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Purpose: The aim of this study was to evaluate the microstrain exhibited by bone around immediately loaded, platform-switched, and non-platform-switched implants under vertical and angled loading using a finite element analysis (FEA) and also to evaluate whether platform-switched implants evoke a better response than non-platform-switched implants on a mechanical basis. Materials and Methods: Three-dimensional finite element study was undertaken to model and analyze an immediate loaded situation. FEA was chosen for this study since it is useful in determining the stress and strain around the dental implant. Bone responses to vertical and angulated loads on straight and angulated abutments (platform-switched and non-platform-switched abutments) were evaluated. Results: Non-platform-switched abutments tend to exhibit a lower tensile stress and compressive stress but higher microstrain value (conducive to higher chance of bone resorption) than platform-switched abutments. Ideal bone remodeling values of microstrain (50-3000 μϵ) were exhibited by platform-switched straight abutments under vertical load and angled load (with an abutment-implant diameter difference of 1 mm). Conclusion: In spite of the obvious advantages, the practice of immediate loading is limited due to apprehension associated with compromised bone response and a higher rate of bone loss around an immediately loaded implant. The mechanical basis for the concept of "platform switching" in immediately loaded situation is analyzed in this context. The results of this limited investigation indicated that the ideal values of microstrain (50-3000 microstrain) can be exhibited by platform switching of dental implants (with an abutment-implant diameter difference of 1 mm) and can be considered as a better alternative for prevention of crestal bone loss when compared to non-platform-switched implants.

Introduction Cardiovascular disease (CVD) prevention relies on timely identification of and intervention for individuals at risk. Risk assessment models such as the Framingham Risk Score (FRS) have been shown to over-estimate or under-estimate risk in certain groups, such as socioeconomically disadvantaged populations. Artificial intelligence (AI) and machine learning (ML) could be used to address such equity gaps to improve risk assessment; however, critical appraisal is warranted before ML-informed clinical decision-making is implemented.Methods and analysis This study will employ an equity-lens to identify sources of bias (ie, race/ethnicity, gender and social stratum) in ML algorithms designed to improve CVD risk assessment relative to the FRS. A comprehensive literature search will be completed using MEDLINE, Embase and IEEE to answer the research question: do AI algorithms that are designed for the estimation of CVD risk and that compare performance with the FRS address the sources of bias inherent in the FRS? No study date filters will be imposed on the search, but English language filters will be applied. Studies describing a specific algorithm or ML approach that provided a risk assessment output for coronary artery disease, heart failure, cardiac arrhythmias (ie, atrial fibrillation), stroke or a global CVD risk score, and that compared performance with the FRS are eligible for inclusion. Papers describing algorithms for the diagnosis rather than the prevention of CVD will be excluded. A structured narrative review analysis of included studies will be completed.Ethics and dissemination Ethics approval was not required. Ethics exemption was formally received from the General Research Ethics Board at Queen’s University. The completed systematic review will be submitted to a peer-reviewed journal and parts of the work will be presented at relevant conferences.

Es casi imposible estar en desacuerdo con una propuesta de ralentizar las cosas para minimizar el daño al planeta. Sin embargo, la pregunta es dónde. El manifiesto propuesto en The Case for Degrowth reconoce el desafío de pedir a distintas poblaciones que reduzcan su crecimiento económico y bienestar. Sugieren alianzas, haciéndose eco de los comunes, y destacan antiguas tradiciones culturales que han imaginado otros mundos. En contraste, la discusión ofrecida por Deepak Lamba-Nieves, mediante el caso de Puerto Rico y su subyugación colonial compartida o equivalente a muchos otros lugares, en especial en el sur global, nos pide reflexionar sobre de quién podemos esperar o pedir decrecimiento.

It is almost impossible to disagree with a proposal seeking to slow things down to minimize harm to the planet. However, the question is where. The manifesto in The Case for Degrowth acknowledges the challenge of asking distinct populations to lower their economic growth and well-being. They suggest alliances, echoing the commons, and highlight ancient cultural traditions that have envisioned other worlds. In contrast, the discussion offered by Deepak Lamba-Nieves through the case of Puerto Rico and its colonial subjugation - shared or equivalent to many in the Global South and elsewhere - asks us to reflect upon who is demanding or expecting us to degrowth.

IntroductionAfter African Americans, Latinx are the second largest population affected by Sickle Cell Disease (SCD) in the U.S. However, research has largely ignored how this devastating rare blood disorder specifically affects Latinx nationwide.MethodsThis study compared demographics, genotypes, primary insurance, and health care utilization among Latinx and non-Latinx Californians living with SCD, using data from the California SCD Data Collection Program (2016-2018) and newborn screening cases 2000-2017.ResultsStemming from 6,837 SCD patients, 501(7%) were Latinx. Latinx with SCD (Lx-SCD) were statistically significantly younger than non-Latinx (NLx-SCD) counterparts. Within both groups, females predominated, with 70% being insured by Medicaid. Mean Emergency Department encounters were statistically significantly lower among Lx-SCD adults.DiscussionLx-SCD differ in age, genotype, and Emergency Department utilization, when compared to NLx-SCD counterparts in California. Latinx are now the largest racial and/or ethnic group in the US, and their presence in SCD population is expected to grow. Therefore, their specific demographic, genotypic, and health care utilization characteristics merit attention to inform policies and programs that will improve their health.

Abstract Background and aims When patients with sickle cell disease have appropriate indications, they can be prescribed hydroxyurea (HU) and deferasirox (DFX) concurrently despite little knowledge about how the two medications interact. We wished to analyze whether there was evidence of adverse interaction between HU and DFX when taken simultaneously and hypothesized that those who took both drugs together had similar clinical complications when compared to those who took only one or neither drug. Methods We conducted this retrospective cohort investigation between 2009 and 2016 of persons with SCD in the California Sickle Cell Data Collection Program, a validated database of Californians with SCD a statewide. People in the database who took HU and DFX simultaneously for at least 3 months as compared to those who took either HU or DFX alone or to matched persons who took neither drug were eligible. Results We identified 104 people who were prescribed both HU and DFX concurrently, 877 who were prescribed HU only, and 314 who were prescribed DFX only during the study period. We identified 416 matched controls who took neither HU nor DFX. People who took both HU and DFX concurrently had similar rates of ED and inpatient encounters and had similar rates and distribution of adverse effects compared to those who took either HU or DFX alone or took neither drug. Conclusion Three months of concurrent use of DFX and HU appears safe, but further studies are required to better understand the safety and effectiveness of this medication combination. (Funded by CDC, CDC Foundation, and others).

Abstract Harmful environmental consequences of growth have been rigorously documented and widely publicized throughout the past half-century. Yet, the quantity of matter and energy used by human economies continues to increase by the minute, while governments and businesses continue to promise and to prioritize further economic growth. Such a paradox raises questions about how we humans change course. This introduction to a Special Section offers a new theoretical approach to change, together with glimpses of adaptations underway around the world. It directs attention away from individual decision-making and toward systems of culture and power through which socialized humans and socioecological worlds are (re)produced, sustained and adapted. Potential for transformative change is found in habitual practices through which skills, perspectives, denials and desires are viscerally embodied, and in cultural systems (economic, religious, gender and other) that govern those practices and make them meaningful. Case studies reviewed illuminate diverse communities acting to maintain old and to forge new moral and material worlds that prioritize wellbeing, equity and sustainability rather than expansion. This article endeavors to galvanize change by conceptualizing degrowth, by decolonizing worldviews of expansionist myths and values, and by encouraging connections between science and activism, north and south. Key words: degrowth, transition, climate change, socioecological systems

In varied contexts around the world, groups and communities forging different kinds of futures are challenging the universal desirability of development toward ever-greater production, consumption, and ecological footprints. This article is about learning from some of those pathways in order to broaden horizons for conversations about degrowth beyond Europe where they first gained traction. It reviews empirical research on wide-ranging phenomena, and documents processes of mutual learning among researchers from varied cultural, linguistic, and national backgrounds. Affirmative political ecology is appraised as a framework for analyzing relations among differently shaped phenomena operating in different contexts and on various scales, and for supporting life-affirming efforts to co-construct worlds that might be healthier and happier for more people and other nature. Pluriverse is explored as an epistemological stance and a dialogic method to enhance appreciation of multiple ways of knowing and being in the world, and to foster enquiry that decenters models of science and development that have been portrayed as universally true and good. After conceptualizing key ideas and reflecting on learning processes and challenges among a network of 40 collaborators, the text turns to some movements that I have engaged in Latin America in search of insights to support ongoing development of thought and practice with degrowth.

Residents in rural Yucatan, Mexico, have experienced dramatic employment changes from one generation to the next: most older men are farmers, while young men work in manufacturing and services. Young women engage informal employment much more than their mothers. We examine several factors originating outside the territory,including international markets and Mexican public policies, to see how they interact with social, political and cultural processes within the territory in the development of these occupational transformations. Attention to the role gender plays in external factors as well as in territorial processes drives our analysis of a key territorial process: the implementation of national legislation for sustainable rural development.

Background: It is well documented that India is an example of the unequal distribution of dental caries among different population groups, as higher prevalence and incidence have been reported among people with a low socioeconomic level. The objective of this review was to systematically map the scientific literature on the effect of socioeconomic status (SES) on dental caries among adults, identify the research gaps in this area, and propose recommendations for future research. Methods: This scoping review was conducted based on the updated framework recommended by Joanna Briggs Institute. Relevant studies undertaken in India were identified by searching Medline/PubMed, EBSCO, and Google Scholar. The search strategy was limited to journal articles published between January 2012 and October 2022. Titles and abstracts were screened, and full texts were reviewed by two reviewers independently. Results: The scoping review comprised 7 cross-sectional studies and 1 cohort study. Most reviewed studies used the Kuppuswamy scale or its modifications to assess the SES. Four studies determined the caries status regarding mean values according to SES and reported higher DMFT (decayed, missing, and filled teeth) among the middle and lower-class SES. Three studies employed regression analysis to determine the association, and all found that the DMFT score was significantly associated with socioeconomic status. Conclusion: The findings of this review confirm the existence of inequalities in caries experience in adults from different socioeconomic backgrounds. More high-quality and follow-up studies are needed to establish the magnitude of the scientific evidence regarding the association between socioeconomic status and dental caries among adults in India.

Background: A person is said to have a functional limitation when he/she does not have the physical or cognitive ability to independently perform the routine activities of daily living. If recognized at an early stage, these can often be improved greatly, helping them regain their functional abilities and independence. Objective: The objective of the study was to determine the prevalence of functional limitations among older adults in a rural area in south Kerala. Materials and Methods: The cross-sectional study was conducted among older adults residing in the field practice area of a rural health training center of a medical college in south Kerala for 3 months from October 2019 to December 2019. Data were collected by interview of the participants by the investigator. The modified Barthel Index for activities of daily living was used to determine the prevalence of functional limitations. Results: The overall prevalence of functional limitations among older adults in a rural area in south Kerala was 35.9%. The most common functional limitation experienced by the participants was difficulty in climbing stairs. Functional limitation was found to be significantly associated with the age, socioeconomic status, and type of family of the participants. Conclusion: There is an urgent need to focus on the functional limitation among older adults, especially among the oldest old and those in lower socioeconomic status with emphasis on the need to strengthen the health-care facilities for them, with respect to early identification and management of their functional limitations.

Introduction: As we are moving from millennium development goals to sustainable development goals, food insecurity is imposing a formidable challenge to the policymakers, especially in developing countries such as India. A survey conducted in the urban slum areas of Vellore district, 6 years back, had reported food insecurity as high as 75%. The current study was a resurvey to assess the food security status in the aforementioned area. Materials and Methods: A community-based survey was conducted in which data were collected using a self-administered questionnaire from 150 households, selected through multistaged cluster sampling, who had given oral consent to be a part of the survey. The prevalence of food security calculated from this study was compared with the results from a previous survey to look for any significant improvement. Results: Nearly 42.7% of the households were food secure, while 26.7% were food insecure without hunger and 30.6% were food insecure with some degree of hunger. Low socioeconomic status (odds ratio [OR]: 3.25, 95% confidence interval [CI]: 1.29–8.16; P < 0.012) and presence of debt (OR: 3.84, 95% CI: 1.90–7.73; P < 0.001) were the major risk factors for food insecurity. A comparison with the findings from the previous study has shown a statistically significant improvement in food security from 25.4% to 42.7% (Chi-square: 27.072, df: 2, P < 0.0001). Conclusion: Although food security levels have shown marked improvement over the years, much needs to be done for India to be free from the shackles of hunger.

Aim: To empower and bring the underprivileged senior citizens in the rural areas to the mainstream of life through setting up of model “senior citizens' recreation centers” that can be replicated in the other parts of the country. Materials and Methods: Six senior citizens' recreation centers are run in six villages under a community health program of a leading Medical College in South India, which were started by looking into their perceived needs and in a location where organized self-help women groups (SHGs) showed willingness to take the role of caretakers. Together there are 140 members in 6 centers and the most deserving members were identified using a participatory rural appraisal (PRA) method. These centers are open for 5 days a week and the main attraction of the center has been provision of one good, wholesome, noon-meal a day, apart from several recreational activities. The members were also assessed for chronic energy deficiency (CED) and quality of life at the beginning of enrolment using body mass index (BMI) and WHO-BREF scale. Results: The attendance to these centers was nearly 90% of the enrolled beneficiaries. A statistically significant improvement was noticed in quality of life in the physical, psychological, social, and environmental domain (P < 0.05). There was also a significant increase in the average BMI after 1 year of the intervention (P < 0.05). Conclusion: Care of underprivileged senior citizens is a growing need in the rural areas and the “Recreation centers” proved to be a beneficial model that can be easily replicated.

In an anticipation of the rising geriatric population in India, the Central government constituted the National Policy for Older Persons in 1999 to promote the health and welfare of senior citizens in India. A major strategy of this policy is to encourage families to take care of their older family members. The policy also encourages voluntary organizations to supplement the care provided by the family and provide care and protection to vulnerable elderly people. The implementation of this policy, particularly in the rural areas, has been negligible and calls for a scaling-up of programs to address the physical, psychological, and social needs of the poor. Due to breakdown of the joint family system and the migration of the younger generation to the towns and cities, the elderly parents in the villages are left to fend for themselves. Too old to work and with little or no source of income, the elders are struggling even to satisfy their basic needs. This article primarily focuses on the various facets of elderly care in India. As a fledgling nation in elderly care, we should take cues from other nations who have pioneered in this field and should constantly evolve to identify and face the various challenges that come up, especially from rural India. The Rural Unit for Health and Social Affairs Department of a well-known Medical College in South India has developed a “senior recreation day care” model which proves to be a useful replicable model to improve the quality of life and nutritional status of the elderly in the lower rungs of society. More than a decade since its inception, it is now the right time to assess the implementation of our geriatric health policy and scale-up programs so that the elderly in our country, irrespective of urban and rural, will have a dignified and good quality life.