A compact high bandwidth ratio (BDR) super wide band flower slotted micro strip patch antenna (SWB-FSMPA) for super wide band (SWB) applications is presented. The SWB-FSMPA is constructed on a FR-4 substrate having a size of 16 × 22 mm2. The SWB-FSMPA incorporates a 50 Ω tapered micro strip line and a rectangular beveled defected ground structure (RB-DGS). This design enables a simulation bandwidth from 3.78 to 109.86 GHz, allowing for coverage of various wireless applications such as WiMAX (3.3-3.6 GHz), 5G (3.3-3.7 GHz), WLAN (5.15-5.825 GHz), UWB (3.1-10.6 GHz), Ku- (12-18 GHz), K- (18-27 GHz), Ka- (27-40 GHz), V- (40-75 GHz), and W- (75-110 GHz) millimeter wave bands. The SWB-FSMPA antenna exhibits a gain that varies within the range of 3.22-7.23 dBi and a peak efficiency of 93.3 %. The SWB-FSMPA possesses a bandwidth ratio (BR) of 29.1:1, a BDR of 5284 in the frequency domain, a minimal group delay (GD) fluctuation of <0.48 ns, and a linear phase in the time domain, making it well-suited for SWB applications.

This systematic review aimed to investigate whether minimally invasive root canal preparation ensures higher fracture resistance compared to conventional root canal preparation in endodontically treated teeth (ETT). A comprehensive search strategy was conducted on the \"PubMed, Web of Science, and Scopus\" databases, alongside reference and hand searches, with language restrictions applied. Two independent reviews selected pertinent laboratory studies that explored the effect of minimally invasive root canal preparation on fracture resistance, in comparison to larger preparation counterparts. The quality of the studies was assessed, and the risk of bias was categorized as low, moderate, or high. The electronic search yielded a total of 1,767 articles. After applying eligibility criteria, 8 studies were included. Given the low methodological quality of these studies and the large variability of fracture resistance values, the impact of reduced apical size and/or taper on the fracture resistance of the ETT can be considered uncertain. This systematic review could not reveal sufficient evidence regarding the effect of minimally invasive preparation on increasing fracture resistance of ETT, primarily due to the inherent limitations of the studies and the moderate risk of bias.

The risks of concomitant benzodiazepine (BZ) and opioid use are significant. Despite the urgent need to reduce BZ use among patients taking opioids, no treatment intervention research to our knowledge has addressed treatment for this concurrent, high-risk use. The current study will evaluate the efficacy of augmenting BZ taper procedures with CBT for anxiety disorders that has been adapted specifically for patients with concomitant BZ and opioid use (either use as prescribed or misuse), a high-risk patient population. Research combining rapidly scalable behavioral interventions ancillary to pharmacological approaches delivered via telehealth in primary care settings is innovative and important given concerning trends in rising prevalence of BZ/opioid co-prescription, BZ-associated overdose deaths, and known barriers to implementation of behavioral health interventions in primary care. CBT delivery using telehealth has the potential to aid adherence and promote access and dissemination of procedures in primary care. Lastly, the current study will utilize an experimental therapeutics approach to preliminarily explore the mechanism of action for the proposed interventions. The overall aim of the present pilot randomized controlled trial is to examine the feasibility and preliminary efficacy of a BZ taper with CBT for anxiety disorders adapted for patients with concomitant BZ (BZT + CBT) and opioid use to a BZ taper with a control health education program (BZT + HE) in a sample of individuals (N = 54) who have been prescribed and are taking benzodiazepines and opioids for at least 3 months prior to baseline and experience anxious distress. Screening and outcome measures, methods, and implications are described. Trial Registration: ClinicalTrials.gov (NCT05573906).

UNASSIGNED: The aim of this study was to evaluate and compare the pericervical dentin preservation and fracture resistance of root canal-treated teeth with rotary endodontic file systems of different types of taper.
UNASSIGNED: Thirty-two single-rooted human-extracted premolars were used. They were mounted in wax, and preoperative cone-beam computed tomography (CBCT) scans were taken with 11 × 8 Field of view (FOV). The evaluation of the pericervical dentin thickness was done at the cementoenamel junction level. After pre-CBCT, the 32 samples were divided into four groups (n = 8) - Group A: fixed tapered hand files, Group B: variable regressive tapered TruNatomy, Group C: progressive tapered ProTaper Gold, and Group D: fixed tapered HyFlex EDM. Following instrumentation, postoperative CBCT scans were taken to evaluate pericervical dentin thickness. Obturation was done and access cavity was restored with composite. Fracture strength was checked for all the samples using \"universal testing machine\" until fracture, and calculated in newtons (N).
UNASSIGNED: Student\'s t-test and ANOVA test, along with Tukey\'s post hoc analysis, were used for comparing mean values between the groups, and P < 0.05 was considered statistically significant.
UNASSIGNED: The results of this study showed that there is no statistically significant difference in preserving pericervical dentin with file system of different types of taper and fracture resistance between the groups.
UNASSIGNED: Within the limitations of the study, it was concluded that different types of file taper systems used for root canal preparation have no significant effect on the preservation of pericervical dentin and fracture resistance of teeth.

UNASSIGNED: This research was done to evaluate how the root canal taper affects the Endodontically Treated Teeth (ETT) prepared with the TruNatomy and Protaper Next file systems in terms of fracture resistance.
UNASSIGNED: Forty recently extracted mandibular premolar teeth were used in this research, which was classified into four groups at random. Groups 1a and 1b used TruNatomy 4% and 6%, respectively, while groups 2a and 2b used the Protaper Next 4% and 6% file systems, respectively. The root canals were cleaned, shaped, and sealed using cold lateral compaction. The root canals were then fixed in standardized autopolymerizing acrylic resin blocks and tested for vertical root fracture using a universal testing machine. Newtons were used to measure the forces needed to cause fractures. Data were statistically analyzed.
UNASSIGNED: In comparison with other groups, group 1a (TruNatomy 4%) displayed greater fracture resistance (423.322.43 Newtons), and group 2b (Protaper Next 6%) displayed the least fracture resistance (264.512.76 Newtons).
UNASSIGNED: Protaper Next file system had lower fracture resistance than TruNatomy file system. With the use of greater taper instruments, a notable decrease in the fracture resistance of ETT was observed.

UNASSIGNED: As an attempt to simplify the obturation process and create a tight seal, manufacturers offer gutta-percha (GP) cones matching different sizes of endodontic files. The purpose of this study was to evaluate whether intra-manufacture GP diameters matched the diameters of their corresponding files at different horizontal levels of the canal.
UNASSIGNED: Twenty files and corresponding GP master cones of Reciproc R 40/0.08 (VDW, Munich, Germany), WaveOne Large (40/0.08) (Dentsply Maillefer, Ballaigues, Switzerland), ProTaper F3 (30/0.09) (Dentsply Maillefer, Ballaigues, Switzerland), and Mtwo (40/0.06) (VDW, Munich, Germany) were examined using laser micrometer (LSM 6000 by Mitutoyo, Japan) with accuracy of 1 nm to establish their actual diameter at D0, D1, D3 and D6. Data were analysed using the independent t-test. The differences were considered as significant for P<0.05. Results: The diameter of GP master cones was significantly larger than the corresponding files at all levels with all the above brands. ProTaper GP diameter were closest to the file diameter at D1 (GP=0.35, File=0.35 mm), and D3 (GP=0.48, file=0.49).
UNASSIGNED: This in vitro study showed that within the same manufacturer GP cone diameters do not match the diameters of their corresponding files.

The development of restless legs syndrome (RLS) has been rarely reported during and following opioid withdrawal. We aimed to determine the presence and severity of RLS symptoms during and after supervised opioid tapering.
Ninety-seven adults enrolled in the Mayo Clinic Pain Rehabilitation Center who underwent supervised prescription opioid tapering were prospectively recruited. RLS presence and severity was assessed with the Cambridge-Hopkins Questionnaire 13 and International Restless Legs Syndrome Study Group Rating Severity Scale at admission, midpoint, and dismissal from the program as well as 2 weeks, 4 weeks, and 3 months after completion. Frequency and severity of RLS symptoms were compared between admission and each time point.
Average age of the cohort was 52.6 ± 13.3 years with a morphine milligram equivalent dose for the cohort of 45.6 ± 48.3 mg. Frequency of RLS symptoms increased from 28% at admission to peak frequency of 41% at 2 weeks following discharge from the Mayo Pain Rehabilitation Clinic (P = .01), returning to near baseline frequency 3 months after opioid discontinuation. International Restless Legs Syndrome Study Group Rating Severity Scale increased from baseline and then remained relatively stable at each time point following admission. Thirty-five (36.1%) participants developed de novo symptoms of RLS during their opioid taper, with those being exposed to higher morphine milligram equivalent doses having higher risk of developing RLS.
Moderately severe symptoms of RLS, as assessed by survey, occur commonly in individuals undergoing opioid tapering, particularly if exposed to higher doses. In many cases, symptoms appear to be self-limited, although a minority develop persistent symptoms. Our results may have implications for successful opioid tapering, but future confirmatory studies with structured clinician interview are needed to establish that these symptoms truly represent restless legs syndrome given the potential for RLS-mimicking symptoms in individuals with chronic pain syndromes.
McCarter SJ, Labott JR, Mazumder MK, et al. Emergence of restless legs syndrome during opioid discontinuation. J Clin Sleep Med. 2023;19(4):741-748.

The aim of the current study is to evaluate the use of an enteral clonidine transition for the prevention or management of dexmedetomidine withdrawal symptoms in critically ill children not exposed to other continuous infusion sedative agents. A retrospective, single-center study was conducted in patients ≤ 18 years of age admitted to the pediatric intensive care unit who received a continuous infusion of dexmedetomidine for ≥ 24 hours and who were prescribed enteral clonidine within 72 hours of dexmedetomidine discontinuation. Predefined withdrawal terminology was established to assess for hypertension, tachycardia, agitation, tremors, and decreased sleep. A total of 105 patients were included and received enteral clonidine for prevention or management of dexmedetomidine withdrawal symptoms, with 13 patients (12.4%) requiring a taper modification to manage withdrawal symptoms. The median duration of dexmedetomidine infusion was 120.5 hours (95.5, 143.5) and median peak infusion rate was 1 µg/kg/h (1, 1.2). A higher cumulative dexmedetomidine dose of 119.2 µg/kg (96.6, 154.9) and duration of 142.9 hours (122.6, 158.3) were noted in patients who required a taper modification. Risk factors for dexmedetomidine withdrawal such as dexmedetomidine duration and cumulative dose may help predict patients at the highest risk of withdrawal that would benefit from an enteral clonidine taper to prevent dexmedetomidine withdrawal symptoms. An enteral clonidine taper can be effective in the prevention and management of dexmedetomidine withdrawal symptoms.

This study aimed to quantify the internal and external training load profile of an international training camp and identify any differences between positional groups or starting status.
18 players were sampled using a global positioning system (GPS) and internal training load (TL) via session rate of perceived exertion (RPE).
Internal and external training load variation was present across all six individual training sessions. Results indicated match day -7 (MD-7), had significantly (P= 0.001) less training volume (3339.5 m) than all other training sessions. MD-5 and MD-2 were the most intense (387.5 and 201 m very high speed running (VHSR) and 187.5 and 49 m sprint distance (SPD) respectively in combination with large volume (5933.5 and 5151.5 m). Differences in playing position and starting status were observed in MD-2. Forwards (FW) covered significantly greater distances of VHSR (P= 0.008) and SPD (P= 0.008) in comparison to midfielders (MF) whilst starters reported significantly (P = 0.013) higher internal training loads (TL).
This study provides the first report on training load in elite female footballers during an international training camp including a competitive fixture highlighting the undulation of training loads across the individual training sessions, playing positions and starting status.

Introduction: This study assessed the effect of apical size and taper on the efficacy of root canal disinfection with LED photodynamic therapy (PDT) as an adjunct to irrigation with sodium hypochlorite. Methods: A total of 126 extracted human mandibular molars were divided into 4 groups. The mesiobuccal canal was prepared to size 25/4% in group 1, 25/6% in group 2, 30/4% in group 3, and 30/6% in group 4 using the iRaCe rotary system. A 21-day Enterococcus faecalis biofilm was prepared and used for inoculation of the canals. Each group was randomly divided into 3 subgroups for canal disinfection with 2.5% sodium hypochlorite, sodium hypochlorite plus LED PDT and saline (positive control). Samples from the root canals were obtained with rotary files and cultured. Microbiologic data were analyzed using the Poisson regression test. Results: The bacterial count significantly decreased following disinfection with sodium hypochlorite with/without PDT in all sizes and tapers of preparation compared with the control group (P<0.05). Increasing the apical taper or apical size and the use of PDT as an adjunct did not have a significant effect on the reduction of the bacterial count (P>0.05). However, the apical size and PDT had a significant effect on the number of residual bacteria (P<0.05), and increasing the apical size and conduction of PDT significantly decreased the number of residual bacteria. Conclusion: The apical size and taper and the use of PDT as an adjunct did not have a significant effect on the reduction of the bacterial count. However, increasing the apical size and conduction of PDT as an adjunct to sodium hypochlorite irrigation significantly decreased the number of residual bacteria in the root canal system.