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The success of endodontically treated teeth (ETT) is influenced by factors that include the use of prefabricated glass fiber posts. A consideration for success is the presence of a circumferential ferrule, but systematic reviews and meta-analyses are lacking. The purpose of this systematic review and meta-analysis was to assess the impact of the presence or absence of a circumferential ferrule on the survival and success rates of ETT restored with prefabricated fiber posts. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a comprehensive search of the major scientific literature databases was conducted. Eligible studies included randomized clinical trials and prospective cohort studies with a minimum 6-month follow-up, focusing on ETT restored with fiber posts either with or without a uniform circumferential ferrule. Relative risks (RRs) and 95% confidence intervals (CIs) were calculated to compare outcomes. The degree of variability among studies was assessed using the chi-squared test (α=.05). Of 3731 identified records, 8 were eligible for inclusion. Direct analysis of success rates (2 studies, 123 teeth) showed a significant increase in success when a uniform circumferential ferrule was present (RR=1.28, 95% CI: 1.06, 1.54, P <.05). However, indirect analysis of survival and success rates (8 studies, 407 teeth) indicated no significant differences in outcomes between the ferrule and no ferrule groups (P >.05). The results of this systematic review and meta-analysis determined that a uniform circumferential ferrule had a positive effect on the success rates of ETT restored with prefabricated fiber posts. However, further high-quality studies are required to provide more robust evidence and to allow potential confounding factors to be considered. [ABSTRACT FROM AUTHOR]

The increasing integration of intermittent renewable sources (RSs) poses a dynamic frequency stability challenge for modern marine vessel microgrids. To address this issue, this paper proposes a novel control approach, specifically targeting frequency and tie-line power stabilization in a diverse source marine microgrid (MμG) with two intertied areas featuring renewable (wind-wave) sources. The suggested approach introduces a modified tilt-integral active disturbance rejection (TI-ADRC) controller designed to ensure effective damping of power frequency oscillations. As the control scheme depends on the optimal setting of the proposed controller, a recently developed marine predator technique (MPT) has been adopted. The performance of the proposed controller is compared with other recent controllers viz. PID, tilt-integral derivative (TID), two-degree-of-freedom (2DOF)-PID, fuzzy-PI, and ADRC to validate its superiority. To further enhance the system dynamics, a precise modeling of inertia emulated direct current (IEPDC) tie link is incorporated in microgrid system. The impact assessments, considering time delays with pre/post IEPDC link, demonstrate a substantial 57.79% and 81.53% reduction in peak frequency overshoot compared to DC link (conventional model) and AC link, respectively. The analysis of the eigen plot confirms the stability of the control system. Sensitivity assessments of the controller against ± 30% parametric variations and load fluctuations are conducted, affirming its robustness. Finally, the result from OPAL-RT confirm the practicality of the proposed method. It is asserted that the suggested controller is reliable and functions well in n the presence of diverse disruptions and parametric variations. • An integrated two-area inter-tied marine microgrid model based on intermittent renewable sources for secondary frequency control. • Novel MPT-tuned tilt integral-active disturbance rejection controller (TI-ADRC) for marine microgrid. • Comprehensive modelling of inertia emulated DC (IEPDC) link with parallel AC link. • Stability and dynamic response analysis of the proposed control strategy. • Sensitivity analysis to validate robustness of the proposed control strategy under uncertain parametric variation. [ABSTRACT FROM AUTHOR]

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Background: Roughly 80% of total energy intake (TEI) in most human diets originates from digestible carbohydrates (eCarb) and fat (eFat), but the impact of their proportions on cognitive performance is poorly understood. Objectives: Our primary aim was to investigate estimates of global cognition in relation to macronutrient intake, with the log-ratio eCarb/eFat (CFr) as the primary predictor variable of interest. Secondary predictors were protein and the saturated/total fat ratio. Exploratory comparisons of CFr with eCarb and eFat as separate predictors were an additional aim. Methods: The observations were made on panel data (years 0, 1, 2) from the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability, n = 1251; 1251; age 60-77 y; 47% females; selected by risk factors for dementia. Self-reported diet was assessed by 3-d food records. Global cognition was measured using a modified Neuropsychological Test Battery. A mixed linear regression model was used, adjusted for age, sex, education, body-mass index, cholesterol-lowering drugs, TEI, time, time x intervention/control group, with study site and subject as random factors. Estimates were standardized (mean = 0; SD = 1) with 95% CI. Results: CFr had a negative estimate to global cognition (β = -0.022, CI: -0.039, -0.005; P = 0.011). 0.011). The point estimate for protein was β = 0.013 (P = 0.41), and for the saturated/total fat ratio, associations with cognition were nonlinear. CFr correlated highly with eCarb (Pearson's r = 0.92) and eFat (r=-0.94 The point estimate for CFr fell between eCarb (β ¼-0.026, P < 0.001) and (inversely) eFat (β = 0.017, P = 0.090). Conclusions: A lower CFr was associated with better global cognition among older adults at risk for dementia. Because this is an important target group for preventive interventions, clinical trials are warranted to further investigate the impact of macronutritional composition on cognitive health. The potential role of CFr as a predictor for cognitive health should be further studied. [ABSTRACT FROM AUTHOR]

Infection with SARS-CoV-2 may perturb normal microbiota, leading to secondary infections that can complicate the viral disease. The aim of this study was to probe the alteration of nasopharyngeal (NP) microbiota in the context of SARS-CoV-2 infection and obesity and to identify other respiratory pathogens among COVID-19 cases that may affect patients' health. A total of 107 NP swabs, including 22 from control subjects and 85 from COVID-19 patients, were processed for 6S amplicon sequencing. The respiratory pathogens causing secondary infections were identified by RT-PCR assay, using a kit that contained specific primers and probes combinations to amplify 33 known respiratory pathogens. No significant (p > 0.05) difference was observed in the alpha and beta diversity analysis, but specific taxa differed significantly between the control and COVID-19 patient groups. Genera of Sphingomonas, Kurthia, Microbacterium, Methylobacterium, Brevibacillus, Bacillus, Acinetobacter, Lactococcus, and Haemophilus was significantly abundant (p < 0.05) in COVID-19 patients compared with a healthy control group. Staphylococcus was found in relatively high abundance (35.7 %) in the COVID-19 patient groups, mainly those treated with antibiotics. A relatively high percentage of Streptococcus was detected in COVID-19 patient groups with obesity or other comorbidities. Respiratory pathogens, including Staphylococcus aureus , Streptococcus pneumoniae , Haemophilus influenzae , Moraxella catarrhalis , and Salmonella species, along with Pneumocystis jirovecii fungal species were detected by RT-PCR mainly in the COVID-19 patients. Klebsiella pneumoniae was commonly found in most of the samples from the control and COVID-19 patients. Four COVID-19 patients had viral coinfections with human adenovirus, human rhinovirus, enterovirus, and human parainfluenza virus 1. Overall, no substantial difference was observed in the predominant NP bacterial community, but specific taxa were significantly changed between the healthy control and COVID-19 patients. Comparatively, an increased number of respiratory pathogens were identified in COVID-19 patients, and NP colonization by K. pneumoniae was probably occurring in the local population. [ABSTRACT FROM AUTHOR]

Understanding, visualizing, and quantifying how resources are allocated and the fairness of distributions and access is significant for supporting decision-makers in incentivizing development and ensuring that future changes are widely beneficial and fair. By pointing out the need for mobility justice research to shift from state-centric to more society-centric frameworks and metrics, this study proposed a Mobility Justice Framework that integrated two important theories of justice: distribution and recognition justice. The proposed framework highlights the distribution of amenities and burdens in providing transport infrastructure. It also aims to identify those disadvantaged socio-economic groups more exposed to mobility inequalities. To make the framework applicable within the city context and guide decision-making, several metrics (variables) were identified to make principles of distributive and recognition justice operationalizable. Variables such as 1) accessibility by walking, 2) exposure to traffic negative effects, 3) frequency of use of transport modes, and 4) availability of transport infrastructure were used to identify neighborhoods and the different types of mobility resources/burdens that disadvantaged socio-economic groups are exposed to. To showcase its usability, the framework and methodology have been applied to the city of Munich to highlight neighborhoods with a higher proportion of older people and the transport disadvantages associated with these target groups. A higher negative correlation between older people and mobility resources/burdens can be observed for the following variables: accessibility by walking to activities, availability of walking and cycling infrastructure, and availability of car-sharing services. When measured against exposure to negative transport effects, a higher positive correlation was observed. The paper ends with a discussion section on the relevance and usability of the proposed framework for transport planning and policy and its limitations. [ABSTRACT FROM AUTHOR]

Vitamin D deficiency and periodontitis are commonly prevalent among Saudi adults. However, the association between periodontitis and vitamin D status has not been well documented. This study aims to examine the association between periodontitis and vitamin D status among adults in the Albaha region of Saudi Arabia. A case-control study of 123 Saudi adults was conducted; 60 had severe or moderate periodontitis, and 63 were periodontally healthy. Data was collected by an online self-reported sociodemographic questionnaire. All participants then underwent a full periodontal examination. Blood samples were also provided to assess participants' vitamin D statuses through serum levels of 25-hydroxyvitamin D (25(OH)D). A total of 60 cases and 63 controls matched for BMI (30.2 ± 4.86 kg/m2), age (40.01 ± 7.73 years), and sex (46.3% and 53.7% male and female, respectively) participated in the study. Mean levels of 25(OH)D were significantly lower in periodontitis participants than in controls (25.03 ± 8.55 ng/ml, 29.19 ± 12.82 ng/ml, p = 0.037, respectively). Lower odds of periodontitis were detected per unit of 25(OH)D level (OR 0.964, 95% CI; 0.931–0.999, p = 0.043). In conclusion, periodontitis is significantly associated with deficient and insufficient levels of vitamin D among Saudi adults in the Albaha region. Future longitudinal research with a larger sample size may be suggested to confirm these results. [ABSTRACT FROM AUTHOR]

Coronavirus disease-19 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and is currently a major cause of intensive care unit (ICU) admissions globally. The role of machine learning in the ICU is evolving but currently limited to diagnostic and prognostic values. A decision tree (DT) algorithm is a simple and intuitive machine learning method that provides sequential nonlinear analysis of variables. It is simple and might be a valuable tool for bedside physicians during COVID-19 to predict ICU outcomes and help in critical decision-making like end-of-life decisions and bed allocation in the event of limited ICU bed capacities. Herein, we utilized a machine learning DT algorithm to describe the association of a predefined set of variables and 28-day ICU outcome in adult COVID-19 patients admitted to the ICU. We highlight the value of utilizing a machine learning DT algorithm in the ICU at the time of a COVID-19 pandemic. This was a prospective and multicenter cohort study involving 14 hospitals in Saudi Arabia. We included critically ill COVID-19 patients admitted to the ICU between March 1, 2020, and October 31, 2020. The predictors of 28-day ICU mortality were identified using two predictive models: conventional logistic regression and DT analyses. There were 1468 critically ill COVID-19 patients included in the study. The 28-day ICU mortality was 540 (36.8 %), and the 90-day mortality was 600 (40.9 %). The DT algorithm identified five variables that were integrated into the algorithm to predict 28-day ICU outcomes: need for intubation, need for vasopressors, age, gender, and PaO2/FiO2 ratio. DT is a simple tool that might be utilized in the ICU to identify critically ill COVID-19 patients who are at high risk of 28-day ICU mortality. However, further studies and external validation are still required. [ABSTRACT FROM AUTHOR]

• Dietary intervention reduced daily variability of human milk lactoferrin and lysozyme. • No significant lactoferrin and lysozyme differences between breasts. • Morning human milk samples showed lower lactoferrin, higher lysozyme levels. It is known that human milk (HM) 1 1 Human milk. antimicrobial protein composition varies during lactation. However, the impact of maternal diet on these antimicrobial proteins, particularly lactoferrin and lysozyme remains unknown. In addition, it is unclear whether daily, circadian, and between breast variations exist for lactoferrin and lysozyme concentrations. We investigated the impact of a low sugar, low fat, high fibre dietary intervention on HM lysozyme and lactoferrin concentrations. HM was sampled across a 3-week period; daily, at different times of day, and from both breasts to measure the level of intraindividual variation. The intervention significantly reduced maternal sugar, total fat, and saturated fat intake. HM lactoferrin concentration declined significantly over the course of the intervention however the effect size was relatively small. In addition, lactoferrin and lysozyme concentrations were variable over time, and differed significantly within and across the day but not between breasts. [ABSTRACT FROM AUTHOR]

Abdominal pregnancy is a rare and potentially fatal variant of ectopic pregnancy, presenting unique clinical challenges. This report discusses an unusual case of abdominal pregnancy associated with uterine and high rectal perforations, complications that are rarely reported in clinical practice. We report a case involving a 31-year-old woman from a rural area, with a psychiatric history, presenting severe abdominal pain, vomiting, and constipation. Initial investigations revealed a hemopneumoperitoneum and a fetal skeleton in the pelvic area by CT, leading to a diagnosis of abdominal pregnancy. Surgical findings included a nonviable fetus, approximately 5 months gestational age, and perforations in both the rectum and the posterior uterine wall. The patient underwent extensive surgery, including placental dissection, anterior rectal resection, Hartmann's colostomy, hysterorrhaphy, and drainage of the peritoneal cavity. The complexity of managing abdominal pregnancy, especially with additional complications such as organ perforations, poses significant surgical challenges. This case emphasizes the need to consider abdominal pregnancy in differential diagnoses of abdominal pain in women, due to the risk of misdiagnosis and complex surgical requirements. This case highlights the critical importance of prompt diagnosis and comprehensive care in managing rare and life-threatening presentations of abdominal pregnancy. It underscores the need to increase awareness among clinicians for timely intervention and provides information on the complexities of surgical management in cases with additional organ perforations. • Rare case of abdominal ectopic pregnancy with concurrent uterine and high rectal perforations • Successful management of a complex surgical scenario in a patient with psychiatric history • Utilization of advanced imaging for accurate diagnosis of an intricate abdominal pregnancy • Comprehensive surgical intervention including placental dissection, anterior rectal resection, and Hartmann's colostomy • Highlights the need for differential diagnosis awareness and surgical adaptability in rare ectopic pregnancies [ABSTRACT FROM AUTHOR]

Interest from industry and policy makers on the use of autonomous goods vehicles (AGVs) for commercial use, has increased rapidly as the underlying technology has developed. This study looks at the potential impact of autonomous road haulage on logistics operations and barriers for commercial implementation in the UK. The research focuses on large goods vehicles, capable of automated driving, where the driver is not required for some or all of the journey, for logistics operations between suppliers, manufacturing plant, and retailer. The data is collected through semi-structured interviews and scoring questionnaires. All 76 participants had experience working in the logistics industry, from various parts of the operations process. The data was analysed using thematic analysis followed with the results subsequently ranked by participants to identify the importance and perceived impact. Results revealed a near-term barrier for adoption of autonomous technology, is the lack of standardisation, as technology is progressing in many different directions, with little consultation on what features are needed or how they will be implemented. The findings show the main impact of commercialisation of autonomous road haulage are overall maintenance cost reduction, due to less wear and tear, and operational cost reduction, especially for long-haul journeys, as vehicles can operate for longer hours. Moreover, despite barriers in the short term, such as public acceptance and transition costs, these will likely be outweighed by improvements in efficiency and utilisation. Based on findings from the study, we present six key considerations for the introduction of commercial autonomous road haulage, which can be used as a guide for policy makers, insurance companies, transport planning authorities, and vehicle manufacturers. • Six key recommendations are presented for the introduction of autonomous road haulage. • Interviews conducted with 76 experts from the logistics industry. • Autonomous trucks are viewed as a necessary solution to driver shortages. • Autonomous road haulage barriers include standardisation, AV legislation, and cost. • Upfront cost should be outweighed by improvements in efficiency and utilisation. [ABSTRACT FROM AUTHOR]