Apical extrusion of debris using reciprocating files and rotary instrumentation systems

Background: To compare the preparation time and amount of apically extruded debris after the  preparation of root canals in extracted human teeth using the reciprocating files and rotary nickel.titanium systems.Procedure: Sixty extracted human mandibular premolars were used. The root canals were instrumented using reciprocating (WaveOne, Reciproc, SafeSider) or rotary motion (Typhoon, ProTaper Universal,  Mtwo), and the debris produced was collected in glass vials. The remaining debris was assessed using a microbalance and statistically analyzed using the one.way ANOVA and Duncan multiple range tests at a significance level of P < 0.05. The time required to prepare the canals with different instruments was also recorded.Results: The Reciproc group produced significantly less debris when compared to the Typhoon group (P < 0.05), and instrumentation with the single.file systems was significantly faster than in the multi.file systems (P < 0.05). The WaveOne group extruded significantly more debris per unit of time than the other groups, with the exception of the Typhoon group (P < 0.05).Conclusion: According to our study, all systems caused apical debris extrusion. However, the Reciproc group was associated with less debris extrusion when compared to the other groups.Key words: Apical extrusion, endodontics, single file system

Product Development in Crowdfunding: Theoretical and Empirical Analysis

Problem definition: Crowdfunding goes beyond raising funds. Entrepreneurs often use crowdfunding to solicit feedback from customers in order to improve their products, and may therefore prefer to launch their crowdfunding campaigns using basic versions of their products with fewer features. However, customers may not be persuaded by a campaign if the product appears to be underdeveloped. In view of this trade-off, a key question for entrepreneurs is how much to develop a product before launching a crowdfunding cam- paign. / Methodology/results: Analyzing a game-theoretical model and testing its predictions empirically, we study: 1) how the development level of a product at campaign launch, measured by the initial number of product features, in uences whether customers will make comments that help entrepreneurs improve the product; 2) whether entrepreneurs continue to improve the product during the campaign; and 3) whether the campaign is successful. We show that, as the number of product features at campaign launch increases, the likelihood that customers will make comments and that the product will be improved during the campaign first increases but then decreases. Furthermore, the likelihood of campaign success first increases but then decreases with the number of product features at campaign launch. Finally, by analyzing the interactions between customer feedback, product improvement, and campaign success, we show that customer feedback motivates entrepreneurs to improve the product during the campaign. Moreover, entrepreneurs should take account of the initial number of features and customer feedback when improving the product, because oth- erwise product improvements can harm campaign success. / Managerial implications: Our study provides practical insights on how entrepreneurs can use crowdfunding to aid product development and improve- ment. Specifically, entrepreneurs should avoid overdeveloping their products before crowdfunding campaigns because, as well as decreasing the chance of campaign success, this could hinder their ability to save devel- opment costs (e.g., market research costs) through involving customers in product development

Social sciences research in neglected tropical diseases 2: A bibliographic analysis

The official published version of the article can be found at the link below.Background There are strong arguments for social science and interdisciplinary research in the neglected tropical diseases. These diseases represent a rich and dynamic interplay between vector, host, and pathogen which occurs within social, physical and biological contexts. The overwhelming sense, however, is that neglected tropical diseases research is a biomedical endeavour largely excluding the social sciences. The purpose of this review is to provide a baseline for discussing the quantum and nature of the science that is being conducted, and the extent to which the social sciences are a part of that. Methods A bibliographic analysis was conducted of neglected tropical diseases related research papers published over the past 10 years in biomedical and social sciences. The analysis had textual and bibliometric facets, and focussed on chikungunya, dengue, visceral leishmaniasis, and onchocerciasis. Results There is substantial variation in the number of publications associated with each disease. The proportion of the research that is social science based appears remarkably consistent (<4%). A textual analysis, however, reveals a degree of misclassification by the abstracting service where a surprising proportion of the "social sciences" research was pure clinical research. Much of the social sciences research also tends to be "hand maiden" research focused on the implementation of biomedical solutions. Conclusion There is little evidence that scientists pay any attention to the complex social, cultural, biological, and environmental dynamic involved in human pathogenesis. There is little investigator driven social science and a poor presence of interdisciplinary science. The research needs more sophisticated funders and priority setters who are not beguiled by uncritical biomedical promises

Neurogenic bladder in patients with traumatic spinal cord injury: Treatment and follow-up

Study design:Multi-center, cross-sectional study.Objectives:Our aim was to evaluate the treatment methods and follow-up of neurogenic bladder in patients with traumatic spinal cord injury retrospectively using a questionnaire.Setting: Turkey.Methods:Three hundred and thirty-seven patients who had spinal cord injury for at least 2 years were enrolled from six centers in the neurogenic bladder study group. They were asked to fill-out a questionnaire about treatments they received and techniques they used for bladder management.Results:The study included 246 male and 91 female patients with a mean age of 42±14 years. Intermittent catheterization ( IC) was performed in 77.9% of the patients, 3.8% had indwelling catheters, 13.8% had normal spontaneous micturition, 2.6% performed voiding maneuvers, 1.3% used diapers and 0.6% used condom catheters. No gender difference was found regarding the techniques used in bladder rehabilitation ( P>0.05). Overall, 63.2% of patients used anticholinergic drugs; anticholinergic drug use was similar between genders ( P>0.05). The most common anticholinergic drug used was oxybutynin ( 40.3%), followed by trospium ( 32.6%), tolterodine ( 19.3%) darifenacin ( 3.3%), propiverine ( 3.3%) and solifenacin ( 1.1%). The specialties of the physicians who first prescribed the anticholinergic drug were physiatrists ( 76.2%), urologists ( 22.1%) and neurologists ( 1.7%). Only four patients had previously received injections of botulinum-toxin-A into the detrusor muscle and three of them stated that their symptoms showed improvement. Most of the patients ( 77%) had regular follow-up examinations, including urine cultures, urinary system ultrasound and urodynamic tests, when necessary; the reasons for not having regular control visits were living distant from hospital ( 15.3%) and monetary problems ( 7.7%). Of the patients, 42.7% did not experience urinary tract infections ( UTI), 36.4% had bacteriuria but no UTI episodes with fever, 15.9% had 1-2 clinical UTI episodes per year and 5% had ≥3 clinical UTIs. The clinical characteristics of patients with and without UTI ( at least one symptomatic UTI during 1 year) were similar ( P>0.05). The frequency of symptomatic UTI was similar in patients using different bladder management techniques ( P>0.05).Conclusion:The most frequently used technique for bladder rehabilitation in patients with SCI was IC ( 77.9%). In all, 63.2% of patients used anticholinergic drugs, oxybutynin being the most commonly used drug. Also, 77% of patients had regular control visits for neurogenic bladder; 42.7% did not experience any UTIs. © 2014 International Spinal Cord Society

Intermittent catheterization in patients with traumatic spinal cord injury: Obstacles, worries, level of satisfaction

Objectives: The aim of this study is to examine the obstacles in people with traumatic spinal cord injury (SCI) face performing intermittent catheterization (IC), also their worries and level of satisfaction. Methods: Two hundred sixty-nine patients performing IC for at least 3 months were asked to fill-out a questionnaire about their opinions on IC. Results: In total, 69.5% of patients performed IC themselves, 10.4% had performed by their mothers, 7.8% by another caregiver and 7.4% by their spouse. For the 72 (26%) patients unable to apply IC, reasons were insufficient hand function (56.1%), being unable to sit appropriately (35.4%) and spasticity (8.5%). In all, 70% of male patients had insufficient hand function, 20% could not sit and 10% had spasticity while 56.3% of female patients could not sit, 37.5% had insufficient hand function and 63% had spasticity. Difference between sexes was found to be statistically significant (P<0.05). Worries patients had when starting IC were fear of being dependent on IC (50.2%), accidentally injuring self (43.8%), embarrassment (43.2%), causing an infection (40.2%), bleeding (32.7%), fear of feeling pain (30.2%) and hygiene (24.7%). More women felt embarrassment; other items were similar in both sexes. In all, 46.9% of patients had urinary incontinence in intervals. Conclusion: In total, 69.5% of patients performed IC themselves. Men's most common obstacle was insufficient hand function while women's was being unable to sit appropriately. Patients' most common worries were being dependent on IC for life. In all, 46.9% had incontinence in intervals; 47.9% said IC improved their life quality; and 97.4% preferred IC over continuous catheterization. © 2014 International Spinal Cord Society All rights reserved

Does Deep Tectonic Tremor Occur in the Central‐Eastern Mediterranean Basin?

Tectonic tremor has been observed at the roots of many fault systems around the Pacific rim, including convergent and transform plate boundaries. The extent to which deep tremor signals are prevalent along fault systems elsewhere, including the Mediterranean basin, has not yet been documented in detail. A body of evidence suggests that tremor triggered during the surface waves of teleseismic events may commonly occur where ambient tremor during episodic tremor and slip episodes occur, suggesting triggered tremor provides a useful tool to identify regions with ambient tremor. We perform a systematic search of triggered tremor associated with large teleseismic events between 2010 and 2020 at four major fault systems within the central-eastern Mediterranean basin, namely the Hellenic and Calabrian subduction zones, and the North Anatolian and Kefalonia transform faults. In addition, we search for ambient tremor during a slow slip event in the eastern Sea of Marmara along a secondary branch of the North Anatolian Fault, and two slow slip events beneath western Peloponnese (Hellenic Subduction Zone). We find no unambiguous evidence for deep triggered tremor, nor ambient tremor. The absence of triggered tremor at the Hellenic and Calabrian subduction zones supports an interpretation of less favorable conditions for tremorgenesis in the presence of old and cold slabs. The absence of tremor along the transform faults may be due to an absence of the conditions commonly promoting tremorgenesis in such settings, including high-fluid pressures and low-differential stresses between the down-dip limit of the seismogenic layer and the continental Moho

Panic disorder subtypes: Differential responses to CO2 challenge

Objective: The purpose of this study was to investigate the possibility of a differential sensitivity to CO2 in patients diagnosed with panic disorder subtypes that were defined by the presence of prominent respiratory symptoms. Method: The authors used a 35% CO2 and 65% O-2 mixture as a challenge agent. Fifty-one unmedicated subjects with DSM-III-R panic disorder, who were divided into respiratory (N=28) and nonrespiratory (N=23) subtypes by their symptom profiles, underwent a CO2 challenge procedure. Patients in the two groups were compared with regard to physiological and psychological measures, pulmonary function tests, panic rates, and smoking habits. Results: The patients in the respiratory group were significantly more sensitive to CO2 than were the patients in the nonrespiratory group. The respiratory group also had higher scores on the Panic and Agoraphobia Scale and had a longer duration of illness; both of these factors can be indicators of illness severity. In addition, the respiratory group's higher cigarette consumption (mean=12.46 package-years, SD=2.49) may have been a contributory factor not only for illness severity but also for the pathogenesis of panic disorder. Conclusions: The CO2 challenge procedure appears to be a good dissection tool in the understanding of different subtypes of panic disorder. Moreover, there may be a more specific association with prominent respiratory symptom subtype and CO2 hypersensitivity