Estudio sobre la adaptación apical de conos maestros de gutapercha en conductos radiculares instrumentados con limas Lightspeed

El objetivo de este trabajo fue establecer la coincidencia entre el calibre del cono maestro apical y la lima maestra apical, así como medir cualitativamente la adaptación de diferentes marcas de conos de gutapercha en el tercio apical de conductos radiculares instrumentados con limas Lightspeed. Se instrumentaron 100 conductos de molares naturales extraídos con el sistema Lightspeed. Las muestras se distribuyeron aleatoriamente en cinco grupos. Cada grupo fue obturado mediante condensación lateral, empleando gutapercha de diferentes marcas (Maillefer, Roeko, Kerr, Zipperer y P.D.). Las raíces se seccionaron a 1,5 mm del ápice, siendo observadas mediante estereomicroscopio. Se observó una coincidencia del 70% entre los conos Roeko y la lima maestra apical, siendo significativamente más alta (p = 0,0061) que los resultados de los grupos Kerr, Zipperer, P.D. y Maillefer, en los que la coincidencia fue del 55%, 45%, 40% y 35% de las muestras, respectivamente. Se apreció buena adaptación en el 70-80% de los conductos obturados con Kerr, Zipperer, Maillefer y Roeko, y el 50% con P.D

Microanatomical findings with relevance to trigeminal ganglion enhancement on post-contrast T1-weighted magnetic resonance images in dogs

Trigeminal ganglion contrast enhancement (TGCE) is reported to be a normal and a common finding on magnetic resonance imaging studies of dogs, cats and humans. The intent of the present study was to describe the anatomical characteristics of the trigeminal ganglion, its surrounding structures, and histological features that are relevant to explain or hypothesize on the reason for TGCE on T1-weighted post-contrast MRI studies of the brain in dogs. Eight dog cadavers were dissected to study the anatomy of the trigeminal ganglion. The presence and anatomy of vessels was studied by dissection and by histological techniques. Two trigeminal ganglia were isolated and stained with hematoxylin-eosin (HE). Two other trigeminal ganglia included in the trigeminal canal and trigeminal cavity were decalcified with formic acid/formalin for 12 weeks and stained with HE to study the related vessels. Additionally, a corrosion cast was obtained from a separate canine specimen. Leptomeninges and a subarachnoid space were identified at the level of the trigeminal nerve roots and the trigeminal ganglion. No subarachnoid space was identified and leptomeninges were no longer present at the level of the three trigeminal nerve branches. Small arterial vessels ran to and supplied the trigeminal ganglion, passing through the dura mater. No venous plexus was visualized at the level of the trigeminal ganglion in the dissections. A complex arterial vascular network was identified within the leptomeningeal covering of the trigeminal ganglion and was best appreciated in the corrosion cast. Histological examination revealed small-to moderate-sized blood vessels located in the epineurium around the ganglion; from there a multitude of arterioles penetrated into the perineurium. Small endoneurial branches and capillaries penetrated the ganglion and the trigeminal nerve branches. Limitations to this study include the limited number of canine specimens included and the lack of electron microscopy to further support current hypotheses included in our discussion. In conclusion, this study provides further support to the theory that TGCE in dogs may be due an incomplete blood-nerve barrier or blood-ganglion barrier at the interface between the central nervous system and the peripheral nervous system

GANimation: one-shot anatomically consistent facial animation

The final publication is available at link.springer.comRecent advances in generative adversarial networks (GANs) have shown impressive results for the task of facial expression synthesis. The most successful architecture is StarGAN (Choi et al. in CVPR, 2018), that conditions GANs’ generation process with images of a specific domain, namely a set of images of people sharing the same expression. While effective, this approach can only generate a discrete number of expressions, determined by the content and granularity of the dataset. To address this limitation, in this paper, we introduce a novel GAN conditioning scheme based on action units (AU) annotations, which describes in a continuous manifold the anatomical facial movements defining a human expression. Our approach allows controlling the magnitude of activation of each AU and combining several of them. Additionally, we propose a weakly supervised strategy to train the model, that only requires images annotated with their activated AUs, and exploit a novel self-learned attention mechanism that makes our network robust to changing backgrounds, lighting conditions and occlusions. Extensive evaluation shows that our approach goes beyond competing conditional generators both in the capability to synthesize a much wider range of expressions ruled by anatomically feasible muscle movements, as in the capacity of dealing with images in the wild. The code of this work is publicly available at https://github.com/albertpumarola/GANimation.Peer ReviewedPostprint (author's final draft

Excess hospitalizations and mortality associated with seasonal influenza in Spain, 2008–2018

Hospitalization; Influenza; MortalityHospitalització; Grip; MortalitatHospitalización; Gripe; MortalidadBackground Influenza may trigger complications, particularly in at-risk groups, potentially leading to hospitalization or death. However, due to lack of routine testing, influenza cases are infrequently coded with influenza-specific diagnosis. Statistical models using influenza activity as an explanatory variable can be used to estimate annual hospitalizations and deaths associated with influenza. Our study aimed to estimate the clinical and economic burden of severe influenza in Spain, considering such models. Methods The study comprised ten epidemic seasons (2008/2009–2017/2018) and used two approaches: (i) a direct method of estimating the seasonal influenza hospitalization, based on the number of National Health Service hospitalizations with influenza-specific International Classification of Diseases (ICD) codes (ICD-9: 487–488; ICD-10: J09-J11), as primary or secondary diagnosis; (ii) an indirect method of estimating excess hospitalizations and deaths using broader groups of ICD codes in time-series models, computed for six age groups and four groups of diagnoses: pneumonia or influenza (ICD-9: 480–488, 517.1; ICD-10: J09–J18), respiratory (ICD-9: 460–519; ICD-10: J00–J99), respiratory or cardiovascular (C&R, ICD-9: 390–459, 460–519; ICD-10: I00–I99, J00–J99), and all-cause. Means, excluding the H1N1pdm09 pandemic (2009/2010), are reported in this study. Results The mean number of hospitalizations with a diagnosis of influenza per season was 13,063, corresponding to 28.1 cases per 100,000 people. The mean direct annual cost of these hospitalizations was €45.7 million, of which 65.7% was generated by patients with comorbidities. Mean annual influenza-associated C&R hospitalizations were estimated at 34,894 (min: 16,546; max: 52,861), corresponding to 75.0 cases per 100,000 (95% confidence interval [CI]: 63.3–86.3) for all ages and 335.3 (95% CI: 293.2–377.5) in patients aged ≥ 65 years. We estimate 3.8 influenza-associated excess C&R hospitalizations for each hospitalization coded with an influenza-specific diagnosis in patients aged ≥ 65 years. The mean direct annual cost of the estimated excess C&R hospitalizations was €142.9 million for all ages and €115.9 million for patients aged ≥ 65 years. Mean annual influenza-associated all-cause mortality per 100,000 people was estimated at 27.7 for all ages. Conclusions Results suggest a relevant under-detected burden of influenza mostly in the elderly population, but not neglectable in younger people.The BARI study was funded by Sanofi. Martinón-Torres F has received support for the present work from the Instituto de Salud Carlos III (Proyecto de Investigación en Salud, Acción Estratégica en Salud): Fondo de Investigación Sanitaria (FIS; PI070069/PI1000540/PI1601569/PI1901090) del plan nacional de I + D + I and ‘fondos FEDER’ and Proyectos GAIN Rescata-Covid_IN845D 2020/23 (GAIN, Xunta de Galicia)

Clinical and imaging features of a feline lumbar myelopathy resembling ossification of the posterior longitudinal ligament in humans

Altres ajuts: acords transformatius de la UABA 9-year-old, male, neutered Russian blue cat was presented for a 2-week history of pelvic limb weakness and reluctance to jump and climb stairs. Neurological examination was consistent with an L4-L6 myelopathy. Ectopic calcification of soft tissues within the vertebral canal involving the dorsal longitudinal ligament over the L5-L6 vertebrae was diagnosed based on radiography, magnetic resonance imaging and computed tomography. The lesion was surgically excised, and histopathological examination demonstrated fibrous connective tissue with calcification. The patient was neurologically normal 2 months after surgery, and no relapses have occurred in a follow-up period of 2 years. The findings in this case had not been previously reported in cats, and share some similarities with a clinical entity in humans named ossification of the posterior longitudinal ligament

Estudio con microscopio electrónico de barrido del smear layer residual después de la instrumentación de conductos radiculares con distintos instrumentos rotatorios

Objetivo: Se evaluó comparativamente la presencia de smear layer residual tras la instrumentación de conductos con dos sistemas de instrumentación diferentes; uno con apoyos radiales: ProFile y otro sin ellos: RaCe. Metodología: Se seleccionaron 15 conductos de molares extraídos y se distribuyeron aleatoriamente en tres grupos de 5 cada uno (grupo PF: ProFile, grupo RC: RaCe, grupo RCSA: RaCe y S-Apex). Todos los instrumentos fueron utilizados con un contraángulo reductor 18:1 y un motor eléctrico a una velocidad de 300 r.p.m. y un torque dinámico AP-10. En los tres grupos, la irrigación entre cada instrumento se realizó alternando 2 ml de NaOCl (5,25%) y 2 ml de ác. Cítrico (20%). La limpieza de las paredes de los conductos se estudió con Microscopia electrónica de barrido utilizando 5 categorías para cuantificar la cantidad de smear layer a 1000 aumentos. El análisis estadístico de los resultados se realizó con el test de Kruskal-Wallis y la U de Mann-Whitney. Resultados: Se hallaron diferencias significativas (P 0,05). Conclusiones: Ninguno de los sistemas consigue una total limpieza de los conductos, pero los resultados son mejores al utilizar instrumentos sin apoyos radiales

Evidence for positive selection of hepatitis A virus antigenic variants in vaccinated men-having-sex-with men patients: implications for immunization policies

Background: A huge outbreak in the men-having-sex-with-men (MSM) has hit Europe during the years 2016-2018. Outbreak control has been hampered by vaccine shortages in many countries, and to minimize their impact, reduction of antigen doses has been implemented. However, these measures may have conse-quences on the evolution of hepatitis A virus (HAV), leading to the emergence of antigenic variants. Cases in vac-cinated MSM patients have been detected in Barcelona, opening the possibility to study HAV evolution under immune pressure. Methods: We performed deep-sequencing analysis of ten overlapping fragments covering the complete capsid coding region of HAV. A total of 14578255 reads were obtained and used for the analysis of virus evolution in vaccinated versus non-vaccinated patients. We estimated maximum and minimum mutation frequencies, and Shan-non entropy in the quasispecies of each patient. Non-synonymous (NSyn) mutations affecting residues exposed in the capsid surface were located, with respect to epitopes, using the recently described crystal structure of HAV, as an indication of its potential role in escaping to the effect of vaccines. Findings: HAV evolution at the quasispecies level, in non-vaccinated and vaccinated patients, revealed higher diversity in epitope-coding regions of the vaccinated group. Although amino acid replacements occurring in and around the epitopes were observed in both groups, their abundance was significantly higher in the quasispecies of vaccinated patients, indicating ongoing processes of fixation. Interpretation: Our data suggest positive selection of antigenic variants in some vaccinated patients, raising concerns for new vaccination polices directed to the MSM group