Additional Treatment Research Articles

Synthesis and Purification of Nano-sized Titanium Carbide Particles through Vacuum Carbothermal Reduction for enhanced Mechanical, Microstructural Morphology, and Tribological Properties in Friction Stir Processed A356-based Aluminum Composites

This study focused on the synthesis and purification of nano-sized titanium carbide (TiC) particles through vacuum carbothermal reduction under a hydrogen/argon atmosphere. The process involved the production of carbon-coated titanium precursors, followed by heating under vacuum conditions at 1500°C for 2.5 hours. The resulting products underwent additional treatment in either a hydrogen/argon (1:1) mixed gas or pure hydrogen gas. Experimental findings revealed that TiC powders exhibiting a single phase are obtained within a molar ratio of Ti to C ranging from 1:2 to 1:4. Adjusting the molar ratio of Ti/C in the precursors allowed for controlled variation in the particle size of the synthesized TiC powders, ranging from 50 to 80 nm. Treatment in hydrogen/argon mixed gas at 850°C for 3 hours resulted in TiC products with an impressive purity of 99.40%. The subsequent incorporation of 5% Nano-TiC-3 (Ti to C ranging from 1:3) as reinforcement into an aluminum alloy by Friction stir process technique demonstrated a remarkable 19.41% improvement in tensile strength, highlighting the efficacy of this specific reinforcement. The nano-TiC-3 reinforced composite exhibited uniform distribution without porosity. Additionally, a notable 50.81% improvement in hardness and the best wear resistance were observed for the 5% Nano-TiC-3 reinforced aluminum composite. This comprehensive study contributes valuable insights into the synthesis, purification, and application of nano-sized TiC particles, paving the way for the development of high-performance aluminum-based composites with enhanced mechanical and tribological properties.

Precise Localization of the Central Left Frontal Cortex in Different Canine Skull Types: A Comparative Study of Frameless Neuronavigation and External Measurement Techniques

Repetitive Transcranial Magnetic Stimulation (rTMS), a non-invasive brain modulation technique, has been explored as an additional treatment option for behaviorally disordered dogs. For optimal effectiveness of the rTMS treatment, accurate coil positioning to the stimulation target is pivotal. Frameless stereotactic neuronavigation for the localization of intracranial regions has been established as a reliable targeting method. However, given the varying skull shape and brain structures among dog breeds, divided into mesocephalic, brachycephalic, and dolichocephalic breeds, localizing the rTMS target area, the central left frontal cortex, can be challenging. Previous neuronavigation studies have only investigated its use in mesocephalic breeds of dogs. Because this neuronavigation is based on expensive high-tesla magnetic resonance imaging data, and anesthesia needed for immobilization, a cheaper and reliable localization alternative to broaden the rTMS use in the veterinary field is needed.The objective of this study was twofold. First, the study aimed to evaluate external localization of the central left frontal cortex within the three skull types (retrospective study 1). Then, this external localization method was compared to the conventional frameless neuronavigation technique to check the consistency, focusing on mesocephalic and dolichocephalic breeds (prospective study 2). Thirty-two brachycephalic, thirty-seven mesocephalic and thirty dolichocephalic dogs were included to evaluate the external localization of the central left frontal cortex by external measurement (retrospective study 1, data obtained from previously performed MRI scans). For the second objective, thirty-eight dogs (35 mesocephalic breeds and 3 dolichocephalic breeds) were recruited to compare the external measurement localization method and the localization by neuronavigation (prospective study 2, data extracted from study 1 and former rTMS studies). The first part of this study showed the central left frontal cortex was externally located approximately two-thirds of the total skull length (sagittal length) in meso- and dolichocephalic dogs, at the center of the skull length in brachycephalic dogs, and 0.65 to 0.70 cm to the left of the cerebral midline for all skull types (retrospective study 1). Using intraclass correlation coefficient (ICC) analysis, the second part of the study showed high consistency between these two methods, for the length of the skull (0.94), the relative position of the left frontal cortex (0.84), and the distance to the cerebral midline (0.69) in mesocephalic and dolichocephalic breeds (prospective study 2). Our findings suggest that the conventional frameless neuronavigation could be replaced by the external localization method in the mesocephalic and dolichocephalic dog breeds, and therefore ultimately reduce anesthesia time and financial burden when applying non-invasive brain modulation techniques like rTMS. More research needs to be conducted for brachycephalic dogs to validate this method in this specific population of dogs.

Distinct accumulation patterns, translocation efficiencies, and impacts of nano-fertilizer and nano-pesticide in wheat through foliar versus soil application.

The use of nano-chemicals in agriculture has been shown to enhance crop production through soil additions or foliar sprays. However, the accumulation pattern, translocation efficiency, mode of action of nanomaterials (NMs) via different application methods remain unclear. In this study, wheat was treated with CuO-NPs/CeO2-NPs (50 and 100nm) for 21 days using soil and foliar application separately. Foliar spray resulted in higher accumulation and more efficient translocation of NMs compared to soil addition. Smaller NMs exhibited higher accumulation and transfer capabilities under the same application method. The accumulation of CuO-NPs was approximately 20 times greater than that of CeO2-NPs, particularly under the soil addition treatment. Scanning electron microscopy analysis demonstrated that NMs could directly enter wheat leaves via stomata during foliar application. Wheat growth was inhibited by roughly 15% following CuO-NPs exposure, whereas no significant effects on growth were observed with CeO2-NPs. By integrating nontargeted metabolomics analysis with targeted physiological characteristics assessments, it was revealed that CuO-NPs mainly disturbed nitrogen metabolism pathways and induced oxidative damage. In contrast, CeO2-NPs enhanced carbohydrates related biological processes such as starch and sucrose metabolism, glycolysis, and TCA cycle, which are crucial for carbon metabolism. These findings suggest that the type of nanomaterial is a crucial factor to consider when evaluating their foliar or soil application in agriculture.

Protective Effects of Purple Corn (Zea mays L.) Byproduct Extract on Blue Light-Induced Retinal Damage in A2E-Accumulated ARPE-19 Cells.

This study investigated the antioxidative characteristics of Zea mays L. purple corn cob and husk extract (PCHE) and its potential protective effects against blue light (BL)-induced damage in N-retinylidene-N-retinylethanolamine (A2E)-accumulated ARPE-19 retinal pigment epithelial cells. PCHE had a 2,2-diphenyl-1-picrylhydrazyl radical-scavenging capacity and Trolox equivalent antioxidant capacity of 1.28±0.43 mM Trolox equivalents (TE)/g and 2,545.41±34.13 mM TE/g, respectively. Total content of anthocyanins, polyphenols, and flavonoids in the PCHE was 11.13±0.10 mg cyanidin-3-glucoside equivalents/100 g, 227.90±7.38 mg gallic acid equivalents/g, and 117.75±2.46 mg catechin equivalents/g, respectively. PCHE suppressed the accumulation of A2E and the photooxidation caused by BL in a dose-dependent manner. After initial treatment with 25 µM/mL A2E and BL, ARPE-19 cells showed increased cell viability following additional treatment with 15 µg/mL PCHE while the expression of the p62 sequestosome 1 decreased, whereas that of heme oxygenase-1 protein increased compared with that in cells without PCHE treatment. This suggests that PCHE may slow the autophagy induced by BL exposure in A2E-accumulated retinal cells and protect them against oxidative stress.

Stereotactic radiosurgery as an alternative treatment for dural arteriovenous fistula

Unlike cerebral arteriovenous malformation or cavernous malformation, dural arteriovenous fistula (DAVF) is an uncommon cerebrovascular malformation in clinical practice. However, the clinical treatment modalities for DAVFs have expanded in recent years. The standard treatment for DAVF is endovascular surgery. Endovascular surgery is an effective and safe treatment method if open surgical treatment is considered dangerous in a patient. Nonetheless, after endovascular embolization, additional treatment is often required due to insecure occlusion or procedure-related sequelae. Recent reports have demonstrated stereotactic radiosurgery (SRS) as an effective and safe alternative to conventional endovascular surgery. This review summarizes DAVF and SRS in general and proposes indications for SRS as an appropriate treatment option for DAVFs.

Method for elimination of residual cavity with rigid fibrous capsule in patients with hepatic echinococcosis and comorbidity

Aim. To improve the results of organ-preserving surgeries for hepatic echinococcal cysts with rigid fibrous capsule.Materials and methods. The study analyzed the results of surgical treatment of 221 patients with hepatic echinococcosis that was performed from 2016 to 2023. The main group included 94 patients (2020–2023), who underwent laparotomic or laparoscopic echinococcectomy followed by additional treatment of the residual cavity by the suggested method (113 cysts in total). The comparison group included 88 patients (2016–2019) who underwent standard interventions (108 cysts in total).Results. A treatment method for the residual cavity is selected with regard to the condition of the fibrous capsule. In case of elastic fibrous capsule, resections were performed in 1.7% of patients in the comparison group and 1.9% in the main group. Laparoscopic echinococcectomy was performed in 29.1% and 38.5% of cases, open echinococcectomy – in 69.2% and 59.6%, respectively. In case of rigid fibrous capsule, resections were made in 4.3% of patients in the comparison group and in 8% in the main group. Laparoscopic echinococcectomy was performed in 8.5% and 23.9% of cases, open echinococcectomy – in 87.2% and 68.2%, respectively.Conclusion. The suggested method of additional treatment for the residual cavity in cases of open and laparoscopic interventions enables the risk of early complications to be reduced from 19.1% to 4.5%, and from 16% to 3.4% within 3 months after surgery.

The role of hyperbaric oxygen treatment in the management of spondylodiscitis.

This study analysed treatment outcomes in a patient cohort diagnosed with spondylodiscitis, who received adjunct hyperbaric oxygen treatment (HBOT) in addition to antibiotic therapy at our clinic. Important considerations included the timing of HBOT initiation on treatment success, and recurrence rates. We retrospectively reviewed the records of all patients diagnosed with spondylodiscitis who received HBOT at the Underwater and Hyperbaric Medicine Clinic in Gulhane Training and Research Hospital, between 1 November 2016 and 25 October 2022. The patients received HBOT at 243.2 kPa for a total of 120 minutes per session, once daily for five days a week for a total of 30 sessions. Twenty-five patients with spondylodiscitis were evaluated before and after combination HBOT and targeted antibiotic treatment. After treatment, patients had lower median (range) visual analogue pain scores (8 [4-10] vs 3 [0-7], P < 0.001) and C-reactive protein (22.3 [4.3-79.9] mg·L⁻¹ vs 6.8 [0.1-96.0] mg·L⁻¹, P = 0.002) and lower mean (standard deviation) white blood cell counts (8.8 [3.5] x 109·L⁻¹ vs 6.1 [1.6] x 109·L⁻¹, P = 0.002). When patients were examined (median) 48 months (2-156 months) after the completion of treatment, there were no persistent cases of spondylodiscitis. Combination HBOT with targeted antibiotic therapy effectively managed our cohort of patients diagnosed with spondylodiscitis. Hyperbaric oxygen treatment was safe, with no complications experienced. Moreover, HBOT may have helped to eliminate persistence and recurrence of symptoms with long term follow-up. A randomised controlled study with a larger number of patients is needed for more definitive conclusions.

Phytoremediation of contaminated urban soils spiked with heavy metals

Urban environments worldwide face toxic heavy metal pollution originating from industrial discharge, municipal waste disposal, vehicular emissions, and atmospheric deposition. Kazakhstan, experiencing accelerated economic growth and extensive mining activities, contends with widespread heavy metal contamination in its soil-plant-air-water ecosystems. This study explores the potential of hyperaccumulating plants for phytoremediation in urban soils of Kazakhstan contaminated with Pb, Cd, and Co. Twelve plant species, including Korean Mint (Lamiaceae), Ornamental Cabbage (Brassica oleracea), Ageratum (Ageratum houstonianum), Coneflower (Echinacea purpurea), Amaranth (Amaranthus Perfect and Amaranthus Emerald), Fescue (Festuca glauca), Burning Bush (Kochia scoparia), Marigold (Tagetes patula nana), White Cabbage (Brassica-Cavolo cappuccino BIANKO), Tepary Bean (Phaseolus acutifolius), and Rapeseed (Brassica napus), were evaluated for growth and biomass production in urban soils spiked with two maximum permissible addition (MPA) treatments of Pb, Co, and Cd. The selected plants demonstrated varied responses to heavy metal stress, with Marigold (8.4 g shoot biomass/plant), Korean mint (10.5 g shoot biomass/plant), Rapeseed (19.9 g/shoot biomass), and Tepary bean (25.9 g shoot biomass/plant) exhibiting resilience or tolerance to Pb, Co, and Cd stresses. The results highlight the significant potential of these plants for efficient phytoremediation, showcasing their unique abilities to absorb and accumulate specific metals. Marigold, particularly, displayed noteworthy Pb accumulation (40.3 mg/kg biomass), resulting in reduced residual Pb concentrations in the soil (74.7 mg/kg). Conversely, White cabbage and Amaranth showed limited efficiency in Cd extraction, while Rapeseed and Tepary bean emerged as promising candidates for Cd phytoremediation. This study emphasizes the critical role of tailored plant species selection in designing effective phytoremediation strategies for specific metal-contaminated urban sites. A comprehensive understanding of the dynamics of metal accumulation and residual concentrations is crucial for the development of sustainable and efficient environmental remediation approaches. Further research is warranted to explore the long-term effects of different plant species on soil metal concentrations, refining and optimizing phytoremediation methods for urban soils grappling with toxic heavy metal contamination.

A Unique Presentation of Excitatory Catatonia Alongside AntiNmda Receptor Encephalitis: A Case Report

Introduction: Anti-NMDA receptor encephalitis, first described in 2007, is a prominent cause of autoimmune encephalitis, predominantly affecting females. Its clinical presentation includes a prodromal phase with flu-like symptoms, followed by psychosis, unresponsiveness, hyperkinesis, and recovery [1]. Catatonia can coexist sounds better than cooccur in patients with anti-NMDA receptor encephalitis, complicating diagnosis and effective treatment. Case Summary: This case report discusses a 41-year-old African American female with a history of seizure disorder, schizoaffective disorder with catatonia, developmental delay, Catatonia in itself is not the diagnosis as per dsm 5. We could use it as a specifier with other diagnosis, be it schizoaffective disorder or seizure disorder here. So we could mention as schizoaffective disorder with catatonia. and recent bereavement. Her symptoms included variable motor hyperactivity, alternating between restlessness and sedation, with an initial Busch Francis Rating Scale score of 18. Initially diagnosed with excitatory catatonia secondary to schizoaffective disorder and treated with benzodiazepines, her condition failed to improve, prompting further investigation. Despite additional treatment for a urinary tract infection and medication adjustment, which included adding valproic acid and amantadine, her condition remained uncontrolled. Subsequent lumbar puncture revealed inflammatory markers, and her anti-NMDA receptor IgG antibody assay was positive at 1:1280, confirming the diagnosis of anti-NMDA receptor encephalitis. Treatment was escalated to include methylprednisolone and intravenous immunoglobulin, alongside six sessions of ECT for management of her catatonia. The patient showed significant improvement, achieving functional recovery and independence in daily activities before discharge. Conclusion: This case emphasizes the importance of considering anti-NMDA receptor encephalitis in patients with unexplained, refractory neuropsychiatric symptoms, such as catatonia, and highlights the value of a multidisciplinary approach in managing and rehabilitating affected individuals. Prompt diagnosis and treatment are crucial to improving outcomes and reducing the risk of persistent cognitive deficits.

Plant-based protein emulsions with soy protein isolate and gluten improve freeze-thaw stability and shelf life of pork meatballs

This study investigated the effects of oil-in-water emulsions used as fat substitutes on the physicochemical properties of meatballs during frozen storage. Different formulations of fat replacers were prepared, including pork fat as the control (C), oil and water (OW), oil-in-water emulsion (E), emulsion with soy protein isolate (SE), emulsion with gluten (GE), and emulsion with soy protein isolate and gluten (SG). These fat substitutes were applied to a meatball paste. The samples were stored at −18 °C for 30 and 60 days, and their physicochemical properties were analyzed after thawing at 4 °C for 12 h. The SE formulation had the highest values for both water content and liquid holding capacity during frozen storage (P < 0.05). SE, GE, and SG showed significantly higher hardness, cohesiveness, springiness, gumminess, and chewiness than those of E during storage (P < 0.05). The vegetable protein addition treatments maintained a compact structure throughout storage. SE, GE, and SG prevented lipid and protein oxidation during frozen storage. These results demonstrated that SE, GE, and SG offer significant advantages in improving the freeze-thaw stability, liquid holding capacity, and oxidation stability of pork meatballs during long-term frozen storage. Therefore, our study suggest that plant-based protein emulsions can effectively replace animal fats while maintaining product quality, offering valuable implications for the meat processing industry.

Efficacy of Probiotics Compared With Pharmacological Treatments for Maintenance Therapy for Functional Constipation in Children: A Systematic Review and Network Meta-analysis.

There has been an increase in randomized controlled trials (RCTs) comparing probiotics with various maintenance therapies, such as polyethylene glycol, lactulose, and mineral oil, to treat functional constipation in children. The aim was to compare probiotics with all other oral maintenance therapies for functional constipation in children and rank all treatments in terms of effectiveness in a network meta-analysis. RCTs were identified through systematically searching the MEDLINE, Scopus, EMBASE, and Cochrane Library databases, trial registries, and forward and backward citation searching. Within-study risk of bias was assessed using the Cochrane Risk of Bias 2 tool, and confidence in the estimates was assessed using the CINeMA (Confidence in Network Meta-Analysis) framework. Random-effects network meta-analyses were conducted. Data were pooled from 41 and 29 RCTs for network meta-analysis of defecation frequency and treatment success, respectively. Probiotics did not significantly increase the number of bowel movements per week when compared with any conventional treatment or placebo. A combination of mineral oil and probiotics was the most effective treatment for increasing defecation frequency (mean difference: 3.13; 95% confidence interval [CI]: 0.64, 5.63). The most effective treatments for increasing the risk of treatment success as compared with placebo were mineral oil (relative risk [RR]: 2.41; 95% CI: 1.53, 3.81) and a combined treatment of polyethylene glycol and lactulose (RR: 2.45; 95% CI: 1.21, 4.97). Confidence in the estimates ranged from very low to moderate. Currently, there is no evidence to suggest that probiotics should be used as a standalone treatment for functional constipation in children. More high-quality studies are needed to evaluate different strains of probiotics and their potential benefit as an additional treatment component to conventional treatments. Mineral oil and polyethylene glycol were the most effective treatments to increase defecation frequency and treatment success rates and should remain the first line of treatment for children with functional constipation. PROSPERO registration no.

Is microfracture sufficient for high-tibial osteotomy, or should intra-articular hyaluronic acid and oral glucosamine-chondroitin be used as additional treatments?

BackgroundThis study aimed to compare the effects of microfracture (MF) versus intra-articular hyaluronic acid (HA) + oral glucosamine and chondroitin sulfate (GC) in addition to MF in patients with osteoarthritic knees who underwent medial open wedge high tibial osteotomy (MOWHTO) after an average follow-up of five years.MethodsThe study was designed retrospectively and included patients who underwent MOWHTO due to gonarthrosis, the MF method performed on these patients, and HA + GC treatments applied in addition to MF. Three groups consisting of 79 patients were formed: only HTO (Group 1), HTO + MF (Group 2), and HTO + MF + HA + GC (Group 3). The groups were compared using knee injury and osteoarthritis outcome score (KOOS), visual analog scale (VAS) for pain, and range of motion (ROM). The associations between the degree of correction and function and pain were evaluated. Additionally, the KOOS subparameters were compared between the groups.ResultsThere were significant improvements in the postoperative KOOS and VAS scores in all three groups (p < 0.05). However, the ROM did not improve in Group 1. There was no significant difference in the postoperative KOOS, VAS, or ROM values ​​between Groups 2 and 3, but these values ​​were significantly better in Groups 2 and 3 than in Group 1 (p < 0.05). When the degree of correction increased, there were no significant positive changes in the postoperative KOOS or VAS score in Group 1, unlike in the other two groups (p < 0.05). In corrections of ≥ 10°, while there was no significant difference in the postoperative KOOS or VAS score ​​between Groups 2 and 3, these parameters significantly improved in these two groups compared to Group 1 (p < 0.05). Among the KOOS subparameters, pain and activities of daily living scores ​​were greater in Groups 2 and 3 than in Group 1 (p < 0.05).ConclusionsIn MOWHTO, MF is a sufficient treatment method that improves the patient’s clinical condition without requiring additional treatments such as HA and GC.Level of evidenceIII, retrospective cohort study.

Synergistic effects of calcium channel blockers and renin-angiotensin inhibitors with gemcitabine-based chemotherapy on the survival of patients with pancreatic cancer

PurposePancreatic cancer remains a significant public health challenge, with poor long-term outcomes due to the lack of effective treatment options. Repurposing commonly used clinical drugs, such as ACE inhibitors, ARBs, CCBs, and metformin, may enhance the efficacy of chemotherapy and offer a promising therapeutic strategy for improving patient outcomes.MethodsA retrospective analysis of concomitant treatment with ACE-Is, ARBs, CCBs, and metformin alongside gemcitabine chemotherapy in patients with pancreatic cancer was conducted. Treatment responses were evaluated, with overall survival (OS) estimated using the Kaplan–Meier method. Additionally, the Cox proportional hazards model was employed to assess the impact of these specific agents on patient survival.Results4628 patients with various stages of pancreatic cancer were identified in the database between 2007 and 2016. The estimated overall survival (OS) in the analyzed group was 6.9 months (95% CI 6.4–7). The use of any of the analyzed drugs was associated with a significant improvement in mOS of 7.5 months (95% CI 6.8–7.8) vs. 6.7 months (95% CI 6.4–7.0) for patients who did not have additional treatment (p < 0.0001). ARBs, ACE-Is, CCBs, and metformin varied in their effectiveness in prolonging mOS among patients. The longest mOS of 8.9 months (95% CI 7.7–11.6) was observed in patients receiving additional therapy with ARBs, while the shortest mOS of 7.7 months (95% CI 6.5–8.9) was achieved by patients receiving metformin. In the adjusted Cox analysis, metformin was associated with a significantly weaker effect on mOS (p = 0.029). A particularly interesting trend in prolonging 5-year survival was demonstrated by ARBs and CCBs with 14.1% (95% CI 9–22%) and 14.8% (95% CI 11.1–19.6%), respectively, compared to patients not taking these drugs, who achieved a 5-year OS of 3.8% (95% CI 3.2–4.4%).ConclusionOur results demonstrate a significant positive impact of ARBs, ACE inhibitors, and CCBs on survival in patients with pancreatic cancer treated with gemcitabine. The addition of these inexpensive and relatively safe drugs in patients with additional comorbidities may represent a potential therapeutic option in this indication. However, prospective clinical trials to evaluate the optimal patient population and further studies to determine the potential impact of these agents on chemotherapy are necessary.

Silica Sand, Activated Carbon, and Manganese Zeolite for Clean Water Filtration

The General Background Water is essential for human life, but many rural areas still lack access to clean drinking water that meets health standards. In Sumbergedang Village, Pandaan, local water sources are often contaminated by dissolved metals and bacteria, posing risks to community health. Current filtration methods in the area are insufficient, and limited studies explore the combined use of silica sand, activated carbon, manganese zeolite, and UV sterilization for improving rural water quality. This study aims to evaluate the performance of these filtration materials and UV sterilization in producing safe drinking water for the village. The results show that the filtration system increased the pH of the water from 7.94 to 7.98, within acceptable drinking water standards. The novelty of this research lies in the integration of filtration materials with UV sterilization to address both chemical and microbial contaminants, offering a comprehensive solution for water purification. The findings suggest that, while the system effectively improves most water quality parameters, additional treatments may be required to reduce aluminum levels to meet national drinking water standards. These results have important implications for water management in rural areas facing similar challenges. Highlihts: The study combines mangan zeolite, silica sand, and activated carbon with UV sterilization for effective water purification. Filtration and UV treatment significantly reduced turbidity, odors, and bacterial contamination in spring water. Aluminum levels exceeded permissible limits, indicating the need for further modifications to the filtration system. Keywords: Water quality, filtration, UV sterilization, rural communities, aluminum levels

Integrative approach for supernumerary teeth: a single-center retrospective analysis.

This study aimed to provide a comprehensive case analysis from a single center, with the objective of clarifying the optimal timing and recommendations for a preferred treatment strategy customized to the specific presentation of each type of supernumerary tooth identified in the research. A retrospective study was conducted on patients who presented with a supernumerary tooth and were treated interdisciplinarily at the clinic. In total, 55 patients with 81 supernumerary teeth of the permanent dentition were analyzed, 30 males and 25 females. The dentition status of the patients was as follows: 31 patients with mixed dentition, no patients with primary dentition, and 24 patients with permanent dentition. The diagnosis of supernumerary tooth was primarily made by general or pediatric dental practitioners and/or orthodontists. Patients were then referred to maxillofacial surgeons for treatment decision. The timing of treatment was mainly determined by the oral surgeon, based on the recommendations of the other specialists involved. Cases involving maleruption or malalignment of permanent teeth required both surgical and orthodontic treatment. Patients over 9 years old were treated either under local anesthesia or sedation, whereas those under 9 years old were treated under deep sedation or general anesthesia. A comprehensive investigation of cases involved the utilization of CBCT at the supernumerary tooth site to facilitate treatment planning. There was a significant correlation between younger age and the preference for treatment under sedation or general anesthesia (P &#61; .01, t test). Similarly, a strong association was found between younger age and the need for additional orthodontic treatment (P &#61; .016, t test). Cases of surgical removal of a supernumerary tooth at a young age typically did not require orthodontic traction of the permanent tooth, in contrast to cases of late surgical intervention (patients over 11 years old), which often did necessitate such traction. There was a strong tendency for treating supernumerary teeth in the maxilla. The proximity of supernumerary teeth to vital anatomical landmarks significantly influenced treatment decisions. Patients with supernumerary teeth near the mental foramen or the inferior dental canal in the premolar area were exclusively placed under follow-up care (P &#61; .002, Pearson chi-square test). However, in the maxilla, the proximity of supernumerary teeth to vital structures such as the floor of the nose and the incisive nerve did not affect the treatment approach, and those supernumerary teeth were mostly removed. A team approach for managing supernumerary teeth is recommended. The timing of treatment should carefully consider the advantages and disadvantages of early versus late intervention. Early surgical treatment in cases where eruption is disturbed might result in spontaneous eruption, eliminating the need for orthodontic traction of the permanent teeth.

The Effect of Corticotomy-Assisted Orthodontic Therapy (CAOT) or Periodontally Accelerated Osteogenic Orthodontics (PAOO) on Bone Remodeling and the Health of Periodontium: A Systematic Review of Systematic Reviews.

Background: Orthodontic treatment involves moving teeth within the alveolar ridge. Bone remodeling is associated with the activity of osteoblasts and osteoclasts. Procedures such as corticotomy-assisted orthodontic therapy (CAOT) or periodontally accelerated osteogenic orthodontics (PAOO) are intended to reduce bone density and negative stress on the grip side and therefore limit bone resorption during orthodontic movement or add bone substitute material so that the tooth does not cross the vestibular plate. Methods: The study was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The study design was defined in the PICO format-Population (P): patients with full permanent dentition, both adolescents and adults; Intervention (I): orthodontic treatment with fixed appliances using additional supportive treatments such as CAOT or PAOO; Comparison (C): assessment of the impact of additional treatments during orthodontic treatment on the remodeling of the alveolar bone and the condition of the periodontium; Result (O): statistically significant/non-significant differences in the condition of the alveolar bone before and after orthodontic treatment. Search filters include the time of publication of the article, systematic reviews from the last five years, and publications that appeared in English. The information provided in the abstracts of systematic reviews that describe the effects of additional procedures during orthodontic treatment such as CAOT or PAOO on the health of periodontium was analyzed. Articles unrelated to the subject of the planned study and those in which tooth movement acceleration was analyzed were excluded. Results: Eight articles were selected in which a total number of 835 subjects took part. The changes in bone density and effects on periodontium were different after CAOT and PAOO. Conclusions: The validity of CAOT and PAOO procedures remains controversial. Better results are obtained when combined with tissue augmentation or thickening of the gingival phenotype rather than as stand-alone procedures, as their uses to protect periodontal tissues are limited.

Exploring strategies for valorizing wood processing waste: advancing sustainable, fully lignocellulosic biocomposites

This study presents the design and synthesis of bio-composites exhibiting high properties, wherein both the matrix and filler originate from wood biomass. Notably, no additional hardener compounds or treatments/modifications of the lignocellulosic filler were employed. Thermosetting materials were developed by homopolymerizing a bio-based aromatic epoxy monomer, the resorcinol diglycidyl ether (RDGE), with different percentages, from 1 wt% to 30 wt% of natural wood processing side-product, such as spruce bark powder (SB), which was used as such without additional treatments and modifications. The DSC analyses revealed enhanced reactivities with the bio-filler content, resulting in a reduced reaction temperature range and maximum reaction temperature. These findings provide evidence of the chemical interaction between the functional groups from spruce bark and the epoxides groups. The obtained fully based lignocellulosic materials show high E' values from 2.4 GPa to 2.5–3.5 GPa (glassy state) and from 64 MPa to 99–156 MPa in the rubbery region. The damping factor of the bio-composites with 1–10 wt% SB have shown an increase of the α transition temperature from 92 °C to 94–97 °C. The excellent filler/matrix interface and optimal adhesion between them were confirmed by SEM analysis.

Newly established borderline resectable 1 (BR1)category is one of the favorable candidates for selecting the use of multidisciplinary combination therapy in patients with advanced hepatocellular carcinoma treated with systemic therapy.

The aim of this study was to evaluate the newly established oncological criteria of resectability of hepatocellular carcinoma (HCC) for selecting suitable candidates for systemic and combination therapy. The data of 156 consecutive HCC patients with intrahepatic target nodules who had initially received systemic therapy (lenvatinib and atezolizumab plus bevacizumab) were reviewed. The patients were classified into three groups according to the novel oncological criteria for resectability (R, resectable; BR1, borderline resectable 1; and BR2, borderline resectable 2). The prognostic ability and clinical utility for selecting this population to receive combined use of multiple systemic sequential and locoregional therapy was then evaluated. Combined use of systemic sequential therapy with more than two agents and locoregional treatment was defined as multidisciplinary combination therapy (MCT), while systemic sequential therapy only and repeated locoregional treatment was defined as a single treatment procedure (STP). Patients classified as R and BR1 had significantly better overall survival (OS) compared with BR2 (R vs. BR2, p=0.012; BR1 vs. BR2, p=0.004). However, there was no significant difference between R and BR1 (p=1.000), in spite of significantly worse oncological status in the BR1 patients. Following a R0 resection and MCT, the BR1 patients had significantly better OS compared with those receiving STP or no additional treatment (median OS, not reached vs. 25.2months and 20.1 vs. 11.3months, respectively; p=0.034). In patients with advanced HCC with intrahepatic target nodules the BR1 category is one of the favorable candidates for selecting those to be treated with MCT strategies.

Compulsory Community Treatment Orders and health outcomes for Ma-ori in New Zealand.

We have previously analysed outcomes for all community treatment orders commenced during a 10-year period in New Zealand. Given Te Tiriti O Waitangi obligations to scrutinise health and consider equity for Māori, we completed this analysis to consider community treatment-order outcomes according to ethnicity. Ministry of Health databases provided demographic, service use and medication dispensing data for community treatment-order recipients between 2009 and 2018. As non-Māori on community treatment orders are older, less deprived and less likely to be diagnosed with a Psychotic Disorder, data were categorised according to age (<35/⩾35 years), level of deprivation (New Zealand Dep levels ⩽3, 4-6 and ⩾7) and diagnosis (Psychotic Disorder/non-Psychotic Disorder). The incidences of key outcome measures (admissions, community care, medication dispensing) were calculated for periods on/off community treatment orders for Māori and non-Māori to consider the differential impact of community treatment orders according to ethnicity. Māori have high rates of community treatment order utilisation and are younger, more likely to be diagnosed with a Psychotic Disorder and spend longer receiving compulsory treatment than non-Māori. Non-Māori are more likely to receive more additional depot antipsychotic medication on-community treatment orders compared with periods off-community treatment order than Māori but other clear patterns of response distinguishing between Māori and non-Māori were not present. The differences between Māori and non-Māori for community treatment-order utilisation suggest the presence of structural inequity in underlying mental illness distribution and treatment provision. Māori cultural expertise at all levels of healthcare including healthcare planning and delivery is required to make advances and reduce disparity.

Designing a biochar-based pretreatment method for distillery effluents entering constructed wetlands

Spent lees is an important distillation waste by-product created during whisky production, characterised by low pH and high dissolved copper (dissCu) content. Constructed wetland systems (CWs) are used in some Scotch whisky distilleries to treat spent lees prior to surface water discharge to prevent substantial environmental risks of spent lees in aquatic ecosystems, by buffering the acidic nature and decreasing the dissCu and organics content. However, as these wetland systems are biological communities (containing bacteria, fungi, plants, etc.), direct disposal of spent lees into CW ecosystems presents a challenge given its nature. This study investigates the efficacy of modified biochar (waste) sourced from whisky cask cooperage operations, as an effluent pretreatment method. The aim is to transform this raw biochar into NaOH-modified biochar, which will be capable of buffering the effluent pH and removing dissCu from spent lees before it enters CWs. To enhance raw biochar, NaOH modification and additional heat treatment were utilised which increased the alkalinity, heavy metal removal capacity and pH buffering potential. Experiments with 0.2% and 2% NaOH treated biochar demonstrated its treatment performance using a diverse range of spent lees samples with varying characteristics, including pH (4.1–4.4), dissCu concentrations (33.8–59.5 mg/L), and total organic carbon (685–754 mg/L). Column studies further supported the efficacy of the modified biochars, showing significant pH elevation and efficient dissCu removal (of 5.72 mg of Cu per g of biochar) when treating spent lees. This dissCu removal capacity compares favorably with other wood-derived biochars studied in the literature, which have reported between 2.75 and 7.44 mg/g. Surface characterisation techniques (EDX, XPS, FTIR, XRD) showed how the Cu ions microprecipitated on the modified biochar surface, validating its remediation potential. This study highlights the potential of biochar as a sustainable pretreatment solution for distillery effluents, paving the way for enhanced and more circular waste management practices within the Scotch whisky industry.