Investigation on the shaping ability of nickel-titanium files when used with a reciprocating motion

Introduction

The introduction of nickel-titanium (NiTi) files into clinical practice has improved the quality of canal shaping, but increasing the curvature of the root canal (or the diameter of the master instrument that prepares the full working length) could result in more transportation, straightening, and aberration of the canal. Nickel-titanium instruments are significantly safer and have an extended cyclic fatigue life when used with a reciprocating movement. The purpose of this study was to compare the shaping ability of FlexMaster NiTi instruments when used in either continuous or reciprocating movements.

Methods

Thirty-two Endo Training Blocks ISO 15, 2% taper, 10-mm radius of curvature, and 70° angle of curvature were prepared, according to the group, with FlexMaster NiTi instruments either in continuous rotation or in reciprocating (60° clockwise, 40° counterclockwise) movement. Preoperative and postoperative images of the simulated canals were taken under standardized conditions. The preoperative and postoperative images were combined exactly. The amount of resin removed was determined both for the inner (convex) and the outer (concave) sides of the curvature at 10 different points.

Results

In the most apical third of the canal, the Continuous group produced the largest enlargement of the canal as compared with the Reciprocating group (P < .05). In the apical third, the Continuous group displayed significantly greater enlargement of the canal at the external side.

Conclusions

The shaping of simulated canals is more centered by using a reciprocating motion when compared with continuous rotation, but the reciprocating motion could be more time-consuming.     

Disc size markedly influences concentration profiles of intravenously administered solutes in the intervertebral disc: a computational study on glucosamine as a model solute

Purpose

Tests on animals of different species with large differences in intervertebral disc size are commonly used to investigate the therapeutic efficacy of intravenously injected solutes in the disc. We hypothesize that disc size markedly affects outcome.

Methods

Here, using a small non-metabolized molecule, glucosamine (GL) as a model solute, we calculate the influence of disc size on transport of GL into rat, rabbit, dog and human discs for 10 h post intravenous-injection. We used transient finite element models and considered an identical GL supply for all animals.

Results

Huge effects of disc size on GL concentration profiles were found. Post-injection GL concentration in the rat disc reached 70 % blood concentration within 15 min but remained below 10 % in the human disc nucleus throughout. The GL rapidly penetrated post-injection into smaller discs resulting in homogeneous concentrations. In contrast, GL concentration, albeit at much lower levels, increased with time in the human disc with a small outward flux at the annulus periphery at longer periods.

Conclusions

Changes in the disc size hugely influenced GL concentrations throughout the disc at all regions and times. Increases in administered dose can neither remedy the very low concentration levels in the disc center in larger human disc at early post-injection hours nor alter the substantial differences in concentration profiles estimated among various species. The size effect will only be exacerbated as molecular weight of the solute increases and as the endplate calcifies. Extrapolation of findings from animal to human discs on the efficacy of intravenously administered solutes must proceed with great caution.     

So what exactly is nursing knowledge?

This paper aims to present a discussion about intrinsic nursing knowledge. The paper stems from the author's study of knowledge claims enshrined in nursing journal articles, books and conference speeches. It is argued that claims by academic nurses have largely depended on principles drawn from continental and not Analytic (British-American) philosophy. Thus, claims are credible only insofar as they defer propositional logic. This is problematic inasmuch as nursing is a practice-based activity usually carried out in medical settings. Transpersonal nursing models are particularly criticizable in respect of their unworldly character as are also concepts based on shallow usages of physics or mathematics. I argue that sensible measurements of the 'real world' are possible--without endorsing positivism--and that nursing requires little recourse to logically unsustainable claims. The paper concludes with an analysis of a recent review of nursing knowledge, which analysis indicates the circularity that attends many discussions on the topic.     

Organization of sensory input to the nociceptive‐specific cutaneous trunk muscle reflex in rat,an effective experimental system for examining nociception and plasticity

Detailed characterization of neural circuitries furthers our understanding of how nervous systems perform specific functions and allows the use of those systems to test hypotheses. We have characterized the sensory input to the cutaneous trunk muscle (CTM; also cutaneus trunci [rat] or cutaneus maximus [mouse]) reflex (CTMR), which manifests as a puckering of the dorsal thoracolumbar skin and is selectively driven by noxious stimuli. CTM electromyography and neurogram recordings in naïve rats revealed that CTMR responses were elicited by natural stimuli and electrical stimulation of all segments from C4 to L6, a much greater extent of segmental drive to the CTMR than previously described. Stimulation of some subcutaneous paraspinal tissue can also elicit this reflex. Using a selective neurotoxin, we also demonstrate differential drive of the CTMR by trkA‐expressing and nonexpressing small‐diameter afferents. These observations highlight aspects of the organization of the CTMR system that make it attractive for studies of nociception and anesthesiology and plasticity of primary afferents, motoneurons, and the propriospinal system. We use the CTMR system to demonstrate qualitatively and quantitatively that experimental pharmacological treatments can be compared with controls applied either to the contralateral side or to another segment, with the remaining segments providing controls for systemic or other treatment effects. These data indicate the potential for using the CTMR system as both an invasive and a noninvasive quantitative assessment tool providing improved statistical power and reduced animal use. J. Comp. Neurol. 522:1048–1071, 2014. © 2013 Wiley Periodicals, Inc.     

The (late?) modern family: The family's significance for adolescents in Germany and Israel

This study presents German and Israeli youth's heroes and role models. Two hundred twenty-six students from 22 high schools took part in small group interviews. Despite differences in the normative place of the family in the two cultures, the comparison reveals significant similarities between their views and what attributes the subjects assign to their families. Three main models of family members as hero arise from the data: The Self-made Person; sacrifice and pro-social action; and contending with everyday reality. The results point to a) the fading of traditional heroes from the imagination of youth in post-industrial societies; b) the substantive place the family holds in young people's lives. I suggest that the rise of uncertainty and risk in the current socio-historical constellation, contributes to adolescents' choice of figures from their immediate environments that embody safety and a moral framework.     

Learning Markov random walks for robust subspace clustering and estimation

Markov Random Walks (MRW) has proven to be an effective way to understand spectral clustering and embedding. However, due to less global structural measure, conventional MRW (e.g., the Gaussian kernel MRW) cannot be applied to handle data points drawn from a mixture of subspaces. In this paper, we introduce a regularized MRW learning model, using a low-rank penalty to constrain the global subspace structure, for subspace clustering and estimation. In our framework, both the local pairwise similarity and the global subspace structure can be learnt from the transition probabilities of MRW. We prove that under some suitable conditions, our proposed local/global criteria can exactly capture the multiple subspace structure and learn a low-dimensional embedding for the data, in which giving the true segmentation of subspaces. To improve robustness in real situations, we also propose an extension of the MRW learning model based on integrating transition matrix learning and error correction in a unified framework. Experimental results on both synthetic data and real applications demonstrate that our proposed MRW learning model and its robust extension outperform the state-of-the-art subspace clustering methods.     

Virtual surgery simulation in orbital wall reconstruction: Integration of surgical navigation and stereolithographic models

PurposeCorrection of post traumatic orbital and zygomatic deformity is a challenge for maxillofacial surgeons. Integration of different technologies, such as software planning, surgical navigation and stereolithographic models, opens new horizons in terms of the surgeons' ability to tailor reconstruction to individual patients. The purpose of this study was to analyze surgical results, in order to verify the suitability, effectiveness and reproducibility of this new protocol.MethodsEleven patients were included in the study. Inclusion criteria were: unilateral orbital pathology; associated diplopia and enophthalmos or exophthalmos, and zygomatic deformities. Syndromic patients were excluded. Pre-surgical planning was performed with iPlan 3.0 CMF software and we used Vector Vision II (BrainLab, Feldkirchen, Germany) for surgical navigation. We used 1:1 skull stereolithographic models for all the patients. Orbital reconstructions were performed with a titanium orbital mesh. The results refer to: correction of the deformities, exophthalmos, enophthalmos and diplopia; correspondence between reconstruction mesh positioning and preoperative planning mirroring; and the difference between the reconstructed orbital volume and the healthy orbital volume.ResultsCorrespondence between the post-operative reconstruction mesh position and the presurgical virtual planning has an average margin of error of less than 1.3 mm. In terms of en- and exophthalmos corrections, we have always had an adequate clinical outcome with a significant change in the projection of the eyeball. In all cases treated, there was a complete resolution of diplopia. The calculation of orbital volume highlighted that the volume of the reconstructed orbit, in most cases, was equal to the healthy orbital volume, with a positive or negative variation of less than 1 cm³.ConclusionThe proposed protocol incorporates all the latest technologies to plan the virtual reconstruction surgery in detail. The results obtained from our experience are very encouraging and lead us to pursue this path.