Surface Properties and Wear Resistance of Injectable and Computer-Aided Design/Computer Aided Manufacturing-Milled Resin Composite Thin Occlusal Veneers.

OBJECTIVES: This study was conducted to investigate the microhardness, surface roughness (Ra), and wear behavior of thin occlusal veneers (TOV) fabricated from different injectable composite materials and compare them to a Computer-Aided Design (CAD)/Computer-Aided Manufacturing (CAM) resin-based material. MATERIALS AND METHODS: A 1-mm occusal veneer preparation was done in a mandibular right second molar typodont tooth. The prepared model was duplicated to fabricate 32 replicas and divided into four groups (n = 8). Standard TOV were fabricated either indirectly from Cerasmart blocks, Cerasmart, GC (CS), or directly from Beautifil Injectable X, Shofu (BF), G-ænial Universal injectable, GC (GU), or SonicFill 2, Kerr (SF) using the injection molding technique. All the specimens were subjected to both thermomechanical cyclic loading (TMC) in a chewing simulator. Wear measurement was conducted by three-dimensional (3D) scanning of the veneered models before and after TMC, and the difference in the volume of the sample was recorded as the volumetric material loss due to wear. Ra before and after TMC and Vickers microhardness (VHN) of the tested materials were measured using standardized samples (n = 8). Representative samples from each group were investigated under a stereomicroscope and a scanning electron microscope. STATISTICAL ANALYSIS: One-way analysis of variance (ANOVA) was applied to detect the effect of material on VHN and wear. Two-way ANOVA was utilized to examine the impact of material and TMC on Ra. Multiple comparisons between the groups were conducted using Tukey's post hoc test (α = 0.05). The Pearson's correlation coefficient was used to determine the relationship between hardness and wear and between roughness and wear (α = 0.05). RESULTS: CS exhibited the highest mean VHN (p ≤ 0.001), followed by GU and SF which were statistically similar (p = 0.883) but significantly higher than BF (p < 0.001). After TMC, GU revealed the lowest Ra and volumetric wear (VW), followed by CS, BF, and SF (p < 0.5). A highly significant correlation existed between Ra and VW (p = 0.001, R 2 = 0.9803). CONCLUSION: The effect of TMC on the surface properties and wear resistance of the investigated TOV is material-dependent. GU injectable TOV are less influenced by TMC than CS milled TOV. In contrast, BF and SF demonstrated significant VW and Ra which might limit their clinical use as TOV.

Exercise is Medicine on Campus: A Scoping Review of Evidence 2009 to 2021 and Call to Action.

ABSTRACT: The Exercise is Medicine On Campus (EIM-OC) program began in 2009 at Chatham University by Dr. Robert Sallis, Dr. Carena Winters, and ACSM leadership. The vision of EIM-OC is "to see all campus and community members across multiple disciplines discover, share, and adopt the principles of EIM that will help change the culture of physical activity and chronic disease prevention and management campus wide." Although EIM-OC maintains close track of programmatic details, such as the number of registered and recognized institutions, a comprehensive review of EIM-OC publications has not been previously reported. The purpose of this scoping review was to 1) identify and examine all peer-reviewed evidence of EIM-OC, including scholarly articles and published abstracts of presentations; 2) analyze the key themes of EIM-OC implementation and outcomes; and 3) identify gaps in the literature. The scoping review covered all peer-reviewed publications, including scholarly articles and published abstracts, from 2009 to December 2021. In total, 9 scholarly articles and 46 published abstracts were included in this review. The articles and abstracts covered a wide range of topics, including gold level (physical activity assessment and exercise referral), silver level (physical activity education), and bronze level (physical activity awareness and promotion) activities, as well as evaluation of EIM-OC programming. Now that EIM-OC programming is firmly established, we now call on campuses and leaders to strengthen their reporting of EIM-OC outcomes at all levels: gold, silver, and bronze. Publishing research evidence will strengthen EIM-OC programming and initiatives. Specifically, we encourage publishing scholarly articles and using broad means for increasing dissemination.

Bone marrow aspirate injection for osteoarthritis of the hip; A pilot study.

Objectives: Bone marrow aspirate (BMA) intra-articular injection is a minimally invasive orthobiologic treatment option for osteoarthritis (OA). Hip OA affects a significant portion of the population and has a paucity of data surrounding orthobiologic treatments. The primary objective of this study was to delineate the clinical impact of bone marrow aspirate intra-articular injections on decreasing pain and improving function in patients with hip OA. Methods: A single-center, retrospective analysis of thirty-one patients, aged 32 to 83 (62.4 â€‹± â€‹16.5), with Kellgren-Lawrence (KL) Hip OA grading of 2-4 (mean 2.9 â€‹± â€‹0.7), who underwent intra-articular bone marrow aspirate injection into the hip and were followed for twelve months. Evaluation was at baseline, 12 weeks, 6 months, and 12 months using the Numerical Rating Scale (NRS) for pain and the Hip Disability and Osteoarthritis Outcome Score Jr (HOOS-Jr) for function. The proportion of responders, as defined by a ≥50% reduction in NRS pain score, was assessed at 12 weeks, 6 months and 12 months. Results: At 6 and 12 months follow-up, there was a statistically significant improvement in NRS scores (P â€‹< â€‹0.05). Stratifying by KL grade, subjects with KL grades 2 and 3 experienced statistically significant improvement in NRS scores at 6 and 12 months. Patients with KL grade 4 showed significant improvement in pain at 12 months. Forty-two percent of patients at 6 months and 61% at 12 months reported ≥50% reduction in pain. When stratifying by KL grade, 80% and 71% of KL2 and KL3 grades respectively were responders by 12 months. Patients experienced statistically significant improvement in HOOS-Jr scores at 6 and 12 months. Conclusion: In patient with mild, moderate, and severe hip OA, BMA may be an alternative treatment that improves pain and function in patients for as long as 12 months. In addition, BMA may also be an effective, lower cost option to more expensive BMAC preparations.

Methods for Quantifying Optic Disc Volume and Peripapillary Deflection Volume Using Radial Optical Coherence Tomography Scans and Association With Intracranial Pressure.

Purpose: Papilledema and peripapillary deformation of Bruch's membrane (BM) are associated with elevated intracranial pressure (ICP). We have developed a novel methodology to measure these parameters using a radial optical coherence tomography (OCT) scan pattern and apply this to test the hypothesis that ICP is associated with volumetric features of ophthalmic structures. Methods: 6-radial OCT B-scans centered over the optic nerve head were acquired in 17 subjects (30 eyes) before lumbar puncture with measurement of ICP (range: 10-55 cm H2O). Internal limiting membrane (ILM) and BM were segmented. Three definitions of BM were studied to account for imaging artifact affecting peripapillary BM: connecting rater-identified BM margins(traditional), connecting rater-identified BM 1.6 mm on either side of the ONH(estimated), and excluding BM in the central 3.2 mm of the images(excluded). Optic nerve head volume (ONHV), BM displacement volume (BMDV) and cup volume (CV) were calculated by interpolating between B-scans. Ganglion cell complex volume (GCCV) was measured in the macula. Linear generalized estimating equations (GEE) modeled ONVH, BMDV, and CV as a function of ICP and GCCV. Results: Increased ONHV was associated with elevated ICP for traditional (p = 0.006), estimated (p = 0.003) and excluded (p = 0.05) BM definitions. Decreased BMDV was associated with elevated ICP for traditional (p < 0.0005), estimated (p < 0.0005) and excluded (p = 0.001) definitions. Decreased ONHV was independently associated with decreased GCCV (p = 0.001) and decreased ICP (p = 0.031) in multivariable models. CV was neither associated with ICP nor GCCV in univariate or multivariable models. Conclusions: Elevated ICP is associated with ONHV increase and BMDV decrease, calculated from OCT images accounting for image artifact. Ganglion cell atrophy affects the relationship between ICP and ONHV. OCT derived volumetric measures of the posterior eye may have application as biomarkers for elevated ICP.

Retinal Vessel Diameters Change Within 1 Hour of Intracranial Pressure Lowering.

PURPOSE: We tested the hypotheses that retinal venule diameter (Dv) is associated with baseline intracranial pressure (ICP) level and that Dv is reduced shortly after ICP lowering. METHODS: Dv and arteriole diameter (Da) were extracted from scanning laser ophthalmoscopic images in 40 eyes of 20 adult human subjects (10 with and 10 without papilledema) immediately before and after measurement of ICP (range, 10-55 cm H2O) and ICP lowering by cerebrospinal fluid (CSF) drainage via lumbar puncture (LP). Generalized estimating equations (GEE) modeled the relationship between baseline ICP, Da and Dv before LP. Additional GEE modeled the relationship between initial ICP and change in Da and Dv (post-LP - pre-LP) following ICP lowering. RESULTS: Test-retest variability of diameter measurements ranged from 0.1 to 2.9 µm (0.1%-2.72%). Neither Da nor Dv pre-LP was associated with baseline ICP level (P = 0.140 Dv, P = 0.914 Da, GEE). Da and Dv change after ICP lowering was associated with baseline ICP, with vessel diameters increasing with lower baseline ICP and decreasing with elevated initial ICP (P = 0.030 baseline ICP vs. Dv change, P = 0.012 baseline ICP vs. Da change, GEE models). CONCLUSIONS: Retina arteriole and venule diameters change immediately following ICP lowering. The direction of change is dependent on the initial ICP; both increased in subjects with high ICP and both decreased in subjects with normal ICP. TRANSLATIONAL RELEVANCE: The relationship between initial ICP and direction of retinal vessel size change following ICP lowering suggests a potential effect of ICP on cerebral and ocular hemodynamics that is relevant when considering the use of retinal vessel measurements as a clinical marker of ICP change.

Association Between Peripapillary Bruch's Membrane Shape and Intracranial Pressure: Effect of Image Acquisition Pattern and Image Analysis Method, a Preliminary Study.

Background/Aims: High intracranial pressure (ICP) is associated with changes in peripapillary Bruch's membrane (pBM) shape on optical coherence tomography (OCT) images of the optic nerve head. It is not known if image acquisition pattern and analysis method impact this association. Materials and Methods: Cross sectional OCT scans of the optic nerve head were obtained at six angles using a radial scan pattern in 21 subjects immediately prior to ICP measurement via lumbar puncture. On each image, Bruch's membrane was manually segmented and defined by either 14 or 16 semi-landmarks and either rater identified, or distance identified boundaries. For each of these four image analysis strategies, geometric morphometric analysis identified the first principal component of Bruch's membrane shape for all images and for the set of images taken at each angle. Repeated measures ANOVA of the first principal component magnitude (PC1) for all images assessed for shape difference between image angles. Linear generalized estimating equation models assessed association between angle specific first principal component magnitudes (PC1) and ICP for each angle. Receiver operating characteristic analysis assessed angle specific PC1s' ability to differentiate elevated from normal ICP. Results: The first principal component represented deflection into the vitreous for all scan angles, but quantitatively differed across scan angles (p < 0.005, repeated measures ANOVA). Angle specific first principal components were positively correlated with ICP (p < 0.005 for all angles, generalized estimating equation models). All angle specific first principal components showed excellent ability to classify ICP (area under curve ≥ 0.8 for all). These results were independent from image analysis strategy. Discussion: Though qualitative changes in Bruch's membrane shape are similar regardless of cross-sectional angle of the 2-D OCT scan, they differ quantitatively between OCT scan angles, meaning that pBM is not axially symmetric and therefore PC1 extracted from different 2-D scan angles can't be compared between individuals. However, we do not identify an optimal scan angle for classification of ICP since there is a similarly strong linear relationship between the first principal component of shape and ICP and angle specific first principal components of Bruch's membrane shape showed similarly excellent ability to differentiate elevated from normal ICP. The results support development of Bruch's membrane shape extracted from 2-D cross sectional optic nerve head OCT scans as a biomarker of ICP and emphasize the importance of consistency of scan angle. This is relevant for developing diagnostic protocols that use OCT to detect high ICP states.

Quantitative Association Between Peripapillary Bruch's Membrane Shape and Intracranial Pressure.

Purpose: The purpose of this study was to determine if there is a quantitative relationship between chronic intracranial pressure (ICP) and peripapillary Bruch's membrane (pp-BM) shape and to determine whether change in pp-BM shape can be detected within 1 hour after ICP lowering by lumbar puncture (LP). Methods: In this study, 30° nasal-temporal optical coherence tomography B-scans were obtained within 1 hour before and after LP in 39 eyes from 20 patients (age = 23-86 years, 75% female, ICP [opening pressure] = 10-55 cm H2O). A total of 16 semi-landmarks defined pp-BM on each image. Geometric morphometric analysis identified principal components of shape in the image set. Generalized estimating equation models, accounting for within-subject correlation, were used to identify principal components that were associated with chronic ICP (comparing pre-LP images between eyes) and/or acute ICP changes (comparing pre- and post-LP images within eyes). The pp-BM width and anterior pp-BM location were calculated directly from each image and were studied in the same manner. Results: Principal component 1 scalar variable on pre-LP images was associated with ICP (P < 0.0005). Principal component 4 magnitude changed within eyes after LP (P = 0.003). For both principal components 1 and 4, lower ICP corresponded with a more posterior position of pp-BM. Chronic ICP was associated with both pp-BM width (6.81 µm/cm H2O; P = 0.002) and more anterior location of temporal and nasal pp-BM margins (3.41, 3.49 µm/cm H2O; P < 0.0005, 0.002). Conclusions: This study demonstrates a quantitative association between pp-BM shape and chronic ICP level. Changes in pp-BM shape are detectable within 1 hour of lowering ICP. pp-BM shape may be a useful marker for chronic ICP level and acute ICP changes. Further study is needed to determine how pp-BM shape changes relate to clinical markers of papilledema.