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Background: The objective of the present study was to measure and compare how the length of CM Gold Wire and CM Blue Wire NiTi alloy endodontic rotary files impacts their resistance to cyclic fatigue. Methods: A total of 40 sterile endodontic rotary files were chosen and allocated to the following study groups: (A) 25.06 CM Gold wire NiTi alloy endodontic rotary files, 31 mm in length (n = 10); (B) 25.06 CM Gold wire NiTi alloy endodontic rotary files, 25 mm in length (n = 10); (C) 25.06 CM Gold wire NiTi alloy endodontic rotary files, 21 mm in length (n = 10); and (D) 25.06 CM Blue wire NiTi alloy endodontic rotary files, 17 mm in length (n = 10). A specialized device was designed using artificial root canal systems made from stainless steel for the dynamic cyclic fatigue tests, with an apical diameter of 250 µm, curvature angle of 60°, radius of curvature of 5 mm, lengths of 31, 25, 21, and 17 mm, and a 6% taper. An individual operator determined failure of the endodontic rotary instrument through direct observation and the tests were filmed so as to precisely measure the exact time to failure. The results were analyzed using ANOVA and Weibull statistical analysis. Results: The results found statistically significant differences across all study groups (p < 0.05). Conclusions: Rotary file length is inversely proportional to the cyclic fatigue resistance of the 25.06 CM Gold wire NiTi alloy at 31 mm, 25 mm, and 21 mm in length and of the 25.06 CM Blue wire NiTi alloy 17 mm length endodontic rotary files, with a greater length contributing to lower resistance to cyclic fatigue.

The purpose of this article is to substantiate the benefits of the method of public debate in educational activity, specifically in family education from the neighborhoods, in tune with the felt and manifest requirements of actors and educational institutions that are inserted in them, and the role that, in this sense, entities and formative agents play. From this perspective, it is not a question of applying the essences of the political praxis of the integral environment of the method in question; but to rationally analyze their methodological procedures in order to specify effective educational practices for families and community agents, based on the criterion of formative accompaniment that endorses the alternative in question. [ABSTRACT FROM AUTHOR]

This study investigates the capability of WC/C coatings to protect bearing bores against fretting wear when there is a lack of lubrication, a typical failure mechanism in bearings subjected to vibrations. Linear pin-on-disc and rotary oscillating block-on-ring tribological tests were carried out reproducing fretting conditions to evaluate the tribological performance and fretting resistance of the developed WC/C coating in comparison with those of the two common coatings currently employed to prevent this type of bearing failure, i.e. thin-dense chrome and fluoropolymer coatings. The friction forces generated under fretting conditions were evaluated, and a deep surface analysis of the tribosystems was carried out through different microscopic techniques in order to identify the wear mechanisms prevailing in each coating. Results suggested that WC/C coatings could be promising candidates to mitigate fretting damage, as they combine a low friction coefficient with good wear resistance. Furthermore, WC/C coatings constitute a more sustainable solution compared to the currently employed PTFE and chrome-based coatings, paving the way to a greener society. [ABSTRACT FROM AUTHOR]

Background: Disparities in orthopedic trauma care have been reported for racial-ethnic minority and socially disadvantaged patients. We examined differences in perioperative metrics by patient race and ethnicity and insurance after pelvic fracture in a national sample in the United States. Materials and Methods: The 2016–2019 National Inpatient Sample was queried for White, Black, and Hispanic patients 18 to 64 years old with private, Medicaid, or self-pay insurance who underwent non-elective pelvic fracture surgery. Associations between combined race and ethnicity and insurance subgroups and perioperative metrics (time to surgery, length of stay, inhospital complications, institutional discharge) were assessed using multivariable generalized linear and logistic regression models. Adjusted percent differences or odds ratios (ORs) were reported. Results: A weighted total of 14,375 surgeries were included (68.8% in White patients, 16.1% in Black patients, and 15.1% in Hispanic patients; 60.0% private insurance, 26.3% Medicaid, and 13.7% self-pay). Compared with White patients with private insurance, all Black insurance subgroups had longer length of stay (+15.38% to +38.78%, P≤.001), as did Hispanic patients with Medicaid (+28.03%, P<.001), White patients with Medicaid (+13.08%, P<.001), and White patients with self-pay (+9.47%, P=.04). Additionally, compared with White patients with private insurance, decreased odds of institutional discharge were observed for all patients with self-pay (OR, 0.24–0.37, P<.001) as well as White patients with Medicaid (OR, 0.70, P=.003) and Hispanic patients with Medicaid (OR, 0.57, P=.002). There were no significant adjusted associations between race and ethnicity and insurance subgroups and in-hospital complications or time to surgery. Conclusion: These differences in perioperative metrics, primarily for Black patients and patients with self-pay insurance, warrant further examination to identify whether they reflect disparities that should be addressed to promote equitable orthopedic trauma care. [Orthopedics. 2024;47(5):e233–e240.] [ABSTRACT FROM AUTHOR]

There is limited consensus on the optimal time to initiate supervised physical rehabilitation after a rotator cuff repair (RCR). We examined whether timing of initiating supervised physical rehabilitation was associated with repeat RCR or development of adhesive capsulitis within 12 months postoperatively in an observational cohort of commercially insured adults. This retrospective cohort study used the IBM MarketScan Commercial Claims and Encounters Database. We included adults aged 18-64 who underwent a unilateral outpatient RCR between 2017 and 2020 and initiated supervised physical rehabilitation 1-90 days postoperatively. Multivariable logistic regression models examined the adjusted association between time of initiating supervised physical rehabilitation (1-13, 14-27, 28-41, and 42-90 days postoperatively) and each of the primary outcomes: repeat RCR and capsulitis. In a sensitivity analysis, time to rehabilitation was alternatively categorized using a data-driven approach of quartiles (1-7, 8-16, 17-30, and 31-90 days postoperatively). We report adjusted odds ratios (OR). Among 33,841 patients (86.7% arthroscopic index RCR), the median time between index RCR and rehabilitation initiation was 16 days (interquartile range 7-30), with 39.9% initiating rehabilitation at 1-13 days. Additionally, 2.2% underwent repeat RCR within 12 months, and 12-month capsulitis was identified in 1.9% of patients. There were no significant associations between timing of initiating rehabilitation and 12-month repeat RCR (OR 0.85-0.93, P =.18-.49) or 12-month capsulitis (OR 0.83-0.94, P =.22-.63). Lack of associations between timing and outcomes was supported in sensitivity analyses. Timing of initiating rehabilitation was not significantly associated with adverse outcomes after RCR. The finding of no increased odds of repeat RCR or capsulitis with the earliest timing may support earlier initiation of rehabilitation to accelerate return to daily activities. Findings should be replicated in another dataset of similarly-aged patients. [ABSTRACT FROM AUTHOR]

The problems of generalization and transportation of treatment effect estimates from a study sample to a target population are central to empirical research and statistical methodology. In both randomized experiments and observational studies, weighting methods are often used with this objective. Traditional methods construct the weights by separately modeling the treatment assignment and study selection probabilities and then multiplying functions (e.g., inverses) of their estimates. In this work, we provide a justification and an implementation for weighting in a single step. We show a formal connection between this one-step method and inverse probability and inverse odds weighting. We demonstrate that the resulting estimator for the target average treatment effect is consistent, asymptotically Normal, multiply robust, and semiparametrically efficient. We evaluate the performance of the one-step estimator in a simulation study. We illustrate its use in a case study on the effects of physician racial diversity on preventive healthcare utilization among Black men in California. We provide R code implementing the methodology. [ABSTRACT FROM AUTHOR]

This article presents a participatory research project developed in a school in Cantabria (Spain) that has sought to enhance the participation of the educational community to transform the school. The article focuses on the analysis of the contributions of the students (children from 3 to 12 years of age), key agents and promoters of change. Pedagogical documentation has been used as a tool to narrate the development of this research and to encourage subsequent reflection. The students have experienced what it means to participate, to listen, to be listened to, to feel recognised and to exert influence in their own lives. The results go beyond mere changes in the configuration and use of spaces. The project has made it possible to think of the school as a forum for citizen participation, favouring the experience of a democratic school, the development of otherness, the feeling of belonging and the experience of community. [ABSTRACT FROM AUTHOR]

Background: The aim of this retrospective cohort study was to determine the rate of prolonged opioid use and identify associated risk factors after perioperative opioid exposure for tibial shaft fracture surgery. Materials and Methods: We used the MarketScan Commercial Claims and Encounters database (IBM) to identify patients 18 to 64 years old who filled a peri-operative opioid prescription after open reduction and internal fixation of a tibial shaft fracture from January 2016 to June 2020. Multivariable logistic regression identified factors (eg, demographics, comorbidities, medications) associated with prolonged opioid use (ie, filling an opioid prescription 91 to 180 days postoperatively); adjusted odds ratios (ORs) and 95% CIs were reported. Results: The rate of prolonged opioid use was 10.5% (n=259/2475) in the full cohort and 6.1% (n=119/1958) in an opioid-naive subgroup. In the full cohort, factors significantly associated with increased odds of prolonged use included preoperative opioid use (OR, 4.76; 95% CI, 3.60–6.29; P<.001); perioperative oral morphine equivalents in the 4th (vs 1st) quartile (OR, 2.68; 95% CI, 1.75–4.09; P<.001); age (OR, 1.03; 95% CI, 1.02–1.04; P<.001); and alcohol or substance-related disorder (OR, 1.66; 95% CI, 1.15–2.40; P=.01). Patients in the Northeast and North Central (vs South) regions had decreased odds of prolonged use (OR, 0.61–0.69; P=.02–.04). When removing preoperative use, findings were similar in the opioid-naive subgroup. Conclusion: Prolonged opioid use is not uncommon in this orthopedic trauma population, with the strongest risk factor being preoperative opioid use. Nevertheless, shared risk factors exist between the opioid-naive and opioid-tolerant subgroups that can guide clinical decision-making. [Orthopedics. 2024;47(4):e188–e196.] [ABSTRACT FROM AUTHOR]

Weighting is a general and often-used method for statistical adjustment. Weighting has two objectives: first, to balance covariate distributions, and second, to ensure that the weights have minimal dispersion and thus produce a more stable estimator. A recent, increasingly common approach directly optimizes the weights toward these two objectives. However, this approach has not yet been feasible in large-scale datasets when investigators wish to flexibly balance general basis functions in an extended feature space. To address this practical problem, we describe a scalable and flexible approach to weighting that integrates a basis expansion in a reproducing kernel Hilbert space with state-of-the-art convex optimization techniques. Specifically, we use the rank-restricted Nyström method to efficiently compute a kernel basis for balancing in nearly linear time and space, and then use the specialized first-order alternating direction method of multipliers to rapidly find the optimal weights. In an extensive simulation study, we provide new insights into the performance of weighting estimators in large datasets, showing that the proposed approach substantially outperforms others in terms of accuracy and speed. Finally, we use this weighting approach to conduct a national study of the relationship between hospital profit status and heart attack outcomes in a comprehensive dataset of 1.27 million patients. We find that for-profit hospitals use interventional cardiology to treat heart attacks at similar rates as other hospitals but have higher mortality and readmission rates. [ABSTRACT FROM AUTHOR]

Abstract Background The purpose of this study was to evaluate the changes in canal volume after root canal preparation in vivo with 3 different single-file techniques (Reciproc-Blue®, WaveOne-Gold® and XP-EndoShaper®), with a new method using CBCT and 3D reconstruction. Methods In this prospective study, thirty human lower premolars from healthy patients were used, in which extraction was indicated for orthodontic reasons. All the teeth used were caries- and restoration-free with complete root development, without signs of periodontal disease or traumatic occlusion, and with only one straight canal (up to 25º curvature). Teeth were randomly divided into three different groups: Reciproc-Blue, WaveOne-Gold and XP-EndoShaper. CBCT scans before root canal preparation were used to create a 3D reconstruction with RHINOCEROS 5.0 software to assess the initial canal volume, and then compared with 3D reconstructions after canal preparation to measure the increase in canal volume. Student’s t test for paired data were used to determine statistically significant differences between the before and after canal volumes. Anova test was used to determine statistically significant differences in the percentage of canal volume increase between the groups and Tukey's post-hoc test were used to paired comparison. Results Reciproc-Blue showed the higher increase in canal volume, followed by WaveOne-Gold and XP-EndoShaper (p = 0.003). XP-EndoShaper did not show a statistically significant increase in canal volume after root canal preparation (p = 0.06). Conclusion With this model, Reciproc-Blue showed higher increase in root canal volume, followed by WaveOne-Gold, while XP-EndoShaper did not significantly increase root canal volume during preparation.

En la sociedad hipermedia donde predomina el uso indiscriminado de múltiples pantallas desde edades cada vez más tempranas, es necesaria no solo la convivencia digital, sino además el respeto a los derechos de la infancia. Aspectos a los que debe unirse la responsabilidad por parte de los medios y también de las familias que educan a los menores. En este contexto surge esta investigación donde se revisa la literatura existente y se identifican dos planteamientos diferentes en torno a los dispositivos móviles e infancia; el referido a usos y posibilidades educativas y de enriquecimiento personal para los pequeños y, el que apunta usos abusivos y problemas derivados de su utilización. Este estudio de corte teórico muestra una revisión y reflexión basada en las ideas de un importante conjunto de autores que, en la era digital cuando la sociedad en general y de forma concreta la infancia utilizan la tecnología, apuestan por el empoderamiento del niño para convertirle en un receptor crítico. Por tanto, teniendo en cuenta que la infancia convive con los medios y que existen diferentes niveles de actividad de los niños frente a estos, se plantea una propuesta de niveles centrada en la actividad, la creación y la crítica social. Una propuesta que es posible alcanzar teniendo en cuenta la educación en, con y para los medios. Así mismo, en el marco de la CDN se propone que familias y escuelas potencien un uso adecuado de medios y pantallas por parte de la infancia.

I. INTRODUCTION 418 II. WORKPLACE DISCRIMINATION BASED ON GENDER IDENTITY 420 A. FEDERAL LAW ON EMPLOYMENT DISCRIMINATION AND THE UNITED 420 STATES MILITARY 1. Federal Laws on Employment Discrimination Against [...]