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"Gomez, J"
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Detection and diagnosis of the early caries lesion
The purpose of this manuscript is to discuss the current available methods to detect early lesions amenable to prevention. The current evidence-based caries understanding, based on biological concepts, involves new approaches in caries detection, assessment, and management that should include non-cavitated lesions.
Even though the importance of management of non-cavitated (NC) lesions has been recognized since the early 1900s, dental caries have been traditionally detected at the cavitation stage, and their management has focused strongly on operative treatment. Methods of detection of early carious lesions have received significant research attention over the last 20 years. The most common method of caries detection is visual-tactile. Other non-invasive techniques for detection of early caries have been developed and investigated such as Quantitative Light-induced Fluorescence (QLF), DIAGNOdent (DD), Fibre-optic Transillumination (FOTI) and Electrical Conductance (EC). Based on previous systematic reviews, the diagnosis of NCCLs might be more accurately achieved in combination of the visual method and the use of other methods such as electrical methods and QLF for monitoring purposes.
Journal Article
What about Moose?
\"Fox and her friends are building a playhouse. Everything goes smoothly until bossy Moose tromps in and tries to be in charge of everything. When Moose's bossing causes the project to go awry, can the friends work as a team to come up with a solution?\"-- Provided by publsiher.
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Is calcifediol better than cholecalciferol for vitamin D supplementation?
Modest and even severe vitamin D deficiency is widely prevalent around the world. There is consensus that a good vitamin D status is necessary for bone and general health. Similarly, a better vitamin D status is essential for optimal efficacy of antiresorptive treatments. Supplementation of food with vitamin D or using vitamin D supplements is the most widely used strategy to improve the vitamin status. Cholecalciferol (vitamin D3) and ergocalciferol (vitamin D2) are the most widely used compounds and the relative use of both products depends on historical or practical reasons. Oral intake of calcifediol (25OHD3) rather than vitamin D itself should also be considered for oral supplementation. We reviewed all publications dealing with a comparison of oral cholecalciferol with oral calcifediol as to define the relative efficacy of both compounds for improving the vitamin D status. First, oral calcifediol results in a more rapid increase in serum 25OHD compared to oral cholecalciferol. Second, oral calcifediol is more potent than cholecalciferol, so that lower dosages are needed. Based on the results of nine RCTs comparing physiologic doses of oral cholecalciferol with oral calcifediol, calcifediol was 3.2-fold more potent than oral cholecalciferol. Indeed, when using dosages ≤ 25 μg/day, serum 25OHD increased by 1.5 ± 0.9 nmol/l for each 1 μg cholecalciferol, whereas this was 4.8 ± 1.2 nmol/l for oral calcifediol. Third, oral calcifediol has a higher rate of intestinal absorption and this may have important advantages in case of decreased intestinal absorption capacity due to a variety of diseases. A potential additional advantage of oral calcifediol is a linear dose-response curve, irrespective of baseline serum 25OHD, whereas the rise in serum 25OHD is lower after oral cholecalciferol, when baseline serum 25OHD is higher. Finally, intermittent intake of calcifediol results in fairly stable serum 25OHD compared with greater fluctuations after intermittent oral cholecalciferol.
Journal Article
Fast computational optimization of TMS coil placement for individualized electric field targeting
•Auxiliary dipole method (ADM) optimizes TMS coil placement in under 8 min.•Optimum coil position is up to 14 mm away from conventional targeting.•Optimum coil orientation is typically near normal to the sulcal wall.•TMS induced E-field is less sensitive to orientation than position errors.
During transcranial magnetic stimulation (TMS) a coil placed on the scalp is used to non-invasively modulate activity of targeted brain networks via a magnetically induced electric field (E-field). Ideally, the E-field induced during TMS is concentrated on a targeted cortical region of interest (ROI). Determination of the coil position and orientation that best achieve this objective presently requires a large computational effort.
To improve the accuracy of TMS we have developed a fast computational auxiliary dipole method (ADM) for determining the optimum coil position and orientation. The optimum coil placement maximizes the E-field along a predetermined direction or, alternatively, the overall E-field magnitude in the targeted ROI. Furthermore, ADM can assess E-field uncertainty resulting from precision limitations of TMS coil placement protocols.
ADM leverages the electromagnetic reciprocity principle to compute rapidly the TMS induced E-field in the ROI by using the E-field generated by a virtual constant current source residing in the ROI. The framework starts by solving for the conduction currents resulting from this ROI current source. Then, it rapidly determines the average E-field induced in the ROI for each coil position by using the conduction currents and a fast-multipole method. To further speed-up the computations, the coil is approximated using auxiliary dipoles enabling it to represent all coil orientations for a given coil position with less than 600 dipoles.
Using ADM, the E-fields generated in an MRI-derived head model when the coil is placed at 5900 different scalp positions and 360 coil orientations per position (over 2.1 million unique configurations) can be determined in under 15 min on a standard laptop computer. This enables rapid extraction of the optimum coil position and orientation as well as the E-field variation resulting from coil positioning uncertainty. ADM is implemented in SimNIBS 3.2.
ADM enables the rapid determination of coil placement that maximizes E-field delivery to a specific brain target. This method can find the optimum coil placement in under 15 min enabling its routine use for TMS. Furthermore, it enables the fast quantification of uncertainty in the induced E-field due to limited precision of TMS coil placement protocols, enabling minimization and statistical analysis of the E-field dose variability.
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Journal Article
Endoscopic retromuscular technique (eTEP) vs conventional laparoscopic ventral or incisional hernia repair with defect closure (IPOM +) for midline hernias. A case–control study
PurposeThis study aimed at clinical results in terms of postoperative pain and functional recovery of new technique (eTEP) compared to IPOM + for ventral/incisional midline hernias. Recurrence rate, intra/postoperative complications and aesthetic results are secondary aims.MethodsData from consecutive patients requiring minimally invasive hernia repair were collected. From January 2015 to September 2018, patients with midline ventral/incisional hernias underwent IPOM + were compared to patients underwent eTEP procedure from October 2018 to December 2019 in a case/control study.ResultsThirty-nine patients in IPOM + group and 40 in eTEP group were included. No significant differences were identified when hernias types, mean defect area, mean mesh area and intraoperative/postoperative complications (except seroma rate in favor of eTEP group) were compared. Operative time and hospital stay were significantly higher in eTEP group and IPOM + group, respectively. eTEP group showed significantly less pain on 1st, 7th and 30th postoperative days than IPOM + group. Restriction of activities was significantly decreased in eTEP group on the 30th and 180th day after surgery. Significant differences were observed in terms of cosmetic results 30th and 180th days after surgery in favor of eTEP group.Average follow-up was 15 months in eTEP group and 28 months in IPOM + group. No recurrences were identified in eTEP group and one recurrence in IPOM + group with no significant differences.ConclusionEndoscopic retromuscular technique shows significant lower postoperative pain, better functional recovery and cosmesis than IPOM + without differences in intra/postoperative complications (except seroma rate) or recurrences during the follow-up. eTEP requires longer operative time.
Journal Article
A decade of progress in critical care echocardiography: a narrative review
IntroductionThis narrative review focusing on critical care echocardiography (CCE) has been written by a group of experts in the field, with the aim of outlining the state of the art in CCE in the 10 years after its official recognition and definition.ResultsIn the last 10 years, CCE has become an essential branch of critical care ultrasonography and has gained general acceptance. Its use, both as a diagnostic tool and for hemodynamic monitoring, has increased markedly, influencing contemporary cardiorespiratory management. Recent studies suggest that the use of CCE may have a positive impact on outcomes. CCE may be used in critically ill patients in many different clinical situations, both in their early evaluation of in the emergency department and during intensive care unit (ICU) admission and stay. CCE has also proven its utility in perioperative settings, as well as in the management of mechanical circulatory support. CCE may be performed with very simple diagnostic objectives. This application, referred to as basic CCE, does not require a high level of training. Advanced CCE, on the other hand, uses ultrasonography for full evaluation of cardiac function and hemodynamics, and requires extensive training, with formal certification now available. Indeed, recent years have seen the creation of worldwide certification in advanced CCE. While transthoracic CCE remains the most commonly used method, the transesophageal route has gained importance, particularly for intubated and ventilated patients.ConclusionCCE is now widely accepted by the critical care community as a valuable tool in the ICU and emergency department, and in perioperative settings.
Journal Article
Coherent elastic neutrino-nucleus scattering at the European Spallation Source
A
bstract
The European Spallation Source (ESS), presently well on its way to completion, will soon provide the most intense neutron beams for multi-disciplinary science. Fortuitously, it will also generate the largest pulsed neutrino flux suitable for the detection of Coherent Elastic Neutrino-Nucleus Scattering (CE
ν
NS), a process recently measured for the first time at ORNL’s Spallation Neutron Source. We describe innovative detector technologies maximally able to profit from the order-of-magnitude increase in neutrino flux provided by the ESS, along with their sensitivity to a rich particle physics phenomenology accessible through high-statistics, precision CE
ν
NS measurements.
Journal Article
Changes in plasma levels of fat-derived hormones adiponectin, leptin, resistin and visfatin in patients with rheumatoid arthritis
Background: Rheumatoid arthritis is a chronic autoimmune inflammatory condition characterised by polyarthritis and severe change in body mass and neuroendocrine environment. Objectives: To investigate plasma levels of adipocytokines (leptin, adiponectin, visfatin and resistin) in patients with rheumatoid arthritis and to compare them with levels in healthy controls. Methods: Adiponectin, resistin, visfatin and leptin concentrations were measured in 31 patients with rheumatoid arthritis and 18 healthy controls by using specific enzyme-linked immunosorbent assays. Results: Patients with rheumatoid arthritis showed considerably higher plasma levels of leptin, adiponectin and visfatin than healthy controls. No marked difference was observed in resistin levels between patients and controls. Conclusion: A marked increase in plasma levels of leptin, adiponectin and visfatin was noted in patients with rheumatoid arthritis, whereas resistin levels were similar to those observed in healthy controls. Coordinated roles for adiponectin, leptin and visfatin are suggested in the modulation of the inflammatory environment in patients with rheumatoid arthritis, whereas the lack of modulation in resistin levels is predictive of an irrelevant role for this peptide, suggesting that resistin level is probably not one of the main signals associated with the pathogenesis of this disease.
Journal Article
Decolonisation of fractional calculus rules: Breaking commutativity and associativity to capture more natural phenomena
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To answer some issues raised about the concept of fractional differentiation and integration based on the exponential and Mittag-Leffler laws, we present, in this paper, fundamental differences between the power law, exponential decay, Mittag-Leffler law and their possible applications in nature. We demonstrate the failure of the semi-group principle in modeling real-world problems. We use natural phenomena to illustrate the importance of non-commutative and non-associative operators under which the Caputo-Fabrizio and Atangana-Baleanu fractional operators fall. We present statistical properties of generator for each fractional derivative, including Riemann-Liouville, Caputo-Fabrizio and Atangana-Baleanu ones. The Atangana-Baleanu and Caputo-Fabrizio fractional derivatives show crossover properties for the mean-square displacement, while the Riemann-Liouville is scale invariant. Their probability distributions are also a Gaussian to non-Gaussian crossover, with the difference that the Caputo Fabrizio kernel has a steady state between the transition. Only the Atangana-Baleanu kernel is a crossover for the waiting time distribution from stretched exponential to power law. A new criterion was suggested, namely the Atangana-Gómez fractional bracket, that helps describe the energy needed by a fractional derivative to characterize a 2-pletic manifold. Based on these properties, we classified fractional derivatives in three categories: weak, mild and strong fractional differential and integral operators. We presented some applications of fractional differential operators to describe real-world problems and we proved, with numerical simulations, that the Riemann-Liouville power-law derivative provides a description of real-world problems with much additional information, that can be seen as noise or error due to specific memory properties of its power-law kernel. The Caputo-Fabrizio derivative is less noisy while the Atangana-Baleanu fractional derivative provides an excellent description, due to its Mittag-Leffler memory, able to distinguish between dynamical systems taking place at different scales without steady state. The study suggests that the properties of associativity and commutativity or the semi-group principle are just irrelevant in fractional calculus. Properties of classical derivatives were established for the ordinary calculus with no memory effect and it is a failure of mathematical investigation to attempt to describe more complex natural phenomena using the same notions.
Journal Article