Effect of ferrule height and distribution on the fracture resistance of endodontically treated premolars.

OBJECTIVE: To evaluate the effect of varying ferrule height and distribution on the fatigue resistance and fracture strength of endodontically treated premolars. MATERIALS AND METHOD: Thirty-two extracted human premolars were endodontically treated and prepared to receive all-ceramic crowns. Teeth were randomly divided into two groups. The occluso-cervical height was reduced to 2 mm and 4 mm for the 1st and 2nd groups, respectively. According to the ferrule distribution, samples in each group were randomly divided into two subgroups with inadequate ferrule on 1 or 2 proximal walls, respectively. Coronal tooth structure was built-up to 4 mm using a core build-up material retained by a fiber post. The CEREC system (Sirona) was used to design and mill lithium-disilicate crowns. All posts and crowns were cemented to their respective teeth using self-adhesive universal resin cement. All crowns were subjected to cyclic loading in a universal testing machine (Instron) (20-100N, 100,000 cycles, 20Hz). After fatigue, crowns were loaded to fracture. Fracture load data were analyzed using two-way ANOVA at α = 0.05. RESULTS: All crowns passed the fatigue testing without any signs of fracture or crack. Two-way ANOVA revealed a statistically significant effect of the number of missing walls (P < 0.05) on the fracture load, but not the ferrule height or the interaction terms. Samples with one missing wall showed higher fracture load in comparison to samples with two missing walls. CONCLUSION: The number of missing walls, not the ferrule height, has a significant effect on the fracture load of the lithium-disilicate crowns restoring endodontically treated premolars.

Supercomputer-Based Ensemble Docking Drug Discovery Pipeline with Application to Covid-19.

We present a supercomputer-driven pipeline for in silico drug discovery using enhanced sampling molecular dynamics (MD) and ensemble docking. Ensemble docking makes use of MD results by docking compound databases into representative protein binding-site conformations, thus taking into account the dynamic properties of the binding sites. We also describe preliminary results obtained for 24 systems involving eight proteins of the proteome of SARS-CoV-2. The MD involves temperature replica exchange enhanced sampling, making use of massively parallel supercomputing to quickly sample the configurational space of protein drug targets. Using the Summit supercomputer at the Oak Ridge National Laboratory, more than 1 ms of enhanced sampling MD can be generated per day. We have ensemble docked repurposing databases to 10 configurations of each of the 24 SARS-CoV-2 systems using AutoDock Vina. Comparison to experiment demonstrates remarkably high hit rates for the top scoring tranches of compounds identified by our ensemble approach. We also demonstrate that, using Autodock-GPU on Summit, it is possible to perform exhaustive docking of one billion compounds in under 24 h. Finally, we discuss preliminary results and planned improvements to the pipeline, including the use of quantum mechanical (QM), machine learning, and artificial intelligence (AI) methods to cluster MD trajectories and rescore docking poses.

The association of single nucleotide polymorphisms of Toll-like receptor 3, Toll-like receptor 7 and Toll-like receptor 8 genes with the susceptibility to HCV infection.

BACKGROUND: Single nucleotide polymorphisms (SNPs) of Toll-like receptors (TLRs) are linked with functional modification of cytokine responses. In chronic hepatitis C virus (HCV) infection, studies of TLR polymorphisms have primarily targeted receptor pathways implicated in viral immune responses. We hypothesized that one or more variant(s) of TLR3, TLR7 and TLR8 are associated with different outcomes of HCV infection. MATERIALS & METHODS: A total of 3368 subjects from 850 families were recruited and divided into three main groups categorized as chronic HCV CHC spontaneous viral clearance (SVC), and controls. All individuals were genotyped for three SNPs for TLR3, two SNPs for TLR7, and two SNPs for TLR8 using allelic discrimination real-time PCR. RESULTS: Carriage of the C allele in three SNPs of TLR3 (rs3775290, rs3775291, and rs5743312), the C allele in TLR7 (rs3853839) in females only, and the C allele in TLR8 (rs3764879) in males only were significantly higher in SVC group than CHC group (P < 0.001), while carriage of the T allele in TLR7 (rs179008) in females only and the A allele in TLR8 (rs3764880) in both males and females were significantly higher in CHC infection more than SVC group (P < 0.001). CONCLUSION: The C allele is protective of HCV in TLR3, TLR7 (rs3853839) in females only, and TLR8 (rs3764879) in males only, while risk of infection is linked to the T allele in TLR7 (rs179008) in females only and the A allele in TLR8 (rs3764880) in both sexes.

Female sexual dysfunction post radical cystectomy and urinary diversion.

OBJECTIVES: To evaluate the impact of radical cystectomy and urinary diversion on female sexual function. MATERIALS AND METHODS: A Medline search was conducted according to the PRISMA statement for all English full-text articles published between 1980 and 2016 and assessing female sexual function post radical cystectomy and urinary diversion. Eligible studies were subjected to critical analysis and revision. The primary outcomes were the reporting methods for female sexual dysfunction (FSD), manifestations of FSD, and factors associated with FSD, postoperative recoverability of FSD, and awareness level regarding FSD. RESULTS: From the resulting 117 articles, 11 studies were finally included in our systematic review, with a total of 361 women. Loss of sexual desire and orgasm disorders were the most frequently reported (49% and 39%). Dyspareunia and vaginal lubrication disorders were reported in 25% and 9.5%, respectively. The incidence of sexual dysfunction was 10% in 30 patients receiving genital- or nerve-sparing cystectomy vs. 59% receiving conventional cystectomy. CONCLUSION: Although female sexual function is an important predictor of health-related quality of life post radical cystectomy and urinary diversion, the available literature is not enough to provide proper information for surgeons and patients.

Alzheimer's disease: new insight in assessing of amyloid plaques morphologies using multifractal geometry based on Naive Bayes optimized by random forest algorithm.

Alzheimer's disease (AD) is a physical illness, which damages a person's brain; it is the most common cause of dementia. AD can be characterized by the formation of amyloid-beta (Aß) deposits. They exhibit diverse morphologies that range from diffuse to dense-core plaques. Most of the histological images cannot be described precisely by traditional geometry or methods. Therefore, this study aims to employ multifractal geometry in assessing and classifying amyloid plaque morphologies. The classification process is based on extracting the most descriptive features related to the amyloid-beta (Aß) deposits using the Naive Bayes classifier. To eliminate the less important features, the Random Forest algorithm has been used. The proposed methodology has achieved an accuracy of 99%, sensitivity of 100%, and specificity of 98.5%. This study employed a new dataset that had not been widely used before.

A new strategy for the early detection of alzheimer disease stages using multifractal geometry analysis based on K-Nearest Neighbor algorithm.

Alzheimer's Disease (AD) is considered one of the most diseases that much prevalent among elderly people all over the world. AD is an incurable neurodegenerative disease affecting cognitive functions and were characterized by progressive and collective functions deteriorating. Remarkably, early detection of AD is essential for the development of new and invented treatment strategies. As Dementia causes irreversible damage to the brain neurons and leads to changes in its structure that can be described adequately within the framework of multifractals. Hence, the present work focus on developing a promising and efficient computing technique to pre-process and classify the AD disease especially in the early stages using multifractal geometry to extract the most changeable features due to AD. Then, A machine learning classification algorithm (K-Nearest Neighbor) has been implemented in order to classify and detect the main four early stages of AD. Two datasets have been used to ensure the validation of the proposed methodology. The proposed technique has achieved 99.4% accuracy and 100% sensitivity. The comparative results show that the proposed classification technique outperforms is recent techniques in terms of performance measures.

Tension-type headache in the Emergency Department Diagnosis and misdiagnosis: The TEDDi study.

Headache is a common reason to visit the emergency department (ED). Tension-type headache (TTH) is the commonest headache. The diagnosis of TTH implies a mild condition, with no need for special tests. We evaluated the use of the International Classification of Headache Disorders (ICHD) criteria for TTH in the ED. We performed a cross-sectional study including all ED patients with a definite TTH diagnosis in their discharge report for 2.5 years. We evaluated whether the ICHD criteria for TTH were referenced and met. We analysed discrepancies concerning anamnesis or prior history and reclassified patients. A total of 211 out of 2132 patients fulfilled the criteria (9.9%). Only five patients fulfilled TTH criteria. Criteria A-D were referenced in 60-84% of patients and met in 16-74% of these patients. Anamnesis was discrepant in 87.5% as was prior history in 20.8%. After re-reclassification, 21 patients fulfilled the criteria for TTH (five) or probable TTH (16). In 106 patients, another headache was diagnosed, with migraine in 40 (18.9%), secondary headache in 64 (30.3%), and a life-threatening disorder in 13 (6.1%). In our sample, TTH was overdiagnosed. Only a minority of patients fulfilled the ICHD criteria. Inconsistencies in prior medical history or anamnesis were frequent.

Supercomputer-Based Ensemble Docking Drug Discovery Pipeline with Application to Covid-19.

We present a supercomputer-driven pipeline for in-silico drug discovery using enhanced sampling molecular dynamics (MD) and ensemble docking. We also describe preliminary results obtained for 23 systems involving eight protein targets of the proteome of SARS CoV-2. THe MD performed is temperature replica-exchange enhanced sampling, making use of the massively parallel supercomputing on the SUMMIT supercomputer at Oak Ridge National Laboratory, with which more than 1ms of enhanced sampling MD can be generated per day. We have ensemble docked repurposing databases to ten configurations of each of the 23 SARS CoV-2 systems using AutoDock Vina. We also demonstrate that using Autodock-GPU on SUMMIT, it is possible to perform exhaustive docking of one billion compounds in under 24 hours. Finally, we discuss preliminary results and planned improvements to the pipeline, including the use of quantum mechanical (QM), machine learning, and AI methods to cluster MD trajectories and rescore docking poses.

The role of artery-preserving varicocelectomy in subfertile men with severe oligozoospermia: a randomized controlled study.

BACKGROUND: There is wide agreement nowadays that a clinical varicocoele should be ligated to treat male factor infertility. However, the significance of testicular artery preservation in patients with severe oligozoospermia has not been addressed before. OBJECTIVES: To assess the outcome of varicocelectomy in infertile men with severe oligozoospermia and clinical varicocoeles and to compare internal spermatic artery preservation vs. artery ligation. MATERIALS AND METHODS: This prospective randomized study included 302 infertile patients with severe oligozoospermia and clinical (grade II/III) varicocoeles. Patients were randomized into two groups: group A (150 patients) underwent artery-preserving varicocelectomy (APV) and group B (152 patients) underwent artery-ligating varicocelectomy (ALV). The primary outcome was to assess the changes in sperm density and motility at 3 and 6 months postoperatively in both groups. The secondary outcome was to compare the natural pregnancy rate at 1-year of follow-up. Univariate and multivariate analyses were performed to determine factors affecting pregnancy rate. RESULTS: In both groups, there was a statistically significant improvement in sperm density and motility at 3 and 6 months postoperatively. In group A, there was a greater improvement in sperm density (p < 0.001) and motility (p < 0.001) compared to group B. At 1-year follow-up, overall 35.1% achieved a natural pregnancy. Group A achieved a significantly higher natural pregnancy rate (40% vs. 30%, p value = 0.03) compared to group B. Smaller testicular volume and ALV were the independent predictors of lower pregnancy rate ((HR = 3.2, 95% CI 1.2-8.3, p = 0.01) and (HR = 3.2, 95% CI 1.4-7.1, p = 0.003), respectively). CONCLUSION: In men with severe oligozoospermia and a clinical varicocoele, APV results in improved outcomes as compared to ALV with respect to semen parameters and natural pregnancy rates. Therefore, all attempts should be made to preserve internal spermatic arteries (ISA) during varicocelectomy in men with severe oligozoospermia.

Heatless synthesis of well dispersible Au nanoparticles using pectin biopolymer.

Due to its potency to utilize in enormous applications, preparation of nanogold is of interest. Moreover, getting of highly dispersed nanogold with small size is extremely needful in specific fields. Herein, Au nanocolloid was prepared using alkali catalyzed pectin biopolymer. Pectin was concurrently used as reductant for Au ions and stabilizer for the produced Au nanoparticles (AuNPs). Reducing sugars were evaluated in the colloidal solution reflecting the role alkali in catalytic degradation of pectin to produce much powerful reducing moieties. The obtained Au nanocolloid was monitored via changing in color, UV-visible spectral and transmission electron microscopy. Using of NaOH as strong alkali achieving rapid rate of degradation reaction, resulted in 0.45g/L reducing sugars from 0.2g/L pectin which produced AuNPs with mean size of 6.5nm. In case of Na2CO3 which attained slow degradation rate led to, slightly low reducing sugar content (0.41g/L), fabricated comparatively size of AuNPs (7.5nm). In both cases, well distributed AuNPs was obtained with suitable stabilization up to 5 months and Na2CO3 exhibited higher stability. The current successful method used to produce small sized AuNPs with high dispersion is an innovative, one-step, easily, costless, energy saving and eco-friendly method.

Instantly AgNPs deposition through facile solventless technique for poly-functional cotton fabrics.

Nowadays, functional clothes are employed for human body protection in addition to be fashionable clothes. Hence functionalization of clothes increases the attention of scientists and business. In the current study, poly-functional cotton fabric was carried out by instantly deposition of AgNPs using two solventless techniques namely; sorption and padding. Sorption technique was exhibited extremely high efficiency than padding one by ca. 10 times. By using the same concentrations of AgNO3, Ag content was ranged 69.3-6094.8 mg/kg and 33.8-609.3 mg/kg for sorption and padding, respectively. After AgNPs deposition, fabrics color was turned to gray-reddish yellow. By applying 5912.3 mgAg/kg fabric, bacterial reduction and UPF value were reached 99% and 12.59. Bacterial reduction and UPF were lessened to 90% and 10.19 after 20 washings. These findings proved that the direct AgNPs deposition into cotton using solventless/sorption technique is applicable in manufacturing of antibacterial/UV resistant fabrics with acquired decorative color.

Ag(0) nanoparticles containing cotton fabric: Synthesis, characterization, color data and antibacterial action.

The main objective of the current research was to successfully employ the reducing and stabilizing features of xanthan gum to synthesize nanosilver, then coating cotton fabrics with the net produced nanosilver in order to obtain finished fabrics valuable in medical applications. Pre-hydrolyzed xanthan gum was used to reduce Ag(+) to Ag(0) in nano size using a simple one-step rapid synthetic route. The reduction step was followed up by measuring the concentration of reducing sugars eliminated in the reaction medium. The optimum concentration of xanthan gum was 3g/L to reduce 1 mmol/L Ag(+), as 2.66 ± 0.4 g/L was the maximum concentration of reducing sugars obtained in the reaction. Transmission microscope images show that the AgNPs are spherical in shape with mean size 9.1 ± 4.8 nm. Cotton fabrics were then coated with the produced AgNPs using pad-dry-cure method. Well dispersed layer from Ag(0) on cotton surface was showed under electron microscope. The biocidal activities of the coated fabrics were tested against Staphylococcus aureus and showed excellent results for antibacterial even after 20 washing cycles. This method has the advantage of not necessitating aggressive conditions such as the presence of organic solvents to produce durable antibacterial cotton fabrics.

Functionalization of medical cotton by direct incorporation of silver nanoparticles.

Medical cotton is usually used to clean skin, pack wounds and in other surgical tasks. Such important usages make imparting the antibacterial property to medical cotton is so essential research. The current research focuses on functionalization of medical cotton by direct incorporation of silver nanoparticles (AgNPs) in two-step process namely, pre-alkalization followed by sorption. Decorative color and antibacterial action were accomplished for medical cotton after in situ incorporation of AgNPs without using any other external reducing agent. AgNPs were produced due to the reduction action of alcoholic and aldehydic groups of cotton's skeletal blocks. Cotton fibers were acquired a decorative color attributed to surface plasmon resonance of AgNPs. The treated cotton was characterized by using electron microscope. Results showed that Ag(0) with size distribution of 0-160 nm was formed in the cotton fibers and their size majority (70%) was less than 80 nm. The reduction of Ag(+) to Ag(0) was confirmed by measuring the carboxylic and aldehydic contents. The treated cotton exhibited excellent antibacterial action at low silver contents. The absorbency of cotton was not affected by treatment. The produced medical cotton could be used to safe cleaning of wounds without getting any microbial infections.

Study of bilharzial uropathy by means of hippuran I131 extended renography.

Renal, ureteral, and vesicle functions were evaluated in 209 patients with obstructive lesions of the ureter due to schistosomiasis haematobia (bilharziasis), using Hippuran I131 extended renography. High values for Tmax. and T 1/2 were noted for both kidneys irrespective of radiological diagnosis of a left- or right-sided lesion. A high percentage of residual vesicle urine was demonstrated in a number of patients with bilharzial uro-obstructive lesions. The incidence of vesicoureteral reflux in relation to different lesions was also correlated. The results of this study support the concept that urinary schistosomiasis is a progressive disease which affects mainly the urinary bladder and lower ureter. The data obtained demonstrate the efficacy of extended renography in assessing renal, ureteral, and vesical function in patients with bilharziasis.

Flap ureteroplasty for segmental structure of middle third of ureter.

A technique is described for repair of segmental stricture of the middle third of the ureter utilizing spiral or vertical flap from the proximal dilated ureter. In all cases a 10 F polyethylene ureteric stent with a ureterotomy exit 5 cm. distal to the repair site was used. Twenty-eight ureters in 27 patients were repaired by this technique, with good results in all except 3 cases which showed postoperative residual dilatation three months after surgery.

Bilharziasis of urinary bladder and ureter: comparative histopathologic study.

The relative incidence and intensity of oviposition in schistosomiasis in different layers of both the urinary bladder and the ureter are presented. Histopathological changes in both organs are elucidated. Oviposition was heaviest in the submucosa of the urinary bladder, while the muscle layer was affected in 15% of specimens. Oviposition was mainly periureteral and in outer muscle layer of the ureter, and was present in only 22% in the ureteral submucosa. Epithelial changes, namely, Brunn nests, cystitis glandularis, cystitis cystica, and squamous metaplasia, were more marked in the bladder specimens than in the ureteral specimens. Squamous cell papilloma and squamous metaplasia associated with acanthosis of the bladder specimens were identified. Results indicate unanimously that the heavy deposition of ova in the submucosa of the bladder leads through its mechanical and toxic irritation to marked epithelial and premalignant changes which pave the way for the disturbing frequency of carcinoma of the bladder in the bilharzial patients which is not the case in the ureter.

Effects of contraceptive pills and intrauterine devices on urinary bladder.

The incidence of bacteriuria and cystoscopic changes in women on oral contraceptives or users of IUD (intrauterine devices) were evaluated compared with a control group. Subjects with bacteriuria accounted for 40.5 per cent of pill users, 20 per cent of women fitted with IUD, and 16 per cent of the control group. Bladder trabeculations were found in 50.5 per cent of the pill group, 8.7 per cent of the IUD group, and 8 per cent of the controls. Congested bladder trigone was observed in 24.6 per cent of women fitted with an IUD. The mode of action of ovarian hormones and their possible side effects on the bladder are discussed. The relation of IUD to pelvic inflammatory disease and its effect on the urinary bladder are evaluated.

PIP: The incidence of bacteriuria and cystoscopic changes in 200 women using oral contraceptives from 1 month to 2 years and 150 users of IUD were compared with 50 women using neither method. Bacteriuria in midstrean urine samples of all subjects were identified qualitatively and quantitatively by the method of Stamey et al. Cystoscopy was performed on all subjects. Positive bacteriuria were found in 40.5% of patients on oral contraceptives, 20% of IUD users, and 16% of the control group. Positive pathogenic bacterial cultures in women using oral contraceptives were proportional to the length of time the pill had been used: 27% for 1 year users, 35% for 2 year users, and 50% for longer users. The potency and dosage is correlated with the pathogenic effects observed. Bladder trabeculations were found in 50.5% of oral contraceptive users, 8.7% of IUD users, and 8% of control subjects. The highest incidence was in subjects using pills for 2 years or more, and is correlated with the dosage used. Bladder trigone congestion was observed in 24.6% of IUD users; 56% of users from 1 to 3 months, 35% of users more than 2 years, and no users between these time extremes. The high incidence of bladder trabeculations might be explained by the effect of progestogens and estrogens on bladder tone; progestogens producing hypotonia and estrogens hypertonia. The IUD should not be used more than 2-3 years continuously to avoid urinary bladder effects and inflammatory pelvic disease.

In situ hypothermic renal perfusion. Evaluation of three intracellular solutions.

Description of a simple technique for in situ hypothermic renal perfusion is presented. Three intracellular solutions simulating perfusates were tried on three groups of mongrel dogs with a fourth group that served as control. Right nephrectomy was performed on all dogs. The left kidney was perfused for two and one-half hours at a temperature of 15 degrees to 17 degrees C. Follow-up evaluation by estimation of five enzymes, glutamic oxaloacetic transaminase, alkaline phosphatase, lactic dehydrogenase, sorbitol dehydrogenase, and phospholexose isomerase in serum, urine, and renal tissue was conducted. Renal function was evaluated by the level of serum creatinine and its twenty-four-hour urinary excretion. Minimal biochemical changes comparable to the control group were observed in the group perfused by Chapman solution.

Hemodynamic performance of stentless porcine bioprosthesis and mechanical bileaflet prosthesis using dobutamine stress echocardiography.

Currently available aortic valve prostheses have satisfactory hemodynamic performance during rest, but with exercise they possess different responses. The objective was to compare the hemodynamic response of the stentless porcine bioprosthesis (SP) and the mechanical bileaflet prosthesis (MB) at rest and during peak exercise using dobutamine stress echocardiography (DSE). DSE was used to evaluate the effective orifice area index (EOAI), peak and mean pressure gradients at rest and during maximum stress in 15 patients with SP (group T, mean age, 30.9 year) and another 15 patients with MB (group M, mean age, 28.6 year). The increment in pressure gradient (mean/peak) was significantly less in patients with SP than those with MB (P <.01). The EOAI did not change with exercise. At rest, both valve substitutes have satisfactory hemodynamics, but during exercise the stentless porcine bioprosthesis has better hemodynamics because it is less obstructive that justifies its use in young population.

Serum nickel, copper and zinc in Norplant users.

Changes in serum nickel, copper and zinc were evaluated in 45 Norplant users. Two groups were selected for this study. Group I included 15 regularly menstruating females as controls and as short-term users (90 days after Norplant insertion). Group II included 30 Norplant users for one year or more as long-term users. These elements were determined by atomic absorption spectrophotometry. Serum nickel showed no significant change in short-term nor in long-term users when compared to the control group or to each other. Serum copper and zinc revealed a significant increase in short-term users for a short period of time, which returned to normal levels in long-term users. There was disappearance of the cyclic changes in serum copper and zinc concentrations on comparing their levels in ovulatory to non-ovulatory Norplant users. The use of Norplant has no deleterious effects on serum levels of nickel, copper and zinc.

PIP: Serum nickel, copper, and zinc levels were monitored by atomic absorption spectrophotometry in 15 women in the proliferative and luteal phases of their cycles before beginning Norplant contraception and 3 months later, and in 30 users of Norplant for 1 year or more. Serum nickel did not change significantly in short or longterm Norplant users in comparison with before Norplant self-controls or between groups, ranging from 0.221 to 0.28 mcg.dl. Serum copper rose from 100.07 mcg.dl in new users on Cycle Day 5 to 110.86 in ovulating women and 123.5 in nonovulating women in the control cycle. Copper was 118.7 before Norplant and not significantly different at 120.87 after 3 months. Copper levels were 104.26 in the 1st sample in longterm users, rising to 129.14 and 126.5 in ovulating and non-ovulating longterm users 3 months later. Zinc averaged 121.1 mcg/dl before Norplant on Day 5, falling to 94.86 and 97.38 in ovulating and nonovulating women in the luteal phase. Zinc rose slightly from 118.9 to 125.27 before and after 3 months on Norplant. Zinc fell from 107.9 to 91.86 and 94.61 in ovulating and nonovulating longterm users. The similarities and differences of these results with prior reports of trace element in oral and injectable contraceptive users are discussed.