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To assess the efficacy of the metal artifact reduction algorithm (MARA) of the Cranex 3D cone beam computed tomography (CBCT) device in the detection of peri-implant dehiscence and fenestration around zirconia implants. In total, 60 implants were placed in bovine ribs. Dehiscence and fenestration defects were created around the implants, after which 60 CBCT images were obtained with and 60 without activation of MARA. Three radiologists examined the images for the presence of defects. The area under the curve (AUC) from receiver operating characteristic analysis, sensitivity, and specificity were calculated to assess the ability to discriminate the presence vs absence of bone defects. One-way analysis of variance was employed to analyze outcome measures. The significance level was established at 5% (α = 0.05). AUC values indicated excellent discrimination of dehiscence on images with MARA activation and an excellent to outstanding range of discrimination with MARA deactivation. For fenestration, MARA activation and deactivation both led to outstanding discrimination. Sensitivity and specificity values revealed that activation of MARA was helpful in distinguishing the presence vs. absence of dehiscence, while both MARA conditions were helpful for fenestration. However, there were no statistically significant differences between MARA activation and deactivation for any outcome measure (P >.05). CBCT is suitable for detecting peri-implant defects, but MARA application does not significantly affect peri-implant dehiscence and fenestration detection. [ABSTRACT FROM AUTHOR]

Background Epistemic Network Analysis (ENA) is a technique for modeling and comparing the structure of connections between elements in coded data. We hypothesized that connections among team discourse elements as modeled by ENA would predict the quality of team performance in trauma simulation. Methods The Modified Non-technical Skills Scale for Trauma (T-NOTECHS) was used to score a simulation-based trauma team resuscitation. Sixteen teams of 5 trainees participated. Dialogue was coded using Verbal Response Modes (VRM), a speech classification system. ENA was used to model the connections between VRM codes. ENA models of teams with lesser T-NOTECHS scores ( n  = 9, mean = 16.98, standard deviation [SD] = 1.45) were compared with models of teams with greater T-NOTECHS scores ( n  = 7, mean = 21.02, SD = 1.09). Results Teams had different patterns of connections among VRM speech form codes with regard to connections among questions and edifications (meanHIGH = 0.115, meanLOW = −0.089; t  = 2.21; P  = .046, Cohen d = 1.021). Greater-scoring groups had stronger connections between stating information and providing acknowledgments, confirmation, or advising. Lesser-scoring groups had a stronger connection between asking questions and stating information. Discourse data suggest that this pattern reflected increased uncertainty. Lesser-scoring groups also had stronger connections from edifications to disclosures (revealing thoughts, feelings, and intentions) and interpretations (explaining, judging, and evaluating the behavior of others). Conclusion ENA is a novel and valid method to assess communication among trauma teams. Differences in communication among higher- and lower-performing teams appear to result from the ways teams use questions. ENA allowed us to identify targets for improvement related to the use of questions and stating information by team members. [ABSTRACT FROM AUTHOR]

The object of this review was to determine the incidence, morbidity, and mortality of an umbilical arterial pH < 7.0; the incidence of hypoxic-ischemic encephalopathy; and the proportion of cerebral palsy associated with intrapartum hypoxia-ischemia in nonanomalous term infants. A systematic review of the English language literature on the association between intrapartum hypoxia-ischemia and neonatal encephalopathy was conducted by using Pubmed and Embase. For nonanomalous term infants, the incidence of an umbilical arterial pH < 7.0 at birth is 3.7 of 1000, of which 51 of 297 (17.2%) survived with neonatal neurologic morbidity, 45 of 276 (16.3%) had seizures, and 24 of 407 (5.9%) died during the neonatal period. The incidence of neonatal neurologic morbidity and mortality for term infants born with cord pH < 7.0 was 23.1%. The incidence of hypoxic-ischemic encephalopathy is 2.5 of 1000 live births. The proportion of cerebral palsy associated with intrapartum hypoxia-ischemia is 14.5%. The vast majority of cases of cerebral palsy in nonanomalous term infants are not associated with intrapartum hypoxia-ischemia. [Copyright &y& Elsevier]

Steviol glycosides are fully deglycosylated to steviol in the presence of bacterial populations that were isolated from different soil samples. Heating (20 min at 80 °C) or boiling (10 min at 100 °C) of soils had little effect on the steviol formation. It is suggested that bacteria that survived with highly resistant spores are responsible for the deglycosylation of steviol glycosides. A bio-organic preparation method for steviol was developed which had a total yield of 90%. Beside deglycosylation, other reactions also occur. The steviol formed can be degraded. Under anaerobic conditions, rebaudioside A was not hydrolyzed while stevioside was degraded to steviol via rubusoside. Moreover, after an extended incubation (4 weeks) and repetitive sub-cultivation, a bacterial community was selected that converted steviol glycosides to a new and unknown ketone, given the nickname Monicanone. It appeared to be the steviol nucleus without the A-ring that underwent a Walden inversion at its original C-10. A second and related unknown compound could be isolated from an impure preparation of Monicanone by chromatographic separation and purification; this compound was a reduced form of Monicanone and named Monicanol. Steviol glycosides that were incubated with a UASB effluent of an industrial wastewater treatment system – supplemented or not – with sludge of a lab scale nitrification or denitrification unit – were completely degraded via steviol and Monicanone. [Display omitted] • Steviol glycosides (SG) were initially hydrolyzed to steviol by soil samples. • Steviol was fully degraded by extension of the incubation period. • In anaerobic conditions, the deglycosylation pathway was different. • SG were converted to Monicanone by a specific bacterial consortium. • SG were fully degraded via steviol and Monicanone by a sample of an UASB effluent. [ABSTRACT FROM AUTHOR]