Search

Few data exist regarding the effectiveness of ustekinumab in inflammatory bowel disease (IBD) patients treated for concomitant psoriasis or psoriatic arthritis. to describe the outcomes of IBD patients who received subcutaneous ustekinumab through a dermatological or rheumatological prescription. This multicenter, retrospective study included all IBD patients who were started on ustekinumab for concomitant active psoriasis/ psoriatic arthritis, irrespective of IBD activity. The primary endpoint was overall ustekinumab persistence, defined as the maintenance of therapy because of sustained clinical benefit for IBD. Seventy patients (64 Crohn's disease / 6 ulcerative colitis) were enrolled. The median follow-up on ustekinumab therapy was 10.7 months (range, 1.4–67.3). Twelve patients (17.1%) withdrew the treatment after a median of 7.4 months (range, 0.9–23.8). The cumulative probability of maintaining ustekinumab treatment was 97.1% at 6 months and 77.1% at 12 months. Among the 56 patients with baseline active IBD, 34 (60.7%) were in clinical remission at the last follow-up visit. Their cumulative probability of achieving clinical remission was 84.7% and 63.9% at 6 and 12 months, respectively. Two patients stopped ustekinumab for an adverse event. Subcutaneous ustekinumab had a good effectiveness profile for IBD patients treated for concomitant dermatological or rheumatological conditions. [ABSTRACT FROM AUTHOR]

The authors aimed to identify interventions documented by randomized controlled trials (RCTs) that reduce mortality in adult critically ill and perioperative patients, followed by a survey of clinicians' opinions and routine practices to understand the clinicians' response to such evidence. The authors performed a comprehensive literature review to identify all topics reported to reduce mortality in perioperative and critical care settings according to at least 2 RCTs or to a multicenter RCT or to a single-center RCT plus guidelines. The authors generated position statements that were voted on online by physicians worldwide for agreement, use, and willingness to include in international guidelines. From 262 RCT manuscripts reporting mortality differences in the perioperative and critically ill settings, the authors selected 27 drugs, techniques, and strategies (66 RCTs, most frequently published by the New England Journal of Medicine [13 papers], Lancet [7], and Journal of the American Medical Association [5]) with an agreement ≥67% from over 250 physicians (46 countries). Noninvasive ventilation was the intervention supported by the largest number of RCTs (n = 13). The concordance between agreement and use (a positive answer both to "do you agree" and "do you use") showed differences between Western and other countries and between anesthesiologists and intensive care unit physicians. The authors identified 27 clinical interventions with randomized evidence of survival benefit and strong clinician support in support of their potential life-saving properties in perioperative and critically ill patients with noninvasive ventilation having the highest level of support. However, clinician views appear affected by specialty and geographical location. [ABSTRACT FROM AUTHOR]

The vapor-liquid equilibrium (VLE) of methane + water mixtures has been studied with nuclear magnetic resonance (NMR) spectroscopy. This work had two primary goals. The first goal was to develop methods that broaden the utility of NMR spectroscopy for VLE measurements. In this regard, we report a method by which the liquid-phase and vapor-phase compositions are measured in separate experiments by adjusting the height of the liquid phase in the sample tube. We also report a method for hastening phase equilibration by adding glass beads to the sample and repeatedly inverting the sample tube. The second goal of this work was to collect VLE data on a challenging mixture with real-world importance. Mixtures of methane + water are a useful test case because of their challenging characteristics, including the widely differing vapor pressures of the two components. One use for accurate VLE data on methane + water mixtures is to better predict the formation of harmful liquid phases in natural gas pipelines. Herein we utilize 1H NMR spectroscopy to measure the VLE of methane + water mixtures at temperatures of 299.73, 307.98, and 323.25 K, and pressures ranging from 0.69 MPa to 13.89 MPa. Experiments were carried out with a 600 MHz spectrometer. Mixtures were prepared and equilibrated in a high-pressure zirconia sample tube with an integrated needle valve. NMR-based VLE measurements on the liquid phase are in good agreement with available literature data and with Henry's Law predictions at low pressures. However, the commonly used GERG-2008 model for natural gas systems deviates dramatically from the experimental data for the liquid phase. NMR-based VLE measurements on the vapor-phase resulted in measured water concentrations that are systematically lower than available literature data and models. This systematic offset is likely caused by peak overlap in the NMR spectra. • Nuclear magnetic resonance spectroscopy for measurements of vapor liquid equilibrium. • First such measurements on methane + water mixtures by nuclear magnetic resonance. • Pressures up to 13.89 MPa and temperatures from 299.73 to 323.25 K. • Liquid-phase measurements agree with Henry's Law and data from other methods. • Vapor-phase measurements show less water in the vapor phase than other methods. [ABSTRACT FROM AUTHOR]

The use of whitening dentifrices during oral hygiene may cause surface modifications such as color change (ΔE) and increase surface roughness (Ra) of composite resin. Aim: This study aimed to evaluate the effect of whitening dentifrices and mechanical brushing on color change and surface roughness of Bulk Fill (Filtek Bulk Fill - F) and (Aura Bulk Fill - A) composite resins. Materials and methods: Sixty cylindrical specimens were fabricated of each composite resin. After initial color evaluations (Konica Minolta CM-700d), with D65 standard illuminant, and the surface roughness (Surfcorder SE 1700, Kosalab), the specimens were assigned (n=10) according to the whitening dentifrice used: True White (T), Colgate Total 12 Professional Whitening (D), Luminous White Advanced (L). Specimens were submitted to mechanical brushing (10,000 cycles); new color and surface roughness evaluations were taken. Data were analyzed by ANOVA, Duncan test and Dunnet test were used to identify differences between groups (α=5%). Results: The results showed that the tooth brushing time promoted a significant increase in ΔE of the FT group. The FD group exhibited intermediate values of ΔE and was similar to all groups tested. There was a significant increase in the surface roughness of the AD and AT groups after the mechanical tooth brushing. Conclusion: The results showed no significant changes were observed in surface roughness for F groups after toothbrushing. It be concluded that the color change and surface roughness of the composite resins after toothbrushing are dependent on the interaction between the composition of the composite resin and the characteristics of the dentifrice. [ABSTRACT FROM AUTHOR]

The purpose of the study was to evaluate the current literature on the use of weighted vests (WV) with individuals with autism spectrum disorder (ASD). A literature review using the standards recommended by the What Works Clearinghouse was conducted. The studies included in the review met the following criteria: (a) use of a single case research design; (b) inclusion of at least one individual with ASD; (c) examination of the effects of WV on a particular dependent variable; and (d) publication in English in a peer-refereed journal in the past 25 years. The results of the review show that the use of WV with individuals with ASD is not an evidence-based practice. [ABSTRACT FROM AUTHOR]

This paper examines three stories in Tarchetti’s Amore nell’arte as case studies of the conjunction of art, love, and death, which plays a central role in the decadent imagination. In advancing the idea that art is superior to life, these texts couple the artistic ideal with a propensity toward necrophilic excess of love. Departing from the critical tendency to view such excess as evidence of an anticonventional stance, I explore how Tarchetti’s writing points to complicity between unfettered ideals and worldly power structures. I rely on an ecocritical perspective to trace this complicity to a necro logic: a hollowed out, life-denying symbolic order that posits abstract, polarizing distinctions between self and other in order to enable limitless self-expansion at the expense of the other. The paper’s central argument can be summed up as follows: the path to self-fulfillment emplotted in Tarchetti’s stories shows deathly implications in the creative vitality of decadent literature by leading from idealistic love, through necrophilicamore nell’arte, to ultimate self-destruction. At the root of this outcome lies a tendency to devalue life processes and overvalue pure abstractions — a tendency ultimately consistent with the conventional ethos that the misfit Scapigliati and other decadent writers ostensibly rejected. [ABSTRACT FROM PUBLISHER]

Aim: The aim of this study was to evaluate how acid-etching of the cavosurface enamel in Class I resin composite restorations influences the bond strength to the pulpal wall and the restoration, Knoop microhardness and nanoleakage after thermomechanical aging. For this research 76 fresh human molars were selected and restored with Silorane or Clearfil SEBond/Z350XT composite divided in 4 groups (Silorane system restored with or without enamel cavosurface acid-etching and Clearfil SEBond/Z350XT with or without enamel cavosurface acid-etching). To induce artificial aging, samples were subjected to thermomechanical cycling through 200,000 and thermal cycling between 5 and 55 °C with 30 second filling and 15-second drainage steps. Microhardness and microtensile bond strength were evaluated in 32 teeth (n=8) each and nanoleakage evaluation was performed in 12 teeth (n=3). Samples restored by Clearfil SEBond/Z350 XT without cavosurface acid-etching showed significantly lower microtensile bond strength results. The resin composite Z350XT presented higher values of Knoop microhardness. It was observed little or no infiltration for Silorane groups and moderate infiltration for Clearfil SE Bond groups. Acid-etching of the cavosurface enamel during restoration procedure with Clearfil Se Bond resulted in a stronger bond after thermomechanical cycling. Silorane groups showed less infiltration than Clearfil SE Bond groups. [ABSTRACT FROM AUTHOR]

The interaction of bleaching technique (in-office or at-home) and solutions (deionized distilled water with and without sugar, red wine with and without sugar, coffee with and without sugar) on the effectiveness of in vitro dental bleaching was evaluated. Hydrogen peroxide (HP) 37.5% gel was used for in-office bleaching, 3 applications of 8 min each, 3 sessions with an interval of 7 days. At-home bleaching was performed with 10% Carbamide peroxide (CP), 2 h/day, for 30 days. The enamel vestibular surfaces (n = 72) were subjected daily to test solutions for 45 min, washed with distilled water for 5 min and stored in artificial saliva. The enamel color analysis was performed with a spectrophotometer through color variation (ΔE) and luminosity variation (ΔL). Roughness analysis was performed by atomic force microscopy (AFM) and scanning electron microscopy (SEM). Enamel composition was determined by energy dispersive X-ray spectrometry (EDS). The results were submitted to one-way analysis of variance (ANOVA) for ΔE, ΔL and EDS and two-way for AFM. For ΔE and ΔL there was no statistically significant difference. An increase in roughness was observed on the surface when exposed to a sugar-water solution for at-home bleaching and a lower concentration of Ca and P in the deionized water solution with sugar. Solutions containing or not sugar did not influence the bleaching potential, however the presence of sugar in the water solution increased the surface roughness with CP. [ABSTRACT FROM AUTHOR]

Abstract OBJECTIVE To assess the effect of a 12-hour shift on mood states and sleepiness at the beginning and end of the shift. METHOD Quantitative, cross-sectional and descriptive study.It was conducted with 70 neonatal intensive care unit nurses. The Brunel Mood Scale (BRUMS), Karolinska Sleepiness Scale (KSS), and a socio-demographic profile questionnaire were administered. RESULTS When the KSS and BRUMS scores were compared at the beginning of the shift associations were found with previous sleep quality (p ≤ 0.01), and quality of life (p ≤ 0.05). Statistical significant effects on BRUMS scores were also associated with previous sleep quality, quality of life, liquid ingestion, healthy diet, marital status, and shift work stress. When the beginning and end of the shift were compared, different KSS scores were seen in the group of all nurses and in the night shift one. Significant vigor and fatigue scores were observed within shift groups. CONCLUSION A good night’s sleep has positive effects on the individual`s mood states both at the beginning and the end of the shift. The self-perception of a good quality of life also positively influenced KSS and BRUMS scores at the beginning and end of the shift. Proper liquid ingestion led to better KSS and BRUMS scores.

Background A major cause of the increase in antimicrobial resistance is the inappropriate use of antimicrobials. Aims To evaluate the impact on antimicrobial consumption and clinical outcome of an antimicrobial stewardship program in an Italian Gastroenterology Department. Methods Between October 2014 and September 2015 (period B), a specialist in infectious diseases (ID) controlled all antimicrobial prescriptions and decided about the therapy in agreement with gastroenterologists. The defined daily doses of antimicrobials (DDDs), incidence of MDR-infections, mean length of stay and overall in-hospital mortality rate were compared with those of the same period in the previous 12-months (period A). Results During period B, the ID specialist performed 304 consultations: antimicrobials were continued in 44.4% of the cases, discontinued in 13.8%, not recommended in 12.1%, de-escalated 9.9%, escalated in 7.9%, and started in 4.0%. Comparing the 2 periods, we observed a decreased of antibiotics consumption (from 109.81 to 78.45 DDDs/100 patient-days, p = 0.0005), antifungals (from 41.28 to 24.75 DDDs/100pd, p = 0.0004), carbapenems (from 15.99 to 6.80 DDDsx100pd, p = 0.0032), quinolones (from 35.79 to 17.82 DDDsx100pd, p = 0.0079). No differences were observed in incidence of MDR-infections, length of hospital stay (LOS), and mortality rate. Conclusions ASP program had a positive impact on reducing the consumption of antimicrobials, without an increase in LOS and mortality. [ABSTRACT FROM AUTHOR]

Resin-based restorative materials, widely used to cement posts, may be influenced by irrigants used during endodontic chemical-mechanical preparation. This study evaluated the impact of endodontic irrigating solutions and adhesive cement systems on the push-out shear bond strength of glass fiber posts to root dentin. Ninety-six bovine incisors were divided into 12 groups (4 irrigants x 3 resin cements; n = 8). Prepared canals were irrigated with saline solution, 2.5% sodium hypochlorite (NaOCI), 5.25% NaOCI, or 2% chlorhexidine gel, and posts were cemented with RelyX ARC, Panavia F, or RelyX U100. The bond strength was evaluated by means of the push-out test, and results were subjected to analysis of variance. The mean bond strength observed for the combination of 5.25% NaOCI irrigant and RelyX U100 cement was significantly lower (8.82 MPa) than the values found for the other groups [P < 0.05). The other combinations of irrigating solution and resin cement had no adverse effect on the bond strength of the glass fiber posts to dentin. [ABSTRACT FROM AUTHOR]

The aim of this in vitro study was to evaluate the influence of different irrigation protocols on the bond strength, at different root depths, of fiber posts cemented with a self-adhesive cement 24 hours after endodontic treatment. Fifty-six bovine incisor roots were endodontically prepared and separated into 7 groups (n = 8) according to irrigation protocols: group 1, sterile saline (control); group 2, chlorhexidine (CHX) gel 2% and saline; group 3, sodium hypochlorite (NaOCl) 5.25% and saline; group 4, CHX and saline (final irrigation with ethylenediaminetetraacetic acid [EDTA] 17%); group 5, NaOCl and saline (final irrigation with EDTA); group 6, CHX and saline (final irrigation with NaOCl and EDTA); and group 7, NaOCl (final irrigation with CHX and EDTA). No statistically significant difference was found among the groups. Within the limitations of this study, it can be concluded that the different irrigation protocols did not influence the bond strength of self-adhesive resin cement, which presented similar behaviors at the 3 root depths studied. [ABSTRACT FROM AUTHOR]

The aim of this in vitro study was to evaluate the nanoleakage of fiber posts luted using different adhesive strategies and to investigate the effect of 2% chlorhexidine (CHX) on nanoleakage at the resin-dentin interfaces of self-adhesive cements. The self-adhesive and etch-and-rinse adhesive groups tested demonstrated similar results with regard to nanoleakage. Pretreatment with CHX promoted an adequate seal at the resin-dentin interface for self-adhesive cements. [ABSTRACT FROM AUTHOR]

The aim of the present study was to evaluate, by scanning electron microscopy and microtensile bond strength, the influence of dentin adhesion sites and of storage times of two adhesive systems with different compositions and applications techniques under hydrostatic pressure. Thirty-six third molars were used. Dental discs were randomly divided into twelve groups and fixed in a device, which simulated a pulpal pressure of 25 mmHg. Clearfil Mega Bond (MB) and Prime & Bond 2.1 (PB) systems were used and the surfaces were restored. After storage in distilled water for 7 (A), 60 (B) or 180 (C) days, the discs were sectioned to obtain sticks from the central area of oclusal dentin(CD) and from the area above the pulpal horns (PD) with 1 mm2 area of the bonded interface and submitted to tensile test. Fisher's Least Significant Difference test showed statistically significant differences among groups (ρ< 0.05). Scanning electron microscopy images (x1000/ x1500) were qualitatively evaluated. Mean values in MPa were: PBCDA-38.86, PBCDB-38.48, PBCDC-36.81, MBCDA-34.42, MBPDA-33.49, PBPDA-30.04, PBPDB-29.0, PBPDC-21.67, MBCDB-10.40, MBCDC-8.17, MBPDC-7.47 and MBPDB-7.36. The results showed that adhesive systems were affected by the simulated pulpal pressure and water storage used. Additionally, Prime & Bond 2.1 showed a more stable bonding. [ABSTRACT FROM AUTHOR]

Background: N-terminal pro-brain natriuretic peptide (NT-proBNP) and high sensitivity Troponin T (hsTnT) are markers of cardiac injury used in diagnosis of heart failure and myocardial infarction respectively, and associated with increased risk of cardiovascular disease. Since physical activity is protective against cardiovascular disease and heart failure, we investigated whether higher levels of physical activity, and less sedentary behaviour were associated with lower NT-proBNP and hsTnT. Methods and results Cross sectional study of 1130 men, age 70–91 years, from the British Regional Heart Study, measured in 2010–2012. Fasting blood samples were analysed for NT-proBNP and hsTnT. Physical activity and sedentary behaviour were measured using ActiGraph GT3X accelerometers. Relationships between activity and NT-proBNP or hsTnT were non-linear; biomarker levels were lower with higher total activity, steps, moderate/vigorous activity and light activity only at low to moderate levels of activity. For example, for each additional 10 min of moderate/vigorous activity, NT-proBNP was lower by 35.7% (95% CI − 47.9, − 23.6) and hsTnT by 8.4% (95% CI -11.1, − 5.6), in men who undertook < 25 or 50 min of moderate/vigorous activity per day respectively. Biomarker levels increased linearly with increasing sedentary behaviour, but not independently of moderate/vigorous activity. Conclusion: Associations between biomarkers and moderate/vigorous activity (and between hsTnT and light activity) were independent of sedentary behaviour, suggesting activity is driving the relationships. In these older men with concomitantly low levels of physical activity, activity may be more important in protecting against cardiac health deterioration in less active individuals, although reverse causality might be operating.

Background: kidney function declines in older adults and physical activity levels are low. We investigated whether higher levels of physical activity and lower levels of sedentary behaviour were associated with lower odds of low kidney function in older men. Methods: cross-sectional study of 1,352 men from the British Regional Heart Study, mean (standard deviation) age 78.5 (4.6) year. Physical activity and sedentary behaviour were measured using Actigraph GT3X accelerometers. Kidney function was measured by estimated Glomerular filtration rate (eGFR) using the chronic kidney disease-EPI creatinine-cystatin equation. Associations between physical (in)activity and kidney function were investigated using regression models. Results: higher levels of physical activity and lower levels of sedentary behaviour were associated with reduced odds ratios (ORs) for lower eGFR (<45 versus ≥45 ml/min per 1.73 m2) after adjustment for covariates. Each additional 1,000 steps, 30 min of light physical activity and 10 min of moderate/vigorous physical activity per day were associated with a lower odds (95% confidence interval (CI)) of a low eGFR; OR 0.81 (0.73, 0.91), OR 0.87 (0.78, 0.97) and OR 0.84 (0.76, 0.92), respectively. Each additional 30 min of sedentary behaviour per day was associated with a higher odds of a low eGFR (1.16 95% CI 1.06, 1.27). Associations between moderate/vigorous physical activity and lower kidney function persisted after adjustment for light physical activity or sedentary behaviour. Conclusion: physical activity is associated with kidney function in older men and could be of public health importance in this group who are at increased risk of poor kidney function and low physical activity. More evidence is needed on whether the association is causal.

• Various methods are used to estimate acorn production but comparisons of resultant data among methods are limited. • Strongly correlated (r > 0.84) visual survey methods provide a reliable means to standardize results among methods. • Continuous data provide the strongest relationships. • A 30-second count of acorns in the tree crown captures the most detailed variation in acorn production. • Nearly perfect correlations (r = 0.99) are held between survey methods performed in different ways. Acorns are a vital resource for many wildlife species and are required for oak (Quercus spp.) regeneration. Many different methods can be used to estimate acorn production and generate a hard mast index (HMI), however, the ability to compare data collected with different visual survey methods is limited. We conducted five visual acorn production survey methods on 70 oak trees (Quercus spp.) in northern Wisconsin from 1 August to 15 September 2020 to generate equations that convert indices of acorn production into a standardized index based on a 30-second count. We also used historical acorn production data from West Virginia (2000–2020) and North Carolina (2006–2019) for the standardization procedure. Indices from all visual survey methods were highly correlated to the 30-second count estimates, with HMI methods by Ryan et al. (2004) and Greenberg et al. (2007) having the strongest relationships (r = 0.99) with the 30-second count. The conversion equations from this study will provide managers a means of comparing data across visual survey methods and will expand the ability for future research in relation to acorn production. [ABSTRACT FROM AUTHOR]