Category: Nevin Manimala

Eur Endod J. 2021 Aug;6(2):221-225. doi: 10.14744/eej.2021.30602.

ABSTRACT

OBJECTIVE: To compare the amount of apically extruded bacteria between hand-filed preparations, rotary and reciprocation glide path preparations in curved canals of extracted teeth infected with Enterococcus faecalis.

METHODS: Forty mandibular first molar teeth were decoronated, fitted into rubber stoppers and fixed onto glass vials. The mesiobuccal canals from mandibular first molar teeth were infected with Enterococcus faecalis, then randomly assigned to one of five groups for glide path preparation: manual stainless-steel file (K-files), rotary file (One G), reciprocating file (WaveOne Gold Glider) and two control groups. After glide path preparation, 0.01 mL of saline was taken from the experimental vials. The solution was plated on tryptic soy agar and colonies of bacteria were counted as colony-forming units. The results were analysed statistically using Kruskal-Wallis and post hoc Mann-Whitney U tests.

RESULTS: The manual K-file group was associated with significantly more bacteria extrusion compared to the rotary and reciprocating groups (P<0.05). However, no significant difference occurred between rotary and reciprocation instruments.

CONCLUSION: All instrumentation techniques resulted in a measurable amount of apical extrusion of bacteria. Manual K-files extruded the highest quantity of bacteria compared to One G rotary file and WaveOne Gold Glider reciprocation file during glide path preparation.

PMID:34650017 | DOI:10.14744/eej.2021.30602

Blood Coagul Fibrinolysis. 2021 Oct 1;32(7):496-503. doi: 10.1097/MBC.0000000000001088.

ABSTRACT

This study aimed to detect the defects of the current methods used to monitor unfractionated heparin (UFH) anticoagulant effect and find possible assistive parameters for activated partial thromboplastin time (aPTT) test to improve treatment performance. The required information was gathered from patients’ case records, treatment charts and laboratory reports. Kendall’s tau correlation coefficient was calculated for analysing the relationship between variables. The partial least squares (PLS) and the stepwise multiple regression were operated, and the area under the receiver operating characteristic curve (AUC) and the r-squared (r2) were used to show the analytical ability of the models, respectively. Overall, 102 UFH-receiving ischemic heart disease patients participated in this study. The aPTT value varied from 30 to 95 s (mean ± SD = 44 ± 14). Therapeutic aPTT values were observed in 15% of hospitalization days. The aPTT value showed statistically significant correlations with mean UFH infusion (U/kg/h), age, prothrombin time (PT), smoking, international normalized ratio, haemoglobin (Hgb) and blood triglyceride level. Triglyceride level and PT were efficacious predictors of aPTT value (P < 0.001, r2 = 0.336). Moreover, blood urea nitrogen (BUN) and blood creatinine (Cr) levels were the best predictors for mortality. The mean BUN/Cr ratio was 18 ± 5 and 25 ± 12 in nonexpired and expired subjects, respectively. If calibrated institution-specific therapeutic aPTT ranges and updated weight-based UFH nomograms get employed, aPTT test, along with the BUN/Cr ratio and Hgb level, as assistive parameters for predicting haemorrhagic incidents, would be near ideal monitoring method in UFH-receiving patients.

PMID:34650022 | DOI:10.1097/MBC.0000000000001088

Eur Endod J. 2021 Aug;6(2):189-196. doi: 10.14744/eej.2021.66375.

ABSTRACT

OBJECTIVE: To assess and quantify coronal tooth discolouration by ProRoot MTA, Biodentine and MTA repair HP as pulpotomy agents and to identify colour stability of these materials in presence of blood contamination.

METHODS: 120 human premolar teeth were used in the study. The teeth were sectioned horizontally 1 mm apical to the cementoenamel junction. A retrograde cavity extending within 2 mm of the incisal edge was prepared. The specimens were randomly distributed as; Control: Group 1, ProRoot MTA: Group 2, Biodentine: Group 3 and MTA repair HP: Group 4. The groups werefurther subdivided on basis of exposure to saline (subgroup A) or blood (subgroup B). The access was sealed with light cured Glass ionomer cemet and the specimens were stored in artificial saliva at 37°C. The Colour change was evaluated with a spectrophotometer at: day 0 (T0), day 1 (T1), day 7 (T7), 1 month (T30), 2 months (T60), and 6 months (T180). The colour measurements were recorded using the Commission Internationale de l’Eclairage L*a*b* value.

RESULTS: For all groups, there was a sharp increase in L* parameter at T1. At 6 months, Group 1B (Control + blood) showed maximum decrease in luminosity followed by Group 2A (ProRoot + saline) > Group 4B (MTA repair HP + blood) > Group 2B (ProRoot + blood). Group 3A (Biodentine + saline) showed the least amount of decrease in luminosity followed by Group 4A (MTA repair HP + saline) and Group 3B (Biodentine + blood). No significant difference was found in ∆E change between any of the groups from baseline to 180 days (P>0.05).

CONCLUSION: Relative to L* parameter, it was possible to observe a statistically significant decrease in luminosity in the Group1B (Control + blood) followed by ProRoot MTA (Group 2A and 2B) and MTA repair HP (Group 4A and 4B). Biodentine (Group 3A and 3B) showed least tooth discolouration in terms of L* parameter.

PMID:34650014 | DOI:10.14744/eej.2021.66375

Eur Endod J. 2021 Aug;6(2):197-204. doi: 10.14744/eej.2021.10437.

ABSTRACT

OBJECTIVE: TruNatomy and XP-endo Shaper are recently introduced file systems showing increased fatigue resistance rate. The present study aims to evaluate the surface topographic changes and nickel (Ni) and titanium (Ti) elemental loss of XP-endo Shaper (XPS) and TruNatomy (TN) files on exposure to conventionally used root canal irrigants; [5.25% sodium hypochlorite (NaOCl) and 17% ethylenediaminetetraacetic acid (EDTA)] at a 10 minute time frame using atomic force microscopy (AFM) and energy dispersion X-ray spectroscopy (EDX) analytical techniques.

METHODS: Twelve samples for each of XPS (30/.04 taper) and TN (26/.04 taper; prime) instruments were dynamically exposed to 5.25% NaOCl, 17% EDTA separately for 10 minutes and in combination of 5.25% NaOCl (8 minutes)+17% EDTA (2 minutes) for a total of 10 minutes. Post exposure, the files were subjugated to AFM and EDX analysis. Independent t test and one-way ANOVA were used for statistical analysis, and the level of significance was set at 0.05.

RESULTS: XPS and TN showed a significant increase of surface roughness (Ra) and roughness mean square (RMS) on exposure to various irrigants (P<0.05) using AFM analysis. Increased overall roughness was observed with TN in comparison to XPS (P<0.05). Elements Ni and Ti loss was found in both XPS and TN files using EDX analysis. Both files exhibited Ni and Ti loss with the loss of Ni content higher for TN after exposure to 17% EDTA. Loss of Ti was seen for both files on exposure to a combination of 5.25% NaOCl+17% EDTA.

CONCLUSION: After exposure to root canal irrigants, the surface roughness was lesser in XPS compared to TN files. 17% EDTA caused significantly higher surface roughness in both file systems when compared to 5.25% NaOCl. TN exhibited overall higher elemental (Ni and Ti) loss on exposure to 17% EDTA and 5.25% NaOCl+17% EDTA in comparison to XPS files.

PMID:34650015 | DOI:10.14744/eej.2021.10437

Eur Respir J. 2021 Oct 14:2101574. doi: 10.1183/13993003.01574-2021. Online ahead of print.

ABSTRACT

BACKGROUND: High-flow nasal cannula (HFNC) has become a frequently used non-invasive form of respiratory support in acute settings, however evidence supporting its use has only recently emerged. These guidelines provide evidence-based recommendations for the use of HFNC alongside other noninvasive forms of respiratory support in adults with acute respiratory failure (ARF).

MATERIALS AND METHODOLOGY: The European Respiratory Society Task Force panel included expert clinicians and methodologists in pulmonology and intensive care medicine. The Task Force used the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) methods to summarise evidence and develop clinical recommendations for the use of HFNC alongside conventional oxygen therapy (COT) and non-invasive ventilation (NIV) for the management of adults in acute settings with ARF.

RESULTS: The Task Force developed 8 conditional recommendations, suggesting using: 1) HFNC over COT in hypoxemic ARF, 2) HFNC over NIV in hypoxemic ARF, 3)HFNC over COT during breaks from NIV, 4) either HFNC or COT in post-operative patients at low risk of pulmonary complications, 5) either HFNC or NIV in post-operative patients at high risk of pulmonary complications, 6) HFNC over COT in non-surgical patients at low risk of extubation failure, 7) NIV over HFNC for patients at high risk of extubation failure unless there are relative or absolute contraindications to NIV, 8) trialling NIV prior to use of HFNC in patients with chronic obstructive pulmonary disease (COPD) and hypercapnic ARF.

CONCLUSIONS: HFNC is a valuable intervention in adults with ARF. These conditional recommendations can assist clinicians in choosing the most appropriate form of non-invasive respiratory support to provide to patients in different acute settings.

PMID:34649974 | DOI:10.1183/13993003.01574-2021

Pediatrics. 2021 Oct 14:e2020033878. doi: 10.1542/peds.2020-033878. Online ahead of print.

ABSTRACT

OBJECTIVES: With the Children with Hemiparesis Arm and Hand Movement Project (CHAMP) multisite factorial randomized controlled trial, we compared 2 doses and 2 constraint types of constraint-induced movement therapy (CIMT) to usual customary treatment (UCT).

METHODS: CHAMP randomly assigned 118 2- to 8-year-olds with hemiparetic cerebral palsy to one of 5 treatments with assessments at baseline, end of treatment, and 6 months posttreatment. Primary blinded outcomes were the assisting hand assessment; Peabody Motor Development Scales, Second Edition, Visual Motor Integration; and Quality of Upper Extremity Skills Test Dissociated Movement. Parents rated functioning on the Pediatric Evaluation of Disabilities Inventory-Computer Adaptive Test Daily Activities and Child Motor Activity Log How Often scale. Analyses were focused on blinded and parent-report outcomes and rank-order gains across all measures.

RESULTS: Findings varied in statistical significance when analyzing individual blinded outcomes. parent reports, and rank-order gains. Consistently, high-dose CIMT, regardless of constraint type, produced a pattern of greatest short- and long-term gains (1.7% probability of occurring by chance alone) and significant gains on visual motor integration and dissociated movement at 6 months. O’Brien’s rank-order analyses revealed high-dose CIMT produced significantly greater improvement than a moderate dose or UCT. All CIMT groups improved significantly more in parent-reported functioning, compared with that of UCT. Children with UCT also revealed objective gains (eg, 48% exceeded the smallest-detectable assisting hand assessment change, compared with 71% high-dose CIMT at the end of treatment).

CONCLUSIONS: CHAMP provides novel albeit complex findings: although most individual blinded outcomes fell below statistical significance for group differences, high-dose CIMT consistently produced the largest improvements at both time points. An unexpected finding concerns shifts in UCT toward higher dosages, with improved outcomes compared with previous reports.

PMID:34649982 | DOI:10.1542/peds.2020-033878

Eur Respir J. 2021 Oct 14:2102099. doi: 10.1183/13993003.02099-2021. Online ahead of print.

NO ABSTRACT

PMID:34649973 | DOI:10.1183/13993003.02099-2021

Biotechnol J. 2021 Oct 14:e2100414. doi: 10.1002/biot.202100414. Online ahead of print.

ABSTRACT

BACKGROUND: Recent technological advancements in synthetic and systems biology have enabled the construction of microbial cell factories expressing diverse heterologous pathways in unprecedentedly short time scales. However, the translation of such laboratory scale breakthroughs to industrial bioprocesses remains a major bottleneck.

METHODS AND MAJOR RESULTS: In this study, an accelerated bioprocess development approach was employed to optimize the biosynthetic pathway of the blockbuster chemotherapy drug, Taxol. Statistical design of experiments approaches were coupled with an industrially relevant high-throughput microbioreactor system to optimize production of key Taxol intermediates, Taxadien-5α-ol and Taxadien-5α-yl-acetate, in engineered yeast cell factories. The optimal factor combination was determined via data driven statistical modelling and validated in 1L bioreactors leading to a 2.1-fold improvement in taxane production compared to a typical defined media. Elucidation and mitigation of nutrient limitation enhanced product titers a further two-fold and titers of the critical Taxol precursors, Taxadien-5α-ol and Taxadien-5α-yl-acetate were improved to 34 and 11 mg/L, representing a three-fold improvement compared to the highest literature titers in S. cerevisiae. Comparable titers were obtained when the process was scaled up a further five-fold using 5L bioreactors.

CONCLUSIONS: The results of this study highlight the benefits of a holistic design of experiments guided approach to expedite early stage bioprocess development. This article is protected by copyright. All rights reserved.

PMID:34649302 | DOI:10.1002/biot.202100414

Stat Med. 2021 Oct 14. doi: 10.1002/sim.9214. Online ahead of print.

ABSTRACT

Alzheimer’s disease (AD) is a severe neurodegenerative disorder impairing multiple domains, for example, cognition and behavior. Assessing the risk of AD progression and initiating timely interventions at early stages are critical to improve the quality of life for AD patients. Due to the heterogeneous nature and complex mechanisms of AD, one single longitudinal outcome is insufficient to assess AD severity and disease progression. Therefore, AD studies collect multiple longitudinal outcomes, including cognitive and behavioral measurements, as well as structural brain images such as magnetic resonance imaging (MRI). How to utilize the multivariate longitudinal outcomes and MRI data to make efficient statistical inference and prediction is an open question. In this article, we propose a multivariate joint model with functional data (MJM-FD) framework that relates multiple correlated longitudinal outcomes to a survival outcome, and use the scalar-on-function regression method to include voxel-based whole-brain MRI data as functional predictors in both longitudinal and survival models. We adopt a Bayesian paradigm to make statistical inference and develop a dynamic prediction framework to predict an individual’s future longitudinal outcomes and risk of a survival event. We validate the MJM-FD framework through extensive simulation studies and apply it to the motivating Alzheimer’s Disease Neuroimaging Initiative (ADNI) study.

PMID:34649301 | DOI:10.1002/sim.9214

Med Sci Sports Exerc. 2021 Jul 7. doi: 10.1249/MSS.0000000000002739. Online ahead of print.

ABSTRACT

PURPOSE: To describe changes in laboratory-assessed anthropometric and physiological characteristics, training volumes and competitive performance in national development-team cross-country (XC) skiers over a 25-month period, and to analyze whether changes in competitive performance could be predicted by changes in laboratory-assessed qualities and training volumes.

METHODS: Data collected over 25 months from 30 national development-team XC skiers (14 women, 16 men; age 18-23 y) were analyzed retrospectively using multivariate statistics. Anthropometric and physiological characteristics were assessed via dual-energy X-ray absorptiometry and incremental roller-ski treadmill tests, respectively. Total training volumes and distributions of low- and high-intensity training (LIT and HIT) were analyzed from online training diaries, and competitive performance was determined by International Ski Federation (FIS) distance and sprint points.

RESULTS: Whole- and upper-body lean mass increased in the full cohort of skiers (n = 30; both p < 0.05), while lower-body lean mass, whole-body fat mass, speed and oxygen uptake (V˙O2) at a blood lactate concentration (BLa) of 2 and 4 mmol·L-1, as well as time-trial (TT) completion time, power output and peak V˙O2, improved in the women only (all p < 0.05). Valid predictive models were identified for female skiers’ best FIS distance points (R2 = 0.81 / Q2 = 0.51) and changes in FIS distance points (R2 = 0.83 / Q2 = 0.54), with body mass, fat mass, lean mass, V˙O2peak and speed at a BLa of 4 mmol·L-1 identified as consistently important variables for projection.

CONCLUSION: The valid prediction of competitive performance was achieved for women only in distance events. This study suggests that improvements in body composition and aerobic capacity may be more beneficial for elite female development-level skiers than for their male counterparts. These results have implications for athlete selection and performance development.

PMID:34649265 | DOI:10.1249/MSS.0000000000002739