Sudden hearing loss as an early detector of multiple sclerosis: a systematic review

To evaluate whether Sudden Sensorineural Hearing Loss (S-SNHL) may be an early symptom of Multiple Sclerosis (MS). A systematic review was conducted using the following keywords: "Multiple sclerosis, hearing loss, sudden hearing loss, vertigo, tinnitus, magnetic resonance imaging, otoacoustic emission, auditory brainstem responses, white matter lesions, sensorineural hearing loss, symptoms of MS and otolaryngology, nerve disease and MS". Only the articles that included results of at least one auditory test and MRI were considered. We evaluated the prevalence of SNHL in patients with MS, the presence of different forms of SNHL (S-SNHL and Progressive SNHL (P-SNHL)) and their correlation with the stage of MS, the results of electrophysiological tests, and the location (if any) of MS lesions as detected by white matter hyperintensities in the MRI. We reviewed a total of 47 articles, which included 29 case reports, 6 prospective studies, 6 cohort studies, 4 case-control studies, and 2 retrospective studies. 25% of patients suffered from SNHL. S-SNHL typically occurred in the early stage of the disease (92% of patients) and was the only presenting symptom in 43% of female subjects. Instead, P-SNHL occurred in the late stage of MS (88% of patients). Auditory Brainstem Responses (ABR) were abnormal in all MS patients with S-SNHL. When S-SNHL appeared during the early stage of the disease, MS lesions were found in the brain in 60% of patients and in the Internal Auditory Canal in 40% of patients. ABR remained abnormal after recovery. S-SNHL can be an early manifestation of MS and should always be considered in the differential diagnosis of this condition, especially in women. The pathophysiology can be explained by the involvement of microglia attacking the central and/or peripheral auditory pathways as indicated by WMHs

Analysis of the trueness and precision of complete denture bases manufactured using digital and analog technologies

PURPOSE. Digital technology has enabled improvements in the fitting accuracy of denture bases via milling techniques. The aim of this study was to evaluate the trueness and precision of digital and analog techniques for manufacturing complete dentures (CDs). MATERIALS AND METHODS. Sixty identical CDs were manufactured using different production protocols. Digital and analog technologies were compared using the reference geometric approach, and the Delta-error values of eight areas of interest (AOI) were calculated. For each AOI, a precise number of measurement points was selected according to sensitivity analyses to compare the Delta-error of trueness and precision between the original model and manufactured prosthesis. Three types of statistical analysis were performed: to calculate the intergroup cumulative difference among the three protocols, the intergroup among the AOIs, and the intragroup difference among AOIs. RESULTS. There was a statistically significant difference between the dentures made using the oversize process and injection molding process (P < .001), but no significant difference between the other two manufacturing methods (P = .1227). There was also a statistically significant difference between the dentures made using the monolithic process and the other two processes for all AOIs (P = .0061), but there was no significant difference between the other two processes (P = 1). Within each group, significant differences among the AOIs were observed. CONCLUSION. The monolithic process yielded better results, in terms of accuracy (trueness and precision), than the other groups, although all three processes led to dentures with Delta-error values well within the clinical tolerance limit. [J Adv Prosthodont 2023;15:22-32

Evaluation of trueness and precision of removable partial denture metal frameworks manufactured with digital technology and different materials

PURPOSE. The aim of this study is to evaluate the accuracy of removable partial denture (RPD) frameworks produced using different digital protocols. MATERIALS AND METHODS. 80 frameworks for RPDs were produced using CAD-CAM technology and divided into four groups of twenty (n = 20): Group 1, Titanium frameworks manufactured by digital metal laser sintering (DMLS); Group 2, Co-Cr frameworks manufactured by DMLS; Group 3, Polyamide PA12 castable resin manufactured by multi-jet fusion (MJF); and Group 4, Metal (Co-Cr) casting by using lost-wax technique. After the digital acquisition, eight specific areas were selected in order to measure the Δ-error value at the intaglio surface of RPD. The minimum value required for point sampling density (0.4 mm) was derived from the sensitivity analysis. The obtained Δ-error mean value was used for comparisons: 1. between different manufacturing processes; 2. between different manufacturing techniques in the same area of interest (AOI); and 3. between different AOI of the same group. RESULTS. The Δ-error mean value of each group ranged between -0.002 (Ti) and 0.041 (Co-Cr) mm. The Pearson’s Chi-squared test revealed significant differences considering all groups paired two by two, except for group 3 and 4. The multiple comparison test documented a significant difference for each AOI among group 1, 3, and 4. The multiple comparison test showed significant differences among almost all different AOIs of each group. CONCLUSION. All Δ-mean error values of all digital protocols for manufacturing RPD frameworks optimally fit within the clinical tolerance limit of trueness and precision

Aberrant brain network connectivity in pre-symptomatic and manifest Huntington's disease: a systematic review

Resting-state functional magnetic resonance imaging (rs-fMRI) has the potential to shed light on the pathophysiological mechanisms of Huntington's disease (HD), paving the way to new therapeutic interventions. A systematic review of the literature was conducted in three online databases according to PRISMA guidelines, using keywords for HD, functional connectivity, and rs-fMRI. We included studies investigating connectivity in pre-symptomatic (pre-HD) and manifest HD gene carriers compared to healthy controls, implementing seed-based connectivity, independent component analysis, regional property and graph analysis approaches. Visual network showed reduced connectivity in manifest HD, while network/areas underpinning motor functions were consistently altered in both manifest HD and pre-HD, showing disease stage-dependent changes. Cognitive networks underlying executive and attentional functions showed divergent anterior-posterior alterations, reflecting possible compensatory mechanisms. The involvement of these networks in pre-HD is still unclear. In conclusion, aberrant connectivity of the sensory-motor network is observed in the early stage of HD while, as pathology spreads, other networks might be affected, such as the visual and executive/attentional networks. Moreover, sensory-motor and executive networks exhibit hyper- and hypo-connectivity patterns following different spatiotemporal trajectories. These findings could help to implement future huntingtin-lowering interventions

Improving water use efficiency in vertical farming: Effects of growing systems, far-red radiation and planting density on lettuce cultivation

Vertical farms (VFs) are innovative urban production facilities consisting of multi-level indoor systems equipped with artificial lighting in which all the environmental conditions are controlled independently from the external climate. VFs are generally provided with a closed loop fertigation system to optimize the use of water and nu-trients. The objective of this study, performed within an experimental VF at the University of Bologna, was to quantify the water use efficiency (WUE, ratio between plant fresh weight and the volume of water used) for a lettuce (Lactuca sativa L.) growth cycle obtained in two different growing systems: an ebb-and-flow substrate culture and a high pressure aeroponic system. Considering the total water consumed (water used for irrigation and climate management), WUE of ebb-and-flow and aeroponics was 28.1 and 52.9 g L-1 H2O, respectively. During the growing cycle, the contribution generated by the recovery of internal air moisture from the heating, ventilation and air conditioning (HVAC) system, was quantified. Indeed, by recovering water from the dehu-midifier, water use decreases dramatically (by 67 %), while WUE increased by 206 %. Further improvement of WUE in the ebb-and-flow system was obtained through ameliorated crop management strategies, in particular, by increasing planting densities (e.g., 153, 270 and 733 plants m-2) and by optimizing the light spectrum used for plant growth (e.g., adjusting the amount of far-red radiation in the spectrum). Strategies for efficient use of water in high-tech urban indoor growing systems are therefore proposed

Assessment of the different types of failure on anterior cantilever resin-bonded fixed dental prostheses fabricated with three different materials: An in vitro study

background: resin-bonded fixed dental prosthesis (RBFDP) represents a highly aesthetic and conservative treatment option to replace a single tooth in a younger patient. The purpose of this in vitro study was to compare the fracture strength and the different types of failure on anterior cantilever RBFDPs fabricated using zirconia (ZR), lithium disilicate (LD), and PMMA-based material with ceramic fillers (PM) by the same standard tessellation language (STL) file. Methods: sixty extracted bovine mandibular incisives were embedded resin block; scanned to design one master model of RBFDP with a cantilevered single-retainer. Twenty cantilevered single-retainer RBFDPs were fabricated using ZR; LD; and PM. Static loading was performed using a universal testing machine. Results: the mean fracture strength for the RBFDPs was: 292.5 Newton (Standard Deviation (SD) 36.6) for ZR; 210 N (SD 37.6) for LD; and 133 N (SD 16.3) for PM. All the failures of RBFDPs in ZR were a fracture of the abutment tooth; instead; the 80% of failures of RBFDPs in LD and PM were a fracture of the connector. Conclusion: within the limitations of this in vitro study, we can conclude that the zirconia RBFDPs presented load resistance higher than the maximum anterior bite force reported in literature (270 N) and failure type analysis showed some trends among the groups

White matter tract disconnection in Gerstmann's syndrome: Insights from a single case study

It has been suggested that Gerstmann's syndrome is the result of subcortical disconnection rather than emerging from damage of a multifunctional brain region within the parietal lobe. However, patterns of white matter tract disconnection following parietal damage have been barely investigated. This single case study allows characterising Gerstmann's syndrome in terms of disconnected networks. We report the case of a left parietal patient affected by Gerstmann's tetrad: agraphia, acalculia, left/right orientation problems, and finger agnosia. Lesion mapping, atlas-based estimation of probability of disconnection, and DTI-based tractography revealed that the lesion was mainly located in the superior parietal lobule, and it caused disruption of both intraparietal tracts passing through the inferior parietal lobule (e.g., tracts connecting the angular, supramarginal, postcentral gyri, and the superior parietal lobule) and fronto-parietal long tracts (e.g., the superior longitudinal fasciculus). The lesion site appears to be located more superiorly as compared to the cerebral regions shown active by other studies during tasks impaired in the syndrome, and it reached the subcortical area potentially critical in the emergence of the syndrome, as hypothesised in previous studies. Importantly, the reconstruction of tracts connecting regions within the parietal lobe indicates that this critical subcortical area is mainly crossed by white matter tracts connecting the angular gyrus and the superior parietal lobule. Taken together, these findings suggest that this case study might be considered as empirical evidence of Gerstmann's tetrad caused by disconnection of intraparietal white matter tracts

Efeito do flunixin meglumine na taxa de prenhez de vacas leiteiras inseminadas em tempo-fixo.

O objetivo deste estudo foi avaliar o efeito do flunixin meglumine (FM) após a inseminação artificial em tempo-fixo (IATF) sobre a taxa de prenhez de vacas de leite