Indirect Procedure Research Articles

Evaluation of the Efficacy of the HaeNaem Zero Bone Loss Kit in Indirect Sinus Lift Using Osseodensification.

Aim The purpose of this study was to evaluate alveolar height at the antral floor following dental implant placement after an indirect sinus lift using osseodensification (OD) with the HaeNaem bur system. Materials and methods A total of 12 patients seeking implant rehabilitation in the maxillary posterior region were selected for the study. Preoperative cone beam CT (CBCT) was performed to measure the residual crestal bone height (RCBH). Patients with an RCBH of 6-8 mm were included in the study. The HaeNaem Zero Bone Loss bur kit was utilized to create an osteotomy site through OD, accompanied by a simultaneous indirect sinus lift. Postoperative CBCT was obtained after four months to assess the difference in bone height and implant stability following implant placement. Results In our study, we performed a comparison of the alveolar ridge height before and after the procedure among the study participants using a paired t-test. This analysis revealed statistically significant differences (p-value <0.01) between the measurements taken before and after the procedure, indicating that the intervention yields effective results. Conclusions Based on the results of this study, it can be inferred that the indirect sinus lift procedure utilizing the OD technique with the HaeNaem Zero Bone Loss bur kit presents an effective treatment alternative for cases with insufficient bone height in the posterior maxilla. This approach is particularly advantageous when considering the increased financial feasibility of treatment options or in situations where advanced and/or time-consuming complex surgeries are contraindicated.

Comparative Efficacy of Biodentine® and Calcium Hydroxide in Pulp Capping Treatment

Background: This study is focused on — Assessing Biodentine and Calcium hydroxide in indirect pulp capping procedures. Various materials have been used in indirect pulp capping but this comparative study may help appreciate which material produces better results: Biodentine or Calcium hydroxide. Objective: To compare treatment outcomes post indirect pulp capping treatment using Biodentine® and Calcium hydroxide (Ca(OH)2) . Materials and Methods: A blinded, randomized clinical control trial involving 50 consenting subjects, comparing Biodentine® (test) and Ca(OH)2 (control). Cavity preparation was done and the cavity was dressed with either Biodentine® or Ca(OH)2 and then restored with Glass ionomer cement. The subjects’ teeth were later examined clinically and radiographically at 3, 6, and 9 months post treatment. The indicators of clinical success were absence of pain, swellings, sinus, fistula, abscess, mobility, tenderness to percussion, normal response to electric pulp tester, and Endo-ice cold test. The indicator of radiographic success was absence of periapical pathosis. The probability level of p&lt;0.05 was considered significant. Results: The success rate at three months was 100% for both groups; at six months, it was 92% for both groups and at nine months, 92% of subjects were successful in the Biodentine® group while the Ca(OH)2 group recorded 88% which was statistically insignificant (P=0.74). Conclusion: Biodentine® and Calcium hydroxide have shown comparable effectiveness in improving treatment outcomes, thus, contributing to the longevity of the teeth, and the period of optimum efficaciousness of the pulp capping materials in this study was three months.

An in vitro experimental study on the interference of glyphosate on the urease enzyme

Purpose: Exposure to glyphosate is increasing due to the density of agricultural areas in Türkiye. In this study, the possible interference effect of glyphosate on urease, an enzyme that is frequently used in the diagnosis and follow-up of many diseases and in the measurement of urea in biological samples was examined. Materials and Methods: First, glyphosate was observed to have a negative interference in experiments using solutions of varying concentrations of urea. Second, blood samples were examined using the urease-glutamate dehydrogenase (GLDH) and indirect nesslerization procedures to determine the effects of glyphosate on the results before and after its addition. To determine the morphological and chemical alterations, scanning electron microscope (SEM) and Fourier-transform infrared spectroscopy (FTIR) analyses were conducted, and binding patterns were established through molecular docking. Urea measurements conducted with urease-GLDH and indirect nesslerization demonstrated a negative interference on the results with glyphosate concentrations of 10–3, 10–4, and 10–5 M. Results: Morphological changes observed in the SEM analysis were supported by the 3228.25 (O-H), 1642.08 (C=C), and 1531.20 (N-O) cm–1 bonds formed in the FTIR analysis. Furthermore, the molecular docking analysis showed that glyphosate affected the urease via hydrogen bonding (Gly13, Ser12, Lys14, Thr15, and Asp37) and hydrophobic interactions (Val10, Asp37, and Glu98). It was hypothesized that these interacting amino acids limit the accessibility of the urease’s active catalytic conformation and/or impact the stability of the catalytic transition state. Conclusion: Glyphosate leads to negative interference in human serum urea assays, leading to incorrect test results in clinical biochemistry, microbiology, and agricultural laboratories. This effect should be considered when conducting analysis, and clinicians as well as hospital information management systems should be informed ahead of time, with special emphasis devoted to this interference.

Taylor Swift does not boost face recognition in reaction time-based Concealed Information Test: investigating target-familiarity effects

Eyewitness identifications from lineups are prone to error. More indirect identification procedures, such as the reaction-time based Concealed Information Test (RT-CIT) could be a viable alternative to lineups. The RT-CIT uses response times to assess facial familiarity. Theory and initial evidence with autobiographical stimuli suggests that the accuracy of RT-CIT can be augmented when participants’ reliance on familiarity-based responding increases. We tested this assumption in two pre-registered experiments with 173 participants. Participants witnessed a mock crime. In the subsequent RT-CIT protocol, participants reacted to probe faces from the mock crime video, to irrelevant faces, and to target faces that required a unique response. Targets were either unknown people or were well-known celebrities (e.g., Taylor Swift). As expected, reaction times were longer to probes than to irrelevants in all conditions, indicating a CIT effect. Contrasting our pre-registered predictions, the CIT effect was not larger in the familiar condition (Experiment 1: unfamiliar targets: d = 0.77 vs. celebrity targets: d = 0.24; Experiment 2: unfamiliar targets: d = 1.09 vs. celebrity targets: d = 0.79). This suggests that familiar targets did not increase the validity of the RT-CIT in diagnosing concealed face recognition. A potential lack of saliency of the familiar targets might explain these unexpected findings. Of note, we did find medium to large effect sizes overall, speaking to the potential of diagnosing face recognition with the RT-CIT.

Seroprevalence of infectious bursal disease in backyard chickens of selected districts of Buno Bedelle zone, Southwestern Ethiopia.

Infectious bursal disease (IBD) is a viral infectious disease that affects young chicks. A cross-sectional study was conducted from October 2020 to June 2021 to determine seroprevalence and associated risk factors of IBD on backyard chickens of purposively selected three districts of Buno Bedelle Zone, Southwestern Ethiopia. The study was carried out via a collection of serum samples, questionnaire surveys, and a total of 768 serum samples were collected from randomly selected backyard chickens of the study areas and examined for the presence of IBD virus. These serum samples were processed by using an indirect enzyme-linked immunosorbent assay test procedure in laboratories. SPSS version 20 was used for data analysis and descriptive statics techniques were used. Out of a total serum samples collected, 361 of them were found positive for the disease with an overall seroprevalence of 47%. Different seroprevalence rates of IBD with 55.9%, 43.3% and 41.2% were recorded in Didessa, Chora and Gechi districts, respectively. The result indicated that there was statistically significant difference (p<0.05) of the disease among the three districts. Among the nine Peasant Associations (PAs) observed for seroprevalence of IBD, highest (62.9%) and lowest (34.20%) seroprevalence of the disease was recorded in Yembero and Shengela PAs, respectively. However, IBD was statistically significant in only Shengela PA of Chora district (p=0.04, OR=1.93 and 95% CI 1.04-3.58) and Seko PA of Gechi district (p=0.05, OR=1.79 and 95% CI 1.01-3.16). Even though sex, breed, age, source and management-based seroprevalence was observed in the present study, the result indicated that there was only statistical significant difference (p=0.004, OR=0.62 and 95% CI 0.45-0.86) seen in which higher seroprevalence of IBD was determined in exotic (50.3%) than in local (38.6%) chickens breeds of the study areas. Generally, higher seroprevalence of IBD in the present study indicates a widely distribution of the disease and one of the potential threats for poultry production in the study areas. So, chicken vaccination and improved management system should be warranted in order to control the disease effectively.

Long-Term Evaluation of Pulp Vitality Preservation in Direct and Indirect Pulp Capping: A Retrospective Clinical Study.

Background: This retrospective clinical study aimed to assess dental pulp tissue reactions to direct and indirect pulp capping after 10 years of follow-up. Methods: A total of 276 permanent teeth with deep carious lesions were evaluated and divided into five groups: Group (1), direct pulp capping with Mineral Trioxide Aggregate cement; Group (2), direct pulp capping with a resin-based glass ionomer; Group (3), direct pulp capping with TheraCal; Group (4), indirect pulp capping with a three-step total-etch adhesive system; and Group (5), indirect pulp capping with a two-step self-etch adhesive system. Results: A 72.5% success rate was achieved overall. A statistically significant difference was found when comparing direct and indirect pulp capping with a success rate of 23.8% and 93.8%, respectively. For direct pulp-capping procedures, the area of pulp exposure was correlated with pulp necrosis (p = 0.035), while bleeding after exposure appeared independent (p = 0.053). Patient age was significantly related to the maintenance of pulp vitality (p = 0.013). A statistically significant correlation between the pulp-capping material and the occurrence of pulp necrosis was discovered (p = 0.017). For the indirect pulp-capping treatments, a significant correlation between patient age (p = 0.021) and the adhesive system (p = 0.019) with pulp necrosis was described. Conclusions: The pulp-capping material, patient age, and the width of the pulp exposure before the procedure should be carefully considered when performing direct pulp-capping treatments. The performance of the etch-and-rinse adhesive systems was superior to the self-etch system during the indirect pulp-capping procedures.

Calculation of reference intervals for the concentrations of α-tocopherol and retinol in serum using indirect data-mining procedures

BackgroundEstablishing adequate reference intervals (RIs) for vitamins A and E is essential for diagnosing and preventing deficiencies. Due to the current boom in data mining and its easy applicability, more laboratories are establishing RIs using indirect methods. Our study aims to obtain RIs using four indirect data-mining procedures (Bhattacharya, Hoffmann, Kosmic, and RefineR) for vitamins A and E. Material and methods8943 individuals were collected to establish the RIs. After using different data cleaning steps and checking whether these data should be divided according to age and gender based on multiple linear regression and variance component analyses, indirect RIs were calculated using specific Excel spreadsheets or R-packages software. ResultsA total of 2004 records were eligible. For vitamin A, the RIs obtained were (1.11 − 2.68) µmol/L, (1.13 − 2.70) µmol/L, (1.13 − 2.71) µmol/L, and (1.17 − 2.66) µmol/L using the Bhattacharya, Hoffmann, Kosmic and RefineR approaches, respectively. For vitamin E, these intervals were (17.3 − 49.9) µmol/L (Bhattacharya), (17.3 − 48.9) µmol/L (Hoffmann), (19.6 − 50.3) µmol/L (Kosmic), and (19.4 − 50.9) µmol/L (RefineR). In all cases, the RIs were comparable. ConclusionsSuitable RIs for vitamins A and E were calculated using four indirect methods that are suitable and adapted to our population’s demographic characteristics.

Combined Direct and Indirect Revascularization for Adults with Moyamoya Disease: A Single-Center Retrospective Study.

Background Moyamoya vasculopathy is a rare neurological disease characterized by the progressive constriction of major intracranial vessels and secondary collateral formation. In the past decade, the popularity of combined bypass surgery has increased. They take advantage of the quick perfusion of direct bypass and collaterals ingrowth from indirect bypass. Objective This study aimed to describe a single-center experience with surgical management of moyamoya disease (MMD) and moyamoya syndrome (MMS) over 7 years. Materials and Methods In this retrospective medical records review, we enrolled patients diagnosed with MMD and MMS who were treated with combined surgical revascularization at the Hamad Medical Corporation center between 2015 and 2022. SPSS 26.0 was used to analyze the data. Results A total of 20 patients were included, with 15% having MMS. The mean age was 37.4 ± 10.26 years, and 60% of them were males. The mean follow-up period was 13.6 months. The modified Rankin score was significantly decreased by 1.9 ± 2.1, p = 0.0001. Following surgery, no deficits were observed in 16 cases, whereas three were not improved, and one died. Following up on the stroke status, one patient developed a hemorrhagic stroke, and another showed right-side numbness. The postoperative status was substantially linked with the initial clinical presentation ( p = 0.004). Conclusion Combined direct and indirect surgical revascularization procedures have favorable outcomes in MMD and MMS patients. Additional rigorous, prospective, controlled, high-quality trials with large-sample are needed to support our results.

A Novel Interhemispheric Dural Inversion Technique for Indirect Parafalcine Cerebral Revascularization: Case Report

BACKGROUND AND IMPORTANCE: Variety of revascularization strategies have been deployed to treat the deterioration of cerebral blood flow. Blood flow restoration can be achieved by direct or indirect procedures. The indirect reconstructive procedure to augment blood flow involves encephalomyosynangiosis, encephaloduroarteriosynangiosis, or encephalodurosynangiosis, and has been used effectively in ischemic Moyamoya disease. However, the preferred procedure must be evaluated on a case-by-case basis and remains controversial in other cerebral arterial diseases. Here, we report the “interhemispheric dural inversion (IDI)” as a novel technique for indirect parafalcine cortical revascularization. CLINICAL PRESENTATION: A 54-year-old white man with a complex history of neck radiation secondary to childhood Hodgkin's lymphoma presented with focal perfusion deficit in the right mesial occipital lobe near the primary visual cortex. A large c-shaped dural flap with a paramedian base is harvested and, after an interhemispheric dissection, placed in contact with the ischemic parafalcine cortical tissue (IDI). CONCLUSION: The IDI was used successfully for indirect revascularization of a focal right paramedian occipital lobe deficit in a 54-year-old man with complex cerebro-occlusive disease from childhood radiation and multiple previous bypass surgeries. The IDI is a simple approach for targeted indirect parafalcine cortical revascularization to facilitate an increased blood supply and prompt new vessels to sprout from preexisting dural arteries. It can be used as a standalone technique or combined with other revascularization strategies, as warranted.

An enhanced indirect modal identification procedure for bridges based on the dynamic response of moving vehicles

Indirect dynamic structural identification, referred to as Vehicle Scanning Method (VSM), pertains to the estimation of bridge modal parameters by using data recorded from sensors directly mounted on a moving vehicle. This procedure has recently gained increasing attention due to its low cost and simple implementation. Nevertheless, the non-stationary and complex nature of the vehicle–bridge interaction phenomenon poses some limitations to the applicability of the method, especially in terms of accuracy. In this regard, in this paper, an enhanced procedure for the dynamic identification of bridges modal parameters based on the VSM is introduced, taking into account the effects of vehicle/bridge damping and road pavement roughness. Specifically, based on the Variational Mode Decomposition (VMD) method, the relevant Intrinsic Mode Functions (IMFs) and corresponding modal frequencies are determined from the recorded signal. Further, the Natural Excitation Technique (NExT) is adopted in conjunction with a noise-robust area ratio-based approach, for modal damping ratios estimation. Finally, mode shapes are evaluated by properly correcting the instantaneous amplitudes of each IMF considering the influence of the corresponding estimated modal damping ratio. Several numerical simulations are presented to show the validity of the proposed procedure and comparisons with the classical Hilbert Spectrum-based identification approach are employed to assess its reliability and improved accuracy.

Combined Direct and Indirect Revascularisation With Superficial Sparing of Temporalis Muscle in Moyamoya Disease: Operative Technique: 2-Dimensional Operative Video.

The primary objective of revascularization surgery for moyamoya disease (MMD) is to augment cerebral blood flow and prevent disease progression.1 There are several options for bypass surgery, including direct methods such as superficial temporal artery-middle cerebral artery anastomosis, indirect bypasses such as encephalomyosynangiosis, encephaloduroarteriosynangiosis or encephaloduroarteriomyosynangiosis, or combined procedures.2-5 In our institution, we undertake a combined approach involving multiple low-flow bypasses and a modified indirect bypass technique, with additional attention to achieving an optimal cosmetic result. Given that MMD often affects young patients, considering cosmesis as a significant factor in managing this condition should be standard practice. We present our modified operative technique of a combined approach to revascularization surgery in patients with MMD with particular emphasis on the indirect bypass procedure. The temporalis muscle is divided in two parts in the sagittal plane where the deeper portion is mobilized to perform an EMS, and the superficial portion is reattached to the bone flap to maintain cosmetic symmetry. A 23-year-old woman presented with a 6-month history of transient left-sided hemiparesis on a background of MMD (previous left-sided revascularization surgery). Subsequent imaging demonstrated worsening right internal carotid artery stenosis. The patient and her family were extensively counseled and decision to proceed with right-sided bypass surgery was undertaken (Video). The patient had an unremarkable postoperative course and was discharged home on day 14. Institutional review board approval was not required in our institution. The patient consented to the procedure and to the publication of his/her images.

Indirect frequency estimation by time-shifted accelerations subtraction: Generalization of the methodology and numerical application on a Warren truss bridge

In the context of Structural Health Monitoring (SHM) of transportation infrastructures, bridge eigen frequencies are commonly adopted as diagnostic indices. Under this regard, as a cost-effective identification methodology, indirect SHM, which consists in the use of sensors installed on running vehicles, is attracting attention. In particular, methods relying on the use of two or more on-board sensors may suppress the influence of track irregularity, which is a remarkable drawback for indirect SHM, and improve the identification accuracy. However, the combination characteristics of the two on-board sensors is still an open issue to be addressed. Also, in many studies, test bridges consist of simple girders, and there are few verifications on complex structures, such as truss bridges. The first contribution of this study is the analytical and generalized expression of the operational range defining the use of time-shifted signals subtraction operation for indirect frequency estimation. After the outcomes provided by this formulation were confirmed by the results obtained from a 2D explanatory example, the proposed procedure was further validated through three-dimensional train-track-bridge dynamic simulations. For this purpose, 3D FE model of a real existing Warren truss bridge, dynamically validated through experimental tests, and a 3D multi-body rail vehicle were adopted. From an engineering standpoint, a relevant result of this study found is that the coexistence of proper sensors onboard positioning and sufficient target bridge component excitation revealed to be crucial for the success of an indirect frequency identification procedure which is based on time-shifted accelerations subtraction.

New Method to Estimate Rock Mass Deformation Modulus Based on BQ System

The rock mass deformation modulus is one of the most important design parameters in a range of rock engineering applications. Its value is usually obtained directly through in situ testing or estimated indirectly on the basis of a rock mass quality classification system. Because in situ testing is generally costly, time-consuming, and presents operational difficulties, it cannot be carried out extensively, and many researchers have concentrated on developing indirect procedures to obtain information on the modulus of deformation, such as the RMR method, Q method, and GSI method. The purpose of this paper is to present a new system for estimating the rock mass deformation modulus called the BQ method, which is based on the BQ (basic quality) system. In this paper, the BQ system is first briefly reviewed, and then more than 60 in situ measurements from three large hydropower stations in China are used to develop a new relationship between BQ and the deformation modulus, based on a power function relationship. The paper also derives correlations based on the existing estimation formula and the relationship between BQ and other classification schemes, resulting in several recommended formulas for estimating the deformation modulus of a rock mass using the BQ method.

The Potential Role of Preoperative Posterior Cerebral Artery Involvement in Predicting Postoperative Transient Neurological Deficits and Ischemic Stroke After Indirect Revascularization in Patients With Moyamoya Disease

ObjectiveTransient neurological deficits (TNDs) are known to develop after direct bypass for moyamoya disease (MMD) and may be risk factors for subsequent stroke. However, the factors involved in the development of TNDs and stroke after indirect revascularization alone, including their association with subsequent stroke, remain unclear. The purpose of this study was to investigate this issue. MethodsThe subjects of the study were 30 patients with MMD who underwent a total of 40 indirect revascularization procedures at our institution. Clinical and radiological data were collected retrospectively. To examine factors associated with the development of postoperative TND/stroke/asymptomatic disease, the clinical characteristics of each group were statistically compared. ResultsThe mean age at surgery was 7 years (range 1-63). TNDs developed after surgery in 9 out of 40 patients (22.5%). Stroke in the acute postoperative period occurred in 3 patients (7.5%), all of whom experienced cerebral infarctions. Demographic data and preoperative clinical information were not different between the groups. However, posterior cerebral artery (PCA) involvement on preoperative imaging was significantly associated with the development of TNDs and stroke (p=0.006). Furthermore, postoperative stroke was associated with unfavorable outcomes (p=0.025). ConclusionsPCA involvement is significantly associated with the occurrence of TNDs. In contrast, TNDs after indirect revascularization have little relationship with the subsequent development of stroke. TNDs usually resolve without new strokes, and a better understanding of this particular pathology could help establish an optimal treatment regimen.

Exploring Indicators for Training Load Control in Young Swimmers: The Role of Inspiratory Spirometry Outcomes.

One of the most important implications of technology in swimming is to control training loads. Lactate control, video-analysis of the technique or the assessment of specific actions, i.e., the vertical jump, have helped to provide load adaptation indicators in swimmers in recent decades. However, these indicators have led to a longer application time, due to their indirect procedure and the need to analyze each variable. The aim of this study was to analyze whether inspiratory spirometry values can serve as a training load control tool in swimmers. Countermovement jump (CMJ), Inspiratory Force Index (S-INDEX) and Peak Inspiratory Flow (PIF) were evaluated with a load of 3 cm H2O before, during and after performing a swimming performance test (critical speed test: specific warming up, 400 m and 100 m freestyle). Positive correlations were found between S-INDEX and jump height after warm-up, after 400 m and at the end of 100 m (Spearman = 0.470, R2 = 0.280; Spearman = 0.508, R2 = 0.392; Spearman = 0.458, R2 = 0.359, p < 0.05, respectively). Moreover, positive correlations were also found between PIF and jump height at the same evaluated moments (Spearman = 0.461, R2 = 0.305; Spearman = 0.493, R2 = 0.386; Spearman = 0.454, R2 = 0.374, p < 0.05). Both the S-INDEX and the PIF could serve as useful tools for swimmer load control, allowing coaches to make more immediate decisions.

History of surgical treatment of cardiac arrhythmias in Germany : Surgical treatment of ventricular tachycardia and supraventricular tachycardia, especially pre-excitation syndromes (WPW)

The history of surgical treatment of ventricular tachycardias (VT) is short, lasting from 1978 until 1993. "Indirect procedures" with infarct scar resection were performed without electrophysiologic studies, whereas "direct procedures" consisted of either complete endocardial incisions ("encircling endocardial ventriculotomy") or large endocardial resections ("endocardial peel-off" technique) after precise epicardial and endocardial mapping procedures. In Germany, the first to report on intra-operative electrophysiologic mapping for VT treatment were Ostermeyer, Breithardt and Seipel in 1979. In 1981, the Hannover group (Frank, Klein) published their first results of surgical treatment of VT. In 1984, Ostermeyer et al. demonstrated that apartial endocardial incision resulted in more beneficial results with less myocardial damage (8% versus 46%) than applying acomplete encircling incision. In 1987, the Düsseldorf group reported treatment results of 93patients. After 5years, 77% had no VT recurrence, while total mortality after 1year was 11% and after 5years 30%. In 1992, the Hannover group reported results of 147patients after endocardial resection for VT. Total mortality after 3years was 27%; recurrence of VT events occurred in 18% of the surviving cohort.The history of surgical procedures for supraventricular tachycardia (SVT), in particular Wolff-Parkinson-White (WPW) syndrome, is even shorter than that of surgery for VT. As early as 1969, Sealy, Gallagher and Cox reported the first cases of surgical intervention for WPW syndrome via endocardial access in cardioplegic arrest. In 1984, Guiraudon and Klein reported on anew procedure with epicardial access to the accessory bundle without cardioplegia in laterally localised conduction pathways. In Germany, too, the groups in Düsseldorf (Ostermeyer, Seipel, Breithardt, Borggrefe) from 1980 and the Hannover group (Frank, Klein and Kallfelz) from 1981 performed surgical procedures for WPW syndrome. In 1987, Borggrefe reported on 18patients with WPW syndrome and atrial fibrillation who had undergone surgery. After 2years, 14 of 18patients had no recurrences of tachycardia; in 1989, Frank, Klein and Kallfelz (Hannover) reported on 10children (2-14 years) operated on using the cryoablation technique. Between 1984 and 1992, atotal of 120 patients with SVT, mostly WPW syndrome, were operated on in Hannover; after 42months, 12patients had a recurrence of SVT. Two patients died during the reoperation.

Surgical revascularization as a procedure to prevent neurological complications in children with moyamoya syndrome associated with neurofibromatosis I: a single institution case series.

The optimal timing and surgical approach for surgical revascularization in patients with moyamoya syndrome (MMS) associated with neurofibromatosis type I (NF1) remain so far elusive. We aimed to compare the long-term clinical, radiological, and cognitive effects of different revascularization procedures in a pediatric cohort of NF1-associated MMS. We reviewed the clinical, radiological, and surgical data of 26 patients with NF1-associated MMS diagnosed at our institution between 2012 and 2022, at the clinical onset and last follow-up. Indirect bypasses were performed in 12/26 patients (57.1%), while combined direct and indirect procedures in 9/26 subjects (42.9%); 5 patients did not undergo surgery. Through logistic regression analysis, pathological Wechsler Intelligence Scale for Children (WISC) at onset was found to be associated with symptom improvement at 1-year follow up (p = 0.006). No significant differences were found in long-term neurocognitive outcome and stroke rate in patients receiving combined or indirect bypass (p > 0.05). Currently, whether combined or indirect bypass should be considered the treatment of choice in pediatric patients with NF1-associated MMS remains unclear, as well as the optimal time approach. In our series, no significant differences were found in long-term neurocognitive outcome and stroke rate between patients treated with either of these two approaches. Clinical evidence supports the crucial role of early diagnosis and surgical revascularization in subjects with MMS-associated NF1, even in case of mildly symptomatic vasculopathy. This allows to achieve a good long-term outcome with improved intellectual function and prevention of stroke and seizure in these patients.

Indirect Sinus Lift in Conjunction with Platelet- Rich Fibrin: A Systematic Review

The indirect sinus lift procedure is one of the main treatment options to manage atrophy in the residual bone height in the posterior maxilla. This procedure can be performed alone or complemented by biomaterials grafting, such as platelet-rich fibrin (PRF), followed by implant placement. PRF is considered a highly regenerative biomaterial derived from the patient's blood, stands out for its safety, cost-effectiveness, and wide range of applications in both medical and dental contexts, particularly in bone augmentation and sinus lift procedures. This systematic review synthesizes data from articles published between January 2010 and January 2023, sourced from PubMed, assessing the vertical bone gain post-indirect sinus lift with PRF. The eligible articles were selected according to the inclusion and exclusion criteria. Quality assessments were rigorously conducted on all selected articles, leading to a meta-analysis that revealed an average vertical bone gain of 4.35 ± 1.23 mm at a three-month follow-up. The findings endorse the indirect sinus lift with PRF as an effective treatment modality, promising significant bone augmentation.

The role of protective liners and glass ionomer in managing pulp temperature during light curing.

To evaluate the thermal insulation of protective liners and glass ionomer cement during light-curing procedures. Human third molars underwent Class I preparations with dimensions 5 mm long × 4 mm wide × 4 mm deep in a standardized manner ensured a consistent ±0.5 mm dentin thickness at the pulpal floor. The teeth were attached to a customized oral cavity chamber simulator with a circulating bath at a standardized temperature of 34.2 ± 1oC. The temperature variations at the pulpal floor were captured in real-time by video using an infrared thermal camera (FLIR ONE Pro, FLIR Systems). The materials evaluated were: Dycal (Dentsply), TheraCal LC (Bisco), Activa (Pulpdent), and Fuji II LC (GC). All light-activation procedures were performed with the same light-curing unit (Valo Grand, Ultradent) in standard mode, 1000 mW/cm2, and time of exposure following manufacturer instructions. A power analysis was conducted to determine the sample size considering a minimal power of 0.8, with α=0.05. Statistical analyses were performed using ANOVA and Tukey's test for multiple comparisons. The temperature at the pulpal floor increased above the 5.5 ºC safety threshold difference for clinical scenarios tested. None of the materials provided proper thermal insulation for light-curing procedures (p = 0.25). The higher the number of light-cured steps, the longer the pulp remained above the 5.5 ºC temperature threshold. The materials tested provided improper thermal insulation (Δ > 5.5 ºC). Thus, prolonged or multiple light-curing exposures can be harmful to the pulp tissues. Therefore, for indirect pulpal capping procedures, self-cured materials or a reduced number of steps requiring light curing must be adopted to reduce the amount of time the pulp remains above the 5.5 ºC safety temperature threshold. Key words:Dental Pulp Capping, Calcium hydroxide, Bioactive, Thermal Damage.

Serum myokines as potential biomarkers of myostatin inhibition in sport doping: a preliminary study on their baseline levels in elite athletes.

We considered in this study the possibility of developing an indirect procedure for detecting myostatin inhibition/suppression, a practice that is prohibited as doping in sport. We have specifically considered the potential diagnostic utility of human serum myokines as indirect markers of myostatin inhibition. Myostatin, its main antagonist follistatin, and other myokines (follistatin-like 1, musclin, oncostatin, osteonectin, irisin, brain derived neurotrophic factor, and insulin-like growth factor-1) were selected as a panel of potential biomarkers whose levels may be altered following myostatine suppression. The serum levels of myostatin and of the nine myokines were measured in elite athletes of different age, sex, and sport discipline, and their cross correlation assessed by multivariate analysis. All myokines resulted to be measurable in human serum, except for musclin and irisine, whose levels were below the limits of quantitation in a reduced number of samples. Serum concentrations varied of different orders in magnitude (musclin and osteonectin < 1 ng/mL; follistatin, myostatine and irisine 1-5 ng/mL; brainderived neurotrophic factor, follistatin-like 1 and iinsulin-like growth factor-1 > 10 ng/mL), while no significant differences were found between female and male subjects, with the exceptions of follistatin-like 1 and musclin, showing a higher concentrations in females (p < 0.05). Levels of insulin-like growth factor 1 and brain derived neurotrophic factor were significantly higher in power athletes than in endurance ones. Multivariate statistics showed that musclin, follistatin-like 1 and oncostatin are more clustered and correlated to myostatin than other myokines, suggesting they could be considered as potential biomarkers of doping by myostatin inhibitors.