Influence of polymerization time on properties of dual-curing cements in combination with high translucency monolithic zirconia

Purpose: The aim of this in vitro study was to assess conversion degree (DC), micro-hardness (MH) and bond strength of two dual-curing resin cements employed under translucent monolithic zirconia irradiated with different time protocols. Methods: 84 square shaped samples of 1 mm thickness were prepared from high translucency zirconia blocks and divided into two groups (n = 24) according to the cement employed: (1) Rely-X Ultimate; (2) Panavia SA. Each group was further divided into 3 subgroups (n = 8) according to the irradiation time: (a) no light; (b) 20 s; (c) 120 s. Light curing was performed 60 s after the sample was placed on the diamond support of a FT-IR spectrophotometer with a high power multiLED lamp. Final DC% were calculated after 10 min. After 24 h, Vickers Test on the cement layer was performed. The same protocol was used to lute composite cylinders in order to evaluate microshear bond-strength test. ANOVA and Bonferroni tests were performed to find differences between MH and bond-strength to zirconia, while for DC% the Scheirer\u2013Ray\u2013Hare two-way test was used. Results: The two cements reached higher DC% in subgroup (b) and (c). As concern MH, statistics showed an increase in curing time was able to improve MH significantly. Bond-strength was not affected by irradiation time only for Panavia SA. Conclusions: The first null hypothesis has to be rejected since DC% and MH of the dual-cements tested were influenced by the curing time. The second null hypothesis is partially rejected since the bond strength was influenced by the curing time only for Rely-X Ultimate

Guidance to post-mortem collection and storage of biological specimens for the diagnosis of Covid-19 infection

The following document is based on the current knowledge of SARS-CoV-2 and the related disease (COVID-19). The Italian Institute of Health (ISS) is monitoring the virus spread throughout the country through daily reports sent by individual regions and regional reference laboratories. The diagnosis of infection is based on the use of standardized and validated molecular tests for the search for viral RNA in different sets of biological samples, from patients suspected of having contracted the infection. This document provides a specific guidance for the collection and storage of biological samples from deceased persons. It also provides recommendations on safety practices to be adopted during both collection and handling of specimens, and during autopsy procedures. With regard autopsy, it is recommended to follow the procedures for the execution of diagnostic findings in patients died with SARS-CoV-2 infection issued by ISS Working Group on Causes of Death from COVID-19, published on March 27, 2020

Exposure to Gastric Acid Inhibitors Increases the Risk of Infection in Preterm Very Low Birth Weight Infants but Concomitant Administration of Lactoferrin Counteracts This Effect

Objective: To investigate whether exposure to inhibitors of gastric acidity, such as H2 blockers or proton pump inhibitors, can independently increase the risk of infections in very low birth weight (VLBW) preterm infants in the neonatal intensive care unit. Study design: This is a secondary analysis of prospectively collected data from a multicenter, randomized controlled trial of bovine lactoferrin (BLF) supplementation (with or without the probiotic Lactobacillus rhamnosus GG) vs placebo in prevention of late-onset sepsis (LOS) and necrotizing enterocolitis (NEC) in preterm infants. Inhibitors of gastric acidity were used at the recommended dosages/schedules based on the clinical judgment of attending physicians. The distribution of days of inhibitors of gastric acidity exposure between infants with and without LOS/NEC was assessed. The mutually adjusted effects of birth weight, gestational age, duration of inhibitors of gastric acidity treatment, and exposure to BLF were controlled through multivariable logistic regression. Interaction between inhibitors of gastric acidity and BLF was tested; the effects of any day of inhibitors of gastric acidity exposure were then computed for BLF-treated vs -untreated infants. Results: Two hundred thirty-five of 743 infants underwent treatment with inhibitors of gastric acidity, and 86 LOS episodes occurred. After multivariate analysis, exposure to inhibitors of gastric acidity remained significantly and independently associated with LOS (OR, 1.03; 95% CI, 1.008-1.067; P = .01); each day of inhibitors of gastric acidity exposure conferred an additional 3.7% odds of developing LOS. Risk was significant for Gram-negative (P < .001) and fungal (P = .001) pathogens, but not for Gram-positive pathogens (P = .97). On the test for interaction, 1 additional day of exposure to inhibitors of gastric acidity conferred an additional 7.7% risk for LOS (P = .003) in BLF-untreated infants, compared with 1.2% (P = .58) in BLF-treated infants. Conclusion: Exposure to inhibitors of gastric acidity is significantly associated with the occurrence of LOS in preterm VLBW infants. Concomitant administration of BLF counteracts this selective disadvantage. Trial registration: isrctn.org: ISRCTN53107700

TELEMEDICINA COMO FERRAMENTA DE INTEGRAÇÃO ENTRE TUTORES E VETERINÁRIOS DURANTE O MONITORAMENTO PÓS-OPERATÓRIO

A telemedicina está sendo vista como um conjunto de conhecimentos importantes para enfrentar os desafios dos sistemas de saúde veterinárias que desde 2021 começou a ser liberado para atividades em território nacional. Destina-se a assistência contínua de parâmetros fisiológicos, realizado sob supervisão médico veterinária, para acompanhamento a distância proporcionando um atendimento mais efetivo ao animal. O objetivo deste estudo foi examinar a opinião dos tutores acerca da telemedicina veterinária (TV) realizados pelos acadêmicos da disciplina de Técnica Cirúrgica durante o acompanhamento do pós-operatório de seus pacientes. Além disso, compreender sob o aspecto do acadêmico se o pós-operatório cirúrgico humanizado, sob orientação veterinária, pode ser prática rotineira na saúde animal diante da limitação de internação. Os acadêmicos responsáveis pela cirurgia, no seu grupo de aula prática, acompanharam diariamente por cinco dias o pós-operatório domiciliar. Para esse levantamento foi realizado uma pesquisa qualitativa exploratória, com coleta de dados informativos por meio de entrevistas semiestruturadas através de duas plataformas visuais (WhatsApp e Google Meet), com 60 tutores de animais que passaram pelos serviços cirúrgicos do IFC-Concórdia, no período de março a julho de 2023. Foram formuladas pelos cirurgiões acadêmicos (n=40) dez perguntas, que foram gravadas, sob autorização concedida, e posteriormente transcritas, acerca de suas posições sobre a definição do telemonitoramento, dificuldades ou facilidades de manipulação animal, vantagens/desvantagens, modos de comunicação, relação do futuro veterinário e o paciente virtual. Os desfechos primários foram o tempo de acompanhamento e percepção do acadêmico. Os desfechos secundários foram a habilidade do tutor em cuidar do seu pet e satisfação de atendimento no pós operatório. Na atribuição alteração do comportamento, 5% dos pacientes demonstraram modificação comportamental e 3% apresentaram alterações no apetite. Destes, 92% dos tutores não notaram alteração na ferida cirúrgica; 91% declararam não ter dificuldade em realizar o pós-operatório domiciliar e 4% dos tutores afirmaram ter tido dificuldade em manipular seu animal; 3% julgaram acreditar que o animal possa ter sentido dor, mas ficaram com dúvidas; 91% mencionaram que o animal não sentiu dor e 6% não souberam responder. Além disso, 99% dos tutores confirmam que as orientações repassadas, a dedicação acadêmica e poder contar com ajuda independente do horário foram importantes para sucesso no tratamento, 98% relataram que a atenção prestada pelo acadêmico, ultrapassou a expectativa e 100% deles submeteria seu animal a outro procedimento terapêutico no IFC. Dentre as qualidades dos serviços oferecidos,100% dos entrevistados julgaram que o tempo de acompanhamento foi suficiente e significativo para a correta realização do pós-operatório. Como resultado, nota-se que a maioria (96%) dos tutores usariam serviços de TV no pós-operatório e alguns (4%) não souberam responder. Afirmaram que a metodologia didática prestada uniu a família e ajudou economicamente. Os acadêmicos destinados a essa metodologia concluíram que a dinâmica foi positiva para o aprendizado

MOLNUPIRAVIR COMPARED TO NIRMATRELVIR/RITONAVIR FOR COVID-19 IN HIGH-RISK PATIENTS WITH HAEMATOLOGICAL MALIGNANCY IN EUROPE. A MATCHED-PAIRED ANALYSIS FROM THE EPICOVIDEHA REGISTRY

Introduction: Molnupiravir and nirmatrelvir/ritonavir are antivirals used to prevent progression to severe SARS-CoV-2 infections, which reduce both hospitalization and mortality rates. Nirmatrelvir/ritonavir was authorised in Europe in December 2021, while molnupiravir is not yet licensed in Europe as of February 2022. Molnupiravir may be an alternative to nirmatrelvir/ritonavir, because it displays less frequent drug-drug interactions and contraindications. A caveat connected to molnupiravir derives from the mode of action inducing viral mutations. In clinical trials on patients without haematological malignancy, mortality rate reduction of molnupiravir appeared less pronounced than that of nirmatrelvir/ritonavir. Little is known about the comparative efficacy of the two drugs in patients with haematological malignancy at high-risk of severe COVID-19. Thus, we here assess the effectiveness of molnupiravir compared to nirmatrelvir/ritonavir in our cohort of patients with haematological malignancies. Methods: Clinical data of patients treated either with molnupiravir or nirmatrelvir/ritonavir monotherapy for COVID-19 were retrieved from the EPICOVIDEHA registry. Patients treated with molnupiravir were matched by sex, age (±10 years), and baseline haematological malignancy severity to controls treated with nirmatrelvir/ritonavir. Results: A total of 116 patients receiving molnupiravir for the clinical management of COVID-19 were matched to an equal number of controls receiving nirmatrelvir/ritonavir. In each of the groups, 68 (59%) patients were male; with a median age of 64 years (IQR 53-74) for molnupiravir recipients and 64 years (IQR 54-73) for nirmatrelvir/ritonavir recipients; 57% (n=66) of the patients had controlled baseline haematological malignancy, 13% (n=15) stable, and 30% (n=35) had active disease at COVID-19 onset in each of the groups. During COVID-19 infection, one third of patients from each group were admitted to hospital. Although a similar proportion of vaccinated patients was observed in both groups (molnupiravir n=77, 66% vs nirmatrelvir/ritonavir n=87, 75%), those treated with nirmatrelvir/ritonavir had more often received four doses (n=27, 23%) as compared to patients treated with molnupiravir (n=5, 4%, p&lt;0.001). No differences were detected in COVID-19 severity (p=0.39) or hospitalization (p=1.0). No statistically significant differences were identified in overall mortality rate (p=0.78) or in survival probability (d30 p=0.19, d60 p=0.67, d90 p=0.68, last day of follow up p=0.68). In all patients, deaths were either attributed to COVID-19 or the infection contributed to death as per treating physician's judgement. Conclusions: In high-risk patients with haematological malignancies and COVID-19, molnupiravir showed rates of hospitalization and mortality comparable to those of nirmatrelvir/ritonavir in this matched-pair analysis. Molnupiravir appears to be a plausible alternative to nirmatrelvir/ritonavir for COVID-19 treatment in patients with haematological malignancy

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements