Zirconia enriched dental adhesive: A solution for OCT contrast enhancement. Demonstrative study by synchrotron radiation microtomography

Objective The major aim of this study was to prove the capability of the optical coherence tomography (OCT) method in visualizing the integrity of the adhesive fillings and of the interfaces between the adhesive, tooth structures and composite resin. As zirconium dioxide was added to the composition of the adhesive layer in order to strengthen the backscattered light in the OCT investigation, for a better visualization of the interfaces, the determination of a proper zirconia concentration was another aim of our study. Method Several class II cavities were prepared in human premolars and were filled with dental adhesive containing different zirconia concentrations and light-curing composite resin. Both OCT and synchrotron radiation microtomography (micro-CT) were used to analyse the morphology of the tooth-adhesive-composite interfaces and to investigate the adhesive layer. Results The pore distribution, both at the interfaces level and in the resin, and the analysis of the adhesive layer integrity were obtained. A good agreement between OCT and micro-CT analyses was observed in terms of detecting discontinuities in the adhesive layer. Furthermore, micro-CT showed that zirconia percentages in the adhesive higher than 20 vol.% lead to conglomerates formation, which can negatively influence mechanical properties. Meanwhile, OCT confirmed a factor of 3 for the contrast enhancement when 20% of zirconia was included in the adhesive composition. Significance The present study proved the capability of the OCT method in visualizing the morphology and integrity of zirconia doped tooth adhesive fillings, to be used for a further in vivo tool development. © 2014 Academy of Dental Materials

A Quantitative Assessment of Factors Affecting the Technological Development and Adoption of Companion Diagnostics

[This corrects the article on p. 357 in vol. 6, PMID: 26858745.]

Low incidence of SARS-CoV-2, risk factors of mortality and the course of illness in the French national cohort of dialysis patients

International audienceThe aim of this study was to estimate the incidence of COVID-19 disease in the French national population of dialysis patients, their course of illness and to identify the risk factors associated with mortality. Our study included all patients on dialysis recorded in the French REIN Registry in April 2020. Clinical characteristics at last follow-up and the evolution of COVID-19 illness severity over time were recorded for diagnosed cases (either suspicious clinical symptoms, characteristic signs on the chest scan or a positive reverse transcription polymerase chain reaction) for SARS-CoV-2. A total of 1,621 infected patients were reported on the REIN registry from March 16th, 2020 to May 4th, 2020. Of these, 344 died. The prevalence of COVID-19 patients varied from less than 1% to 10% between regions. The probability of being a case was higher in males, patients with diabetes, those in need of assistance for transfer or treated at a self-care unit. Dialysis at home was associated with a lower probability of being infected as was being a smoker, a former smoker, having an active malignancy, or peripheral vascular disease. Mortality in diagnosed cases (21%) was associated with the same causes as in the general population. Higher age, hypoalbuminemia and the presence of an ischemic heart disease were statistically independently associated with a higher risk of death. Being treated at a selfcare unit was associated with a lower risk. Thus, our study showed a relatively low frequency of COVID-19 among dialysis patients contrary to what might have been assumed

Rivaroxaban with or without aspirin in stable cardiovascular disease

BACKGROUND: We evaluated whether rivaroxaban alone or in combination with aspirin would be more effective than aspirin alone for secondary cardiovascular prevention. METHODS: In this double-blind trial, we randomly assigned 27,395 participants with stable atherosclerotic vascular disease to receive rivaroxaban (2.5 mg twice daily) plus aspirin (100 mg once daily), rivaroxaban (5 mg twice daily), or aspirin (100 mg once daily). The primary outcome was a composite of cardiovascular death, stroke, or myocardial infarction. The study was stopped for superiority of the rivaroxaban-plus-aspirin group after a mean follow-up of 23 months. RESULTS: The primary outcome occurred in fewer patients in the rivaroxaban-plus-aspirin group than in the aspirin-alone group (379 patients [4.1%] vs. 496 patients [5.4%]; hazard ratio, 0.76; 95% confidence interval [CI], 0.66 to 0.86; P<0.001; z=−4.126), but major bleeding events occurred in more patients in the rivaroxaban-plus-aspirin group (288 patients [3.1%] vs. 170 patients [1.9%]; hazard ratio, 1.70; 95% CI, 1.40 to 2.05; P<0.001). There was no significant difference in intracranial or fatal bleeding between these two groups. There were 313 deaths (3.4%) in the rivaroxaban-plus-aspirin group as compared with 378 (4.1%) in the aspirin-alone group (hazard ratio, 0.82; 95% CI, 0.71 to 0.96; P=0.01; threshold P value for significance, 0.0025). The primary outcome did not occur in significantly fewer patients in the rivaroxaban-alone group than in the aspirin-alone group, but major bleeding events occurred in more patients in the rivaroxaban-alone group. CONCLUSIONS: Among patients with stable atherosclerotic vascular disease, those assigned to rivaroxaban (2.5 mg twice daily) plus aspirin had better cardiovascular outcomes and more major bleeding events than those assigned to aspirin alone. Rivaroxaban (5 mg twice daily) alone did not result in better cardiovascular outcomes than aspirin alone and resulted in more major bleeding events