Excess Mortality in Individuals with Autism Spectrum Disorder: A Population-Based Cohort Study.

Purpose: Autism spectrum disorder (ASD) may be associated with increased mortality, but relevant findings have been inconsistent. The modifying effects of gender and intellectual disability on excess mortality in individuals with ASD are underexplored. Patients and Methods: Using Taiwan's National Health Insurance Research Database and the National Death Registry, this population-based cohort study selected the data of 75,946 patients with ASD (ASD cohort) and 75,946 age group-, gender-, and income-matched (1:1) patients without ASD (non-ASD cohort). Cox proportional hazards models were used to compare mortality rates between the cohorts, and stratified analyses were used to evaluate the influence of gender and intellectual disability on mortality risk. Results: The ASD cohort had higher mortality rates for all causes of death than did the non-ASD cohort (adjusted hazard ratio 1.64, 95% confidence interval 1.54-1.75). Comorbid intellectual disability was associated with an increased risk of mortality, and this association was stronger in female patients than in male patients. Moreover, when focusing on deaths from natural causes, we found a significantly higher odds ratio for mortality in the ASD population with ID compared to those without ID. Conclusion: ASD is associated with increased mortality, especially among female individuals and those with intellectual disability.

Psychiatric disorders in term-born children with marginally low birth weight: a population-based study.

BACKGROUND: Marginally low birth weight (MLBW) is defined as a birth weight of 2000 ~ 2499 g. Inconsistent findings have been reported on whether children with low birth weight had higher rates of neurological, attention, or cognitive symptoms. No studies have explored the occurrence of clinically diagnosed psychiatric disorders in term- born MLBW infants. We aimed to investigate the risk of subsequent psychiatric disorders in term-born children with MLBW. METHODS: This is a nationwide retrospective cohort study, by analysing the data from Taiwan's National Health Insurance Research Database from 2008 to 2018. The study population includes propensity-score-matched term-born infants with MLBW and those without MLBW (birth weight ≥ 2500 g). Cox proportional hazard analysis was used after adjustment for potential demographic and perinatal comorbidity confounders. Incidence rates and hazard ratios (HR) of 11 psychiatric clinical diagnoses were evaluated. RESULTS: A total of 53,276 term-born MLBW infants and 1,323,930 term-born infants without MLBW were included in the study. After propensity score matching for demographic variables and perinatal comorbidities, we determined that the term-born MLBW infants (n = 50,060) were more likely to have attention deficit and hyperactivity disorder (HR = 1.26, 95% confidence interval (CI) [1.20, 1.33]), autism spectrum disorder (HR = 1.26, 95% CI [1.14, 1.40]), conduct disorder (HR = 1.25, 95% CI [1.03, 1.51]), emotional disturbance (HR: = 1.13, 95% CI [1.02, 1.26]), or specific developmental delays (HR = 1.38, 95% CI [1.33, 1.43]) than term-born infants without MLBW (n = 50,060). CONCLUSION: MLBW was significantly associated with the risk of subsequent psychiatric disorder development among term-born infants. The study findings demonstrate that further attention to mental health and neurodevelopment issues may be necessary in term-born children with MLBW. However, possibilities of misclassification in exposures or outcomes, and risks of residual and unmeasured confounding should be concerned when interpreting our data.

How Impulsivity is Associated with Adolescent Depression: The Role of Substance Use, Gender and Social Support.

Background: Some risk/protective factors of adolescent depression have been proposed but have not been comprehensively studied. Recent advances in neuroimaging techniques have provided greater insight into the underlying neuropsychiatric mechanisms of depression-related factors such as impulsivity, substance use, gender difference and social support. However, how these factors are interconnected and how they affect depression in the real world is poorly understood. This study aimed to explore the relationships between adolescent depression with trait impulsivity, substance use and gender. We also tested the hypothesis that social support may play a buffering role in preventing depression. By expanding the diathesis-stress model. Methods: The adolescents enrolled in this study were grade 1 senior high school students from northern Taiwan (N = 5879), and they were assessed for depression, trait impulsivity, and tobacco/alcohol use. Hierarchical multiple linear regression was performed to control possible confounders, including other depression-related diathesis and sociodemographic variables. Gender differences were also analyzed by separately examining variables significantly associated with depression. Results: A higher level of depression was associated with female gender, trait impulsivity, low self-esteem, negative attitude towards the future, tobacco use, alcohol use, family discord and difficulty in basic family needs. Good parental health, living with their biological family and social support were protective factors. Trait impulsivity was significantly associated with depression after controlling for the confounding factors. Gender-specific analysis showed that trait impulsivity and tobacco use had a significant synergistic interaction on female depression. Social support from parents/peers was significantly associated with depression, but social support from other family members/teachers was not. Conclusion: The current study advances the understanding of adolescent depression and highlights that trait impulsivity, addictive substance use, social support and their interaction may play an influential role in the emergence of adolescent depression. Gender-specific research and treatment approach are also crucial, and more investigations are necessary.

Psychometric properties of the Chinese Mandarin version of the Borderline Symptom List, short form (BSL-23) in suicidal adolescents.

BACKGROUND: The short form of the Borderline Symptom List (BSL-23) is a self-rated instrument developed from the initial 95-item German version of the Borderline Symptom List (BSL-95). It is widely used among Chinese adults, but its applicability, factor structure and validity remain uncertain in adolescents. This study aimed to evaluate the psychometric properties of the Chinese Mandarin version of the BSL-23 in a sample of suicidal adolescents. METHODS: The Chinese Mandarin BSL-23 was given to 279 outpatient adolescents with self-injurious thoughts or behaviors. The factor structure, reliability, convergent validity, criterion-related validity and cut-off value were investigated. RESULTS: The Chinese Mandarin version of the BSL-23 demonstrated a one-factor structure and replicated the original version. The scale had high reliability and good test-retest stability. The Chinese Mandarin BSL-23 was correlated with depression, hopelessness, impulsivity, emotional dysregulation, self-esteem, loneliness, childhood trauma and parental bonding patterns evaluated with a variety of scales. The measure showed good criterion-related validity and predictive accuracy (AUC = 0.87) for self-injurious and suicidal adolescents with borderline personality disorder (BPD) at a cut-off point of 60/61 (mean score 2.60/2.65), with a sensitivity of 0.76 and specificity of 0.83. CONCLUSIONS: The Chinese Mandarin version of the BSL-23 is a reliable and valid self-reported instrument to assess BPD symptomatology among suicidal adolescents.

Development and Optimization of Black Rice (Oryza sativa L.) Sourdough Fermented by Levilactobacillus brevis LUC 247 for Physicochemical Characteristics and Antioxidant Capacity.

This study used Levilactobacillus brevis LUC 247 to ferment black rice sourdough, made into Type III black rice sourdough powder to produce black rice sourdough bread. The composition analysis, antioxidant capacity, and storage stability of the black rice sourdough bread with different proportions of black rice powder (0-60%) and fermented for different lengths of time (0-48 h) were discussed. The results showed that the black rice sourdough had the maximum lactic acid bacteria count (9 Log CFU/g) during 12 to 36 h of fermentation. The titratable acid, lactic acid, and acetic acid yields increased with the fermentation time and the proportion of black rice powder. The total anthocyanin content and antioxidant capacity increased with the fermentation time. The hardness and chewiness of the black rice sourdough bread were positively correlated with the black rice sourdough powder content and increased with storage time. In addition, the growth of fungi was significantly slowed as the additional level of black rice sourdough powder increased.

Distinct features of the host-parasite interactions between nonadherent and adherent Trichomonas vaginalis isolates.

Cytoadherence of Trichomonas vaginalis to human vaginal epithelial cells (hVECs) was previously shown to involve surface lipoglycans and several reputed adhesins on the parasite. Herein, we report some new observations on the host-parasite interactions of adherent versus nonadherent T. vaginalis isolates to hVECs. The binding of the TH17 adherent isolate to hVECs exhibited an initial discrete phase followed by an aggregation phase inhibited by lactose. T. vaginalis infection immediately induced surface expression of galectin-1 and -3, with extracellular amounts in the spent medium initially decreasing and then increasing thereafter over the next 60 min. Extracellular galectin-1 and -3 were detected on the parasite surface but only the TH17 adherent isolate could uptake galectin-3 via the lysosomes. Only the adherent isolate could morphologically transform from the round-up flagellate with numerous transient protrusions into a flat amoeboid form on contact with the solid surface. Cytochalasin D challenge revealed that actin organization was essential to parasite morphogenesis and cytoadherence. Real-time microscopy showed that parasite exploring and anchoring on hVECs via the axostyle may be required for initial cytoadherence. Together, the parasite cytoskeleton behaviors may collaborate with cell surface adhesion molecules for cytoadherence. The nonadherent isolate migrated faster than the adherent isolate, with motility transiently increasing in the presence of hVECs. Meanwhile, differential histone acetylation was detected between the two isolates. Also, TH17 without Mycoplasma symbiosis suggests that symbiont might not determine TH17 innate cytoadherence. Our findings regarding distinctive host-parasite interactions of the isolates may provide novel insights into T. vaginalis infection.

Germanium-Tin (GeSn) Metal-Semiconductor-Metal (MSM) Near-Infrared Photodetectors.

Narrow-bandgap germanium-tin (GeSn) is employed to fabricate metal-semiconductor-metal (MSM) near-infrared photodetectors with low-dark currents and high responsivity. To reduce the dark current, the SiO2 layer is inserted in between the metal and semiconductor to increase the barrier height, albeit at the expense of photocurrent reduction. To couple more incident light into the absorption layer to enhance the responsivity, the distributed Bragg reflectors (DBRs) are deposited at the bottom of the GeSn substrate while placing the anti-reflection layer on the surface of the absorption layer. With the interdigital electrode spacing and width, both set at 5 µm and with 1 V bias applied, it is found the responsivities of the generic MSM control sample detector, the MSM with DBR, and the MSM with AR layer are 0.644 A/W, 0.716 A/W, and 1.30 A/W, respectively. The corresponding specific detectivities are 8.77 × 1010, 1.11 × 1011, and 1.77 × 1011 cm·Hz1/2/W, respectively. The measurement data show that these designs effectively enhance the photocurrent and responsivity. At 1 V bias voltage, normalized responsivity evinces that the photodetection range has been extended from 1550 nm to over 2000 nm, covering the entire telecommunication band. Incorporating GeSn as a sensing layer offers one of the new alternative avenues for IR photodetection.

Predictors of repeated adolescent self-harm: The display of multiple variables and mediators in a 2-year study.

BACKGROUND: Data on self-harm (SH) repetition in non-Western adolescents are limited; this study is to survey the predictors. METHODS: A total of 5879 adolescents (mean age 16.02 years) in Northern Taiwan were recruited. The participants filled in online questionnaires about their sociodemographic data, suicidality, depressive symptoms, self-esteem, social support, family discord, impulsivity, and alcohol and tobacco use at baseline (T1) and at the 1 year follow-up (T2). We used logistic regression analysis to examine the predictors of SH continuation. Generalized structural equation modeling (GSEM) was then estimated to analyze the treatable variables for both years and to investigate their relationships and mediating effects. RESULTS: A total of 125 students were identified as being in the SH continuation group; while 470 students were identified as being in the SH stop group. The SH continuation rate was 21%; no significant gender difference was found. Logistic regression analysis showed that the predictors of SH continuation were low school ranking, poor quality of listening from relatives, use of the cutting method for SH, and a suicide plan in the past year at T1, and more depressed mood, use of the cutting method for SH, more suicide ideation and plans at T2. Similar predictors were found by GSEM; self-esteem at T1 and depressed mood at T2 were found to be mediators in the pathways. CONCLUSION: The continuation rate of SH was similar to that reported in Western countries. These predictors should be included in the treatment plan to prevent SH continuation.

Comprehensive Investigation of Electrical and Optical Characteristics of InGaN-Based Flip-Chip Micro-Light-Emitting Diodes.

Micro-light-emitting diodes (micro-LEDs) have been regarded as the important next-generation display technology, and a comprehensive and reliable modeling method for the design and optimization of characteristics of the micro-LED is of great use. In this work, by integrating the electrical simulation with the optical simulation, we conduct comprehensive simulation studies on electrical and optical/emission properties of real InGaN-based flip-chip micro-LED devices. The integrated simulation adopting the output of the electrical simulation (e.g., the non-uniform spontaneous emission distribution) as the input of the optical simulation (e.g., the emission source distribution) can provide more comprehensive and detailed characteristics and mechanisms of the micro-LED operation than the simulation by simply assuming a simple uniform emission source distribution. The simulated electrical and emission properties of the micro-LED were well corroborated by the measured properties, validating the effectiveness of the simulation. The reliable and practical modeling/simulation methodology reported here shall be useful to thoroughly investigate the physical mechanisms and operation of micro-LED devices.

An unsymmetrical thermally activated delayed fluorescence emitter enables orange-red electroluminescence with 31.7% external quantum efficiency.

The thermally activated delayed fluorescence (TADF) emitters based on donor-acceptor (D-A) configuration were continuously developed in the past few years, whereas an unsymmetrical TADF emitter with A-D-A' configuration has never been reported. Herein, an A-D-A' type TADF emitter of TRZ-SBA-NAI was firstly developed by simultaneously integrating 2-phenyl-1H-benzo[de]isoquinoline-1,3(2H)-dione and 2,4,6-triphenyl-1,3,5-triazine acceptors into a spirobiacridine donor core. Due to the coexistence of double charge-transfer excited states, TRZ-SBA-NAI displayed dual emission containing a dominant orange-red emission and an anti-Kasha's rule sky-blue emission shoulder in solution. As doped into the host matrix, TRZ-SBA-NAI only exhibited an orange-red emission, together with a high photoluminescence quantum yield of 87%. The linear molecular shape imparted TRZ-SBA-NAI with a high horizontal dipole ratio of 88%. As a result, the TRZ-SBA-NAI based devices achieved a record-high external quantum efficiency of 31.7% with an electroluminescence peak at 593 nm. This finding not only enriches the diversity in TADF molecular design, but also unlocks the huge potential of A-D-A' type TADF emitters for excellent device performance.

High-Efficiency Red Electroluminescence Based on a Carbene-Cu(I)-Acridine Complex.

How to develop efficient red-emitting organometallics of earth-abundant copper(I) is a formidable challenge in the field of organic light-emitting diodes (OLEDs) because Cu(I) complexes have weak spin-orbit coupling and a serious excited-state reorganization effect. Here, a red Cu(I) complex, MAC*-Cu-DPAC, was developed using a rigid 9,9-diphenyl-9,10-dihydroacridine donor ligand in a carbene-metal-amide motif. The Cu(I) complex achieved satisfactory red emission, a high photoluminescence quantum yield of up to 70%, and a sub-microsecond lifetime. Thanks to a linear geometry and the acceptor and donor ligands in a coplanar conformation, the complex exhibited a high horizontal dipole ratio of 77% in the host matrix, first demonstrated for coinage metal(I) complexes. The resulting OLEDs delivered high external quantum efficiencies of 21.1% at a maximum and 20.1% at 1000 nits, together with a red emission peak at ∼630 nm. These values represent the state-of-the-art performance for red-emitting OLEDs based on coinage metal complexes.

Modified distributed Bragg reflector for protecting organic light-emitting diode displays against ultraviolet light.

Sunlight/UV (ultraviolet)-induced degradation is still a critical issue for outdoor applications of organic light-emitting diode (OLED) displays. Therefore, effective UV-blocking structures that can prevent OLED displays from sunlight/UV degradation and still keep the OLED panels' display performance is necessary. In this report, modified distributed Bragg reflector (DBR) structures having UV-absorbing dielectric materials and adjusted layer/pair thicknesses were developed to realize effective UV blocking properties (nearly 0% transmittance below 400 nm), constantly high transmittance like glass in the visible range (∼92%) required for display applications, and sharp transition in transmission between the UV and the visible ranges. Furthermore, under the rigorous IEC 60068-2-5 solar test condition, it was verified that the developed modified, UV-blocking DBR can effectively enhance the OLED panel's resistance against UV/solar-induced degradation, effectively reducing voltage shifts of OLED devices after repeated solar test cycles.

Prevalence and psychosocial risk factors associated with current cigarette smoking and hazardous alcohol drinking among adolescents in Taiwan.

BACKGROUND: Cigarette smoking and alcohol drinking are the most common types of substance use and misuse (SUM) among adolescents. This study aimed to estimate the prevalence and psychosocial factors associated with current cigarette smoking and hazardous alcohol drinking among adolescents in Taiwan. METHODS: Data were collected via self-administered questionnaires on computers from students at 14 senior high schools in Taipei, Taiwan. Hierarchical multiple regression strategies were used to determine the risk factors for SUM. RESULTS: A total of 5879 participants were recruited, the majority of whom were female (56.7%). The prevalence rates of current smoking and hazardous alcohol drinking were 3.84% and 7.38%, respectively. Risk factors associated with current smoking were similar to those for hazardous alcohol drinking, including male gender, low school ranking, and depression. In addition, current smoking was associated with increasing age, hazardous alcohol drinking, and fewer parents with whom they can talk, whereas hazardous alcohol drinking was associated with current smoking, not living with both biological parents, and more peers with whom they can talk. CONCLUSION: The potential coexistence of adolescent SUM and common psychosocial correlates demands an integrated approach. Health professionals should provide corresponding intervention programs and coordinate with parents and teachers to develop an anti-SUM environment, especially for males and high-risk schools. Preventive psychiatric services as an integral part of anti-SUM strategies for adolescents targeting to depression may be useful in reducing the risk.

Acceptor plane expansion enhances horizontal orientation of thermally activated delayed fluorescence emitters.

Manipulating orientation of organic emitters remains a formidable challenge in organic light-emitting diodes (OLEDs). Here, expansion of the acceptor plane of thermally activated delayed fluorescence (TADF) emitters was demonstrated to selectively modulate emitting dipole orientation. Two proof-of-the-concept molecules, PXZPyPM and PXZTAZPM, were prepared by introducing a planar 2-phenylpyridine or 2,4,6-triphenyl-1,3,5-triazine substituent into a prototypical molecule (PXZPM) bearing a pyrimidine core and two phenoxazine donors. This design approach suppressed the influence of substituents on electronic structures and associated optoelectronic properties. Accordingly, PXZPyPM and PXZTAZPM preserved almost the same excited states and similar emission characteristics as PXZPM. The expanded acceptor plane of PXZPyPM and PXZTAZPM resulted in a 15 to 18% increase in horizontal ratios of emitting dipole orientation. PXZPyPM supported its green device exhibiting an external quantum efficiency of 33.9% and a power efficiency of 118.9 lumen per watt, competitive with the most efficient green TADF OLEDs reported so far.

Neurotoxic microglia promote TDP-43 proteinopathy in progranulin deficiency.

Aberrant aggregation of the RNA-binding protein TDP-43 in neurons is a hallmark of frontotemporal lobar degeneration caused by haploinsufficiency in the gene encoding progranulin1,2. However, the mechanism leading to TDP-43 proteinopathy remains unclear. Here we use single-nucleus RNA sequencing to show that progranulin deficiency promotes microglial transition from a homeostatic to a disease-specific state that causes endolysosomal dysfunction and neurodegeneration in mice. These defects persist even when Grn-/- microglia are cultured ex vivo. In addition, single-nucleus RNA sequencing reveals selective loss of excitatory neurons at disease end-stage, which is characterized by prominent nuclear and cytoplasmic TDP-43 granules and nuclear pore defects. Remarkably, conditioned media from Grn-/- microglia are sufficient to promote TDP-43 granule formation, nuclear pore defects and cell death in excitatory neurons via the complement activation pathway. Consistent with these results, deletion of the genes encoding C1qa and C3 mitigates microglial toxicity and rescues TDP-43 proteinopathy and neurodegeneration. These results uncover previously unappreciated contributions of chronic microglial toxicity to TDP-43 proteinopathy during neurodegeneration.

A Randomized Controlled Trial of Transcultural Validation of Group-Based Psychosocial Intervention for Patients with Bipolar Disorder.

Adjunctive psychosocial interventions are part of the preferred method to treat bipolar disorder (BD). This study aimed to conduct a randomized control and protocol-guided trial, in order to evaluate the feasibility and effectiveness of adjunctive group-based treatments for Chinese outpatients with BD. A single-blind trial in which 68 outpatients with BD were randomly assigned to either treatment as usual (TAU) or to an experimental group with 12 additional weekly sessions and 3 monthly booster sessions. Participants were assessed at baseline for mood condition, suicidal ideation, medication adherence, and quality of life (QoL), with follow-up assessments every 3 months over a 1-year period. The overall retention rate of this study was 89.7%. The results showed significant differences between groups for the variables evaluated, which included achieving euthymia, decrease of depression symptoms, and improvement of QoL. No improvements in medication adherence, reduction in manic symptoms, or suicidal ideation was observed. The results of this study support the transcultural validity and efficacy of group-based psychosocial intervention as anadjunct to TAU among Chinese outpatients with BD to promote improvements during the course of the illness including achieving euthymia, reducing depressive symptoms, and improving QoL.

Endomembrane Protein Trafficking Regulated by a TvCyP2 Cyclophilin in the Protozoan Parasite, Trichomonas vaginalis.

In Trichomonas vaginalis, the TvCyP1-catalyzed conformational switches of two glycinyl-prolyl imide bonds in Myb3 were previously shown to regulate the trafficking of Myb3 from cytoplasmic membrane compartments towards the nucleus. In this study, TvCyP2 was identified as a second cyclophilin that binds to Myb3 at the same dipeptide motifs. The enzymatic proficiency of TvCyP2, but not its binding to Myb3, was aborted by a mutation of Arg75 in the catalytic domain. TvCyP2 was localized to the endoplasmic reticulum with a weak signal that extensively extends into the cytoplasm as well as to the plasma membrane according to an immunofluorescence assay. Moreover, TvCyP2 was co-enriched with TvCyP1 and Myb3 in various membrane fractions purified by differential and gradient centrifugation. TvCyP2 was found to proficiently enzymatically regulate the distribution of TvCyP1 and Myb3 among purified membrane fractions, and to localize TvCyP1 in hydrogenosomes and on plasma membranes. Protein complexes immunoprecipitated from lysates of cells overexpressing TvCyP1 and TvCyP2 were found to share some common components, like TvCyP1, TvCyP2, TvBip, Myb3, TvHSP72, and the hydrogenosomal heat shock protein 70 (HSP70). Direct interaction between TvCyP1 and TvCyP2 was confirmed by a GST pull-down assay. Fusion of vesicles with hydrogenosomes was observed by transmission electron microscopy, whereas TvCyP1, TvCyP2, and Myb3 were each detected at the fusion junction by immunoelectron microscopy. These observations suggest that T. vaginalis may have evolved a novel protein trafficking pathway to deliver proteins among the endomembrane compartments, hydrogenosomes and plasma membranes.

The LC3-conjugation machinery specifies the loading of RNA-binding proteins into extracellular vesicles.

Traditionally viewed as an autodigestive pathway, autophagy also facilitates cellular secretion; however, the mechanisms underlying these processes remain unclear. Here, we demonstrate that components of the autophagy machinery specify secretion within extracellular vesicles (EVs). Using a proximity-dependent biotinylation proteomics strategy, we identify 200 putative targets of LC3-dependent secretion. This secretome consists of a highly interconnected network enriched in RNA-binding proteins (RBPs) and EV cargoes. Proteomic and RNA profiling of EVs identifies diverse RBPs and small non-coding RNAs requiring the LC3-conjugation machinery for packaging and secretion. Focusing on two RBPs, heterogeneous nuclear ribonucleoprotein K (HNRNPK) and scaffold-attachment factor B (SAFB), we demonstrate that these proteins interact with LC3 and are secreted within EVs enriched with lipidated LC3. Furthermore, their secretion requires the LC3-conjugation machinery, neutral sphingomyelinase 2 (nSMase2) and LC3-dependent recruitment of factor associated with nSMase2 activity (FAN). Hence, the LC3-conjugation pathway controls EV cargo loading and secretion.

Dentists' performance in dentin-composite resin bonding before and after hands-on course learning.

BACKGROUND/PURPOSE: The restoration longevity depends on a high dentin-composite bond quality. This study investigated learning outcomes when using etch-and-rinse and self-etch adhesives among general practitioners in a hands-on bonding test course. METHODS: We recruited 30 general practitioners to perform shear bond strength (SBS) tests using five adhesives: one Peak® Universal Bond (PUB) etch-and-rinse and four Futurabond DC, Single Bond universal (SBU), Versa Optibond (VOB), and Tetric-N Bond Self-Etch (TNS) self-etch adhesives. SBS tests were conducted at pre-demonstration (pre-demo), post-demonstration (post-demo), and 24-h storage (delayed bonding) stages. SBS data were analyzed with paired Student's t-tests. We defined 17 MPa as "qualified bond strength (QBS)". The percentages of samples with SBS achieving QBS were analyzed using Mantel-Haenszel chi-square tests. The fracture surfaces of the samples were examined by scanning electron microscopy (SEM). RESULTS: Using PUB caused no significant differences in SBS between pre- and post-demo samples, whereas the SBS of the two self-etch adhesives (SBU and VOB) improved in post-demo samples (p < 0.05). SBU showed the highest percentage of samples with SBS achieving QBS in all three groups (pre-demo = 70%, post-demo = 83%, and delayed bonding = 76.5%). The QBS percentages of VOB and TNS notably improved from 0% (pre-demo) to 71.4% and 23.5% (post-demo), respectively. SEM indicated bubble-like defects at the dentin-resin interfaces in cases of low SBS. CONCLUSION: Bonding performance is both operator- and product-dependent. The continuing education hands-on course does help dentists to improve the bond strength especially when the self-etch system is used.

Synergistic symptom-specific effects of ketorolac-tramadol and ketorolac-pregabalin in a rat model of peripheral neuropathy.

BACKGROUND: Although current neuropathic pain treatment guidelines do not recommend the use of nonsteroidal anti-inflammatory drugs (NSAIDs), whether NSAIDs can serve as a useful adjuvant to conventional multimodal therapy remains unclear. METHODS: The spared nerve injury (SNI) rats rapidly developed profound and long-lasting spontaneous and evoked pain behaviors, including mechanical and cold allodynia of the ipsilateral hind paw. At day 5, we first characterized the nociceptive responses to ketorolac, tramadol, pregabalin, and their combinations. RESULTS: We found that tramadol and pregabalin exerted dose-dependent analgesic effects on both spontaneous and evoked behaviors. However, ketorolac alone did not suppress any behaviors regardless of the dose. Ketorolac-tramadol and ketorolac-pregabalin produced variable degrees of additive suppression of spontaneous and evoked behavioral responses. Cold allodynia was profoundly diminished after ketorolac was added to ineffective pregabalin or tramadol. Mechanical allodynia was markedly attenuated by ketorolac-pregabalin but less so by ketorolac-tramadol mixtures. CONCLUSION: Our data demonstrated that an NSAID alone failed to relieve spontaneous or evoked pain behaviors in the rat SNI model, but when combined with a weak opioid and α-2-δ-ligand produced a profound synergistic analgesic effect on cold allodynia and discrepant efficacy for mechanical allodynia and spontaneous pain.