was to compare the effect of calcium hydroxide (Ca(OH)2) and diode laser on the improvement of apical periodontitis following root canal retreatment (RCR). Methods: Twenty-four teeth of 19 patients with periapical lesions which needed RCR were divided into two groups (Ca(OH)2 and Ca(OH)2+laser irradiation [LI]). In the first session, after gutta-percha removal, cleaning, and shaping, Ca(OH)2 was used for 10 days. In the secondsession, in the Ca(OH)2+LI group, the irradiation utilizing a diode laser (using non-initiated 200- µm fiber, continuous wave (CW), power output of 1W) was done. The periapical radiographic healing was assessed before the retreatment and after 3-month and 6-month follow-ups by periapical index (PAI) Qrstavik. The quantitative data were analyzed (P<0.05). Results: The initial periapical lesion score was 3.75 and 3.88 in the Ca(OH)2 and Ca(OH)2+LIgroups, respectively. In the Ca(OH)2 and Ca(OH)2+LI groups, 3 months after the RCR, the average periapical lesion score was 2.94 and 3.05, respectively. In the Ca(OH)2 and CA(OH)2+LI groups, 6 months after the RCR, the average periapical lesion score was 1.80 and 1.75, respectively. No significant differences were found at the 3 and 6 months between the experimental groups. Conclusion: The diode laser can reduce the periapical lesion, but there was no significant difference between CA(OH)2+LI and Ca(OH)2 at 3-month and 6-month follow-ups

تبیین زیبایی‌شناسی اخلاق‌مدار از دیدگاه مدیران پرستاری

Background and Aim: Aesthetic leadership is a leadership style closely intertwined with ethical leadership. This style is values-based and focused on promoting ethical behaviors, with a strong ethical goal centered on values of justice and fairness. This study aimed to explore ethical aesthetics from the perspective of nursing managers at Tehran University of Medical Sciences. Methods: This descriptive qualitative study used a customary content analysis with the approach of Graneheim and Lundman. The study population included the leadership and management team of hospitals affiliated with Tehran University of Medical Sciences. Data collection was done through semi-structured, face-to-face interviews. The sampling method was purposive snowball sampling and participants were selected until data saturation was reached. A total of 28 interviews were conducted with matrons, supervisors and head nurses. Ethical Considerations: The study was approved by the ethics committee. Ethical considerations such as obtaining informed consent, voluntary participation, explaining the research objectives and ensuring confidentiality were adhered to. Results: After analysis, three main categories and sub-categories were identified. The main categories included aesthetic ethical thinking (self-discipline, absence the sense of superiority, respect in work, empathy and understanding of others, altruism, having a clear conscience, attention to human dignity, adherence to professional ethics principles), aesthetic ethical behavior (efforts to uphold employee rights, ethical judgments, ethical disciplinary methods, appreciation and recognition of staff efforts, adherence to justice, patience, forgiveness, altruism in behavior) and aesthetic ethical speech (respectful communication, courage in speech, fairness in speech, preservation of human dignity in speech, honesty and truthfulness in speech, respecting individuals' privacy in speech). Conclusion: The aesthetics of ethics is an internalized ethical inclination that leads to actions (speech and behavior) grounded in human aesthetic values, goodness, benefit and truth. This research can strengthen the theoretical foundation of aesthetic leadership and complement the model of aesthetic nursing leadership within the healthcare system. It also contributes to the objectification and clarification of the concept of beauty and the sublime beauty of ethics in organizational life and nursing leadership and management in the Iranian healthcare system.زمینه و هدف: رهبری زیباشناخت‌گرا یکی از سبک‌های رهبریست که با سبک رهبری اخلاقی عجین است. این سبک، ارزش‌مدار و معطوف به بروز رفتار‌های اخلاقی و به عنوان یک سبک رهبری با هدف اخلاقی قوی حول ارزش‌های عدالت، انصاف در نظر گرفته می‌شود و مروج اهداف اخلاقی می‌باشد. این مطالعه با هدف تبیین زیبایی‌شناسی اخلاق‌مدار از دیدگاه مدیران پرستاری در دانشگاه علوم پزشکی تهران انجام شده است. روش: مطالعه حاضر، مطالعه كیفی با روش تحلیل محتوی مرسوم با رویکرد Graneheim و Lundman است. جامعه پژوهش شامل تیم رهبری و مدیریت بیمارستان‌های دانشگاه علوم پزشکی تهران بود و جمع‌آوری داده‌‌ها، به صورت مصاحبه فردیِ عمیق نیمه‌ساختارمند و چهره به چهره انجام شد. روش نمونه‌گیری، هدفمند و گلوله برفی بوده است و تعداد مشارکت‌کنندگان تا اشباع داده‌‌ها انتخاب شدند و در مجموع 28 مصاحبه با مترون، سوپروایزر، سرپرستار انجام شد. ملاحظات اخلاقی: این مطالعه توسط کمیته اخلاق تأیید شده است. ملاحظات اخلاقی نظیر تکمیل فرم رضایت آگاهانه کتبی، مشارکت داوطلبانه، توضیح اهداف تحقیق و اطمینان در مورد محرمانه‌بودن اطلاعات رعایت گردید. یافته‌‌ها: پس از تحلیل، سه طبقه اصلی و زیرطبقات شناسایی گردید. محوریت طبقات اصلی حاصل از تحلیل نهایی عبارت از تفکر زیباشناخت اخلاق‌مدار (خودآیینی‌داشتن، احساس تفوق و ریاست‌نداشتن، اعتقاد به احترام در کار، تلاش برای مفاهمه و درک افراد، خیرخواهی برای دیگران، داشتن وجدان بیدار، توجه داشتن به کرامت انسانی، پایبندبودن به اصول اخلاق حرفه‌ای)، رفتار زیباشناخت اخلاق‌مدار (تلاش برای احقاق حقوق کارکنان، قضاوت اخلاق‌مدارانه، استفاده از روش‌های تنبیهی اخلاق‌مدارانه، قدردانی و دیدن زحمات کارکنان، رعایت‌کردن عدالت، صبوربودن، گذشت‌داشتن، خیرخواهی در رفتار)، گفتار زیباشناخت اخلاق‌مدار (رعایت احترام در گفتار، شجاعت‌داشتن در گفتار، انصاف‌داشتن در گفتار، حفظ کرامت انسانی در گفتار، صداقت و راستگویی در کلام، رعایت حریم افراد در کلام) می‌باشد. نتیجه‌گیری: زیبایی‌شناسی اخلاق‌مدار نوعی گرایش اخلاقی درونی شده است که به کنش (گفتار و رفتار) با ارزش‌های زیباشناسانه انسانی، خیر، سودمندی و حقیقت منجر خواهد شد. این پژوهش، می‌تواند سبب تحکیم مبانی نظری رهبری زیباشناخت‌گرا گردد و تکمیل‌کننده مدل رهبری پرستاری زیباشناخت‌گرا در نظام مراقبت سلامت می‌باشد. همچنین به عینی‌سازی و تبیین مفهوم زیبایی و والایی زیبایی اخلاق در زیست سازمانی و رهبری و مدیریت پرستاری در نظام مراقبت سلامت ایران کمک می‌کند

تبیین مدل معادلات ساختاری پایداری خانواده بر اساس شناخت اجتماعی و عشق با میانجی‌گری مهارت‌های ارتباطی در شهر تهران

Background and Aim: The family, as the most stable social unit, is the main source of individual growth and a fundamental axis for the healthy functioning of individuals and society. Due to the importance of the family, many studies have been conducted in relation to it, most of which, of course, have focused on variables that are the cause of family disintegration. So in the situation of severe lack of research related to family stability, this article raised the question of whether it is possible to predict family stability based on social cognition and love with the mediation of communication skills. Methods: The present study was a correlational survey (structural equation model explanation). The statistical population of the study included the citizens of Tehran, 400 of who were selected by multi-stage cluster random sampling. The data collection tool included a researcher-made questionnaire of family stability, social cognition and communication skills and Sternberg's Love Questionnaire. SPSS 26 and AMOS 23 software were used for data analysis. Ethical Considerations: In compiling this article, ethical aspects including maintaining the authenticity of the texts, honesty and trustworthiness and informed consent have been observed. Also, all the questionnaires have been completed without the names and personal information of the individuals. Results: Correlation findings showed that social cognition, communication skills and love have a positive and significant correlation with family stability. Also, social cognition and love have a positive and significant correlation with communication skills. The model data also showed that the CFI and NFI indexes in the model are equal to 0.999 and 0.995 respectively, which indicate the acceptable fit of the model. RMSEA value is equal to 0.077 and a value less than 0.08 which means a good fit. GFI is also equal to 0.996, which indicates a good fit. As a result, it can be concluded from all the indicators that the research model has a good fit. Conclusion: By increasing each of the variables of social cognition, love and communication skills, family stability increases.زمینه و هدف: خانواده‎‏ به عنوان پایدارترین واحد اجتماعی، منبع اصلی رشد فردی و محوری اساسی برای عملکرد سالم افراد و جامعه می‌باشد. با توجه به اهمیت خانواده مطالعات بسیاری در ارتباط با آن انجام شده است که البته بیشتر آن‌ها بر متغیرهایی تمرکز کرده‌اند که مایه ازهم‌پاشیدن خانواده هستند. این مقاله در وضعیت فقدان شدید پژوهش‌های مرتبط با پایداری خانواده به طرح این پرسش پرداخت که آیا می‌توان بر اساس شناخت اجتماعی و عشق با میانجی‌گری مهارت‌های ارتباطی، پایداری خانواده را پیش‌بینی نمود؟ روش: پژوهش حاضر، پیمایشی از نوع همبستگی (تبین مدل معادلات ساختاری) بود. جامعه آماری پژوهش شامل شهروندان شهر تهران بود که 400 نفر از آن‌ها به صورت نمونه‌گیری تصادفی خوشه‌ای چندمرحله‌ای انتخاب شد. ابزار گردآوری اطلاعات شامل پرسشنامه محقق‌ساخته پایداری خانواده، شناخت اجتماعی و مهارت‌های ارتباطی و پرسشنامه عشق Sternberg بود. برای تجزیه و تحلیل داده‌ها از نرم‌افزار SPSS 26 و AMOS 23 استفاده شد. ملاحظات اخلاقی: در تدوین این مقاله جنبه‌های اخلاقی شامل حفظ اصالت متون، صداقت و امانتداری و رضایت و اطلاع‌رسانی، رعایت شده است. همچنین کلیه پرسشنامه‌ها بدون نام و اطلاعات شخصی افراد تکمیل گردیده است. یافته‌ها: یافته‌های همبستگی نشان داد که به ترتیب شناخت اجتماعی، مهارت‌های ارتباطی و عشق همبستگی مثبت و معنی‌داری با پایداری خانواده دارند. همچنین شناخت اجتماعی و عشق همبستگی مثبت و معنی‌داری با مهارت‌های ارتباطی دارند. داده‌های مدل نیز نشان داد که شاخص‌های CFI و NFI به ترتیب در مدل برابر 999/0 و 995/0 هستند که نشان‌دهنده برازش قابل قبول مدل می‌باشند. مقدار RMSEA برابر است با 077/0 و مقدار کمتر از 08/0 که به معنای برازش خوب است. GFI نیز برابر 996/0 می‌باشد که نشانگر برازش مطلوب است، در نتیجه از تمامی شاخص‌ها اینطور استنباط می‌شود که مدل پژوهش برازش مطلوبی دارد. نتیجه‌گیری: با افزایش هر یک از متغیرهای شناخت اجتماعی، عشق و مهارت‌های ارتباطی، پایداری خانواده افزایش می‌یابد

Impact of Inward Internationalization on Outward Internationalization in Enhancing Organizational Capabilities in Iranian Pharmaceutical Companies

Background: The objective of this study was to propose a model for examining the impact of inward internationalization on outward internationalization in Iranian pharmaceutical companies by focusing on organizational capabilities. Methods: Qualitative research was employed, and the grounded theory approach was utilized for data analysis. The study involved conducting interviews with 16 individuals who possessed experience in international activities within the pharmaceutical sector and expertise, using the snowball sampling method. The data gathered from the interviews underwent open, axial, and selective coding analyses, resulting in the development of a paradigm model of internationalization within the pharmaceutical industry. The paradigm model is composed of causal conditions, background conditions, intervening conditions, central phenomena, strategies, and consequences. Results: The research findings indicated that causal factors of internationalization encompass learning from other countries, updating medical and technical knowledge, expanding activities beyond domestic markets, facilitating production quality improvement, and promoting growth within the pharmaceutical industry. Strategies for internationalization include adopting an international perspective, implementing effective macro-level policies, utilizing long-term strategies, enhancing workforce professional capabilities through training, improving standards and documentation, devising strategies for rational budget utilization, planning for optimal capacity utilization, and strengthening international communication and political relationships. Conclusion: Ultimately, the consequences of inward internationalization and the enhancement of organizational capabilities lead to outward internationalization and a favorable position within the global pharmaceutical industry, improvements in organizational capabilities and international relations, development of cross-border business, economic prosperity within the pharmaceutical industry, and heightened commitment to foreign markets