On the thermal impact during drilling operations in guided dental surgery: An experimental and numerical investigation

In recent years, a major development in dental implantology has been the introduction of patient-specific 3D-printed surgical guides. The utilization of dental guides offers advantages such as enhanced accuracy in locating the implant sites, greater simplicity, and reliability in performing bone drilling operations. However, it is important to note that the presence of such guides may contribute to a rise in cutting temperature, hence increasing the potential hazards of thermal injury to the patient's bone. The aim of this study is to examine the drilling temperature evolution in two distinct methods for 3D-printed surgical dental guides, one utilizing an internal metal bushing system and the other using external metal reducers. Cutting tests are done on synthetic polyurethane bone jaw models using a lab-scale automated Computer Numeric Control (CNC) machine to find out the temperature reached by different drilling techniques and compare them to traditional free cutting configurations. Thermal imaging and thermocouples, as well as the development of numerical simulations using finite element modeling, are used for the aim. The temperature of the tools' shanks experienced an average rise of 2.4 °C and 4.8 °C, but the tooltips exhibited an average increase of around 17 °C and 24 °C during traditional and guided dental surgery, respectively. This finding provides confirmation that both guided technologies have the capability to maintain temperatures below the critical limit for potential harm to bone and tissue. Numerical models were employed to validate and corroborate the findings, which exhibited identical outcomes when applied to genuine bone samples with distinct thermal characteristics

Economic Growth and Cancer Incidence

Why do we observe increasing rates of new cancer cases? Is the increasing burden of cancer mainly the outcome of higher life expectancy and better life conditions brought about by economic development? To what extent do environmental degradation and changes in life-styles play a relevant role? To answer these questions, we empirically assessed the relationship between per capita income and new cancer cases (incidence) by using cross-sectional data from 122 countries. We found that the incidence rate of all-sites cancer increases linearly with per capita income, even after controlling for population ageing, improvement in cancer detection, and omitted spatially correlated variables. If higher incidence rates in developed countries were merely due to those factors, and not also to life-styles and environmental degradation, we would have found a flat or even an inverted-U pattern between per capita income and cancer incidence. The regression analysis was applied also to the eight most common site-specific cancers. This confirmed the existing evidence on the different patterns in rich and poor countries, explained the pattern of the estimated relationship for aggregate cancers, and gave some other interesting insights

Updated and new perspectives on diagnosis, prognosis, and therapy of malignant pheochromocytoma/paraganglioma.

Malignant pheochromocytomas/paragangliomas are rare tumors with a poor prognosis. Malignancy is diagnosed by the development of metastases as evidenced by recurrences in sites normally devoid of chromaffin tissue. Histopathological, biochemical, molecular and genetic markers offer only information on potential risk of metastatic spread. Large size, extraadrenal location, dopamine secretion, SDHB mutations, a PASS score higher than 6, a high Ki-67 index are indexes for potential malignancy. Metastases can be present at first diagnosis or occur years after primary surgery. Measurement of plasma and/or urinary metanephrine, normetanephrine and metoxytyramine are recommended for biochemical diagnosis. Anatomical and functional imaging using different radionuclides are necessary for localization of tumor and metastases. Metastatic pheochromocytomas/paragangliomas is incurable. When possible, surgical debulking of primary tumor is recommended as well as surgical or radiosurgical removal of metastases. I-131-MIBG radiotherapy is the treatment of choice although results are limited. Chemotherapy is reserved to more advanced disease stages. Recent genetic studies have highlighted the main pathways involved in pheochromocytomas/paragangliomas pathogenesis thus suggesting the use of targeted therapy which, nevertheless, has still to be validated. Large cooperative studies on tissue specimens and clinical trials in large cohorts of patients are necessary to achieve better therapeutic tools and improve patient prognosis

Awareness and Sources of Knowledge about Obstructive Sleep Apnea: A Cross Sectional Survey Study

Obstructive sleep apnea (OSA) is a multifactorial sleep breathing disorder, seriously impacting quality of life and involving approximately 1 billion of the world’s population. It is characterized by episodes of total cessation of breathing or decreases in airflow during sleep. Available data suggest that most cases of OSA remain undiagnosed even in developed countries. This is due to a lack of widespread knowledge about this pathology and the medical morbidities and mortality it brings about, among both laypeople and physicians. Moreover, despite receiving indications about the need to undergo specific evaluations for OSA signs and symptoms, sometimes patients do not pay sufficient attention to the problem. This is probably due to a lack of correct information on these issues. The present investigation analyzed the level of knowledge about OSA pathology and the sources through which a group of OSA patients gained information on their condition. A survey of 92 patients diagnosed with OSA (mean age 60.55 ± 10.10) and referred to the Unit of Orthodontics and Dental Sleep Medicine of the University of Bologna was conducted by means of a questionnaire investigating sociodemographic characteristics, the level of general knowledge on OSA pathology and its possible medical consequences. Despite about two third (67.38%) of the population demonstrating extensive knowledge, remarkably, a group of subjects (20.65%) had poor awareness of the OSA condition. A statistically significant correlation emerged between the level of knowledge about OSA and the level of education (p = 0.002). A great effort should be made to improve the quality of information and the communication modalities for OSA to enable a fully appropriate awareness of the condition among patients

Equation of state at high densities and modern compact star observations

Recently, observations of compact stars have provided new data of high accuracy which put strong constraints on the high-density behaviour of the equation of state of strongly interacting matter otherwise not accessible in terrestrial laboratories. The evidence for neutron stars with high mass (M =2.1 +/- 0.2 M_sun for PSR J0751+1807) and large radii (R > 12 km for RX J1856-3754) rules out soft equations of state and has provoked a debate whether the occurence of quark matter in compact stars can be excluded as well. In this contribution it is shown that modern quantum field theoretical approaches to quark matter including color superconductivity and a vector meanfield allow a microscopic description of hybrid stars which fulfill the new, strong constraints. The deconfinement transition in the resulting stiff hybrid equation of state is weakly first order so that signals of it have to be expected due to specific changes in transport properties governing the rotational and cooling evolution caused by the color superconductivity of quark matter. A similar conclusion holds for the investigation of quark deconfinement in future generations of nucleus-nucleus collision experiments at low temperatures and high baryon densities such as CBM @ FAIR.Comment: 6 pages, 2 figures, accepted for publication in J. Phys. G. (Special Issue

'White knuckle care work' : violence, gender and new public management in the voluntary sector

Drawing on comparative data from Canada and Scotland, this article explores reasons why violence is tolerated in non-profit care settings. This article will provide insights into how workers' orientations to work, the desire to care and the intrinsic rewards from working in a non-profit context interact with the organization of work and managerially constructed workplace norms and cultures (Burawoy, 1979) to offset the tensions in an environment characterized by scarce resources and poor working conditions. This article will also outline how the same environment of scarce resources causes strains in management's efforts to establish such cultures. Working with highly excluded service users with problems that do not respond to easy interventions, workers find themselves working at the edge of their endurance, hanging on by their fingernails, and beginning to participate in various forms of resistance; suggesting that even among the most highly committed, 'white knuckle care' may be unsustainable

Genotype of Immunologically Hot or Cold Tumors Determines the Antitumor Immune Response and Efficacy by Fully Virulent Retargeted oHSV

We report on the efficacy of the non-attenuated HER2-retargeted oHSV named R-337 against the immunologically hot CT26-HER2 tumor, and an insight into the basis of the immune protection. Preliminarily, we conducted an RNA immune profiling and immune cell content characterization of CT26-HER2 tumor in comparison to the immunologically cold LLC1-HER2 tumor. CT26-HER2 tumor was implanted into HER2-transgenic BALB/c mice. Hallmarks of R-337 effects were the protection from primary tumor, long-term adaptive vaccination directed to both HER2 and CT26-wt cell neoantigens. The latter effect differentiated R-337 from OncoVEXGM-CSF. As to the basis of the immune protection, R-337 orchestrated several changes to the tumor immune profile, which cumulatively reversed the immunosuppression typical of this tumor (graphical abstract). Thus, Ido1 (inhibitor of T cell anticancer immunity) levels and T regulatory cell infiltration were decreased; Cd40 and Cd27 co-immunostimulatory markers were increased; the IFNγ cascade was activated. Of note was the dampening of IFN-I response, which we attribute to the fact that R-337 is fully equipped with genes that contrast the host innate response. The IFN-I shut-down likely favored viral replication and the expression of the mIL-12 payload, which, in turn, boosted the antitumor response. The results call for a characterization of tumor immune markers to employ oncolytic herpesviruses more precisely

Wodzicki Residue for Operators on Manifolds with Cylindrical Ends

We define the Wodzicki Residue TR(A) for A in a space of operators with double order (m_1,m_2). Such operators are globally defined initially on R^n and then, more generally, on a class of non-compact manifolds, namely, the manifolds with cylindrical ends. The definition is based on the analysis of the associate zeta function. Using this approach, under suitable ellipticity assumptions, we also compute a two terms leading part of the Weyl formula for a positive selfadjoint operator belonging the mentioned class in the case m_1=m_2.Comment: 24 pages, picture changed, added references, corrected typo

Promoter Methylation Leads to Decreased ZFP36 Expression and Deregulated NLRP3 Inflammasome Activation in Psoriatic Fibroblasts

The mRNA-destabilizing protein tristetraprolin (TTP), encoded by the ZFP36 gene, is known to be able to end inflammatory responses by directly targeting and destabilizing mRNAs encoding pro-inflammatory cytokines. We analyzed its role in psoriasis, a disease characterized by chronic inflammation. We observed that TTP is downregulated in fibroblasts deriving from psoriasis patients compared to those deriving from healthy individuals and that psoriatic fibroblasts exhibit abnormal inflammasome activity compared to their physiological counterpart. This phenomenon depends on TTP downregulation. In fact, following restoration, TTP is capable of directly targeting for degradation NLRP3 mRNA, thereby drastically decreasing inflammasome activation. Moreover, we provide evidence that ZFP36 undergoes methylation in psoriasis, by virtue of the presence of long stretches of CpG dinucleotides both in the promoter and the coding region. Besides confirming that a perturbation of TTP expression might underlie the pathogenesis of psoriasis, we suggest that deregulated inflammasome activity might play a role in the disease alongside deregulated cytokine expression

Magnetic activity and the solar corona: first results from the Hinode satellite

The structure, dynamics and evolution of the solar corona are governed by the magnetic field. In spite of significant progresses in our insight of the physics of the so- lar corona, several problems are still under debate, e.g. the role of impulsive events and waves in coronal heating, and the origin of eruptions, flares and CMEs. The Hinode mis- sion has started on 22 september 2006 and aims at giving new answers to these questions. The satellite contains three main instruments, two high resolution telescopes, one in the optical and one in the X-ray band, and an EUV imaging spectrometer. On the Italian side, INAF/Osservatorio Astronomico di Palermo has contributed with the ground-calibration of the filters of the X-ray telescope. We present some preliminary mission results, with partic- ular attention to the X-ray telescope data