Physical and mechanical properties of experimental dentinogenic pulp capping material

Bioactive Inorganic Element (BIE) is a bioactive glass that has been developed and studied for bone regeneration, and dentinogenesis. OBJECTIVE: To test the physical and mechanical properties (setting time, pH level, solubility, and compressive strength) of two groups of BIE-containing materials: 20% BIE (20% BIE, 60% Portland cement, and 20% bismuth oxide) and 40% BIE (40% BIE, 40% Portland cement, and 20% bismuth oxide), and compare them with Dycal® and Experimental Mineral Trioxide Aggregate (EMTA) as the control groups, with and without calcium chloride at three different concentrations (5%, 10%, and 15%). METHODS: Ten samples in each group were tested for setting time, pH level, compressive strength, and solubility. Setting time was determined following the ISO specification 6876 using digital dial indicator. The pH level of the storage solutions of each specimen in deionized water was measured after 2 hours, and 1, 7, 21, and 28 days. The compressive strength was measured following the ISO specification 9917, and solubility was measured as a weight loss after storage in deionized water. The compressive strength and solubility were measured at 1, 7, 21, and 28 days. Data were statistically analyzed with two-way ANOVA and Tukey’s tests. RESULTS: Dycal® showed the least setting time material, which was comparable to the 40% BIE + 10%, and 15% CaCl2 (p > 0.05). EMTA showed the longest setting time (p 0.05). The pH level, compressive strength, and solubility of all tested material increased with time and decreased with CaCl2 addition. CONCLUSION: The 40% BIE with 10% CaCl2 showed promising physical and mechanical properties that could compete the Dycal® and EMTA when used in pulp capping

Classifying the Capabilities of Robotic Systems. What is a robot?

There are various types of robots, yet there are no defined characteristics that relate them to each other. In order to compare robots, a detailed cross-domain classification system is required. The classification needs to be simple enough to be applicable to all robotic fields, yet comprehensive enough to capture robots accurately. The aim of the research reported in this thesis is to develop a novel classification scheme, subsequently named ‘ToRCH’ (Toward Robot CHaracterization), that categorizes robots according to their characteristics via a hierarchical structure. The layers of the hierarchy capture robot capabilities, sub-categorizes them and provides appropriate measurement levels. Some capabilities were adopted from the Multi-Annual Road map (MAR), that was developed to shape the European research development and innovation program, and the research reported in this thesis first extends MAR in a number of important dimensions. Then the study utilizes the extensive capability layers in ToRCH to characterize a robot’s performance in a form defined as the ‘Robot Capability Profile’ (RCP). The RCP helps in designing, developing, deploying and testing a robot for specific applications. It also facilitates the assessment of the best application that matches the specification of any particular robot. Finally, several aspects of ToRCH are evaluated including its structure, its usability and its generated RCPs. The results confirm that ToRCH is able to capture the capabilities of different robots in a way that could answer the question ‘what is a robot?’

Cytokines in recurrent miscarriage : Genetic and molecular studies.

Recurrent miscarriage, is defined as three or more consecutive pregnancy losses before 20 weeks of gestation. It affects 0.5-2% of pregnant women. A great variety of aetiologic factors has been identified, but a specific cause is still unknown in 50% of cases. It has been suggested that immune causes, including abnormalities in either cytokine production or immune cell populations may be the reason for some of these cases. It is also known that some women with recurrent miscarriage have an endometrial defect, which may lead to abnormal development of the feto-placental unit and subsequent miscarriage. Cytokines are known to be important in the control of embryo implantation and therefore it is possible that abnormalities in endometrial cytokine expression could provide an explanation for unexplained recurrent miscarriages. This study has therefore focused on the possible role of some pro-inflammatory cytokines and leptin in recurrent miscarriage. In the first part of the study, polymerase chain reaction (PCR) was used to establish the frequency of alleles of IL1RN, IL1beta and leptin receptor genes in the DNA extracted from peripheral blood from women who suffer recurrent miscarriage and compared to that seen in controls. The results for both IL1RN tandem repeat polymorphism and IL1beta-511 polymorphism showed that there was no significant difference between the genotype distribution or allele frequency in recurrent miscarriage women and the control population. For IL1beta-511 this was true whether the analysis was carried out on data obtained from the recurrent miscarriage group as a whole or when the women were divided according to the cause of the miscarriage. In the case of IL1RN polymorphism, an increased frequency of 2,2 genotype was seen in recurrent miscarriage women with PCOS, but the numbers in this group were very small.The GLN223ARG leptin receptor polymorphism investigated in this study results in the substitution of amino acids glutamine to arginine in the transmembrane section of the receptor. The results showed no significant difference between the distribution of GLN223ARG leptin receptor genotypes in the recurrent miscarriage women as a whole group compared to the control group.when divided according to the cause of recurrent miscarriage there was a significant increase in the AA genotype in women with secondary recurrent miscarriage and those whose aetiology is unknown.In the second part of the study, expression of IL-11 and IL-11Ralpha in endometrium of recurrent miscarriage and control women were compared using RT-PCR and immunocytochemistry. The results showed that IL-11 and IL-11 Ralpha mRNA and protein were expressed in the endometrium throughout the menstrual cycle by both stromal and epithelial cells. IL-11 and IL-11 Ralpha protein expression was greater in epithelial cells than stromal cells. IL-11 and IL-11Ralpha mRNA and protein were significantly higher in the late secretory phase compared to the proliferative phase of the menstrual cycle. The high levels of IL-11 and IL-11Ralpha mRNA and protein in the late secretory phase suggest that IL-11 may play a role in the functional differentiation that occurs during decidualization of human endometrial stromal cells. IL-11 and IL-11Ralpha were also expressed in the endometrium of women with recurrent miscarriage. There was no significant difference in amounts of IL-11 Ralpha mRNA and protein in the endometrium obtained from normal fertile women or recurrent miscarriage women during the peri-implantation period. However, IL-11 protein expression was decreased in endometrial epithelial cells in the recurrent miscarriage women compared to that seen in normal fertile women. Taken together these results, show decrease endometrial IL-11 production by women with recurrent miscarriage. They also suggest that leptin may be important in preventing miscarriage in some groups of recurrent miscarriage. However, further studies on large groups of recurrent miscarriage women need to be carried out in order to define the importance of this polymorphism. Although, the IL-1RN tandem repeat and IL-1beta-511 polymorphisms appear not to be associated with recurrent miscarriage, this does not mean that the IL-1 system is not involved in causing recurrent miscarriage, as plasma levels of IL-1 did not appear to be different in women with different genotypes

The study of once- and twice-daily biphasic insulin aspart 30 (BIAsp 30) with sitagliptin, and twice-daily BIAsp 30 without sitagliptin, in patients with type 2 diabetes uncontrolled on sitagliptin and metformin—The Sit2Mix trial

AbstractAimsInvestigate efficacy and tolerability of intensifying diabetes treatment with once- or twice-daily biphasic insulin aspart 30 (BIAsp 30) added to sitagliptin, and twice-daily BIAsp 30 without sitagliptin in patients with type 2 diabetes (T2D) inadequately controlled on sitagliptin.MethodsOpen-label, three-arm, 24-week trial; 582 insulin-naïve patients were randomized to twice-daily BIAsp 30+sitagliptin (BIAsp BID+Sit), once-daily BIAsp 30+sitagliptin (BIAsp QD+Sit) or twice-daily BIAsp 30 without sitagliptin (BIAsp BID), all with metformin.ResultsAfter 24 weeks, HbA1c reduction (%) was superior with BIAsp BID+Sit vs. BIAsp QD+Sit (BIAsp BID+Sit minus BIAsp QD+Sit difference: −0.36 [95% CI –0.54; –0.17], P<0.001) and BIAsp BID (BIAsp BID minus BIAsp BID+Sit difference: 0.24 [0.06; 0.43], P=0.01). Observed final HbA1c values were 6.9%, 7.2% and 7.1% (baseline 8.4%), and 59.8%, 46.5% and 49.7% of patients achieved HbA1c <7.0%, respectively. Confirmed hypoglycaemia was lower with BIAsp QD+Sit vs. BIAsp BID (P=0.015); rate: 1.17 (BIAsp QD+Sit), 1.50 (BIAsp BID+Sit) and 2.24 (BIAsp BID) episodes/patient-year. Difference in bodyweight change favoured BIAsp QD+Sit vs. both BID groups (P<0.001).ConclusionsAdding BIAsp 30 to patients with T2D poorly controlled with sitagliptin and metformin is efficacious and well tolerated; however, while BIAsp BID+Sit showed superior glycaemic control, BIAsp QD+Sit had a lower rate of hypoglycaemia and showed no weight gain

Relationship between maxillary central incisors and incisive canal (IC): a cone beam computed tomography study

This study aimed to assess the relationship between the maxillary incisors and the incisive canal (IC) using cone-beam computed tomography (CBCT). Archived CBCTs from 120 subjects (60 males and 60 females, mean age: 34.2±13.1 years) were analyzed in this cross-sectional study. The following variables were measured: incisor/palatal plane (PP), IC/PP angles, palatal alveolar bone width (PABW) at apex, IC width, inter-root width at apex and IC level to incisor apex. The relationship between the incisors and IC with respect to sex and age was calculated using one-way analysis of variance, independent samples t-test, and regression analysis. The confidence level was set at 95%. Results showed that half of the study population exhibited IC palatal opening at the level of the maxillary incisor apices. Significant associations were observed between IC/PP and incisor/PP angles and between IC width and PABW at the apical level (p&lt;0.05), and between age and IC width in the sagittal and axial perspectives and age and IC level relative to the incisor apices. A significant association was observed between sex and IC/PP angle, IC width in the sagittal perspective, and PABW at the apical level. The association was found between IC and maxillary incisors angulations but not between IC width and inter-root distance. Age showed varied associations while sex was significantly associated with most variables assessed

Relationship between mandibular symphysis dimensions and skeletal pattern in adults

Background: The knowledge of dimensions of the symphysis is important for morphological and orthodontic studies. This research evaluates the association between mandibular symphysis dimensions and anteroposterior and vertical skeletal patterns in adults. Materials and methods: This cross-sectional cephalometric study included 90 lateral cephalograms of untreated subjects presenting for orthodontic treatment. The inclusion criteria were adults with lateral cephalograms showing the symphyseal region and anterior cranial base. One investigator traced and analyzed all cephalograms. Symphyseal height, thickness, and ratio between height and thickness were measured in relation to seven anteroposterior and vertical skeletal measurements in females and males. Results: Symphyseal measurements were associated with SNAo (anteroposterior) in females and Gonial angle (vertical) in males. When analyzed by anteroposterior skeletal classification (ANBo), no significant differences in symphyseal dimensions were found. Multiple linear regression analyses showed that Gonion-Nerve (mm) and Gonial angle were significantly associated with symphyseal height. Gonion-Nerve (mm), basal bone width (mm), and alveolar bone height (mm) were associated with symphyseal thickness. Basal bone width (mm) and alveolar bone height (mm) were associated with symphyseal ratio. Conclusions: Symphyseal dimensions were significantly associated with vertical but not anteroposterior skeletal patterns. Future studies are warranted to evaluate the Gonion-nerve measurements concerning the symphysis in relation to vertical and anteroposterior skeletal patterns

IDegLira Improves Both Fasting and Postprandial Glucose Control as Demonstrated Using Continuous Glucose Monitoring and a Standardized Meal Test

Objective: IDegLira is a novel, fixed-ratio combination of the long-acting basal insulin, insulin degludec, and the long-acting glucagon-like peptide-1 analog liraglutide. We studied the effect of IDegLira versus its components on postprandial glucose (PPG) in type 2 diabetes. Methods: In this substudy, 260 (15.6%) of the original 1663 patients with inadequate glycemic control participating in a 26-week, open-label trial (DUAL I) were randomized 2:1:1 to once-daily IDegLira, insulin degludec or liraglutide. Continuous glucose monitoring (CGM) for 72 hours and a meal test were performed. Results: At week 26, IDegLira produced a significantly greater decrease from baseline in mean PPG increment (normalized iAUC0-4h) than insulin degludec (estimated treatment difference [ETD] -'12.79 mg/dl [95% CI: -'21.08; -'4.68], P =.0023) and a similar magnitude of decrease as liraglutide (ETD -'1.62 mg/dl [95% CI: -'10.09; 6.67], P =.70). CGM indicated a greater reduction in change from baseline in PPG increment (iAUC0-4h) for IDegLira versus insulin degludec over all 3 main meals (ETD -'6.13 mg/dl [95% CI: -'10.27, -'1.98], P =.0047) and similar reductions versus liraglutide (ETD -'1.80 mg/dl [95% CI: -'2.52, 5.95], P =.4122). Insulin secretion ratio and static index were greater for IDegLira versus insulin degludec (P =.048 and P =.006, respectively) and similar to liraglutide (P =.45 and P =.895, respectively). Conclusions: Once-daily IDegLira provides significantly better PPG control following a mixed meal test than insulin degludec. The improvement is at least partially explained by higher endogenous insulin secretion and improved beta cell function with IDegLira. The benefits of liraglutide on PPG control are maintained across all main meals in the combination

Neuroendocrine (Merkel cell) carcinoma of the retroperitoneum with no identifiable primary site

<p>Abstract</p> <p>Background</p> <p>Neuroendocrine carcinoma is an aggressive neoplasm that mainly affects elderly Caucasians and typically arises in sun-exposed areas of the skin. The disease is rather rare and only a relatively few cases present with no apparent primary lesion.</p> <p>Case presentation</p> <p>We report a case of an 81-year-old Caucasian male with neuroendocrine carcinoma, which initially presented as a large retroperitoneal mass. Pathological and immunohistochemical analysis of the transabdominal CT-guided biopsy specimen revealed tissue consistent with neuroendocrine carcinoma. The patient underwent exploratory laparotomy and the mass was successfully excised along with an associated mesenteric lymph node.</p> <p>Discussion</p> <p>There are currently two possible explanations for what occurred in our patient. First, the retroperitoneal mass could be a massively enlarged lymph node where precursor cells became neoplastic. This would be consistent with a presumptive diagnosis of primary nodal disease. Alternatively, an initial skin lesion could have spontaneously regressed and the retroperitoneal mass represents a single site of metastasis. Since Merkel cell precursors have never been identified within lymph nodes, the latter theory seems more befitting. Moreover, metastasis to the retroperitoneal lymph nodes has been reported as relatively common when compared to other sites such as liver, bone, brain and skin.</p> <p>Conclusion</p> <p>Wide local excision of the primary tumor is the surgical treatment of choice for localized disease. We propose that further studies are needed to elucidate the true efficacy of chemotherapy in conventional as well as unconventional patients with neuroendocrine carcinoma.</p