In this paper, a model for a multi-agent swarm evolving in a d-dimensional space is proposed. The model consists of a balance among attraction to a given goal and attraction/repulsion among agents. ...One of the main characteristics of the model is the presence of an interaction matrix on agents' coordinates, defining some properties of the swarm formation. The paper focuses on the analysis of the new model highlighting the agents' steady-state behaviour both in terms of static and rotating configuration around the goal. Numerical simulations are provided to support the obtained results.
Aim
To compare the educational outcomes using artificial teeth versus extracted teeth for pre‐clinical endodontic training.
Data sources
Literature searches of PubMed, Scopus, Cochrane Library, Trip ...Database, Web of Science and Open Grey databases were conducted from their inception until November 2018 with no language restriction. Hand searching of most likely relevant journals was performed. The review followed the PRISMA guidelines.
Study eligibility criteria, participants and interventions
Studies that compared pre‐clinical endodontic training using extracted teeth and artificial teeth were included.
Study appraisal and synthesis methods
The quality of included studies was appraised by Joanna Briggs Institute Critical Appraisal tools. The findings were tabulated and summarized according to their outcomes with distinct narrative syntheses.
Results
Five studies were included. The component studies included 359 operators in total, mainly consisting of undergraduate students (97%, n = 349) and 10 endodontists (3%). Forty‐seven per cent (n = 170) operated on artificial teeth only, whilst 19% (n = 67) worked primarily on extracted teeth, with the final treatment outcome being evaluated by independent observers using objective criteria. Operators in two studies (34%, n = 122) used both artificial teeth and ET and compared their experiences in surveys. Regarding technical outcomes, no significant differences between training with artificial teeth and extracted teeth were found, but the performance tended to be better in artificial teeth than extracted teeth. Operators trained solely on artificial teeth appeared to be adequately educated for subsequent root canal treatment (RCT) in the clinical setting.
Limitations
Due to the scarcity of research on the topic overall, and the methodological variation between the studies, it was not possible to perform a quantitative analysis (meta‐analysis).
Conclusions and implications of key findings
Based on the available evidence, the use of artificial teeth for pre‐clinical endodontic training achieved similar educational outcomes compared to extracted teeth. However, the experiences reported by the operators diverged. Further studies assessing other artificial teeth available in the market testing other RCT procedures are necessary.
The assessment of root canal curvature is essential for clinical and research purposes. This systematic review presents an overview of the published techniques for the measurement of root canal ...curvature features using imaging and to provide a critique of their clinical application. A database search in PubMed, PubMed Central, Embase, Scopus, EBSCO Dentistry & Oral Sciences Source and Virtual Health Library was conducted, using appropriate key words to identify measurement methods for root canal curvatures. The search strategy retrieved 10594 records in total, and 31 records fulfilled the inclusion criteria. From 2D image acquisitions, eleven studies measured exclusively the angle of curvature, an additional thirteen measured other curvature features (level, height, radius, length and shape). Seven reports described methods from 3D imaging (CBCT, μCT). Root canal curvatures should be measured, for clinical proposes, to facilitate endodontic treatment planning, and in research, to reduce the risk of selection bias. This review has revealed that there are many methods described in the literature; however, no consensus exists on which method should be used. Some of the methodologies have potential clinical translation, whereas others are suitable for research purpose only, as they require a specific software or radiographic exposure in the mesiodistal direction.
Aim
To assess the prevalence of dental emergency visits (DEV) involving pain relief and their relationship with socio‐economic and clinical factors in an Australian representative sample in the ...primary care setting.
Methodology
Data on reason for visit and patient characteristics were collected from a representative random sample of Australian dentists in private practice surveyed in 2009–2010. Information regarding socio‐economic (gender, age, health insurance) and clinical factors (number of teeth, number of decayed teeth, diagnosis and reason for visit DEV, check‐up, other reasons not involving pain relief) were retrieved from compiled questionnaires. Descriptive statistics were reported, and Poisson regression models were used to assess the association between socio‐economic and clinical factors and DEV. Prevalence ratio (PR) and 95% confidence interval (CI) were calculated.
Results
A total of 1148 dentists responded (67%), resulting in records from 6504 patients. The overall prevalence of DEV was 20.8%. The unadjusted analysis, according to the reason of visit, revealed the following predictors for DEV: male gender (PR = 1.18; 95% CI = 1.08–1.29), age 18–64 years (PR = 2.70; 95% CI = 2.19–3.33) and over 65 years (PR = 2.64, 95% CI = 2.10–3.32), uninsured patients (PR = 1.36; 95% CI = 1.24–1.49), patients with <20 teeth (PR = 1.19; 95% CI = 1.06–1.33), decayed teeth (PR = 1.64; 95% CI = 1.48–1.81). After adjustment for confounding factors (gender, age, insurance status, number of teeth and decayed teeth) apart from ‘dental trauma’ (PR = 1.37), all remaining diagnoses had lower PR (‘other’ PR = 0.19, ‘decay’ PR = 0.34, ‘periodontal’ PR = 0.51, ‘failed restoration’ PR = 0.45) compared with ‘pulp/periapical disease’.
Conclusions
In the primary care setting, the diagnoses ‘pulp/periapical’ and ‘dental trauma’ had a stronger association with DEV compared with visits not involving relief of pain. Both socio‐economic (male gender, older age and uninsured individuals) and clinical factors (tooth loss, decayed teeth, endodontic diseases and dental trauma) were identified as independent risk indicators for DEV in this population. Future public health policies should include specific preventive strategies addressing these factors, aiming to reduce the need for DEV.
Metastasis is the major cause of breast cancer mortality. Phosphoinositide 3-kinase (PI3K) generated PtdIns(3,4,5)P3 activates AKT, which promotes breast cancer cell proliferation and regulates ...migration. To date, none of the inositol polyphosphate 5-phosphatases that inhibit PI3K/AKT signaling have been reported as tumor suppressors in breast cancer. Here, we show depletion of the inositol polyphosphate 5-phosphatase PIPP (INPP5J) increases breast cancer cell transformation, but reduces cell migration and invasion. Pipp ablation accelerates oncogene-driven breast cancer tumor growth in vivo, but paradoxically reduces metastasis by regulating AKT1-dependent tumor cell migration. PIPP mRNA expression is reduced in human ER-negative breast cancers associated with reduced long-term outcome. Collectively, our findings identify PIPP as a suppressor of oncogenic PI3K/AKT signaling in breast cancer.
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•Pipp knockout promotes oncogene-driven breast cancer initiation and growth•Ablation of Pipp impairs metastasis in a mouse model of breast cancer•PIPP regulates AKT1-dependent cell migration and invasion•Low PIPP expression is associated with ER-negative breast cancer and poor prognosis
Ooms et al. identify the inositol polyphosphate 5-phosphatase PIPP as a suppressor of oncogenic PI3K/AKT signaling in breast cancer. PIPP depletion increases transformation and accelerates oncogene-driven tumor growth in vivo, while paradoxically reducing cell migration, invasion, and metastasis.
The role and effect of glide path preparation in root canal treatment remain controversial. This systematic review aims to compare apical transportation and canal centring of different glide path ...preparation techniques, with or without subsequent engine‐driven root canal preparation. A database search in PubMed, PubMed Central, Embase, Scopus, EBSCO Dentistry & Oral Sciences Source and Virtual Health Library was conducted, using appropriate key words to identify the effect of glide path preparation (or its absence) on apical transportation and canal centring. An assessment for the risk of bias in included studies was carried out. Amongst 2146 studies, 18 satisfied the inclusion criteria. Nine studies assessed glide path preparation per se, comparing apical transportation and canal centring of rotary systems and/or manual files; eleven further investigations examined the efficacy of the glide path prior to final canal preparation with different engine‐driven systems. Risk of bias and other study design features with potential influence on study outcomes and clinical implications were assessed. Based on the available evidence, and within the limitation of the studies included, preparation of a glide path using rotary sequences performs similarly (in most of the component studies) or significantly better than manual preparation when assessing apical transportation or canal centring. When compared to the absence of a glide path, canal shaping following glide path preparation was of similar, or significantly better quality, in regard to apical transportation or canal centring.
Aim
To compare soft‐tissue dissolution by sodium hypochlorite, with an EDTA intermediate rinse, with or without activation with passive ultrasonic activation (PUI) or sonic activation using the ...Endoactivator (EA) or Eddy tips (ED).
Methodology
The root canals of eighty‐three human maxillary central incisors were chemo‐mechanically prepared and the teeth split. A standardized longitudinal intracanal groove was created in one of the root halves. Eighty‐three porcine palatal mucosa samples were collected, adapted to fit into the grooves and weighed. The re‐assembled specimens were randomly divided into four experimental groups (n = 20), based on the final rinse: no activation; EA; PUI; ED, using 2.5% sodium hypochlorite, with an EDTA intermediate rinse. A control group (n = 3) was irrigated with distilled water without activation. The solutions were delivered using a syringe and needle 2 mm from working length. Total irrigation time was 150 s, including 60 s of activation in the specific groups. The study was carried out at 36 ± 2 °C. The porcine palatal mucosa samples were weighed after completion of the assays. Student paired t‐test and anova were used to assess the intra‐ and intergroup weight changes. The multiple comparisons were evaluated using Bonferroni correction (α = 0.05).
Results
Weight loss occurred in all experimental groups. Irrigant activation resulted in greater weight loss when compared to the nonactivated group vs. EA (P = 0.001); vs. PUI (P < 0.001); vs. ED (P < 0.001). No significant differences were found amongst the different activation systems.
Conclusions
Activation increased the tissue‐dissolving activity of irrigants from artificial grooves in root canals of maxillary central incisors.
Biologic medications (BMs) are increasingly used for the management of systemic chronic inflammatory diseases. These diseases are often associated with a higher prevalence of apical periodontitis ...(AP) and periodontitis (P). The purpose of this systematic review was to ascertain the interactions between AP and/or P and BMs. The review was registered in the PROSPERO database (CRD42017054756). Electronic searches were performed on Pubmed Medline, Scopus and The Web of Science from their inception through to 20 March 2018. The references of the articles selected were checked. The keywords were chosen based on a pilot search, which aimed to find the most frequently prescribed BMs. The included studies were appraised qualitatively using appropriate tools. Thirty‐five articles met the inclusion criteria, comprising 16 non‐randomized clinical studies, 12 in vivo animal studies and 7 case reports. Quality of information was assessed as high in 18 articles, moderate in 16 articles and low in 1 article. BMs in patients suffering from chronic inflammatory diseases seems to inhibit the progression of AP and P, and to enhance the healing response to periodontal and endodontic treatment. A healthier condition of the periodontal tissues seems to be associated with a better response of the patient to BMs therapy.
Lenvatinib is a multi-kinase inhibitor approved for patients with radioactive iodine (RAI)–resistant differentiated thyroid cancer (DTC). Before the drug approval from the Italian National Regulatory ...Agency, a compassionate use programme has been run in Italy. This retrospective study aimed to analyse data from the first series of patients treated with lenvatinib in Italy.
The primary aim was to assess the response rate (RR) and progression-free survival (PFS). Secondary end-points include overall survival (OS) and toxicity data.
From November 2014 to September 2016, 94 patients were treated in 16 Italian sites. Seventeen percent of patients had one or more comorbidities, hypertension being the most common (60%). Ninety-eight percent of patients were treated by surgery, followed by RAI in 98% of cases. Sixty-four percent of patients received a previous systemic treatment. Lenvatinib was started at 24 mg in 64 subjects. Partial response and stable disease were observed in 36% and in 41% of subjects, respectively; progression was recorded in 14% of patients. Drug-related side-effects were common; the most common were fatigue (13.6%) and hypertension (11.6%). Overall, median PFS and OS were 10.8 months (95% confidence interval CI, 7.7–12.6) and 23.8 months (95% CI, 19.7–25.0) respectively.
Lenvatinib is active and safe in unselected, RAI-refractory, progressive DTC patients in real-life setting. RR and PFS seem to be less favourable than those observed in the SELECT trial, likely due to a negative selection that included heavily pretreated patients or with poor performance status.
•Patients with metastatic differentiated thyroid cancer (DTC) have poor survival rate.•Lenvatinib improved clinical outcomes in patient with metastatic radioactive iodine-refractory DTC.•Lenvatinib is active and safe, even in a real-life patient population.•Older patients show survival benefit from lenvatinib, without safety concern.
Inositol polyphosphate 4-phosphatase-II (INPP4B) is a regulator of the phosphoinositide 3-kinase (PI3K) signaling pathway and is implicated as a tumor suppressor in epithelial carcinomas. INPP4B loss ...of heterozygosity (LOH) is detected in some human breast cancers; however, the expression of INPP4B protein in breast cancer subtypes and the normal breast is unknown. We report here that INPP4B is expressed in nonproliferative estrogen receptor (ER)-positive cells in the normal breast, and in ER-positive, but not negative, breast cancer cell lines. INPP4B knockdown in ER-positive breast cancer cells increased Akt activation, cell proliferation, and xenograft tumor growth. Conversely, reconstitution of INPP4B expression in ER-negative, INPP4B-null human breast cancer cells reduced Akt activation and anchorage-independent growth. INPP4B protein expression was frequently lost in primary human breast carcinomas, associated with high clinical grade and tumor size and loss of hormone receptors and was lost most commonly in aggressive basal-like breast carcinomas. INPP4B protein loss was also frequently observed in phosphatase and tensin homolog (PTEN)-null tumors. These studies provide evidence that INPP4B functions as a tumor suppressor by negatively regulating normal and malignant mammary epithelial cell proliferation through regulation of the PI3K/Akt signaling pathway, and that loss of INPP4B protein is a marker of aggressive basal-like breast carcinomas.
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