Bisphosphonate-Induced Osteonecrosis of the Maxilla Resembling a Persistent Endodontic Lesion

A 52-year-old Caucasian woman suffering from pain in the anterior maxillary region, presented to the clinic. Examination revealed a draining sinus tract in the buccal vestibule of the maxilla in the left anterior segment and expansion in the middle of palate. On conventional radiographic examination the lesion was initially assumed to be a periapical problem related to the incisors but subsequently it was diagnosed to be a bisphosphonate osteonecrosis. Conclusion: Acquiring a comprehensive medical history from the patients, conducting the clinical vitality tests and most importantly being familiar with the non-odontogenic lesions that can be side effects of specific medications are important requirements for reaching a correct diagnosis.Keywords: Bisphosphonate; Breast Cancer; Osteonecrosis; Periapical Pathosi

Diagnostic Accuracy of Reverse Contrast Enhancement for Detection of Vertical Root Fractures

Objectives Vertical root fracture (VRF) is a common complication in endodontically-treated teeth. Due to its poor prognosis, a valid and reliable detection method is imperative for treatment planning. The aim of this study was to evaluate the application of reverse contrast in diagnosis of VRF by digital radiography. Methods Fifty extracted single-rooted premolar teeth were selected for this in-vitro experimental study. The teeth were mounted in a dry mandible and fixed with wax. Radiographs were obtained of all teeth with 0° horizontal angle, and 0° and +15° vertical angle. VRFs were then created by a hammer in vertical direction. Radiographs were obtained again as previously described. Radiographs of each tooth were evaluated twice: once without reverse contrast and then with reverse contrast 2 weeks later. The weighted kappa coefficient was calculated to assess the inter-observer agreement. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR+) and negative likelihood ratio (LR-) were compared in use and no use of reverse contrast using the Cochrane Q test. Results Radiographic angle had no significant effect on the diagnostic accuracy in use or no use of reverse contrast, except for the sensitivity value in no use of reverse contrast which was significantly higher in 15° vertical angle. The diagnostic accuracy of images enhanced with reverse contrast had no significant difference with original images in 0° and 15° vertical angles.   Conclusion Radiographs enhanced with reverse contrast had no significant difference with original radiographs for diagnosis of VRFs. Thus, for detection of VRFs, reverse contrast should only be considered as an adjunct

Analysis of the Relationship between "Agricultural Information System Members'ViewpointtowardsOrganic Products" and "their Environmental Attitude": the Case of the Central District of Boyer-ahmad County

The aim of this research was to investigate this research was to investigate the relationship between Agricultural Information System (AIS) members' viewpoint towards organic products and their environmental in central District of BoyerAhmad County. The research population included researchers, extension agents and contact farmers of the study area and based on this population numbers, the sample sizes were determined 62, 55 and 60 persons respectively using Krejcie and Morgan sampling table. The main tool for collecting data about the respondent’s viewpoints towards organic products was a pre-designed questionnaire which its validity was confirmed by rural development experts and its reliability also confirmed by using Cronbach-Alpha coefficient (0.76-0.94). Moreover, the environmental attitude of the respondents was measured using Dunlap & Van Liere's New Ecological Paradigm (NEP) scale. The results showed that researchers, extension agents and farmers had a moderate environmental attitude. Furthermore, researchers and extension agents had above average viewpoint towards organic products.27However, farmers had a fairly favorable viewpoint. In addition, the relationship between Agricultural Information System members' viewpoint towards organic products and their environmental attitude was positive and significant which indicated that the more favorable environmental attitude they have, the more tendenciestowards organic products they have. As a result, improving environmental attitude should be given priority in order to produce healthy products and preserve the environment

Effect of Field of View and Resolution in Detection of Horizontal Root Fractures in CBCT images: An In Vitro Study

Introduction: New cone-beam computed tomography (CBCT) devices are capable of imaging with different resolutions and field of views (FOVs), in which higher resolutions and FOVs impose a higher dose to the patient. This study was an attempt to investigate the detection accuracy from different FOVs and resolutions in detection of horizontal root fractures.  Methods and Materials: Through this experimental study, in five different field of views (FOV) and resolutions (voxel size) of New Tom VGi CBCT (Italy) system was used to scan fifty teeth with horizontal root fractures in half of them. The images were evaluated by four observers (two maxillofacial radiologists and two general dentists) who recorded the presence or absence of horizontal root fractures. The data were analyzed by SPSS 22 software and MacNemar and kappa test were used to compare results with reality. Results: The highest sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy (AZ) were attributed to 8×8 FOV and high resolutions (0.125 mm voxel size) but the difference between sensitivity, specificity, PPV and NPV was not significant. Kappa values for inter-observer agreement between radiologists and general dentists and also intra-observer agreement were in excellent ranges. The highest Kappa in both cases was attributed to 8×8 FOV and high resolutions. Conclusion: There was no significant difference to diagnose of horizontal root fracture between two observer groups and for all of the FOVs and voxel sizes. Keywords: Cone-Beam Computed Tomography; Field of View; Horizontal Root Fracture

Accuracy of CBCT, Digital Radiography and Cross-Sectioning for the Evaluation of Mandibular Incisor Root Canals

ntroduction: The aim of this study was to compare the accuracy of cone-beam computed tomography (CBCT), digital radiography and tooth sectioning in evaluating root canal morphology of mandibular incisors in an in vitro setting. Methods and Materials: A total of 76 samples were imaged using CBCT, and digital radiography in straight and angled views. The samples were then sectioned at different distances from the apex for further visualization under stereomicroscope. The agreement between the observers was statistically analyzed by kappa correlation coefficient and the chi-square test. Results: The results showed that the majority of the samples had a single canal (Vertucci’s Type I). CBCT analysis reported more frequent multi-canal roots in comparison with the other techniques. In pairwise comparisons, the highest agreement was found between digital radiographic imaging and microscopic cross-sectioning both in terms of canal configuration and the number of root canals. Conclusion: None of the used imaging techniques per se could adequately show the exact internal anatomical configuration in accordance with the gold standard.Keywords: Anatomy; Cone-Beam Computed Tomography; Digital Radiography; Incisor Teet

Review of recent advances in lithium extraction from subsurface brines

Lithium has been a critical metal for energy transition, mainly because of its application as an energy storage matrix, which has seen its demand increasing exponentially in the last decades. To supply the current demand chain and overcome the geographical and technological limitations of lithium extraction from Salt Lake brines, the present article investigates the possibility of lithium extraction from non-conventional resources, such as Oilfields and Geothermal brines. Thus, our investigation seeks to answer the following research questions: (1) Are there identified lithium-rich subsurface brine resources? (2) Could the conventional lithium extraction precipitation method be successfully applied to those resources? (3) What are the state-of-the-art of alternative technologies that can economically be applied for efficient lithium recovery from those subsurface brine resources? First, our investigation identifies and distributes geographically lithium-rich subsurface brine resources worldwide, with the American continent being abundant on Oilfield brine. Europe, on the other hand, was much more abundant in Geothermal water. The UK possesses lithium-rich oilfields at relatively low concentrations and highly enriched geothermal brine, with an abundance of other lithium-rich brine sites possible across Africa and Asia. Secondly, it was established through a critical evaluation that conventional precipitation methods are insufficient for lithium extraction when applied to subsurface brines. Thus, it leads us to survey the state-of-the-art of novel extraction technologies with data from 1960 to the present, with the highest information density covering the last 22 years. Out of the reviewed extraction technologies, ion-sieve adsorbent and nanofiltration were found to be the best ally for lithium extraction from subsurface brine in the present and near future with low energy consumption, excellent lithium recovery, high extraction rate, outstanding selectivity, and forming adaptability

Vitamin K1 As A Potential Molecule For Reducing Single-Walled Carbon Nanotubes-Stimulated α-Synuclein Structural Changes And Cytotoxicity

Aims: Different kinds of vitamins can be used as promising candidates to mitigate the structural changes of proteins and associated cytotoxicity stimulated by NPs. Therefore, the structural changes of α-syn molecules and their associated cytotoxicity in the presence of SWCNTs either alone or co-incubated with vitamin K1 were studied by spectroscopic, bioinformatical, and cellular assays. Methods: Intrinsic and ThT fluorescence, CD, and Congo red absorption spectroscopic approaches as well as TEM investigation, molecular docking, and molecular dynamics were used to explore the protective effect of vitamin K1 on the structural changes of α-syn induced by SWCNTs. The cytotoxicity of α-syn/SWCNTs co-incubated with vitamin K1 against SHSY5Y cells was also carried out by MTT, LDH, and caspase-3 assays. Results: Fluorescence spectroscopy showed that vitamin K1 has a significant effect in reducing SWCNT-induced fluorescence quenching and aggregation of α- syn. CD, Congo red adsorption, and TEM investigations determined that co-incubation of α- syn with vitamin K1 inhibited the propensity of α-syn into the structural changes and amorphous aggregation in the presence of SWCNT. Docking studies determined the occupation of preferred docked site of SWCNT by vitamin K1 on α- syn conformation. A molecular dynamics study also showed that vitamin K1 reduced the structural changes of α- syn induced by SWCNT. Cellular data exhibited that the cytotoxicity of α- syn co-incubated with vitamin K1 in the presence of SWCNTs is less than the outcomes obtained in the absence of the vitamin K1. Conclusion: It may be concluded that vitamin K1 decreases the propensity of α- syn aggregation in the presence of SWCNTs and induction of cytotoxicity

Burden of disease scenarios for 204 countries and territories, 2022–2050: a forecasting analysis for the Global Burden of Disease Study 2021

Background: Future trends in disease burden and drivers of health are of great interest to policy makers and the public at large. This information can be used for policy and long-term health investment, planning, and prioritisation. We have expanded and improved upon previous forecasts produced as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) and provide a reference forecast (the most likely future), and alternative scenarios assessing disease burden trajectories if selected sets of risk factors were eliminated from current levels by 2050. Methods: Using forecasts of major drivers of health such as the Socio-demographic Index (SDI; a composite measure of lag-distributed income per capita, mean years of education, and total fertility under 25 years of age) and the full set of risk factor exposures captured by GBD, we provide cause-specific forecasts of mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) by age and sex from 2022 to 2050 for 204 countries and territories, 21 GBD regions, seven super-regions, and the world. All analyses were done at the cause-specific level so that only risk factors deemed causal by the GBD comparative risk assessment influenced future trajectories of mortality for each disease. Cause-specific mortality was modelled using mixed-effects models with SDI and time as the main covariates, and the combined impact of causal risk factors as an offset in the model. At the all-cause mortality level, we captured unexplained variation by modelling residuals with an autoregressive integrated moving average model with drift attenuation. These all-cause forecasts constrained the cause-specific forecasts at successively deeper levels of the GBD cause hierarchy using cascading mortality models, thus ensuring a robust estimate of cause-specific mortality. For non-fatal measures (eg, low back pain), incidence and prevalence were forecasted from mixed-effects models with SDI as the main covariate, and YLDs were computed from the resulting prevalence forecasts and average disability weights from GBD. Alternative future scenarios were constructed by replacing appropriate reference trajectories for risk factors with hypothetical trajectories of gradual elimination of risk factor exposure from current levels to 2050. The scenarios were constructed from various sets of risk factors: environmental risks (Safer Environment scenario), risks associated with communicable, maternal, neonatal, and nutritional diseases (CMNNs; Improved Childhood Nutrition and Vaccination scenario), risks associated with major non-communicable diseases (NCDs; Improved Behavioural and Metabolic Risks scenario), and the combined effects of these three scenarios. Using the Shared Socioeconomic Pathways climate scenarios SSP2-4.5 as reference and SSP1-1.9 as an optimistic alternative in the Safer Environment scenario, we accounted for climate change impact on health by using the most recent Intergovernmental Panel on Climate Change temperature forecasts and published trajectories of ambient air pollution for the same two scenarios. Life expectancy and healthy life expectancy were computed using standard methods. The forecasting framework includes computing the age-sex-specific future population for each location and separately for each scenario. 95% uncertainty intervals (UIs) for each individual future estimate were derived from the 2·5th and 97·5th percentiles of distributions generated from propagating 500 draws through the multistage computational pipeline. Findings: In the reference scenario forecast, global and super-regional life expectancy increased from 2022 to 2050, but improvement was at a slower pace than in the three decades preceding the COVID-19 pandemic (beginning in 2020). Gains in future life expectancy were forecasted to be greatest in super-regions with comparatively low life expectancies (such as sub-Saharan Africa) compared with super-regions with higher life expectancies (such as the high-income super-region), leading to a trend towards convergence in life expectancy across locations between now and 2050. At the super-region level, forecasted healthy life expectancy patterns were similar to those of life expectancies. Forecasts for the reference scenario found that health will improve in the coming decades, with all-cause age-standardised DALY rates decreasing in every GBD super-region. The total DALY burden measured in counts, however, will increase in every super-region, largely a function of population ageing and growth. We also forecasted that both DALY counts and age-standardised DALY rates will continue to shift from CMNNs to NCDs, with the most pronounced shifts occurring in sub-Saharan Africa (60·1% [95% UI 56·8–63·1] of DALYs were from CMNNs in 2022 compared with 35·8% [31·0–45·0] in 2050) and south Asia (31·7% [29·2–34·1] to 15·5% [13·7–17·5]). This shift is reflected in the leading global causes of DALYs, with the top four causes in 2050 being ischaemic heart disease, stroke, diabetes, and chronic obstructive pulmonary disease, compared with 2022, with ischaemic heart disease, neonatal disorders, stroke, and lower respiratory infections at the top. The global proportion of DALYs due to YLDs likewise increased from 33·8% (27·4–40·3) to 41·1% (33·9–48·1) from 2022 to 2050, demonstrating an important shift in overall disease burden towards morbidity and away from premature death. The largest shift of this kind was forecasted for sub-Saharan Africa, from 20·1% (15·6–25·3) of DALYs due to YLDs in 2022 to 35·6% (26·5–43·0) in 2050. In the assessment of alternative future scenarios, the combined effects of the scenarios (Safer Environment, Improved Childhood Nutrition and Vaccination, and Improved Behavioural and Metabolic Risks scenarios) demonstrated an important decrease in the global burden of DALYs in 2050 of 15·4% (13·5–17·5) compared with the reference scenario, with decreases across super-regions ranging from 10·4% (9·7–11·3) in the high-income super-region to 23·9% (20·7–27·3) in north Africa and the Middle East. The Safer Environment scenario had its largest decrease in sub-Saharan Africa (5·2% [3·5–6·8]), the Improved Behavioural and Metabolic Risks scenario in north Africa and the Middle East (23·2% [20·2–26·5]), and the Improved Nutrition and Vaccination scenario in sub-Saharan Africa (2·0% [–0·6 to 3·6]). Interpretation: Globally, life expectancy and age-standardised disease burden were forecasted to improve between 2022 and 2050, with the majority of the burden continuing to shift from CMNNs to NCDs. That said, continued progress on reducing the CMNN disease burden will be dependent on maintaining investment in and policy emphasis on CMNN disease prevention and treatment. Mostly due to growth and ageing of populations, the number of deaths and DALYs due to all causes combined will generally increase. By constructing alternative future scenarios wherein certain risk exposures are eliminated by 2050, we have shown that opportunities exist to substantially improve health outcomes in the future through concerted efforts to prevent exposure to well established risk factors and to expand access to key health interventions