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Pulpotomy is the total amputation of coronal pulp tissue and subsequent placement of a pulpotomy agent over the root canal orifices, followed by a coronal seal. The most suitable pulpotomy agent for successful treatment outcomes remains controversial. To evaluate and compare the clinical and radiographic success of calcium hydroxide (CH) and Biodentine (BD) in primary tooth pulpotomy at 6 and 12 months. An automatised search of the PubMed-Medline, Web of Science, and SCOPUS electronic databases was performed to identify scientific articles on primary tooth pulpotomies with either calcium hydroxide (CH) or Biodentine (BD) as a pulpotomy agent, published until January 2024. The software used for meta-analysis was R 4.3.1 (R Core Team, 2023). Of the 594 potentially eligible articles, 14 met the inclusion criteria: seven articles on CH pulpotomy and seven articles on BD pulpotomy with 6- and 12-months of follow-up. The meta-analysis concluded a mean clinical success rate of 91.8 % at 6 months and 79.0 % at 12 months for the CH group, and 99.2 % at 6 months and 98.8 % at 12 months for the BD group. In terms of the mean radiographic success, the CH group achieved 74.2 % at 6 months and 63.7 % at 12 months, whereas the BD group achieved 99.4 % at 6 months and 98.4 % at 12 months. In comparison, the meta-analysis concluded a marginally significant difference in clinical success in favour of the BD group at 6 months (p = 0.091). At 12 months, clinical success was significant in the BD group (p = 0.023). Regarding radiographic success, a significant difference in favour of the BD group was observed at 6 (p = 0.008) and 12 months (p < 0.001). BD showed significantly higher clinical and radiographic success than CH in pulpotomy. [ABSTRACT FROM AUTHOR]

Rabies virus (RABV; Lyssavirus rabies) is a neurotropic virus that can be transmitted to mammals by the hematophagous bat Desmodus rotundus. An accurate, accessible method for the detection of RABV in cattle is necessary in Paraguay; thus, we evaluated the detection of RABV using 4 techniques: fluorescent antibody test (FAT), immunochromatography rapid detection test (RDT; Anigen Rapid Rabies Ag test kit; Bionote), a reverse-transcription PCR (RT-PCR) assay, and histologic lesions in different portions of the CNS of 49 Paraguayan cattle to determine the most sensitive and specific technique. By FAT and RDT, 15 of 49 (31%) samples were positive. By RT-PCR amplification of N and G genes, 13 of 49 (27%) and 12 of 49 (25%) were positive, respectively. RDT had high agreement with FAT (kappa = 1); sensitivity was 100% (95% CI: 97–100%) and specificity was 100% (95% CI: 99–100%). The amplification of the N and G genes resulted in substantial agreement (kappa of 0.9 and 0.8, respectively) compared with FAT, and the sensitivity and specificity of the N gene were 87% (95% CI: 66–100%) and 100% (95% CI: 98–100%), respectively, and those of the G gene were 80% (95% CI: 56–100%) and 100% (95% CI: 98–100%), respectively. Histologic lesions observed were lymphoplasmacytic meningoencephalitis, gliosis, and neuronophagia. The agreement observed between the FAT and RDT tests suggests that RDT is an accurate tool for the detection of RABV. Histopathology can be used to confirm lesions caused by RABV and to rule out other conditions; the RT-PCR assay is useful for molecular epidemiology studies. [ABSTRACT FROM AUTHOR]

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INTRODUCTION: Leveraging the nonmonolithic structure of Latin America, which represents a large variability in social determinants of health (SDoH) and high levels of genetic admixture, we aim to evaluate the relative contributions of SDoH and genetic ancestry in predicting dementia prevalence in Latin American populations. METHODS: Community‐dwelling participants aged 65 and older (N = 3808) from Cuba, Dominican Republic, Mexico, and Peru completed the 10/66 protocol assessments. Dementia was diagnosed using the cross‐culturally validated 10/66 algorithm. Multivariate linear regression models adjusted for SDoH were used in the main analysis. This study used cross‐sectional data from the 1066 population‐based study. RESULTS: Individuals with higher proportions of Native American (>70%) and African American (>70%) ancestry were more likely to exhibit factors contributing to worse SDoH, such as lower educational levels (p < 0.001), lower socioeconomic status (p < 0.001), and higher frequency of vascular risk factors (p < 0.001). After adjusting for measures of SDoH, there was no association between ancestry proportion and dementia probability, and ancestry proportions no longer significantly accounted for the variance in cognitive performance (African predominant p = 0.31 [‐0.19, 0.59] and Native predominant p = 0.74 [‐0.24, 0.33]). DISCUSSION: The findings suggest that social and environmental factors play a more crucial role than genetic ancestry in predicting dementia prevalence in Latin American populations. This underscores the need for public health strategies and policies that address these social determinants to effectively reduce dementia risk in these communities. Highlights: Countries in Latin America express a large variability in social determinants of health and levels of admixture.After adjustment for downstream societal factors linked to SDoH, genetic ancestry shows no link to dementia.Population ancestry profiles alone do not influence cognitive performance.SDoH are key drivers of racial disparities in dementia and cognitive performance. [ABSTRACT FROM AUTHOR]

Reducing mitral regurgitation (MR) during mitral transcatheter edge-to-edge repair (M-TEER) may come at the cost of increased mitral valve gradient (MVG). The combined impact of residual MR and MVG on clinical outcomes after M-TEER is unknown. This study sought to evaluate the impact of postprocedure MR and MVG on clinical outcomes after M-TEER. EXPANDed is a pooled, patient-level cohort of the EXPAND (A Contemporary, Prospective Study Evaluating Real-world Experience of Performance and Safety for the Next Generation of MitraClip Devices) and EXPAND G4 studies, which were designed to evaluate real-world safety and effectiveness of the third- and fourth-generation MitraClip TEER Systems. Subjects were categorized by echocardiographic core laboratory (ECL) assessments into 4 groups according to 30-day MR grade and mean MVG: 1) MR ≤1+/MVG <5 mm Hg; 2) MR ≤1+/MVG ≥5 mm Hg; 3) MR ≥2+/MVG <5 mm Hg; and 4) MR ≥2+/MVG ≥5 mm Hg. A total of 1,723 subjects had evaluable echocardiograms at 30 days: 72% had MR ≤1+/MVG <5 mm Hg, 18% had MR ≤1+/MVG ≥5 mm Hg, 7% had MR ≥2+/MVG <5 mm Hg, and 3% had MR ≥2+/MVG ≥5 mm Hg. MR≤1+ was sustained through 1 year in 93% of patients who achieved 30-day MR≤1+. MVG decreased from 30 days to 1 year in subjects with MVG ≥5 mm Hg (6.7 ± 4.0 to 5.5 ± 2.5 mm Hg MR ≤1+/MVG ≥5 mm Hg and 6.5 ± 1.5 to 5.5 ± 1.7 mm Hg MR ≥2+/MVG ≥5 mm Hg). One-year rates of all-cause mortality and heart failure hospitalization were lower for subjects who achieved MR ≤1+ at 30 days, regardless of MVG. Reduction of MR to mild or less after M-TEER with the latest-generation MitraClip systems was associated with clinical benefit regardless of MVG. [Display omitted] [ABSTRACT FROM AUTHOR]

Several protocols have been used with computer-aided design and computer-aided manufacture (CAD-CAM) prostheses after image-guided implant surgery based on a prosthetically driven surgical plan. For delayed approaches, a CAD-CAM custom healing abutment can be manufactured before the surgery and installed immediately after implant placement. However, information on the use of emergence profile segmentation on which to base the digital design and on the use of low-cost 3-dimensional printers to produce custom healing abutments are lacking. The purpose of this article was to present a fully digital workflow to digitally design and 3-dimensionally print custom healing abutments with a biocompatible light-polymerizing resin based on the natural emergence profile of the tooth to be replaced. [ABSTRACT FROM AUTHOR]

The Screening for Cardiac Amyloidosis with Nuclear Imaging in Minority Populations study seeks to determine the prevalence of transthyretin cardiac amyloidosis (ATTR-CA) among older Black or Caribbean Hispanic individuals with heart failure and an increased wall thickness. We noticed varied recruitment percentages across the recruiting sites and sought to determine the factors associated with greater percentage enrollment of eligible participants. The percentage of enrolled to eligible participants was calculated across study sites. Baseline demographic and clinical characteristics, health literacy, trust in providers, perceived discrimination, area deprivation index (ADI) and English proficiency were compared by site using Kruskal-Wallis's test or one-way ANOVA for continuous variables and the Chi-Square test or Fisher's exact test for categorical variables. Wilcoxon rank sum and Chi-Square tests, with multiple comparisons correction using the false discovery rate (FDR) method, were used as post-hoc analysis when results were statistically significant. Among the four recruiting sites, Boston Medical Center, Columbia University Irving Medical Center, Harlem Hospital and Yale University, which employed different recruitment approaches, the percentage of participants enrolled among eligible participants differed, with the highest rate at Harlem Hospital (n=149 of 310, 48%), followed by Yale University (n=27 of 67, 40%), Boston University (n=247 of 655, 38%), and Columbia University (n=137of 442, 32%), p <0.01. Direct recruitment by the primary cardiovascular care team providing clinical care was associated with higher percent enrolled across sites as were higher education levels and English proficiency. Enrollment differences across sites were not associated with the number of chronic diseases, physician trust, perceived discrimination, or health literacy. Recruitment of eligible under-represented minorities (URMs) in SCAN-MP was associated with approaches employed in recruitment, including direct initial contact by the primary cardiovascular care team providing the potential participant's clinical care. Such data may help improve approaches to more successful recruitment of URMs in clinical research. [ABSTRACT FROM AUTHOR]

This paper proposes a model-based optimization method for the production of automotive seals in an extrusion process. The high production throughput, coupled with quality constraints and the inherent uncertainty of the process, encourages the search for operating conditions that minimize nonconformities. The main uncertainties arise from the process variability and from the raw material itself. The proposed method, which is based on Bayesian optimization, takes these factors into account and obtains a robust set of process parameters. Due to the high computational cost and complexity of performing detailed simulations, a reduced order model is used to address the optimization. The proposal has been evaluated in a virtual environment, where it has been verified that it is able to minimize the impact of process uncertainties. In particular, it would significantly improve the quality of the product without incurring additional costs, achieving a 50% tighter dimensional tolerance compared to a solution obtained by a deterministic optimization algorithm. • Optimizing automotive seal production with a model-based approach. • A reduced order model (ROM) is used for efficient optimization. • Uncertainties in the model and the system itself are taken into account. • Bayesian optimization is applied for robust parameter determination. • A 50% tighter dimensional tolerance is achieved compared to a deterministic solution. [ABSTRACT FROM AUTHOR]

Background: Acute rhinosinusitis (ARS) is one of the most encountered conditions in primary care and otolaryngology clinics. However, little is known about how antibiotic prescription practices following a diagnosis of ARS compare to guidelines set forth by the American Academy of Otolaryngology in 2015. Objective: To investigate the epidemiology of ARS and the corresponding antibiotic prescribing practices by physicians and compare to published guidelines. Methods: Using the TriNetX Live database, we identified all patients diagnosed with ARS using the ICD10 code J01 between April 2015 and December 2022 across the state of Tennessee. After investigating the demographics of this cohort, we compared the first prescribed antibiotic within one day of ARS diagnosis to published guidelines. Antibiotics were grouped into their respective classes. Results: Of 81 310 patients diagnosed with ARS identified in the specified time frame, 66% were Female, 49% were African American, 44% were White, and the mean age was 47 ± 20 years. The six most common initial antibiotics prescribed for ARS were erythromycins/macrolides [14 609 (25.8%)], amoxicillin/clavulanate [14 322 (25.3%)], amoxicillin [9300 (16.4%)], third generation cephalosporins [7733 (13.6%)], quinolones [3648 (6.4%)] and tetracyclines [2235 (3.9%)]. Of this cohort, 56 719 patients (69.8%) of patients were prescribed an antibiotic within one day of diagnosis. Conclusion: Despite published guidelines recommending amoxicillin with or without clavulanic acid as first-line treatment for ARS, only 42.2% of prescribed antibiotics followed this guideline in our cohort. While accounting for patients with penicillin allergy, the second-most represented antibiotics were erythromycins/macrolides, which are specifically recommended against due to high rates of S. Pneumonia e resistance. Our results suggest that further investigation into the causes of erythromycin/macrolide prescriptions as first line treatment for ARS and practices at other institutions should be conducted. In addition, building awareness around published ARS guidelines for physicians may be useful in improving antibiotic stewardship in treatment of ARS. [ABSTRACT FROM AUTHOR]

Aortic stenosis (AS) is characterized by calcification and fibrosis. The ability to quantify these processes simultaneously has been limited with previous imaging methods. The purpose of this study was to evaluate the aortic valve fibrocalcific volume by computed tomography (CT) angiography in patients with AS, in particular, to assess its reproducibility, association with histology and disease severity, and ability to predict/track progression. In 136 patients with AS, fibrocalcific volume was calculated on CT angiograms at baseline and after 1 year. CT attenuation distributions were analyzed using Gaussian-mixture-modeling to derive thresholds for tissue types enabling the quantification of calcific, noncalcific, and fibrocalcific volumes. Scan-rescan reproducibility was assessed and validation provided against histology and in an external cohort. Fibrocalcific volume measurements took 5.8 ± 1.0 min/scan, demonstrating good correlation with ex vivo valve weight (r = 0.51; P < 0.001) and excellent scan-rescan reproducibility (mean difference −1%, limits of agreement −4.5% to 2.8%). Baseline fibrocalcific volumes correlated with mean gradient on echocardiography in both male and female participants (rho = 0.64 and 0.69, respectively; both P < 0.001) and in the external validation cohort (n = 66, rho = 0.58; P < 0.001). The relationship was driven principally by calcific volume in men and fibrotic volume in women. After 1 year, fibrocalcific volume increased by 17% and correlated with progression in mean gradient (rho = 0.32; P = 0.003). Baseline fibrocalcific volume was the strongest predictor of subsequent mean gradient progression, with a particularly strong association in female patients (rho = 0.75; P < 0.001). The aortic valve fibrocalcific volume provides an anatomic assessment of AS severity that can track disease progression precisely. It correlates with disease severity and hemodynamic progression in both male and female patients. [Display omitted] [ABSTRACT FROM AUTHOR]

Pes planus occurs due to the loss of the longitudinal arch of the foot, resulting in altered gait mechanics. This may lead to increased complications following total hip arthroplasty (THA). Thus, the aim of this study was to assess the effects that pes planus has on rates of falls, implant complications, fall-related injuries, and times to revision among THA patients. A retrospective review of a private insurance claims database was conducted from 2010 to 2021. Patients who had a diagnosis of congenital or acquired pes planus and cases of THA were identified. Patients undergoing THA with a diagnosis of pes planus were matched to control patients 1:5 based on age, sex, and comorbidity profiles. Logistic regression was utilized to assess for differences in complication rates. A total of 3,622 pes planus patients were matched to 18,094 control patients. The pes planus group had significantly higher rates of falls than the control group (6.93 versus 2.97%, OR [odds ratio]: 2.43; CI [confidence interval]: 2.09 to 2.84; P <.001). Pes planus patients also had significantly greater odds of dislocation (OR: 1.89; CI: 1.58 to 2.27; P <.001), mechanical loosening (OR: 2.43; CI: 2.09 to 2.84; P =.019), and periprosthetic fracture (OR: 2.43; CI: 2.09 to 2.84; P <.001). The pes planus group had significantly greater rates of proximal humerus fractures (P =.008), but no difference was seen in distal radius fractures (P =.102). The time to revision was significantly shorter in the pes planus group (190 versus 554 days, P <.001). Pes planus in patients undergoing THA is associated with increased risk of complications and faster time to revision. These findings may allow orthopaedic surgeons to identify those patients at risk and allow for more educated patient counseling and operative planning. [ABSTRACT FROM AUTHOR]

BACKGROUND: Disparities in guideline-based quality measures likely contribute to differences in heart failure (HF) outcomes. We evaluated between- and within-hospital differences in the quality of care across sex, race, ethnicity, and insurance for patients hospitalized for HF. METHODS: This retrospective analysis included patients hospitalized for HF across 596 hospitals in the Get With the Guidelines-HF registry between 2016 and 2021. We evaluated performance across 7 measures stratified by patient sex, race, ethnicity, and insurance. We evaluated differences in performance with and without adjustment for the treating hospital. We also measured variation in hospital-specific disparities. RESULTS: Among 685 227 patients, the median patient age was 72 (interquartile range, 61-82) and 47.2% were women. Measure performance was significantly lower (worse) for women compared with men for all 7 measures before adjustment. For 4 of 7 measures, there were no significant sex-related differences after patient-level adjustment. For 20 of 25 other comparisons, racial and ethnic minorities and Medicaid/uninsured patients had similar or higher (better) adjusted measure performance compared with White and Medicare/privately insured patients, respectively. Angiotensin receptor neprilysin inhibitor measure performance was significantly lower for Asian, Hispanic, and Medicaid/uninsured patients, and cardiac resynchronization therapy implant/prescription was lower among women and Black patients after hospital adjustment, indicating within-hospital differences. There was hospital-level variation in these differences. For cardiac resynchronization therapy implantation/prescription, 278 hospitals (46.6%) had ≥2% lower implant/prescription for Black versus White patients compared with 109 hospitals (18.3%) with the same or higher cardiac resynchronization therapy implantation/prescription for Black patients. CONCLUSIONS: HF quality measure performance was equitable for most measures. There were within-hospital differences in angiotensin receptor neprilysin inhibitor and cardiac resynchronization therapy implant/prescription for historically marginalized groups. The magnitude of hospital-specific disparities varied across hospitals. [ABSTRACT FROM AUTHOR]

Effort-based decision-making is particularly relevant to psychiatric conditions where motivation deficits are prominent features. Despite its clinical significance, the neurochemical mechanisms of this cognitive process remain unclarified. This study explores the impact of serotonin synthesis inhibition (PCPA) and modulation of serotonin release and 5-HT1A receptor agonism (8-OH-DPAT) on effort-based decision-making in rats. Adult male rats were trained in a modified T-maze task where they could obtain a high reward for climbing a mesh barrier or a low reward for no extra effort. Following training, rats received either acute 8-OH-DPAT treatment or subchronic PCPA treatment and were tested on their choices between high- and low-effort arms. The goal-arm choices and goal-arm entrance latencies were recorded. Next, homovanillic acid and 5-hydroxyindoleacetic acid, metabolites of dopamine and serotonin, respectively, were quantified in the rats' prefrontal cortex, striatum, and hippocampus. 8-OH-DPAT significantly increased low-effort, low-reward choices and increased goal-arm latency. In contrast, PCPA treatment did not affect these measures. Both PCPA and 8-OH-DPAT significantly decreased 5-hydroxyindoleacetic acid levels in the prefrontal cortex and the hippocampus. 8-OH-DPAT treatment was also associated with decreased homovanillic acid levels in the hippocampus. Our findings suggest that the overall reduction of serotonin levels alone does not affect effort-based decisionmaking and highlights the possible role of the hippocampus and the 5-HT1A receptor in this cognitive process. [ABSTRACT FROM AUTHOR]

For centuries Eastern Churches only employed the semantron , usually an elongated piece of wood that is struck with a hammer, to gather the faithful. Eventually, most adopted bell ringing, even though semantra continue to be used by some Orthodox Churches. In the West bells were rung for the same purpose and the semantron was unknown. As a result, Western pilgrims, diplomats, and other travellers to the eastern Mediterranean were astonished and intrigued when they encountered the instrument. This article looks at their descriptions and discusses how the instrument and its sounds were used to other Oriental Christianity. [ABSTRACT FROM AUTHOR]

The first trimester placenta is very rarely investigated for placental vascular formation in developmental or diseased contexts. Defects in placental formation can cause heart defects in the fetus, and vice versa. Determining the causality is therefore difficult as both organs develop concurrently and express many of the same genes. Here, we performed a systematic review to determine feto-placental and coronary endothelial genes implicated in miscarriages, stillbirth and congenital heart defects (CHD) from human genome wide screening studies. 4 single cell RNAseq datasets from human first/early second trimester cardiac and placental samples were queried to generate a list of 1187 endothelial genes. This broad list was cross-referenced with genes implicated in the pregnancy disorders above. 39 papers reported feto-placental and cardiac coronary endothelial genes, totalling 612 variants. Vascular gene variants were attributed to the incidence of miscarriage (8 %), CHD (4 %) and stillbirth (3 %). The most common genes for CHD (NOTCH, DST, FBN1, JAG1, CHD4), miscarriage (COL1A1, HERC1), and stillbirth (AKAP9, MYLK), were involved in blood vessel and cardiac valve formation, with roles in endothelial differentiation, angiogenesis, extracellular matrix signaling, growth factor binding and cell adhesion. NOTCH1, AKAP12, CHD4, LAMC1 and SOS1 showed greater relative risk ratios with CHD. Many of the vascular genes identified were expressed highly in both placental and heart EC populations. Both feto-placental and cardiac vascular genes are likely to result in poor endothelial cell development and function during human pregnancy that leads to higher risk of miscarriage, congenital heart disease and stillbirth. • Placental and cardiac vascular endothelial genes are associated with pregnancy-associated conditions. • 39 studies reported significant vascular genes for congenital heart defects, miscarriage and stillbirth. • Many genes were expressed in both first trimester and early second trimester coronary and placental endothelial cells. • This data verifies known vascular genes with important roles in endothelial specification and function. • This provides new gene candidates to explore in the miscarriage, congenital heart disease and stillbirth fields. [ABSTRACT FROM AUTHOR]

In the Anthropocene, ecosystems are changing along with their capacity to support human well‐being. Monitoring ecosystem services (ESs) is required to assess the changing state of human–nature interactions. To standardize the monitoring of multiple facets of ESs, the Group on Earth Observations Biodiversity Observation Network (GEO BON) recently proposed the essential ecosystem service variables (EESVs), which are organized into six classes: Ecological Supply, Use, Demand, Anthropogenic Contribution, Instrumental Value, and Relational Value. We apply the EESV framework to three case studies in British Columbia, Canada, each targeting a single ES. Using trend and intervention analysis, we show how EESVs are changing and affected by policy. We discuss key challenges and solutions while providing guidance on how to quantify EESVs. Finally, we demonstrate the potential of EESVs to harmonize metrics across conceptual frameworks, monitor ES change, and provide decision support to assess progress under various international policy conventions. [ABSTRACT FROM AUTHOR]

• Temporal lobe epilepsy and mood disorders share a common pathogenic network. • Surgery for Temporal lobe epilepsy may lead to the appearance of mood disorders. • We investigated the connectivity between the Nucleus Accumbens and Hippocampus. • Patients who developed de novo mood disorders had a decrease in connectivity. • A single-subject level analysis was used to account for individual differences. Surgical removal of the mesial temporal lobe can effectively treat drug-resistant epilepsy but may lead to mood disorders. This fact is of particular interest in patients without a prior psychiatric history. The study investigates the relationship between Temporal Lobe Epilepsy (TLE), mood disorders, and the functional connectivity of the Hippocampus (Hipp) and Nucleus Accumbens (NAcc). In this case control study, twenty-seven TLE patients and 18 control subjects participated, undergoing structural and functional magnetic resonance imaging (MRI) scans before and after surgery. Post-surgery, patients were categorized into those developing de novo depression (DnD) within the first year and those without depression (nD). Functional connectivity maps between NAcc and the whole brain were generated, and connectivity strength between the to-be-resected Hipp area and NAcc was compared. Within the first year post-surgery, 7 out of 27 patients developed DnD. Most patients (88.8 %) exhibited a significant reduction in NAcc-Hipp connectivity compared to controls. The DnD group showed notably lower connectivity values than the nD group, with statistically significant disparities. Receiver Operating Characteristic (ROC) curve analysis identified a potential biomarker threshold (Crawford-T value of -2.08) with a sensitivity of 0.83 and specificity of 0.76. The results suggest that functional connectivity patterns within the reward network could serve as a potential biomarker for predicting de novo mood disorders in TLE patients undergoing surgery. This insight may assist in identifying individuals at a higher risk of developing DnD after surgery, enhancing therapeutic guidance and clinical decision-making. [ABSTRACT FROM AUTHOR]