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Objectives: Zinc is considered an essential multipurpose trace element because of its ability to act as a cofactor and signaling molecule. As reported in earlier studies of pediatric respiratory infection management, zinc exhibits potent immunoregulatory and antiviral properties, but its effects on pediatric patients with COVID-19 remain unknown. The aim of this study was to determine the extent to which zinc supplementation improves COVID-19 symptoms, length of hospitalization and, to determine how zinc supplementation impacts ICU admission, in-hospital mortality, need for ventilation, duration of ventilation, need for vasopressors, development of liver injury, or respiratory failure. Methods: Pediatric patients younger than 18 years with confirmed COVID-19 infection during the study period (March 1, 2020, to December 31, 2021) were recruited for this retrospective cohort study. The study population was divided into two arms (zinc/no zinc supplementation as an adjunct to standard therapy). Results: Of 169 hospitalized patients who were screened, 101 met the inclusion criteria. No statistically significant association was found between the administration of zinc as adjunctive therapy and symptom reduction, intensive care unit (ICU) admission, or mortality (p = 0.105; p = 0.941, and p = 0.073, respectively). However, zinc supplementation was associated with a statistically significant reduction in respiratory failure and length of hospitalization (p = 0.004 and p = 0.017, respectively), also, zinc administration was associated with elevated serum creatinine (p = 0.01*) Conclusions: Among pediatric patients with COVID-19, zinc supplementation was associated with shorter hospital stay. However, there was no significant difference between the two groups in terms of symptom improvement, in-hospital mortality, or ICU admission. In addition, the study raises question about the possibility of kidney injury as indicated by high levels of serum creatinine.

Background: Analysis of the survival of root‐filled posterior teeth and the associated prognostic tooth‐related factors will enable clinicians to predict the outcome of root canal treatment. Objectives: To investigate (i) the survival of root‐filled posterior teeth and (ii) the tooth‐related factors that may affect their survival. Methods: Randomized controlled trials, comparative studies and observational studies assessing survival rates of root‐filled posterior teeth with a minimum 4‐year follow‐up period were identified through an electronic search of the following databases up to January 2023: The Cochrane Central Register of Controlled Trials, Medline via PubMed, the Cochrane Database of Systematic Reviews, Embase, Web of Science and NIHR centre for reviews and dissemination. Two reviewers (SP and ML) independently selected the final studies based on pre‐defined inclusion criteria. The Newcastle Ottawa Scale and the Cochrane Risk of Bias Tool for Randomized Trials were used to assess the risk of bias. Pooled weighted survival rates were analysed using a random effects meta‐analysis model using DerSimonean and Laird methods. Descriptive analysis of studies describing any prognostic tooth‐related factors was conducted. Results: Of the 72 studies identified, data from 20 studies were included in the survival meta‐analysis, and data from 13 of these studies were included in the descriptive analysis of tooth‐related factors; 12 studies were retrospective, 7 were prospective, and one was a randomized control trial. The pooled survival rates at 4–7 years and 8–20 years of root‐filled posterior teeth regardless of tooth type was 91% (95% CI, 0.85; 0.95) and 87% (95% CI, 0.77; 0.93), respectively. The prognostic tooth‐related factors mentioned in the included studies were (i) remaining coronal tooth structure, (ii) ferrule, (iii) crown‐to‐root ratio (iv) tooth type and location (v) periodontal disease (vi) proximal contacts and (vii) cracks. Conclusions: The meta‐analysis suggests that root canal treatment has a high medium to long term survival outcome. The narrative summary identified 7 factors that affect tooth survival. However, there is a paucity of evidence, and more research is needed in this area. Registration: PROSPERO Registration: CRD42021227213. [ABSTRACT FROM AUTHOR]

This study was carried out to investigate the effect of partial substitution (5, 10 and15%) of wheat flour (72% ext.) by whole meal quinoa flour (QF) on quality parameter of pan bread. QF contained the highest percentage of protein, Lipids, ash and crude fiber. Also, QF contained the highest amount of essential amino acids such as (threonine, methionine, lysine and histidine). From the results, it could be seen that, water absorption and degree of softening increased by increasing the substitution levels, but stability, resistance to extensions and energy of dough decreased. The addition of QF adversely affected on the specific volume of pan bread. The lightness (L*) and yellowness (b*) of pan bread decreased, but redness (a*) increased gradually by increasing QF. Evaluation of the organoleptic properties of pan bread revealed that no significant differences (P≥0.05) between control sample and bread samples contained QF for taste and summitry form. The bread contained QF had higher score for crust color, pore size and overall acceptability than control sample. Hardness (g) of pan bread increased and springiness decreased gradually during storage of bread at (25˚c ±2). The rate of staling of bread contained QF lower than control sample. Gluten - free biscuit made from 100%QF contained the highest percentage of protein, lipids, ash and crude fiber compared to that of corn and rice - quinoa composite flour. The addition of corn and rice flour adversely affected on the thickness, diameter and spread ratio. The highest spread ratio was noticed in the biscuit made from 100% QF. It is worth mentioning that the biscuit made from 100 % QF or that of corn and rice - quinoa composite flour gave the biscuit with sensory acceptable. On the other hand, it could be noticed to that the biscuit contained high level of quinoa flour was darker in compared to another samples. [ABSTRACT FROM AUTHOR]

Background Data: Optimal surgical approach for anterior cervical discectomy and fusion (ACDF) is still controversial. Some authors believe that addition of locking plate (ACDFP) has higher costs and longer operative time. Other surgeons believe that ACDFP have better clinical outcomes and more sound fusion. The debate is higher in single and double level ACDF. Purpose: To compare the clinical and radiological outcomes in patients with single or double level cervical disc herniation operated by ACDF versus those operated by ACDFP. Study Design: A retrospective, descriptive controlled, non-randomized, clinical case study. Patients and Methods: Forty patients underwent ACDF. They were divided into two groups; ACDF group and ACDFP fixation group. Each group included 20 patients. They were operated between 2010 and 2017. Participants were evaluated pre-operatively and post-operatively 1, 3, 6, 9 and 12 months after surgery. Operative time, hospital stay and complications were assessed. Pain was scored by a VAS for both upper arm and cervical pain. The clinical outcomes were compared using Odom’s criteria. Cervical fusion was assessed radiologically. Results: The demographic data of the two groups of patients were fairly homogeneous and comparable. ACDFP group showed slightly better clinical outcome parameters in comparison to ACDF group including VAS for cervical pain (9±5 versus 28±11) and Odom’s criteria scores (15 excellent outcome versus 10). Also ACDFP group showed slightly better radiological fusion rate (100%) in comparison to (85%) in ACDF group. Reported nonunion was higher in ACDF group (15%) in comparison to ACDFP group (0%). Conclusion: Our data suggest that the addition of cervical plate fixation to ACDF might leads to better clinical outcome and radiological fusion in single and double cervical disc disease. (2018ESJ155)

Aims To assess and compare how UK general dental practitioners (GDPs) restore endodontically treated molars and what tooth-related factors they consider relevant to their management.Method An online cross-sectional vignette survey was sent out to UK dentists via email and the use of social media platforms. Three clinical cases were designed.Results In total, 394 participants completed the survey. GDPs showed a preference towards restoring the endodontically treated molars with indirect restorations, such as crowns and onlays. Material selection varied, with a notable inclination towards gold and lithium disilicate. This was influenced by factors such as the number of remaining tooth walls, thickness of walls and the presence of parafunction.Conclusion Clinicians generally agreed on whether to place a direct or indirect restoration but there was greater disagreement when deciding on the type of restoration and material. Further evidence and education are required to help UK dentists decide more objectively whether to place an onlay or a crown, what material to select and what prognostic factors are most pertinent to the case., (© 2024. The Author(s).)

Background: Child physical abuse, a type of child maltreatment (CM), poses a significant global public health concern. Nonaccidental fractures and soft tissue injuries, which encompass any action that directly or indirectly harms a child, are the primary indicators of physical abuse in children., Objective: This study aimed to investigate the prevalence, risk factors, and outcomes of accidental and nonaccidental skeletal fractures in a sample of Egyptian children., Methods: A cross-sectional analytical study was conducted between March 2022 and August 2022. A total of 156 children who presented with skeletal injuries and attended Mobarak Central Hospital were enrolled. Patients were subjected to full history taking, complete examination, and investigations. A structured questionnaire was administered to all the legal guardians., Results: Physical abuse was reported in 22.4 % of cases, while medical neglect was reported in 19.9 % of cases. The incidence of physical abuse was notably higher among children whose fathers were smokers and/or drug addicts (p ≤ 0.05). The most common form of physical abuse was hitting (94.3 %). Among skeletal injuries, fractures were predominant (94.3 %), primarily closed fractures associated with contusions. Fractures of the upper limb accounted for the highest incidence (94.3 %) of skeletal injuries, and 60 % of physically abused children experienced moderate-severity injuries., Conclusion: The most common fracture observed in abused children is the upper limb fracture, typically involving a single bone. Clinicians should be more vigilant in suspecting abuse, even in cases where there is an isolated fracture, and advocate for the development of parental training programs., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

For nearly 90 years, aluminum (Al) salts have been utilized as vaccination adjuvants. Nevertheless, there is a risk of adverse effects associated with the amount of nanoaluminum used in various national pediatric immunization regimens. This study aimed to investigate the possible genotoxic effects of nanoaluminum incorporated in human vaccines on the brains of newborn albino rats and whether nanocurcumin has a potential protective effect against this toxicity. Fifty newborn albino rats were randomly assigned to 5 groups, with 10 in each group. Groups 1 and 2 received "high" and "low" Al injections corresponding to either the American or Scandinavian pediatric immunization schedules, respectively, as opposed to the control rats (group 5) that received saline injections. Groups 3 and 4 received the same regimens as groups 1 and 2 in addition to oral nanocurcumin. The expression of both the cell breakdown gene tumor protein (P53) and the cell stress gene uncoupling protein 2 (UCP2) was significantly greater in groups 1 and 2 than in group 5. Groups 1 and 2 exhibited severe DNA fragmentation, which was observed as DNA laddering. Nanocurcumin significantly reduced the expression of the P53 and UCP2 genes in groups 3 and 4, with very low or undetectable DNA laddering in both groups. Vaccination with nanoaluminum adjuvants can cause genotoxic effects, which can be mediated by the inflammatory response and oxidative stress, and nanocurcumin can protect against these toxic effects through the modulation of oxidative stress regulators and gene expression.

The preparation of an access cavity is the first part of endodontic treatment and is a key stage in the healing of both periapical and pulpal infections. It should allow endodontists to remove obstructions in the pulp chamber, locate all canal orifices and clean the entire root canal system with minimum coronal tooth structure removed. This has been done traditionally through establishing straight line access. The development of minimally invasive endodontics aimed to preserve as much of the natural tooth structure as possible, particularly dentine, while undertaking root canal treatment, resulting in the development of other access cavity preparations. This includes conservative, ultra conservative (ninja), truss, guided access, caries-orientated and restorative access cavities. These access cavity preparations also gained popularity due to increased magnification and enhanced lighting, allowing practitioners to visualise the pulpal space in greater detail throughout treatment.Our current recommendation is to conduct access cavities traditionally rather than conservatively. Ideally, conservative access cavities need magnification, which might not be available for all clinicians. With traditional access cavity, the procedure takes less time and it is more predictable to locate the canal orifices, deliver irrigation effectively, avoid iatrogenic damage with biomechanical preparation and achieve better obturation., (© 2023. The Author(s), under exclusive licence to the British Dental Association.)

Purpose: Establishment of the specifications and standards for successful radiotherapy treatments through identifying three objectives: administering the appropriate low-waste dose, developing dose-delivery skills and monitoring an earlier response to therapy., Methods: The appropriate low-waste dose is administered via the work-energy principle, considering the interaction between the drug and the tumor as an isolated system. Then, chelated with any compound that could form a lipid-soluble complex with the radioactive metal ions, it is injected directly into the tumor via a multihole needle to improve the distribution of the injectate solution. This can be detected by monitoring the tumor response through newer imaging techniques that combine single photon emission computed tomography (SPECT) with computed tomography (CT), or positron emission tomography (PET) with CT, so that nonresponding tumors can be identified early to modify the administered dose., Results: The accuracy of estimating the initial effective radioactive dose depends on the equivalence of the growth energy of the tumor estimated from the CT scan and the decay energy of the effective radioactive dose. Besides earlier or more accurate assessment of the tumor response by PET with the glucose analogue (18)F-fluoro-2-deoxyglucose ((18)F-FDG), this contributes to the most safe and low-cost successful treatment. This approach assessed the therapeutic significance of lipid-soluble compounds with the radioactive metal ions in protecting system isolation, which plays a major role in targeted tumor therapy., Conclusion: Treatment success shows that the three identified objectives are completely dependent objectives. It should also be taken into consideration that radionuclide decay-generated Auger electrons may be more effective in very small tumors to avoid a cross dose.

Fourteen of nitrogeneous heterocyclic compounds that accommodate the sulfonate-ester moiety were synthesized through interaction of 2-benzenesulfonylo xyphenyl-3,1-benzoxazine-4-one with some nucleophilic reagents. The assigned structures for the prepared new compounds were confirmed on the basis of elemental and spectral data. Evaluation of the antimicrobial activity of these products, relative to standard antibiotics was tested and discussed.

Several sulfonate ester-containing quinazolinone derivatives that are substituted with, isolated or fused, aryl, hetaryl or hetarylphenyl ring systems were synthesized with a view to evaluate their efficacy as new bactericidal and/or fungicidal agents. Synthesis of these products involved prior preparation of the 2-[4'-(benzenesulfonyloxy)phenyl]-3,1- 4(H)-benzoxazin-4-one derivative (2) and subsequent reaction with several nitrogen nucleophiles. The structure of these products were established from elemental and spectral analyses. Most of the prepared compounds showed high antimicrobial activity, comparable to standard chemotherapeutic agents, when screened against different microorganisms.

A convenient route is reported for the synthesis of 1,2,3-selenadiazole, 1,2,3-thiadiazole, 1,2,4-triazolo[4,3-a]pyrimidine, tetrazolo[4,5-a]pyrimidine, benzimidazolo[1,2-a]pyrimidine and pyrazolo[3,4-b]pyridine derivatives in which the naphthyl nucleus is incorporated. The preliminary results of antifungal testing are reported.