One Piece CAD/CAM Abutment for Screw-Retained Single-Tooth Restorations: A 5-Year Prospective Cohort Study.

BACKGROUND: The use of ceramic-coated patient-specific CAD/CAM titanium abutments represents a therapeutic option for the rehabilitation of single tooth. The utilization of highly customized abutments enables the accurate three-dimensional positioning of the prosthetic emergence. This study evaluates the clinical performance of implant-prosthetic rehabilitations carried out using ceramic-coated CAD/CAM titanium abutments. MATERIALS AND METHODS: Thirty implants were placed in thirty patients and rehabilitated with thirty single crowns attached to CAD/CAM titanium abutments. A conventional procedure was applied, with implant placement after post-extraction socket healing and prosthetic restoration after implant healing. Implants of lengths ranging from 6-15 mm and widths of 3.6, 4.2, and 4.8 mm were used in this study. At the time of prosthesis delivery (T0), after two years (T1), and after five years (T2), plaque (PI) and bleeding (BoP) indices, probing depths (PPD), marginal bone levels (MBL), and PES/WES were evaluated for each implant. RESULTS: No patient dropped out of the study during the follow-up period. All thirty implants were clinically successful at five years post-prosthesis delivery (survival rate: 100%) and showed no signs of peri-implant infection. Peri-implant soft tissues were in good health (BoP at T2: 0% in 73% of patients; 25% in 13% of patients; 50% in 10% of patients; and 75% in 3% of patients). The mean PPD was 2.05±0.56 mm at T0, 1.992±0.6 mm at T1, and 1.867±0.439 mm at T2. The mean MBL at T0 was 0.413±0.440 mm, at T1 was 0.306±0.388 mm, and at T2 was 0.263±0.368 mm. The mean PES, WES, and PES/WES indices, 7.43±1.04, 7.57±0.82, and 15.00±1.17, respectively, indicate good integration of soft tissues, satisfactory aesthetics, and an overall positive outcome. CONCLUSIONS: The success rates, maintenance of marginal bone levels, and periodontal and aesthetic indices suggest the validity of implant-prosthetic rehabilitations with CAD/CAM abutments in cases of single crowns.

Knowledge and barriers of out of hospital cardiac arrest bystander intervention and public access automated external defibrillator use in the Northeast of England: a cross-sectional survey study.

Intervention by members of the public during an out of hospital cardiac arrest (OHAC) including resuscitation attempts and accessible automated external defibrillator (AED) has been shown to improve survival. This study aimed to investigate the OHCA and AED knowledge and confidence, and barriers to intervention, of the public of North East England, UK. This study used a face-to-face cross-sectional survey on a public high street in Newcastle, UK. Participants were asked unprompted to explain what they would do when faced with an OHCA collapse. Chi-Square analysis was used to test the association of the independent variables sex and first aid trained on the participants' responses. Of the 421 participants recruited to our study, 82.9% (n = 349) reported that they would know what to do during an OHCA collapse. The most frequent OHCA action mentioned was call 999 (64.1%, n = 270/421) and 58.2% (n = 245/421) of participants reported that they would commence CPR. However, only 14.3% (n = 60/421) of participants spontaneously mentioned that they would locate an AED, while only 4.5% (n = 19/421) recounted that they would apply the AED. Just over half of participants (50.8%, n = 214/421) were first aid trained, with statistically more females (57.3%, n = 126/220) than males (43.9%,  n = 87/198) being first aiders (p = 0.01 χ2 = 7.41). Most participants (80.3%, n = 338/421) knew what an AED was, and 34.7% (n = 326/421) reported that they knew how to use one, however, only 11.9% (n = 50/421) mentioned that they would actually shock a patient. Being first aid trained increased the likelihood of freely recounting actions for OHCA and AED intervention. The most common barrier to helping during an OHCA was lack of knowledge (29.9%, n = 126/421). Although most participants reported they would know what to do during an OHCA and had knowledge of an AED, low numbers of participants spontaneously mentioned specific OHCA and AED actions. Improving public knowledge would help improve the public's confidence of intervening during an OHCA and may improve OHCA survival.

Compressive stress triggers fibroblasts spreading over cancer cells to generate carcinoma in situ organization.

At the early stage of tumor progression, fibroblasts are located at the outer edges of the tumor, forming an encasing layer around it. In this work, we have developed a 3D in vitro model where fibroblasts' layout resembles the structure seen in carcinoma in situ. We use a microfluidic encapsulation technology to co-culture fibroblasts and cancer cells within hollow, permeable, and elastic alginate shells. We find that in the absence of spatial constraint, fibroblasts and cancer cells do not mix but segregate into distinct aggregates composed of individual cell types. However, upon confinement, fibroblasts enwrap cancer cell spheroid. Using a combination of biophysical methods and live imaging, we find that buildup of compressive stress is required to induce fibroblasts spreading over the aggregates of tumor cells. We propose that compressive stress generated by the tumor growth might be a mechanism that prompts fibroblasts to form a capsule around the tumor.

First-in-Human Pilot Study to Assess Methodology for Using a Mineral-Organic Bone Adhesive for Optimization of Primary Stability and Implant Success for Implants Glued into Immediate Extraction Sockets and Immediately Temporized: Pilot Study.

PURPOSE: To assess the handling properties and clinical function of a new class of material, a so-called mineral-organic bone adhesive (Tetranite; TN), which as yet has no precedent in orthopedic or oral and maxillofacial surgery, for clinically unstable implants placed in immediate extraction sockets and immediately temporized in the anterior maxilla. MATERIALS AND METHODS: A cohort of up to 15 patients requiring between one and four immediate dental implants placed into maxillary extraction sockets from canine to canine were eligible for inclusion. Implants had to be unstable with an insertion torque of < 15 Ncm. Implants were then stabilized using TN, which was allowed to set before reassessing stability using both torque and resonance frequency measurements. Implant stability quotients (ISQs) taken after TN setting were compared to ISQs taken prior to its application, and the implants had to demonstrate resistance to a forward torque of 20 Ncm to be considered stable. ISQs were monitored at 1 week and 1, 3, 7, and 12 months postplacement. In addition, peri-implant tissue health was monitored, adverse events were recorded, and implant success was determined at 1 year postplacement. RESULTS: Eleven patients received a total of 14 implants. Three out of the first six implants failed within 1 month (50%), and thus a protocol amendment was made to remove steps considered potentially destructive to the bonding process. As a result of these amendments, only one further failure was experienced for the next eight implants placed (12.5%). Mean ISQ data averaged for buccolingual and mesiodistal measurements demonstrated a baseline value before TN application of 59.1 Ncm (SD: ± 9.7; range: 40.5 to 73.0). After final setting of the TN, mean ISQ measured 71.9 Ncm (± 6.5; 56.0 to 80.0). At 3 months, just prior to restoration placement, mean ISQ measured 71.0 Ncm (± 6.6; 57.0 to 78.0). Thereafter, the mean ISQ continued to increase at both the 7- and 12-month follow-ups with scores of 78.9 (± 4.6; 72.0 to 84.5) and 80.3 (± 3.8; 74.5 to 85.0), respectively. The surviving 10 implants went on to be fully restored and remained in function beyond the end of the study period to yield a final success rate of 71.4%. CONCLUSIONS: The purpose of a first-in-human study is to demonstrate an extrapolation of preclinical data into the controlled human clinical arena. It is an opportunity to learn what does and does not translate well from experimental data. In that regard, the current pilot study can be deemed a complete success. The implant survival rate of 71.4%, while disappointing, should be considered in light of the protocol amendments identified, the user handling experience learned, and the opportunity to modify the material to better perform in the human patient, as all represent important lessons learned. The notable increase in ISQ sheds light on the nature by which the glue was substituted for bone to yield a stable implant by the end of the study period.

Fully digital workflow for implant-supported fixed restorations consisting of a titanium primary structure and a zirconia secondary structure.

PURPOSE: To describe a fully digital workflow for an implant-supported fixed hybrid restoration that involves a double CAD/CAM structure and to highlight the benefits of this type of restoration. MATERIALS AND METHODS: Using a fully digital workflow, starting from intraoral scans, the necessary steps for producing the final hybrid prosthesis are described. The prosthesis consists of a titanium primary structure and a zirconia secondary structure that is cemented onto the primary structure in the laboratory. A clinical case is presented to illustrate the steps required for prosthetic rehabilitation. RESULTS: This technique enables the fabrication of clinically valid and passive prostheses using a fully digital workflow. CONCLUSION: In just three clinical sessions, a fully digital workflow makes it possible to produce robust implant-supported fixed hybrid prostheses, comprising a titanium primary structure and an outer secondary structure made of zirconia. This procedure can be applied to a wide range of cases from simple to extended, including full-arch restorations.

First-in-Human Pilot Study to Assess Methodology for Using a Mineral-Organic Bone Adhesive for Optimization of Primary Stability & Implant Success for Implants Glued into Immediate Extraction Sockets and Immediately Temporized. Pilot Study 1.

PURPOSE: The purpose of this First-in-Human pilot study was to assess the handling properties and clinical function of a new class of material, so-called mineral-organic bone adhesive (Tetranite, TN), that as yet has no precedent in orthopedic or oral & maxillofacial surgery, for clinically unstable implants, stabilized by this bone adhesive, in immediate extraction sockets and immediately temporized in the anterior maxilla. MATERIALS & METHODS: A cohort of up to 15 patients requiring between 1 and 4 immediate dental implants inserted into maxillary extraction sockets from canine to canine could be enrolled to the study. Implants had to be unstable, <15Ncm. Implants would then be stabilized by the use of a TN, which was allowed to set and the stability re-assessed using both torque and resonance frequency. Implant Stability Quotients (ISQ) taken after TN set were compared to ISQs taken prior to its application and the implants had to demonstrate resistance to a forward torque of 20Ncm. ISQs were monitored at 1 week and 1, 3, 7 and 12 months post-placement. In addition, peri-implant tissue health was monitored, adverse events recorded and implant success determined 1-year post-placement. RESULTS: 11 patients received a total of 14 implants. Three out of the first 6 implants failed within one month (50%), subsequent to which a protocol amendment was made to remove steps considered potentially destructive to the bonding process. As a result of these amendments only 1 further failure was experienced for the next 8 implants placed (12.5%). Mean ISQ data averaged for bucco-lingual and mesio-distal measurements, demonstrated a baseline value before TN application of 59.1 (Std Dev: ±9.7; Min: 40.5; Max: 73.0). After final set of the TN, mean ISQ measured 71.9 (Std Dev: ±6.5; Min: 56.0; Max: 80.0). At 3 months, just prior to restoration, mean ISQ measured 71.0 (Std Dev: ±6.6; Min: 57.0; Max: 78.0). Thereafter mean ISQ continued to increase at both the 7- and 12- month reviews with scores of 78.9 (Std Dev: ± 4.6; Min: 72.0; Max: 84.5) and 80.3 (Std Dev: ± 3.8; Min: 74.5; Max: 85.0) respectively. The surviving 10 implants went on to be fully restored and remain in function beyond the end of the study period to yield a final success rate of 71.4%. CONCLUSION: The purpose of a first-in-human study is to demonstrate an extrapolation of pre-clinical data into the controlled human clinical arena. It is an opportunity to learn what does and does not translate well from experimental data. In that regard the current pilot study can be deemed a complete success. The implant survival rate of 71.4%, while disappointing, should be considered in light of protocol amendments identified, user handling experience learned, and the opportunity to modify the material to better perform in the human subject, as all represent important lessons learnt. The notable increase in ISQ sheds light on the nature by which the glue is substituted for bone to yield a stable implant at the end of the study period.

From disks to channels: dynamics of active nematics confined to an annulus.

Confinement can be used to systematically tame turbulent dynamics occurring in active fluids. Although periodic channels are the simplest geometries to study confinement numerically, the corresponding experimental realizations require closed racetracks. Here, we computationally study 2D active nematics confined to such a geometry-an annulus. By systematically varying the annulus inner radius and channel width, we bridge the behaviors observed in the previously studied asymptotic limits of the annulus geometry: a disk and an infinite channel. We identify new steady-state behaviors, which reveal the influence of boundary curvature and its interplay with confinement. We also show that, below a threshold inner radius, the dynamics are insensitive to the presence of the inner hole. We explain this insensitivity through a simple scaling analysis. Our work sheds further light on design principles for using confinement to control the dynamics of active nematics.

Biologic and Mechanical Stability of Screw-Retained Layered Zirconia Crowns Bonded to CAD/CAM Titanium Abutments Using Angulated Screw Access: A Prospective Closed Cohort Study.

Purpose: To evaluate hard and soft tissue response and mechanical integrity for screw-retained layered zirconia crowns bonded to titanium nitride-coated titanium (TiN) CAD/CAM abutments supported by implants at 1- and 2-year follow-ups. Materials and Methods: A total of 46 patients were restored with a total of 102 free-standing implant-supported layered zirconia crowns, which were bonded to their respective abutments in the dental laboratory and delivered as a one-piece screw-retained crown. Baseline, 1-year, and 2-year data were collated on pocket probing depth, bleeding on probing, marginal bone levels, and mechanical complications. Results: Of the 46 patients, 4 patients with one implant each were not followed-up. These patients were not included in the analysis. Of the remaining 98 implants, due to failed appointments during the global pandemic, soft tissue measurements were recorded for 94 implants at year 1 and 86 implants at year 2, with a mean buccal/lingual pocket probing depth of 1.80/1.95 mm and 2.09/2.17 mm, respectively. Mean bleeding on probing was 0.50 and 0.53 at 1 and 2 years, which represents somewhere between no bleeding and a spot bleed according to the study protocol. Radiographic data were available for 74 implants at year 1 and 86 implants at year 2. The mean marginal bone change from baseline was +0.11 mm mesially and +0.19 mm distally at 1 year and +0.24 mm mesially and +0.16 mm distally at 2 years. The final bone level with respect to the reference point was +0.49 mm mesially and +0.19 mm distally at the end of the study period. Mechanical complications involving a slight misfit of the crown margin were recorded for one unit (1%), porcelain fracture for 16 units (16%), and a loss of preload for 12 units (12%) of < 5 Ncm (< 20% of initial preload). Conclusion: The biologic and mechanical stability of ceramic crowns bonded to CAD/CAM screw-retained abutments using angulated screw access was considered to be high, with overall bone gain, excellent soft tissue health, and only limited mechanical complications related to generally small fractures of the porcelain and a clinically insignificant loss of preload.

Peer support working: a question of ontology and epistemology?

Mental health services are currently undergoing immense cultural, philosophical, and organisational change. One such mechanism involved in this change has been the recognition of lived experience as a knowledge subset in its own right. Within five Community Health Care Organisations [CHOs] in the Irish mental health services, 2017 marked a new era as the traditional statutory mental health service hired a total of 30 Peer Support Workers. Since then, additional Peer Support Workers were recruited along with the added addition of Family Peer Support Work. The purpose of such positions is to use their lived experiences and the knowledge subset within it to normalise experiences, break down hierarchical barriers and facilitate candid conversations that will allow the service user to progress on their own, self-defined recovery journey. Since it's inception into Irish mental health services, peer support has been line managed by a non-peer discipline. It is this where this paper highlights a potential problem. The paper raises concerns that the supervision conducted by these non-peer professionals could tamper, mutate and destroy the essence of peer support-the transfer and use of lived experience between service users. As such, a recommendation is suggested that the literature pauses discussions as to the mechanism by which lived experience is delivered and instead focus energies on identifying the ontological and epistemological position that underpins the experiences.One potential position to examine is that of constructionism as such knowledge is created or constructed through the fusion of life experiences and sub-concious thoughts and emotions experienced at a particular moment in time which are then entangled together with current information to create a narrative or story that can be therapeutic. It is through this philosophical exercise involviong/including existential themes that the essence of lived experience can be identified, protected, and nourished within mental health discourse.

Perceived and Ideal Inequality in University Endowments in the United States.

Whether and which university to attend are among the most financially consequential choices most people make. Universities with relatively larger endowments can offer better education experiences, which can drive inequality in students' subsequent outcomes. We first explore three interrelated questions: the current educational inequality across U.S. universities, people's perceptions of this inequality, and their desired inequality. Educational inequality is large: the top 20% of universities have 80% of the total university endowment wealth while the bottom 20% have around 1%. Studies 1 to 3 demonstrated that people underestimate university endowment inequality and desire more equality. These perceptions and ideals were mostly unaffected by contextual factors (e.g., salience of endowment consequences, distribution range) and were not well explained by participants' demographics. Finally, Study 4 revealed that learning about current endowment inequality decreased tolerance of the distribution of university wealth. We discuss the implications of awareness of educational inequality for behaviors and educational policies.

Examining the existing knowledge base for enablers of family recovery in mental health: a protocol for a scoping review of national and international literature.

INTRODUCTION: Recovery-oriented services in mental health are becoming an accepted approach across much of the globe. While the development of recovery-oriented approaches has focused mainly on people accessing mental health services, families of those accessing services also need to be included under the discussions of mental health recovery within mental health service provision. It is important that service providers understand what support families require in order to facilitate their recovery journeys. To that end, this review will seek to ascertain what evidence exists on the enablers of family recovery from national and international literature. METHOD AND ANALYSIS: This proposed scoping review aims to investigate the family recovery enablers within a mental health context. A Preferred Reporting Items for Systematic Reviews and Meta-Analysis compliant scoping review is proposed, based on Arksey and O'Malley's framework. Search terms are stated and a variety of databases (CINAHL, JSTOR, Ovid SP, PsycINFO, PubMed, RCNi, Science Direct, Web of Science and Wiley Online Library) and repositories (Google, Google Scholar and ResearchGate) will be consulted to examine papers based on a predetermined inclusion/exclusion criteria. The search range is from 1 January 2012 to 31 December 2022. ETHICS AND DISSEMINATION: As this paper presents a protocol for a scoping review of the literature into family enablers in mental health, no ethical approval is required. The preprint protocol was added to OSF Registries on 29 October 2021 where it is freely available. The registry will be updated once this paper has been published. The resulting scoping review will be distributed through peer-reviewed publication in a high impact journal.

In situ preparation of molybdenum-dioxide-incorporated carbonized silk fiber and its application in supercapacitors.

A previous study found that the capacitive behavior of nanoparticles fed to the silkworm can be delivered to carbonized silk fibers, which can be used to fabricate electrodes for the construction of flexible supercapacitors. However, the tendency of nanoparticles to aggregate decreases the quantity of nanoparticles that enter the silk and therefore reduces the capacitance performance of the prepared carbonized silk. Here, we sprayed ammonium molybdate tetrahydrate (AMT) on the surface of mulberry leaves used for feeding silkworms and investigated the effect of feeding AMT on the growth of silkworms and the properties of spun silk. The precursor incorporated into the silk was converted into scattered MoO2 NPs, which were embedded within the carbonized silk fiber (CSF) via carbothermal reduction. The specific capacitance of CSF obtained from silkworms fed with an aqueous solution of AMT-treated mulberry leaves reached up to 298 F/g at 0.2 g/A, which is much higher than that of the control group (102 F/g). Since AMT is highly water-soluble, and its concentration can be easily modulated, we believe that the proposed strategy is feasible for the large-scale fabrication of CSF with enhanced capacitive performance.

Self-mixing in microtubule-kinesin active fluid from nonuniform to uniform distribution of activity.

Active fluids have applications in micromixing, but little is known about the mixing kinematics of systems with spatiotemporally-varying activity. To investigate, UV-activated caged ATP is used to activate controlled regions of microtubule-kinesin active fluid and the mixing process is observed with fluorescent tracers and molecular dyes. At low Péclet numbers (diffusive transport), the active-inactive interface progresses toward the inactive area in a diffusion-like manner that is described by a simple model combining diffusion with Michaelis-Menten kinetics. At high Péclet numbers (convective transport), the active-inactive interface progresses in a superdiffusion-like manner that is qualitatively captured by an active-fluid hydrodynamic model coupled to ATP transport. Results show that active fluid mixing involves complex coupling between distribution of active stress and active transport of ATP and reduces mixing time for suspended components with decreased impact of initial component distribution. This work will inform application of active fluids to promote micromixing in microfluidic devices.

IDENTIFIABILITY OF INFECTION MODEL PARAMETERS EARLY IN AN EPIDEMIC.

It is known that the parameters in the deterministic and stochastic SEIR epidemic models are structurally identifiable. For example, from knowledge of the infected population time series I(t) during the entire epidemic, the parameters can be successfully estimated. In this article we observe that estimation will fail in practice if only infected case data during the early part of the epidemic (prepeak) is available. This fact can be explained using a well-known phenomenon called dynamical compensation. We use this concept to derive an unidentifiability manifold in the parameter space of SEIR that consists of parameters indistinguishable from I(t) early in the epidemic. Thus, identifiability depends on the extent of the system trajectory that is available for observation. Although the existence of the unidentifiability manifold obstructs the ability to exactly determine the parameters, we suggest that it may be useful for uncertainty quantification purposes. A variant of SEIR recently proposed for COVID-19 modeling is also analyzed, and an analogous unidentifiability surface is derived.

Relational diversity in social portfolios predicts well-being.

We document a link between the relational diversity of one's social portfolio-the richness and evenness of relationship types across one's social interactions-and well-being. Across four distinct samples, respondents from the United States who completed a preregistered survey (n = 578), respondents to the American Time Use Survey (n = 19,197), respondents to the World Health Organization's Study on Global Aging and Adult Health (n = 10,447), and users of a French mobile application (n = 21,644), specification curve analyses show that the positive relationship between social portfolio diversity and well-being is robust across different metrics of well-being, different categorizations of relationship types, and the inclusion of a wide range of covariates. Over and above people's total amount of social interaction and the diversity of activities they engage in, the relational diversity of their social portfolio is a unique predictor of well-being, both between individuals and within individuals over time.

Opportunity Neglect: An Aversion to Low-Probability Gains.

Seven preregistered studies (N = 2,890, adult participants) conducted in the field, in the lab, and online documented opportunity neglect: a tendency to reject opportunities with low probability of success even when they come with little or no objective cost (e.g., time, money, reputation). Participants rejected a low-probability opportunity in an everyday context (Study 1). Participants also rejected incentive-compatible gambles with positive expected value-for both goods (Study 2) and money (Studies 3-7)-even with no possibility of monetary loss and nontrivial rewards (e.g., a 1% chance at $99). Participants rejected low-probability opportunities more frequently than high-probability opportunities with equal expected value (Study 3). Although taking some real-life opportunities comes with costs, we show that people are even willing to incur costs to opt out of low-probability opportunities (Study 4). Opportunity neglect can be mitigated by highlighting that rejecting an opportunity is equivalent to choosing a zero probability of success (Studies 6-7).

White (but Not Black) Americans Continue to See Racism as a Zero-Sum Game; White Conservatives (but Not Moderates or Liberals) See Themselves as Losing.

In a 2011 article in this journal entitled "Whites See Racism as a Zero-Sum Game That They Are Now Losing" (Perspectives on Psychological Science, 6, 215-218), Norton and Sommers assessed Black and White Americans' perceptions of anti-Black and anti-White bias across the previous 6 decades-from the 1950s to the 2000s. They presented two key findings: White (but not Black) respondents perceived decreases in anti-Black bias to be associated with increases in anti-White bias, signaling the perception that racism is a zero-sum game; White respondents rated anti-White bias as more pronounced than anti-Black bias in the 2000s, signaling the perception that they were losing the zero-sum game. We collected new data to examine whether the key findings would be evident nearly a decade later and whether political ideology would moderate perceptions. Liberal, moderate, and conservative White (but not Black) Americans alike believed that racism is a zero-sum game. Liberal White Americans saw racism as a zero-sum game they were winning by a lot, moderate White Americans saw it as a game they were winning by only a little, and conservative White Americans saw it as a game they were losing. This work has clear implications for public policy and behavioral science and lays the groundwork for future research that examines to what extent racial differences in perceptions of racism by political ideology are changing over time.