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Biofilm formation by Enterococcus faecalis ( E. faecalis) in root canals is a significant challenge in endodontic therapy, often leading to persistent infections and treatment failures. This research paper investigates the antibiofilm efficacy of methylene blue mediated photothermal treatment (MB-PTT), as compared to the sole effect of diode laser, PTT, and sodium hypochlorite (NaOCl) on E. faecalis biofilms. 45 maxillary central incisors were decoronated, prepared and infected by E faecalis for seven days. Forty samples were randomly allocated as follows; GI; irrigated with 2.6% NaOCl, GII; irradiated with 660 nm diode laser (250 mW) for 180 s. GIII; Silver nanoparticles (AgNPs) with diode laser application at same parameters (AgNPs-PTT), GIV: accompanied MB and AgNPs-PTT, while 5 samples were kept as control for biofilm formation. The antibiofilm effect was demonstrated both by bacterial colonies counting (CFU/ml) and scanning electron microscope images. The results highlight the potential of all experimental treatment modalities ( P  < 0.01), However complete absence of detactable bacterial colonies was only evident when MB was coupled with AgNPs-PTT. Accompanied MB with PTT is a promising approach with effective antibiofilm activity against E. faecalis biofilms.

BackgroundThe detection and early diagnosis of root fractures can be challenging; this difficulty applies particularly to newly qualified dentists. Aside from clinical examination, diagnosis often requires radiographic assessment. Nonetheless, human fallibility can introduce errors due to a lack of experience.AimThe proposed system aimed to assist in detecting root fractures through the integration of artificial intelligence techniques into the diagnosis process as a step for automating dental diagnosis and decision-making processes.Materials and methodA total of 400 radiographic images of fractured and unfractured teeth were obtained for the present research. Data handling techniques were implemented to balance the distribution of the samples. The AI-based system used the voting technique for five different pretrained models namely, VGG16, VGG19, ResNet50. DenseNet121, and DenseNet169 to perform the analysis. The parameters used for the analysis of the models are loss and accuracy curves.ResultsVGG16 exhibited notable success with low training and validation losses (0.09% and 0.18%, respectively), high specificity, sensitivity, and positive predictive value (PPV). VGG19 showed potential overfitting concerns, while ResNet50 displayed progress in minimizing loss but exhibited bias toward unfractured cases. DenseNet121 effectively addressed overfitting and noise issues, achieving balanced metrics and impressive PPVs for both fractured and unfractured cases (0.933 and 0.898 respectively). With increased depth, DenseNet169 demonstrated enhanced generalization capability.ConclusionThe proposed AI- based system demonstrated high precision and sensitivity for detecting root fractures in endodontically treated teeth by utilizing the voting method.

Background Regenerative endodontic therapy (RET) is still coming up short to demonstrate histological evidence for true regeneration with clinically feasible protocol of cell homing in single visit approach. Aim The aim of the present study is to evaluate the regenerative potential of photobiomodulation (PBM) on RET in immature roots when photodynamic therapy (PDT) protocol is implemented for root canal disinfection in canine model. Materials and methods Seventy-two root canals were recruited, with sixty assigned to experimental groups and twelve to positive and negative controls. Following the induction of pulp necrosis and apical periodontitis, the roots were divided into two experimental groups: Group I received RET followed by PBM (seven sessions with an 808 nm diode laser at 300 mW for 90 s), and Group II received RET without PBM. Follow-ups were conducted at 1, 2, and 3 months (subgroups A, B, and C respectively). Qualitative and quantitative assessment was carried out histologically. All data were statistically analyzed with the Mann-Whitney U test and Bonferroni’s adjustment, as well as Chi square test. Results The newly formed hard tissue highly resembled true dentine where the dentinal tubules looked well organized lined by poly layers palisading pattern of rounded odontoblast-like cells with cytoplasmic processes extending through the predentine layer. GI exhibited statistically significantly higher scores of vital tissue infiltration and hard tissue deposition in subgroups A and B ( P  ≤ 0.05). The inflammatory cells scores were significantly lower in GI than in GII at all time intervals. However, no significance could be detected regarding apical closure. Conclusion The disinfection protocol of PDT and subsequent irradiation with low power laser in PBM protocol pose a promising potential for regenerative endodontics in immature teeth.

Aim of the study This study aims to evaluate the effectiveness of a 980-nm diode laser in inducing mineral trioxide aggregate (MTA) nanoparticle precipitation on root canal dentin surfaces for dentinal coverage. Materials and methods Sixty mature single-rooted teeth were decoronated at a fixed length of 16 mm and instrumented to size #40/0.04. Canals were filled with either distilled water or nanoMTA suspension and randomly divided based on the treatment modality into: G I and G II flooded with distilled water and laser irradiated at 2 Watt and 4 Watt respectively, GIII and GIV flooded with nanoMTA suspension and laser irradiated at 2 Watt and 4 Watt respectively, G V, flooded with nanoMTA suspension without laser irradiation, and G VI flooded with distilled water without laser irradiation. All samples were longitudinally split and scanned by environmental scanning electron microscopy (ESEM) to evaluate dentinal tubule (DT) occlusion and MTA surface precipitation. Image J analysis software was used to quantify open DTs, while a scoring system assessed dentine coverage. Results Laser irradiation significantly enhanced nanoMTA precipitation and dentinal tubule occlusion. The highest dentinal surface coverage, indicated by the lowest pixel percentage, was in laser-irradiated nanoMTA suspension groups G IV (3.4 ± 3.1) and G III (16.7 ± 3), while the lowest coverage was in the non-irradiated saline group G VI (53.4 ± 9.6) ( p  < 0.05). Median dentinal coverage scores were also highest in G III and G IV (both = 4). G VI showed the least dentinal occlusion, with a statistically significant difference from other groups ( p  < 0.05). Conclusion The 980-nm diode laser effectively enhances MTA nanoparticle precipitation on root canal surfaces, improving dentinal tubule occlusion and sealing potential. Further research is warranted to optimize laser parameters, MTA suspension ratios and to assess clinical outcomes.

Introduction Rett syndrome is a rare genetic neurodevelopmental disorder that predominantly impacts females. It presents with loss of acquired skills, impaired communication, and stereotypic hand movements. Given the limited treatment options for Rett syndrome, there is a dire need for effective interventions. Objective To evaluate the safety and efficacy of trofinetide in Randomized Controlled Trials (RCTs) that report on Rett syndrome patients. Methods We identified 109 articles from four databases (Scopus, PubMed, Web of Science, and Cochrane CENTRAL). After removing the duplicates, we narrowed them down to 59 articles for further assessment. We included RCTs that evaluated the efficacy and safety of trofinetide in patients with Rett syndrome. Three studies were eligible for inclusion. Two independent reviewers evaluated the identified studies’ titles, abstracts, and full texts, extracting pertinent data. We assessed the quality of the studies using the Cochrane Risk of Bias (RoB) 2.0 tool. We then conducted a meta-analysis using the fixed effects model in the case of insignificant heterogeneity; otherwise, we used the random effects model. Based on the nature of the outcome, we analyzed the mean difference or the odds ratio. Analysis was conducted using RevMan version 5.3. Results Among the analyzed outcomes in 181 patients in the trofinetide group and 134 patients in the placebo group, significant improvement in Rett Syndrome Behavior Questionnaire (RSBQ) scores was observed at 200 mg dosage (overall mean difference: -3.53, p  = 0.001). Clinical Global Impression-Improvement (CGI-I) scores improved considerably at 200 mg dosage (overall mean difference: -0.34, p  < 0.0001). No substantial changes were observed in Motor Behavioral Assessment (MBA) or Top 3 Caregiver Concerns. We evaluated Treatment Emergent Adverse Events (TEAEs) across the various dosages and noted significant associations with diarrhea (200 mg), vomiting (200 mg), and irritability (200 mg). However, we did not find a significant association between any of the dosages and the incidence of decreased appetite. Conclusion Trofinetide demonstrated potential in improving RSBQ and CGI-I scores at 200 mg dosage. Although no substantial changes were found in MBA and top 3 caregiver concerns. Adverse events were linked to specific dosages.

BackgroundCoronaphobia refers to intensified and persistent fears of contracting COVID-19 virus infection. This study aimed to evaluate the newly termed phenomenon, coronaphobia, and address its associated correlates among Egyptian physicians during the outbreak. A cross-sectional study, including a total of 426 Egyptian physicians working during COVID-19 outbreak, was conducted between March 1st and May 1st, 2020. The Fear of COVID-19 Scale (FCV-19S) and Hospital Anxiety and Depression Scale (HADS) were utilized for assessment of coronaphobia, and comorbid anxiety and depressive symptoms among physicians, respectively during the outbreak.ResultsModerate-to-severe symptoms of anxiety and depression were reported by 28% and 30% of physicians, respectively. Physicians experiencing higher levels of coronaphobia were more likely to be females, nonsmokers, having death wishes and/or self-harming thoughts, receiving insufficient training, dissatisfied with their personal protective equipment (PPE), and had colleagues infected with COVID-19 virus infection. Coronaphobia was positively correlated with anxiety (r = 0.59, P < 0.001) and depressive symptoms (r = 0.47, P < 0.001).ConclusionsEgyptian physicians experienced higher levels of coronaphobia, anxiety, and depressive symptoms during the COVID-19 outbreak. Yet, frontline physicians did not differ from their second-line counterparts regarding the aforementioned symptoms. Routine mental and physical assessment measures of medical staff should be implemented.

With low-dose stimulation and high-dose inhibition, insecticide-induced hormesis, a biphasic phenomenon, can contribute to pest resurgence. The cowpea aphid, Aphis craccivora (Koch) (Homoptera: Aphididae), is a vital insect that infests legume crops. Its hormesis of flupyradifurone has not been previously established. Age-stage two-sex life analysis is used to investigate the sublethal and transgenerational effects of flupyradifurone on two successive generations of A. craccivora. A leaf-dip bioassay method revealed high toxicity of flupyradifurone against A. craccivora, with lethal concentration 50% value (LC50) of 1.82 mg L−1 after 48 h exposure. Treatment of parent generation (F0) with LC10 and LC25 of flupyradifurone significantly increased the longevity and fecundity of the directly exposed adults. The results of transgenerational effects showed that the treatment of (F0) with LC25 induced significant hormetic effects in progeny generation (F1). Furthermore, flupyradifurone at LC25 significantly enhanced the biological traits, such as intrinsic rate of increase (r), finite rate of increase (λ), and net reproductive rate (R0) compared with the control. Similarly, both LC10 and LC25 induced a significant increase in the mean generation time T (d). Conversely, both treatments caused a significant decrease in the doubling time (DT). Data in the present study demonstrate that the exposure of (F0) to flupyradifurone at LC10 and LC25 enhanced longevity and fecundity in the directly exposed adults of A. craccivora, and induced transgenerational hormesis across the subsequent (F1) generation. These results should be taken into consideration when using flupyradifurone for controlling cowpea aphid.

Spodoptera littoralis (Boisd.) (Lepidoptera: Noctuidae) is a major economic pest attacking a variety of crops in Egypt and other Mediterranean countries. S. littoralis has developed resistance to both traditional and novel insecticides. The current study investigated S. littoralis resistance to indoxacarb regarding inheritance mode, realized heritability (h2), and fitness costs. An indoxacarb-resistant strain (Indoxa-SEL) was obtained by selecting a field strain with indoxacarb. Indoxa-SEL strain outperformed the susceptible one (Indoxa-S) by 29.77-fold after 16 consecutive generations of selection. Based on the LC50 values of the progenies of reciprocal crosses F1 (R♂ × S♀) and F1′ (R♀ × S♂), S. littoralis resistance to indoxacarb was found to be autosomal and partially recessive. Chi-square tests for goodness-of-fit between observed and expected mortalities of self-bred F1 and resistant strain reciprocal crosses revealed that the resistance was controlled by multiple genes. The resistant strain had a relative fitness of 0.80, with significantly increased total preovipositional period of females, egg, larvae, pupae, preadult, adult, and total longevity period. The estimated realized heritability value in the Indoxa-SEL strain was 0.21. The current study will contribute to sustaining indoxacarb efficacy and designing effective resistance management programs against S. littoralis. Graphical Abstract

Background: The cabbage moth, Mamestra brassicae, is a polyphagous pest that attacks several crops. Here, the sublethal and lethal effects of chlorantraniliprole and indoxacarb were investigated on the developmental stages, detoxification enzymes, reproductive activity, calling behavior, peripheral physiology, and pheromone titer of M. brasssicae. Methods: To assess pesticide effects, the second instar larvae were maintained for 24 h on a semi-artificial diet containing insecticides at their LC10, LC30, and LC50 concentrations. Results: M. brassicae was more susceptible to chlorantraniliprole (LC50 = 0.35 mg/L) than indoxacarb (LC50 = 1.71 mg/L). A significantly increased developmental time was observed with both insecticides at all tested concentrations but decreases in pupation rate, pupal weight, and emergence were limited to the LC50 concentration. Reductions in both the total number of eggs laid per female and the egg viability were observed with both insecticides at their LC30 and LC50 concentrations. Both female calling activity and the sex pheromone (Z11-hexadecenyl acetate and hexadecenyl acetate) titer were significantly reduced by chlorantraniliprole in LC50 concentration. Antennal responses of female antennae to benzaldehyde and 3-octanone were significantly weaker than controls after exposure to the indoxocarb LC50 concentration. Significant reductions in the enzymatic activity of glutathione S-transferases, mixed-function oxidases, and carboxylesterases were observed in response to both insecticides.

Mixed lineage kinase domain-like pseudokinase (MLKL), one of the main downstream components of the necroptosis or programmed necrosis has recently been demonstrated in advanced atherosclerotic lesions. However, its precise role in the atherosclerosis pathogenesis still requires more elucidation. Our study was set to delineate both the changes in peripheral MLKL gene expression and its influence on disease severity in atherosclerotic patients with and without type 2 diabetes mellitus. The study involved 50 patients (20 non-diabetics and 30 diabetics) undergoing coronary artery bypass graft and 20 apparently healthy controls. Taqman RT-PCR was used to quantify MLKL mRNA expression levels, while ELISA was employed to estimate serum insulin and high sensitivity C-reactive protein (hsCRP) levels. Compared with the control group, MLKL gene was up regulated significantly in cardiovascular diseases (CVD; p ≤ 0.001). Higher MLKL expression was demonstrated in diabetic CVD group than non-diabetic group (p < 0.05). Correlation studies reported positive associations between MLKL and markers of dyslipidemia, inflammation, and insulin resistance. Multiple regression analysis revealed that FBG levels, hsCRP levels, and total white blood cells count were significant predictors for MLKL levels. Receiver operating characteristic curve showed a significant diagnostic value of MLKL for CVD. Moreover, regression analysis demonstrated that MLKL and hsCRP were independent predicting factors for the severity of CVD. MLKL is linked to hallmarks of atherosclerosis and could explain increased cardiovascular risk in diabetic patients. Thus, it can be a potential drug target for treatment of atherosclerotic patients.