A Comparative Study of the Microleakage of Resilon/Epiphany and Gutta-Percha/AH-Plus Obturating Systems

Introduction: The aim of the present study was to investigate and compare the apical sealing ability of Resilon/Epiphany-filled root canals with those that were obturated with gutta-percha/AH-Plus endodontic sealer. Materials and Methods: A total of 60 extracted human single-rooted teeth were selected; 25 teeth for each test group and five for each control group. After conducting conventional endodontic treatment, the teeth were immersed in physiologic saline solution for thirty days, and subsequently sealed and stored in methylene blue dye solution for seven days. The teeth were sectioned to evaluate the linear apical leakage using a stereoscopic microscope. The data were statistically analyzed by non-parametric Kruskal-Wallis and Mann-Whitney U tests. Results: The results showed significant differences between the two groups of endodontic sealers (P<0.001). Conclusion: Within the limitation of the present in vitro study, Resilon/Epiphany sealer had better apical sealing ability than gutta-percha/AH-Plus sealer

Management And Outcome Of Diabetic Charcot’s Foot: Jabir Abueliz Diabetic Center Experience 2019 (JADC)

Charcot foot is a rare but a serious diabetic related condition. Usually it is misdiagnosed although its prognosis related to timely and proper management. Objective: To study the management and outcome of diabetic Charcot’s foot in Jabir AbuEliz diabetic center in period between 2012 and 2019. Methods: A combined retro-prospective descriptive analytical study and hospital based. Study conducted to 134 diabetic patients with charcot joint attended to JADC during the study period. The study sample was calculated by total coverage. Study questionnaires captured mainly quantitative data. Data analyzed by using SPSS version 21. Results: 134 diabetic patients with charcot joint were involved in this study, most of the patients were males, in the age group 51-60 years and had NIDDM associated with other medical disorders.  At the time of presentation, 91% of the patients presented with swelling and 53.7% of the patients had pain. On examination of the foot; 84.3% of the patients had swelling and 59.7% of the patients had dry skin. Hammer toes deformity was the commonest feet deformity. Based on modified Sella and Barrette classification, 17.2% of the patients in grade 1. Casting was performed to all patients with good outcome to 91.1% of the patients. Conclusion: This study reveals that grade 0,1&2 Charcot neuroarthropathy feet had good outcome if properly recognized and early managed. The total contact cast (TCC) and CAM walker is effective in the management

Mixed-Ligand Complexes of Fe(II) & Cu(II) with Alizarin Maroon as a Primary Ligand & 5-Sulphosalicylic Acid as a Secondary Ligand

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Setting Reading Fluency Benchmark in Bangla for the Students of Grade III and Grade V

Reading is one of the most significant media of learning. Reading with comprehension mostly depends on reading fluency. It is necessary to measure students fluency through the reading rate of words per minute to know the level of comprehension. There was no benchmark in Bangla reading fluency at the primary level, which is necessary to check students\u27 reading performances regarding the targeted level. This study aims to set a reading fluency benchmark for grade III and grade V in Bangla. This study followed quantitative approaches with a cross-sectional survey design. A total of 1536 students from both grades were selected through a multistage cluster sampling procedure. Two types of texts for each grade were developed and finalized alter piloting to administer. The median method was used for setting the fluency benchmark as many countries already had used it for the same purpose. This study recommended setting the reading fluency benchmark for grade III in Bangla at 46 CWPM and 54 CWPM for grade V. It also recommended that policymakers need to take the necessary teaching-learning interventions to achieve this benchmark

Hydrogeophysical and hydrochemical assessment of the northeastern coastal aquifer of Egypt for desalination suitability

Recently the limited freshwater resources have become one of the most significant challenges facing Egypt. Thus, new resources of drinkable water are required to meet the growing population demands and the national projects, to support the country’s economy. Saline groundwater desalination is an option that can support limited freshwater resources. This research represents a detailed analysis of hydrogeological and hydrochemical characteristics of a coastal aquifer in the West Port Said area, northeastern Egypt, to assess the desalination suitability of the aquifer, especially when the nearby seawater is contaminated. The hydrogeological characterization included various integrated approaches: geophysical survey, field investigations, wells drilling, well logging, pumping tests, and water sampling. The results show that: (1) The subsurface lithology consists of sandstone and clay, and three water bearing layers: A, B and C. (2) The average porosity values are 22%, 27.5%, and 25% for layers A, B, and C, respectively. The hydraulic conductivity values fall in the ranges of 5.8–12.7 m/day for layer A, 7.6–11.7 m/day for layer B, and 11.1–19.5 m/day for layer C, while the highest transmissivity values are in ranges of 5.8 × 102–12.7 × 102 m2/day for layer A, 7.6 × 102–11.7 × 102 m2/day for layer B and 11.1 × 102–19.5 × 102 m2/day for layer C. (3) The average storage values are 2.1 × 10−3, 1.8 × 10−3 and 5.3 × 10−3 in layers A, B and C, respectively. (4) Layers A and B showed Na-Cl-type, similar to seawater, but free from oil pollution. These results show layer B’s higher productivity and better quality. Despite the salinity, desalination technology can improve.Geolog

Genetic modification of Mucor circinelloides for canthaxanthin production by heterologous expression of β-carotene ketolase gene

11 pags, 4 figs, 1 tab. -- he Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fnut.2021.756218/full#supplementary-materiaCanthaxanthin is a reddish-orange xanthophyll with strong antioxidant activity and higher bioavailability than carotenes, primarily used in food, cosmetics, aquaculture, and pharmaceutical industries. The spiking market for natural canthaxanthin promoted researchers toward genetic engineering of heterologous hosts for canthaxanthin production. Mucor circinelloides is a dimorphic fungus that produces β-carotene as the major carotenoid and is considered as a model organism for carotenogenic studies. In this study, canthaxanthin-producing M. circinelloides strain was developed by integrating the codon-optimized β-carotene ketolase gene (bkt) of the Haematococcus pluvialis into the genome of the fungus under the control of strong promoter zrt1. First, a basic plasmid was constructed to disrupt crgA gene, a negative regulator of carotene biosynthesis resulted in substantial β-carotene production, which served as the building block for canthaxanthin by further enzymatic reaction of the ketolase enzyme. The genetically engineered strain produced a significant amount (576 ± 28 μg/g) of canthaxanthin, which is the highest amount reported in Mucor to date. Moreover, the cell dry weight of the recombinant strain was also determined, producing up to more than 9.0 g/L, after 96 h. The mRNA expression level of bkt in the overexpressing strain was analyzed by RT-qPCR, which increased by 5.3-, 4.1-, and 3-folds at 24, 48, and 72 h, respectively, compared with the control strain. The canthaxanthin-producing M. circinelloides strain obtained in this study provided a basis for further improving the biotechnological production of canthaxanthin and suggested a useful approach for the construction of more valuable carotenoids, such as astaxanthin.This work was supported by the National Natural Science Foundation of China (Grant Nos. 31670064 and 31972851), the Tai Shan Industrial Experts Program tscy 20160101, and the Shandong provincial key technology R&D plan (2018GNC110039, 2018GSF121013).Peer reviewe

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Global economic burden of unmet surgical need for appendicitis

Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe