Anterior Z250 resin composite restorations: one-year evaluation of clinical performance.

AbstractThe purpose of this practice-based study was to compare the clinical performance of a new universal composite resin material (Z250) used for Class III and V cavities in anterior teeth. Restorative materials (Z250 and Z100; 3 M ESPE) placed by six operators were used for a total of 150 restorations during the 6-month enrollment period. After 1 year, 141 restorations (76 Z250 and 66 Z100) were available and evaluated for overall quality, color match, marginal adaptation, surface appearance and the presence of secondary caries, using modified USPHS criteria. The overall quality was excellent for both materials and no significant changes were noted during the follow-up. None of the scores between the two materials were statistically significant. Major changes were seen in color match and surface appearance. At baseline, the color match of 71% of Z250 and 62% of Z100 was rated as Alfa, after 1 year the figures were 60 and 65%. Regarding surface appearance, 97% of the Z250 were rated Alfa at baseline, whereas at 1 year the figure was 76%. For Z100, the scores were 94 and 79%, respectively. After 1 year, the clinical performance of Z250 restorative composite resin was clinically acceptable and similar to that of Z100.</div

Heterogeneity of executive functions among preschool children with psychiatric symptoms

The aim of the present study was to investigate associations between internalizing and externalizing symptoms and deficits in executive functions (EF) as well as to examine the overall heterogeneity of EFs in a sample of preschool children attending a psychiatric clinic (n = 171). First, based on cut-off points signifying clinical levels of impairment on the parent-completed Child Behavior Checklist (CBCL), children were assigned into groups of internalizing, externalizing, combined or mild symptoms and compared to a reference group (n = 667) with regard to day care teacher ratings of EFs on the Attention and Executive Function Rating Inventory-Preschool (ATTEX-P). Second, latent profile analysis (LPA) was employed to identify distinct subgroups of children representing different EF profiles with unique strengths and weaknesses in EFs. The first set of analyses indicated that all symptom groups had more difficulties in EFs than the reference group did, and the internalizing group had less inhibition-related problems than the other symptom groups did. Using LPA, five EF profiles were identified: average, weak average, attentional problems, inhibitory problems, and overall problems. The EF profiles were significantly associated with gender, maternal education level, and psychiatric symptom type. Overall, the findings suggest that the comparison of means of internalizing and externalizing groups mainly captures the fairly obvious differences in inhibition-related domains among young psychiatric outpatient children, whereas the person-oriented approach, based on individual differences, identifies heterogeneity related to attentional functions, planning, and initiating one's action. The variability in EF difficulties suggests that a comprehensive evaluation of a child's EF profile is important regardless of the type of psychiatric symptoms the child presents with.Peer reviewe

Oral health assessment in domiciliary care service planning of older people

ObjectivesThe aim was to examine importance and consideration of oral health‐related issues (OHRIs) during service planning by the case managers (CMs).Methods and resultsThe study was conducted in a major Finnish city. All 25 CMs, supervising over 450 domiciliary care employees who are caring for 4600 domiciliary care clients, received a multiple‐choice questionnaire with additional open‐ended questions. CMs were dichotomized by age and educational background. Differences were compared with the chi‐square test and Fisher´s exact test. Response rate was 88%. All CMs considered OHRIs important. However, OHRIs were not routinely considered during service planning, especially by the CMs with a social service than health background (0% vs 30%, P ConclusionOHRIs are not routinely considered in service planning. This study indicated a need for structured guidelines and further education for assess the need for oral home care assistance.</div

Effect of Age on Flow-Rate, Protein and Electrolyte Composition of Stimulated Whole Saliva in Healthy, Non-Smoking Women

As relatively little is known about the effect of age on salivary electrolytes we studied the composition of saliva as function of age to provide reference values for healthy non-smoking women. All non-medicated and non-smoking 30-59-year-old subjects (n=255) selected from among 1030 women participating in a screening program formed the material of the present study. Salivary calcium, inorganic phosphate, magnesium, sodium, potassium, protein and flow-rate of stimulated whole saliva were measured. We found age-related changes in salivary calcium and phosphate concentrations (p=0.001 and p=0.004, respectively, one-way ANOVA). Peak values occurred at around 50-54 years of age. Age had no effect on flow-rate, magnesium, sodium, potassium or proteins. The concentration of sodium correlated positively, while phosphate, potassium, magnesium and protein correlated negatively with the salivary flow-rate. Calcium was the only electrolyte which had no association with flow-rate. Our study provides reference values for salivary electrolytes of 30-59-year-old women

Capturing complex tumour biology in vitro: Histological and molecular characterisation of precision cut slices

Precision-cut slices of in vivo tumours permit interrogation in vitro of heterogeneous cells from solid tumours together with their native microenvironment. They offer a low throughput but high content in vitro experimental platform. Using mouse models as surrogates for three common human solid tumours, we describe a standardised workflow for systematic comparison of tumour slice cultivation methods and a tissue microarray-based method to archive them. Cultivated slices were compared to their in vivo source tissue using immunohistochemical and transcriptional biomarkers, particularly of cellular stress. Mechanical slicing induced minimal stress. Cultivation of tumour slices required organotypic support materials and atmospheric oxygen for maintenance of integrity and was associated with significant temporal and loco-regional changes in protein expression, for example HIF-1α. We recommend adherence to the robust workflow described, with recognition of temporal-spatial changes in protein expression before interrogation of tumour slices by pharmacological or other means

Real-time observation of dissipative soliton formation in nonlinear polarization rotation mode-locked fibre lasers

Formation of coherent structures and patterns from unstable uniform state or noise is a fundamental physical phenomenon that occurs in various areas of science ranging from biology to astrophysics. Understanding of the underlying mechanisms of such processes can both improve our general interdisciplinary knowledge about complex nonlinear systems and lead to new practical engineering techniques. Modern optics with its high precision measurements offers excellent test-beds for studying complex nonlinear dynamics, though capturing transient rapid formation of optical solitons is technically challenging. Here we unveil the build-up of dissipative soliton in mode-locked fibre lasers using dispersive Fourier transform to measure spectral dynamics and employing autocorrelation analysis to investigate temporal evolution. Numerical simulations corroborate experimental observations, and indicate an underlying universality in the pulse formation. Statistical analysis identifies correlations and dependencies during the build-up phase. Our study may open up possibilities for real-time observation of various nonlinear structures in photonic systems

How Distinctive are ADHD and RD? Results of a Double Dissociation Study

The nature of the comorbidity between Attention-Deficit/Hyperactivity Disorder (ADHD) and Reading Disability (RD) was examined using a double dissociation design. Children were between 8 and 12 years of age and entered into four groups: ADHD only (n = 24), ADHD+RD (n = 29), RD only (n = 41) and normal controls (n = 26). In total, 120 children participated in the study; 38 girls and 82 boys. Both ADHD and RD were associated with impairments in inhibition and lexical decision, although inhibition and lexical decision were more severely impaired in RD than in ADHD. Visuospatial working memory deficits were specific to children with only ADHD. It is concluded that there was overlap on lexical decision and to a lesser extent on inhibition between ADHD and RD. In ADHD, impairments were dependent on IQ, which suggest that the overlap in lexical decision and inhibition is different in origin for ADHD and RD. The ADHD only group was specifically characterized by deficits in visuospatial working memory. Hence, no double dissociation between ADHD and RD was found on executive functioning and lexical decision

Implementation of corticosteroids in treatment of COVID-19 in the ISARIC WHO Clinical Characterisation Protocol UK: prospective, cohort study

Background: Dexamethasone was the first intervention proven to reduce mortality in patients with COVID-19 being treated in hospital. We aimed to evaluate the adoption of corticosteroids in the treatment of COVID-19 in the UK after the RECOVERY trial publication on June 16, 2020, and to identify discrepancies in care. Methods: We did an audit of clinical implementation of corticosteroids in a prospective, observational, cohort study in 237 UK acute care hospitals between March 16, 2020, and April 14, 2021, restricted to patients aged 18 years or older with proven or high likelihood of COVID-19, who received supplementary oxygen. The primary outcome was administration of dexamethasone, prednisolone, hydrocortisone, or methylprednisolone. This study is registered with ISRCTN, ISRCTN66726260. Findings: Between June 17, 2020, and April 14, 2021, 47 795 (75·2%) of 63 525 of patients on supplementary oxygen received corticosteroids, higher among patients requiring critical care than in those who received ward care (11 185 [86·6%] of 12 909 vs 36 415 [72·4%] of 50 278). Patients 50 years or older were significantly less likely to receive corticosteroids than those younger than 50 years (adjusted odds ratio 0·79 [95% CI 0·70–0·89], p=0·0001, for 70–79 years; 0·52 [0·46–0·58], p80 years), independent of patient demographics and illness severity. 84 (54·2%) of 155 pregnant women received corticosteroids. Rates of corticosteroid administration increased from 27·5% in the week before June 16, 2020, to 75–80% in January, 2021. Interpretation: Implementation of corticosteroids into clinical practice in the UK for patients with COVID-19 has been successful, but not universal. Patients older than 70 years, independent of illness severity, chronic neurological disease, and dementia, were less likely to receive corticosteroids than those who were younger, as were pregnant women. This could reflect appropriate clinical decision making, but the possibility of inequitable access to life-saving care should be considered. Funding: UK National Institute for Health Research and UK Medical Research Council