Autologous Plasma rich platelet versus Low Molecular weight Hyaluronic Acid in Knee Osteoarthritis: a Non-placebo Randomized Controlled Trial

Objective: This study aimed to compare the effect of autologous plasma rich platelet (PRP) versus Low molecular weight Hyaluronic acid (HA) on pain, function and stiffness in knee osteoarthritis during six months follow-up. Design: Through a non-placebo blocked randomized controlled trial with parallel design on 77 patients with knee osteoarthritis; 50 in intervention group, treated by PRP; 27 in control group, treated by HA.  They received three injections and assessed before, after two and six months. Pain, stiffness and function were assessed using WOMAC and VAS. Descriptive statistics, chi-square, and ANOVA were used when appropriate. Results: Pain reduced in both groups compared to their respective baseline (P<0.007); the reduction rates were similar in both groups (P>0.1). WOMAC and VAS scores were different between before injection and both two and six months follow-ups in both groups (P<0.001); although increasing of VAS score between two and six months follow-ups was more considerable in PRP but not statistically significant (P=0.08). Considering Kellgren-lawrence classification of knee osteoarthritis, WOMAC scores were different in patients with grade 2 and 3 in both groups (P<0.01); but VAS scores were different with grade 3 only in PRP group (P=0.009). Conclusions: There was no difference between PRP and HA in reducing symptoms of knee osteoarthritis compare to their baseline but sustainability of the effect may be more with HA

Some results on the cofiniteness of local cohomology modules

summary:Let $R$ be a commutative Noetherian ring, $\mathfrak {a}$ an ideal of $R$, $M$ an $R$-module and $t$ a non-negative integer. In this paper we show that the class of minimax modules includes the class of $\mathcal {AF}$ modules. The main result is that if the $R$-module ${\rm Ext}^t_R(R/\mathfrak {a},M)$ is finite (finitely generated), $H^i_\mathfrak {a}(M)$ is $\mathfrak {a}$-cofinite for all $i<t$ and $H^t_\mathfrak {a}(M)$ is minimax then $H^t_\mathfrak {a}(M)$ is $\mathfrak {a}$-cofinite. As a consequence we show that if $M$ and $N$ are finite $R$-modules and $H^i_\mathfrak {a}(N)$ is minimax for all $i<t$ then the set of associated prime ideals of the generalized local cohomology module $H^t_\mathfrak {a}(M,N)$ is finite

The Efficacy of FlexMaster’s IntroFile, PreRaCe and Gates Glidden Drills in Straight-Line Access: A CBCT Assessment

Introduction: An overlooked but important part of successful root canal treatment is a straight-line access (SLA). The purpose of this in vitro study was to compare the efficacy of IntroFile and PreRaCe rotary instruments with Gates Glidden (GG) drills in gaining SLA by cone-beam computed tomography (CBCT). Methods and Materials: A total of forty five extracted mandibular first molars were selected and mounted in dental like arches. Subsequently, they were randomly classified into three groups (n=15). After preparation of a standard access cavity, orifices of the mesiobuccal canal was reached and a #10 file was inserted to explore the canals until the file tip was visible at the apex. Then, preoperative CBCT images were taken. SLA was gained in three groups; group 1, FlexMaster’s IntroFile (FM); group 2, PreRaCe (RC) and group 3, GG. Again, the first binding file at the working length (WL) was placed in the canal and postoperative CBCT images in similar positions were taken. The pre/post operative morphology of the canal was evaluated for changes. Data was analyzed using the one-way ANOVA and post-hoc Bonferroni analysis. Results: The average amount of reduction in coronal canal curvature in FM, RC and GG groups was 2.43±1.79, 3.17±2.05 and 8.7±3.45, respectively. This descending trend was statistically significant. The difference between pre/post SLA changes in FM and RC groups was significant compared to GG group, while there were no significant differences between RC and FM. Conclusion: GG drills produced extraordinary results in reducing coronal curvature of the canal and achieving SLA. They are also more effective than nickel-titanium (NiTi) rotary instruments in canals with coronal curvature

Compressive Strength of Mineral Trioxide Aggregate with and without Disodium Hydrogen Phosphate at Different Mixing Ratios

Introduction: Mineral Trioxide Aggregate (MTA) is a substance with favorable physical-mechanical properties. Disodium hydrogen phosphate(DHP) is sometimes added to MTA to reduce its setting time. Therefore, this study was conducted to evaluate the effect of various ratios of liquid to powder of white MTA (WMTA) and addition of DHP on its compressive strength. Methods and Materials: One hundred and twenty samples were prepared with a two-piece stainless steel mold with a height of 6 mm and a diameter of 4 mm in order to evaluate the compressive strength where WMTA was used in 60 samples and DHP in white MTA composition (DHPWMTA) was used in other 60 samples. The compressive strength of WMTA and DHPWMTA was measured in various ratios of liquid to powder including 50, 60 and 70% and at 24 h and 21 days (n=10). Univariate Analysis of Variance test with SPSS 16 software were used to determine the difference between groups. The level of significance was set at 0.05. Results: The maximum and minimum compressive strength of WMTA groups were 63.25±1.96 (50% ratio and 21 days) and 37.79±1.28 (70% ratio and 24 h), respectively. The maximum and minimum compressive strength of DHPWMTA groups were 63.96±1.40 (60% ratio and 21 days) and 37.37±1.62 (70% ratio and 24 h), respectively. The effect of each of factors (type of material, powder to liquid ratio and time) alone were significant on the compressive strength (P&lt;0.05). However, the interactive effect of three factors (type of material, powder to liquid ratio and time) were not statistically significant on compressive strength (P&gt;0.05). Conclusion: Adding 2.5 wt% of DHP to white MTA increased samples compressive strength. Compressive strength in liquid to powder ratios of 50 and 60% compare to 70% and at 21 days compared to 24 h was high.Keywords: Compressive Strength; Disodium Hydrogen Phosphate; Mineral Trioxide Aggregat

Accuracy of Cone-Beam Computed Tomography in Determining the Root Canal Morphology of Mandibular First Molars

Introduction: The aim of the present in vitro study was to compare the accuracy of cone-beam computed tomography (CBCT) in determining root canal morphology of mandibular first molars in comparison with staining and clearing technique. Methods and Materials: CBCT images were taken from 96 extracted human mandibular first molars and the teeth were then evaluated based on Vertucci’s classification to determine the root canal morphology. Afterwards, access cavities were prepared and India ink was injected into the canals with an insulin syringe. The teeth were demineralized with 5% nitric acid. Finally, the cleared teeth were evaluated under a magnifying glass at 5× magnification to determine the root canal morphology. Data were analyzed using the SPSS software. The Fisher’s exact test assessed the differences between the mesial and distal canals and the Cohen’s kappa test was used to assess the level of agreement between the methods. Statistical significance was defined at 0.05. Results: The Kappa coefficient for agreement between the two methods evaluating canal types was 0.346 (95% CI: 0.247-0.445), which is considered a fair level of agreement based on classification of Koch and Landis. The agreement between CBCT and Vertucci’s classification was 52.6% (95% CI: 45.54-59.66%), with a significantly higher agreement rate in the mesial canals (28.1%) compared to the distal canals (77.1%) (P&lt;0.001). Conclusion: Under the limitations of this study, clearing technique was more accurate than CBCT in providing accurate picture of the root canal anatomy of mandibular first molars.Keywords: Cone-Beam Computed Tomography; Root Canal Morphology; Root Clearin

Edge computing in IoT for smart healthcare

The rapid advances in the Internet of Things (IoT) and the increment of its users have opened a door to put into service IoT in healthcare, known as the Internet of Medical Things (IoMT), which consists of cloud, fog, and edge computing. IoMT has shown to be a flexible framework to remove traditional healthcare limits through utilizing technology/techniques and innovative digital devices to monitor patients’ conditions and to address medical service problems such as inaccuracy and long response time. It also could be helpful within critical and unexpected circumstances like epidemic diseases. Fortunately, some methods, including Edge Computing, were introduced to improve the healthcare system, make it more effective and solve problems. In this work, a Systematic Literature Review (SLR) was used to study Edge Computing solutions in healthcare, evaluate efficient therapeutic approaches, and demonstrate key factors that have not been considered in previous studies

Cone-Beam Computed Tomography Comparison of Canal Transportation after Preparation with BioRaCe and Mtwo Rotary Instruments and Hand K-Flexofiles

Introduction: The aim of this in vitro study was to evaluate the transportation of mesiobuccal canals of mandibular first molars prepared with either BioRaCe or Mtwo rotary instruments or hand K-Flexofile, by means of cone-beam computed tomography (CBCT). Methods and Materials: Forty-five mandibular molars were selected and randomly divided into three groups (n=15). Mesiobuccal roots of these teeth were prepared by BioRaCe, Mtwo, or hand K-Flexofile. Transportation was measured by pre- and post-operative CBCT images. Two-way ANOVA analysis was applied to detect any differences between the groups followed by the post hoc Tukey’s tests. The level of significance was set at 0.05. Results: The non-parametric Friedman test was used to compare the behavior of each file at 3-, 6- and 9-mm levels. There were no significant differences between different levels in Mtwo group (P=0.15); however, the differences in K-Flexofile and BioRaCe groups were significant (P&gt;0.05). Post hoc Tukey’s test revealed significant differences between BioRaCe and K-Flexofile and also between Mtwo and K-Flexofile, both in the 3-mm depths (P&lt;0.05). Conclusion: Under the limitations of the present study, BioRaCe and Mtwo rotary instruments are considered suitable for canal preparation to greater apical sizes provided that the recommended sequences are observed

Abiraterone-Docetaxel scheduling for metastatic castration-resistant prostate cancer based on evolutionary dynamics.

Patients with metastatic castration-resistant prostate cancer (mCRPC) are divided into three groups based on their response to Abiraterone treatment: best responder, responder, and non-responder. In the latter two groups, successful outcomes may not be achieved due to the development of drug-resistant cells in the tumor environment during treatment. To overcome this challenge, a secondary drug can be used to control the population of drug-resistant cells, potentially leading to a longer period of disease inhibition. This paper proposes using a combination of Docetaxel and Abiraterone in some polytherapy methods to control both the overall cancer cell population and the drug-resistant subpopulation. To investigate the competition and evolution of mCRPC cancer phenotypes, as in previous studies, the Evolutionary Game Theory (EGT) has been used as a mathematical modeling of evolutionary biology concepts