Teaching Minimally Invasive Interventions in Paediatric Dentistry: A Cross-Sectional Survey of Dental Schools in Iran.

BACKGROUND: Dental caries is a significant public health problem in Iran. Teaching  minimally invasive interventions in paediatric dentistry may facilitate the provision of treatment for untreated dental caries in children. We evaluated the teaching of such interventions in both undergraduate dental curriculum and Paediatric Dentistry Specialty Training Programme (PDSTP) in Iran. METHODS: This was a cross-sectional questionnaire-based survey. Participants in this study were the directors of 40 undergraduate programmes and 15 PDSTPs in all Iranian dental schools (response rate = 100%). Descriptive statistics were reported. RESULTS: The most commonly taught methods were preventive fissure sealant and preventive resin restoration (PRR), which were taught 'both didactically and clinically' in all undergraduate dental programmes. The least commonly taught methods were silver diamine fluoride (SDF), the Hall technique and resin infiltration, which were taught 'both didactically and clinically' in less than 5% of dental schools. The same three methods were the least commonly approaches taught in PDSTP, further, they were less often perceived to be 'essential'. CONCLUSIONS: There was a notable variation in the teaching of the management of dental caries in Iran's dental education. Some minimally invasive approaches including SDF, the Hall technique and resin infiltration are not being commonly taught in Iranian dental schools despite the evidence base for these techniques.

Differential molecular response of maize and Johnson grass against maize dwarf mosaic virus and bermuda grass southern mosaic virus.

Maize dwarf mosaic virus (MDMV) and bermuda grass southern mosaic virus (BgSMV) is the most important cereal potyvirus in Iran. Expression of some key genes in maize plants susceptible and tolerant to MDMV or BgSMV and gene expression profile of MDMV and BgSMV compatible or incompatible to Johnson grass plants were studied. Time points of 1, 9, 24 and 72 h after inoculation with both viruses were investigated as well. By analyzing the expression of the genes, it was identified that in maize infected by MDMV and BgSMV, the transcript levels of the peroxiredoxin, GLP, SAM, NPR1 and chlorophyll a-b binding genes were significantly higher in the tolerant than in susceptible plants during the entire experiment. In the BgSMV inoculated Johnson grass plants, some of the genes related to plant defense responses including NPR1, peroxiredoxin and SAM had higher expression level than the Johnson grass plants inoculated by MDMV. Important genes in maize tolerance like NPR1 and MT-LP, were analyzed by trilinear decomposition analysis and genes clustering. The upregulated expression of genes at one-hour post inoculation showed that the plant response to viruses was activated at the early stage of infection. Keywords: MDMV; BgSMV; gene expression; quantitative real-time PCR; trilinear decomposition analysis.

Comparative evaluation of cervical pulpotomy and pulpectomy for primary molars with irreversible pulpitis: a multicentre randomised controlled trial.

PURPOSE: The objective of this multicentre randomised controlled trial was to compare the clinical/radiographic outcomes of cervical pulpotomy using calcium-enriched mixture cement (PCEM) and pulpectomy using Metapex (PM) in primary molars with irreversible pulpitis (IP). METHODS: A total of 134 primary molars from 94 children were randomly assigned to two intervention groups: the PCEM group (n = 74) and the PM group (n = 60). Baseline characteristics including age/gender/molar type/tooth type/jaw were recorded. The primary outcome measures were clinical/radiographic success rates assessed at the first and second follow-up appointments. Secondary outcomes included reasons for clinical/radiographic failures. Multiple logistic regression analysis was performed to determine the impact of various factors on the success rates. RESULTS: The mean age of the participants in both groups was similar (PCEM group: 5.4 years, PM group: 5.5 years). Gender distribution, molar type, tooth type, jaw, and number of practitioners were comparable between the groups. The clinical success rate at the first follow-up was 98.6% in the PCEM group and 96.4% in the PM group. At the second follow-up, the clinical success rate was 97.1% in the PCEM group and 91.1% in the PM group. The radiographic success rates at the first and second follow-up were 98.6% and 96.4% in the PCEM group and 96.4% and 91.1% in the PM group, respectively. Multiple logistic regression analysis did not reveal any significant association between the success rates and age/gender/molar type/jaw, or treatment groups (P > 0.05). CONCLUSION: In primary molars with IP, both simple/conservative cervical pulpotomy using calcium-enriched mixture cement and pulpectomy using Metapex demonstrated high clinical/radiographic success rates. No significant differences were observed between the two treatment modalities. These findings suggest that both techniques can be considered effective treatment options for managing primary molars with IP. TRIAL REGISTRATION NUMBER: Trial registration number: IRCT20201226049838N1, retrospectively registered on 12 January 2021.

High-harmonic fast-wave power flow along magnetic field lines in the scrape-off layer of NSTX.

A significant fraction of high-harmonic fast-wave (HHFW) power applied to NSTX can be lost to the scrape-off layer (SOL) and deposited in bright and hot spirals on the divertor rather than in the core plasma. We show that the HHFW power flows to these spirals along magnetic field lines passing through the SOL in front of the antenna, implying that the HHFW power couples across the entire width of the SOL rather than mostly at the antenna face. This result will help guide future efforts to understand and minimize these edge losses in order to maximize fast-wave heating and current drive.

Effect of collisionality on kinetic stability of the resistive wall mode.

The impact of collisionless, energy-independent, and energy-dependent collisionality models on the kinetic stability of the resistive wall mode is examined for high pressure plasmas in the National Spherical Torus Experiment. Future devices will have decreased collisionality, which previous stability models predict to be universally destabilizing. In contrast, in kinetic theory reduced ion-ion collisions are shown to lead to a significant stability increase when the plasma rotation frequency is in a stabilizing resonance with the ion precession drift frequency. When the plasma is in a reduced stability state with rotation in between resonances, collisionality will have little effect on stability.

Evidence for the importance of trapped particle resonances for resistive wall mode stability in high beta tokamak plasmas.

Active measurements of the plasma stability in tokamak plasmas reveal the importance of kinetic resonances for resistive wall mode stability. The rotation dependence of the magnetic plasma response to externally applied quasistatic n=1 magnetic fields clearly shows the signatures of an interaction between the resistive wall mode and the precession and bounce motions of trapped thermal ions, as predicted by a perturbative model of plasma stability including kinetic effects. The identification of the stabilization mechanism is an essential step towards quantitative predictions for the prospects of "passive" resistive wall mode stabilization, i.e., without the use of an "active" feedback system, in fusion-alpha heated plasmas.

Continuous improvement of H-mode discharge performance with progressively increasing lithium coatings in the National Spherical Torus Experiment.

Lithium wall coatings have been shown to reduce recycling, improve energy confinement, and suppress edge localized modes in the National Spherical Torus Experiment. Here, we show that these effects depend continuously on the amount of predischarge lithium evaporation. We observed a nearly monotonic reduction in recycling, decrease in electron transport, and modification of the edge profiles and stability with increasing lithium. These correlations challenge basic expectations, given that even the smallest coatings exceeded that needed for a nominal thickness of the order of the implantation range.

When Should a Brain MRI Be Performed in Children with New-Onset Seizures? Results of a Large Prospective Trial.

BACKGROUND AND PURPOSE: There is a paucity of data regarding the incidence of structural brain lesions in children with new-onset unprovoked seizures. Our aim was to determine the frequencies and types of epileptogenic lesions detected on a dedicated epilepsy protocol MR imaging according to age group, the presence of developmental delay, and the number and types of seizures. MATERIALS AND METHODS: Consecutive children between 6 months and 18 years of age with new-onset unprovoked seizures were included. The frequencies and types of epileptogenic lesions were determined and then stratified according to sex, age groups, the presence of developmental delay, and the number and types of seizures at presentation. Multivariate analysis was used to identify variables significantly associated with the presence of epileptogenic lesions. RESULTS: One thousand children were included. An epileptogenic lesion was identified in 26%, with malformations of cortical development being the most common lesion (32%), followed by hypoxic-ischemic injury (20%) and vascular etiologies (16%). Univariate analysis showed a significant increase in the frequency of epileptogenic lesions with decreasing age, the presence of developmental delay, and the number and types of seizures at presentation. The presence of developmental delay and seizure type at presentation remained significant in a multivariate analysis. CONCLUSIONS: We documented a relatively high rate of epileptogenic lesions in children with new-onset seizures, with the presence of developmental delay and specific seizure types being associated with a higher likelihood of detecting an epileptogenic lesion on neuroimaging. This study fulfills the requirements of the study design recommended by the Practice Committee of the American Academy of Neurology, and we hope that our results will assist the relevant societies and committees in formulating neuroimaging guidelines for children with new-onset seizures.

Resistive wall mode instability at intermediate plasma rotation.

Experimental observation of resistive wall mode (RWM) instability in the National Spherical Torus Experiment (NSTX) at plasma rotation levels intermediate to the ion precession drift and ion bounce frequencies suggests that low critical rotation threshold models are insufficient. Kinetic modifications to the ideal stability criterion yield a more complex relationship between plasma rotation and RWM stability. Good agreement is found between an experimental RWM instability at intermediate plasma rotation and the RWM marginal point calculated with kinetic effects included, by the MISK code. By self-similarly scaling the experimental plasma rotation profile and the collisionality in the calculation, resonances of the mode with the precession drift and bounce frequencies are explored. Experimentally, RWMs go unstable when the plasma rotation is between the stabilizing precession drift and bounce resonances.

Demonstration of Tokamak ohmic flux saving by transient coaxial helicity injection in the national spherical torus experiment.

Transient coaxial helicity injection (CHI) started discharges in the National Spherical Torus Experiment (NSTX) have attained peak currents up to 300 kA and when coupled to induction, it has produced up to 200 kA additional current over inductive-only operation. CHI in NSTX has shown to be energetically quite efficient, producing a plasma current of about 10 A/J of capacitor bank energy. In addition, for the first time, the CHI-produced toroidal current that couples to induction continues to increase with the energy supplied by the CHI power supply at otherwise similar values of the injector flux, indicating the potential for substantial current generation capability by CHI in NSTX and in future toroidal devices.

On demand triggering of edge localized instabilities using external nonaxisymmetric magnetic perturbations in toroidal plasmas.

The application of nonaxisymmetric magnetic fields is shown to destabilize edge-localized modes (ELMs) during otherwise ELM-free periods of discharges in the National Spherical Torus Experiment (NSTX). Profile analysis shows the applied fields increased the temperature and pressure gradients, decreasing edge stability. This robust effect was exploited for a new form of ELM control: the triggering of ELMs at will in high performance H mode plasmas enabled by lithium conditioning, yielding high time-averaged energy confinement with reduced core impurity density and radiated power.

Triggered confinement enhancement and pedestal expansion in high-confinement-mode discharges in the national spherical torus experiment.

We report observation of a new high performance regime in discharges in the National Spherical Torus Experiment, where the H mode edge "pedestal" temperature doubles and the energy confinement increases by 50%. The spontaneous transition is triggered by a large edge-localized mode, either natural or externally triggered by 3D fields. The transport barrier grows inward from the edge, with a doubling of both the pedestal pressure width and the spatial extent of steep radial electric field shear. The dynamics suggest that 3D fields could be applied to reduce edge transport in fusion devices.

Root exudate impact on gene expression of Sporisorium reilianum.

Sporisorium reilianum f.sp zeae, a basidiomycetous fungus belonging to Ustilaginaceae, is the causal agent of the maize head smut disease. This soilborne pathogen infects the host plant at the seedling stage by penetrating roots. The infection is systemic, and disease symptoms become apparent only after the onset of flower development when the fungal sori replace male or female inflorescences. In order to investigate the mechanism of infection, we analysed the transcriptome of the fungus in response to root exudates during the previous phase of infection. A suppression subtractive hybridization (SSH) was used to generate cDNA libraries representing genes differentially expressed in haploid cell forms of the fungus exposed to root exudates Leading to 960 ESTs. By using cDNA macroarray hybridization, we identified 36 ESTs which were differentially expressed in response to exudates application. In this first transcriptomic analysis realized on S. reilianum, we show that maize root exudates may affect gene expression of the fungus involved in cell respiration, cell wall development, metabolism and hypothetical proteins during the previous step of infection and could play an important role in fungi growth promotion and plant pathogenesis.

[Quality of life in children with epilepsy: a review]. / La qualité de vie chez l'enfant avec épilepsie: revue de la littérature.

Health-related quality of life (HRQOL) is a multidimensional construct, without general agreement on the number of domains and the content of each domain. In children with epilepsy, the HRQOL evaluation includes both nonspecific aspects, such as behavioral, psychological and cognitive difficulties and the impact of a chronic pediatric illness on the child and its family and specific aspects, such as the perception of the severity of the seizures and of the undesirable effects of the antiepileptic treatments, as well as the social impact of a negative attitude toward epilepsy. The present article presents a review of the methods proposed for the assessment of HRQOL in children with epilepsy. Most methods rely on parental reports; however, there is an increasing effort to develop tools taking the child's point of view into account. HRQOL tools have often been used in clinical trials and, especially, to evaluate the surgical treatments of epilepsy. For the clinician, HRQOL tools may be a preliminary approach to the patient's problems to be interpreted in relation to the patient's medical, psychological, cognitive, social and familial context. In France, few large-scale studies on HRQOL in children with epilepsy have been conducted. We present the preliminary results of a French study based on parental reports.

Isolation of a natural solopathogenic strain of Sporisorium reilianum f.sp. zeae (Ustilaginaceae, Basidiomycetes).

Sporisorium reilianum f.sp. zeae (Kühn) Langdon and Fullerton (Basidiomycota, Ustilaginaceae) is the causal agent of head smut of maize and sorghum. The parasitism is initiated by the fusion of two compatible sporidia which give rise to the formation of dikaryotic pathogen hyphae. However, in Ustilaginaceae, some fuzzy diploid strains could also be formed. These strains are solopathogen as they can infect a host in absence of crossing with a compatible haploid sporidia. A solopathogenic strain of S. refilianum was obtained using an original protocol. Sporidia were isolated from germinated teliospores and spread on solid medium to identify stable fuzzy solopathogenic strain. Confocal observations of the solopathogenic strain (SRZS1) after nucleus staining with propidium iodide indicates that they are formed by rounded shape cells which are monokaryotic. A CAPS approach was used to analysis the matb gene of S. reilianum. The presence of two matb loci in SRZS1 showed that this monocaryotic strain is diploid. The pathogenicity of SRZS1 was investigated by maize infection. Our results confirmed that SRZS1 is infectious, induces some typical symptoms in maize but could not sporulate and form sori.

Clinical and radiographic outcomes of laser pulpotomy in vital primary teeth: a systematic review and meta-analysis.

AIM: This was to compare clinical and radiographic success rates of laser pulpotomy with those of other pulpotomy techniques in primary teeth. METHODS: PubMed, SCOPUS, EMBASE, Cochrane and ISI Web of Knowledge databases were searched electronically without time or language limitations. Clinical trials in which laser pulpotomy was compared with at least one other pulpotomy modality in primary teeth were selected. The bibliographic reference lists of eligible articles were also hand-searched. Odds ratios, risk differences and 95% confidence intervals were calculated with the aid of Comprehensive Meta-Analysis software (Version 2.2.050, Biostat, Englewood, NJ, USA). The methodological quality of articles included in the meta-analysis was determined using the Jadad scale. RESULTS: Twelve pulpotomy studies were selected for systematic review and underwent data extraction. Of these studies, statistical analysis was conducted on 11. All clinical trials had low to moderate risks of methodological bias. The meta-analysis showed no significant differences in clinical and radiographic pulpotomy outcomes with laser compared with other techniques (p > 0.05). Likewise, no differences were found in the outcomes at 1, 3, 6, 9, 12 or ≥ 18 months (all p > 0.05). CONCLUSIONS: For primary molar pulpotomy, the laser technique showed comparable clinical and radiographic results to other conventional pulpotomy medicaments, including formocresol and mineral trioxide aggregate.

Simultaneous feedback control of plasma rotation and stored energy on NSTX-U using neoclassical toroidal viscosity and neutral beam injection.

A model-based feedback system is presented enabling the simultaneous control of the stored energy through ßn and the toroidal rotation profile of the plasma in National Spherical Torus eXperiment Upgrade device. Actuation is obtained using the momentum from six injected neutral beams and the neoclassical toroidal viscosity generated by applying three-dimensional magnetic fields. Based on a model of the momentum diffusion and torque balance, a feedback controller is designed and tested in closed-loop simulations using TRANSP, a time dependent transport analysis code, in predictive mode. Promising results for the ongoing experimental implementation of controllers are obtained.

Thermo-expandable intra-prostatic stent in the treatment of acute urinary retention in elderly patients with significant co-morbidities.

We assess the use of thermo-expandable intra-prostatic stent (Memokath, Engineers and Doctors A/S, Denmark) for the treatment of acute urinary retention (AUR) in men with significant co-morbidities for transurethral resection of prostate (TURP). We evaluate the pre- and post-operative complications, duration of stents in-situ and patients quality of life after the stent insertion. Patients with significant co-morbidities presenting with AUR were selected, who were unfit for TURP. The co-morbidities included ischaemic heart disease, congestive heart failure, and chronic obstructive pulmonary disease. The exclusion criteria were bladder tumour and atonic bladder. The Memokath stents were inserted using a flexible cystoscope under local anaesthesia. The patients were followed up at 3 and 6 months after the procedure and the ones who remained alive were asked to complete self-administered questionnaires and IPSS scores. Fifteen men with acute urinary retention were recruited for stent insertion with the mean age of 87 years. No peri-operative complications were recorded. Three patients died after the insertion with functional Memokath in-situ. Nine patients had good functioning stents post-operatively, and remain catheter free up to 30 months after the procedure. The mean duration of stent life was 18 months. Three long-term complications were detected, including stent migration and prostate overgrowth. The Memokath is a good option for frail elderly patients presenting with AUR. The procedure is safe and has minimal long term complications. The stent also provides a sustained good quality of life for patients and avoids the necessity of long term catheterisation.

New criteria for interpretation of the 75 g oral glucose tolerance test in pregnancy.

A 75 g oral glucose tolerance test (OGTT) was performed on 135 high-risk pregnant patients. When the current World Health Organization (WHO) criteria for the diagnosis of gestational-glucose tolerance were applied, 88 patients were considered normal, 11 had gestational diabetes, and 36 patients had impaired-glucose tolerance, respectively. The plasma glucose, insulin, and C-peptide levels during the OGTT were further studied in the 88 patients (who had normal results). Two metabolically distinct groups were identified; a group (n = 53) with a 2-hour plasma glucose less than or equal to 6.6 mmol/L (118.8 mg/dL), had a normal insulin and C-peptide pattern, and a second group (n = 35) who had 2-hour plasma glucose greater than 6.6 mmol/L displayed a glycemic, insulin, and C-peptide pattern similar to that of patients with gestational diabetes mellitus. The risks of macrosomic babies and operative delivery were significantly greater in the latter group. These results suggest that in our pregnant population, a group of patients with impaired glucose tolerance will be under-diagnosed using the current WHO criteria. Based on our results new criteria for gestational glucose intolerance are suggested for our population.