Different surface treatments on recently introduced CAD-CAM resin-modified ceramics: Implications on bond strength.

STATEMENT OF PROBLEM: The diverse chemical composition of recently introduced resin-modified ceramics complicates the establishment of a universally accepted clinical bonding protocol. PURPOSE: The purpose of this in vitro study was to evaluate the influence of different surface treatments of resin-modified ceramics on the bond strength to a resin cement. MATERIAL AND METHODS: Sixteen 10×12×3-mm resin-modified ceramic slices were obtained from each material (Cerasmart; GC, Shofu Block HC; Shofu, Vita Enamic; Vita, Evolux hybrid; BlueDent, Alium; Alium). Slices were assigned to 4 groups based on surface treatments: Control (no treatment), airborne-particle abrasion with Al2O3 (Al2O3), conditioning with 9% HF (HF), and Al2O3+HF. After treatments and silane coupling agent (Monobond N; Ivoclar) application, 7 resin cement cylinders (Choice 2 veneer; Bisco) were built on each slice and light polymerized for 20 seconds. Half of the specimens (n=14 cylinders) were stored for 24 hours, and the other half were thermocycled (20 000 cycles, 5 °C to 55 °C, 30-second dwell time). Microshear bond strength was tested and analyzed with 3-way ANOVA and the Tukey HSD test (α=.05), and failure patterns were classified. Surface morphology after treatments was observed with scanning electron microscopy and Raman spectroscopy. RESULTS: After 24 hours, all treatments induced higher bond strength (P<.05) than in the control in Evolux. Al2O3+HF caused higher bond strength (P<.05) than in the control in Cerasmart and Shofu, and higher bond strength than Al2O3 in Cerasmart. However, it resulted in lower bond strength (P<.05) than Al2O3 in Alium. After thermocycling, irrespective of the resin-modified ceramic, all treatments induced higher bond strength (P<.05) than in the control. HF induced lower bond strength (P<.05) than Al2O3 in Alium. Al2O3+HF caused the highest bond strength (P<.05) in Evolux and higher bond strength (P<.05) than HF in Vita Enamic. Adhesive failures were prevalent under control conditions, and mixed failures were common after treatments. Al2O3 induced surface alterations in all resin-modified ceramics. HF notably altered Vita Enamic, while it had no noticeable impact on the other resin-modified ceramics. Al2O3+HF caused a considerable alteration in Vita Enamic and modified the other resin-modified ceramics. Vita Enamic had the characteristic vibrational bands of inorganic compounds, while the other resin-modified ceramics exhibited distinct bands associated with organic compounds. CONCLUSIONS: Airborne-particle abrasion with Al2O3 followed by HF yielded the highest bond strength, regardless of the resin-modified ceramic, except for Alium, which demonstrated better bond strength after airborne-particle abrasion with Al2O3. 9% HF for 30 seconds caused notable surface alterations in Vita Enamic, negatively impacting its bond strength. Vita Enamic was the only resin-modified ceramic displaying both organic and inorganic composition, while the other resin-modified ceramics showed predominantly organic composition.

Effects of Delaying the Storage of 'Hass' Avocados under a Controlled Atmosphere on Skin Color, Bioactive Compounds and Antioxidant Capacity.

During ripening, 'Hass' avocado skin changes from green to purple/black. Low-temperature storage with a controlled atmosphere (CA) is the most widely used method for avocado storage; however, few studies have simulated this technology and considered the days of regular air (RA) storage prior to CA storage. Herein, the effect of delaying the storage of 'Hass' avocado (>30% dry matter) in a CA was examined. Long-term storage conditions (5 °C for 50 days) corresponded to (i) regular air storage (RA), (ii) CA (4 kPa O2 and 6 kPa CO2) and (iii) 10 days in RA + 40 days in a CA and (iv) 20 days in RA + 30 days in a CA. Evaluations were performed during storage and at the ready-to-eat (RTE) stage. Skin color remained unchanged during storage, but at the RTE stage, more color development was observed for fruits stored under CA conditions, as these fruits were purple/black (>50%). At the RTE stage, the anthocyanin content increased, and compared to fruit under RA, fruit under a CA contained a five-fold greater content. A 20-day delay between harvest and CA storage increased the fruit softening rate and skin color development after cold storage, reducing the effectiveness of CA as a postharvest technology for extending storage life.

A short treatment with resveratrol after a renal ischaemia-reperfusion injury prevents maladaptive repair and long-term chronic kidney disease in rats.

Acute kidney injury (AKI) often triggers physiological processes aimed at restoring renal function and architecture. However, this response can become maladaptive, leading to nephron loss and fibrosis. Although the therapeutic effects of resveratrol (RSV) are well established, its impact after AKI and for subsequent chronic kidney disease (CKD) remains unclear. This study assessed whether transient administration of RSV following ischaemia-reperfusion injury (IRI) could prevent the progression to CKD. Forty-one male Wistar rats were assigned randomly to sham surgery, bilateral renal ischaemia for 30 min (IR) or IR+RSV. The RSV treatment commenced 24 h after IRI and continued for 10 days. The rats were studied for either 10 days or 5 months, after which kidney function and structure were evaluated. Mitochondrial homeostasis, oxidant defence and renal inflammation state were also evaluated. Despite having the same severity of AKI, rats receiving RSV for 10 days after IRI exhibited significant improvement in kidney histological injury and reduced inflammation, although renal haemodynamic recovery was less pronounced. Resveratrol effectively prevented the elevation of tubular injury-related molecules and profibrotic signalling with reduced myofibroblast proliferation. Furthermore, RSV substantially improved the antioxidant response and mitochondrial homeostasis. After 5 months, RSV prevented the transition to CKD, as evidenced by the prevention of progressive proteinuria, renal dysfunction and tubulointerstitial fibrosis. This study demonstrates that a brief treatment with RSV following IRI is enough to prevent maladaptive repair and the development of CKD. Our findings highlight the importance of the early days of reperfusion, indicating that maladaptive responses can be reduced effectively following severe AKI. KEY POINTS: Physiological processes activated after acute kidney injury (AKI) can lead to maladaptive responses, causing nephron loss and fibrosis. Prophylactic renoprotection with resveratrol (RSV) has been described in experimental AKI, but its impact after AKI and for subsequent chronic kidney disease (CKD) remains unclear. In this study, we found that histological tubular injury persists 10 days after ischaemia-reperfusion injury and contributes to a failed repair phenotype in proximal tubular cells. Short-term RSV intervention influenced the post-ischaemic repair response and accelerated tubular recovery by reducing oxidative stress and mitochondrial damage. Furthermore, RSV targeted inflammation and profibrotic signalling during the maladaptive response, normalizing both processes. Resveratrol effectively prevented AKI-to-CKD transition even 5 months after the intervention. The study serves as a proof of concept, proposing RSV as a valuable candidate for further translational clinical studies to mitigate AKI-to-CKD transition.

Transient inhibition of sodium-glucose cotransporter 2 after ischemia/reperfusion injury ameliorates chronic kidney disease.

Sodium-glucose cotransporter 2 (SGLT2) inhibitor, dapagliflozin (Dapa), exhibited nephroprotective effects in patients with chronic kidney disease (CKD). We assessed the efficacy of short-term Dapa administration following acute kidney injury (AKI) in preventing CKD. Male Wistar rats were randomly assigned to Sham surgery, bilateral ischemia for 30 minutes (abbreviated as IR), and IR + Dapa groups. Daily treatment with Dapa was initiated just 24 hours after IR and maintained for only 10 days. Initially, rats were euthanized at this point to study early renal repair. After severe AKI, Dapa promptly restored creatinine clearance (CrCl) and significantly reduced renal vascular resistance compared with the IR group. Furthermore, Dapa effectively reversed the mitochondrial abnormalities, including increased fission, altered mitophagy, metabolic dysfunction, and proapoptotic signaling. To study this earlier, another set of rats was studied just 5 days after AKI. Despite persistent renal dysfunction, our data reveal a degree of mitochondrial protection. Remarkably, a 10-day treatment with Dapa demonstrated effectiveness in preventing CKD transition in an independent cohort monitored for 5 months after AKI. This was evidenced by improvements in proteinuria, CrCl, glomerulosclerosis, and fibrosis. Our findings underscore the potential of Dapa in preventing maladaptive repair following AKI, emphasizing the crucial role of early intervention in mitigating AKI long-term consequences.

Artificial intelligence: ChatGPT as a disruptive didactic strategy in dental education.

PURPOSE: To evaluate the influence of ChatGPT on academic tasks performed by undergraduate dental students. METHOD: Fifty-five participants completed scientific writing assignments. First, ChatGPT was utilized; subsequently, a conventional method involving the search of scientific articles was employed. Each task was preceded by a 30-min training session. The assignments were reviewed by professors, and an anonymous questionnaire was administered to the students regarding the usefulness of ChatGPT. Data were analyzed by Mann-Whitney U-test. RESULTS: Final scores and scores for the criteria of utilization of evidence, evaluation of arguments, and generation of alternatives achieved higher values through the traditional method than with ChatGPT (p = 0.019, 0.042, 0.017, and <0.001, respectively). No differences were found between the two methods for the remaining criteria (p > 0.05). A total of 64.29% of the students found ChatGPT useful, 33.33% found it very useful, and 3.38% not very useful. Regarding its application in further academic activities, 54.76% considered it useful, 40.48% found it very useful, and 4.76% not very useful. A total of 61.90% of the participants indicated that ChatGPT contributed to over 25% of their productivity, while 11.9% perceived it contributed to less than 15%. Concerning the relevance of having known ChatGPT for academic tasks, 50% found it opportune, 45.24% found it very opportune, 2.38% were unsure, and the same percentage thought it is inopportune. All students provided positive feedback. CONCLUSION: Dental students highly valued the experience of using ChatGPT for academic tasks. Nonetheless, the traditional method of searching for scientific articles yield higher scores.

Diagnosis of patients with Lynch syndrome lacking the Amsterdam II or Bethesda criteria.

BACKGROUND: Lynch Syndrome (LS) is an autosomal dominant inheritance disorder characterized by genetic predisposition to develop cancer, caused by pathogenic variants in the genes of the mismatch repair system. Cases are detected by implementing the Amsterdam II and the revised Bethesda criteria, which are based on family history. MAIN BODY: Patients who meet the criteria undergo posterior tests, such as germline DNA sequencing, to confirm the diagnosis. However, these criteria have poor sensitivity, as more than one-quarter of patients with LS do not meet the criteria. It is very likely that the lack of sensitivity of the criteria is due to the incomplete penetrance of this syndrome. The penetrance and risk of developing a particular type of cancer are highly dependent on the affected gene and probably of the variant. Patients with variants in low-penetrance genes have a lower risk of developing a cancer associated with LS, leading to families with unaffected generations and showing fewer clear patterns. This study focuses on describing genetic aspects of LS cases that underlie the lack of sensitivity of the clinical criteria used for its diagnosis. CONCLUSION: Universal screening could be an option to address the problem of underdiagnosis.

SerpinA3K Deficiency Reduces Oxidative Stress in Acute Kidney Injury.

We previously showed that SerpinA3K is present in urine from rats and humans with acute kidney injury (AKI) and chronic kidney disease (CKD). However, the specific role of SerpinA3K during renal pathophysiology is unknown. To begin to understand the role of SerpinA3K on AKI, SerpinA3K-deficient (KOSA3) mice were studied 24 h after inducing ischemia/reperfusion (I/R) and compared to wild type (WT) mice. Four groups were studied: WT+S, WT+IR, KOSA3+S, and KOSA3+IR. As expected, I/R increased serum creatinine and BUN, with a GFR reduction in both genotypes; however, renal dysfunction was ameliorated in the KOSA3+IR group. Interestingly, the increase in UH2O2 induced by I/R was not equally seen in the KOSA3+IR group, an effect that was associated with the preservation of antioxidant enzymes' mRNA levels. Additionally, FOXO3 expression was initially greater in the KOSA3 than in the WT group. Moreover, the increase in BAX protein level and the decrease in Hif1a and Vegfa induced by I/R were not observed in the KOSA3+IR group, suggesting that these animals have better cellular responses to hypoxic injury. Our findings suggest that SerpinA3K is involved in the renal oxidant response, HIF1α/VEGF pathway, and cell apoptosis.

Aula invertida utilizada en la enseñanza de la estomatología: una aproximación / Flipped Classroom Approach in Dental Education: An Overview

RESUMEN El aula invertida es una estrategia didáctica en la cual se brinda a los estudiantes videos, podcast, entre otros, para que sean revisados con anticipación, de modo que cuando se realice la actividad presencial o virtual se profundicen y aclaren los conceptos pertenecientes a la información brindada previamente. El aprendizaje invertido busca generar una oportunidad de cambio en la dinámica de la enseñanza; promueve el aprendizaje activo dentro del ambiente de clase; y busca que el aprendizaje se focalice en el estudiante. En el presente documento, se hace una revisión de los aspectos más notables del aula invertida y sus diferencias con el método del aula magistral; asimismo, se revisa su impacto en la odontología y se plantean los retos, los compromisos y las dificultades que puede tener su implementación.

Abstract The flipped classroom is a pedagogical approach in which students are provided with videos, podcasts, and other resources to review in advance. This allows for a deeper understanding and clarification of the concepts during in-person or virtual activities. The flipped learning approach aims to bring about a change in the dynamics of teaching, promoting active learning within the classroom environment and placing the focus on the student. This document provides a review of the notable aspects of the flipped classroom and highlights its differences from the traditional lecture-based teaching method. Additionally, the impact of this approach in dentistry is examined, along with the challenges, commitments, and difficulties that may arise during its implementation.

Particulate matter and ultrafine particles in urban air pollution and their effect on the nervous system.

According to the World Health Organization, both indoor and urban air pollution are responsible for the deaths of around 3.5 million people annually. During the last few decades, the interest in understanding the composition and health consequences of the complex mixture of polluted air has steadily increased. Today, after decades of detailed research, it is well-recognized that polluted air is a complex mixture containing not only gases (CO, NOx, and SO2) and volatile organic compounds but also suspended particles such as particulate matter (PM). PM comprises particles with sizes in the range of 30 to 2.5 µm (PM30, PM10, and PM2.5) and ultrafine particles (UFPs) (less than 0.1 µm, including nanoparticles). All these constituents have different chemical compositions, origins and health consequences. It has been observed that the concentration of PM and UFPs is high in urban areas with moderate traffic and increases in heavy traffic areas. There is evidence that inhaling PM derived from fossil fuel combustion is associated with a wide variety of harmful effects on human health, which are not solely associated with the respiratory system. There is accumulating evidence that the brains of urban inhabitants contain high concentrations of nanoparticles derived from combustion and there is both epidemiological and experimental evidence that this is correlated with the appearance of neurodegenerative human diseases. Neurological disorders, such as Alzheimer's and Parkinson's disease, multiple sclerosis, and cerebrovascular accidents, are among the main debilitating disorders of our time and their epidemiology can be classified as a public health emergency. Therefore, it is crucial to understand the pathophysiology and molecular mechanisms related to PM exposure, specifically to UFPs, present as pollutants in air, as well as their correlation with the development of neurodegenerative diseases. Furthermore, PM can enhance the transmission of airborne diseases and trigger inflammatory and immune responses, increasing the risk of health complications and mortality. Therefore, understanding the different levels of this issue is important to create and promote preventive actions by both the government and civilians to construct a strategic plan to treat and cope with the current and future epidemic of these types of disorders on a global scale.

Hematopoietic stem cell transplantation activity in Mexico during the COVID19 pandemic: on the way to recovery.

OBJECTIVE: To analyze the number of HSCTs performed in 2019 vs. 2020 and report the status of transplant centers (TCs) during and a year after the COVID-19 pandemic. METHODS: We performed a comprehensive cross-sectional nationwide study including active TCs interrogating HSCT activity from 2019 through September 2021. An electronic survey was sent to TCs and consisted of items regarding the number and characteristics of procedures performed and were compared yearly. Changes to their institutions' transplant policies and practices during the COVID19 pandemic were also documented. Fifty centers were invited to participate, 33 responded. RESULTS: Most TCs were part of the public health system (63.7%). Almost half are in the country's capital, Mexico City (45.5%). Most centers performed <10 procedures per year. The number of HSCTs decreased from 835 in 2019-505 in 2020 (p < .001), representing a 40% reduction in transplant activity. The monthly transplant rate in 2021 increased to 58.3, compared to 42 in 2020 and close to 69.5 in 2019 (p < .001). All types of HSCTs decreased excluding haploidentical transplants. All institutions treated patients with COVID19, and over two-thirds experienced some form of hospital reconversion. Transplant activity stopped completely in 23 TCs (70%) during the pandemic with a median closure duration of 9.9 months (range, 1-21). In 2021, 9.1% of TCs remained closed, all of them in the public setting. CONCLUSION(S): The limited transplant activity in Mexico decreased significantly during the pandemic but is recovering and nearly in pre-pandemic levels.

Molecular Profiling of Tumor Tissue in Mexican Patients with Colorectal Cancer.

Colorectal cancer is a heterogeneous disease with multiple genomic changes that influence the clinical management of patients; thus, the search for new molecular targets remains necessary. The aim of this study was to identify genetic variants in tumor tissues from Mexican patients with colorectal cancer, using massive parallel sequencing. A total of 4813 genes were analyzed in tumoral DNA from colorectal cancer patients, using the TruSight One Sequencing panel. From these, 192 variants with clinical associations were found distributed in 168 different genes, of which 46 variants had not been previous reported in the literature or databases, although genes harboring those variants had already been described in colorectal cancer. Enrichment analysis of the affected genes was performed using Reactome software; pathway over-representation showed significance for disease, signal transduction, and immune system subsets in all patients, while exclusive subsets such as DNA repair, autophagy, and RNA metabolism were also found. Those characteristics, whether individual or shared, could give tumors specific capabilities for survival, aggressiveness, or response to treatment. Our results can be useful for future investigations targeting specific characteristics of tumors in colorectal cancer patients. The identification of exclusive or common pathways in colorectal cancer patients could be important for better diagnosis and personalized cancer treatment.

Urinary serpin-A3 is an early predictor of clinical response to therapy in patients with proliferative lupus nephritis.

We have previously reported that urinary excretion of serpin-A3 (uSerpA3) is significantly elevated in patients with active lupus nephritis (LN). Here, we evaluated the course of uSerpA3 during the first year of treatment and its association with response to therapy in patients with proliferative LN. The observational longitudinal study included 60 Mexican adults with proliferative LN followed during the first year after LN flare. uSerpA3 was detected by Western blot analysis at flare and after 3, 6, and 12 mo. The response to therapy was determined 1 yr after the LN flare. We evaluated the correlation between uSerpA3 and histological parameters at LN flare. The temporal association between uSerpA3 and response to therapy was analyzed with linear mixed models. uSerpA3 prognostic performance for response was evaluated with receiver-operating characteristic curves. Among the 60 patients studied, 21 patients (35%) were class III and 39 patients (65%) were class IV. uSerpA3 was higher in class IV than in class III LN (6.98 vs. 2.89 dots per in./mg creatinine, P = 0.01). Furthermore, uSerpA3 correlated with the histological activity index (r = 0.29, P = 0.02). There was a significant association between the temporal course of uSerpA3 and response to therapy. Responders showed a significant drop in uSerpA3 at 6 mo compared with LN flare (P < 0.001), whereas nonresponders persisted with elevated uSerpA3. Moreover, uSerpA3 was significantly lower at flare in responders compared with nonresponders (2.69 vs. 6.98 dots per in./mg creatinine, P < 0.05). Furthermore, uSerpA3 was able to identify nonresponders since 3 mo after LN flare (area under the curve: 0.77). In conclusion, uSerpA3 is an early indicator of kidney inflammation and predictor of the clinical response to therapy in patients with proliferative LN.NEW & NOTEWORTHY LN requires aggressive immunosuppression to improve long-term outcomes. Current indicators of remission take several months to normalize, prolonging treatment regiments in some cases. Serpin-A3 is present in urine of patients with proliferative LN. We evaluated the excretion of serpin-A3 in serial samples of patients with proliferative LN during the first year after flare. We found that uSerpA3 correlates with kidney inflammation and its decline at early points predicts the response to therapy 1 yr after flare.

Uso del microarenador intraoral para colocación de selladores de fosas y fisuras: Caso clínico / Use of the intraoral microblaster for placement of pit and fissure sealants: Clinical case

RESUMEN Los selladores de fosas y fisuras han demostrado ser una alternativa eficiente y eficaz para proteger las superficies oclusales del desarrollo de lesiones cariosas. Se realiza una revisión del aire abrasivo usado en odontología resturadora y se presenta un caso clínico del uso de esta tecnologia para la colocación de selladores de fosas y fisuras.

ABSTRACT Pit and fissure sealants have proven to be an efficient and effective alternative to protect occlusal surfaces from the development of carious lesions. A review of the abrasive air used in restorative dentistry is carried out and a clinical case of the use of this technology for the placement of pit and fissure sealants is presented.

Sirtuin 7 Deficiency Reduces Inflammation and Tubular Damage Induced by an Episode of Acute Kidney Injury.

Acute kidney injury (AKI) is a public health problem worldwide. Sirtuins are a family of seven NAD+-dependent deacylases, Overexpression of Sirtuin 1, 3, and 5 protect against AKI. However, the role of Sirtuin 7 (Sirt7) in AKI is not known. Here, we analyzed how Sirt7 deficient mice (KO-Sirt7) were affected by AKI. As expected, wild-type and Sirt7 heterozygotes mice that underwent renal ischemia/reperfusion (IR) exhibited the characteristic hallmarks of AKI: renal dysfunction, tubular damage, albuminuria, increased oxidative stress, and renal inflammation. In contrast, the KO-Sirt7+IR mice were protected from AKI, exhibiting lesser albuminuria and reduction in urinary biomarkers of tubular damage, despite similar renal dysfunction. The renoprotection in the Sirt7-KO+IR group was associated with reduced kidney weight, minor expression of inflammatory cytokines and less renal infiltration of inflammatory cells. This anti-inflammatory effect was related to diminished p65 expression and in its active phosphorylation, as well as by a reduction in p65 nuclear translocation. Sirt7 deficient mice are protected from AKI, suggesting that this histone deacetylase promotes tubular damage and renal inflammation. Therefore, our findings indicate that Sirt7 inhibitors may be an attractive therapeutic target to reduce NFκB signaling.

Large-scale screening for severe acute respiratory coronavirus virus 2 (SARS-CoV-2) among healthcare workers: Prevalence and risk factors for asymptomatic and pauci-symptomatic carriers, with emphasis on the use of personal protective equipment (PPE).

Healthcare workers (HCWs) not fulfilling the coronavirus disease 2019 (COVID-19) case definition underwent severe acute respiratory coronavirus virus 2 (SARS-CoV-2) screening. Risk of exposure, adherence to personal protective equipment (PPE), and symptoms were assessed. In total, 2,000 HCWs were screened: 5.5% were positive for SARS-CoV-2 by polymerase chain reaction (PCR). There were no differences in PPE use between SARS-CoV-2-positive and -negative HCWs (adherence, >90%). Nursing and kitchen staff were independently associated with positive SARS-CoV-2 results.