Treatment outcome of partial pulpotomy using two different calcium silicate materials in mature permanent teeth with symptoms of irreversible pulpitis: A randomized clinical trial

AIM To assess the clinical and radiographic outcome of partial pulpotomy by comparing MTA Angelus and Total Fill BC, as pulpotomy agents, in mature teeth with deep caries and symptoms indicative of irreversible pulpitis. METHODOLOGY The study was designed as a parallel-two arm, double-blind, randomized superiority clinical trial registered at www. CLINICALTRIALS gov (NCT04870398). Symptomatic mature permanent teeth with deep caries fulfilling the inclusion criteria were randomly treated using either MTA Angelus or Total Fill BC. A partial pulpotomy was performed and following complete haemostasis, the capping material was placed over the remaining pulp tissue and a postoperative periapical radiograph was taken. Clinical and radiographic follow-up evaluation was performed for a median time of 2 years, whereas levels of pain intensity were evaluated preoperatively and for 7 days after intervention using Visual Analogue Scale. For the primary outcome (failure/success of treatment), the Kaplan-Meier survival curves for the capping materials were plotted and a log-rank test for equality of survivor functions was applied. A multivariable random effects Cox Regression model was also applied. For the secondary outcome (postoperatively reported pain), a multivariable mixed effects ordinal logistic regression was structured. RESULTS One hundred and thirty-seven teeth in 123 patients underwent partial pulpotomy using randomly either MTA Angelus (N = 74) or Total Fill BC (n = 63). The percentage failure for MTA Angelus and Total Fill BC was 10.8% (8/74) and 17.5% (11/63), respectively, but the difference was not statistically significant [adjusted HR: 1.83; 95% confidence interval (CI): 0.68, 4.91; p = .23]. Weak evidence was found that secondary caries involvement may impose a 3.54 times greater hazard for treatment failure (adjusted HR: 3.54; 95% CI: 1.00, 12.51; p = .05). For each passing minute of procedural bleeding control, there was also a 57% higher hazard for treatment failure (adjusted HR: 1.57; 95% CI: 0.99, 2.48; p = .05). The odds for higher postoperative pain were 4.73 times greater for the Total Fill BC compared to MTA Angelus (adjusted OR: 4.73; 95% CI: 2.31, 9.66; p < .001). CONCLUSIONS Both materials exhibited similar and favourable outcome rates after partial pulpotomy in teeth with deep caries and symptoms of irreversible pulpitis. Total Fill BC was associated with a higher level of postoperative pain intensities

Outcome of Partial Pulpotomy in Immature Permanent Teeth with Symptomatic Irreversible Pulpitis: A Prospective Case Series Assessment

INTRODUCTION The aim of this prospective case series was to assess the clinical and radiographic outcome of partial pulpotomy in caries-exposed symptomatic, vital, immature, permanent molars. METHODS Thirty-four immature molars with deep caries and symptoms of irreversible pulpitis were treated by partial pulpotomy and ProRoot MTA as a capping material. After complete caries removal, the inflamed part of the pulp was removed. Complete hemostasis was achieved using a sterile cotton pellet moist initially with sodium hypochlorite 1.5% and then with sterile saline. ProRoot MTA (Dentsply Sirona, Charlotte, NC) was placed as a capping material onto the remaining pulp tissue. The cavity was sealed using a light-curing resin-modified Ca(OH)$_{2}$ cavity liner, and patients were referred to a pediatric dentist for permanent restoration. Descriptive statistics and cross tabulations were performed including variables examined before, during, and after the procedure. RESULTS All examined teeth presented a favorable clinical and radiographic outcome with normal periapical tissues, complete apical closure, and formation of a dentinal bridge beneath the capping material. Signs of partial pulp chamber calcification were only detected in 2 cases. Postoperatively, most patients did not report any pain (23/34, 67.7%), whereas the rest reported minor intensity pain (11/34, 32.3) and the use of analgesic or anti-inflammatory drugs only for 1 day (10/34, 29.4%). CONCLUSIONS Partial pulpotomy seems to provide a universally successful outcome when managing symptomatic vital immature teeth with no signs of complications and completion of apical closure. It could be a viable treatment of choice in cases of caries-exposed vital immature teeth with symptoms of irreversible pulpitis

Ανάπτυξη της δυναμικής της ομάδας (team building): διερεύνησή της στο πλαίσιο του μαθήματος της Νεοελληνικής Γλώσσας στο Γυμνάσιο

Στην εν λόγω μελέτη εξετάζεται ο τρόπος με τον οποίο αναπτύσσεται η δυναμική της ομάδας (team building) στο πλαίσιο του μαθήματος της Νεοελληνικής Γλώσσας στο Γυμνάσιο. Το δείγμα έχει αντληθεί από ένα τμήμα της Α’ Γυμνασίου και δύο έμπειρους εκπαιδευτικούς στον τομέα της συνεργατικής μάθησης. Πρόκειται για ποιοτική έρευνα τα αποτελέσματα της οποίας δεν μπορούν να γενικευτούν. Για τη συλλογή των δεδομένων αξιοποιήθηκε η συμμετοχική παρατήρηση και η ημι-δομημένη συνέντευξη (οχτώ μαθητών και δύο καθηγητών). Η επεξεργασία των δεδομένων πραγματοποιήθηκε μέσω τριγωνισμού, με στόχο να διαφανούν οι διαφορετικές οπτικές του ζητήματος. Τα αποτελέσματα έδειξαν ότι μέχρι οι μαθητές να εξοικειωθούν με τη διαδικασία, περνούν από κάποια στάδια: 1. το στάδιο του σχηματισμού, 2. το στάδιο των διαφωνιών, 3. το στάδιο της ισορροπίας των σχέσεων και 4. το στάδιο της εκτέλεσης εργασίας. Όπως επιβεβαιώνουν οι δύο εκπαιδευτικοί, απαιτείται χρόνος για να εδραιωθούν οι όροι συνεργασίας και οι άτυποι κανόνες συμπεριφοράς στο στάδιο των διαφωνιών. Ωστόσο, ακόμα και αν δεν έχουν κατακτηθεί ικανοποιητικά τα προηγούμενα στάδια, οι μαθητές πρέπει κάθε φορά να φτάνουν στο τέταρτο στάδιο, καθώς η επανάληψη και οι λανθασμένοι χειρισμοί της προηγούμενης φοράς φαίνεται να εξοικειώνουν σταδιακά τους μαθητές με τη διαδικασία.The following study examines the way in which teams are developed in α Language Course in Junior High School. The sample for the survey has been taken from the First Grade of Junior High School and two teachers experienced in Cooperative Learning. For this purpose, qualitative research has been carried out. The outcome cannot be generalized. Research data was collected through participatory observation and semi-structured interview (8 students and 2 teachers). Processing of data was done through triangulation, in order to examine different perspectives of the issue. The outcome showed that students go through four stages (Formimg, Storming, Norming, Performing), until they become thoroughly acquainted with the process. As confirmed by the two experienced teachers, students need time to establish the conditions of cooperation and non-standard rules of behavior at the stage of disagreement (Storming). However, even if students have not gone through all of the stages with success yet, it is important for them to reach the fourth stage, because revision and awareness of previous errors seem to gradually familiarize students with the process

A hairy-root transformation protocol for Trigonella foenum-graecum L. as a tool for metabolic engineering and specialised metabolite pathway elucidation

The development of genetic transformation methods is critical for enabling the thorough characterization of an organism and is a key step in exploiting any species as a platform for synthetic biology and metabolic engineering approaches. In this work we describe the development of an Agrobacterium rhizogenes-mediated hairy root transformation protocol for the crop and medicinal legume fenugreek (Trigonella foenum-graecum). Fenugreek has a rich and diverse content in bioactive specialised metabolites, notably diosgenin, which is a common precursor for synthetic human hormone production. This makes fenugreek a prime target for identification and engineering of specific biosynthetic pathways for the production of triterpene and steroidal saponins, phenolics, and galactomanans. Through this transformation protocol, we identified a suitable promoter for robust transgene expression in fenugreek. Finally, we establish the proof of principle for the utility of the fenugreek system for metabolic engineering programs, by heterologous expression of known triterpene saponin biosynthesis regulators from the related legume Medicago truncatula in fenugreek hairy roots

Maritime Transport in a Life Cycle Perspective: How Fuels, Vessel Types, and Operational Profiles Influence Energy Demand and Greenhouse Gas Emissions

&ldquo Well-to-Propeller&rdquo Life Cycle Assessment of maritime transport was performed with a European geographical focus. Four typical types of vessels with specific operational profiles were assessed: a container vessel and a tanker (both with 2-stroke engines), a passenger roll-on/roll-off (Ro-Pax) and a cruise vessel (both with 4-stroke engines). All main engines were dual fuel operated with Heavy Fuel Oil (HFO) or Liquefied Natural Gas (LNG). Alternative onshore and offshore fuel supply chains were considered. Primary energy use and greenhouse gas emissions were assessed. Raw material extraction was found to be the most impactful life cycle stage (~90% of total energy use). Regarding greenhouse gases, liquefaction was the key issue. When transitioning from HFO to LNG, the systems were mainly influenced by a reduction in cargo capacity due to bunkering requirements and methane slip, which depends on the fuel supply chain (onshore has 64% more slip than offshore) and the engine type (4-stroke engines have 20% more slip than 2-stroke engines). The combination of alternative fuel supply chains and specific operational profiles allowed for a complete system assessment. The results demonstrated that multiple opposing drivers affect the environmental performance of maritime transport, a useful insight towards establishing emission abatement strategies. Document type: Articl

Differential effect of Pistacia vera extracts on experimental atherosclerosis in the rabbit animal model: an experimental study

<p>Abstract</p> <p>Background</p> <p>Lipid-enriched diets and oxidative stress are risk factors for the development of atherosclerosis. The effects of the methanolic (ME) and cyclohexane (CHE) extracts of the <it>Pistacia vera </it>nut, often included in the Mediterranean diet, were studied in the rabbit model of atherosclerosis.</p> <p>Methods and results</p> <p>Twenty-four New Zealand White rabbits received atherogenic diet (Control Group), supplemented with ME (Group ME) or CHE (Group CHE) for 3 months. Previously, a GC-MS and a UHPLC LC-DAD-ESI(-)-HRMS/MS method were developed to investigate the extracts' chemical profiles. Blood samples at baseline and monthly determined lipid profile, lipid peroxidation and liver function. The aorta, myocardium and liver were examined histologically at 3 months.</p> <p>Groups ME and CHE had significantly higher HDL- and non-significantly lower LDL-cholesterol median % changes from baseline than the Control Group. Triacylglycerol was significantly higher in Group CHE vs. Control. MDA values were significantly lower in Group ME vs. Control and CHE. ALT and AST were significantly higher in Group CHE vs. Control. γ-GT was lower in Group ME vs. Control. Aortic intimal thickness was significantly less in Groups ME and CHE vs. Control; Group ME atherosclerotic lesions were significantly less extensive vs. Groups Control and CHE. Only Group CHE had significant liver fatty infiltration.</p> <p>Conclusions</p> <p>During short-term administration concomitantly with atherogenic diet, both <it>P. vera </it>extracts were beneficial on HDL-, LDL-cholesterol and aortic intimal thickness. The ME additionally presented an antioxidant effect and significant decrease of aortic surface lesions. These results indicate that <it>P. vera </it>dietary inclusion, in particular its ME, is potentially beneficial in atherosclerosis management.</p

Lateinisch-griechisch-arabische Begegnungen

Das spätmittelalterliche Mediterraneum war geprägt von komplexen Gesellschaften mit einem hohen Grad kultureller Heterogenität. Menschen mit unterschiedlichen ethnischen, religiösen und linguistischen Hintergründen lebten zum Teil schon seit Generationen, zum Teil erst kurzfristig mit- oder nebeneinander und kamen auf unterschiedlichen Ebenen miteinander in Kontakt. Die Erforschung dieser spätmittelalterlichen mediterranen "hotspots" kultureller Diversität verspricht wichtige Erkenntnisse über die Konstruktion von sozialen und kulturellen Identitäten und über die integrativen und desintegrativen Prozesse in komplexen pluralen Gesellschaften. Dieser international und interdisziplinär zusammengestellte Sammelband behandelt Aspekte interkultureller Kommunikation, wie sie in Architektur, Bildkunst, Handwerksproduktion und Schrifttum reflektiert werden, untersucht die Genese hybrider Kunstformen sowie Kulturpraktiken und fragt nach der Rolle und Selbstverortung spezifischer Personen und Korporationen in interkulturellen Kontaktsituationen

TREM-1 expression on neutrophils and monocytes of septic patients: relation to the underlying infection and the implicated pathogen

<p>Abstract</p> <p>Background</p> <p>Current knowledge on the exact ligand causing expression of TREM-1 on neutrophils and monocytes is limited. The present study aimed at the role of underlying infection and of the causative pathogen in the expression of TREM-1 in sepsis.</p> <p>Methods</p> <p>Peripheral venous blood was sampled from 125 patients with sepsis and 88 with severe sepsis/septic shock. The causative pathogen was isolated in 91 patients. Patients were suffering from acute pyelonephritis, community-acquired pneumonia (CAP), intra-abdominal infections (IAIs), primary bacteremia and ventilator-associated pneumonia or hospital-acquired pneumonia (VAP/HAP). Blood monocytes and neutrophils were isolated. Flow cytometry was used to estimate the TREM-1 expression from septic patients.</p> <p>Results</p> <p>Within patients bearing intrabdominal infections, expression of TREM-1 was significantly lower on neutrophils and on monocytes at severe sepsis/shock than at sepsis. That was also the case for severe sepsis/shock developed in the field of VAP/HAP. Among patients who suffered infections by Gram-negative community-acquired pathogens or among patients who suffered polymicrobial infections, expression of TREM-1 on monocytes was significantly lower at the stage of severe sepsis/shock than at the stage of sepsis.</p> <p>Conclusions</p> <p>Decrease of the expression of TREM-1 on the membrane of monocytes and neutrophils upon transition from sepsis to severe sepsis/septic shock depends on the underlying type of infection and the causative pathogen.</p

Prox1 Regulates the Notch1-Mediated Inhibition of Neurogenesis

During development of the spinal cord, Prox1 controls the balance between proliferation and differentiation of neural progenitor cells via suppression of Notch1 gene expression

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700