Effect of finishing protocols and staining solutions on color stability of dental resin composites.

OBJECTIVE: The objective of this study was to evaluate the effect of finishing protocol and exposure to staining solutions on color stability of dental resin composites. MATERIALS AND METHODS: A nanofill and microhybrid composite, three finishing protocols (mylar, Soflex disc, and white polishing stone) and four staining solutions (tea, red wine, khat extract-two concentrations, control-distilled water) were evaluated. A digital spectrophotometer was used for color change (ΔE) measurements employing the CIE-Lab-color system. Paired/independent-sample t test and two-way analysis of variance (ANOVA) followed by Tukey's honestly significant difference posthoc test were used for inferential statistics at α = .05. RESULTS: Soflex finish was associated with least staining and comparable color stability for the two materials in tea and red wine. In Khat 2, microhybrid composite had statistically significant better color stability than nanofill for Soflex finish (14 days t = 3.270, p = .011). For microhybrid composite, mylar resulted in highest mean ΔE, whereas Soflex recorded the least in all staining solutions. For nanofill composite, white stone resulted in highest mean ΔE, whereas Soflex demonstrated the least mean ΔE in all staining solutions, except red wine where mylar demonstrated the least mean ΔE. For mylar finish, nanofill demonstrated statistically significant better color stability than microhybrid in both red wine (14 days t = 4.902, p = .001) and Khat 1 (14 days t = 3.252, p = .012). For stone finish, microhybrid demonstrated statistically significant better color stability than nanofill in all staining solutions (14 days t ≥ 4.785, p ≤ .001). Two-way ANOVA showed a statistically significant difference in mean ΔE between and within specimens (F = 42.658, p < .001). All staining solutions caused clinically unacceptable discoloration for mylar and white stone finish. For Soflex finish, red wine produced clinically unacceptable color difference beyond 48 h. CONCLUSION: There was a difference in color stability of resin composites depending on filler type, further influenced by finishing protocol. Soflex disc finish results in better color stability than mylar and white stone in both microhybrid and nanofill composites. CLINICAL SIGNIFICANCE: Esthetic dental restorations such as resin composites are routine in contemporary restorative practice. Color stability of composites may be influenced by surface finish, dependent on the filler type, and consumption of chromogenic substances such as khat. To prolong their service, selection of suitable finishing protocols is an important consideration.

AI-assisted tracking of worldwide non-pharmaceutical interventions for COVID-19.

The Coronavirus disease 2019 (COVID-19) global pandemic has transformed almost every facet of human society throughout the world. Against an emerging, highly transmissible disease, governments worldwide have implemented non-pharmaceutical interventions (NPIs) to slow the spread of the virus. Examples of such interventions include community actions, such as school closures or restrictions on mass gatherings, individual actions including mask wearing and self-quarantine, and environmental actions such as cleaning public facilities. We present the Worldwide Non-pharmaceutical Interventions Tracker for COVID-19 (WNTRAC), a comprehensive dataset consisting of over 6,000 NPIs implemented worldwide since the start of the pandemic. WNTRAC covers NPIs implemented across 261 countries and territories, and classifies NPIs into a taxonomy of 16 NPI types. NPIs are automatically extracted daily from Wikipedia articles using natural language processing techniques and then manually validated to ensure accuracy and veracity. We hope that the dataset will prove valuable for policymakers, public health leaders, and researchers in modeling and analysis efforts to control the spread of COVID-19.

Factors associated with physical violence by a sexual partner among girls and women in rural Kenya.

BACKGROUND: Intimate partner physical violence increases women's risk for negative health outcomes and is an important public health concern. The purpose of the present study was to determine 1) the proportion of girls (≤18 years) and women (>18 years) who experienced physical violence by a sexual partner, and 2) factors (including self-reported HIV infection) associated with girls and women who experienced physical violence by a sexual partner. METHODS: Cross-sectional surveys conducted in the Gem Health and Demographic Surveillance System (HDSS) area in Siaya County, western Kenya in 2011-2012 (Round 1) and 2013-2014 (Round 2). FINDINGS: Among 8003 unique participants (582 girls and 7421 women), 11.6% reported physical violence by a sexual partner in the last 12 months (girls: 8.4%, women: 11.8%). Three factors were associated with physical violence by a sexual partner among girls: being married or cohabiting (nearly 5-fold higher risk), low education, and reporting forced sex in the last 12 months (both with an approximate 2-fold higher risk). Predictive factors were similar for women, with the addition of partner alcohol/drug use and deliberately terminating a pregnancy. Self-reported HIV status was not associated with recent physical violence by a sexual partner among girls or women. CONCLUSIONS: Gender-based physical violence is prevalent in this rural setting and has a strong relationship with marital status, low education level, and forced sex among girls and women. Concerted efforts to prevent child marriage and retain girls in school as well as implementation of school and community-based anti-violence programs may help mitigate this risk.

Complementary and Alternative Medicine Use in Rheumatoid Arthritis: Considerations for the Pharmacological Management of Elderly Patients.

Complementary and alternative medicines (CAMs) are widely used by patients with rheumatoid arthritis (RA); however, a significant proportion of these patients do not inform their physicians. This has many potential implications in a group of predominantly elderly patients with altered pharmacokinetics, comorbidities and polypharmacy of potentially toxic drugs. CAM usage may affect compliance and pharmacokinetics of conventional therapy for RA and comorbidities; therefore, physicians should engage patients in dialogues regarding CAM usage. This review introduces common CAMs used by RA patients, such as herbal remedies, supplements, and fish and plant oils, and their potential impact on conventional therapy. Efficacy of these treatments are not reviewed in detail but references for reviews and trials are provided for further reading. Fish oils and vitamin D supplementation may generally be recommended, while thunder god vine should be avoided. Patients should also be made aware of the risks of contamination and adulteration of less reputable sources of CAMs, and directed to evidence-based sources of information. Physicians should acknowledge the limitations of scientific evidence and not be prejudiced or dogmatic; however, they should remain resolute against therapies that are known to be ineffective or unsafe.

Mortality trends in the era of antiretroviral therapy: evidence from the Network for Analysing Longitudinal Population based HIV/AIDS data on Africa (ALPHA).

BACKGROUND: The rollout of antiretroviral therapy (ART) is one of the largest public health interventions in Eastern and Southern Africa of recent years. Its impact is well described in clinical cohort studies, but population-based evidence is rare. METHODS: We use data from seven demographic surveillance sites that also conduct community-based HIV testing and collect information on the uptake of HIV services. We present crude death rates of adults (aged 15-64) for the period 2000-2011 by sex, HIV status, and treatment status. Parametric survival models are used to estimate age-adjusted trends in the mortality rates of people living with HIV (PLHIV) before and after the introduction of ART. RESULTS: The pooled ALPHA Network dataset contains 2.4 million person-years of follow-up time, and 39114 deaths (6893 to PLHIV). The mortality rates of PLHIV have been relatively static before the availability of ART. Mortality declined rapidly thereafter, with typical declines between 10 and 20% per annum. Compared with the pre-ART era, the total decline in mortality rates of PLHIV exceeds 58% in all study sites with available data, and amounts to 84% for women in Masaka (Uganda). Mortality declines have been larger for women than for men; a result that is statistically significant in five sites. Apart from the early phase of treatment scale up, when the mortality of PLHIV on ART was often very high, mortality declines have been observed in PLHIV both on and off ART. CONCLUSION: The expansion of treatment has had a large and pervasive effect on adult mortality. Mortality declines have been more pronounced for women, a factor that is often attributed to women's greater engagement with HIV services. Improvements in the timing of ART initiation have contributed to mortality reductions in PLHIV on ART, but also among those who have not (yet) started treatment because they are increasingly selected for early stage disease.