Choice Of Agent Research Articles

Periocular Chemotherapy in Palpebral Malignancies: A Review

Background: Palpebral malignancy is still a significant health problem and consists of sebaceous gland carcinoma (SGC), basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and malignant melanoma (MM). Although total resection using the Moh micrograph method is standard therapy for these cases, perioral chemotherapy may be an alternative therapy in patients where surgery cannot be performed.Content: Periocular chemotherapy in lid malignancy is recommended in cases that are inhibited or contraindicated for surgery, with obscure tumor margins, with markers of tumor invasion of vascular, lymphatic, nerve, or other orbital structures, signs of relapse after surgery, local pagetoid involvement, sizeable tumor size, and also presented an appearance of diffuse and multifocal tumor on histopathological examination. Choices of local chemotherapeutic agents based on the variety of palpebral malignancy, namely: (1) imiquimod for BCC; (2) mitomycin-C for SGC; (3) cisplatin, doxorubicin, bleomycin, peplomycin, methotrexate, and 5-fluorouracil for SCC; and (4) Imiquimod for MM. Topical chemotherapy is given to patients using an iodontotherapy method or ophthalmic cream.. More often than not, topical chemotherapy possessed a few side effects that are mild and tolerable and disappear on their own after treatment has finished.Conclusion: Local/periocular chemotherapy for palpebral malignancy is an alternative adjuvant therapy that can be considered, especially in cases where surgery is not possible. Key words: Malignancy, chemotherapy, palpebral, periocular

Survey of urinary tract infection among male students residing in the federal polytechnic, Ado-Ekiti

Urinary tract infections are among the most common bacterial infections in humans both in the community and hospital settings, and they occur in all age groups, and usually required urgent treatment. This study aimed at determining the prevalence of urinary tract infection among male students residing in the Federal Polytechnic, Ado-Ekiti, Ekiti State, Nigeria. Clean-catch midstream urine was collected from fifty (50) male students in the study area into clean sterile specimen bottles. The urine samples were processed and microbial isolates identified. The prevalence of urinary tract infection was significantly high (50%). Five bacterial strains were identified which are; Staphylococcus saphrophyticus, Staphylococcus aureus, Escherichia coli, Enterococcus faecalis and Pseudomonas aeruginosa. S. aureus was found to be the most prevalent and predominant bacterial causing urinary tract infection in males in the study area. The best choice of active antibacterial agents would be trimethoprim, cephalosporin and Fluoroquinolones in the treatment of urinary tract infections in male.

Bone-Targeted Therapy Regimen and Skeletal-Related Events in Patients Surviving Longer Than 2 Years With Metastatic Breast Cancer and Bone Metastasis

BackgroundBone-targeted therapy (BTT) including zoledronic acid (ZA) and denosumab decreases the risk of skeletal-related events (SREs) in patients with metastatic breast cancer (MBC) and bone metastasis. The impacts from prolonged BTT on SREs and BTT-associated harms are unknown and are becoming important to understand as these patients survive for longer periods. Methods and MaterialsWe conducted a retrospective study of 224 patients with MBC and bone metastasis who survived for more than 2 years after diagnosis and received treatment at our institution between 2016 and 2021. We defined 3 BTT patterns: (1) ZA only, (2) denosumab only, (3) both ZA and denosumab. The association between these BTT patterns and SREs and harms was assessed using Fisher exact test and logistic regression. ResultsRates of SREs overall were 21.2% of patients given ZA only, 8.8% of those given denosumab only, and 20% of those given both, without statistically significant differences (p = .32). However, those treated with denosumab only had significantly fewer compression fractures (0.7%) (p = .02). BTT-associated harm was observed in 5.8% of the ZA-only group, 11.7% of the denosumab-only group, and 14.3% of the group given both, without statistically significant differences (p = .37). ConclusionOncologists may have increased flexibility regarding the frequency of administration of BTT along with their choice of agent. Our study showed no significant difference in the prevention of overall SRE or development of BTT-associated harms between the BTT regimens evaluated.

Does the Type of Failure and the Choice of the Second Biologic Influence Response and Persistence on Medication in Rheumatoid Arthritis?

The type of failure may predict response to a second biologic. We evaluated the response to a second tumor necrosis factor inhibitor (TNFi) or non-TNFi in patients failing their initial TNFi, either primarily or secondarily. Patients with rheumatoid arthritis who were biologic-naive and had a Clinical Disease Activity Index (CDAI) >10, who started their first TNFi for ≥3 months and then switched to a second biologic, were included in the study. Secondary failure was defined as 2 consecutive low-CDAI visits and then switching to a second biologic while they had moderate/severe CDAI. Primary failure was defined if it did not meet the definition of secondary failure, or if they had at least 1 moderate/severe CDAI after 3 months on treatment. We used multivariable logistic regression comparing primary versus secondary failure for achievement of CDAI ≤10 (primary outcome) and minimal clinically important differences (secondary outcome) at 6 months after switch. Of the 462 patients included, 64.3% and 35.7% stopped the first TNFi because of a primary and secondary failure, respectively. Patients with primary failure had a more severe disease (CDAI mean, 26.39 vs. 21.61; p < 0.001). The likelihood of achieving CDAI ≤10 (odds ratio, 4.367; 95% confidence interval, 2.428-7.856) and minimal clinically important difference (odds ratio, 2.851; 95% confidence interval, 1.619-5.020) was significantly higher for secondary than primary failure regardless of choice of a second agent. Patients with rheumatoid arthritis with secondary failure to a first TNFi responded better to a second biologic agent, regardless of the choice of biologic.

Intranasal analgesia for acute moderate to severe pain in children – a systematic review and meta-analysis

BackgroundChildren in acute pain often receive inadequate pain relief, partly from difficulties administering injectable analgesics. A rapid-acting, intranasal (IN) analgesic may be an alternative to other parenteral routes of administration. Our review compares the efficacy, safety, and acceptability of intranasal analgesia to intravenous (IV) and intramuscular (IM) administration; and to compare different intranasal agents.MethodsWe searched Cochrane Library, MEDLINE/PubMed, Embase, Web of Knowledge, Clinicaltrials.gov, Controlled-trials.com/mrcr, Clinicaltrialsregister.eu, Apps.who.int/trialsearch. We also screened reference lists of included trials and relevant systematic reviews. Studies in English from any year were included.Two authors independently assessed all studies. We included randomised trials (RCTs) of children 0–16, with moderate to severe pain; comparing intranasal analgesia to intravenous or intramuscular analgesia, or to other intranasal agents. We excluded studies of procedural sedation or analgesia.We extracted study characteristics and outcome data and assessed risk of bias with the ROB 2.0-tool. We conducted meta-analysis and narrative review, evaluating the certainty of evidence using GRADE.Outcomes included pain reduction, adverse events, acceptability, rescue medication, ease of and time to administration.ResultsWe included 12 RCTs with a total of 1163 children aged 3 to 20, most below 10 years old, with a variety of conditions. Our review shows that:- There may be little or no difference in pain relief (single dose IN vs IV fentanyl MD 4 mm, 95% CI -8 to 16 at 30 min by 100 mm VAS; multiple doses IN vs IV fentanyl MD 0, 95%CI -0.35 to 0.35 at 15 min by Hannallah score; single dose IN vs IV ketorolac MD 0.8, 95% CI -0.4 to 1.9 by Faces Pain Scale-Revised), adverse events (single dose IN vs IV fentanyl RR 3.09, 95% CI 0.34 to 28.28; multiple doses IN vs IV fentanyl RR 1.50, 95%CI 0.29 to 7.81); single dose IN vs IV ketorolac RR 0.716, 95% CI 0.23 to 2.26), or acceptability (single dose IN vs IV ketorolac RR 0.83, 95% CI 0.66 to 1.04) between intranasal and intravenous analgesia (low certainty evidence).- Intranasal diamorphine or fentanyl probably give similar pain relief to intramuscular morphine (narrative review), and are probably more acceptable (RR 1.60, 95% CI 1.42 to 1.81) and tolerated better (RR 0.061, 95% CI 0.03 to 0.13 for uncooperative/negative reaction) (moderate certainty); adverse events may be similar (narrative review) (low certainty).- Intranasal ketamine gives similar pain relief to intranasal fentanyl (SMD 0.05, 95% CI -0.20 to 0.29 at 30 min), while having a higher risk of light sedation (RR 1.74, 95% CI 1.30 to 2.35) and mild side effects (RR 2.16, 95% CI 1.72 to 2.71) (high certainty). Need for rescue analgesia is probably similar (RR 0.85, 95% CI 0.62 to 1.17) (moderate certainty), and acceptability may be similar (RR 1.15, 95% CI 0.89 to 1.48) (low certainty).ConclusionsOur review suggests that intranasal analgesics are probably a good alternative to intramuscular analgesics in children with acute moderate to severe pain; and may be an alternative to intravenous administration. Intranasal ketamine gives similar pain relief to fentanyl, but causes more sedation, which should inform the choice of intranasal agent.

Impact of converting from povidone iodine to chlorhexidine gluconate for vaginal preparation prior to hysterectomy

While vaginal preparation prior to hysterectomies to reduce the risk of contamination by vaginal flora is standard, there is no consensus on the appropriate choice of antisepsis agent. The aim of this study was to evaluate whether the conversion from povidone-iodine (PI) to chlorhexidine gluconate (CHG) would reduce surgical site infection (SSI) rates and improve standardized infection ratios (SIR). A quality improvement process was implemented to educate all providers, trainees, and staff followed by wide-spread conversion to CHG vaginal preparation prior to all hysterectomies starting on June 1, 2021. The SSI rates and SIRs were compared between the preintervention and postintervention periods. There was no significant change in SSI rate or SIR from the preintervention to the postintervention period, indicating that CHG is noninferior to PI. The SSI rate was 1.53% preintervention compared to 1.57% post, and the SIR was 1.976 and 2.049, respectively. While our data suggests that the conversion from PI to CHG for vaginal prep alone is insufficient to reduce SSI rates and SIRs, it is noninferior and should be considered as part of a larger preventative bundle.

Venous Thromboembolism Prophylaxis in Major Orthopedic Surgeries and Factor XIa Inhibitors.

Venous thromboembolism (VTE), comprising pulmonary embolism (PE) and deep vein thrombosis (DVT), poses a significant risk during and after hospitalization, particularly for surgical patients. Among various patient groups, those undergoing major orthopedic surgeries are considered to have a higher susceptibility to PE and DVT. Major lower-extremity orthopedic procedures carry a higher risk of symptomatic VTE compared to most other surgeries, with an estimated incidence of ~4%. The greatest risk period occurs within the first 7-14 days following surgery. Major bleeding is also more prevalent in these surgeries compared to others, with rates estimated between 2% and 4%. For patients undergoing major lower-extremity orthopedic surgery who have a low bleeding risk, it is recommended to use pharmacological thromboprophylaxis with or without mechanical devices. The choice of the initial agent depends on the specific surgery and patient comorbidities. First-line options include low-molecular-weight heparins (LMWHs), direct oral anticoagulants, and aspirin. Second-line options consist of unfractionated heparin (UFH), fondaparinux, and warfarin. For most patients undergoing knee or hip arthroplasty, the initial agents recommended for the early perioperative period are LMWHs (enoxaparin or dalteparin) or direct oral anticoagulants (rivaroxaban or apixaban). In the case of hip fracture surgery, LMWH is recommended as the preferred agent for the entire duration of prophylaxis. However, emerging factor XI(a) inhibitors, as revealed by a recent meta-analysis, have shown a substantial decrease in the occurrence of VTE and bleeding events among patients undergoing major orthopedic surgery. This discovery poses a challenge to the existing paradigm of anticoagulant therapy in this specific patient population and indicates that factor XI(a) inhibitors hold great promise as a potential strategy to be taken into serious consideration.

Influence of silane interfacial chemistry on the curing process of anionic Polyamide 6 in glass reinforced composites

The manufacturing of composites based on reactive thermoplastic polyamide 6 (PA6), reinforced with glass particles or fibers for structural applications, is quite sensitive to the state of the interface. Surface hydroxyls present at the glass surface can completely inhibit both the PA6 polymerization and crystallization processes. Care must then be exerted when tuning the interfacial chemistry in this system. This work demonstrates how an adequate choice of silane coupling agent, combined with a precise surface grafting methodology and tight control of hydroxyl groups density on glass particulates, yields kinetics and degrees of polymerization and crystallization comparable to the pure PA6 resin. Various silanes were grafted onto the microparticles and their surfaces were characterized by Fourier transform infrared spectroscopy, X-ray photoelectron spectroscopy, thermogravimetric analysis, confocal laser scanning microscopy and contact angle measurements. The activator was also grafted onto the glass surface to initiate polymerization directly from the surface. The results showed that all treated glass particles surfaces allowed obtaining a high degree of conversion but with varying polymerization and crystallization kinetics. The results provide fundamental information on the role of the surface chemistry of glass reinforcements on the polymerization and crystallization of PA6, which are essential for the proper control of composite manufacturing.

Use of the mCherry fluorescent protein to optimize the expression of class I lanthipeptides in Escherichia coli

BackgroundLanthipeptides are a rapidly expanding family of ribosomally synthesized and post-translationally modified natural compounds with diverse biological functions. Lanthipeptide structural and biosynthetic genes can readily be identified in genomic datasets, which provides a substantial repository for unique peptides with a wide range of potentially novel bioactivities. To realize this potential efficiently optimized heterologous production systems are required. However, only a few class I lanthipeptides have been successfully expressed using Escherichia coli as heterologous producer. This may be attributed to difficulties experienced in the co-expression of structural genes and multiple processing genes as well as complex optimization experiments.ResultsHere, an optimized modular plasmid system is presented for the complete biosynthesis for each of the class I lanthipeptides nisin and clausin, in E. coli. Genes encoding precursor lanthipeptides were fused to the gene encoding the mCherry red fluorescent protein and co-expressed along with the required synthetases from the respective operons. Antimicrobially active nisin and clausin were proteolytically liberated from the expressed mCherry fusions. The mCherry-NisA expression system combined with in vivo fluorescence monitoring was used to elucidate the effect of culture media composition, promoter arrangement, and culture conditions including choice of growth media and inducer agents on the heterologous expression of the class I lanthipeptides. To evaluate the promiscuity of the clausin biosynthetic enzymes, the optimized clausin expression system was used for the heterologous expression of epidermin.ConclusionWe succeeded in developing novel mCherry-fusion based plug and play heterologous expression systems to produce two different subgroups of class I lanthipeptides. Fully modified Pre-NisA, Pre-ClausA and Pre-EpiA fused to the mCherry fluorescence gene was purified from the Gram-negative host E. coli BL21 (DE3). Our study demonstrates the potential of using in vivo fluorescence as a platform to evaluate the expression of mCherry-fused lanthipeptides in E. coli. This allowed a substantial reduction in optimization time, since expression could be monitored in real-time, without the need for extensive and laborious purification steps or the use of in vitro activity assays. The optimized heterologous expression systems developed in this study may be employed in future studies for the scalable expression of novel NisA derivatives, or novel genome mined derivatives of ClausA and other class I lanthipeptides in E. coli.

Recent Progress of Photothermal Therapy Based on Conjugated Nanomaterials in Combating Microbial Infections.

Photothermal therapy has the advantages of non-invasiveness, low toxicity, simple operation, a broad spectrum of antibacterial ability, and non-proneness to developing drug resistance, which provide it with irreplaceable superiority in fighting against microbial infection. The effect of photothermal therapy is closely related to the choice of photothermal agent. Conjugated nanomaterials are potential candidates for photothermal agents because of their easy modification, excellent photothermal conversion efficiency, good photostability, and biodegradability. In this paper, the application of photothermal agents based on conjugated nanomaterials in photothermal antimicrobial treatment is reviewed, including conjugated small molecules, conjugated oligomers, conjugated polymers, and pseudo-conjugated polymers. At the same time, the application of conjugated nanomaterials in the combination of photothermal therapy (PTT) and photodynamic therapy (PDT) is briefly introduced. Finally, the research status, limitations, and prospects of photothermal therapy using conjugated nanomaterials as photothermal agents are discussed.

Procedural (Conscious) Sedation and Analgesia in Emergency Setting: How to Choose Agents?

Pain has long been defined as an unpleasant sensory and emotional experience originating from any region of the body in the presence or absence of tissue injury. Physicians involved in acute medicine commonly undertake a variety of invasive and painful procedures that prompt procedural sedation and analgesia (PSA), which is a condition sparing the protective airway reflexes while depressing the patient's awareness of external stimuli. This state is achieved following obtaining the patient's informed consent, necessary point-ofcare monitoring, and complete recording of the procedures. The most commonly employed combination for PSA mostly comprises short-acting benzodiazepine (midazolam) and a potent opioid, such as fentanyl. The biggest advantage of opioids is that despite all the powerful effects, upper airway reflexes are preserved and often do not require intervention. Choices of analgesic and sedative agents should be strictly individualized and determined for the specific condition. The objective of this review article was to underline the characteristics, effectiveness, adverse effects, and pitfalls of the relevant drugs employed in adults to facilitate PSA in emergency procedures.

Cost-effectiveness of Trastuzumab Deruxtecan for HER2-low Advanced Breast Cancer in the United States

Trastuzumab deruxtecan has been shown to be effective for advanced breast cancer with low levels of human epidermal growth factor receptor 2. To optimize the allocation of limited health care resources, this study evaluated the cost-effectiveness of trastuzumab deruxtecan from the US payer perspective. A partitioned survival model was developed to project the disease course of advanced breast cancer. Clinical efficacy, treatment utilization, safety, and cost data were gathered from the DESTINY-Breast04 (Trastuzumab Deruxtecan in Previously Treated HER2-Low Advanced Breast Cancer) trial and the Centers for Medicare & Medicaid Services. Transition probabilities were obtained from the reported survival probabilities per DESTINY-Breast04 group. The incremental cost-effectiveness ratio (ICER), the incremental monetary benefit, and the incremental net health benefit were measured. One-way sensitivity analysis, probabilistic sensitivity analysis, and subgroup analysis were performed to explore the uncertainty of the model. Trastuzumab deruxtecan had an ICER of $307,751 per quality-adjusted life-year (QALY) gained, with an incremental net health benefit of -0.317 QALY and an incremental monetary benefit of -$63,313 compared with the physician's choice of alternative chemotherapy agents. Subgroup analysis indicated that trastuzumab deruxtecan had an ICER of $383,776 per QALY gained for the hormone receptor-positive subgroup and an ICER of $194,424 per QALY for the hormone receptor-negative subgroup. One-way sensitivity analysis showed that the cost of trastuzumab deruxtecan had the most impact on model outcomes. The cost-effectiveness acceptability curve projected that the probability of trastuzumab deruxtecan being cost-effective was 5% in the overall population, 2% in the hormone receptor-positive subgroup, and 56% in the hormone receptor-negative subgroup at the willingness-to-pay threshold of $200,000 per QALY. Trastuzumab deruxtecan may be a cost-effective option for hormone receptor-negative patients with advanced breast cancer with low levels of human epidermal growth factor receptor 2.

Antithrombotic therapy with Transcatheter aortic valve replacement.

Aortic valve replacement is a necessary management strategy for patients with severe aortic stenosis. The use of transaortic valve replacement (TAVR) has increased significantly over the last decade and now exceeds traditional surgical aortic valve replacement. Since the valve systems used in TAVR consist of bioprosthetic valve tissue encased in a metal stent frame, antithrombotic therapy recommendations cannot be extrapolated from prior data with differently constructed surgical bioprosthetic or mechanical valves. Data on the use of antithrombotic therapy with TAVR are a rapidly developing area of medicine. Choice of agents depends on several patient factors. Patients undergoing TAVR also have a relatively high incidence of subclinical valve thrombosis. The clinical impact of this phenomenon and the implications for antithrombotic therapy continue to evolve. It is critical for clinicians who treat patients undergoing TAVR to have a firm understanding of practice guidelines, the evolving evidence, and its implications for the use of antithrombotic therapy in these patients.

Stated Product Choices of Heterogeneous Agents are Largely Consistent with Standard Models

In this paper we analyze how stated choices for the amount of risk in pension assets of Dutch participants in DC pension products vary with their characteristics. We find strong evidence that this variation is in line with standard portfolio choice models. Heterogeneity in age, risk aversion, loss aversion, non-pension financial wealth, the relative importance of DC pension wealth and educational attainment leads to differences in product choice that are largely in line with standard theory. This applies to investment choices in the accumulation phase as well as in the retirement phase.

A challenge in paediatrics: concurrent atopic dermatitis and vitiligo

Atopic dermatitis is one of the most common dermatoses globally. It has been established that it can often be associated with a variety of autoimmune diseases. Vitiligo is one of such comorbidities. This concurrent combination is most often found in paediatric practice, as an early onset is typical for both diseases. Early onset of vitiligo and involvement of a larger area of skin have been shown to be associated with higher odds of atopic dermatitis. The pathogenesis of vitiligo is characterized by altered immune responses, and genetic factors also counts. It has been shown that some of these mechanisms are shared with the pathogenesis of atopic dermatitis, but the issue warrants further study. Oxidative stress triggering melanocytes destruction is believed to be a key factor in the development of vitiligo. In this regard, patients with vitiligo are advised to use photoprotective agents. Today, the study of effects of visible light on the skin is a very topical issue, specifically, particular attention is paid to blue light (400-500 nm). Studies show that it is this wavelength that has a more pronounced negative effect on the skin. However, research findings are contradictory, as this spectrum radiation is used in the treatment of various dermatoses, including atopic dermatitis. Thus, the concurrent vitiligo and atopic dermatitis place certain restrictions on the choice of therapy, care products and photoprotective agents. A photoprotective agent for such difficult patients should protect the skin from exposure to as wide solar radiation spectrum as possible and at the same time not contain potentially allergenic components that can aggravate the course of atopic dermatitis.

Variation of rectal temperature in dogs undergoing 3T-MRI in general anesthesia.

Managing body temperature during MRI scanning under general anesthesia poses challenges for both human and veterinary patients, as many temperature monitoring devices and patient warming systems are unsuitable for the use inside an MRI scanner. MRI has the potential to cause tissue and body warming, but this effect may be counteracted by the hypothermia induced by general anesthesia and the low ambient temperature usually encountered in scanner rooms. This study aimed to observe temperature variations in dogs undergoing MRI under general anesthesia. In this prospective observational study, client-owned dogs scheduled for 3-Tesla MRI under anesthesia between February and October 2020 at a veterinary teaching hospital were eligible for enrollment. Recorded data included breed, body mass, body condition score, age, fur quality, pre- and post-MRI rectal temperatures, time in the MRI room, scan area and coil used, application of contrast medium, choice of anesthetic agents, use of blankets, and infusion therapy. Group comparisons were conducted using the Mann-Whitney U-test or Kruskal-Wallis test, with p < 0.05 considered significant. In total 171 dogs met the inclusion criteria. The median body temperature at admission was 38.4°C (IQR 38.1-38.7°C). The median body temperature before MRI was 38.2°C (IQR 37.8-38.6°C), and the median temperature after the MRI scan was 37.7°C (IQR 37.238.2°C) resulting in a median temperature difference (∆T) before and after MRI of - 0.6°C (IQR -0.8--0.1°C). The median duration of MRI scans was 49 min (IQR 38-63 min). A temperature loss of more than 0.1°C was observed in 121 (70.8%) dogs, 29 (16.9%) dogs maintained their temperature within 0.1°C, and 21 (12.3%) dogs experienced a temperature increase of more than 0.1°C. Factors associated with a higher post-MRI temperature included greater body mass, medium or long fur, and the application of α2- receptor-agonists. Dogs undergoing MRI under general anesthesia are likely to experience temperature loss in the given circumstances. However, in larger dogs and those with much fur, an increase in body temperature is possible and more common than generally anticipated, although clinically insignificant in most cases.

Biodentine as a Pulpotomy Agent in Primary Teeth; A Systematic Review

Pulpotomy is a commonly performed procedure in pediatric dentistry to preserve the vitality and function of the dental pulp in cases of deep caries or traumatic injuries. The choice of pulpotomy agent is crucial for successful outcomes. Biodentine, a bioactive dentin substitute, has gained popularity as a potential alternative to conventional pulpotomy agents. This systematic review aims to evaluate the effectiveness of Biodentine as a pulpotomy agent in primary teeth and compare it with other commonly used materials, including ferric sulfate. A comprehensive search was conducted in electronic databases (PubMed, Embase, and Cochrane Library) using relevant keywords and MeSH terms. Out of the initially identified 233 publications, studies published until June 2023 that evaluated the use of Biodentine as a pulpotomy agent in primary teeth were included. The selection process involved screening the titles, abstracts, and full texts of the articles. Data were extracted, and the risk of bias assessment was performed using appropriate tools. The outcomes of interest included clinical success rates, pulpal healing, postoperative pain, and adverse events. The review includes 9 studies that evaluated the use of Biodentine as a pulpotomy agent in primary teeth. Additionally, 3 studies comparing Biodentine and ferric sulfate as pulpotomy agents were identified. The clinical success rates of Biodentine ranged from 85% to 97%, with favorable pulpal healing observed in the majority of cases. Postoperative pain was reported to be minimal, and no major adverse events were recorded. Comparative studies showed comparable or superior outcomes for Biodentine when compared to ferric sulfate. These additional studies provide further insights into the comparison between Biodentine and ferric sulfate as pulpotomy agents in primary teeth, including clinical outcomes, long-term results, and radiographic assessments. Based on the available evidence, Biodentine demonstrates promising ........

Unlocking the potential of non-managerial employees in corporate entrepreneurship: a systematic review and research agenda

PurposeWhile extant literature has advanced our understanding of senior and middle managers in corporate entrepreneurship, studies have only recently attended to the role of non-managerial employees (NMEs). These organizational members bring ideas, resources and energy to the pursuit of innovative opportunities, yet the determinants of their entrepreneurial behavior are poorly understood.Design/methodology/approachThe authors performed a systematical literature review on the subject of NMEs in corporate entrepreneurship to identify gaps and recommend an agenda for future research.FindingsThe review revealed gaps regarding (1) the distance of NMEs from decisions on corporate strategic intent, (2) agentic choices made by NMEs to use their subject matter expertise for their employers' benefit, and the influences of (3) job characteristics and (4) organizational infrastructural support of entrepreneurial behavior.Originality/valueThe authors present a theoretical framework and directions for future research.

Individualization of hypertension treatment: an expert review

Management of hypertension is complex in patients with comorbid conditions and in those who are at high cardiovascular risk. Multiple guidelines recommend different treatment goals and therapeutic approaches for hypertension. In this review, we take an individualized management approach for hypertension with comorbidities mainly diabetes and chronic kidney disease (CKD), coronary artery disease, and for young patients and the elderly. Current evidence indicates a blood pressure goal of &lt;130/80 mmHg for most patients with comorbidities except for the elderly aged &gt;75 years in whom systolic pressure of 130-139 mmHg and diastolic pressure of 70-80 mmHg may be considered. For patients with diabetes and CKD, renin angiotensin aldosterone system (RAAS) inhibitors remain the initial choice of agents whereas in the young or elderly, any class including RAAS inhibitors, calcium channel blockers, and thiazide diuretics may be preferred. Special consideration is necessary for the elderly concerning the possible side effects of each drug class. In the presence of additional risk factors, an individualized approach is necessary to tailor the most effective therapy as per patient needs. Thus, in treating hypertension, a multipronged but individualized approach is necessary to optimize blood pressure control and clinical outcomes in the real-world setting.

Pegylated liposomal doxorubicin for relapsed epithelial ovarian cancer.

Pegylated liposomal doxorubicin for relapsed epithelial ovarian cancer.