Effectiveness of a dental simulation game on reducing pain and anxiety during primary molars pulpotomy compared with tell-show-do technique in pediatric patients: a randomized clinical trial.

BACKGROUND: Dental simulation games are virtual educational games that help children get familiar with different dental procedures. This study aimed to evaluate the pretreatment exposure to the "Baby Panda Dental Care" game in reducing pain and anxiety in comparison with the tell-show-do (TSD) technique during primary molars pulpotomy for patients aged 6-10 years. MATERIALS AND METHODS: It was a triple-blinded, two-arm, parallel-group, randomized, active-controlled trial. It was done on 60 patients, who were randomly divided into two groups: the control group, TSD technique (n = 30), and the experimental group, "Baby Panda Dental" Care (n = 30). For the TSD technique, children were provided with a verbal explanation followed by a demonstration of the dental treatment in a non-threatening way. The "do" phase is then initiated during performing treatment. For the "Baby Panda dental care" game, children were asked to play for 5 min before treatment, selecting root canal therapy procedures. Pulse rate and RMS pictorial scale were recorded at four time points: (1) at the baseline (t0). (2) After conditioning the child (t1). (3) During treatment (t2). (4) After finishing the treatment (t3). Face, Legs, Activity, Cry, Consolability (FLACC) behavioral pain scale was recorded during treatment (t2). RESULTS: The pulse rate is higher in the control group at t1 (p = 0.012) and t2 (p = 0.015). There was a statistically significant difference in the mean RMS pictorial scale score at t1 (p < 0.001), t2 (p = 0.006), and t3 (p < 0.001), a statistically significant difference was noticed in FLACC behavioral pain assessment between the two groups (p = 0.033). CONCLUSIONS: The mobile dental game showed better results than the TSD technique, but neither technique did not reduce anxiety and pain effectively during dental treatment. TRIAL REGISTRATION: The trial was registered at the ISRCTN registry (ISRCTN30470866) on 19/04/2024.

Prosody Trumps Orthography in Second Language Phonology: The Case of Consonant Gemination.

This paper examines the understudied phenomenon of consonant gemination in the pronunciation of English among Levantine Arabic learners of English (LA learners). The very few studies that touched on gemination among LA learners attributed gemination to spelling in the target language (English). This study challenges this analysis and demonstrates that gemination is primarily a phonological phenomenon that is triggered by first language under-represented structural rules as well as Universal Grammar (UG) markedness principles. Data were elicited through semi-structured interviews with three groups of LA learners. Contrary to previous studies (on other phonological aspects), which argue that interference errors decrease over time, findings show that gemination is attested across all groups of LA learners and persists even among advanced learners. Results show that interface phenomena involving more than one phonological level pose a great challenge to second language learners.

Foreign Accented-Speech and Perceptions of Confidence and Intelligence.

The purpose of the current study is to explore listeners' perception of accented speech in terms of confidence and intelligence. To this end, three groups of listeners were asked to rate speakers of English with various accent strengths based on a 9-point scale in terms of accent magnitude, confidence and intelligence. Results show that the two Jordanian listener groups, unlike the English listeners, reacted similarly toward Jordanian-accented speakers of English. Overall, the three groups tended to link accentedness with perceptions of confidence and intelligence. The findings of this study have significant implications for advocating a tolerant attitude toward speakers of English as a foreign language in the fields of education, employment opportunities, and social justice. It is suggested that stereotyping speakers as inferior in terms of qualities such as confidence and intelligence reflects established listener's bias rather than lack of speaker's intelligibility.

COMPARATIVE ASSESSMENT OF NOVEL 3D PRINTED RESIN CROWNS VERSUS DIRECT CELLULOID CROWNS IN RESTORING PULP TREATED PRIMARY MOLARS.

PURPOSE: The primary objective of this randomized controlled trial is to compare the clinical impact of using crowns manufactured by 3D printing and direct composite celluloid crowns as a final restoration for primary molars after pulpotomy procedures. MATERIAL AND METHODS: Fifty primary molars selected from the children needing treatment at the Pediatric Dentistry Clinic at Damascus University Faculty of Dentistry were randomized by using SPSS and divided into 2 groups based on fabricating methods: Group A: 3D-printed crowns with the utilization of biocompatible light-curing composite, and Group B: Crowns were made directly using composite carried out by prefabricated celluloid crown. The evaluation team assessed the crowns in each group using the United States Public Health Service (USPHS) criteria for retention, marginal integrity, and gingival health at baseline, followed by 3 follow-up sessions at 3, 6, and 12 months. RESULTS: Chi-Square statistical testing was accomplished using SPSS software to compare crown failure among the experimental group. At the 12-month follow-up, no statistically significant differences were noted between groups (P = .157). For gingival health assessment, the Mann-Whitney test was used. No statistically significant differences were recorded between the 2 groups in the third follow-up month (P = .058); However, a significant difference was noted in the 6th and 12th follow-up months (P = .023, P = .000). For marginal integrity comparison, Mann-Whitney statistical Test was used for the third, sixth, and twelfth-month follow-up sessions. A significant difference was noted in all follow-up periods (3-6-12 months) between the direct and indirect crowns (P = .025, P = .025, P = .002, respectively). CONCLUSION: The 2 types of experimental crowns (direct composite celluloid crowns and the resin crowns manufactured via 3D printer) were suitable esthetic alternatives for restoring pulp-treated primary molars with a notably higher rate of retention with direct composite crowns. 3D-printed resin crowns, however, portrayed superior gingival health in addition to greater marginal integrity.

Carbon and Nitrogen Dynamics, and CO2 Efflux in the Calcareous Sandy Loam Soil Treated with Chemically Modified Organic Amendments.

In Saudi Arabia, more than 335,000 tons of cow manure is produced every year from dairy farming. However, the produced cow manure is usually added to the agricultural soils as raw or composted manure; significant nitrogen losses occur during the storage, handling, and application of the raw manure. The recovery of ammonia from cow manure through thermochemical treatments is a promising technique to obtain concentrated nitrogen fertilizer and reducing nitrogen losses from raw manure. However, the byproduct effluents from the recovery process are characterized by different chemical properties from the original raw manure; thus, its impact as soil amendments on the soil carbon and nitrogen dynamics is unknown. Therefore, a 90-day incubation experiment was conducted to study the impact of these effluents on CO2 efflux, organic C, microbial biomass C, available NH4+, and NO3- when added to agricultural soil. In addition to the two types of effluents (produced at pH 9 and pH 12), raw cow manure (CM), composted cow manure (CMC), cow manure biochar (CMB), and control were used for comparison. The application of CM resulted in a considerable increase in soil available nitrogen and CO2 efflux, compared to other treatments. Cow manure biochar showed the lowest CO2 efflux. Cumulative CO2 effluxes of cow manure effluents were lower than CM; this is possibly due to the relatively high C:N ratio of manure effluent. The content of P, Fe, Cu, Zn, and Mn decreased as incubation time increased. Soil microbial biomass C for soil treated with cow manure effluents (pH 12 and 7) was significantly higher than the rest of the soil amendments and control.

Exploring the use of grammarly in assessing English academic writing.

This study explores the extent to which Grammarly can be a reliable assessment tool for academic English writing. Ten articles published in high-status scholarly Q.1 journals and written by specialist English native speakers were used to evaluate the accuracy of Grammarly's flagged issues. The results showed that Grammarly tends to over-flag many issues resulting in many false positives; besides, it does not take into consideration optional usage in English. The study concluded that although Grammarly can identify many ambiguous instances of language use that writers would do well to review and consider for revision, it does not seem to be a reliable tool for assessing academic written English.

Three-dimensional Pouchography: A Proof-of-concept Study of a Breakthrough Technique for Visualising Ileoanal Pouch Anatomy and Morphology in Normal and Mechanical Pouch Complication Patients.

BACKGROUND: Herein, we present a proof-of-concept study of three-dimensional [3D] pouchography using virtual and printed 3D models of ileal pouch-anal anastomosis [IPAA] in patients with normal pouches and in cases of mechanical pouch complications. METHODS: We performed a retrospective, descriptive case series of a convenience sample of 10 pouch patients with or without pouch dysfunction, who had CT scans appropriate for segmentation who were identified from our pouch registry. The steps involved in clinician-driven automated 3D reconstruction are presented. RESULTS: We included three normal patients who underwent CT imaging and were found to have no primary pouch pathology, and seven patients with known pouch pathology identifiable with 3D reconstruction [including pouch strictures, megapouch, pouch volvulus, and twisted pouches], underwent 3D virtual modelling; one normal and one twisted pouch were 3D-printed. We discovered that 3D pouchography reliably identified staple lines [pouch body, anorectal circular and transverse, and tip of J], the relationship between staple lines, and variations in pouch morphology and pouch pathology. CONCLUSION: Three-dimensional reconstruction of IPAA morphology is highly feasible using readily available technology. In our practice, we have found 3D pouchography to be an extremely useful adjunct to diagnose various mechanical pouch complications and improve planning for pouch salvage strategies. Given its ease of use and helpfulness in understanding the pouch structure and function, we have started to routinely integrate 3D pouchography into our clinical pouch referral practice. Further study is needed to formally assess the value of this technique to aid in the diagnosis of pouch pathology.

Impact of climate change on paediatric respiratory health: pollutants and aeroallergens.

Paediatric populations are particularly vulnerable to respiratory diseases caused and exacerbated by aeroallergens, pollutants and infectious agents. Worsening climate change is expected to increase the prevalence of pollutants and aeroallergens while amplifying disease severity and causing disproportionate effects in under-resourced areas. The purpose of this narrative review is to summarise the role of anthropogenic climate change in the literature examining the future impact of aeroallergens, pollutants and infectious agents on paediatric respiratory diseases with a focus on equitable disease mitigation. The aeroallergens selected for discussion include pollen, dust mites and mould as these are prevalent triggers of paediatric asthma worldwide. Human rhinovirus and respiratory syncytial virus are key viruses interacting with climate change and pollution and are primary causal agents of viral respiratory disease. Within this review, we present the propensity for aeroallergens, climate change and pollution to synergistically exacerbate paediatric respiratory disease and outline measures that can ameliorate the expected increase in morbidity and severity of disease through a health equity lens. We support shifting from fossil fuels to renewable energy worldwide, across sectors, as a primary means of reducing increases in morbidity.

Innovative Approaches to Safe Surgery: A Narrative Synthesis of Best Practices.

By encompassing a wide range of best practices within the ever-changing realm of modern surgical care, this exhaustive narrative compendium attempts to unravel the complex tapestry of novel approaches to safe surgery. Within the context of a dynamic surgical environment, this research endeavors to illuminate and integrate state-of-the-art methods that collectively methodically improve patient safety. The narrative elucidates a diverse array of practices that seek to revolutionize the paradigm of safe surgery, emphasizing technological progress, patient-centric approaches, and global viewpoints. The combined effectiveness of these methods in fostering an all-encompassing culture of safety, improving surgical precision, and decreasing complications is revealed by the results obtained from their implementation. The recognition of the dynamic interplay among multiple components, including the active participation of patients, the integration of cutting-edge technologies, and the establishment of comprehensive quality improvement programs, is fundamental to this narrative. By their collective composition, these components support the notion that secure surgical practices are intricate and interrelated. The present synthesis functions as a fundamental resource for healthcare professionals, policymakers, and researchers, providing an enlightening examination of the current condition of secure surgical practices. By emphasizing the promotion of innovation, continuous development, and the utmost quality of patient care, it offers a strategic guide for navigating the complex terrain of safe surgery. In the ever-evolving landscape of surgical care, this narrative synthesis serves as a guiding principle for stakeholders striving to understand better and implement safe surgical procedures in various healthcare environments.

Clinical Performance of Two Types of Primary Molar Indirect Crowns Fabricated by 3D Printer and CAD/CAM for Rehabilitation of Large Carious Primary Molars.

OBJECTIVES: This randomized clinical trial aimed to evaluate clinical outcomes of two types of esthetic crowns fabricated using a three-dimensional (3D) dental printer and computer-aided design and manufacturing (CAD/CAM) system as an alternative full-coronal restoration for extensively carious pulp-treated primary molars. MATERIALS AND METHODS: Randomization was done for 50 lower primary molars in 50 child patients, split into two groups based on the fabrication method used: Group A: CAD/CAM crowns using polymethyl methacrylate (PMMA) blocks and Group B: 3D dental printed crowns using GC photopolymer resin. All crowns were evaluated at baseline and at 3rd, 6th, and 12th months using the U.S. Public Health Service criteria for gingival health, retention, and marginal integrity for both groups. STATISTICAL ANALYSIS: The survival rate of 3D-printable crowns was 84% compared with 80% survival rate using CAD/CAM fabricated crowns at the end of the 12th-month follow-up. No statistically significant differences were noted in restoration failure. In the evaluation of gingival health between the two groups' follow-up times, no statistically significant differences were noted at the 3rd- and 6th-month follow-ups, yet at the 12th month, statistically significant differences were noted (p = 0.022) when comparing gingival health. No statistically significant differences were noted between the two groups when comparing marginal integrity scores in all the follow-up periods. CONCLUSION: Resin crowns fabricated via 3D dental printer and PMMA crowns fabricated using CAD/CAM are acceptable esthetic choices in restoring pulp-treated primary molars with great marginal integrity and crowns retention. 3D-printed resin crowns showed less cementing failure and performed better regarding gingival response compared with PMMA crowns.

Low dose gamma irradiation attenuates cyclophosphamide-induced cardiotoxicity in rats: role of NF-κB signaling pathway.

PURPOSE: Cyclophosphamide (Cyp) is one of the most commonly used, wide spectrum chemotherapeutic agents. Cyp has multi-organ toxicities that are dose limiting, thus it's mostly used in chemotherapeutic combinations. Radiation is well known as a hazardous sort of energy, recent studies are interested in studying the beneficial therapeutic effects of low-dose gamma radiation. This study examined the protective effect of two different doses/dose-rates of irradiation either alone or combined with telmisartan against Cyp-induced cardiotoxicity. MATERIALS AND METHODS: Rats were divided into seven groups; (1): Control, (2): Cyp, (3-4): 0.05 Gy low dose rate (LDR) irradiation, 0.25 Gy high dose rate (HDR) irradiation, respectively, prior to Cyp dose, (5-7): telmisartan either alone or with 0.05 Gy LDR-irradiation or 0.25 Gy HDR-irradiation, respectively, prior to Cyp dose. The current investigation studied the effect of Cyp alone or combined with different treatment regimens on serum cTn-I and LDH, nuclear factor-κB (NF-κB) pathway (p65/IκB/IKK-α/IKK-ß) in the myocardium. Pro-inflammatory cytokines IL-1ß, IL-6 and TNF-α were assessed in addition to histopathological examination of the heart. RESULTS: Low-dose irradiation attenuated cardiac enzymes, pro-inflammatory cytokines, NF-κB content, and histology, in both low and HDRs. Furthermore, the combination of low-dose irradiation with telmisartan (an angiotensin-II receptor type-1 blocker and a known cardio-protective drug) offered the best histological results. CONCLUSIONS: Low-dose irradiation-induced amelioration is partially but not completely through canonical activation of NF-κB, and may have another atypical pathway. While telmisartan probably ameliorates NF-κB totally through canonical pathway.

Effect of nicotine replacement therapy on cardiovascular outcomes after acute coronary syndromes.

The optimal approach to encourage smoking cessation after acute coronary syndrome (ACS) remains unclear. The safety of nicotine replacement therapy (NRT) after ACS is not well established. The aim of the present study was to determine the relationship between NRT use and adverse cardiovascular outcomes after ACS. Using a pre-existing database, 663 smokers with ACS were identified. The patients were separated into the NRT (n = 184) or control (n = 479) groups according to whether NRT was prescribed on hospital discharge. Multivariate logistic regression analysis was used to account for the baseline differences between the 2 groups. Of the 663 patients, 202 had adverse events in the first year after ACS. No significant differences were seen with NRT use for the 1-year combined end point of death, myocardial infarction), repeat revascularization, or rehospitalization for angina, congestive heart failure or arrhythmia (odds ratio [OR] 0.89, 95% confidence interval [CI] 0.61 to 1.30, p = 0.54). There were no differences in the individual 1-year end points of death (odds ratio 0.80, 95% confidence interval 0.33 to 1.91, p = 0.61), myocardial infarction (odds ratio 0.90, 95% confidence interval 0.40 to 2.06, p = 0.80), repeat revascularization (odds ratio 0.77, 95% confidence interval 0.44 to 1.36, p = 0.37), or rehospitalization for angina, congestive heart failure, or arrhythmia (odds ratio 1.01, 95% confidence interval 0.66 to 1.53, p = 0.97). In conclusion, NRT use was not associated with an increased risk of adverse cardiovascular events in the first year after ACS.