Knowledge, attitude and perception on the adoption of evidence-based practice among practitioners of general dentistry

Evidence based dentistry (EBD) is the “conscientious, explicit and judicious use of the best evidence in making decisions about care of individual patients”, as defined by the American Dental Association. Bridging clinical expertise and patient values, it involves the systematic assessment of scientific evidence, linking it to a patient’s medical condition and with a scientifically backed framework, the dentist begins to treat the patient. Its basis lies in choosing the right type of evidence which could be highly patient subjective. The present study aims to assess the knowledge, attitude and perception prevalent among currently practicing dentists regarding EBD and their willingness to incorporate it into their practice. The study was a survey conducted using an online questionnaire on Google forms, with specifically framed, about 16 questions, that would elicit the current status of EBD among Dental UG students, interns and practising dentists. The responses obtained were statistically analysed using SPSS v26 (IBM.inc.,USA). From the responses, it can be observed that there is only a vague awareness on EBD and a satisfactory level of willingness to incorporate it into one’s practice, given that constraints in doing so are addressed. The study was handy in inferring the current status of EBD among today’s practitioners and would be useful in devising ways of overcoming any limitations in incorporating the same into routine clinical practice

Formability of AA-7075 sheets subjected to repetitive bending under tension

The fundamental objective of this work is to study the cold formability of AA-7075_O by a testing methodology known as repetitive bending under tension. The repetitive bending under tension is a testing methodology to create a similar deformation condition to that which occurs during incremental sheet forming. In the case of repetitive bending under tension tests, the sheet metal sample is subjected to localised bending under tensile loading. This additional bending during testing is applied by sliding a set of rollers over the gauge length of the tested sample. In order to study the influence of various strain conditions at the plastic deformation zone, specimens with different geometries were investigated. In addition, samples from three different orientations of 0˚, 45˚ and 90˚ with respect to the rolling direction were tested to study the effect of mechanical anisotropy on deformation behaviour. The results confirmed a significant increase in elongation to failure in samples subjected to repetitive bending under tension as compared to those subjected to standard tensile tests under similar conditions. It is shown that this could be due to a delay in localised necking during repetitive bending under tension. Finite element analysis (FEA) has also been used to simulate the process. In agreement with the experimental finding, FEA results show that the maximum force required to deform the material is less than that required during a standard tensile test. Analysis of 3D scanning of samples that went up to fracture during repetitive bending under tension and a standard tensile test revealed that the samples undergoing the former underwent a more uniform reduction in thickness and width along the gauge length, compared to the latter. TEM observations of the microstructure confirms grain refinement in the samples subjected to repetitive bending under tension. This could be due to a strain induced dynamic recrystallisation process occurring during the test. Analysing the crystallographic texture using neutron diffraction revealed that a strong {111}//ND fibre texture had been developed during the repetitive bending under tension test. This could be due plastic shear strain introduced by repetitively bending and unbending through the sheet thickness

Microstructure and mechanical properties of Al-1050 during incremental ECAP

Incremental ECAP is a new method of ECAP process were the severe shear deformation is incrementally applied on the sample resulting in grain refining and new texture developing. The fundamental objective of the present work is an observation of effect of different passes of I-ECAP on microstructure and mechanical properties of AA1050 billet. To that end, 8 pass of I-ECAP have been carried out using Bc route and microstructure evolution and mechanical properties of the I-ECAPed samples have been studied. The EBSD and TEM analyses indicates that I-ECAP is as capable as conventional ECAP to grain refinements and a UFG structure is resulted after I-ECAP cycles. Tensile testing and hardness measurements indicates that mechanical properties of the Al-1050 billets increases dramatically by increasing the I-ECAP passes

Effect of selective heart rate slowing in heart failure with preserved ejection fraction

Background Heart failure with preserved ejection fraction (HFpEF) is associated with significant morbidity and mortality but is currently refractory to therapy. Despite limited evidence, heart rate reduction has been advocated, on the basis of physiological considerations, as a therapeutic strategy in HFpEF. We tested the hypothesis that heart rate reduction improves exercise capacity in HFpEF. Methods and Results We conducted a randomized, crossover study comparing selective heart rate reduction with the If blocker ivabradine at 7.5 mg twice daily versus placebo for 2 weeks each in 22 symptomatic patients with HFpEF who had objective evidence of exercise limitation (peak oxygen consumption at maximal exercise [GraphicO2 peak] <80% predicted for age and sex). The result was compared with 22 similarly treated matched asymptomatic hypertensive volunteers. The primary end point was the change in GraphicO2 peak. Secondary outcomes included tissue Doppler–derived E/e′ at echocardiography, plasma brain natriuretic peptide, and quality-of-life scores. Ivabradine significantly reduced peak heart rate compared with placebo in the HFpEF (107 versus 129 bpm; P<0.0001) and hypertensive (127 versus 145 bpm; P=0.003) cohorts. Ivabradine compared with placebo significantly worsened the change in GraphicO2 peak in the HFpEF cohort (-2.1 versus 0.9 mL·kg−1·min−1; P=0.003) and significantly reduced submaximal exercise capacity, as determined by the oxygen uptake efficiency slope. No significant effects on the secondary end points were discernable. Conclusion Our observations bring into question the value of heart rate reduction with ivabradine for improving symptoms in a HFpEF population characterized by exercise limitation

DIA1R Is an X-Linked Gene Related to Deleted In Autism-1

Background: Autism spectrum disorders (ASDs) are frequently occurring disorders diagnosed by deficits in three core functional areas: social skills, communication, and behaviours and/or interests. Mental retardation frequently accompanies the most severe forms of ASDs, while overall ASDs are more commonly diagnosed in males. Most ASDs have a genetic origin and one gene recently implicated in the etiology of autism is the Deleted-In-Autism-1 (DIA1) gene. Methodology/Principal Findings: Using a bioinformatics-based approach, we have identified a human gene closely related to DIA1, we term DIA1R (DIA1-Related). While DIA1 is autosomal (chromosome 3, position 3q24), DIA1R localizes to the X chromosome at position Xp11.3 and is known to escape X-inactivation. The gene products are of similar size, with DIA1 encoding 430, and DIA1R 433, residues. At the amino acid level, DIA1 and DIA1R are 62 % similar overall (28 % identical), and both encode signal peptides for targeting to the secretory pathway. Both genes are ubiquitously expressed, including in fetal and adult brain tissue. Conclusions/Significance: Examination of published literature revealed point mutations in DIA1R are associated with X-linked mental retardation (XLMR) and DIA1R deletion is associated with syndromes with ASD-like traits and/or XLMR. Together, these results support a model where the DIA1 and DIA1R gene products regulate molecular traffic through the cellular secretory pathway or affect the function of secreted factors, and functional deficits cause disorders with ASD-lik

Consensus Paper: Cerebellum and Social Cognition.

The traditional view on the cerebellum is that it controls motor behavior. Although recent work has revealed that the cerebellum supports also nonmotor functions such as cognition and affect, only during the last 5 years it has become evident that the cerebellum also plays an important social role. This role is evident in social cognition based on interpreting goal-directed actions through the movements of individuals (social "mirroring") which is very close to its original role in motor learning, as well as in social understanding of other individuals' mental state, such as their intentions, beliefs, past behaviors, future aspirations, and personality traits (social "mentalizing"). Most of this mentalizing role is supported by the posterior cerebellum (e.g., Crus I and II). The most dominant hypothesis is that the cerebellum assists in learning and understanding social action sequences, and so facilitates social cognition by supporting optimal predictions about imminent or future social interaction and cooperation. This consensus paper brings together experts from different fields to discuss recent efforts in understanding the role of the cerebellum in social cognition, and the understanding of social behaviors and mental states by others, its effect on clinical impairments such as cerebellar ataxia and autism spectrum disorder, and how the cerebellum can become a potential target for noninvasive brain stimulation as a therapeutic intervention. We report on the most recent empirical findings and techniques for understanding and manipulating cerebellar circuits in humans. Cerebellar circuitry appears now as a key structure to elucidate social interactions

White Matter Microstructure Predicts Autistic Traits in Attention-Deficit/Hyperactivity Disorder

Traits of autism spectrum disorder (ASD) in children with attention-deficit/hyperactivity disorder (ADHD) have previously been found to index clinical severity. This study examined the association of ASD traits with diffusion parameters in adolescent males with ADHD (n = 17), and also compared WM microstructure relative to controls (n = 17). Significant associations (p < 0.05, corrected) were found between fractional anisotropy/radial diffusivity and ASD trait severity (positive and negative correlations respectively), mostly in the right posterior limb of the internal capsule/corticospinal tract, right cerebellar peduncle and the midbrain. No case–control differences were found for the diffusion parameters investigated. This is the first report of a WM microstructural signature of autistic traits in ADHD. Thus, even in the absence of full disorder, ASD traits may index a distinctive underlying neurobiology in ADHD