Miracle-dz/UniFAR-FTUs huggingface dataset:
What type of filling? Best practice in dental restorations.

Dental caries (tooth decay) is one of the most common diseases, with approximately 80% of the population in developed countries having experienced the condition. If decay has not been prevented cavities develop. To prevent considerable pain and tooth loss it may be necessary to remove the diseased tissues and restore the cavities (a filling). Restorations have a limited lifespan and, once a tooth is restored, the filling is likely to be replaced several times in the patient’s lifetime. Studies in the UK suggest that much of restorative dentistry is replacement of existing restorations, accounting for around 60% of all restorative work. Similar figures have been found in other parts of Europe, 4 and the USA. (Quality in Health Care 1999;8:202–207) There is a large choice of materials which can be used for fillings. Many are introduced into the market place and used on patients with limited evidence that they are more eVective or robust than existing materials. Consequently, one of the key questions is, all other things being equal, what type of filling is best? This paper summarises the results of a systematic review of the relative longevity and cost eVectiveness of routine intracoronal dental restorations, which formed the basis of a recent issue of EVective Health Care. The reasons for replacing a restoration are numerous and vary with tooth type and restorative material. Once inserted, restorations may fail at variable rates due to various “objective” factors aVecting both the failure of the filling material and further decay of the tooth around the filling. These factors include the characteristics of the filling material and eVect modifiers related to operator skill and technique, patients’ dental characteristics, and the environment around the tooth. The decision to replace a restoration is also influenced by more subjective factors such as dentists’ interpretation of the restoration’s condition and the health of the tooth, the criteria used to define failure, and patient demand. These decisions are subject to much variation. 10 A lack of standardisation exists, and no generally agreed criteria are used to decide when a restoration requires replacement. Types of restoration Tooth restorations may be classified as intracoronal, when they are placed within a cavity prepared in the crown of a tooth, or extracoronal, when they are placed around (outside) the tooth as in the case of a crown. Intracoronal restorations are usually placed directly into the tooth cavity and normally consist of a mouldable material that sets and becomes rigid; the material is retained by the surrounding walls of the remaining tooth tissue. An alternative intracoronal restoration uses an indirect technique; here an impression of the cavity is taken and a laboratory constructed inlay is produced and subsequently cemented into the prepared cavity. The materials currently used to restore intracoronal preparations are: dental amalgam, composite resins, glass ionomer cements, resin modified glass ionomer cements, compomers and cermets, cast gold, and other alloys inlays and porcelain (box 1).
Did the S.A.R.S. epidemic weaken the integration of Asian stock markets? Evidence from smooth time-varying cointegration analysis

Abstract The purpose of this study is to examine the effect of the Severe Acute Respiratory Syndrome (S.A.R.S.) epidemic on the long-run relationship between China and four Asian stock markets. To this end, we first employ the advanced smooth time-varying cointegration model to investigate the existence of a time-varying cointegration relation among these markets and then employ the difference-in-differences approach to analyse whether or not the S.A. R.S. epidemic impacted the long-run relation between China and these four markets during the period 1998–2008, covering 5 years before and after the S.A. R.S. outbreak. Our results support the existence of a time-varying cointegration relation in the aggregate stock price indices, and that the S.A. R.S. epidemic did weaken the long-run relationship between China and the four markets. Therefore, stockholders and policy makers should be concerned about the influence of catastrophic epidemic diseases on the financial integration of stock market in Asia.
[The transcription and expression of IL-18 gene in HBV infectors].

OBJECTIVE To evaluate the possible roles of interleukin 18 (IL-18) in hepatitis B virus (HBV) infection. METHODS Peripheral blood lymphocytes from 3 groups of HBV infectors (including 15 asymptomatic carriers, 30 patients with chronic hepatitis, 12 patients with fulminant hepatitis) and 10 blood donors (as normal controls) were analyzed. The transcription and expression of IL-18 in PBMC were assessed by semi-quantitive reverse transcription polymerase chain reaction and flow cytometry. RESULTS (1) There were significant differences in the transcription and expression levels of IL-18 between each group of HBV infectors. Interestingly, it was highest in fulminant hepatitis group, and lowest in asymptomatic carrier group. However there was no significant difference between chronic hepatitis and normal controls. The severity of disease was accompanied with the elevation of IL-18 production. (2) The severity degree of liver inflammation in chronic hepatitis was ccompanied with the elevation of IL-18 production. (3) The transcription and expression of IL-18 in chronic hepatitis B correlated with serum ALT positively (r = 0.54, P < 0.01; r = 0.63, P < 0.01). (4) There was a positive correlation in transcription and expression of IL-18 in each group of HBV infectors (asymptomatic carrier r = 0.980, P < 0.001; chronic hepatitis r = 0.910, P < 0.001; fulminant hepatitis r = 0.975, P < 0.001). CONCLUSION IL-18 may take part in the host immunity against HBV,and relate to the inflammation degree of liver.
Dual effects of weight and weight gain on breast cancer risk.

CONTEXT Breast cancer is a major cause of mortality among women. It is important to identify modifiable risk factors for this disease. OBJECTIVE To examine body mass index (BMI) at the age of 18 years and at midlife and adult weight change in relation to breast cancer incidence and mortality. DESIGN Cohort study. SETTING A cohort of 95256 US female nurses aged 30 to 55 years who were followed up for 16 years. MAIN OUTCOME MEASURE Incident and fatal breast cancer. RESULTS During 1203498 person-years, 2517 incident breast cancers (60% postmenopausal) were documented. Higher current BMI was associated with lower breast cancer incidence before menopause and was minimally associated with incidence after menopause. However, a stronger positive relationship was seen among postmenopausal women who never used hormone replacement (relative risk=1.59 for BMI >31 kg/m2 vs < or = 20 kg/m2; 95% confidence interval, 1.09-2.32; P for trend <.001). Higher BMI at the age of 18 years was associated with lower breast cancer incidence both before and after menopause. Weight gain after the age of 18 years was unrelated to breast cancer incidence before menopause, but was positively associated with incidence after menopause. This increased risk with weight gain was limited to women who never used postmenopausal hormones; among these women, the relative risk was 1.99 (95% confidence interval, 1.43-2.76) for weight gain of more than 20 kg vs unchanged weight (P for trend <.001). Current BMI and weight gain were even more strongly associated with fatal postmenopausal breast cancer. In this population, the percentage of postmenopausal breast cancer accounted for by weight gain alone was approximately 16% and by hormone replacement therapy alone was 5%, but when the interaction between these variables was considered, together they accounted for about one third of postmenopausal breast cancers. CONCLUSIONS Avoiding adult weight gain may contribute importantly to the prevention of breast cancer after menopause, particularly among women who do not use postmenopausal hormones.
Role of nitric oxide in exercise hyperaemia during prolonged rhythmic handgripping in humans.

1. We sought to determine whether the vasodilating molecule nitric oxide (NO) contributes to the forearm hyperaemia observed during prolonged rhythmic handgripping in humans. 2. Two bouts of exercise were performed during experimental protocols conducted on separate days. During each protocol the subject performed a 10 min and a 20 min bout of rhythmic (30 min‐1) handgripping at 15% of maximum. Two exercise bouts were required to facilitate pharmacological interventions during the second protocol. Blood flow in the exercising forearm was measured every minute with plethysmography during brief pauses in the contractions. During both exercise bouts in the first protocol, forearm blood flow increased 2‐ to 3‐fold above rest after 1 min of handgripping and remained constant at that level throughout the exercise. 3. During the 10 min bout of exercise in the second protocol, acetylcholine was given via a brachial artery catheter at 16 micrograms min‐1 for 3 min to evoke NO release from the vascular endothelium. This caused forearm blood flow to increase above the values observed during exercise alone. 4. During the 20 min trial of handgripping in the second protocol, the NO synthase blocker NG‐monomethyl‐L‐arginine (L‐NMMA) was infused in the exercising forearm via the brachial catheter after 5 min of handgripping. The L‐NMMA was infused at 4 mg min‐1 for 10 min. 5. L‐NMMA during exercise caused forearm blood flow to fall to values approximately 20‐30% lower than those observed during exercise alone. When ACh was given during exercise after L‐NMMA administration the rise in blood flow was also blunted, indicating blockade of NO synthase. These data suggest NO plays a role in exercise hyperaemia in humans.
Longitudinal Study of Emerging Mental Health Concerns in Youth Perinatally Infected With HIV and Peer Comparisons

Objective: Cross-sectional research indicates high rates of mental health concerns among youth with perinatal HIV infection (PHIV), but few studies have examined emerging psychiatric symptoms over time. Methods: Youth with PHIV and peer comparisons who were HIV-exposed but uninfected or living in households with HIV-infected family members (HIV-affected) and primary caregivers participated in a prospective, multisite, longitudinal cohort study. Groups were compared for differences in the incidence of emerging psychiatric symptoms during 2 years of follow-up and for differences in psychotropic drug therapy. Logistic regression models were used to evaluate the association of emerging symptoms with HIV status and psychosocial risk factors. Results: Of 573 youth with study entry assessments, 92% attended at least 1 annual follow-up visit (PHIV: 296; comparisons: 229). A substantial percentage of youth who did not meet symptom criteria for a psychiatric disorder at study entry did so during follow-up (PHIV = 36%; comparisons = 42%). In addition, those who met criteria at study entry often met criteria during follow-up (PHIV = 41%; comparisons = 43%). Asymptomatic youth with PHIV were significantly more likely to receive psychotropic medication during follow-up than comparisons. Youth with greater HIV disease severity (entry CD4% <25% vs 25% or more) had higher probability of depression symptoms (19% vs 8%, respectively). Conclusions: Many youth in families affected by HIV are at risk for development of psychiatric symptoms.
The Basel III Capital Framework: a decisive breakthrough

Ten days ago, the Basel III framework was endorsed by the G20 leaders in South Korea. Basel III is the centrepiece of the financial reform programme coordinated by the Financial Stability Board. This endorsement represents a critical step in the process to strengthen the capital rules by which banks are required to operate. When the international rule-making process is completed and Basel III has been implemented domestically, we will have considerably reduced the probability and severity of a crisis in the banking sector, and by extension enhanced global financial stability.
Comparable aciclovir exposures produced by oral valaciclovir and intravenous aciclovir in immunocompromised cancer patients.

The objective of this study was to evaluate the comparability of systemic aciclovir exposure at steady state in immunocompromised patients following oral valaciclovir 1000 mg tds and intravenous (iv) aciclovir 5 mg/kg tds. A two-centre, randomized, open label, two-way crossover study was undertaken. Patients aged 18-65 years who had undergone high-dose chemotherapy for cancer and were neutropenic (neutrophil count <0.5 x 109/mL) with normal renal function were recruited. The pharmacokinetic parameters of aciclovir after oral valaciclovir 1000 mg or iv aciclovir 5 mg/kg given as 1 h infusion, each administered every 8 h for seven doses, were compared. Fifteen patients were enrolled and 13 completed both treatments. The mean (s.d.) values for aciclovir after oral valaciclovir and iv aciclovir were: AUC0-8 76.3 (29.7) and 64.2 (20.0) microM x h; peak plasma concentration (Cmax) 26.6 (10.5) and 34.0 (11.9) microM; time to maximal plasma concentration (tmax) 2.01 (0.65) and 0.95 (0.19); and plasma elimination half-life (t1/2) 2.83 (0.91) and 2.44 (0.62) h, respectively. The mean absolute bioavailability of aciclovir from oral valaciclovir was 60 +/- 21%. Equivalent systemic exposure to aciclovir after oral valaciclovir 1000 mg and iv aciclovir 5 mg/kg was observed with AUC0-8 (oral/iv ratio = 1.16; 90% CI 0.98-1.39), whilst significantly reduced peak aciclovir concentrations were obtained with oral valaciclovir (ratio = 0.75; 90% CI 0.60-0.94). Oral valaciclovir offers a convenient, and possibly safer, alternative to iv aciclovir, delivering comparable systemic exposures with reduced peak levels. This may contribute to shorter hospitalization, reduced costs for healthcare providers and improved quality of life for patients.
Endocervical Curettage in Cervical Evaluation

Objective. To evaluate the role of endocervical curettage (ECC) in the diagnosis of cervical intraepithelial neoplasia. Materials and Methods. Retrospectively we studied 581 patients who had ECC, 43 (7.4%) had cervical intraepithelial lesions (CIN) 1 ECC, 23 (4.0%) CIN 2‐3 ECC, and 515 negative ECC (88.6%). Analysis of variance was used to compare for age and parity, and Pearson's chi‐square test was used to analyze the association with other variables such as cytology, images, acetowhite epithelium, microbiopsy, and ECC. Significance level was set at p = 0.05. Results. Age for CIN 1 ECC was at 32.3 (16‐66) years; parity was at 0.82 (parity 0‐7) compared with 35.2 (18‐70) years and parity at 1.52 (parity 0‐12) for CIN 2‐3 ECC, and 36.1 (14‐68) years, parity at 1.1 (parity 0‐10) for negative ECC. ECC is associated with Cytobrush cytology (Zelsmyr Cytobrush, International Cytobrush Inc., Hollywood. FL) (p = 0.000) in CIN 2‐3 ECC and high‐grade squamous intraepithelial lesion (HGSIL) cytology. Positive ECC was not overrepresented in unsatisfactory colposcopy (14/61, 23%) compared with negative ECC (158/526, 30%, p = 0.43). If positive ECC is not associated with the presence of significant acetowhite epithelium, a net association (p = 0.000) was observed between CIN 1 microbiopsies and CIN 1 ECC 9 (12/19), and CIN 2‐3 biopsies and CIN 2‐3 ECC (12/17). Conization for CIN 2‐3 ECC (n = 23) yielded 15 CIN 2‐3, two CIN 1, one microinvasive cervical cancer, one cancer of the cervix, and four negative cones. Conclusions. Positive endocervical curettage is associated with endocervical cytology and microbiopsy. In ablative treatments, when low‐grade squamous intraepithelial lesion (LGSIL) smear, satisfactory colposcopy, and CIN 1 biopsy is observed, ECC appears unnecessary since CIN 2‐3 ECC was not observed in these patients. All other cases should have ECC prior to ablative therapy. CIN 2‐3 ECC, commands conization, in order to eliminate invasive cancer, and confirm and treat CIN 2‐3. ▪
Clinical characteristics of febrile convulsions during primary HHV-6 infection

OBJECTIVE To clarify clinical characteristics of children with febrile convulsions during primary human herpesvirus 6 (HHV-6) infection. SUBJECTS AND METHODS The clinical characteristics of first febrile convulsion were compared between those with and without primary HHV-6 infection in 105 children. HHV-6 infection was verified by culture or acute/convalescent anti-HHV-6 antibody titres. RESULTS Primary infection with HHV-6 was seen in 21 of 105 patients with febrile convulsions (3 upper respiratory infection, 1 lower respiratory infection, and 17 exanthem subitum). 13 of 23 patients < 1 year, 19 of 79 patients with first febrile convulsion, and 2 of 15 with second convulsion were infected with HHV-6. The median age of patients with first febrile convulsion and HHV-6 was significantly lower than those without infection. The frequency of clustering seizures, long lasting seizures, partial seizures, and postictal paralysis was significantly higher among those with primary HHV-6 infection than among those without. The frequency of atypical seizures in 19 patients with first febrile convulsion associated with primary infection was significantly higher than in 60 patients without primary infection. The frequency in infants younger than 1 year of age was also significantly higher than that in 10 age matched infants without primary infection. CONCLUSIONS These findings suggest that primary infection with HHV-6 is frequently associated with febrile convulsions in infants and young children and that it often results in the development of a more severe form of convulsions, such as partial seizures, prolonged seizures, and repeated seizures, and might be a risk factor for subsequent development of epilepsy.
Analysis of the Synaptotagmin Family during Reconstituted Membrane Fusion

Ca2+-triggered exocytosis in neurons and neuroendocrine cells is regulated by the Ca2+-binding protein synaptotagmin (syt) I. Sixteen additional isoforms of syt have been identified, but little is known concerning their biochemical or functional properties. Here, we assessed the abilities of fourteen syt isoforms to directly regulate SNARE (soluble N-ethylmaleimide-sensitive factor (NSF) attachment protein receptor)-catalyzed membrane fusion. One group of isoforms stimulated neuronal SNARE-mediated fusion in response to Ca2+, while another set inhibited SNARE catalyzed fusion in both the absence and presence of Ca2+. Biochemical analysis revealed a strong correlation between the ability of syt isoforms to bind 1,2-dioleoyl phosphatidylserine (PS) and t-SNAREs in a Ca2+-promoted manner with their abilities to enhance fusion, further establishing PS and SNAREs as critical effectors for syt action. The ability of syt I to efficiently stimulate fusion was specific for certain SNARE pairs, suggesting that syts might contribute to the specificity of intracellular membrane fusion reactions. Finally, a subset of inhibitory syts down-regulated the ability of syt I to activate fusion, demonstrating that syt isoforms can modulate the function of each other.
Detection of Francisella tularensis in Biological Specimens Using a Capture Enzyme-Linked Immunosorbent Assay, an Immunochromatographic Handheld Assay, and a PCR

ABSTRACT The early detection of Francisella tularensis, the causative agent of tularemia, is important for adequate treatment by antibiotics and the outcome of the disease. Here we describe a new capture enzyme-linked immunosorbent assay (cELISA) based on monoclonal antibodies specific for lipopolysaccharide (LPS) of Francisella tularensis subsp. holarctica and Francisella tularensis subsp. tularensis. No cross-reactivity with Francisella tularensis subsp. novicida,Francisella philomiragia, and a panel of other possibly related bacteria, including Brucella spp. ,Yersinia spp. , Escherichia coli, andBurkholderia spp. , was observed. The detection limit of the assay was 103 to 104 bacteria/ml. This sensitivity was achieved by solubilization of the LPS prior to the cELISA. In addition, a novel immunochromatographic membrane-based handheld assay (HHA) and a PCR, targeting sequences of the 17-kDa protein (TUL4) gene of F. tularensis, were used in this study. Compared to the cELISA, the sensitivity of the HHA was about 100 times lower and that of the PCR was about 10 times higher. All three techniques were successfully applied to detect F. tularensis in tissue samples of European brown hares (Lepus europaeus). Whereas all infected samples were recognized by the cELISA, those with relatively low bacterial load were partially or not detected by PCR and HHA, probably due to inhibitors or lack of sensitivity. In conclusion, the HHA can be used as a very fast and simple approach to perform field diagnosis to obtain a first hint of an infection with F. tularensis, especially in emergent situations. In any suspect case, the diagnosis should be confirmed by more sensitive techniques, such as the cELISA and PCR.
Pharmacokinetics and Safety of Fluconazole in Young Infants Supported With Extracorporeal Membrane Oxygenation

Background: Candida infections are a leading cause of infectious disease–related death in infants supported with extracorporeal membrane oxygenation (ECMO). The ECMO circuit can alter drug pharmacokinetics; thus, standard fluconazole dosing in children on ECMO may result in suboptimal drug exposure. This study determined the pharmacokinetics of fluconazole in infants on ECMO. Methods: Infants <120 days of age received either intravenous fluconazole prophylaxis (25 mg/kg once a week) or treatment (12 mg/kg daily) while on ECMO. Paired plasma samples were collected preoxygenator and postoxygenator around doses 1 and 2 to calculate pharmacokinetic indices and describe oxygenator extraction. A 1-compartment model was fit to the data using nonlinear regression. Surrogate pharmacodynamic targets for efficacy were evaluated. Results: Ten infants were enrolled. After dose 1 (n = 9), the median clearance was 17 mL/kg/h, the median volume of distribution was 1.5 L/kg and the median exposure in the first 24 hours (area under the curve from 0 to 24 hours) was 322 h × mg/L. After multiple doses (n = 7), the median clearance was 22 mL/kg/h, the median volume of distribution was 1.9 L/kg and the area under the curve from 0 to 24 hours was 352 h × mg/L. After dose 1, 78% of infants achieved the prophylaxis target, whereas only 11% achieved the therapeutic target. Oxygenator extraction of fluconazole was minimal (–2.0%, standard deviation 15.0), and extraction was not correlated with age of the ECMO circuit (&rgr;= –0.05). There were no adverse events related to fluconazole. Conclusions: Infants on ECMO had higher volume of distribution but similar clearance when compared with historical controls not on ECMO. In infants on ECMO, a fluconazole dose of 25 mg/kg weekly provides adequate exposure for prophylaxis against Candida infections. However, higher doses may be needed for treatment.