Apolipoprotein E genotype does not moderate the associations of depressive symptoms, neuroticism and allostatic load with cognitive ability and cognitive aging in the Lothian Birth Cohort 1936

<div><p>Objectives</p><p>In this replication-and-extension study, we tested whether depressive symptoms, neuroticism, and allostatic load (multisystem physiological dysregulation) were related to lower baseline cognitive ability and greater subsequent cognitive decline in older adults, and whether these relationships were moderated by the E4 allele of the apolipoprotein E (<i>APOE</i>) gene. We also tested whether allostatic load mediated the relationships between neuroticism and cognitive outcomes.</p><p>Methods</p><p>We used data from the Lothian Birth Cohort 1936 (<i>n</i> at Waves 1–3: 1,028 [<i>M</i> age = 69.5 y]; 820 [<i>M</i> duration since Wave 1 = 2.98 y]; 659 [<i>M</i> duration since Wave 1 = 6.74 y]). We fitted latent growth curve models of general cognitive ability (modeled using five cognitive tests) with groups of <i>APOE</i> E4 non-carriers and carriers. In separate models, depressive symptoms, neuroticism, and allostatic load predicted baseline cognitive ability and subsequent cognitive decline. In addition, models tested whether allostatic load mediated relationships between neuroticism and cognitive outcomes.</p><p>Results</p><p>Baseline cognitive ability had small-to-moderate negative associations with depressive symptoms (<i>β</i> range = -0.20 to -0.17), neuroticism (<i>β</i> range = -0.27 to -0.23), and allostatic load (<i>β</i> range = -0.11 to 0.09). Greater cognitive decline was linked to baseline allostatic load (<i>β</i> range = -0.98 to -0.83) and depressive symptoms (<i>β</i> range = -1.00 to -0.88). However, <i>APOE</i> E4 allele possession did not moderate the relationships of depressive symptoms, neuroticism and allostatic load with cognitive ability and cognitive decline. Additionally, the associations of neuroticism with cognitive ability and cognitive decline were not mediated through allostatic load.</p><p>Conclusions</p><p>Our results suggest that <i>APOE</i> E4 status does not moderate the relationships of depressive symptoms, neuroticism, and allostatic load with cognitive ability and cognitive decline in healthy older adults. The most notable positive finding in the current research was the strong association between allostatic load and cognitive decline.</p></div

Influenza della variabile operatore sulla qualità dell'otturazione canalare: studio in vitro [Influence of operator-dependent-variable on the quality of root canal obturation: An in vitro study]

OBJECTIVES The aim of this study was to assess if the operator's experience could influence the quality of root canal fillings performed with two different techniques: continuous wave of condensation technique and carrier based technique. MATERIALS AND METHODS Sixty standardized endo-training- blocks in resin were used for this study. All blocks were divided into 3 groups of 20 each. A chosen operator was then assigned to each group based on his own clinical experience level: inexperienced, average expert, expert. Each operator has filled a group of endocranial block using the two different techniques. The 60 filled blocks were finally x-rayed and analyzed. RESULTS Statistically significative differences were observed between root canal fillings performed with carrier based technique by the expert operator and root canal fillings performed with continuous wave of condensation technique and carrier based technique by the inexperienced operator. Furthermore, statistically significative differences were observed as regard apical extension parameter, between canal filling performed with both techniques by the inexperienced operators. CONCLUSIONS Within the limits of this in vitro study, it was concluded that the control of apical extension was the standard which defined a better x-ray quality of root canal fillings, when realized by expert operators rather than when realized by inexperienced operators. When the inexperienced operator used continuous wave of condensation technique, obtained better results in terms of apical extension compared to carrier based technique

End-of-life experiences in dementia with Lewy bodies: Qualitative interviews with former caregivers.

BackgroundDementia caregivers describe knowing what to expect as an unmet need and many are unaware that dementia can be a terminal condition. Dementia with Lewy bodies (DLB) is a common neurodegenerative dementia with unique features which may affect the end of life (EOL). Given the paucity of data on EOL experiences in dementia and unique aspects of DLB affecting EOL, we investigated EOL experiences as reported by caregivers of individuals with DLB.MethodWe conducted telephone interviews with caregivers and family members of individuals who died with DLB in the last 5 years using a semi-structured questionnaire to identify and describe EOL experiences. We used a qualitative descriptive approach to analyze interview transcripts and identify common themes.ResultsThirty individuals participated in interviews. Key themes included lack of knowledge regarding what to expect, end-of-life time course (including end-of-life symptoms, declines after hospitalization and falls, and varied EOL trajectories), advance care planning, lack of family understanding, hospice, views regarding right-to-die, medications at the end of life, approaching end of life, the death experience, and activities that enhanced end of life. Lack of communication between health care teams and families and difficulty predicting death timing were two frequently expressed challenges.ConclusionsStudy results emphasize the need for improved EOL counseling in DLB, recognition of EOL symptoms, earlier hospice involvement, tailoring EOL care to DLB-specific needs, and clinician-family communication. Suggestions for patient and family education are provided. Further research should confirm predictors of approaching EOL in DLB, identify strategies to improve physician recognition of EOL, and develop tools to aid communication and quality EOL care

Influence of Access Cavity Preparation and Remaining Tooth Substance on Fracture Strength of Endodontically Treated Teeth

Introduction: The purpose of this study was to assess the impact of access cavity preparation and the remaining tooth substance on the fracture strength of endodontically treated teeth. Methods: One hundred sound mandibular first and second molar teeth were selected and divided into 1 control and 9 test groups (n = 10/group) as follows: control group, intact teeth; group 1, teeth prepared with traditional endodontic access cavity (TEC); group 2, teeth prepared with conservative endodontic access cavity (CEC); group 3, teeth prepared with truss endodontic access cavity (TREC); group 4, TEC + 3 residual walls; group 5, CEC + 3 residual walls; group 6, TREC + 3 residual walls; group 7, TEC + 2 residual walls; group 8, CEC + 2 residual walls; and group 9, TREC + 2 residual walls. After access cavity preparation, all test teeth were endodontically treated and restored. The specimens were then loaded to fracture in a universal loading machine (Triaxial Tester T400 Digital; Controls srl, Cernusco, Italy), and fracture values were recorded in newtons. The data were analyzed with 2-way analysis of variance and Tukey post hoc analysis for multiple comparisons (P &lt;.05). Results: Intact teeth were more resistant to fracture than the teeth in all the test groups. No statistically significant differences were found between the 3 tested access cavities (P &gt;.05). Significant differences were observed between the different number of residual walls (P &lt;.05). Conclusions: TRECs do not increase the fracture strength of endodontically treated teeth in comparison with CECs and TECs. Moreover, the loss of mesial and distal ridges reduced the fracture strength of teeth significantly

Influence of Access Cavity Preparation and Remaining Tooth Substance on Fracture Strength of Endodontically Treated Teeth

Introduction: The purpose of this study was to assess the impact of access cavity preparation and the remaining tooth substance on the fracture strength of endodontically treated teeth. Methods: One hundred sound mandibular first and second molar teeth were selected and divided into 1 control and 9 test groups (n = 10/group) as follows: control group, intact teeth; group 1, teeth prepared with traditional endodontic access cavity (TEC); group 2, teeth prepared with conservative endodontic access cavity (CEC); group 3, teeth prepared with truss endodontic access cavity (TREC); group 4, TEC + 3 residual walls; group 5, CEC + 3 residual walls; group 6, TREC + 3 residual walls; group 7, TEC + 2 residual walls; group 8, CEC + 2 residual walls; and group 9, TREC + 2 residual walls. After access cavity preparation, all test teeth were endodontically treated and restored. The specimens were then loaded to fracture in a universal loading machine (Triaxial Tester T400 Digital; Controls srl, Cernusco, Italy), and fracture values were recorded in newtons. The data were analyzed with 2-way analysis of variance and Tukey post hoc analysis for multiple comparisons (P &lt;.05). Results: Intact teeth were more resistant to fracture than the teeth in all the test groups. No statistically significant differences were found between the 3 tested access cavities (P &gt;.05). Significant differences were observed between the different number of residual walls (P &lt;.05). Conclusions: TRECs do not increase the fracture strength of endodontically treated teeth in comparison with CECs and TECs. Moreover, the loss of mesial and distal ridges reduced the fracture strength of teeth significantly

Influence of proper or reciprocating optimum torque reverse kinematics on cyclic fatigue of four single files

AIM: The aim of the present study was to evaluate the resistance to cyclic fatigue of heat-treated single files used in proper or in reciprocating optimum torque reverse motions. METHODS: Ninety-six HyFlex electrical discharge machining (EDM), Reciproc R25 (Rec), WaveOne Primary (WO), and WaveOne Gold (WOG) Primary were used. Resistance to cyclic fatigue was determined by recording time to fracture in a stainless steel artificial canal. Differential scanning calorimetric analysis was performed. Data were analyzed by two-way analysis of variance and Bonferroni post-hoc tests at 0.05. RESULTS: In both movements, HyFlex EDM showed higher time to fracture than other files (P&nbsp;&lt;&nbsp;0.0001). Rec showed higher time to fracture than WO (P&nbsp;&lt;&nbsp;0.0001), while WOG showed higher cyclic fatigue resistance than Rec and WO with both movements (P&nbsp;&lt;&nbsp;0.005). CONCLUSIONS: Reciprocating optimum torque reverse motion improved significantly cyclic fatigue resistance of gold and controlled memory wire single files

Exploring the association of sense of coherence, and spiritual and religious beliefs in a rural population group on the island of Crete, Greece

OBJECTIVES/AIM: This article reports the results of an observation study, aimed at exploring an association between spirituality, religiousness, and sense of coherence in a population group residing in a rural area of Crete, Greece. STUDY DESIGN AND METHODS: The study was conducted during the period 2007-2009. Subjects aged 65 years and older (n = 118) living in two remote and rural villages in the Heraklion county (Crete) were eligible. Eighty-nine people (51 women and 38 men) participated. Demographic data were obtained, and all participants were asked to complete the Greek version of the self-reported Royal Free Interview for Spiritual and Religious Beliefs, and the Sense of Coherence Scale. RESULTS: Most participants reported strong religious beliefs and this was found to be related with increased age. Widowed participants expressed greater religiousness and spirituality (p = 0.029). The total score for Sense of Coherence was negatively correlated with gender (women have lower scores, p < 0.05), marital status (widows presented lower scores, p < 0.001), and increased age. A strong positive correlation of the Sense of Coherence score with the Spiritual Scale as measured by three questions of the Royal Free Interview was also identified (p = 0.039). CONCLUSIONS: The impact of gender and marital status seem to be emerging determinants in defining sense of coherence among inhabitants of rural Crete. The positive association between religious/spiritual beliefs and sense of coherence deserves further attention to promote a multidimensional approach in its study