Effects on different full-coverage designs and materials of crack propagation in first mandibular molar: an extended finite element method study

Objectives: This study aims to investigate the biomechanical properties of fracture resistance in cracked teeth using five different full-coverage restorations made of three different materials.Materials and Methods: A 3D model of a mandibular first molar was created to design five different full-coverage repair models: crown, crown with composite resin filling inside, occlusal veneer, occlusal veneer with composite resin filling inside and onlay. These repair models were fabricated using three different materials, namely, zirconia, lithium disilicate (LDS), and a hybrid polymer-infiltrated ceramic network material (PIC). In total, 15 repair models were tested using the extended finite element method (XFEM), with an occlusal load of 5000 N applied slowly to the occlusal surface of the restoration. The analysis of stress distribution in the restoration and dentin crack line was conducted to measure and record the crack initial load on the restoration and dentin.Results: The results showed that restorations on the occlusal surface significantly improved crack resistance, with zirconia exhibiting superior fracture resistance among the materials tested. Restorations of crown with composite resin filling inside demonstrated the highest resistance to fracture, while occlusal veneers showed the lowest. MPS concentration was observed at the interface between the restoration and dentin and at the root bifurcation, with the highest values at the top of crack development. Dentin covered by oxidized restorations had the highest displacement, while PIC restorations exhibited the lowest. Pulp analysis revealed selective MPS concentration and strain patterns in models with zirconia restorations and onlay, with pronounced pulp displacement in zirconia restorations and onlay. Enamel analysis indicated larger MPS values and displacements in zirconia restoration models and onlay, with higher strain in onlay. Restoration played a crucial role in protecting the tooth, with crack propagation initial loads in dentin surpassing restorations in experimental groups.Conclusion: This study confirms that full-coverage restorations significantly increased the fracture resistance of cracked teeth, with zirconia restorations significantly protecting the underlying cracked tooth. Elimination of fracture lines in the restoration design can improve fracture resistance in cracked teeth. The findings have implications for dental prosthetic design and clinical practice

Intensified Positive Arctic–Methane Feedback under IPCC Climate Scenarios in the 21st Century

The positive Arctic–methane (CH 4 ) feedback forms when more CH 4 is released from the Arctic tundra to warm the climate, further stimulating the Arctic to emit CH 4 . This study utilized the CLM-Microbe model to project CH 4 emissions across five distinct Arctic tundra ecosystems on the Alaska North Slope, considering three Shared Socioeconomic Pathway (SSP) scenarios using climate data from three climate models from 2016 to 2100. Employing a hyper-resolution of 5 m × 5 m within 40,000 m 2 domains accounted for the Arctic tundra’s high spatial heterogeneity; three sites were near Utqiaġvik (US-Beo, US-Bes, and US-Brw), with one each in Atqasuk (US-Atq) and Ivotuk (US-Ivo). Simulated CH 4 emissions substantially increased by a factor of 5.3 to 7.5 under the SSP5–8.5 scenario compared to the SSP1–2.6 and SSP2–4.5 scenarios. The projected CH 4 emissions exhibited a stronger response to rising temperature under the SSP5–8.5 scenario than under the SSP1–2.6 and SSP2–4.5 scenarios, primarily due to strong temperature dependence and the enhanced precipitation-induced expansion of anoxic conditions that promoted methanogenesis. The CH 4 transport via ebullition and plant-mediated transport is projected to increase under all three SSP scenarios, and ebullition dominated CH 4 transport by 2100 across five sites. Projected CH 4 emissions varied in temperature sensitivity, with a Q 10 range of 2.7 to 60.9 under SSP1–2.6, 3.8 to 17.6 under SSP2–4.5, and 5.7 to 17.2 under SSP5–8.5. Compared with the other three sites, US-Atq and US-Ivo were estimated to have greater increases in CH 4 emissions due to warmer temperatures and higher precipitation. The fact that warmer sites and warmer climate scenarios had higher CH 4 emissions suggests an intensified positive Arctic–CH 4 feedback in the 21st century. Microbial physiology and substrate availability dominated the enhanced CH 4 production. The simulated intensified positive feedback underscores the urgent need for a more mechanistic understanding of CH 4 dynamics and the development of strategies to mitigate CH 4 across the Arctic

Carbon in Chinese grasslands : meta-analysis and theory of grazing effects

Unidad de excelencia María de Maeztu CEX2019-000940-MGlobally, livestock grazing is an important management factor influencing soil degradation, soil health and carbon (C) stocks of grassland ecosystems. However, the effects of grassland types, grazing intensity and grazing duration on C stocks are unclear across large geographic scales. To provide a more comprehensive assessment of how grazing drives ecosystem C stocks in grasslands, we compiled and analyzed data from 306 studies featuring four grassland types across China: desert steppes, typical steppes, meadow steppes and alpine steppes. Light grazing was the best management practice for desert steppes (< 2 sheep ha−1) and typical steppes (3 to 4 sheep ha−1), whereas medium grazing pressure was optimal for meadow steppes (5 to 6 sheep ha−1) and alpine steppes (7 to 8 sheep ha−1) leading to the highest ecosystem C stocks under grazing. Plant biomass (desert steppes) and soil C stocks (meadow steppes) increased under light or medium grazing, confirming the 'intermediate disturbance hypothesis'. Heavy grazing decreased all C stocks regardless of grassland ecosystem types, approximately 1.4 Mg ha−1 per year for the whole ecosystem. The regrowth and regeneration of grasslands in response to grazing intensity (i.e., grazing optimization) depended on grassland types and grazing duration. In conclusion, grassland grazing is a double-edged sword. On the one hand, proper management (light or medium grazing) can maintain and even increase C stocks above- and belowground, and increase the harvested livestock products from grasslands. On the other hand, human-induced overgrazing can lead to rapid degradation of vegetation and soils, resulting in significant carbon loss and requiring long-term recovery. Grazing regimes (i.e., intensity and duration applied) must consider specific grassland characteristics to ensure stable productivity rates and optimal impacts on ecosystem C stocks

Montreal Cognitive Assessment and Modified Mini Mental State Examination in African Americans

Background. Sparse data limit the interpretation of Montreal Cognitive Assessment (MoCA) scores, particularly in minority populations. Additionally, there are no published data on how MoCA scores compare to the widely used Modified Mini Mental State Examination (3MSE). We provide performance data on the MoCA in a large cohort of African Americans and compare 3MSE and MoCA scores, providing a &quot;crosswalk&quot; for interpreting scores. Methods. Five hundred and thirty African Americans with type 2 diabetes were enrolled in African American-Diabetes Heart Study-MIND, a cross-sectional study of cognition and structural and functional brain imaging. After excluding participants with possible cognitive impairment ( = 115), mean (SD) MoCA and 3MSE scores are presented stratified by age and education. Results. Participant mean age was 58.2 years (range: 35-83); 61% were female; and 64.9% had &gt;12 years of education. Mean (SD) 3MSE and MoCA scores were 86.9 (8.2) and 19.8 (3.8), respectively. 93.5% of the cohort had a &quot;positive&quot; screen on the MoCA, scoring &lt;26 (education-adjusted), compared with 47.5% on the 3MSE (cut-point &lt; 88). A 3MSE score of 88 corresponded to a MoCA score of 20 in this population. Conclusion. The present data suggest the need for caution when applying proposed MoCA cutoffs to African Americans

Associations of coronary artery calcified plaque density with mortality in type 2 diabetes: the Diabetes Heart Study

Abstract Background Coronary artery calcified plaque (CAC) is strongly predictive of cardiovascular disease (CVD) events and mortality, both in general populations and individuals with type 2 diabetes at high risk for CVD. CAC is typically reported as an Agatston score, which is weighted for increased plaque density. However, the role of CAC density in CVD risk prediction, independently and with CAC volume, remains unclear. Methods We examined the role of CAC density in individuals with type 2 diabetes from the family-based Diabetes Heart Study and the African American-Diabetes Heart Study. CAC density was calculated as mass divided by volume, and associations with incident all-cause and CVD mortality [median follow-up 10.2 years European Americans (n = 902, n = 286 deceased), 5.2 years African Americans (n = 552, n = 93 deceased)] were examined using Cox proportional hazards models, independently and in models adjusted for CAC volume. Results In European Americans, CAC density, like Agatston score and volume, was consistently associated with increased risk of all-cause and CVD mortality (p ≤ 0.002) in models adjusted for age, sex, statin use, total cholesterol, HDL, systolic blood pressure, high blood pressure medication use, and current smoking. However, these associations were no longer significant when models were additionally adjusted for CAC volume. CAC density was not significantly associated with mortality, either alone or adjusted for CAC volume, in African Americans. Conclusions CAC density is not associated with mortality independent from CAC volume in European Americans and African Americans with type 2 diabetes

Impact of an Innovative Financing and Payment Model on Tuberculosis Patients’ Financial Burden: is Tuberculosis Care More Affordable for the Poor?

Background: In response to the high financial burden of health services facing tuberculosis (TB) patients in China, the China-Gates TB project, Phase II, has implemented a new financing and payment model as an important component of the overall project in three cities in eastern, central and western China. The model focuses on increasing the reimbursement rate for TB patients and reforming provider payment methods by replacing fee-for-service with a case-based payment approach. This study investigated changes in out-of-pocket (OOP) health expenditure and the financial burden on TB patients before and after the interventions, with a focus on potential differential impacts on patients from different income groups

Transferability and Fine Mapping of Type 2 Diabetes Loci in African Americans: The Candidate Gene Association Resource Plus Study

Type 2 diabetes (T2D) disproportionally affects African Americans (AfA) but, to date, genetic variants identified from genome-wide association studies (GWAS) are primarily from European and Asian populations. We examined the single nucleotide polymorphism (SNP) and locus transferability of 40 reported T2D loci in six AfA GWAS consisting of 2,806 T2D case subjects with or without end-stage renal disease and 4,265 control subjects from the Candidate Gene Association Resource Plus Study. Our results revealed that seven index SNPs at the TCF7L2, KLF14, KCNQ1, ADCY5, CDKAL1, JAZF1, and GCKR loci were significantly associated with T2D (P < 0.05). The strongest association was observed at TCF7L2 rs7903146 (odds ratio [OR] 1.30; P = 6.86 × 10−8). Locus-wide analysis demonstrated significant associations (Pemp < 0.05) at regional best SNPs in the TCF7L2, KLF14, and HMGA2 loci as well as suggestive signals in KCNQ1 after correction for the effective number of SNPs at each locus. Of these loci, the regional best SNPs were in differential linkage disequilibrium (LD) with the index and adjacent SNPs. Our findings suggest that some loci discovered in prior reports affect T2D susceptibility in AfA with similar effect sizes. The reduced and differential LD pattern in AfA compared with European and Asian populations may facilitate fine mapping of causal variants at loci shared across populations