Option For Long-term Management Research Articles

Surgical myomectomy followed by oral Myfembree vs standard of care (SOUL trial): Study protocol for a randomized control trial.

Uterine leiomyomas (often referred to as fibroids or myomas) are common benign, hormone-dependent tumors that grow in the uterus and occur in approximately 25% of reproductive age women, depending on selected population. Treatment recommendation is typically based on fibroid size, location, the patient's age, reproductive plans, and obstetrical history. Despite the range of treatment options available for uterine fibroids and their symptoms, including hysterectomy, myomectomy, endometrial ablation, endometrial uterine artery embolization, and magnetic resonance-guided focused-ultrasound surgery, myomectomy remains the gold standard treatment for patients who desire fertility-preserving surgery for their uterine fibroids. Myomectomy, while a prevalent surgical option for the removal of fibroids, carries known risks such as fibroid recurrence, symptom recurrence, and the subsequent need for reintervention. Despite ongoing research and advances in medical treatments for fibroids, there currently are no universally recommended therapeutic interventions proven to effectively delay the recurrence of fibroids or the return of symptoms following this procedure. This situation underscores a significant area of unmet medical need and highlights the importance of continued investigation into preventive strategies and long-term management options for patients undergoing fibroid removal with uterine preservation. We designed a study to assess the efficacy of the new FDA-approved GnRH antagonist, Myfembree in delaying the return of fibroids and their associated symptoms. A randomized, prospective, open-label clinical trial. The participants (n = 136) will be randomly distributed into two groups. The Control Group (Standard of care) will receive treatment with standard of care (SoC) after surgical myomectomy and the treatment group will receive Relugolix combination therapy (Myfembree®) after surgical myomectomy. The study protocol was approved by the University of Chicago's Institutional Review Board (IRB#22-0282), ensuring that all participants would provide written informed consent before their inclusion. In this project, we propose the use of daily dosed Relugolix combination therapy (Relugolix with estradiol and norethindrone acetate), which is approved for uterine fibroids treatment, has the potential to delay the recurrence of fibroid symptoms, prolong the improved quality of life and delay need for re-intervention after uterine sparing surgery. The study protocol was approved by the Institutional Review Board of the University of Chicago on 9/16/2022 and was registered at ClinicalTrials.gov with number NCT05538689 on Sep 7, 2022. All subjects will provide informed consent to participate.

Differentiated thyroid cancer: long-term follow-up and management options for persistent/recurrent disease

Differentiated thyroid cancer: long-term follow-up and management options for persistent/recurrent disease

Field phenology of emerald ash borer (Coleoptera: Buprestidae) parasitoids in New York State.

Emerald ash borer (EAB), Agrilus planipennis Fairmaire (Coleoptera: Buprestidae), has caused extensive mortality of ash across North America. Biological control offers a potential long-term management option, allowing for long-term survival of ash. Careful monitoring of populations of biocontrol agents is necessary to understand their relative impacts. Understanding the emergence and flight phenology of these species allows for the optimization of monitoring schemes and improves our understanding of host-parasitoid interactions. We used yellow pan trapping data to assess the adult phenology of both EAB and its associated native and introduced parasitoids in 3 New York counties. We monitored 2 introduced larval biocontrol agents, Tetrastichus planipennisi Yang (Hymenoptera: Eulophidae) and Spathius galinae Belokobylskij & Strazanac (Braconidae), for 3-4 years post-release, as well as the native parasitoid Phasgonophora sulcata Westword (Chalcididae). Results indicate a single discrete emergence event for both EAB and P. sulcata in all monitored counties, which is consistent with previously reported results. Our results also suggest there are 4 generations per year of T. planipennisi and 3 generations of S. galinae in the monitored counties. We recorded an additional generation of T. planipennisi that had not previously been reported in New York, and both T. planipennisi and S. galinae appeared to emerge earlier than previously documented.

REAL-WORLD LONG-TERM TREATMENT PERSISTENCE AMONG BIO-NAÏVE PATIENTS WITH CROHN’S DISEASE AND HISTORY OF FISTULA INITIATED ON USTEKINUMAB

Abstract BACKGROUND Fistula is a common complication of Crohn’s disease (CD). Treatment with certain biologics have been associated with fistula healing and closure, reduction of symptoms and need for surgical treatments. In clinical practice, biologic persistence and effectiveness are correlated. This study described long-term persistence among bio-naïve patients with CD and history of fistula who were initiated on ustekinumab (anti-interleukin 12/23 antibody). METHODS Adults with CD and history of intestinal fistula initiated on ustekinumab (index date) between 9/23/2016 and 3/2/2022 were selected from the IQVIA PharMetrics® Plus database and followed for the maximum of 24 months. Patients were bio-naïve (i.e., no claim for CD-indicated biological agents) in the 12-month baseline period before the index date. Patients with other auto-immune diseases during the baseline period were excluded. Persistence on ustekinumab was defined as the absence of gaps between days of therapy supply of >120 days (i.e., over twice the duration of the US label maintenance cycle of 8 weeks or 60 days). Composite endpoints of being persistent while on monotherapy (no immunomodulators or biologics other than ustekinumab) and persistent while corticosteroid-free (<14 consecutive days of corticosteroid supply after day 90 post-index) were also assessed. Persistence endpoints were assessed from the index date until the earliest of discontinuation (event), immunomodulator or non-index biologic use (event), corticosteroid use (event), 24 months follow-up or data end (censoring) using Kaplan-Meier analyses. RESULTS The sample included 445 patients (mean age: 42.8 years; 56.6% female; Fig. 1). Among these, 63.1% had CD involving the small intestine, and 59.6% had CD involving the large intestine. The most common type of fistula was anal fistula (36.0%). At 24 months after ustekinumab initiation, 64.2% of patients remained persistent (95% confidence interval [CI]: 55.8-71.4; Fig. 2a). Furthermore, 53.3% of patients were persistent while on monotherapy (95%CI: 45.1-60.7; Fig. 2b). Finally, 45.6% of patients were persistent while being corticosteroid-free (95%CI: 36.9-53.8; Fig. 2c). CONCLUSIONS This study quantified long-term persistence on ustekinumab among bio-naïve patients with CD and history of fistula. Over half of patients initiated on ustekinumab were persistent and persistent while on monotherapy 24 months after the treatment initiation. These findings support ustekinumab as a treatment option for long-term management of CD with history of fistula. Figure 1 Selected baseline characteristics Figure 2 (a) Persistent on ustekinumab, (b) persistent and on monotherapy, c) persistent and corticosteroid-free

Status and distribution of a novel redfin lineage, Pseudobarbus sp. ‘burchelli Tradouw’ from the Cape Fold Ecoregion of South Africa

Freshwater fish are threatened globally and in addition, knowledge of their diversity is incomplete and species richness is underestimated. Within the ichthyofauna of the Cape Fold Ecoregion of South Africa, many undescribed lineages exist and for most of these, information is limited regarding their ecology, distribution and threats. The Tradouw redfin Pseudobarbus sp. ‘burchelli Tradouw’ is a novel and range-restricted lineage within the Breede River redfin Pseudobarbus burchelli. Annual monitoring conducted between 2012 and 2016 investigated spatial and temporal trends in the distribution and population dynamics of this taxon. Results indicated that it is highly fragmented within its distribution range, likely a result of the combined pressures of invasive fish and poor land use practices. Short-term monitoring results indicated that invasive fish are established in most of the catchment and that the relative abundance of redfins remained constant only in the limited section of river where alien fish were absent. Poor land use practices such as water over-abstraction and surface water pollution, are pervasive threats, but the extent to which these affect the redfins requires further investigation. The long-term survival of this taxon remains uncertain, and short-term and long-term conservation and management options are explored.

Irrigation Should be Explored as a Sustainable Management Solution to the Acid Mine Drainage Legacy of the Witwatersrand Goldfields

Mine closure in the Witwatersrand Goldfields of South Africa has resulted in an acid mine drainage (AMD) legacy that is difficult to manage and costly to address. As a short-term measure, three large high-density sludge (HDS) plants were erected that treat 185 megalitres of AMD per day (ML/day), at great cost to taxpayers. Longer-term solutions are sought, as the salt load to the Vaal River System is unacceptable. Long-term modelling was used to assess whether the untreated and HDS-treated AMD could be used for irrigation and to determine the scale of the potential opportunity. The Goldfields waters are not very acidic, and simulations indicate it should be feasible to utilise even the untreated water for irrigation, especially if growers commit to applying limestone to their fields. HDS treatment lowers the corrosivity and trace element concentrations, and because the water is gypsiferous, double cropping will precipitate more than a third of the salts in solution as gypsum in the soil profile, thereby reducing salt load to the water environment. The potential irrigated area depends on the cropping system; it is about 9000 ha for rotational cropping and 30,000 ha for supplemental maize irrigation. It is prudent to seriously consider irrigation as a potential long-term water management option for the Goldfields AMD.

Unveiling the inhibition mechanism of Clostridioides difficile by Bifidobacterium longum via multiomics approach.

Antibiotic-induced gut microbiota disruption constitutes a major risk factor for Clostridioides difficile infection (CDI). Further, antibiotic therapy, which is the standard treatment option for CDI, exacerbates gut microbiota imbalance, thereby causing high recurrent CDI incidence. Consequently, probiotic-based CDI treatment has emerged as a long-term management and preventive option. However, the mechanisms underlying the therapeutic effects of probiotics for CDI remain uninvestigated, thereby creating a knowledge gap that needs to be addressed. To fill this gap, we used a multiomics approach to holistically investigate the mechanisms underlying the therapeutic effects of probiotics for CDI at a molecular level. We first screened Bifidobacterium longum owing to its inhibitory effect on C. difficile growth, then observed the physiological changes associated with the inhibition of C. difficile growth and toxin production via a multiomics approach. Regarding the mechanism underlying C. difficile growth inhibition, we detected a decrease in intracellular adenosine triphosphate (ATP) synthesis due to B. longum-produced lactate and a subsequent decrease in (deoxy)ribonucleoside triphosphate synthesis. Via the differential regulation of proteins involved in translation and protein quality control, we identified B. longum-induced proteinaceous stress. Finally, we found that B. longum suppressed the toxin production of C. difficile by replenishing proline consumed by it. Overall, the findings of the present study expand our understanding of the mechanisms by which probiotics inhibit C. difficile growth and contribute to the development of live biotherapeutic products based on molecular mechanisms for treating CDI.

Device evaluation: eCoin #x2013; implantable tibial nerve stimulator for overactive bladder

ABSTRACT Introduction Peripheral nerve stimulation has been demonstrated as a viable alternative to sacral nerve stimulation in managing refractory overactive bladder (OAB). New technologies allow the internalization of tibial nerve stimulators through various apparatuses. One such device, the eCoin, is a small, coin-shaped device that can be implanted adjacent to the tibial nerve that provides pre-programmed stimulation. Areas Covered We will review the literature on eCoin implantation, from proof of concept to mid-term data, with the longest period of follow-up being 12 months. All studies on this technology will be reviewed, along with an analysis of the current state of play in implantable neuromodulators for overactive bladder. Efficacy, durability, adverse events, and viability of eCoin as a long-term management option will be considered. Expert Opinion The eCoin device demonstrates promising early data for efficacy in managing overactive bladder symptoms. Complication rates remain low and are mostly related to wound healing following the initial placement of the device. Research into the continued improvement and modification of the device appears optimistic, but longer-term data still need to be obtained. Indeed, implantable PTNS have a role in the future management of overactive bladder, and devices such as eCoin will still need to prove a long-term benefit to be a mainstay of management.

Efficacy and safety of dupilumab up to 52 weeks in adults and adolescents with eosinophilic oesophagitis (LIBERTY EoE TREET study): a multicentre, double-blind, randomised, placebo-controlled, phase 3 trial

Efficacy and safety of dupilumab up to 52 weeks in adults and adolescents with eosinophilic oesophagitis (LIBERTY EoE TREET study): a multicentre, double-blind, randomised, placebo-controlled, phase 3 trial

Assessment of Anxiolytic Activity of Brahmi (<i>Bacopa monnieri</i>) in Zebrafish Model System

The increasing prevalence of anxiety and stress-related disorders has made it a leading contributor to the global health burden. The present treatment options have severe side effects and show remission on discontinuation of the medication. Hence, there is an urgent need to explore safer alternative treatments for long-term usage with minimum toxicity. The medicinal plant Brahmi (Bacopa monnieri) has been used in Indian traditional medicine as a neural tonic for centuries. The present study aimed to study the toxicity and anxiolytic activity of Brahmi using the zebrafish model system. The toxicity assays determined the minimum effective concentration of Brahmi to be 0.01%. In addition, behavioral assays such as thigmotaxis and scototaxis and endocrine assays such as the measurement of cortisol levels in stressed zebrafish larvae were performed. Zebrafish embryos exposed to 0.2% Brahmi up to seven days post fertilization (dpf) did not show any developmental toxicity. Behavioral and endocrine assays were performed on 5dpf zebrafish larvae treated with 0.01% Brahmi extract. Our studies show that Brahmi significantly reduced thigmotaxis (wall hugging) and scototaxis behavior in zebrafish larvae exposed to osmotic stress as compared to untreated stressed larvae. Stress activates the hypothalamic-pituitary-interrenal axis and stimulates the release of cortisol in zebrafish larvae. Whole body cortisol assay has shown that Brahmi significantly reduced the stress-induced release of cortisol in zebrafish larvae. Our studies report that Brahmi mitigates the stress response in zebrafish larvae and has minimum toxicity. This suggests that Brahmi may be a safe option for long term management of stress.

Long term results of catheter ablation in patients presented with ventricular storm

Abstract Funding Acknowledgements Type of funding sources: None. Background and Objective Catheter ablation is a treatment option in patients with ventricular tachycardia (VT storm, especially when refractory to medical treatment. In this trial, we aimed to evaluate the long-term results of catheter ablation in patients with VT storm. Method Between January 2015 and January 2022T, we enrolled a total of 65 VT storm patients who underwent catheter ablation. All patients who have either documented episodes of VT or appropriate ICD shocks more than 3in the last 24 hours. Medical treatment with antiarrhythmic drugs was given to all patients before catheter ablation. After the procedure, all-cause mortality, hospitalization due to stroke/myocardial infarction/heart failure, ICD shocks, and anti-tachycardia pacing therapies were recorded during follow-up. Results Among the whole study population (the median age is 65 years (17-85); 56 (86.2%) males) 37 (56.9%) had ischemic CMP, 24 (36.9%) had non-ischemic CMP whose 8 were ARVD, and 3 (4.6%) HCMP. The median left ventricle ejection fraction was 30% (12 – 65%). Activation mapping was performed in 60 patients, and the critical isthmus was ablated in 60 patients whose 22 had more than one critical ablation site. In 3 patients, only substrate mapping was performed, and substrate homogenization was done. In 2 patients, premature ventricular ectopy, which inducted VT, ablation was performed. Epicardial mapping was performed in 23 patients (35.4%). The median follow-up duration was 23 months (1-94 months). During follow-up, 23 patients died, 43 were hospitalized, and four presented again with VS storm. In 13 patients, appropriate shock/pacing therapy was observed. After the index procedure, re-do catheter ablation of ventricular tachycardia was performed in 8 patients. The mean postprocedural VT-free survival time was estimated at 76.5 months (SE:5.0, 95% CI: 66.6-86.4). Conclusion Catheter ablation therapy is an effective option for both acute and long-term management of patients with VT storms. However, postprocedural mortality and morbidity remain high in long-term follow-up duration. Long-term results may be related to the comorbidities and nature of underlying cardiac disorders.

Evidencing success: Data requirements to model the impacts of long-term management of invasive squirrels

Established widespread populations of invasive vertebrates can be challenging to eradicate and for small to medium-sized vertebrates, such as squirrels, is often not deemed feasible. However, long-term trapping campaigns are necessary to limit spread or reduce impacts. The scale of trapping programmes is often limited by budgets that are not commensurate to the scale of the problem. On-going costs and fundraising are key factors used by decision makers to assess the feasibility of complete removal or long-term management options of established populations. Predicting the time and effort required to successfully manage Invasive Alien Species (IAS) remains a challenge, particularly where different strategies need to be employed across different spatial scales and habitat types, and in response to changing population densities. Statistical methods such as removal models can be applied to quantify population abundance during management operations and could inform planning of resource requirements. However, in practice, the lack of awareness of data requirements results in unsuited or non-standardized data collection. We present data from an invasive grey squirrel (Sciurus carolinensis) management project in the United Kingdom as a case study to illustrate common issues that impact on quantifying project outcomes. We focus on human and operational aspects of implementation and suggest ways of prioritizing analytical requirements. Insights consider conservation targets, data collection and operational design and may be of relevance to stakeholders, analysts, field operators and managers.

Long-term management options for sea urchin injury: a case series.

In the UK, sea urchin-related injuries (SUIs) most commonly present in returning travellers. Delayed complications mainly affect the skin but nerves, tendons, joints and bones may also be involved. The management of chronic reactions may be challenging and a variety of approaches have been described. Surgical measures are often undertaken, particularly when retained spines are suspected. We demonstrate, through three cases presenting in the UK with chronic SUIs, that conservative management, surgery and intralesional corticosteroids may all be associated with satisfactory outcomes. Management options should consider the presence of retained spines, injury site, symptoms and importantly, patient preference.

Long-Term Nutrient Supply Options: Strategies to Improve Soil Phosphorus Availability in the Rice-Wheat System

The indiscriminate use of chemical fertilizers can deteriorate soil, grain, and environmental quality; still, these can be restored if integrated nutrient management options with inclusion of legumes in the cropping system are adopted. A long-term (19 year) rice-wheat system experiment was examined to find out the best nutrient management practices (BNMP) through recommended dose of fertilizers (RDF), integrated plant nutrition system (IPNS), soil test crop response (STCR), farmyard manure (FYM), along with the inclusion of pulses (berseem and cowpea). Seven nutrient management practices were applied in combination of organic and chemical fertilizer in the rice-wheat system. Results showed that a significant variation was seen in phosphorus (P) fractions among the treatments and soil depths. The results showed a significantly (p < 0.05) higher contribution to phosphorus availability by Residual-P followed by NaHCO3-Po > NaOH-Pi > NaOH-Po > HCl-P > NaHCO3-Pi > available P and lowest in WSP under different long-term management options in rice-wheat system after completing 19 crop cycles. Variations in soil P-fractions with depth were compared to different treatment combination, and a considerable increase in all the major P-fractions was noticed. The continuous application of various IPNS options as organic farming (OF), RDF, STCR, and the inclusion of pulses (berseem and cowpea) significantly improved all P fractions in the soil system and offered an added benefit in terms of sustainability of production and soil health compared to the solo application of chemical fertilizers. Overall, results showed that IPNS options (berseem and cowpea) showed its superiority over the rest of the treatment. This study suggests that the inclusion of pulses would increase P-availability in soil system.

Long-Term Efficacy and Safety of Guselkumab for Moderate to Severe Psoriasis: A 3-Year Real-Life Retrospective Study.

IntroductionGuselkumab safety and efficacy profiles in psoriasis have been showed by VOYAGE (1 and 2) trials. Although trial results have been already previously confirmed by real-life studies, long-term real-life data, and drug survival data about guselkumab are still poor.Patients and MethodsWe performed a 3-year retrospective study, with the aim of assessing guselkumab efficacy and safety profile in the management of plaque psoriasis in a real-life setting.ResultsThirty-one patients completed the study. Both Psoriasis Area Severity Index (PASI) and Body Surface Area (BSA) statistically improved since week 16, and up to week 144 [PASI reduction from 16.4 ± 6.2 to 0.6 ± 0.9 (p < 0.0001) at week 144 while BSA from 33.2 ± 14.6 to 1.9 ± 1.4 (p < 0.0001)]. At week 12 PASI90 and PASI100 were achieved by 19 (61.3%) and 11 (35.4%) patients, respectively, as well as 24 (77.4%) and 18 (58.1%) subjects reached PASI 90 and PASI 100 at week 144. As regards the safety, no cases of injection site reaction, candida, serious AEs, malignancy, or major cardiovascular events were reported. Of note, mild AEs were collected with pharyngitis as the main one (7, 22.6%), followed by headache (5, 16.1%) and flu-like illness (5, 16.1%), all without requiring treatment discontinuation.ConclusionOur experience confirmed the efficacy and safety of guselkumab in daily clinical practice up to 3 years, suggesting this drug as an effective treatment option in psoriasis long-term management.

Precision Medicine in Adult Obstructive Sleep Apnea and Home Diagnostic Testing: Caution in Interpretation of Home Studies Without Clinician Input Is Necessary

PurposeTo assess the validity of home sleep apnea test directed diagnosis and treatment of obstructive sleep apnea (OSA) in a real-life clinical setting and establish the extent to which clinical evaluation alters diagnosis and therapeutic intervention, in the context of the evolving realm of precision medicine.MethodsRetrospective consecutive cohort study of 505 patients referred to a single center between 15th September 2015 to 14th September 2016, multidisciplinary specialist sleep clinic presenting with a home sleep apnea test prior to referral. We evaluated the effect of sleep medicine practitioner (SMP) and ear, nose, and throat surgeon (ENTS) review on patient diagnoses, disease severity, and management options in OSA.ResultsHundred and fifteen patients were included. Repeat evaluation with in-lab polysomnogram (PSG) was required in 46/115 (40.0%) of patients, of which 20/46 (43.5%) had OSA severity changed. Sleep medicine practitioner review decreased the need for repeat testing with formal in-lab PSG (p < 0.05) and increased patient acceptance of continuous positive airway pressure (CPAP) as a long-term management option for OSA. Sleep medicine practitioner/ENTS review resulted in discovery of a non-OSA related sleep disorder or change in OSA severity in 47.8% (55/115). Ear, nose, and throat surgeon review resulted in additional or changed diagnosis in 75.7% (87/115) of patients.ConclusionIn the clinical assessment and diagnosis of OSA, patients should be reviewed by medical practitioners with an interest in sleep disorders to better navigate the complexities of assessment, as well as the identification of co-morbid conditions.

Long-term treatment of endometriosis-related pain among women seeking hormonal contraception

Objective To evaluate the different effects of a progestin-only contraceptive with desogestrel (DSG) vs combined oral contraceptives (COCs) for a first line long-term treatment of endometriosis-related pain among patients seeking hormonal contraception. Methods An observational retrospective cohort study was conducted in collaboration with a local outpatient clinic for endometriosis among a group of nulliparous young women (n = 216) with endometriosis-related pain and seeking contraception. The cohort was subdivided into a group (n = 73) treated as first line by DSG and another group (n = 75) treated by a COC. During the study, clinical symptoms, side effects and possible changes in OC type use were recorded. Results No significant difference was found between the two groups in terms of clinical characteristics and pain scores before treatment. After 6 months both treatments were effective in reducing endometriosis-related pain, and those treated with DSG showed lower levels of dysmenorrhea, dyspareunia and nonmenstrual pelvic pain than COCs group (p < .01). After 12 months, in DSG Group some patients (15%) switched from DSG to a COC for breakthrough bleeding, whereas in COC Group 48% of patients switched to another type of COC for reduced efficacy on pain and/or for side effects. After 3 years of OC treatment, in DSG Group 79% of patients maintained the same therapy, whereas in COC Group only 14% continued the same COC type, 37% switched to another COC and 47% to DSG. Conclusions A progestin-only contraceptive with DSG is a valid option for long term management of endometriosis-related pain in patients seeking hormonal contraception.

Towards a digital twin for characterising natural source zone depletion: A feasibility study based on the Bemidji site

Natural source zone depletion (NSZD) of light non-aqueous phase liquids (LNAPLs) may be a valid long-term management option at petroleum impacted sites. However, its future long-term reliability needs to be established. NSZD includes partitioning, biotic and abiotic degradation of LNAPL components plus multiphase fluid dynamics in the subsurface. Over time, LNAPL components are depleted and those partitioning to various phases change, as do those available for biodegradation. To accommodate these processes and predict trends and NSZD over decades to centuries, for the first time, we incorporated a multi-phase multi-component multi-microbe non-isothermal approach to representatively simulate NSZD at field scale. To validate the approach we successfully mimic data from the LNAPL release at the Bemidji site. We simulate the entire depth of saturated and unsaturated zones over the 27 years of post-release measurements. The study progresses the idea of creating a generic digital twin of NSZD processes and future trends. Outcomes show the feasibility and affordability of such detailed computational approaches to improve decision-making for site management and restoration strategies. The study provided a basis to progress a computational digital twin for complex subsurface systems.

Prairie and tree planting tool-PT2 (1.0): a conservation decision support tool for Iowa, USA.

This article overviews the prairie and tree planting tool or PT2 (1.0), an online GIS-based decision support tool for landowners interested in exploring opportunities to plant prairie or trees in and around their farm fields for conservation or production purposes. PT2 1.0 can be found online at: https://pt2.nrem.iastate.edu/. With the PT2 (1.0) users locate farm fields of interest in an online aerial photograph and mapping geographic information system (GIS). Users explore areas they are considering for prairie or tree cover by examining different data layers: soil maps, 2-foot contour topography maps, LiDAR hillshade maps, and a map of current land values based on estimated land rent. Users then utilize scaled dimensional drawing tools to measure and delineate areas of interest for planting trees and or prairie. Once an area is delineated, users select from drop-down menus prairie seed mixes or woody species that are suitable for the soils present, and users can select basic long-term management options. PT2 (1.0) estimates total annualized costs for tree or prairie establishment, long-term management, and opportunity costs (based on area weighted expected soil rent), and factors in the potential benefit of utilizing government cost-share programming, e.g., Environmental Quality Incentive Program or the Conservation Reserve Program. Key data layers are currently functional in Iowa, likewise the financial data underlying the cost analysis are specific to Iowa. PT2 (1.0) is, however, open source and open code and guidance is provided regarding how to access and adapt the data for use in other states.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10457-021-00686-8.

Comparative efficacy of BioMin-F, Colgate Sensitive Pro-relief and Sensodyne Rapid Action in relieving dentin hypersensitivity: a randomized controlled trial

BackgroundDentin hypersensitivity (DH) is a sharp toothache that influences a patients' oral health-related quality of life. Oral dentifrices have been marketed for pain relief within a minute for DH. The permanent management of DH is being investigated with the remineralisation potential of bioactive agents in dentinal tubules. This study investigated the relief from pain in DH in one minute after applying over the counter (OTC) dentifrices with Pro-Argin™ and strontium acetate and directly compared them with fluoro-calcium phospho-silicate (FCPS)-based dentifrices for immediate and sustained inhibition of painful stimulus provoking DH.MethodsA randomised, controlled, triple-blinded clinical trial was conducted with 140 participants clinically diagnosed with DH and equally randomized into four groups with parallel treatment assignment of FCPS, Pro-Argin™, 8% strontium acetate, and sodium fluoride-based OTC dentifrices, and tested for DH with air blast, mechanical, and water jet stimuli on SCHIFF cold air sensitivity scale (SCASS) and visual analogue scale (VAS) at interim efficacy intervals of one minute, three days, two, four, and six weeks, subsequently.ResultsA total of 128 participants completed the trial. All the treatment groups showed statistically significant improvement in DH with p < 0.001 relative to baseline at all time points. Pro-Argin™ showed a greater reduction in DH with mean scores of (1.34 ± 0.68) (4.20 ± 1.70) (3.05 ± 2.17) followed by strontium acetate (1.57 ± 0.81) (4.65 ± 1.87) (3.75 ± 1.97) on SCASS and VAS for mechanical and water jet stimuli, one minute after application. There was no statistically significant treatment difference between the two (p = 0.499). FCPS showed the highest reduction in DH on SCASS and VAS for waterjet stimuli with mean scores of (0.97 ± 0.68) (1.80 ± 1.73) and Pro-Argin™ on VAS for mechanical stimuli with mean scores of (2.15 ± 1.92) in six weeks.ConclusionOTC dentifrices with Pro-argin™ and strontium acetate are effective for immediate pain relief from DH, and FCPS could be the best possible treatment option for long term management of DH.Trial registrationID: NCT04249336 (https://clinicaltrials.gov/ct2/show/NCT04249336), Date of Registration: January 30, 2020 (Retrospectively registered).