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Eshaghali Saberi,1 Narges Farhad-Mollashahi,1 Fereydoon Sargolzaei Aval,2,3 Mersad Saberi41Oral and Dental Diseases Research Center, Department of Endodontics, Faculty of Dentistry, Zahedan University of Medical Sciences, Zahedan, Iran; 2Cellular and Molecular Research Center, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran; 3Department of Anatomical, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran; 4General Dentist, Zahedan, IranIntroduction: Clinical applications of bioactive materials are increasing in biomedical tissue engineering. This study sought to assess the effect of calcium enriched mixture (CEM) cement, Biodentine, mineral trioxide aggregate (MTA), octacalcium phosphate (OCP), and Atlantik on proliferation, odontogenic/osteogenic differentiation, and pro-inflammatory cytokine production by human stem cells of the apical papilla (SCAPs).Materials and methods: Proliferation of SCAPs treated with different biomaterials was evaluated using trypan blue exclusion test and flow cytometry. Differentiation of cells was evaluated using ALP activity, alizarin red staining, and RT-PCR. The expression of genes of pro-inflammatory cytokines was also evaluated using RT-PCR.Results: The SCAPs treated with biomaterials showed significantly higher proliferation, increased ALP activity, higher number of calcified nodules, and up-regulation of genes related to odontogenic/osteogenic markers compared to the control group. The expression of pro-inflammatory cytokines increased in all groups compared to the control group.Conclusion: The tested biomaterials could induce odontogenic/osteogenic differentiation in SCAPs. MTA had a greater potential for induction of differentiation of SCAPs to odontoblast-like cells while OCP had higher potential to induce differentiation of SCAPs to osteoblast-like cells (MTA↔ BD↔ CEM↔ Atlantik↔ OCP).Keywords: apical papilla, biomaterials, odontogenic differentiation, stem cells

Eshaghali Saberi,1 Bita Aramesh2 1Department of Endodontics, Oral and Dental Disease Research Center, Dental School, Zahedan University of Medical Sciences, 2Department of Endodontics, Dental School, Zahedan University of Medical Sciences, Zahedan, Iran Background: This ex vivo study aimed to compare transportation of the mesiobuccal root canal of mandibular first molars instrumented with ProTaper, Race and Sendoline rotary systems using cone beam computed tomography (CBCT). Materials and methods: Forty-five mesiobuccal canals of mandibular first molars were randomly divided into three groups of 15. Root canals in each group were instrumented with the ProTaper, Race or Sendoline rotary system according to the manufacturers’ instructions. Root canal preparations were performed by one operator, while root canal wall measurements were made by another operator blinded to the group allocation of teeth. The pre- and post-chemomechanical preparation CBCT scans were obtained and evaluated at 3, 6 and 9 mm levels from the apex. The amount of root canal transportation at these levels was calculated. Data were analyzed using SPSS version 17 via Mann–Whitney and Kruskal–Wallis tests. P0.05), but ProTaper showed the least and Sendoline caused the most canal transportation in the coronal third. Conclusion: ProTaper, Race and Sendoline rotary systems are not significantly different in terms of canal transportation. Although all rotary files cause root canal transportation, ProTaper and Race showed the least amount of canal transportation in the coronal and apical thirds, respectively. Keywords: canal transportation, ProTaper, Race, Sendoline, rotary systems, cone beam computed tomography

Maserat Vida,1 Heshmatallah Shahraki Ebrahimi,2 Sahar Soltani,2 Eshagh Ali Saberi,3 Arezoo Pirhaji2 1Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Zahedan University of Medical Sciences, Zahedan, Iran; 2Department of Endodontics, Faculty of Dentistry, Zahedan University of Medical Sciences, Zahedan, Iran; 3Department of Endodontics, Faculty of Dentistry, Oral and Dental Diseases Research Center, Zahedan University of Medical Sciences, Zahedan, IranCorrespondence: Eshagh Ali SaberiDepartment of Endodontics, Faculty of Dentistry, Oral and Dental Diseases Research Center, Zahedan University of Medical Sciences, Janbazan Boulevard, 1st and 3rd Janbazan Intermediate, Unit 2, Sistan and Baluchestan, Zahedan, IranTel +98 9151416924Email saberiendo@yahoo.comBackground and Objectives: This study aimed to assess the position of distobuccal canal orifice of maxillary second molars using cone-beam computed tomography (CBCT).Materials and Methods: A total of 301 CBCT scans of patients were retrieved from the archives of a radiology clinic, and the distance between the orifices of distobuccal and mesiobuccal root canals, the distance between the orifices of distobuccal and palatal root canals and the angle between the orifices of mesiobuccal, distobuccal and palatal root canals in the axial plane were measured on CBCT scans.Results: Of 301 maxillary second molars evaluated in this study, 202 (67.1%) had three canals and 99 (32.9%) had four canals. The distance between the distobuccal and mesiobuccal canal orifices (DM) ranged from 1.10 to 4.40 mm (mean: 2.1831± 0.6370 mm). The distance between the distobuccal and palatal canal orifices (DP) ranged from 1.20 to 6.20 mm (mean: 3.8704± 0.84944 mm). The mean angle between the mesiobuccal, distobuccal and palatal orifices (MDP) was 106.37± 12.12075°.Conclusion: Around one-third of maxillary second molars had four canals; the rest had three canals. No maxillary second molar with two canals was found. The orifice of distobuccal canal was located at 2 mm distance from the mesiobuccal canal orifice in distopalatal direction in the majority of cases. It had 3 to 4 mm distance from the palatal canal orifice in most cases. CBCT is recommended to find the orifice of distobuccal canal in cases in whom negotiation of this canal is challenging.Keywords: maxillary second molars, pulp chamber, dental pulp, cone-beam computed tomography

Eshagh Ali Saberi,1 Arezoo Pirhaji,2 Fatemeh Zabetiyan3 1Department of Endodontics, Faculty of Dentistry, Oral and Dental Diseases Research Center, Zahedan University of Medical Sciences, Zahedan, Iran; 2Department of Endodontics, Faculty of Dentistry, Zahedan University of Medical Sciences, Zahedan, Iran; 3General Dentistry, Mashhad University of Medical Sciences, Mashhad, IranCorrespondence: Eshagh Ali SaberiDepartment of Endodontics, Faculty of Dentistry, Azadegan Street, Zahedan, IranTel +98 9151416924Email saberiendo@yahoo.comIntroduction: This study aimed to assess the fracture strength of endodontically treated mandibular molars with traditional endodontic access cavity (TEC) and truss endodontic access cavity (TREC) designs that were restored with composite resin and underwent thermocycling.Methods: Sixty mandibular first and second molars were randomly divided into 6 groups (n=10) of intact controls without thermocycling (group 1), intact controls with thermocycling (group 2), TEC without thermocycling (group 3), TEC with thermocycling (TEC-TC, group 4), TREC without thermocycling (group 5) and TREC with thermocycling (TREC-TC, group 6). The root canals were then instrumented to #25,7% using nickel-titanium files and were filled with gutta-percha and AH26 sealer with lateral compaction technique. Access cavity was restored with Gradia composite. All teeth were then thermocycled for 480 cycles between 5°C and 55°C for 30 seconds and their fracture strength was measured in a universal testing machine with a round-end piston with 6 mm diameter at a speed of 1 mm/min. Data were analyzed using two-way and one-way ANOVA.Results: Without thermocycling, the fracture strength of endodontically treated teeth with TREC designs had no significant difference with the control group (P> 0.05). However, both TEC and TREC designs significantly decreased the fracture strength of endodontically treated teeth after thermocycling (P< 0.05), such that minimum fracture strength was noted in TEC-TC group.Conclusion: Under the conditions of this ex vivo study, TREC enhances the fracture strength of endodontically treated teeth under thermal stresses.Keywords: endodontic cavity, fracture strength, minimally invasive intervention

Objective: To understand the motivations of champions who worked to bring about system and practice change that supported routine screening for intimate partner violence (IPV) in two rural emergency departments (EDs)., Introduction: Practice changes are required to achieve routine and effective identification and response to IPV. Nurses play a significant role in affecting such practice change. This paper identifies the motivations of champions in the ED setting who successfully brought about such change., Setting: The EDs of two Level 5 tertiary hospitals within a rural Local Health District (LHD) of New South Wales, Australia., Participants: Twenty-three individuals who identified as champions and worked to introduce routine IPV screening in two rural hospital EDs., Design: Qualitative longitudinal semi-structured interviews employing a process of constant comparison and an interpretive framework to analyse data thematically. Interviews were carried out between June and August 2017 and again between July and August 2019., Results: Over the period of the study, routine screening was established, and screening rates steadily increased from a low baseline to a significantly higher rate. Three aspects of champion motivation emerged from the analysis: formation of an identity as a champion, making a difference to a significant social justice issue and providing quality and community-relevant care., Conclusions: This study is the first study to report on champions and their motivation as they supported IPV practice change in the ED. The findings highlight the capacity for innovation in rural health services, with important implications for other settings looking to translate similar programs. Understanding motivating factors may assist in improved utilisation and support for champions. This is vital if champions are to bring about required practice change within their service and ensure the needs of individuals experiencing IPV are effectively met., (© 2024 The Author(s). Australian Journal of Rural Health published by John Wiley & Sons Australia, Ltd on behalf of National Rural Health Alliance Ltd.)

Psyllid species, including the potato psyllid (PoP) Bactericera cockerelli (Sulc) (Triozidae) serve as host and vector of "Candidatus Liberibacter spp." ("Ca. Liberibacter"), which also infects diverse plant hosts, including citrus and tomato. Psyllid transmission of "Ca. Liberibacter" is circulative and propagative. The time of "Ca. Liberibacter" acquisition and therefore vector life stage most competent for bacterial transmission varies by pathosystems. Here, the potato psyllid-"Ca. Liberibacter solanacearum" (CLso) pathosystem was investigated to dissect CLso-prophage interactions in the tomato plant and PoP-psyllid host by real-time quantitative reverse transcriptase amplification of CLso genes/loci with predicted involvement in host infection and psyllid-CLso transmission. Genes/loci analyzed were associated with (1) CLso-adhesion, -invasion, -pathogenicity, and -motility, (2) prophage-adhesion and pathogenicity, and (3) CLso-lysogenic cycle. Relative gene expression was quantified by qRT-PCR amplification from total RNA isolated from CLso-infected 1st-2nd and 4th-5th nymphs and teneral adults and CLso-infected tomato plants in which CLso infection is thought to occur without SC1-SC2 replication. Gene/loci expression was host-dependent and varied with the psyllid developmental stage. Loci previously associated with repressor-anti-repressor regulation in the "Ca Liberibacter asiaticus"-prophage pathosystem, which maintains the lysogenic cycle in Asian citrus psyllid Diaphorina citri, were expressed in CLso-infected psyllids but not in CLso-infected tomato plants., (© 2024. The Author(s).)

Background: Double-stranded RNA (dsRNA) biopesticides are of interest for the abatement of insect vectors of pathogenic bacteria such as 'Candidatus Liberibacter', which infects both its psyllid and plant hosts. Silencing of genes essential for psyllids, or for Liberibacter, is anticipated to lead to mortality or impeded bacterial multiplication. Foliar delivery is preferred for biopesticide application; however, the cuticle impedes dsRNA penetration into the vasculature. Here, conditions were established for wounding tomato leaves using ultraviolet light amplification by stimulated emissions of radiation (UV-LASER) to promote dsRNA penetration into leaves and vasculature., Results: UV-LASER treatment with application of select adjuvants/surfactants resulted in vascular delivery of 100-, 300- and 600-bp dsRNAs that, in general, were correlated with size. The 100-bp dsRNA required no pretreatment, whereas 300- and 600-bp dsRNAs entered the vasculature after UV-LASER treatment only and UV-LASER adjuvant/surfactant treatment, respectively. Of six adjuvant/surfactants evaluated, plant-derived oil combined with an anionic organosilicon compound performed most optimally. Localization of dsRNAs in the tomato vasculature was documented using fluorometry and fluorescence confocal microscopy. The biological activity of in planta-delivered dsRNA (200-250 bp) was determined by feeding third-instar psyllids on tomato leaves post UV-LASER adjuvant/surfactant treatment, with or without psyllid cdc42- and gelsolin dsRNAs. Gene knockdown was quantified by quantitative, real-time polymerase chain reaction with reverse transcription (RT-qPCR) amplification. At 10 days post the ingestion-access period, knockdown of cdc42 and gelsolin expression was 61% and 56%, respectively, indicating that the dsRNAs delivered to the tomato vasculature were mobile and biologically active., Conclusion: Results indicated that UV-LASER adjuvant/surfactant treatments facilitated the delivery of mobile, biologically active dsRNA molecules to the plant vasculature. © 2023 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry., (© 2023 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.)

Background: The aim of the study was to investigate the morphometric parameters of dental pulp in open apices immature teeth in a sheep model after mechanical pulp exposure and restoration with reinforced zinc oxide-eugenol., Materials and Methods: In this experimental study, a total of 12 immature mandibular central incisors from six adult male sheep, weighing 30-40 kg and with the age of 1 year old with Merino race were examined. After anesthesia, the pulps of the teeth in the case group were mechanically exposed and then were restored with reinforced zinc oxide-eugenol and amalgam. In the control group, the teeth remained intact. The animals were sacrificed at intervals of 2, 4, 6, and 8 weeks (E2, E4, E6, and E8) in the case and 2 and 8 weeks (C2 and C8) in the control groups. Then, their teeth were removed with the surrounding supporting tissues and alveolar bones. Tissue processing and staining were done, and the sections were examined under a light microscope. The Kruskal-Wallis and Mann-Whitney U tests were used to analyze the data and compare the changes between the two groups. P < 0.05 was considered statistically significant., Results: In response to mechanical exposure, reparative or tertiary dentin was formed, and its thickness increased during the time of the study. The thickness of the odontoblastic layer in the E4 group was the highest amount. The pulp chamber diameter in the C2 group was significantly larger than the other groups, and the diameter of the apical foramen in the E8 was decreased significantly compared to the controls ( P < 0.05)., Conclusion: In response to mechanical exposure and restoration with reinforced zinc oxide-eugenol, some morphometric parameters of the dental pulp changed significantly in the sheep model compared to the controls., Competing Interests: The authors of this manuscript declare that they have no conflicts of interest, real or perceived, financial or non-financial in this article., (Copyright: © 2024 Dental Research Journal.)

The Asian citrus psyllid (ACP) is a citrus pest and insect vector of " Candidatus Liberibacter asiaticus", the causal agent of citrus greening disease. Double-stranded RNA (dsRNA) biopesticides that trigger RNA interference (RNAi) offer an alternative to traditional insecticides. Standardized laboratory screening of dsRNA requires establishing the minimal effective concentration(s) that result in effective RNAi "penetrance" and trigger RNAi, resulting in one or more measurable phenotypes, herein, significant gene knockdown and the potential for mortality. In this study, knockdown was evaluated for a range of dsRNA concentrations of three ACP candidate genes, clathrin heavy chain ( CHC ), vacuolar ATPase subunit A ( vATPase-A ), and sucrose non-fermenting protein 7 ( Snf7 ). Gene knockdown was quantified for ACP teneral adults and 3rd instar nymphs allowed a 48 h ingestion-access period (IAP) on 10, 50,100, 200, and 500 ng/µL dsRNA dissolved in 20% sucrose followed by a 5-day post-IAP on orange jasmine shoots. Significant gene knockdown ( p < 0.05) in ACP third instar nymphs and adults ranged from 12-34% and 18-39%, 5 days post-IAP on dsRNA at 10-500 and 100-500 ng/µL, respectively. The threshold concentration beyond which no significant gene knockdown and adult mortality was observed post-48 h IAP and 10-day IAP, respectively, was determined as 200 ng/µL, a concentration indicative of optimal RNAi penetrance.

Aim: To identify the barriers, challenges, and enablers that clinical champions experience whilst implementing Intimate Partner Violence (IPV) screening within Emergency Departments (EDs)., Background: Champions support the introduction of IPV screening within EDs. This paper shares new knowledge about IPV practice change champions: barriers, challenges and enablers they experienced in their efforts., Design: Between 2017-2019, semi structured qualitative interviews were conducted with 23 individuals who identified as champions, working to introduce routine IPV in two rural tertiary hospital Emergency Departments. An interpretive framework and process of constant comparison was used to thematically analyse data from transcribed interviews., Results: Champions identified barriers, challenges, and enablers that they experienced. Enablers included: support for the work of champions; champion leadership and collegiality; and training for the champion role. Challenges and Barriers included: resistance to a change in the focus of practice; and workflow and workload., Conclusions and Implications: Nurse champions can effectively support IPV practice change but face certain barriers, challenges and enablers. Nurse managers can use this information to support champions to undertake their role effectively in order to better meet the needs of individuals experiencing IPV., 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. No funding was received for this research., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background: There is some concern that root resection may alter the surface features and crack formation of the previously set orthograde material. The aim of this in vitro study was to evaluate the crack formation in orthograde mineral trioxide aggregate (MTA) and calcium-enriched mixture (CEM) plugs after root resection., Materials and Methods: This in vitro study was conducted on 170 extracted human maxillary anterior teeth. The teeth were randomly divided three experimental ( n = 50) and control ( n = 20) groups. In Group 1, after root canal treatment, half of the roots were cut with a bur, and the other half with an ultrasonic cutter. In Groups 2 and 3, after the 4-mm CEM and MTA plugs were placed and set, the root ends of half of the samples were cut with a bur and the other half by an ultrasonic cutter. The prevalence of cracks in the dentin and orthograde apical plugs of MTA and CEM was then assessed by scanning electron microscopy. Data were analyzed using the McNemar's, Chi-square, and Fisher's exact tests at P ≤ 0.05 level of significance., Results: In general, the prevalence of crack in dentin in Groups 2 and 3 was significantly higher than in the plug ( P < 0.05). There was no significant difference in the prevalence of dentin crack in the studied groups ( P > 0.05). The prevalence of crack in dentin was lower when the bur was used to cut off the end of the root, although the difference was not significant. The prevalence of crack in the plug was similar in CEM and MTA., Conclusion: Based on the results of this study, the prevalence of crack in dentin is always significantly higher than its prevalence in the plug, and the prevalence of crack in the plug was similar in CEM and MTA; then, when there is an orthograde access to the root canal and surgery is likely in future, MTA and CEM can be placed in an orthograde technique and it just resects the root during surgery., Competing Interests: The authors of this manuscript declare that they have no conflicts of interest, real or perceived, financial or nonfinancial in this article., (Copyright: © 2022 Dental Research Journal.)

Aim: To describe and synthesize evidence for champions of domestic violence practice improvement in health care and highlight implications for leadership and nurse management., Background: Globally, health care leaders have been tasked with improving service responses to domestic violence. Evidencing the role of champions, and how managers may harness champions in improving responses to domestic violence, is an important factor in successfully leading change in this field., Evaluation: A scoping review was conducted using four electronic databases (Proquest, PubMed, Medline and PsycINFO)., Key Issues: Eleven studies were included. Champion characteristics, roles, and factors influencing their impact were distilled. Barriers to the success of champions were identified as were four aspects of the champion role: mentor and expert advice; communication and engagement; strategic advocacy, coordination and project leadership; personal and emotional support., Conclusions: The review highlighted that champions involved in domestic violence project implementation have unique aspect to their role, along with characteristics reported in the broader champion literature. As an emerging field, there is evidence that domestic violence champions play an important role in mentoring and supporting health care workers to effectively change their practice., Implications for Nursing Management: Nurse managers and leaders need to understand the champion construct and the roles that champions enact to generate domestic violence and abuse system and practice change. Further research is required to provide guidance., (© 2021 John Wiley & Sons Ltd.)

Background: Intimate partner violence is a lead cause of ill health and premature death among Australian women. Abused women are likely to present to Emergency Departments. Routine screening provides opportunities to identify and respond to intimate partner violence., Methods: A six-month screening feasibility study was conducted in two rural and one urban NSW Emergency Departments. Surveys with participating nurses, medical officers and social workers, as well as focus groups with nurses and social workers were conducted at each site to understand their experience., Results: Survey respondents (n = 198) agreed it was appropriate (87%) and acceptable (91%) to screen for intimate partner violence in Emergency Departments. Overall 62% of respondents suggested screening had positive impacts on womens' care. Focus group discussions with 39 nurses and social workers identified enablers of screening as: ease of use of the screening tool; availability of social work response within one hour (as per the study protocol); and executive support. Barriers were: high patient volume; lack of integration with existing processes; lack of privacy and brevity of training., Conclusions: Screening in Emergency Departments was strongly supported by health practitioners who responded to the survey. Work is needed to address competing demands, integration of screening processes, and staff training., Competing Interests: Conflict of Interest The authors have no conflicts of interest to declare., (Copyright © 2021 College of Emergency Nursing Australasia. All rights reserved.)

Objective: The concept of minimally invasive endodontics recommends less-invasive vital pulp therapy (VPT) modalities over more aggressive traditional endodontic approaches in mature permanent teeth with carious pulp exposure, including irreversible pulpitis (IP) cases. Consequently, VPT needs to be compared with root canal therapy (RCT) in terms of treatment outcomes. This randomized clinical trial compares the results of full pulpotomy using two calcium-silicate cements, i.e., mineral trioxide aggregate (MTA) and calcium-enriched mixture (CEM) cement, with RCT in mature permanent teeth., Materials and Methods: A total of 157 carious pulp exposure cases in two academic centers with/without established IP were selected/included/randomly appointed to three study arms; (i) RCT (n = 51) as the reference treatment, (ii) pulpotomy with ProRoot MTA (PMTA; n = 55), and (iii) pulpotomy with CEM cement (PCEM; n = 51) as two alternative VPT treatments. Two-year clinical/radiographic results were the outcomes of interest. Data were statistically analyzed through the analysis of variance, chi-square, Fisher exact test, and Kruskal-Wallis., Results: At 2-year recall, 147 teeth were examined (6.4% dropout). All molars, except for one, were clinically functional/symptom-free, and there was no statistical difference between the three study arms (p = 0.653). The radiographic success rates in RCT, PMTA, and PCEM arms were 98%, 100%, and 97.9%, respectively, without statistically significant differences (p = 0.544)., Conclusion: In the management of mature permanent teeth with/without established IP, all experimental groups exhibited equivalent/comparable results., Clinical Relevance: Simple VPT using MTA/CEM can be suggested/recommended as a viable advantageous alternative to RCT for the management of carious pulp exposures with/without sign/symptoms of IP., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Cadmium (Cd) as a heavy metal damages testis and decreases fertility, however, antioxidants can improve sperm parameters and decrease male infertility. In this study we investigated the effect of astaxanthin (AST) on sperm parameters, expression levels of CatSper1 and CatSper2 genes in presence of Cd in mice. Thirty adults' mice were divided into 4 groups, sham group received olive oil and saline (olive oil is the solvent of AST and saline is the solvent of Cd), Cd group received 1 mg/kg Cdcl 2 , a group received 10 mg/kg AST and 1 mg/kg Cdcl 2 and a group received 10 mg/kg AST. The treatments were done intraperitoneally for 14 days. After 14 days sperm parameters were analyzed. Malondialdehyde level, catalase enzyme activity, the alteration of CatSper1 and CatSper2 genes expression were measured in testis. Results showed that Sperm count, viability, CatSper1 gene expression and catalase activity significantly decreased by Cd compared to sham group. Cd significantly increased sperm DNA fragmentation (SDF), abnormal sperm morphology and malondialdehyd level compared to sham group. AST significantly increased sperm count, viability and CatSper1 gene expression and decreased SDF and abnormal sperm in comparison with Cd group. AST protected testis and decreased oxidative stress induced by Cd. Our findings indicated that AST could protect sperm DNA, enhanced CatSper1 gene expression and sperm quality in presence of Cd. No significant differences were found in CatSper2 expression among treatments. Therefore, AST as a strong antioxidant can help to protect the potential of fertility against Cd toxicity., Competing Interests: The authors do not have conflict of interest for the publication of this article., (Thieme. All rights reserved.)

Objective: To test feasibility of a systematic approach to routine screening and response for intimate partner violence among women presenting to three New South Wales EDs., Methods: This prospective feasibility study was conducted over 6 months in two rural and one major tertiary metropolitan ED in New South Wales. Women aged 16-45 years triaged category 3-5 (treat within 30 min/1 h/2 h), who could be approached privately, were screened for intimate partner violence using the validated HITS (Hurts, Insults, Threatens and Screams or Swears) tool. The follow-up protocol for patients who disclosed abuse, specified a social work/psychology (psychosocial) response within 1 h. Outcomes of interest were screening rates of eligible presentations, disclosures of abuse, psycho-social referral and responses. Interviews conducted with ED medical directors and nurse unit managers at each site explored barriers and facilitators., Results: A total of 1047 women (11.4% of eligible presentations) completed screening at their first or subsequent presentation. Of 868 women screened on first presentation, 18% (n = 154) disclosed intimate partner violence, with no significant differences by age group, country of birth, triage category or time/day of arrival. Key barriers to screening were high patient volume, absence of electronic prompts and lack of privacy. Of those who screened positive 49% (n = 75) received an immediate, on-site psycho-social response., Conclusion: The present study demonstrates that it is both possible and relevant, given the 18% disclosure rate, to screen women in relation intimate partner violence in EDs and provide a psycho-social response within 1 h. More needs to be done to address barriers to screening to provide opportunities for early intervention., (© 2020 Australasian College for Emergency Medicine.)

This equivalence, randomized, clinical trial aimed to compare the postoperative pain of root canal therapy (RCT) with pulpotomy with mineral trioxide aggregate (PMTA) or calcium-enriched mixture (PCEM) in permanent mature teeth. In seven academic centers, 550 cariously exposed pulps were included and randomly allocated into PMTA ( n  = 188), PCEM ( n  = 194), or RCT ( n  = 168) arms. Preoperative "Pain Intensity" (PI) on Numerical Rating Scale and postoperative PIs until day 7 were recorded. Patients' demographic and pre-/intra-/postoperative factors/conditions were recorded/analysed. The arms were homogeneous in terms of demographics. The mean preoperative PIs were similar ( P =0.998), the mean sum PIs recorded during 10 postoperative intervals were comparable ( P =0.939), and the trend/changes in pain relief were parallel ( P =0.821) in all study arms. The incidences of preoperative moderate-severe pain in RCT, PMTA, and PCEM arms were 56.5%, 55.7%, and 56.7%, which after 24 hours considerably decreased to 13.1%, 10.6%, and 12.9%, respectively ( P =0.578). The time span of endodontic procedures was statistically different; RCT = 69.73, PMTA = 35.37, and PCEM = 33.62 minutes ( P < 0.001). Patients with greater preoperative pain, symptomatic apical periodontitis, or presence of PDL widening suffered more pain ( P =0.002, 0.035, and 0.023, resp.); however, other pre-/intra-/postoperative factors/conditions were comparable. Pulpotomy with MTA/CEM and RCT demonstrate comparable and effective postoperative pain relief., Competing Interests: Saeed Asgary is the inventor of CEM cement (Endodontic Filling Material, USA, 7,942,961, 17 May, 2011). All other authors declare that there are no conflicts of interest regarding the publication of this paper., (Copyright © 2020 Mohammad Jafar Eghbal et al.)

Background & Objective: Gastric cancer is the second most frequent cause of cancer death worldwide, despite dif- ferences in incidence around the world. The majority of gastric cancer cases concern gastric adenocarcinoma, which has a fairly high 5-year survival rate when coupled with early-stage diagnosis. Versican, a member of the aggregating chondroitin sulfate proteoglycans family, is accumulated predominantly in the tumor stroma. The aim of our study was to investigate versican expression in gastric adenocarcinoma., Methods: In this study we investigated 80 patients with gastric adenocarcinoma who underwent gastrectomy. Each sample was obtained from paraffin-embedded resected specimens of the stomach after histopathological diagnosis. Patient follow-up was performed every 3 months after the beginning of data collection. Survival analysis was calcu- lated using the Kaplan-Meier method for univariate analysis., Results: Out of 80 patients with gastric adenocarcinoma, 76 cases (76.3%males and 23.7% females) completed the follow-up period. Positive versican expression in tumor epithelial and stromal cells was found in 39.5% and 22.4% of tumors, respectively. Shorter survival was observed among patients whose gastric adenocarcinoma expressed epithelial or stromal versican., Conclusion: In summary, the present study suggests that versican is likely a prognostic biomarker that predicts a poor outcome in patients with gastric adenocarcinoma. Comprehensive studies with larger sample sizes are needed., Competing Interests: The authors declared no conflict of interests.

Background: Chemical residues often have cytotoxic effects on the stem cells. This study aimed to assess the cytotoxic effects of intracanal medicaments on stem cells of the apical papilla (SCAPs) using methyl thiazolyl tetrazolium (MTT), trypan blue exclusion (TBE) and lactate dehydrogenase release (LDHR) assays., Methods: SCAPs were cultured and exposed to 0.125, 0.25, 1, 5 and 10 mg/mL concentrations of modified triple antibiotic paste (mTAP)/distilled water (DW), mTAP/chlorhexidine (CHX), calcium hydroxide(Ca(OH)2)/CHX and Ca(OH)2/DW. Cell viability was quantitatively analyzed using the MTT, LDHR and TBE assays. Data were analyzed using one-way ANOVA and Tukey's test., Results: All three assessment methods yielded the same results. Ca(OH)2/ DW resulted in the highest and mTAP/CHX resulted in the lowest cell viability. In contrast to Ca(OH)2, mTAP decreased cell viability in a dose-dependent manner. Also, addition of CHX to mTAP and Ca(OH)2 increased their cytotoxicity., Conclusions: In contrast to the proliferative effects of Ca(OH)2, even low concentrations of mTAP have cytotoxic effects on SCAPs.

Introduction: This study is aimed at evaluating root canal transportation in the mesiobuccal canal of mandibular first molars prepared with One Shape, Reciproc, and M-One nickel titanium (NiTi) single-file rotary systems using cone beam computed tomography (CBCT)., Materials and Methods: In this ex vivo study, CBCT scans of 45 extracted human mandibular first molars with 20-40° curvature were obtained. The teeth were randomly divided into three groups ( n =15) for preparation of the mesiobuccal canal with One Shape, Reciproc, and M-One rotary systems according to the manufacturers' instructions. CBCT scans were obtained again after canal preparation. Changes caused by preparation in the coronal, middle, and apical thirds were determined on CBCT scans and analyzed using the Kruskal-Wallis test at P ≤ 0.05 level of significance., Results: No significant difference was noted in the amount of canal transportation among the three groups ( P > 0.05). M-One caused greater transportation in the apical third compared with Reciproc and One Shape, and One Shape caused greater transportation in the coronal third compared with other groups, although its magnitude was less than 0.3 mm., Conclusion: Reciproc, One Shape, and M-One are not significantly different in terms of canal transportation.

Aims and Objectives: Root canal preparation and obturation are of great importance in endodontics. Its purpose is to eliminate pulpal and periradicular disease. The aim of this study was to compare coronal bacterial microleakage in prepared root canals using Neoniti A1 and Reciproc files that obturated with lateral compaction, single cone gutta-percha, and hybrid (tapered cone/lateral compaction) methods., Materials and Methods: In this ex vivo study, a total of 110 single-rooted mandibular first premolars were choose and randomly divided into two study groups A and B (each 45) that one group was prepared with Reciproc and another with Neoniti A1 and negative and positive control groups (each 10). Each group divided into three subgroups of 15 each and obturated using a single cone, lateral compaction, and hybrid (tapered cone/lateral compaction) techniques. For evaluation of coronal leakage, "two-chamber setup" was used. The solution of enterococcus faecalis culture was injected in the upper chamber and incubated. If the bacteria pass through the canal and obturation materials, the lower chamber becomes turbid. TSB medium in the lower chamber (apex) were investigated every day in terms of occurrence of turbidity, and the duration of occurrence of leakage was recorded. The data were analyzed using Chi-square test., Results: Data analysis showed that in each group the difference in percentages between subgroups was statistically significant ( P = 0.003). So that the highest and the lowest amount of leakage in both groups were related to lateral compaction and hybrid techniques, respectively., Conclusion: Under the conditions of this study, independent of the instrument used for canal preparation, hybrid method and then single-cone technique, however, were more effective in the prevention of coronal leakage than lateral condensation technique., Competing Interests: There are no conflicts of interest.

Aims and Objectives: Instrumentation techniques may cause extrusion of microorganisms and their products into the periapical region resulting inflammation and treatment failure. The aim of this ex vivo study was comparing the apical bacterial extrusion in canals prepared with single file versus multiple file rotary systems., Materials and Methods: Ninety-two human single-rooted mandibular first premolars were used. Endodontic access cavities were prepared, and root canals were contaminated with an Enterococcus faecalis ( E. faecalis ) suspension. The samples were incubated at 37°C for 30 days; the contaminated teeth were divided into four groups of 20 specimens each (1: Reciproc, 2: Mtwo, 3: Neoniti A1, 4: Safesider). Six teeth were not infected and each were prepared with one of the above instruments were considered as negative and six teeth which had been previously infected, were used as positive control groups. Extruded bacteria from the apical foramen during instrumentation were collected into vials containing 0.9% NaCl. The microbial samples were taken from the vials and incubated in brain heart agar medium for 24 h. The resulting bacterial titer, in colony-forming units per mL, was determined. The data entered into SPSS 18 software and were analyzed by Kruskal-Wallis and Mann-Whitney U-tests at 0.05 significance level., Results: Mtwo multifile system showed significantly less bacterial extrusion than Safesider ( P = 0.015) and Neoniti A1 ( P = 0.042) but did not show significant difference with Reciproc system ( P = 0.25)., Conclusions: All instrumentation systems extruded bacteria beyond the apical foramen. However, this study showed that Mtwo multifile rotary system extruded fewer bacteria.

Background: Domestic violence (DV) has significant health impacts for victims and their families. Despite evidence that routine screening increases the identification of DV and opportunities for support; routine screening is uncommon in Australian emergency departments (EDs). This study explored ED clinicians' level of support for DV screening; current screening practices; and perceived barriers and readiness to screen prior to a pilot intervention., Methods: Census survey of 76 ED clinicians. A number of questionnaire items were generated through a review of the literature, with readiness to screen for DV assessed through the short version of the Domestic Violence Healthcare Provider Scale [1]. The confidential and anonymous online survey was hosted on the Qualtrics platform. Descriptive and comparative statistical analysis was performed using IBM SPSS version 22., Results: Most clinicians supported screening for DV in the ED. In the absence of protocols, 72.3% (n=55) of clinicians reported currently engaging in case-based screening, which preferenced women with physical injury. The majority did not always feel comfortable screening for DV (79.7% n=59) and reported they had received insufficient training for this role (88.7% n=55). Lower perceived self-efficacy and fear of offending were statistically associated with discomfort or negative beliefs about DV enquiry (p=<0.05)., Conclusion: Emergency department clinicians reported feeling ill-equipped and under-prepared to inquire about and respond to DV. These findings provide valuable insight about the training and support needs of ED clinicians prior to the commencement of routine screening in EDs., (Copyright © 2017. Published by Elsevier Ltd.)

Background: Vertical root fracture (VRF) is a diagnostic challenge for dentists. Cone-beam computed tomography (CBCT) scans provide accurate three-dimensional images of teeth enabling detection of VRFs. This in-vivo study compared the accuracy of CBCT and exploratory surgery for detection of VRFs in endodontically-treated teeth., Methods: Forty endodontically-treated teeth of 40 patients with clinical signs and symptoms of VRFs were evaluated. No fracture line was detectable on periapical radiographs. The CBCT scans with limited FOV were obtained of the teeth and inspected separately by a radiologist and two endodontists. Exploratory surgery was performed for all patients as part of their treatment to ensure the presence/absence of VRF (gold standard)., Results: The kappa coefficient was 0.71 (95% CI: 0.59 to 0.84). The CBCT scans had 93% sensitivity, 78% specificity and 88% accuracy for detection of VRFs., Conclusions: The results showed low specificity of CBCT imaging in detecting VRFs in endodontically-treated teeth.

Introduction: Root canal disinfection is an important step in regenerative endodontic treatments. An ideal irrigating solution must have high antimicrobial activity and minimum cytotoxicity. This study sought to assess the effect of some irrigating solutions on stem cells from the human apical papilla (SCAP) after different periods of exposure., Methods and Materials: Stem cells were isolated from immature, impacted mandibular third molars, transferred to 24-well plates, randomly divided into 6 experimental groups and exposed to BioPure MTAD Cleanser, QMix, 17% EDTA, 2% chlorhexidine (CHX), 5.25% sodium hypochlorite (NaOCl), sterile saline and untreated control group. Cytotoxicity of these solutions was assessed after 1, 5 and 15 min of exposure using the methyl thiazol tetrazolium (MTT) assay. Data were statistically analyzed using repeated measures ANOVA. Level of significance was set at 0.05., Results: The mean percentage of viable cells in all experimental groups was significantly different from the control and sterile saline groups at all the time points ( P <0.0001). The mean percentage of viable cells significantly decreased over time in NaOCl, QMix, EDTA and MTAD groups, but no significant reduction was noted in CHX group. At all the time points the highest and the lowest cytotoxicity were seen in MTAD and normal saline groups, respectively. Cytotoxicity of the understudy materials from the highest to the lowest was as follows: MTAD>EDTA>QMax=NaOCl>CHX> sterile saline., Conclusion: Chlorhexidine had the lowest cytotoxicity compared to EDTA, MTAD, QMix and NaOCl and its cytotoxicity did not change over time compared to other solutions.

Background: The aim of this in-vitro study was to determine the occurrence of coronal microbial leakage in endodontically treated teeth that have been prepared for post space, and also determine the minimum and maximum time required for the permanent restoration of the teeth after post space preparation., Methods: This experimental study was conducted using a simple random sampling. Fifty extracted single-root teeth with approximately the same length were selected for this study. In order to assimilate the samples length, the crowns of all teeth were cut perpendicular to the long axis of the teeth at a distance of 15 mm from the apex. The canals of 40 teeth were filled with gutta-percha and sealer and prepared for post placement. The teeth were divided randomly into two equal groups of 20 each. In one group, temporary dressing (Cavisol) was used while in the other group, no dressing was used. Five of the teeth were considered as a positive and 5 as a negative control group. For evaluation of microbial leakage, "two-chamber setup" was used. The solution of Proteus mirabilis with fresh culture was injected in the upper chamber and incubated. If the bacteria pass through the dressing and obturation, the trypticase soy broth (TSB) media become turbid. TSB medium in the lower chamber (apex) were investigated every day in terms of occurrence of turbidity and the duration of occurrence of coronal leakage was recorded. The data were analyzed using independent t-test., Results: The leakage time in the group without temporary filling was within 7-21 days and it was within 28-47 days in group with temporary filling (P<0.001)., Conclusions: The minimum time required for microorganisms to enter the canal in group with and without dressing was 28 and 7 days respectively. It is suggested that the teeth with post space preparation receive permanent restoration after RCT in the shortest possible time, to reduce the need for retreatment.

Background. This in vitro study compared the effects of mineral trioxide aggregate (MTA), calcium enriched mixture(CEM) cement, Biodentine (BD) and octacalcium phosphate (OCP) on the viability of human gingival fibroblasts (HGFs). Methods. After completion of the setting time of the materials under study, fibroblasts were placed in 24-well insert platesand 1 mg of each material was added to the respective wells. The plates were then incubated at 37°C. The inserts were removedat 24, 48 and 168 hours and 2,5-diphenyltetrazolium bromide was added to assess cytotoxicity via the MTT colorimetricassay. Data were analyzed at different time intervals using repeated-measures ANOVA, followed by the Bonferronitest at three levels of significance of P < 0.05, P < 0.01 and P < 0.001. Results. Cytotoxicity of the materials under study was not significantly different at 24 and 48 hours compared to the controlgroup. However, at 168 hours, a significant difference was noted between MTA (P < 0.05) and Biodentine (P < 0.01)and the control group. Conclusion. Cytotoxicity of MTA, CEM, Biodentine and OCP against HGFs was similar to that of the control group at 24and 48 hours. Over time, MTA and Biodentine exhibited less cytotoxicity than other materials.

Background/Purpose. In terms of the detection of tooth diagnosis, no intelligent detection has been done up till now. Dentists just look at images and then they can detect the diagnosis position in tooth based on their experiences. Using new technologies, scientists will implement detection and repair of tooth diagnosis intelligently. In this paper, we have introduced one intelligent method for detection using particle swarm optimization (PSO) and our mathematical formulation. This method was applied to 2D special images. Using developing of our method, we can detect tooth diagnosis for all of 2D and 3D images. Materials and Methods. In recent years, it is possible to implement intelligent processing of images by high efficiency optimization algorithms in many applications especially for detection of dental caries and restoration without human intervention. In the present work, we explain PSO algorithm with our detection formula for detection of dental caries and restoration. Also image processing helped us to implement our method. And to do so, pictures taken by digital radiography systems of tooth are used. Results and Conclusion. We implement some mathematics formula for fitness of PSO. Our results show that this method can detect dental caries and restoration in digital radiography pictures with the good convergence. In fact, the error rate of this method was 8%, so that it can be implemented for detection of dental caries and restoration. Using some parameters, it is possible that the error rate can be even reduced below 0.5%.

Background: Apoptosis is an important mechanism that is responsible for the physiological deletion of harmful, damaged, or unwanted cells. Changed expression of apoptosis-related genes may lead to abnormal cell proliferation and finally to tumor genesis. Our aims were to analyze the promoter methylation and gene expression profiles of FADD and FAS genes in risk of OSCC., Material and Methods: we analyze the promoter methylation status of FADD and FAS genes using Methylation - Specific PCR (MSP) in 86 OSCC tissues were kept in paraffin and 68 normal oral tissues applied as control. Also, FADD and FAS genes expression were analyzed in 19 cases and 20 normal specimens by Real-Time Reverse-Transcripts PCR., Results: Aberrant promoter methylation of FADD and FAS genes were detected in 12.79 % (11 of 86) and 60.46 % (52 of 86) of the OSCC cases, respectively, with a significant difference between cases and healthy controls for both FADD and FAS genes (P < 0.001). The gene expression analysis showed statistically significant difference between cases and healthy controls for both FADD (p<0.02) and FAS (p<0.007) genes., Conclusions: To the best our knowledge, the data of this study are the first report regarding, the effect of promoter hypermethylation of the FADD and FAS genes in development of OSCC. To confirm the data, it is recommended doing further study in large sample sizes in various genetic populations.

The Ras/RAF/MEK/ERK1/2 pathway is important in the control of growth signals, differentiation and cell survival. Over-expression and activation of this pathway have been reported in different types of cancer. This study analyses the promoter methylation and RNA expression profiles of ERK and RAF1 genes with risk of oral squamous cell carcinoma (OSCC) along with the promoter methylation status of ERK and RAF1 genes using a methylation-specific polymerase chain reaction (MS-PCR) in 86 paraffin-wax embedded samples of OSCC and 68 normal control tissues. Furthermore, ERK and RAF1 expression was analysed in 19 cases and 20 normal samples by real-time reverse transcription PCR. Frequency of promoter methylation was detected for ERK (93.02% and 6.98%) and RAF1 (95.35% and 4.65%) genes in cases and controls, respectively. Messenger RNA (mRNA) expression analysis indicated statistically significant difference between cases and controls for ERK (P < 0.002) and RAF1 (P < 0.006). The authors believe that this is the first report to show that expression of ERK and RAF1 is involved in risk of OSCC.

Objectives: This study was performed to evaluate the effect of blood contamination on the compressive strength (CS) of Root MTA (RMTA) modified with Calcium chloride (CaCl2) and Disodium hydrogen phosphate (Na2HPO4) as setting accelerators over time., Materials and Methods: A total of 110 cylindrical specimens of RMTA were divided into 6 experimental groups as follows: Group1, RMTA; Group 2, RMTA modified with CaCl2 (RMTA-C); Group 3, RMTA modified with Na2HPO4 (RMTA-N); Group 4, RMTA contaminated with blood; Group 5, RMTA-C contaminated with blood; Group 6, RMTA-N contaminated with blood. The CS of specimens in all groups was evaluated after 3 hr, 24 hr, and 1 wk. In the modified groups (groups 2, 3, 5, and 6) the CS of five specimens per group was also evaluated after 1 hr., Results: Blood contamination significantly reduced the CS of all materials at all time intervals (p < 0.05). After 3 hr, the CS of specimens in the RMTA groups (with and without blood contamination) was significantly lower than those in the RMTA-C and RMTA-N groups (p < 0.05). The CS values were not significantly different at the other time intervals. In all groups, the CS of specimens significantly increased over time (p < 0.05)., Conclusions: Blood contamination decreased the CS of both original and accelerated RMTA.

Introduction: Good radiographs are required for endodontic therapy and because some patient's are intolerant to intraoral films and/or sensors, this can cause complications in endodontic treatment. Extraoral film placement can be used to obtain clinically diagnostic and working radiographs., Materials and Methods: The no. 2 receptor was placed against the model's cheek and centered in the molar-premolar area. The central beam was directed toward this area from the opposite side. The vertical and horizontal angles that achieved the most accurate radiograph were calculated by trial and error., Results: The best method equated with the patient sitting upright and the Frankfort plane being horizontal to the floor and when the head was tilted 10 degrees toward the side being examined. For the upper posterior teeth the center of the image receptor was placed on the intersection of the ala-tragus and a parasagittal line while the upper border of receptor was parallel to the canthomeatal line; the cone was positioned a negative 25 degrees from the horizontal plane. The central beam was directed from midway between maxillary and mandibular premolars and molars of the opposite side. For the lower posterior teeth, the receptor was placed against the cheek on the side of interest and its lower border was parallel and 2 cm above the inferior border of the mandible. The cone was angled -20 degrees from the horizontal plane while the central beam was directed towards the mandibular molar-premolar region 1 cm below the lower border of the mandibular of the contralateral premolar/molar region., Conclusion: Using this novel technique, high quality images can be acquired for patients who cannot tolerate intraoral radiographs.