Influence of ultrasonic agitation on pH and antibiofilm activity of endodontic sealers: an in vitro study

Background: The influence of ultrasonic agitation (UA) on the pH and antibiofilm activity of AH Plus Jet (AHP) and BioRoot RCS (BCS) sealers was evaluated. Subgroups were created based on the sealer/UA application. Material and Methods: The pH was measured at 30 min., 3, 24, 72, 168 h. Antibiofilm activity was determined by direct and indirect contact tests (DCT/ICT) on dual-species biofilms (Enterococcus faecalis and Streptococcus oralis). Bacterial survival was assessed by colony-forming unit (CFU) counting. The Mann-Whitney test was applied for th pH analysis whereas the Kruskall-Wallis and Dunn tests were employed for the DCT/ICT evaluations. Results: BCS presented the highest pH at all time points (p<0.05). Related to UA, it significantly reduced the pH at 30 min., 3, 24 and 72 h (p<0.05). In the DCT, a significant reduction in CFUs was observed in the BCS and BCS/ UA groups compared to the control and AHP/UA group. BCS also showed the best results in the ICT (p<0.05). Conclusions: It was concluded that UA reduced pH and did not improve the sealers’ antibiofilm activity. BCS showed the highest pH values and antibiofilm activity

Innovation Practices in Emerging Economies: Do University Partnerships Matter?

Enterprises’ resources and capabilities determine their ability to achieve competitive advantage. In this regard, the key innovation challenges that enterprises face are liabilities associated with their age and size, and the entry barriers imposed on them. In this line, a growing number of enterprises are starting to implement innovation practices in which they employ both internal/external flows of knowledge in order to explore/exploit innovation in collaboration with commercial or scientific agents. Within this context, universities play a significant role providing fertile knowledge-intensive environments to support the exploration and exploitation of innovative and entrepreneurial ideas, especially in emerging economies, where governments have created subsidies to promote enterprise innovation through compulsory university partnerships. Based on these ideas, the purpose of this exploratory research is to provide a better understanding about the role of universities on enterprises’ innovation practices in emerging economies. More concretely, in the context of Mexico, we explored the enterprises’ motivations to collaborate with universities in terms of innovation purposes (exploration and exploitation) or alternatives to access to public funds (compulsory requirement of being involved in a university partnership). Using a sample of 10,167 Mexican enterprises in the 2012 Research and Technological Development Survey collected by the Mexican National Institute of Statistics and Geography, we tested a multinomial regression model. Our results provide insights about the relevant role of universities inside enterprises’ exploratory innovation practices, as well as, in the access of R&D research subsidies

Effectiveness and costs of phototest in dementia and cognitive impairment screening

<p>Abstract</p> <p>Background</p> <p>To assess and compare the effectiveness and costs of Phototest, Mini Mental State Examination (MMSE), and Memory Impairment Screen (MIS) to screen for dementia (DEM) and cognitive impairment (CI).</p> <p>Methods</p> <p>A phase III study was conducted over one year in consecutive patients with suspicion of CI or DEM at four Primary Care (PC) centers. After undergoing all screening tests at the PC center, participants were extensively evaluated by researchers blinded to screening test results in a Cognitive-Behavioral Neurology Unit (CBNU). The gold standard diagnosis was established by consensus of expert neurologists. Effectiveness was assessed by the proportion of correct diagnoses (diagnostic accuracy [DA]) and by the kappa index of concordance between test results and gold standard diagnoses. Costs were based on public prices and hospital accounts.</p> <p>Results</p> <p>The study included 140 subjects (48 with DEM, 37 with CI without DEM, and 55 without CI). The MIS could not be applied to 23 illiterate subjects (16.4%). For DEM, the maximum effectiveness of the MMSE was obtained with different cutoff points as a function of educational level [k = 0.31 (95% Confidence interval [95%CI], 0.19-0.43), DA = 0.60 (95%CI, 0.52-0.68)], and that of the MIS with a cutoff of 3/4 [k = 0.63 (95%CI, 0.48-0.78), DA = 0.83 (95%CI, 0.80-0.92)]. Effectiveness of the Phototest [k = 0.71 (95%CI, 0.59-0.83), DA = 0.87 (95%CI, 0.80-0.92)] was similar to that of the MIS and higher than that of the MMSE. Costs were higher with MMSE (275.9 ± 193.3€ [mean ± sd euros]) than with Phototest (208.2 ± 196.8€) or MIS (201.3 ± 193.4€), whose costs did not significantly differ. For CI, the effectiveness did not significantly differ between MIS [k = 0.59 (95%CI, 0.45-0.74), DA = 0.79 (95%CI, 0.64-0.97)] and Phototest [k = 0.58 (95%CI, 0.45-0.74), DA = 0.78 (95%CI, 0.64-0.95)] and was lowest for the MMSE [k = 0.27 (95%CI, 0.09-0.45), DA = 0.69 (95%CI, 0.56-0.84)]. Costs were higher for MMSE (393.4 ± 121.8€) than for Phototest (287.0 ± 197.4€) or MIS (300.1 ± 165.6€), whose costs did not significantly differ.</p> <p>Conclusion</p> <p>MMSE is not an effective instrument in our setting. For both DEM and CI, the Phototest and MIS are more effective and less costly, with no difference between them. However, MIS could not be applied to the appreciable percentage of our population who were illiterate.</p

Diabetes mortality and trends before 25 years of age: an analysis of the Global Burden of Disease Study 2019

Background Diabetes, particularly type 1 diabetes, at younger ages can be a largely preventable cause of death with the correct health care and services. We aimed to evaluate diabetes mortality and trends at ages younger than 25 years globally using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. Methods We used estimates of GBD 2019 to calculate international diabetes mortality at ages younger than 25 years in 1990 and 2019. Data sources for causes of death were obtained from vital registration systems, verbal autopsies, and other surveillance systems for 1990–2019. We estimated death rates for each location using the GBD Cause of Death Ensemble model. We analysed the association of age-standardised death rates per 100 000 population with the Socio-demographic Index (SDI) and a measure of universal health coverage (UHC) and described the variability within SDI quintiles. We present estimates with their 95% uncertainty intervals. Findings In 2019, 16 300 (95% uncertainty interval 14 200 to 18 900) global deaths due to diabetes (type 1 and 2 combined) occurred in people younger than 25 years and 73·7% (68·3 to 77·4) were classified as due to type 1 diabetes. The age-standardised death rate was 0·50 (0·44 to 0·58) per 100 000 population, and 15 900 (97·5%) of these deaths occurred in low to high-middle SDI countries. The rate was 0·13 (0·12 to 0·14) per 100 000 population in the high SDI quintile, 0·60 (0·51 to 0·70) per 100 000 population in the low-middle SDI quintile, and 0·71 (0·60 to 0·86) per 100 000 population in the low SDI quintile. Within SDI quintiles, we observed large variability in rates across countries, in part explained by the extent of UHC (r2=0·62). From 1990 to 2019, age-standardised death rates decreased globally by 17·0% (−28·4 to −2·9) for all diabetes, and by 21·0% (–33·0 to −5·9) when considering only type 1 diabetes. However, the low SDI quintile had the lowest decline for both all diabetes (−13·6% [–28·4 to 3·4]) and for type 1 diabetes (−13·6% [–29·3 to 8·9]). Interpretation Decreasing diabetes mortality at ages younger than 25 years remains an important challenge, especially in low and low-middle SDI countries. Inadequate diagnosis and treatment of diabetes is likely to be major contributor to these early deaths, highlighting the urgent need to provide better access to insulin and basic diabetes education and care. This mortality metric, derived from readily available and frequently updated GBD data, can help to monitor preventable diabetes-related deaths over time globally, aligned with the UN's Sustainable Development Targets, and serve as an indicator of the adequacy of basic diabetes care for type 1 and type 2 diabetes across nations.publishedVersio

Evaluation of the cyclic and torsional fatigue resistance of thermally treated hyflex CM versus aurum blue nickel-titanium rotary instruments

Introduction: We aim to evaluate the cyclic and torsional fatigue resistance of two rotary instrumentsinstruments, Hyflex CM 25/0.06 (HCM) (Coletene-Whaledent, Allstetten, Switzerland) and Aurum Blue (AB) 25/0.06 (Meta-Biomed, Republic of Korea). Methods and Materials: Forty rotary instruments, HCM 25/0.06 and AB 25/0.06 (n=20 each) were used. The instruments were rotated in an artificial stainless steel canal with a 60° angle and a 5-mm radius of curvature (n=10) at body temperature (35°±1°C). The torsional test evaluated the torque and angle of rotation at failure of new instruments (n=10) in the portion 3 mm from the tip according to ISO 3630-1. The fractured surface of each fragment was observed by scanning electron microscopy. The data were analyzed using unpaired student’s t- test, and the level of significance was set at 5%. Results: AB 25/0.06 had significantly greater number of cycles to failure than HCM 25/0.06 (P0.05). Conclusion: Based on this in vitro study, AB 25/0.06 instrument was more resistant to cyclic fatigue than the HCM 25/0.06 instrument, suggested that these instruments are safer than HCM 25/0.06 for the preparation of severely curved canals. However; there was no significant difference in the torsional properties of the two instruments then appear to have similar performance during constricted canal preparation.Full Tex

Micro-computed tomography evaluation of maxillary molars mesiobuccal canal preparation using BioRaCe and AlphaKite rotary NiTi systems

Objective: The aim of this study was to evaluate root canal preparation of two nickel-titanium (NiTi) rotary systems (BioRaCe, FKG, Switzerland and AlphaKite, Komet, Germany) using micro-computed tomography (Micro-CT). Material and Methods: A total of 20 maxillary first molars, extracted for periodontal and prosthetic reasons, were divided into two groups (n = 10) and scanned by SkyScan 1172. Root canals were irrigated with 2.5% NaOCl between each file change, the root canal preparation was performed up to instrument 35.04 of both BioRaCe and AlphaKite rotary systems. After root canal preparation, teeth were rescanned by micro-CT. The amount of canal transportation, centering ability of rotary instruments and canal variations were analyzed. Results: There was no significant difference in canal transportation between the two rotary systems at any level (p > 0.05). Conclusion: BioRaCe and AlphaKite instruments showed minimal canal transportation and good centering ability at all areas of the root canal, with no significant difference between the two systems. Root canal curvature did not seem to influence the results.Full Tex