Comparison of Torque,Screw-in Force,and Shaping Ability of Glide Path Instruments in Continuous Rotation and Optimum Glide Path Motion

IntroductionThis study aimed to analyze torque/force generation and transportation in double-curved canals instrumented with 3 types of glide path files using optimum glide path (OGP) motion in comparison with continuous rotation.MethodsSixty simulated double-curved canals were prepared with #10/0.05 or #15/0.03 HyFlex EDM Glidepath files (Coltene/Whaledent, Altstätten, Switzerland) or a #13/0.04 prototype MANI Glidepath file (Tochigi, Japan) using OGP motion or continuous rotation (n = 10 each). Canals were sequentially prepared to 20 mm and 22 mm (full working length) using automated root canal instrumentation and a torque/force analyzing device. Transportation was calculated at 1–9 mm from the apex. Data were compared using 2-way analysis of variance followed by a post hoc simple main effect test with Bonferroni correction and a Kruskal-Wallis test (α = 5%).ResultsAll #10/0.05 instruments fractured. In the 22-mm preparation, the OGP motion resulted in lower clockwise torque and screw-in force than did continuous rotation (P < .05). In the 20-mm preparation, #15/0.03 instruments recorded a lower screw-in force for OGP motion than for continuous rotation (P < .05). Comparing the 2 preparation phases, OGP motion generated no significant differences; however, continuous rotation developed higher clockwise torque and screw-in force in the 22-mm preparation than in the 20-mm preparation (P < .05). There was no significant difference among the tested groups for transportation values.ConclusionsCompared with continuous rotation, OGP motion generated less screw-in force, lower clockwise torque, and similar transportation. The #15/0.03 HyFlex EDM instrument and the #13/0.04 prototype MANI instrument performed similarly well.     

Evaluating the utility of national‐scale data to estimate the local risk of foot‐and‐mouth disease in endemic regions

Knowledge of the distribution of foot‐and‐mouth disease (FMD) is required if control programmes are to be successful. However, data on the seroprevalence and incidence of affected villages in developing countries with endemic disease are scarce. This is partly due to resource constraints as well as the logistical challenges of conducting intensive surveys and diagnostic testing in remote locations. In this study, we evaluated the performance of low resolution national‐scale data against high resolution local survey data to predict the FMD serological status of 168 villages in the Mandalay and Sagaing Regions of central Myanmar using both logistic regression and random forest modelling approaches. Blood samples for ELISA testing were collected from approximately 30 cattle per village in both the 6 to 18 month age range and in the over 18 month age range to distinguish between recent and historical exposure, respectively. The results of the animal level tests were aggregated to the village level to provide the outcome of interest (village positive or not positive for FMD), and three explanatory data sets were constructed: using only nationally available data, using only data collected by survey and using the combined survey and nationally available data. The true seroprevalence of FMD at the village level was 61% when only young animals were included, but increased to 87% when all animals were included. The best performing model was a logistic regression model using the combined national and survey data to predict recent infection in villages. However, this still incorrectly classified 40% of villages, which suggests that using national‐level data were not reliable enough for extrapolating seroprevalence in regions where conducting detailed surveys is impractical. Other methods for collected data on FMD such as the use of local reporting should be explored.     

Incidence and outcomes of catheter related thrombosis (CRT) in patients with acute leukemia using a platelet-adjusted low molecular weight heparin regimen

The purpose of this study is to evaluate the efficacy and safety of novel oral anticoagulant (NOAC) versus warfarin therapy in patients undergoing different operations. We performed a systematic review of MEDLINE, EMBASE, Cochrane Controlled Trials Register, and reports presented at scientific meetings. The efficacy and safety of NOACs during the perioperative period was compared to that using warfarin. Of the 2652 studies initially reviewed, we identified 9 that included 15,880 patients for the meta-analysis. Compared to warfarin, dabigatran increased the risk of major bleeding (RR 1.37, 95% CI 1.06–1.78, P?=?0.02). Apixaban (RR 0.63, 95% CI 0.40–0.99, P?=?0.04) reduced thrombotic events. NOAC therapy decreased thrombotic events in patients undergoing non-cardiac surgery (RR 0.68, 95% CI 0.50–0.92, P?=?0.02). Compared to warfarin, the administration of NOACs in the perioperative period has the same risk of thromboembolism and major bleeding. But patients undergoing non-cardiac surgery may benefit more from perioperative NOAC therapy. Apixaban may reduce thrombotic events and dabigatran increases the risk of major bleeding during the perioperative period.     

The Growth Factor Midkine Antagonizes VEGF Signaling In Vitro and In Vivo

Midkine (MDK) is a heparin-binding growth factor involved in growth, survival, migration, and differentiation of various target cells and dysregulation of MDK signaling is implicated in a variety of inflammatory diseases and cancers. Although MDK has been reported to act on endothelial cells and to have proangiogenic effects, the exact role of MDK in angiogenesis is poorly defined. Here, we report that MDK is actually a modulator of angiogenesis and that it can abrogate the vascular endothelial growth factor A (VEGF-A)-induced proliferation of human microvascular endothelial cells in vitro through the downregulation of proangiogenic cytokines and through the upregulation of the antiangiogenic factor, tissue inhibitor of metalloproteinase 2. Phosphorylation of vascular endothelial growth factor receptor 2 (VEGFR-2) and of downstream signaling molecules, such as phosphatidylinositol-3-kinase and mitogen-activated protein kinases, is also impaired. Moreover, MDK downregulates VEGF-A-induced neovascularization and vascular permeability in vivo. We propose a model in which MDK is a new modulator of the VEGF-A-VEGFR-2 axis.     

Pilot of a novel cervical screening intervention: interactive voice response

OBJECTIVE: This paper describes the pilot of an interactive voice response (IVR) cervical screening brief advice interface. METHOD: In September 2000, 5,000 households within Cessnock, New South Wales, were contacted by an IVR system. The system randomly selected eligible women aged 18-69, assessed their cervical screening status and provided a tailored message about cervical screening. A computer-assisted telephone interview (CATI) evaluated intervention acceptability. Participation rates, participant demographics, IVR use by women, and IVR costs were also examined. RESULTS: 549 (12%) women listened to the IVR call and 587 (59%) completed the CATI interview. IVR listeners under-represented younger and older women, and over-represented women who were married, and of Aboriginal descent. The majority of women (98%) found IVR easy to answer and 90% agreed IVR reminders were a good idea. Unscreened and older women used the system more than screened or younger women. CONCLUSIONS: The IVR call was successfully used by a large number of women to obtain information on cervical cancer screening, with higher use by recognised risk groups. IMPLICATIONS: These results suggest that an IVR reminder might be useful to increase cervical screening rates since those most at risk also used IVR the most. The potential for linking IVR to a database to issue reminders in the same manner as Pap Test Register postal reminders needs to be explored.