Neurosensory Disturbances After Apical Surgery of Mandibular Premolars and Molars: A Retrospective Analysis and Case-Control Study.

OBJECTIVE Apical surgery is an intervention to treat teeth with persistent or recurrent endodontic infection. The proximity of the mental foramen and mandibular canal may pose a risk of altered sensation when performing surgical interventions in the posterior mandible. The objective of this study was to determine the rate of neurosensory disturbances after apical surgery of mandibular premolars and molars. The secondary objective was to evaluate whether the occurrence of altered sensation correlated with the distances from the apex or the periapical lesion to the relevant anatomical structures. METHODS The charts of patients treated from September 1999 to December 2015 were retrospectively evaluated if an apical surgery had been performed in mandibular premolars or molars, and a minimum period of 1-year follow-up was documented. Patients with trauma or other surgical interventions in the same hemimandible were excluded. Cases with postsurgical altered sensation were defined as the test group. From the pool of unaffected cases, patients were selected to serve as controls. Two- or three-dimensional radiographs of test and control cases were assessed with regard to the shortest distances from the root apices/lesions to the mental foramen or mandibular canal. RESULTS The study population included 243 patients with 249 apical surgeries, of which 12.9% led to postoperative neurosensory disturbances. Sensation returned to normal within 22 days on average. The most frequent findings were hyperesthesia or paresthesia. With regard to the treated type of tooth, second premolars resulted more frequently (22.6%) in altered sensation than the other teeth (11.2 to 13.0%; p=0.310). There were no significant differences when comparing test and control cases regarding the measured distances in radiographs from the apex/lesion to the relevant anatomical structures. CONCLUSION Altered sensation may typically occur following apical surgery in posterior mandibular teeth. However, in all cases of the present study, skin sensitivity in the lip/chin region returned to normal. The clinician must be particularly careful when performing apical surgery of second premolars due to the proximity of the mental foramen

Precise Timing of Transcription by c-di-GMP Coordinates Cell Cycle and Morphogenesis in Caulobacter

Bacteria adapt their growth rate to their metabolic status and environmental conditions by modulating the length of their G1 period. Here we demonstrate that a gradual increase in the concentration of the second messenger c-di-GMP determines precise gene expression during G1/S transition in Caulobacter crescentus . We show that c-di-GMP stimulates the kinase ShkA by binding to its central pseudo-receiver domain, activates the TacA transcription factor, and initiates a G1/S-specific transcription program leading to cell morphogenesis and S-phase entry. Activation of the ShkA-dependent genetic program causes c-di-GMP to reach peak levels, which triggers S-phase entry and promotes proteolysis of ShkA and TacA. Thus, a gradual increase of c-di-GMP results in precise control of ShkA-TacA activity, enabling G1/S-specific gene expression that coordinates cell cycle and morphogenesis

Hybrid histidine kinase activation by cyclic di-GMP-mediated domain liberation

Cytosolic hybrid histidine kinases (HHKs) constitute major signaling nodes that control various biological processes, but their input signals and how these are processed are largely unknown. In; Caulobacter crescentus; , the HHK ShkA is essential for accurate timing of the G1-S cell cycle transition and is regulated by the corresponding increase in the level of the second messenger c-di-GMP. Here, we use a combination of X-ray crystallography, NMR spectroscopy, functional analyses, and kinetic modeling to reveal the regulatory mechanism of ShkA. In the absence of c-di-GMP, ShkA predominantly adopts a compact domain arrangement that is catalytically inactive. C-di-GMP binds to the dedicated pseudoreceiver domain Rec1, thereby liberating the canonical Rec2 domain from its central position where it obstructs the large-scale motions required for catalysis. Thus, c-di-GMP cannot only stabilize domain interactions, but also engage in domain dissociation to allosterically invoke a downstream effect. Enzyme kinetics data are consistent with conformational selection of the ensemble of active domain constellations by the ligand and show that autophosphorylation is a reversible process

Theta burst stimulation reduces disability during the activities of daily living in spatial neglect

Left-sided spatial neglect is a common neurological syndrome following right-hemispheric stroke. The presence of spatial neglect is a powerful predictor of poor rehabilitation outcome. In one influential account of spatial neglect, interhemispheric inhibition is impaired and leads to a pathological hyperactivity in the contralesional hemisphere, resulting in a biased attentional allocation towards the right hemifield. Inhibitory transcranial magnetic stimulation can reduce the hyperactivity of the contralesional, intact hemisphere and thereby improve spatial neglect symptoms. However, it is not known whether this improvement is also relevant to the activities of daily living during spontaneous behaviour. The primary aim of the present study was to investigate whether the repeated application of continuous theta burst stimulation trains could ameliorate spatial neglect on a quantitative measure of the activities of daily living during spontaneous behaviour. We applied the Catherine Bergego Scale, a standardized observation questionnaire that can validly and reliably detect the presence and severity of spatial neglect during the activities of daily living. Eight trains of continuous theta burst stimulation were applied over two consecutive days on the contralesional, left posterior parietal cortex in patients suffering from subacute left spatial neglect, in a randomized, double-blind, sham-controlled design, which also included a control group of neglect patients without stimulation. The results showed a 37% improvement in the spontaneous everyday behaviour of the neglect patients after the repeated application of continuous theta burst stimulation. Remarkably, the improvement persisted for at least 3 weeks after stimulation. The amelioration of spatial neglect symptoms in the activities of daily living was also generally accompanied by significantly better performance in the neuropsychological tests. No significant amelioration in symptoms was observed after sham stimulation or in the control group without stimulation. These results provide Class I evidence that continuous theta burst stimulation is a viable add-on therapy in neglect rehabilitation that facilitates recovery of normal everyday behaviou

Theta burst stimulation reduces disability during the activities of daily living in spatial neglect

Left-sided spatial neglect is a common neurological syndrome following right-hemispheric stroke. The presence of spatial neglect is a powerful predictor of poor rehabilitation outcome. In one influential account of spatial neglect, interhemispheric inhibition is impaired and leads to a pathological hyperactivity in the contralesional hemisphere, resulting in a biased attentional allocation towards the right hemifield. Inhibitory transcranial magnetic stimulation can reduce the hyperactivity of the contralesional, intact hemisphere and thereby improve spatial neglect symptoms. However, it is not known whether this improvement is also relevant to the activities of daily living during spontaneous behaviour. The primary aim of the present study was to investigate whether the repeated application of continuous theta burst stimulation trains could ameliorate spatial neglect on a quantitative measure of the activities of daily living during spontaneous behaviour. We applied the Catherine Bergego Scale, a standardized observation questionnaire that can validly and reliably detect the presence and severity of spatial neglect during the activities of daily living. Eight trains of continuous theta burst stimulation were applied over two consecutive days on the contralesional, left posterior parietal cortex in patients suffering from subacute left spatial neglect, in a randomized, double-blind, sham-controlled design, which also included a control group of neglect patients without stimulation. The results showed a 37% improvement in the spontaneous everyday behaviour of the neglect patients after the repeated application of continuous theta burst stimulation. Remarkably, the improvement persisted for at least 3 weeks after stimulation. The amelioration of spatial neglect symptoms in the activities of daily living was also generally accompanied by significantly better performance in the neuropsychological tests. No significant amelioration in symptoms was observed after sham stimulation or in the control group without stimulation. These results provide Class I evidence that continuous theta burst stimulation is a viable add-on therapy in neglect rehabilitation that facilitates recovery of normal everyday behaviour

The GenTree Platform: growth traits and tree-level environmental data in 12 European forest tree species

Background: Progress in the field of evolutionary forest ecology has been hampered by the huge challenge of phenotyping trees across their ranges in their natural environments, and the limitation in high-resolution environmental information. Findings: The GenTree Platform contains phenotypic and environmental data from 4,959 trees from 12 ecologically and economically important European forest tree species: Abies alba Mill. (silver fir), Betula pendula Roth. (silver birch), Fagus sylvatica L. (European beech), Picea abies (L.) H. Karst (Norway spruce), Pinus cembra L. (Swiss stone pine), Pinus halepensis Mill. (Aleppo pine), Pinus nigra Arnold (European black pine), Pinus pinaster Aiton (maritime pine), Pinus sylvestris L. (Scots pine), Populus nigra L. (European black poplar), Taxus baccata L. (English yew), and Quercus petraea (Matt.) Liebl. (sessile oak). Phenotypic (height, diameter at breast height, crown size, bark thickness, biomass, straightness, forking, branch angle, fructification), regeneration, environmental in situ measurements (soil depth, vegetation cover, competition indices), and environmental modeling data extracted by using bilinear interpolation accounting for surrounding conditions of each tree (precipitation, temperature, insolation, drought indices) were obtained from trees in 194 sites covering the species’ geographic ranges and reflecting local environmental gradients. Conclusion: The GenTree Platform is a new resource for investigating ecological and evolutionary processes in forest trees. The coherent phenotyping and environmental characterization across 12 species in their European ranges allow for a wide range of analyses from forest ecologists, conservationists, and macro-ecologists. Also, the data here presented can be linked to the GenTree Dendroecological collection, the GenTree Leaf Trait collection, and the GenTree Genomic collection presented elsewhere, which together build the largest evolutionary forest ecology data collection available

Between but not within species variation in the distribution of fitness effects

New mutations provide the raw material for evolution and adaptation. The distribution of fitness effects (DFE) describes the spectrum of effects of new mutations that can occur along a genome, and is therefore of vital interest in evolutionary biology. Recent work has uncovered striking similarities in the DFE between closely related species, prompting us to ask whether there is variation in the DFE among populations of the same species, or among species with different degrees of divergence, i.e., whether there is variation in the DFE at different levels of evolution. Using exome capture data from six tree species sampled across Europe we characterised the DFE for multiple species, and for each species, multiple populations, and investigated the factors potentially influencing the DFE, such as demography, population divergence and genetic background. We find statistical support for there being variation in the DFE at the species level, even among relatively closely related species. However, we find very little difference at the population level, suggesting that differences in the DFE are primarily driven by deep features of species biology, and that evolutionarily recent events, such as demographic changes and local adaptation, have little impact

Shared Autonomous Vehicles in rural public transportation systems

This article focuses on the economic potential and the consequences on the regulatory context of Shared Autonomous Vehicles (SAV) used in a regional public transportation system. Based on an experimental case study two on-demand scenarios were developed for the Swiss rural area of the Töss Valley. Scenario 1 replaces the current public transportation by SAVs; scenario 2 operates with a SAV fleet instead of buses and integrates the regional railway. Data sources are an overall traffic model and the current business figures of the public transportation. The results suggest that scenario 2 is, out of an economic and traffic system view, an attractive solution compared to line-bound traditional bus and train systems. In both scenarios, a cost-covering service may be possible due to an increase in productivity and demand. Regarding the present regulatory context of the Swiss public transportation system, we propose to change the system of call for tenders for single public transportation lines towards a call for tender for entire regions. This paper contributes to the scholarship discussion on the role of the final provider of new services and which adaptions of current regulations have to be targeted in the future

Die stufengerechte Hirnschlagversorgung – von der Akutphase bis zur Rehabilitation

In den letzten zwei Jahrzehnten hat vor allem die Behandlung von Patienten mit ischämischem Hirnschlag eine radikale Veränderung erlebt. Durch die Einführung kausaler Akuttherapien und der seit Kurzem ebenso evidenzbasierten endovaskulären katheterbasierten Rekanalisationsverfahren sowie der spezialisierten interdisziplinären Versorgung im Rahmen des Stroke-Unit-Konzeptes ist die Prognose für den Patienten heute um ein Vielfaches günstiger als zuvor. Auch im Bereich der Rehabilitation konnten aufgrund neuer Therapieverfahren wie der repetitiven transkraniellen Magnetstimulation (rTMS) und computerunterstützter Methoden wesentliche Fortschritte in der Verbesserung der Schlaganfallfolgen erzielt werden. Dieser Artikel gibt einen Überblick über die zeitgemässe und stufengerechte Hirnschlagversorgung