Assessment of isthmus filling using two obturation techniques performed by students with different levels of clinical experience.

Background/purpose: Root canal filling is a necessary skill for dental students and an important aspect of endodontic education. This study aimed to evaluate the effect of students' clinical experiences on isthmus filling using different techniques and sealers. Materials and methods: One hundred eight three-dimensional-printed resin replicas of isthmus were divided into six groups and either continuous wave of condensation (CWC) or single-cone obturation (SC) was performed. One of three sealers (AH Plus Jet®, GuttaFlow2, iRoot SP) was used together with a size-fitted gutta-percha master cone. All the obturations were completed by students with three different levels of clinical experience including senior postgraduate students (SPS), junior postgraduate students (JPS), and undergraduate students (US). The percentages of filled areas (PFA) at 2, 4, 6, and 8 mm from the apex were analyzed using a light microscope. Data were analyzed using the Mann-Whitney U test or Kruskal-Wallis 1-way ANOVA with Dunn's tests (α = 0.05). Results: The CWC group exhibited a higher PFA than the SC group (P < 0.05). The PFA was higher in the SPS group than in the JPS group or the US group with CWC (P < 0.05). The three clinical experience groups showed similar PFAs with SC (P > 0.05); however, when using SC with iRoot SP, the PFA was higher than with either of the other two sealers (P < 0.05). Conclusion: CWC was found to be technique-sensitive and required clinical training. With SC, clinical experience did not improve the quality of isthmus filling without additional training. CWC was superior to SC for type IV isthmuses. When using SC, better filling quality was obtained with a bioceramic sealer.

Quantitative Assessment of Dimensional Evaluation and Artefacts from Filling Materials with CBCT Using Standard Phantom Roots.

OBJECTIVE: To investigate the accuracy of dimensional evaluation and representation of artefacts generated by different gutta-percha (GP) cones with or without sealer with CBCT using a reproducible, standardised phantom root methodology. METHODS: The reproducible artificial phantom roots with six root canal sizes from #25 to #50 and 0.04 taper were aligned according to the jaw curvature in a stone model for dimensional measurements. Each root was scanned while empty and filled with four types of filling materials. The specimens were scanned using the CS 9300 3D (Carestream Dental, Rochester, NY, USA) (at two different resolutions), 3D Accuitomo (J Morita, Kyoto, Japan) and NewTom VGi (Verona, Italy) CBCT systems. The hyperdense and hypodense axial slice artefacts from root canal sizes #40, #45 and #50 were recorded. RESULTS: Dimensions were significantly smaller and more accurate with CS 9300/0.09 mm voxel size than with other protocols. The hypodense band was found mostly in the CS 9300 3D system with 0.18 mm voxel size, especially in the buccal-lingual (95%) and coronal (64%) sections. The 3D Accuitomo CBCT system showed the lowest presence of the hypodense band. Areas of both light and dark artefacts were significantly larger in the coronal third than in the apical and middle thirds. CONCLUSION: Artefacts in the coronal locations and in buccal-lingual sections were more evident in the CS 9300 3D system with a 0.18-mm voxel size.

A systematic review and meta-analysis of factors related to non-suicidal self-injury among Chinese adolescents.

BACKGROUND: Over the past several decades the prevalence of adolescent non-suicidal self-injury (NSSI) has been rising steadily. Understanding the factors associated with NSSI is a critical public health concern. The current study aims to explore the critical factors related to NSSI among Chinese adolescents. METHODS: A systematic literature search was conducted to identify the studies meeting our eligibility criteria (published until June 2022) in PubMed, Web of Science, Science Direct, Springer Link, CNKI, VIP, and Wanfang data. The meta-package of R language was used to perform a meta-analysis to compute the pooled effect (r). RESULTS: A total of 59 studies were included in this analysis, with a sample size of 192,546. Twenty-four democratic, personal, and social factors were examined in current study. The pooled effect value (r) has revealed that 23 factors are associated with NSSI behaviors among Chinese adolescents. The factor, Internet addiction, has demonstrated the greatest association with NSSI compared to other factors. CONCLUSION: Consistent with previous studies on adolescent NSSI, findings have demonstrated that a number of demographic, personal, and social factors significantly contribute to NSSI behaviors among Chinese adolescents. Future research on prevention and intervention for adolescent NSSI may benefit from targeting these factors.

Cost-effectiveness analysis of the prevention of mother-to-child transmission of HIV.

BACKGROUND: The number of HIV-positive pregnant women accounted for about 10% of China's total over the past few years in Liangshan Prefecture, Sichuan province in China. Although cost-effectiveness of the PMTCT of HIV have been evaluated in other previous studies, no specific study has been conducted in Liangshan prefecture, nor has the expenses paid individually by HIV-positive pregnant women been included. The purpose of this study was to evaluate both the short-term and long-term cost-effectiveness of PMTCT of HIV in Liangshan Prefecture from the social perspective. METHODS: From December 2018 to January 2019, individual expenses and the other costs were collected: individual expenses of 133 recruited HIV-positive pregnant women registered in the National Information System of Prevention of Mother-to-Child Transmission of HIV, Syphilis, and HBV, and the other costs from local maternal and child healthcare hospitals, Centers for Disease Control and Prevention, and general hospitals. The costs, the number of pediatric infections averted from being HIV infected were analyzed. And, Life years gained by pediatric infections averted were calculated by using a life table. Besides, Direct benefit was calculated through a Markov mode. Furthermore, One-way sensitivity analysis was conducted for key variables affecting the benefit-cost ratio. RESULTS: The estimated number of pediatric infections averted was 164.The total cost was USD 114.1 million, including direct medical costs, direct non-medical costs, and indirect costs, which were USD 54.2 million, USD 53.4 million, and USD 6.5 million, respectively. 630.6 person-years discounted to 2017 were gained at a 3% annual rate, and cost per life year gained was USD 1809.50. Direct benefits were USD 198.4 million, indirect benefits USD 82.5 million, and the benefit-cost ratio was 1.5. The sensitivity analysis showed that if PMTCT costs hypothetically ranged from USD 85.6 million to USD 142.6 million, benefit-cost ratio would vary from 1.0 to 2.3. CONCLUSIONS: PMTCT of HIV in Liangshan Prefecture was very cost-effective. It was a great economic burden of PMTCT on HIV-positive pregnant women and their families to take individual expenses. Therefore, it could be suggested that individual expenses should be covered as much as possible by different types of financing.

Current trends and future prediction of novel coronavirus disease (COVID-19) epidemic in China: a dynamical modeling analysis.

The novel coronavirus disease 2019 (COVID-19) infection broke out in December 2019 in Wuhan, and rapidly overspread 31 provinces in mainland China on 31 January 2020. In the face of the increasing number of daily confirmed infected cases, it has become a common concern and worthy of pondering when the infection will appear the turning points, what is the final size and when the infection would be ultimately controlled. Based on the current control measures, we proposed a dynamical transmission model with contact trace and quarantine and predicted the peak time and final size for daily confirmed infected cases by employing Markov Chain Monte Carlo algorithm. We estimate the basic reproductive number of COVID-19 is 5.78 (95%CI: 5.71-5.89). Under the current intervention before 31 January, the number of daily confirmed infected cases is expected to peak on around 11 February 2020 with the size of 4066 (95%CI: 3898-4472). The infection of COVID-19 might be controlled approximately after 18 May 2020. Reducing contact and increasing trace about the risk population are likely to be the present effective measures.

[Heavy Pollution Characteristics and Assessment of PM2.5 Predicted Model Results in Beijing-Tianjin-Hebei Region and Surrounding Areas During November 23 to December 4, 2018].

This study discusses the concentration characteristics of PM2.5 and PM10, as well as pollution meteorology in large-scale and long-term heavy pollution in the Beijing-Tianjin-Hebei region and its surrounding areas from November 23 to December 4, 2018, where the primary pollutants are comprised of PM2.5 and PM10. The monitoring results obtained from ground-based and vehicle-mounted lidars, as well as the HYSPLIT-4 backward trajectory combined with meteorological factors analysis are discussed. The accuracy and uncertainty of the air quality forecast model of NAQPMS, CMAQ, and CAMx during heavy air pollution were analyzed retrospectively. The results show that PM2.5 and sand dust in most cities in the south-central region contribute to severe pollution levels. The hourly peak concentrations of PM10 in Zhangjiakou, Beijing, Shijiazhuang, Handan, and Zhengzhou were 1589, 864, 794, 738, and 766 µg·m-3, respectively. The respective hourly peak concentrations of PM2.5 were 239, 319, 387, 321, and 380 µg·m-3. Ground static pressure field, high humidity, inversion, and other static and stable conditions, as well as sand dust transmitted from the northwest, were important pollution meteorological and weather factors. The monitoring data of ground-based lidar and vehicle-mounted lidar combined with the HYSPLIT-4 backward trajectory analysis showed that the air pollutant transmitted from the Southwest and Southeast during the heavy pollution period was primarily PM2.5. The air pollutant transmitted from the Northwest during the two sand dust processes. Moreover, the model of NAQPMS, CMAQ, and CAMx performed well in forecasting the heavy pollution process in the Beijing-Tianjin-Hebei region and its surrounding areas. However there are slight deviations for some individual cities, related to uncertainty in the meteorological model prediction, atmospheric chemical reaction mechanism, and pollution source list. Furthermore, the reduction in pollution source emissions caused by pollution emergency measures was also one of the main reasons for the overestimation.

[Differences of wheat yield and economic benefits between soybean-wheat and rice-wheat cropping under different nitrogen fertilization patterns in Jianghan Plain, China]. / 江汉平原不同氮肥运筹模式下豆麦和稻/麦轮作系统小麦产量和经济效益差异.

We analyzed winter wheat yield and growth pattern of soybean-wheat and rice-wheat rotation systems in response to different nitrogen fertilization patterns with the aim to provide theoretical basis for narrowing the wheat yield gap between the two rotations in Jianghan Plain. Field experiments were conducted with three treatments, control without nitrogen, traditional nitrogen management (70% nitrogen as basal and 30% nitrogen as topdressing at overwintering), and improved nitrogen management (one third of N was applied at sowing, wintering and jointing, respectively). The growth pattern, grain yield, yield components, fertilizer use-efficiency and economic benefit under the different nitrogen fertilization patterns were examined. Results showed that grain yield was significantly affected by both nitrogen fertilization pattern and crop rotation. Grain yield under improved nitrogen treatment was significantly higher, with the yield gap being 920 kg·hm-2 in soybean-wheat rotation and 2195 kg·hm-2 in rice-wheat rotation. Traditional nitrogen management showed advantage in establishing winter and spring population. Dry matter accumulation was higher under improved nitrogen treatment than traditional treatment with 5%-31% and 14%-28% increases for soybean-wheat and rice-wheat rotations, respectively. The higher yield in the soybean-wheat rotation was due to greater panicle numbers, higher percentage of tiller ears, and dry matter accumulation. The rice-wheat rotation under improved nitrogen showed a significant increase in grain yield compared with soybean-wheat rotation. This result indicated that yield gap between the two crop rotations could be narrowed through suitable nitrogen management. Grain weight after anthesis showed "slow-fast-medium" in soybean-wheat rotation and "medium-fast-slow" in rice-wheat rotation. Nitrogen use efficiency and net benefit of wheat season were higher in rice-wheat system. Overall, the rice-wheat system showed obvious advantages in population structure, dry matter accumulation, grain yield and benefit under improved nitrogen pattern, which was the optimum pattern for both wheat yield and benefit in Jianghan Plain.

[Concentration Characteristics and Assessment of Model-Predicted Results of PM2.5 in the Beijing-Tianjin-Hebei Region in Autumn and Winter].

This paper discusses the concentration characteristics of PM2.5, as well as its relationship with meteorological factors in autumn and winter (from September to the following February), from 2013 to 2018 in the Beijing-Tianjin-Hebei (BTH) region. The accuracy and uncertainty of the air quality forecast models NAQPMS(nested air quality prediction modeling system), CMAQ(community multiscale air quality modeling system), and CAMx (comprehensive air quality model with extensions) were analyzed based on the model-predicted and measured PM2.5 concentration in autumn and winter from 2015 to 2018. The accuracy of NAQPMS, CMAQ, and CAMx during typical heavy air pollution was also tested. Moreover, methods to improve the accuracy of the model forecast were discussed. The results showed that the mean concentrations of PM2.5 in the BTH region were 122, 98, 82, 99, and 65 µg·m-3 in the five autumn and winter periods, respectively. When the air quality index (AQI) exceeded 150 during each autumn and winter, it reached 229, 198, 210, 204, and 180 µg·m-3, respectively. There were 64 occurrences of heavy regional PM2.5 air pollution in autumn and winter from 2013 to 2018. The average duration was longest in the 2013 to 2014 period, and shortest in the 2017 to 2018 period. The peak concentration and average concentration of PM2.5 decreased year on year, except for the period from 2016 to 2017. In autumn and winter, PM2.5 concentration had a relatively close relationship with relative humidity, wind and sunshine duration, compared with a weak relationship with temperature and air pressure. Regional heavy air pollution always happened under the condition of low wind speed(less than 2 m·s-1),higher relative humidity(greater than 65%),and southwest and northeast wind direction. In addition, the heavy air pollution of PM2.5 in BTH in autumn and winter can be effectively forecasted by NAQPMS, CMAQ, and CAMx. The predicted and measured PM2.5 concentration showed a close relationship. The models performed well in forecasting Zhangjiakou, Chengde, and Qinhuangdao, but by contrast overestimated in Tangshan, Shijiazhuang, Baoding, Beijing, and Tianjin. The uncertainty of emission sources, measured and predicted meteorological data, and the atmospheric chemical reaction mechanism may be the main reasons for the overestimate.

Combined Acoustic Radiation Force Impulse and Conventional Ultrasound in the Quantitative Assessment of Immunoglobulin a Nephropathy.

We investigated the value of combined acoustic radiation force impulse (ARFI) imaging and conventional ultrasound (US) in identifying renal histopathological fibrosis with immunoglobulin A nephropathy. A total of 146 patients with immunoglobulin A nephropathy, pathologically confirmed by renal biopsy were grouped according to Oxford classification and Katafuchi grading, were included in the test group, and 39 healthy volunteers were included in the control group. Receiver operating characteristic (ROC) curves were constructed to compare the diagnostic accuracy of ARFI, renal lengths, parenchymal thicknesses and interlobular arterial resistance index (RI) and their combinations in identifying Katafuchi grading at renal biopsy. Shear wave velocity (SWV), renal length, renal parenchyma thickness and the interlobular arterial RI were correlated with Katafuchi grading, mesangial hypercellularity (M) and tubular atrophy/interstitial fibrosis (T) (r = -0.504 to -0.407, p < 0.01) but were not correlated with endocapillary hypercellularity (E) or segmental glomerulosclerosis (S). The area under the curves of SWV value + conventional US index (renal length, renal parenchyma thickness and interlobular arterial RI) was higher than those of the SWV value or of the conventional US index alone. The combination of ARFI imaging and conventional US can improve the diagnostic performance in quantitative evaluation pathologic damage in patients with immunoglobulin A nephropathy.

A fast 3-D ultrasound projection imaging method for scoliosis assessment.

Applying ultrasound for scoliosis assessment has been an attractive topic over the past decade. This study proposed a new fast 3-D ultrasound projection imaging method to evaluate the spine deformity. A narrow-band rendering method was used to generate the coronal images based on B-mode images and their corresponding positional data. The non-planar reslicing method, which followed the natural spine curve, was used to project the complete spine data into the coronal image. The repeatability of the new method was tested. A comparison experiment on the reconstructed images and the processing time between the conventional 3-D rendering method and the developed projection imaging method was also performed among 70 patients with scoliosis. The intra- and inter-operator tests results demonstrated very good repeatability (ICC ≥ 0.90). The mean processing times for the developed projection method and conventional rendering method were 15.07 ± 0.03 s and 130.31 ± 35.07 s, respectively. The angle measurement results showed a high correlation (y = 0.984x, r = 0.954) between the images obtained using the two methods. The above results indicated that the developed projection imaging method could greatly decrease the processing time while preserving the comparative image quality. It can be expected that this novel method may help to provide fast 3-D ultrasound diagnosis of scoliosis in clinics.

RGD-Targeted Ultrasound Contrast Agent for Longitudinal Assessment of Hep-2 Tumor Angiogenesis In Vivo.

OBJECTIVE: To prepare arginine-glycine-aspartate (RGD)-targeted ultrasound contrast microbubbles (MBs) and explore the feasibility of their use in assessing dynamic changes in αvß3 integrin expression in a murine model of tumor angiogenesis. METHODS: RGD peptides were conjugated to the surfaces of microbubbles via biotin-avidin linkage. Microbubbles bearing RADfK peptides were prepared as controls. The RGD-MBs were characterized using an Accusizer 780 and optical microscopy. The binding specificity of the RGD-MBs for ανß3-expressing endothelial cells (bEnd.3) was demonstrated in vitro by a competitive inhibition experiment. In an in vivo study, mice bearing tumors of three different stages were intravenously injected with RGD-MBs and subjected to targeted, contrast-enhanced, high-frequency ultrasound. Subsequently, tumors were harvested and sectioned for immunofluorescence analysis of ανß3 expression. RESULTS: The mean size of the RGD-MBs was 2.36 ± 1.7 µm. The RGD-MBs showed significantly higher adhesion levels to bEnd.3 cells compared to control MBs (P < 0.01). There was rarely binding of RGD-MBs to αvß3-negative MCF-7 cells. Adhesion of the RGD-MBs to the bEnd.3 cells was significantly inhibited following treatment with anti-alpha(v) antibodies. The quantitative acoustic video intensity for high-frequency, contrast-enhanced ultrasound imaging of subcutaneous human laryngeal carcinoma (Hep-2) tumor xenografts was significantly higher in small tumors (19.89 ± 2.49) than in medium tumors (11.25 ± 2.23) and large tumors (3.38 ± 0.67) (P < 0.01). CONCLUSIONS: RGD-MBs enable noninvasive in vivo visualization of changes in tumor angiogenesis during tumor growth in subcutaneous cancer xenografts.

[Spatial Distribution Characteristics and Source Analysis of Dissolved Organic Matter in Beiyun River].

Dissolved organic matter (DOM) in aquatic ecosystems has gained wide concern because of its influence on the light attenuation, nutrient availability and contaminant transport. Human activities strongly influence the DOM of rivers in different ways, including increased agricultural activities and industrial and domestic emissions. However, recent socio-economic development with rapid urban development has significantly enhanced the discharge of sewage, and has caused high loads of DOM, which in turn pose a great risk to aquatic ecosystems. To effectively guide water management for protecting aquatic ecosystem health, it is very critical to investigate the distribution and source of dissolved organic matter in urban rivers. In this study, the distribution and source analysis of DOM in Beiyun River were evaluated, where covers the most populated area with a population of 14 million, representing the most urbanized watershed of Beijing. Since the main receiving source of the river is treated and untreated wastewater in Beijing City, the water quality is highly polluted by anthropogenic inputs. However, information on DOM of Beiyun river has not been reported. Therefore, this study can not only reveal the biogeochemistry of DOM in Beiyu River, but also provide useful implications of pollution control for similar urban rivers. The fingerprint features were extracted from the Excitation-Emission Matrix Spectrum of fluorescent dissolved organic matter (FDOM) in 23 sampling sites of Beiyun river during November 2013. Three separate fluorescent components were identified by Parallel factor analysis (PARAFAC) model, including two humic-like components (C1: 240, 300/385 nm; C2: 255, 350/400 nm) and one protein-like component (C3: 230, 280/340 nm). The results indicated that humic-like materials were generally the dominated component of FDOM, accounting for 76.18% of the average total fluorescence intensity. Positive relationships were found between the fluorescence intensity and the concentrations of some water quality indicators, such as total nitrogen, ammonia nitrogen and total phosphorus, indicating the same sources of these components. Thus, the migration and transformation of nitrogen & phosphorus could also influence the level of FDOM. The distribution of total fluorescence intensity showed a distinctly different spatial pattern. The fluorescence intensity decreased firstly along the upstream to midstream continuum, and then increased from the midstream to downstream. The FDOM in the upstream could be attributed to the industrial effluent and agricultural runoff inputs. Among the upstream to downstream continuum, the content of FDOM in the midstream was the lowest. Limited domestic pollution was suggested as the major source. In the downstream, the sources of FDOM could be interpreted as industrial, agricultural wastewater and livestock wastewater discharge. The relative abundance of protein-like materials was markedly increased in this area, indicating the sources of DOM was highly impacted by human activities. In addition, our study also concluded that the removal efficiency of DOM in wastewater plants is not very desirable, which implied that stronger support for DOM removal in sewage system is needed to alleviate DOM pollution and improve water quality.

Acoustic radiation force impulse imaging for non-invasive assessment of renal histopathology in chronic kidney disease.

OBJECTIVE: To investigate the stiffness values obtained by acoustic radiation force impulse (ARFI) quantification in assessing renal histological fibrosis of chronic kidney disease (CKD). METHODS: 163 patients with CKD and 32 healthy volunteers were enrolled between June 2013 and April 2014. ARFI quantification, given as shear wave velocity (SWV), was performed to measure renal parenchyma stiffness. Diagnostic performance of ARFI imaging and conventional ultrasound (US) were compared with histologic scores at renal biopsy. Intra- and inter-observer reliability of SWV measurement was analyzed. RESULTS: In CKD patients, SWV measurements correlated significantly with pathological parameters (r = -0.422--0.511, P<0.001), serum creatinine (r = -0.503, P<0.001), and glomerular filtration rate (r = 0.587, P<0.001). The mean SWV in kidneys with severely impaired (histologic score: ≥19 points) was significant lower than that mildly impaired (histologic score: ≤9 points), moderately impaired (histologic score: 10-18 points), and control groups (all P<0.001). Receiver operating characteristic (ROC) curves analyses indicated that the area under the ROC curve for the diagnosis of renal histological fibrosis using ARFI imaging was superior to these conventional US parameters. Using the optimal cut-off value of 2.65 m/s for the diagnosis of mildly impaired kidneys, 2.50 m/s for moderately impaired kidneys, and 2.33 m/s for severely impaired kidneys, the corresponding area under the ROC curves were 0.735, 0.744, and 0.895, respectively. Intra- and intre-observer agreement of SWV measurements were 0.709 (95% CI: 0.390-0.859, P<0.001) and 0.627 (95% CI: 0.233-0.818, P = 0.004), respectively. CONCLUSIONS: ARFI may be an effective tool for evaluating renal histological fibrosis in CKD patients.

Color Doppler velocity profile and contrast-enhanced ultrasonography in assessment of liver cirrhosis.

BACKGROUND: This study was designed to probe the clinical value in assessing the degree of liver cirrhosis by using the arrival time of contrast agent in the right portal vein in contrast-enhanced ultrasonography, as well as the velocity and flow volume in the right portal vein using the color Doppler velocity profile technique. METHODS: Twenty-eight patients with HBV post-hepatic cirrhosis were grouped into compensated (13 patients) and decompensated cirrhosis (15); 30 patients without hepatic cirrhosis served as controls. Written informed consent was obtained from each patient. All the patients with hepatic cirrhosis were pathologically confirmed by percutaneous biopsy. SonoVue was injected to detect the arrival time in the right portal vein. The velocity and flow volume in the right portal vein were measured. The value of each parameter was compared for correlation analysis. RESULTS: The arrival time in the right portal vein in the cirrhosis group was much longer than that in the control group (24.92+/-1.34 vs. 20.81+/-0.55 sec, respectively, P<0.01). The mean velocity, maximal velocity and flow volume in the cirrhosis group were much lower than those in the control group (10.64+/-0.84 vs. 14.78+/-0.71 cm/sec, 13.68+/-1.02 vs. 17.30+/-0.68 cm/sec and 358.72+/-23.63 vs. 438.61+/-16.86 ml/min, respectively, P<0.01). With the development of cirrhosis, the arrival time in the right portal vein was longer (P<0.05), and the velocity and flow volume was lower (P<0.01). There was a negative correlation between arrival time and mean velocity, maximal velocity and flow volume in the right portal vein in the cirrhosis group (r=-0.547, P<0.01; r=-0.508, P<0.05; r=-0.471, P<0.05, respectively). CONCLUSIONS: With the development of liver cirrhosis, the arrival time of contrast agent in the right portal vein is gradually prolonged, whereas the velocity and flow volume in this vein decreases markedly, and there is a negative correlation between the results of the two methods.