Search

Introduction Subtotal cholecystectomy (STC) is an alternative to total cholecystectomy (TC) in patients with severe inflammation/adhesions around the hepatocystic triangle. This study aimed to evaluate the safety profile of STC. Methods We retrospectively reviewed all patients who had STC at our unit between February 2009 and August 2019. STC was divided into two types, reconstituting (R-STC) and fenestrating (F-STC), depending on whether the gall bladder remnant was closed or left open. Patients who had cholecystectomy for gall bladder malignancy or as part of another operation were excluded from the study. Results A total of 5,664 patients underwent cholecystectomy during the study period. Of these, 97 (1.7%) underwent STC. The laparoscopic to open conversion rate was high at 48.8% (47 cases), as was the overall postoperative complication rate (45.4%, 44 cases). No patient suffered iatrogenic bile duct injury. Nineteen patients (19.6%) suffered postoperative bile leak. This was significantly higher in patients who had STC in the acute setting (41% vs 13% for elective STC cases; p=0.04). There was no significant difference in rate of bile leak or other complications between R-STC and F-STC types. The 90-day readmission rate was 8.2% (8 cases). No mortalities were recorded within 90 days post STC. Conclusions STC seems to be an effective technique to avoid bile duct injury in difficult cholecystectomy cases. However, the perioperative morbidity associated with STC is relatively high. Surgeons should be aware of the risks of STC and take appropriate steps to minimise them.

Translucent zirconias have been developed with better esthetics than high-strength zirconias by reducing opacity. However, studies on their translucency and strength are sparse.The purpose of this in vitro study was to compare the relationship between translucency and biaxial flexural strength of recently developed high-translucency zirconia, high-strength zirconia, and lithium disilicate ceramics.Disks (n=12) were fabricated for 5 ceramic materials: high-strength zirconia (BruxZir 16 shaded), translucent zirconia (BruxZir Anterior shaded, Katana UTML, Katana STML), and lithium disilicate (IPS e.max, Press HT, and LT). A standard tessellation language (STL) file was designed, and the specimen milled, finished, and glazed according to manufacturer's instructions for each material. The translucency parameter was calculated against black and white backgrounds and white and stump shade with ND4 background by using a spectrophotometer. Biaxial flexural strength was calculated by using the 3-ball test. The load was applied at a crosshead speed of 0.5 mm/min with a 49-N load cell until failure occurred. Translucency parameter and biaxial flexural strength data were analyzed with 1-way analysis of variance (ANOVA). A Tukey honest significant difference multiple comparison test was used to determine significant differences (α=.05).The IPS e.max HT was more translucent against both backgrounds (32.85 for black/white and 15.34 for white/stump), while BruxZir 16 was the least translucent (19.78 for B/W and 8.83 for W/S). All groups tested differed in translucency (P.001) except for BruxZir Anterior and Katana STML, which were not significantly different (P=.052). For biaxial flexural strength, BruxZir 16 had the highest strength (995.44 MPa) and e.max HT, the lowest (186.75 MPa). No significant differences were found between BruxZir anterior and Katana STML, Katana UTML and IPS e.max LT, or IPS e.max LT and IPS e.max HT (P.05). Translucency parameter values using both backgrounds were strongly correlated (r=0.99). However, biaxial flexural strength values were inversely related to translucency parameter values when using black/white and white/stump shade but with high correlation (r=-0.777 and -0.756 respectively).Lithium disilicate was the most translucent and yet the weakest material, whereas high-strength zirconia was the most opaque ceramic and the strongest. Katana UTML had the highest translucency but was weakest among translucent and high-strength zirconia materials. Overall, translucency was negatively correlated with biaxial flexural strength.

PURPOSE To evaluate the effect of cavity tapering on the marginal and internal adaptation of endocrowns fabricated from two different ceramic materials. MATERIALS AND METHODS Two mandibular molar model teeth were prepared with two different cavity tapers (5 and 10 degrees). Forty endocrowns in four groups (n = 10 each) were milled using lithium disilicate and zirconiareinforced lithium silicate ceramics for each cavity taper. The marginal and internal adaptation were measured with a stereomicroscope (×30) at 18 different points. The data were statistically analyzed using independent t test (P < .05). RESULTS A statistically significant difference was shown among the tested groups at 10 degrees of taper (P < .001). At 5 degrees of taper, the difference was insignificant. The greatest internal gap was observed on the pulpal floor in all tested groups. CONCLUSION All materials had clinically acceptable internal and marginal gaps; however, lithium disilicate ceramic had significantly better adaptation at 10 degrees of taper.

Summary Objective The current paper examined the impact of dysphonia on the bandwidth of the first two formants of vowels, and the relationship between the formant bandwidth and vowel intelligibility. Methods Speaker participants of the study were 10 adult females with healthy voice and 10 adult females with dysphonic voice. Eleven vowels in American English were recorded in /h/-vowel-/d/ format. The vowels were presented to 10 native speakers of American English with normal hearing, who were asked to select a vowel they heard from a list of /h/-vowel-/d/ words. The vowels were acoustically analyzed to measure the bandwidth of the first and second formants (B1 and B2). Separate Wilcoxon rank sum tests were conducted for each vowel for normal and dysphonic speech because the differences in B1 and B2 were found to not be normally distributed. Spearman correlation tests were conducted to evaluate the association between the difference in formant bandwidths and vowel intelligibility between the healthy and dysphonic speakers. Results B1 was significantly greater in dysphonic vowels for seven of the eleven vowels, and lesser for only one of the vowels. There was no statistically significant difference in B2 between the normal and dysphonic vowels, except for the vowel /i/. The difference in B1 between normal and dysphonic vowels strongly predicted the intelligibility difference. Conclusion Dysphonia significantly affects B1, and the difference in B1 may serve as an acoustic marker for the intelligibility reduction in dysphonic vowels. This acoustic-perceptual relationship should be confirmed by a larger-scale study in the future.

Background and purpose Mild traumatic brain injury (mTBI) in patients on antiplatelet (AP), anticoagulant (AC) or direct oral anticoagulant (DOAC) medication has become a systematic indication for head CT. However, the over-risk and impact of the intracranial hemorrhages (IH) detected with CT in this population remain unclear and need to be assessed. Materials and methods We prospectively assessed head CTs performed in adults taking AP/AC/DOAC referred after a mTBI to our Emergency Departments between September 2016 and January 2018. Frequency, type and severity of IH were described and frequency was analyzed as a function of treatment. Results 840 patients were prospectively included. 58.9% were treated with AP, 23.7% with AC, 11.7% with DOAC and 5.7% with a combination of antithrombotic agents. The rate of IH detected with head CT was 5.8% (n = 49), of which 81.6% (n = 40) and 18.4% (n = 9) with minor and intermediate severity respectively. No patient required surgical care and no death occurred. No statistically significant difference was found in treatment distribution between patients with or without IH (p = 0.98). Among the patients who discontinued their antithrombotic treatment after mTBI, three experienced thrombotic events during the hospitalization. Conclusions Our results showed a low frequency and severity of IH in mTBI patients indifferently treated with AP, AC or DOAC, without secondary neurological deterioration, death or need of surgical care. Our study suggests the limited benefit of systematic CT head scan as a standard practice for the management of mTBI patients under antithrombotic therapy.

Objective To investigate the choroidal vascularity index (CVI) in patients with thyroid-associated ophthalmopathy (TAO) and its relationship with clinical features and clinical activity score Methods Right eyes of 53 patients with TAO and 53 healthy subjects were scanned for subfoveal choroidal thickness (SFCT), CVI, choroid-stromal area (C-SA), choroid-luminal area (C-LA), choroidal stromal index (CSI), choroid-stromal-to-luminal-area ratio, and CVI and CSI within the central 1500 µm of the macula (CVI1500 and CSI1500) by enhanced-depth imaging optical coherence tomography. The results of the TAO group and the healthy controls were compared. Results The SFCT was significantly greater in the TAO group than in the control group (p = 0.02). The values of C-LA, C-SA, and total choroidal area (TCA) in the TAO group were significantly higher than those in the control group (p = 0.01, p = 0.04, and p = 0.01, respectively). The increases in SFCT, C-LA, C-SA, and TCA were 12.1%, 12.2%, 16.2%, and 13.6%, respectively. There was no statistically significant difference between the groups for CVI, CSI, CVI1500, CSI1500, and choroid-stromal-to-luminal-area ratio (p > 0.05). CVI1500 and CSI1500 have displayed a statistically significant correlation with exophthalmometry and clinical activity score (p Conclusion The alterations in stromal and vascular structures are proportionally similar in TAO; thus CVI may not be affected significantly. However, CVI1500 and CSI1500 may be associated with disease activity. The choroidal thickening in TAO may be the result not only of vascular mechanisms but also by an increase in stromal contents.

In order to know the efficiency of sterilization in eliminating parasites and its suitability for environment measurements, samples of the water and sediments was taken from six stations the Euphrates River. The samples were transported in clean and sterile bottles to the laboratory. A sedimentation method was used for parasites. Ten species of parasites isolated from water of the six stations while isolated seven were exists in the sediments of these stations. The water and sediments of the station first were contaminate with parasites rate 25.8% and 13.7%, the water and sediments of the second station are contaminated with parasites rate 12.8% and 20.2%, the water and sediments of the third station are contaminated with parasites rate 4.2% and 18.2%, the water and sediments of the fourth station are contaminated with parasites rate 22.8% and 18%, the water and sediments of the fifth station are contaminated with parasites rate 12.0% and 5.4% and the water and sediments of the sixth station are contaminated with parasites rate 12.9% and 1.7%. Giardia lamblia rate 25.4% it is most found in water while Trichomonas hominis rate 18.4% It is most found in sediments. A result of the study shows significant difference between of the temperature of air and water in all study stations, the air temperature ranged (40.10–15.2°C) and the water temperature between (26.3–9.4°C) while PH was (9.89–7.5), recorded electrical conductivity (5745–2515 μs/cm) and salinity was (4.80–1.56 g/cm) the river's water was of low salinity also dissolved oxygen was (12.9–6.2 mg/L). Date seed used as granular by activated carbon used for purification and remove parasite from water filter and waste water treatment.

Statement of problem Adhesive resin cement has been the preferred choice for the placement of prosthetic restorations, but evidence-based studies supporting this selection are sparse. Purpose The purpose of this study was to test the hypothesis that restoration placement with the adhesive 4-methacryloxyethyl trimellitate anhydride/methyl methacrylate-tributylborane (4-META/MMA-TBB) resin cement is associated with better longevity of teeth than zinc phosphate cement up to 43 years. Materials and methods Study participants were individuals who had been visiting the clinic regularly for more than 20 years from their first visit between November 1970 and April 1985. The vital teeth with prosthetic restorations (N=454), including cast inlays, onlays, crowns, and fixed partial dentures, of 53 patients were assessed from dental charts and radiographs. Most of the bonding surfaces were precious metal alloy, excluding 4 restorations cemented with zinc phosphate and 6 ceramic crowns cemented with 4-META/MMA-TBB resin cement. The Kaplan-Meier method and log-rank test (α=.05) were used to compare longevity between the 2 materials. Chi-squared tests (α=.001) were also used to examine the occurrence rates of events such as secondary caries, endodontic treatment, and the dislodgement of restorations affecting the longevity of the 2 cements. Results Clinical review examination demonstrated that 55.4% of teeth retained with 4-META/MMA-TBB resin cement had been in service for 30 years compared with 43.5% of those retained with zinc phosphate cement, with a significant difference (P=.006). 4-META/MMA-TBB resin cement also demonstrated lower event occurrence rates than zinc phosphate cement for 3 assessed types of events (P Conclusions Within the limitations of this study, 4-META/MMA-TBB resin adhesive cement demonstrated a higher survival rate than conventional zinc phosphate cement in service for 30 years with a lower occurrence of critical events.

Background: The sella turcica volume is widely measured by the Di Chiro-Nelson method. The purpose is to compare the fidelity of a proposed volumetry method versus the Di Chiro-Nelson method, using Computed Tomography (CT) images. Materials and methods : Morphometric examination of 173 CT were included, of which 52.6% were female. The mean age was 53.2 ± 17.6 years. Considering the Di Chiro-Nelson method, two measurements were added for each axis in the CT evaluation: Length (Central, Left, and Right), Width (Central, Anterior, and Posterior), and Height (Central, Left, and Right). Results : The mean measurements were Length: Central 10.11 ± 1.44, Left 7.45 ± 1.67, Right 7.53 ± 1.59; Width: Central 12.27 ± 2.11, Anterior 10.99 ± 1.92, Posterior 10.10 ± 1.74; Height: Central 7.68 ± 1.38, Left 7.16 ± 1.35, Right 7.40 ± 1.41. A statistically significant difference between sex was found only in the anterior width (p=0.01). Using the proposed method, the volume was 342.2 ± 88.5 and 378. 6 ± 113.9 mm3 respectively between females and males (p=0.02) versus 476.1 ± 132.4 and 523.8 ± 186.0 mm3 (p=0.05) using the Di Chiro-Nelson’s method. Conclusions : Women had significantly smaller sella turcica volume than men. This proposed method considers the sella turcica as a not strictly symmetrical structure and indicates reduced variation between the maximum and minimum values, compared to the Di Chiro-Nelson’s. Our findings may be useful to reassess the volume of the sella turcica as the measurements indicate a higher precision.

Statement of problem The digitalization of completely edentulous arches presents limitations because of the lack of anatomic structures for best-fit alignment during the image generation process of the scanner’s software program. Purpose The purpose of this clinical study was to evaluate a new device for intraoral scanning and to analyze its usefulness in capturing the 3-dimensional (3D) position of implants in edentulous mandibular arches. Material and methods The 3D positions of 40 implants in 10 participants with fixed interim mandibular prostheses were evaluated by comparing 3 scanning techniques. Images were generated in 2 experimental groups, with digital scan bodies (group SC) and with the scanning device (group SD) and in a control group (group CT) in which images were obtained by laboratory scanning of casts produced from splinted impression copings. The standard tessellation language (STL) files were superimposed by using a reverse engineering software program to measure the 3D coordinate system. Variations in implant linear displacements (Δx, Δy, and Δz), total 3D displacement ( Δ x 2 + Δ y 2 + Δ z 2 ), and angle projections (ΔθXY, ΔθXZ, and ΔθYZ) were statistically analyzed (α=.05). The distances between the implants were also measured. The Spearman correlation coefficient (α=.05) was used to find the correlation between the 3D coordinates and the distances between the implants. Results Group SD had lower values for linear displacement than group SC; however, this difference was not statistically significant except for implant #2. The overall evaluation showed a significant difference with better accuracy for group SD. Concerning angular displacements, group SD showed lesser angular variation for the 3 projection planes. For the distances between the implants, significant differences were only observed for the “all” assessment in which group SD behaved similarly to group CT, while group SC showed the highest values (P Conclusions The evaluated scanning device led to improved trueness for linear, angular displacements, and distances between implants in mandibular edentulous arches.

Objective To compare the incidence of endophthalmitis after intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections with and without patient face masking. Design Two-centre retrospective cohort study Participants Patients receiving a total of 28 501 injections (period 1 before masking: n = 13 863; period 2 after masking: n = 14 638) Methods Periods before and after implementation of patient masking were compared: period 1 (July–December 2019) and period 2 (July–December 2020). All patients requiring treatment for endophthalmitis following intravitreal anti-VEGF injections were reviewed. Endophthalmitis risks were compared. Statistical simulations were run to determine the number of injections or endophthalmitis cases required to detect a statistically significant difference between both periods. Results Five patients (0.036%) had endophthalmitis in period 1 compared with 7 patients (0.048%) in period 2. Odds ratio, 95% confidence interval, for risk of patient masking was 1.326, 0.421–4.179 (p = 0.63). Three patients (0.022%) in period 1 had culture-positive endophthalmitis compared with 2 patients (0.014%) in period 2. Risk of patient masking for culture-positive endophthalmitis was 0.631, 0.105–3.779 (p = 0.61). Assuming similar rates of endophthalmitis, 476,806 injections in both groups would be required to detect a significant difference. Alternatively, assuming that masking would increase endophthalmitis risk in period 2, a significant difference would require twice as many cases (n = 15, 0.102%) for a risk of 2.843, 1.033–7.825 (p = 0.043). Conclusions The implementation of patient masking in clinical practice did not significantly alter the rate of endophthalmitis following intravitreal anti-VEGF injections.

Statement of problem Limited information is available on the differences between tissue-level implants with an ultrathin threaded microsurface conical transmucosal portion and bone-level implants rehabilitated with conical custom abutments. Purpose The purpose of this retrospective study was to assess the outcomes of crowns designed as per the biologically oriented preparation technique (BOPT) cemented on conical titanium abutments on tissue-level and bone-level implants. Material and methods Patients consecutively rehabilitated with a delayed loading protocol with anterior implant-supported single crowns with a feather-edge margin, in function for at least 4 years, were recruited and divided into 2 groups based on the implant type they had received: tissue-level implants with a conical transmucosal portion or bone-level implants rehabilitated with a conical abutment by following the platform switching concept. Bone resorption, pink esthetic score (PES), and white esthetic score (WES) were collected and analyzed. The nonparametric Mann-Whitney test was performed to analyze all parameters (α=.05 for all tests). Results A total of 43 participants (48 implants) were included in the present study. The mean follow-up period was 4.5 years (range 52-64 months). A statistically significant difference (P=.004) was found in the mean ±standard deviation bone resorption between tissue-level implants (0.38 ±0.46 mm) and bone-level implants (0.83 ±0.58 mm). Higher values for both PES and WES were obtained in the tissue-level implant group. Conclusions Within the limitations of the present retrospective study, tissue-level implants with a conical transmucosal portion seem to provide a suitable alternative to bone-level implants in the anterior area.

Statement of problem Whether the disinfection of polymethyl methacrylate (PMMA) dentures eliminates Candida albicans biofilm is unclear. Purpose The purpose of this in vitro study was to determine the antimicrobial effect of immersion in hydrogen peroxide (H2O2) and subsequent application of microwaves on the formation of C albicans biofilm on the surface of polished and unpolished PMMA disks. Material and methods Polished and unpolished PMMA disks (n=40) were mounted in a Center for Disease Control (CDC) biofilm reactor by adding yeast-dextrose-peptone (YPD) broth inoculated with C albicans in a cell suspension for 24 hours. After this period, the PMMA disks (n=8) were disinfected with 5 different solutions: saline solution, 1% sodium hypochlorite (NaOCl), H2O2, H2O2 microwaved at 650 W for 3 minutes (H2O2/μw), and distilled water microwaved at 650 W for 3 minutes (H2O/μw). On the polished and unpolished surface of each disk, arbitrary fluorescence units (AFU) were quantified with the live/dead bacterial viability kit (Invitrogen) by using confocal laser scanning microscopy (CLSM) to evaluate 10 different areas of each surface; these were counted as the colony-forming units (CFUs). The mean values were compared by using the Mann–Whitney U test (α=.05). Results Polished surfaces disinfected with H2O2/μw obtained the lowest viable cells (9.76 AFU) and nonviable cells (12.46 AFU) compared with H2O/μw and H2O2. In the unpolished surface the lowest mean values of viable cells (14.64 AFU) and nonviable cells (12.46 AFU) were obtained for the PMMA disks disinfected with H2O/μw compared with H2O2/μw and H2O2. Both polished and unpolished disks showed significant difference (P Conclusions H2O2 alone did not eliminate the formation of the biofilm of C albicans; however, in combination with the use of the microwave at 650 W for 3 minutes, the biofilm formation of C albicans on polished surfaces was reduced. The number of AFUs of viable-nonviable cells and CFUs depended on whether the surfaces are polished or unpolished.

Background Several studies have shown that there are no significant differences in anastomotic leakage associated with Transanal total mesorectal excision (taTME) versus laparoscopic TME (lapTME) for rectal cancer; however, little is known about late anastomotic leakage, such as that primarily found in the chronic presacral sinus. We aimed to compare the occurrence of anastomotic leakage and chronic presacral sinus in rectal cancer for taTME and lapTME. Methods In this retrospective cohort study, data were collected for patients with rectal cancer who underwent surgery between January 2009 and September 2019. Of the 220 patients included in this study, 182 were in the lapTME group and 38 in the taTME group. We compared factors associated with anastomotic leakage and chronic presacral sinus formation between the two groups. A binary-logistic model was used to determine the risk factors for chronic presacral sinus. Results Anastomotic leakage occurred in six patients (15.8%) in the taTME group and 36 patients (19.7%) in the lapTME group. Chronic presacral sinus occurred in three patients (7.9%) in the taTME group and 15 patients (8.2%) in the lapTME group. There was no significant difference in anastomotic leakage or chronic presacral sinus between groups (P = 0.569 and P = 1.000, respectively). Pathologic stage III or higher was significantly associated with chronic presacral sinus formation (P = 0.006). Conclusion There were no significant differences between taTME and lapTME regarding the incidence of anastomotic leakage or chronic presacral sinus. Almost one-third of anastomotic leakages developed into chronic presacral sinus.

To investigate how postural balance is affected by thoracic hyperkyphosis compared to healthy children and elucidate the relationship between balance and strength and tightness.A cross-sectional analysis using standardized measures to identify balance function in children with thoracic hyperkyphosis (n = 31) and compare age-matched healthy children (n = 31). Primary outcome measurements were performed for the static and dynamic balance with the biodex balance system and limits of stability with the functional reach test. Secondary outcome measurements were strength with a hand-held dynamometry, tightness with the length test of pectoralis minor and hip flexors, and the sit-reach test for hamstrings. Mann-Whitney U test was used to compare the difference between the groups. Spearman's correlation was used to analyze the possible correlations between balance and strength and tightness.A significant difference was found between the groups for static balance with eyes closed (except double-leg stance anteroposterior stability index) and for the forward reach distance (p 0.05). Strength and tightness were significantly different in children with thoracic hyperkyphosis than in healthy children (p 0.05). Also, it was found that muscle strength of trunk extension and hip abduction and tightness of hip flexors and hamstring were factors associated with static balance with eyes closed (r 0.10, p 0.05).Static balance in children with thoracic hyperkyphosis is affected when visual input is particularly removed, and static balance with eyes closed is correlated with changed strength and tightness in some of the trunk and lower extremity muscles.

Xiao, F, Yang, Y, Xiao, L, Xia, Z, Wang, L, Yang, K, and Wang, S. Reduction of T cells and hsa-miR150-5p in female canoeing athletes: Preliminary evidence between exercise training and immune. J Strength Cond Res 36(11): e106-e113, 2022-This article aims to reveal the alteration of immune profile in teenage canoeing athletes, by which applies a clue for regulation of exercise on human immune. Thirty-one teenagers of female canoeing athletes and age-matched subjects participated in this research. Peripheral leukocytes' microRNAs (miRNAs) were analyzed using Agilent human microRNA 2.0 and gene software. The miRNA candidates were quantified by reverse transcription real-time quantitative polymerase chain reaction (RT-qPCR). The percentages of various lymphocytes were tested using flow cytometry. There were 6 miRNAs (hsa-miR150-5p, 31-5p, 3659, 4419a, 650, and 8485) lower in canoeing athletes, and the reduction of miR-150 was identified by RT-qPCR ( p = 0.021). Canoeing athletes had lower percent of CD3 + T cells than the subjects with no exercise training had ( p0.001), but the ratio of CD4 + to CD8 + and the percent of CD4 + T cells and CD8 + T cells showed no significant difference between these 2 groups. T cells and hsa-miR150-5p are sensitive to the long-time heavy exercise training, and the exercise for winning competition regulates the immune system by inhibiting T cells and hsa-miR150-5p.

Purpose To determine and compare the mechanical properties of 3D-printed yttriastabilized zirconia to milled isostatic pressed yttria-stabilized zirconia, with the following hypotheses: (1) The flexural strength of 3D-printed yttria-stabilized zirconia is comparable to milled yttria-stabilized isostatic pressed zirconia; and (2) thermocycling and chewing simulation do not affect the flexural strength of 3D-printed yttria-stabilized zirconia. Materials and methods A total of 30 bars of an experimental 3D-printed 3 mol% yttriastabilized zirconia (LithaCon 3Y 230, Lithoz) and 10 bars of milled isostatic pressed zirconia (Prettau Zirconia, Zirkonzahn) were utilized. The printed zirconia bars were divided into three groups (n = 10 bars per group): (1) untreated (control); (2) thermocycled; and (3) tested after chewing simulation. A flexural strength test was performed on all samples using a three-point bend test in an Instron Universal testing machine. One-way analysis of variance on ranks was used to compare milled to printed zirconia. The effects of thermocycling and load cycling on 3D-printed zirconia were also determined. Results The flexural strength values for milled and printed zirconia were 936.3 ± 255.0 MPa and 855.4 ± 112.6 MPa, respectively. There was no statistically significant difference in flexural strength between the milled and printed zirconia (P = .178). No statistically significant differences were observed between the control 3D-printed zirconia group and the thermocycled (888.4 ± 59.3 MPa) or load-cycled printed zirconia (789.6 ± 133.8 MPa; P = .119). Conclusion Printed 3 mol% yttria-stabilized zirconia has comparable flexural strength to milled yttria-stabilized isostatic pressed zirconia. The thermocycling and chewing simulation used in this study did not significantly alter the flexural strength of the printed 3 mol% yttria-stabilized zirconia. These results indicate a promising role for 3D printing in the fabrication of zirconia restorations. Additional studies are needed to explore the full potential of this technology.

This study explored the variations in oxidative stress markers in Parasitized and non- Parasitized Amietophrynus regularis in diverse conditions such as OCP-exposed, unexposed, parasitized, and unparasitized conditions. The toad specimens were collected from natural habitats and dumpsites of three (3) major areas of Lagos. 15g wet weight of the liver, intestine, and parasites were prepared and analysed for oxidative stress parameters including; SOD, CAT, GSH, and MDA activities according to well established protocols. Based on stations, there were significant differences in the SOD and MDA levels in the liver and intestine of uninfected toads obtained at the habitat and the dumpsite. Only SOD had a significant difference in the infected toads. Also, the concentration of SOD in the parasites recovered from the toads at the dumpsite was very much significantly higher than the concentration in those recovered from the toads at the natural habitat (p

Custom mini-implants are needed for edentulous patients with extensive mandibular deficiencies where endosteal placement is not possible. However, the best design for these mini-implants is unclear.The purpose of this in vitro study was to develop 2 dental mini-implant designs to support mandibular overdentures and evaluate the effect of their geometries on primary stability and stress distribution.Two mini-implant designs were developed with changes in the shape, size, and arrangement of threads and chamfers. The experimental mini-implants were made of Grade V titanium alloy (Ti-6Al-4V), (Ø2.0×10 mm) and submitted to a nanoscale surface treatment. Thirty mini-implants (n=10) were placed into fresh swine bones: experimental-threaded, experimental-helical, and a commercially available product model (Intra-Lock System) as the control. The biomechanical evaluations of the experimental mini-implants were compared with those of the control in terms of primary stability, through insertion torque (IT), and with the pullout test. The analysis of stress distribution was performed by using the method of 3D digital image correlation under 250-N axial load and 100-N oblique (30-degree angled model) load. The data were analyzed by ANOVA and the Tukey HSD test (α=.05).The IT and pullout test presented a statistically significant difference for all mini-implants (P.05), with higher IT for the experimental-threaded and maximum pullout force for the control, followed by threaded (P=.001) and helical (P=.001). Regarding the 3D digital image correlation, a lower incidence of stress was found in the cervical third for all mini-implants. No statistically significant differences were found between the designs evaluated (P.05).Comparing the experimental mini-implants with the commercially available control, the experimental-threaded model presented greater primary stability, and all mini-implants showed less stress in the cervical third.

Background We conducted a comparative study to evaluate the efficacy of poloxamer 407-based ropivacaine hydrogel at the wound site (Gel) and continuous thoracic paravertebral block (On-Q) for postoperative pain following thoracoscopic pulmonary resection. Methods This prospective, randomized, noninferiority study included 89 patients randomized into the two groups; Gel (poloxamer 407-based 0.75% ropivacaine, 22.5 mg) and On-Q (0.2% ropivacaine, 4 mg/hour for 48 hours). The primary outcome measure was total fentanyl consumption and secondary outcome measures were the need for rescue analgesia and pain intensity using the numeric rating scale (NRS). Results There was no significant difference in total fentanyl consumption between the Gel group and the On-Q group (1504.29 ± 315.72 mcg vs 1560.32 ± 274.81 mcg, p = 0.374). Pain intensity using the NRS between the Gel group and the On-Q group demonstrated no statistical differences (6 hours: 3.56 vs 3.55, p = 0.958; 24 hours: 3.21 vs 3.00, p = 0.250; 48 hours: 2.75 vs 2.49, p = 0.233; and 72 hours: 2.39 vs 2.33, p = 0.811), and there was no significant difference in the frequency of analgesic rescue medication use (3.70 vs 3.33, p = 0.417). Conclusions We confirm the noninferiority of Gel compared with On-Q for acute postoperative pain following thoracoscopic pulmonary resection. Considering a technical simplicity and low systemic toxicity of the local injection of Gel, this analgesic modality may be worthy of further research and is thus considered to have potential as a viable alternative to On-Q for regional analgesia.

Clinical studies regarding satisfaction and occlusal forces with the complete denture in relation to the menopause are sparse.The purpose of this clinical study was to compare satisfaction levels and occlusal force with complete dentures in premenopausal and postmenopausal Indian women.Twenty premenopausal (group pre-MP) and 20 postmenopausal (group post-MP) completely edentulous participants were selected based on inclusion and exclusion criteria, and estradiol levels were measured. Complete dentures were delivered to all participants following standard fabrication and insertion protocols. Three months after denture insertion, when participants were free of postinsertion complaints, satisfaction level (by using a valid and reliable questionnaire), depression level by using the Patient Health Questionnaire, (PHQ-9) and occlusal force (with a gnathodynamometer) were measured. The obtained data of all parameters were tabulated and compared by using a statistical software program (α=.05).For questions pertaining to the overall satisfaction of maxillary and mandibular dentures, the 2 study groups encountered a significant difference with the premenopausal group showing significantly higher satisfaction levels (P.001). Depression scores in the postmenopausal women group were significantly higher than those of the premenopausal women group (P.001). A negative correlation was found between the overall satisfaction with complete dentures and depression levels in the participants indicating decreased overall satisfaction with increasing depression levels in participants (rho=-0.698). The premenopausal group recorded significantly higher estradiol levels than the postmenopausal group (P.001). Mean occlusal force with complete dentures in the premenopausal women group was significantly higher than that of the postmenopausal women group (P.001). A positive correlation was found between the estradiol levels and occlusal forces in the participants indicating that with decreasing estradiol levels, the occlusal forces decrease in the participants (r=0.740).Satisfaction levels and occlusal force with complete dentures were significantly higher in premenopausal women group than in the postmenopausal group.

Bone tissue engineering is a fast-growing field in regenerative medicine. Consequently, there is a high demand for new, fast and reliable methods to track and quantify the osteogenic differentiation of cells. Recently, a novel method was published to non-destructively quantify the hydroxyapatite content of monolayer and 3-dimensional mesenchymal stem cell cultures using the ability of 99mTechnetium-methylene diphosphonate (MDP), a well-established tracer in clinical nuclear medicine, to bind to newly synthesized hydroxyapatite. In the present study, two other commonly used 99mTechnetium tracers, 2,3-dicarboxypropane-1,1-diphosphonate (DPD) and hydroxydiphosphonate (HDP), were evaluated to see if they could also be used for the same purpose. Furthermore, we investigated if labelling at various timepoints influenced the effectiveness of the labelling. The results were analysed using one-factor ANOVA followed by Bonferroni post-hoc testing. This revealed a highly significant difference between the three osteogenic groups at each timepoint compared to their corresponding negative controls. However, there was no statistically significant difference between the three different tracers (MDP, DPD, HDP) in the osteogenic groups. Therefore all three tracers are of similar value when quantifying the extracellular hydroxylapatite content in osteogenic stem cells cultures.

Breastmilk is the best nutrition to reduce morbidity and mortality among infants with low birth weight (LBW). However, breastfeeding LBW infants during hospitalization is often problematic. Strategies to promote breastfeeding can be done through providing breastfeeding education and support. The purpose of this study was to identify effect of the “SATUPAS” program on breastmilk production, frequency of breastmilk expression, and partial breastfeeding. This study was a randomized controlled trial involving 82 mothers and their LBW infants, which were divided into the intervention group and the control group. Bivariate analysis using the Wilcoxon and Mann Whitney tests showed that there was a significant difference between breastmilk production (p = 0.001), frequency of breastmilk expression (p = 0.001), and partial breastfeeding (p = 0.001) between the control group and the intervention group. This study recommends the implementation of SATUPAS as a strategy to increase breastfeeding of LBW infants undergoing hospitalization.

Introduction Wound infection following burn injury can be clinically challenging to manage. Its presence in a thermally compromised patient can detrimentally affect the ability of the wound to heal leading not only to wound progression but ultimately contribute to a large part of the economic health burden expenditure in the National Health Service. Despite meticulous wound care and infection control measures the colonisation of burn wounds by bacterial pathogens has and continues to be the case. There has been a growing interest in the use of antimicrobial applications when managing localised burn wound infections due to a constantly increasing number of antibiotic-resistant organisms. Aim To survey which antimicrobial dressings are currently being used across UK burns services when managing localised pseudomonas wound infections. Methods We conducted a nationwide telephone survey of UK burns services during October 2019 to determine which topical antimicrobial agent was used to treat local pseudomonas burn wound infections. Results Six burns services (31.6%) used acetic acid-soaked dressings, one of which alternates acetic acid with sodium hypochlorite solution. Silver-based dressings were also used by six burns services (31.6%) – again, one department alternates silver-based dressings with sodium hypochlorite solution. Betadine-soaked, gauze-based dressings were used across five burns services (26.3%) and the remaining two burns services (10.5%) used sodium hypochlorite solution and non-medicated dressings respectively. Conclusion We have identified a significant difference in the UK burns services’ approach to pseudomonas burn wound infections. Our literature review demonstrates that a daily dressing regime of 2.5–3% acetic acid (AA) is a well-tolerated treatment regime in burn patients and that it is in use in UK burns services. There are no current randomised controlled trials that evaluate the usage of AA. The variation in usage suggests that there is scope for further study in order to develop evidence to generate a UK wide approach based on national standardised guidelines.

Tracheobronchoplasty (TBP) is the gold-standard treatment for severe symptomatic excessive central airway collapse; however outcomes among obese patients are unknown.A retrospective, single-center analysis was conducted on consecutive patients undergoing TBP for severe symptomatic excessive central airway collapse from 2003 to 2020. Demographics, comorbidities, functional status, and perioperative complications were collected. Functional status was assessed with a 6-minute walk test (6MWT). Health-related quality of life (HRQOL) was assessed with the St George's Respiratory Questionnaire (SGRQ), Cough-specific Quality of Life Questionnaire, and modified Medical Research Council dyspnea scale (mMRC) at baseline and postoperatively. Wilcoxon rank-sum and χ2 tests were used to compare outcomes between groups. A mixed-effects regression model compared 6MWT and HRQOL over time.One hundred three patients underwent TBP with complete follow-up data. Thirty-four patients (33%) were obese (body mass index ≥ 35 kg/m2). Baseline demographics were similar between obese and nonobese groups, but obese patients had worse preoperative SGRQ and mMRC scores. Overall complication rates were similar (52.9% vs 43.5%, P = .36). At 3 months there was no significant difference in SGRQ, Cough-specific Quality of Life Questionnaire, or 6MWT scores; however mMRC scores were higher in obese patients (P = .04). At 12 months there was no significant difference in SGRQ, Cough-specific Quality of Life Questionnaire, mMRC, or 6MWT scores. Correcting for age, sex, and Charlson Comorbidity Index a mixed-effects regression model demonstrated obesity was not an independent predictor for lower 6MWT scores or HRQOL.Obese patients achieve similar improvement in HRQOL and functional capacity with comparable morbidity after TBP as nonobese patients. Obesity should not preclude patients with severe symptomatic excessive central airway collapse from TBP.

The COVID-19 has led to home quarantine in global scale, which increased people's need for indoor fitness activities in order to relieve stress/anxiety and learn knowledge well during the prevention. In this paper, an augmented reality (AR) indoor exergame is developed, mainly a kind of moving target hitting task with Lomachenko's headwear speedball as the prototype. Then, a comparative experiment is performed to test the effect of the exergame in relieving anxiety, as well as the differences between AR and VR modes (using HTC Vive Pro) on user experience (flow experience and motion sickness) and interaction efficiency. Results from twenty-eight participants show that the anxiety level of participants significantly reduced after using the exergame. Although the difference on flow experience is not significant, there is a marginally significant difference on nausea level, a dimension of motion sickness. Moreover, interaction efficiency between the two modes is significantly different. In the task of moving target hitting, AR mode performed better in avoiding motion sickness and improving interaction performance. IEEE

© 2021 Elsevier Masson SASThe aim of this study is to investigate and compare the changes in psychosocial status, self-esteem, and quality of life in patients treated with conventional and SF approaches. 14 patients (mean age 23.04±3.36; 9 male and 5 female) who met the inclusion criteria were included in the SF group; 18 patients with class III malocclusion (mean age 29.27±3.78; 9 male and 9 female) were included in the COS group. In the research protocol, the first questionnaires were carried out 2 weeks before surgery (T0); second survey approximately 4 weeks after surgery (T1); and the third one was done to patients after the treatment was completed (debonding) (T2). In our study, Orthognathic Quality of Life Questionnaire (OQLQ), Pyschosocial Impact of Dental Aesthetics Questionnaire (PIDAQ), Oral Health Impact Profile (OHIP-14), Beck Depression Inventory second edition (BDI-II) and Rosenberg Self-Esteem Scale (RSES), surveys were conducted. No statistically significant difference was observed in all of the PIDAQ parameters and most of the OQLQ parameters within the COS and SF groups (P>0.05). When the BDI-II results were examined, different trends in scores were observed between the two groups, and this difference was found to be statistically significant (P

Adolescent smoking behavior is a behavior that endangers health, but there are still many teenagers who become smokers who started when they were teenagers or at the age of 11 years, especially teenage boys who often did this action. The use of appropriate media can affect the knowledge of respondents. In general, this study aims to determine the effect of social media intervention (whatsapp) with flyers on changes in adolescent smoking behavior during the COVID-19 pandemic in Tomado Village, Lindu District, Sigi Regency, Central Sulawesi. And specifically, the research objective was to determine the effect of social media intervention (whatsapp) with flyers on smoking knowledge, smoking frequency, changes in smoking attitudes, and adolescent motivation to quit smoking. This type of research is a quasi-experimental design with a pretest-posttest two group design. The research sample used purposive sampling method and obtained a sample of 40 people. The instrument of this research used questionnaires, observation sheets, pretest and posttest questionnaires, and media flyers. Analysis of research data using a comparative test, namely Paired sample t-test, and Independent t-test. The results showed that there was a significant difference in respondents' knowledge about the dangers of smoking in the intervention group, while in the control group it was found that there was no significant difference in respondents' knowledge; there was a significant difference in the frequency of adolescent smoking in the intervention group and the control group; there is a significant difference in adolescent smoking attitudes in the intervention group and the control group; there was a significant difference in motivation to quit smoking in the intervention group and the control group.

Objectives: There have been a number of controversies about which treatment of neuromuscular electrical stimulation (NMES) is more beneficial for overactive bladder (OAB) . An attempt to investigate the therapeutic effect of NMES with different pulse widths for OAB in elderly women has been made in this study. Material and methods: The postmenopausal elderly women without pelvic organ prolapse (POP) who received transvaginal NMES in Beijing Hospital from November 2020 to December 2020 were randomly divided into two groups (Group A and Group B). Patients from Group A accepted the treatment with NMES by pulse width of 300 µs and patients from Group B accepted the treatment with NMES by pulse width of 200 µs. Myoelectric potential of Type I and Type II muscle fibers at pelvic floor and overactive bladder symptom score (OABSS) were valued. Results: There were 46 patients eligible for the study and randomly divided into Group A and Group B, 23 patients for each group. OABSS were significantly reduced in both groups after the treatment of NEMS. And OABSS in Group A (after treated by pulse width of 300 µs) were significantly decreased greater than those in Group B (after treated with pulse width of 200 µs). Both Group A and Group B had no significant difference in the mean myoelectric potential at pre-resting state when compared before and after the treatment of NEMS. Myoelectric potential of TypeⅠmuscle fiber and the maximum myoelectric potential of TypeⅡmuscle fibers were significantly increased after the treatment of NEMS than before the treatment in the two groups, respectively. And myoelectric potential of TypeⅠmuscle fiber and the maximum myoelectric potential of TypeⅡmuscle fibers in group A (after treated with pulse width of 300 µs) were increased significantly much higher than those in Group B (after treated with pulse width of 200 µs). Conclusions: Comparing the indicators before and after the treatments of NMES, our study has preliminarily confirmed that NMES has its advantages in treating with OAB. And NMES by pulse width of 300µs were more effective in improving pelvic floor muscle strength than NMES by pulse width of 200µs.

Objectives: This study aimed to determine the effects of happiness training on the psychological well-being of thalassaemia major (TM) patients. TM is a chronic haematological disease that can have profound effects on patients’ mental health and psychological well-being. Methods: This quasi-experimental study with a pre/post-test design was performed on 52 patients with TM attending the thalassaemia care centre of Imam Khomeini Hospital in Zabol city, Iran, from August to December 2020. The patients were randomly categorised into experimental and control groups. In the experimental group, happiness training was performed in eight sessions, each for 60 minutes. The control group received routine care. The data collection tool employed was the Ryff’s Scale of Psychological Well-Being. Data were analysed by SPSS 16 using descriptive (mean ± standard deviation) and inferential (paired and independent t-test) statistics. Results: Regarding the psychological well-being score at the pre-test stage, there was no statistically significant difference between the intervention (74.92 ± 6.36) and control (74.57 ± 5.83) groups (P = 0.83). After the intervention, however, a statistically significant difference was observed between the two groups in terms of psychological well-being (P

Background: Piriform aperture is anterior opening of the nasal cavity formed by bones of the viscerocranium and knowledge about differences between genders is important for forensic scientists, anthropologists, orthopedists, neurosurgeons and vascular surgeons. The aim of this study was to examine gender differences of piriform aperture on 3D models of human skulls originating from Bosnian population using the geometric morphometric method. Materials and methods: The study was conducted on 211 3D models of human skulls of known gender. 3D models were obtained by laser scanning. We analyzed the gender differences of piriform aperture using geometric morphometrics method. On 3D models we marked four landmarks on piriform aperture in the Landmark editor program, after which we analyzed its gender differences in MorphoJ program. Results: The first PCA axis described 40.398% of total variability of piriform aperture. The greatest gender variability was present in the position of the landmark rhinion. Discriminant functional analysis of the shape and size of the piriform aperture allowed the gender determination with 64.03% accuracy for male and 70.83% accuracy for female gender. The size of the piriform aperture showed a statistically significant difference between genders. Discriminant functional analysis of the shape of the piriform aperture without affecting size enabled gender determination with 59.71% accuracy for male and 62.5% accuracy for female. Conclusions: Analysis showed statistically significant differences in the shape and size of piriform aperture between genders. The accuracy for gender determination based on piriform aperture was higher in females.