However, this approach cannot be applied to the water-water entropy. Furthermore, we test the quantitative validity of our method by computing salting-out coefficients and comparing them to experimental data. We find a good correlation to experimental salting-out constants, while the absolute values are overpredicted due to the approximate second order entropy. Since ions are frequently used in MD, either to neutralize the system or as a part of the investigated process, our method greatly extends the applicability of GIST. The use-cases range from biopharmaceuticals, where many assays require high salt concentrations, to environmental research, where solubility in sea water is important to model the fate of organic substances.

A systematic review was performed to analyze the clinical performance of class I and II restorations in posterior teeth placed with the incremental or the bulk-filling techniques. The primary outcome was retention/fracture rate, and the secondary outcomes evaluated were anatomical form, surface texture, color match, marginal adaption, marginal discoloration, caries, and postoperative sensitivity.

Electronic and manual searches were performed for randomized clinical trials comparing the clinical performance of composite resin restorations in posterior teeth placed with the incremental or the bulk-filling techniques. The Cochrane Collaboration risk of bias tool was used to assess the quality of the studies and the GRADE tool was used to access the quality of the evidence.

Fourteen studies were included in this systematic review and most of them had unclear risk of bias. The risk difference (RD) for retention/fracture was 0.00 (95%CI =  - 0.01, 0.01; p = 0.86) for 1-1.5years of follow-up; 0.00 (95%CI =  - 0.02, 0.02; p = 0.88) for 2-3years of follow-up; 0.05 (95%CI =  - 0.08, 0.18; p = 0.46) for 5 or more years of follow-up. The RD for postoperative sensitivity was 0.04 (95%CI =  - 0.02, 0.10; p = 0.18) for up to 30days; 0.00 (95%CI =  - 0.01, 0.02; p = 0.63) for 1-1.5years of follow-up; and 0.00 (95%CI =  - 0.01, 0.02; p = 0.71) for 2-3years of follow-up. For the other secondary outcomes, no significant differences were observed (p > 0.05) between the restorative techniques. The certainty of evidence was graded as moderate.

The clinical performance of class I and II restorations in posterior teeth is similar when placed with the incremental and bulk-filling techniques.

Based on the results of this study, posterior restorations placed with bulk-filling technique present satisfactory clinical performance, which is similar to direct restorations placed with the conventional incremental technique, considering various follow-up periods evaluated.

CRD42018108450.

CRD42018108450.

To compare caries prevalence and extent in adults with or without diabetes mellitus (DM) according to different caries detection criteria (WHO, ICDAS, and Nyvad).

A cross-sectional study was carried out including 122 individuals, 44 without DM and 78 with type 2 DM. Trained and calibrated examiners performed a visual-tactile inspection to record coronal and root caries lesions (weighted kappa > 0.7). Caries prevalence and extent were calculated according to the WHO (only cavitated lesions, missing and filled surfaces), ICDAS (all non-cavitated and cavitated lesions, missing and filled surfaces), and Nyvad (only active lesions, non-cavitated and cavitated). For root caries, lesions were classified as active or inactive.

A significantly higher overall caries experience (DMF-S) was observed among patients with DM when the WHO (RR = 1.37; 95% CI = 1.09-1.71) and the ICDAS (RR = 1.32; 95% CI = 1.07-1.62) criteria were adopted. No difference between groups was found when the Nyvad criterion was used, although a low study power was observed in this comparison. Estimates for root caries showed a higher prevalence (PR = 2.65; 95% CI = 1.05-6.70) and risk (RR = 6.02, 95% CI = 1.81-20.00) of total D-S among diabetic patients.

DM can predispose individuals to a higher number of root caries lesions, independently of their past caries experience. Missing teeth can overestimate caries extent in individuals with DM.

Individuals with DM should be monitored for the prevention and control of root caries. It is recommended to splitting missing teeth from the caries estimates in studies involving adults, particularly diabetic ones.

Individuals with DM should be monitored for the prevention and control of root caries. It is recommended to splitting missing teeth from the caries estimates in studies involving adults, particularly diabetic ones.

The aim of the present study was to assess the extent and severity of periodontal disease among type 1 diabetic patients (T1DM) and to investigate the possible association with systemic markers of glucose control and variability.

Patients were consecutively enrolled in a Diabetic Unit. A full-mouth periodontal evaluation was performed, and data on systemic markers of diabetes were collected. Descriptive statistics and logistic and linear models were performed.

A total of 136 T1DM patients (mean age 45.5 ± 14.6 years) were examined. Periodontitis was detected in 62% of cases (mean CAL 3.0 ± 0.9 mm) stage III periodontitis was diagnosed in 32% of patients while stage IV in 8%. Mean level of glycated hemoglobin (HbA1c) was 7.5% ± 1.4. Among the investigated factors, mean CAL (p=0.040) was associated with HbA1c ≥ 7%; 93% of patients with mean CAL > 6 mm showed HbA1c ≥ 7%. Mean CAL (p=0.004), mean PPD (p=0.005), mean FMPS (p=0.030), and stage III/IV periodontitis (p=0.018) predict glucose coefficient of variation (CV).

Periodontitis showed a relevant prevalence in the present, well-controlled T1DM population and predicts poor glycemic control (HbA1c ≥7%) and higher glucose variability. The present findings suggest that periodontal infection may have systemic effects also in T1DM patients.

The extent and severity of periodontitis and its possible systemic effects in T1DM patients could be underestimated.

The extent and severity of periodontitis and its possible systemic effects in T1DM patients could be underestimated.

The incidence of eosinophilic esophagitis (EoE), a Th2-type allergic disease of the esophagus, has increased with the higher prevalence of gastroesophageal reflux disease (GERD). Both conditions are chronic inflammatory diseases with similar clinical presentations, yet their pathogenesis is thought to differ. Recent evidence indicates that forkhead box P3 (FOXP3)-positive regulatory T cells (Tregs) play a critical role in immune tolerance and control of Th2-biased responses in various allergic diseases.

This study aimed to investigate differences in Treg induction between EoE and GERD and clarify whether this difference was related to the clinicopathological findings of patients with EoE.

Thirty patients (15 men, 15 women) with EoE and 30 patients (15 men, 15 women) with GERD were included. Patient characteristics, including endoscopic and pathological findings, were compared between the two groups. Immunohistochemistry staining was used to identify T lymphocytes and Tregs. Tregs were identified by CD3 + FOXP3 + staining, and T cells were defined as CD3 + cells. The number of T cells and Tregs in the epithelium was counted, and the average of Tregs/T cells was calculated.

The ratio of Tregs/CD3 + T cells in the esophageal epithelium was significantly lower in the EoE group than in the GERD group (9.9% vs. 23.6%, P = 0.0000012). Comparison of the ratio of Tregs/CD3 + T cells by age, gender, endoscopic findings, and histological findings in patients with EoE revealed a significant difference in gender.

Treg induction was impaired, and this effect was more pronounced in male adult patients with EoE than those with GERD.

Treg induction was impaired, and this effect was more pronounced in male adult patients with EoE than those with GERD.

Hospitals are held accountable for quality metrics, through public reporting programs and by payers. However, little is known about hospital performance in GIB nationally.

A retrospective longitudinal analysis utilizing Vizient’s database was performed to identify GIB hospitalizations across 349 hospitals from 2016 to 2018. The primary outcome was risk-adjusted mortality; secondary outcomes included risk-adjusted length of stay and complication rate. Trends in performance were characterized using quintiles, with analysis of concordance within hospitals and across hospitals over time. Pearson’s correlation coefficients were performed to assess the relationship among metrics.

28.1% of hospitals had a steadily improving risk-adjusted mortality index from 2016 to 2018, while 15.5% were steadily worsening in mortality. For LOS, 25.2% of hospitals were improving, while 22.4% deteriorated. For complication rate, 22.9% of hospitals steadily improved, while 19.2% of hospitals deteriorated. Although many hospitalved in all three metrics. Additionally, many hospitals are deteriorating over time, and further research is needed to determine which care processes are associated with better outcomes.

Myasthenia gravis is an autoimmune disease affecting the neuromuscular junction, often associated with other autoimmune diseases, including rheumatoid arthritis. Patients with rheumatoid arthritis present an increased prevalence of myasthenia gravis compared to the general population. While these two diseases share some therapeutic options, such as glucocorticoids, methotrexate, and rituximab, there are no guidelines for treating concomitant disease. We aim to review the available evidence and to discuss the efficacy and safety of the therapeutic options in patients with rheumatoid arthritis associated with myasthenia gravis.

We described three patients with rheumatoid arthritis associated with myasthenia gravis and we performed a systematic review of the associated literature.

A 48-year-old man and two women (48 and 55years old) with concomitant diagnoses of active rheumatoid arthritis and well-controlled myasthenia gravis are described. They were treated with methotrexate, leflunomide, upadacitinib, a, Janus Kinase inhibitors are a novel interesting option for patients with concomitant rheumatoid arthritis and myasthenia gravis.Two cellulose nanocrystals/single-walled carbon nanotube (CNC/SW) hybrids, using two cellulose polymorphs, were evaluated as electrochemical transducers CNC type I (CNC-I/SW) and CNC type II (CNC-II/SW). They were synthesized and fully characterized, and their analytical performance as electrochemical sensors was carefully studied. In comparison with SWCNT-based and screen-printed carbon electrodes, CNC/SW sensors showed superior electroanalytical performance in terms of sensitivity and selectivity, not only in the detection of small metabolites (uric acid, dopamine, and tyrosine) but also in the detection of complex glycoproteins (alpha-1-acid glycoprotein (AGP)). More importantly, CNC-II/SW exhibited 20 times higher sensitivity than CNC-I/SW for AGP determination, yielding a LOD of 7 mg L-1.These results demonstrate the critical role played by nanocellulose polymorphism in the electrochemical performance of CNC/SW hybrid materials, opening new directions in the electrochemical sensing of these complex molecules.