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Summary Objective This study aimed to assess the relationship of the anteroposterior position of maxillary central incisors with the forehead in an Iranian subpopulation residing in Kermanshah city. Materials and methods In this cross-sectional study, 12 orthodontists were requested to analyse full-smile profile photographs with complete maxillary incisor and forehead show in 70 patients with optimal facial harmony (35 males and 35 females) as the control group and 140 patients without optimal facial harmony (70 males and 70 females) as the test group. The inclusion criteria were (I) males and females between 18–60 years seeking orthodontic treatment and (II) willingness for participation in the study. The exclusion criteria were (I) presence of severe craniofacial anomalies, and (II) history of orthodontic treatment. The photographs were traced and analysed using Digimizer Image Analysis software 5.3.5. Data were analysed using STATA version 14.2 via independent t-test and linear regression. Results A significant difference existed in the anteroposterior position of maxillary incisors in males between the test and control groups (P = 0.002). However, this difference was not significant in females of the two groups (P = 0.77). A significant difference was noted in the anteroposterior position of maxillary incisors between males and females in the test group (P = 0.001) but not in the control group (P = 0.80). The frontal angle had a significant correlation with gender and anteroposterior position of maxillary incisors in both groups (P Conclusions According to the results, the anteroposterior position of maxillary incisors was significantly different in the test and control groups. The maxillary incisors in males were more retruded than in females. Also, the frontal angle had a significant correlation with the anteroposterior position of maxillary incisors, and by 1° increase in the frontal angle, the incisors were protruded by averagely 0.307 mm.

No prospective studies have investigated if repeated testing of physical performance and body composition are associated with exercise attendance or patterns in fitness club members. This study aimed to investigate if repeated physical testing was associated with exercise attendance and patterns in gym members and to report prospective data on use of the fitness club`s facilities and products. Untrained new members were recruited and divided into a test group (n = 125) and as controls (n = 125). All participants answered a survey including exercise involvement, at onset, and after 3, 6, and 12 months follow-up. The test group also measured body composition, maximal oxygen uptake, and maximal muscle strength (onset, and after 3 and 12 months). In total 73.6% answered all surveys, and in the test group, 44.8% completed all physical tests. Regular exercise attendance was defined as ≥2 sessions/week. Repeated testing showed no association with long-term regular exercise attendance (test group: 19.6%, controls: 19.8%; p = 0.638). At 3 months, a lower proportion in the test group reported engagement in resistance exercise (35.3% and 60.2%; p = 0.003) and had lower exercise frequency (2.0 and 2.6 days/week; p = 0.008) than controls. The test group had higher participation in group exercise classes (28.0% and 13.6%; p = 0.040). Exercise frequency decreased from onset to 12 months (from 2.6 to 2.2 days/week; p = 0.025) At 3, 6, and 12 months, 51.8%, 37.6%, and 37.4% reported regular exercise attendance, and 16.9% at all follow-ups. At all time-points, most common workout mode was individual resistance exercise (43.8% to 46.3%). Few attended group exercise classes (7.5% to 13.8%) or used a personal trainer (22.5% to 27.5%). Repeated physical testing did not improve exercise attendance, and we found no changes in members` use of the fitness club`s facilities and products. Only 16.9% reported regular exercise attendance throughout the first year of membership.

To construct a machine learning algorithm model of lymph node metastasis (LNM) in patients with poorly differentiated-type intramucosal gastric cancer. 1169 patients with postoperative gastric cancer were divided into a training group and a test group at a ratio of 7:3. The model for lymph node metastasis was established with python machine learning. The Gbdt algorithm in the machine learning results finds that number of resected nodes, lymphovascular invasion and tumor size are the primary 3 factors that account for the weight of LNM. Effect of the LNM model of PDC gastric cancer patients in the training group: Among the 7 algorithm models, the highest accuracy rate was that of GBDT (0.955); The AUC values for the 7 algorithms were, from high to low, XGB (0.881), RF (0.802), GBDT (0.798), LR (0.778), XGB + LR (0.739), RF + LR (0.691) and GBDT + LR (0.626). Results of the LNM model of PDC gastric cancer patients in test group : Among the 7 algorithmic models, XGB had the highest accuracy rate (0.952); Among the 7 algorithms, the AUC values, from high to low, were GBDT (0.788), RF (0.765), XGB (0.762), LR (0.750), RF + LR (0.678), GBDT + LR (0.650) and XGB + LR (0.619). Single machine learning algorithm can predict LNM in poorly differentiated-type intramucosal gastric cancer, but fusion algorithm can not improve the effect of machine learning in predicting LNM.

Background: Anxiety is a common complaint of patients before diagnostic or therapeutic invasive procedures, especially before open-heart surgery. The most well-known method to reduce anxiety is the use of sedatives, which have pronounced side effects. Objectives: The purpose of this study was to determine the effect of acupressure on anxiety in patients undergoing open-heart surgery. Method: This is a randomized clinical trial study conducted on 90 patients who were candidates for open-heart surgery. The patients were randomly assigned into either intervention or control groups. Acupressure intervention was applied at three real acupoints over two consecutive days in the intervention group. The control group received acupressure on sham points. We used Spielberger State-Trait Anxiety Inventory to assess anxiety in our study. Results: The results showed that before acupressure, there was no statistically significant difference between state anxiety scores and intergroup traits, and this difference was only significant in state anxiety after the second intervention. State and trait anxiety were significant before and after the intervention in the test group, respectively include (p < 0.001) (p = 0.01), but these changes in the control group did not show a statistically significant difference. After completing the second phase of the intervention at the actual sites, systolic blood pressure (p = 0.007) and heart rate (p = 0.001) decreased significantly. However, acupressure did not have a significant effect on diastolic blood pressure in any of the groups. Conclusion: Based on the results of this study, the application of acupressure in patients who are candidates for open-heart surgery can reduce their state anxiety. Further larger-scale and rigorous studies are warranted.

The literature comprehensively analyzed alternative splicing (AS) events in colon cancer is little and corresponding prognostic signature is still a lack. Based on data of TCGA, the relapse-associated ASs were comprehensively analyzed and a signature was further constructed to predict the relapse in I–III colon cancer. In total 1912 ASs of 1384 mRNA were identified as relapse-associated ASs, protein-protein interactions (PPI) and ASs-splicing factors (SF) interactions network were identified. We finally built a robust signature to predict the relapse of I–III colon cancer with a considerable AUC value in both the training group and the test group. The AUC in the entire set at 1, 3 and 5 year was 0.85, 0.83 and 0.836. Our study provided a profile of relapse-associated ASs in I–III colon cancer and built a robust signature to predict the relapse of I–III colon cancer.

OBJECTIVE To explore the value of magnetic resonance imaging (MRI)-based whole tumor texture analysis in differentiating borderline epithelial ovarian tumors (BEOTs) from FIGO stage I/II malignant epithelial ovarian tumors (MEOTs). MATERIALS AND METHODS A total of 88 patients with histopathologically confirmed ovarian epithelial tumors after surgical resection, including 30 BEOT and 58 MEOT patients, were divided into a training group (n = 62) and a test group (n = 26). The clinical and conventional MRI features were retrospectively reviewed. The texture features of tumors, based on T2-weighted imaging, diffusion-weighted imaging, and contrast-enhanced T1-weighted imaging, were extracted using MaZda software and the three top weighted texture features were selected by using the Random Forest algorithm. A non-texture logistic regression model in the training group was built to include those clinical and conventional MRI variables with p value < 0.10. Subsequently, a combined model integrating non-texture information and texture features was built for the training group. The model, evaluated using patients in the training group, was then applied to patients in the test group. Finally, receiver operating characteristic (ROC) curves were used to assess the diagnostic performance of the models. RESULTS The combined model showed superior performance in categorizing BEOTs and MEOTs (sensitivity, 92.5%; specificity, 86.4%; accuracy, 90.3%; area under the ROC curve [AUC], 0.962) than the non-texture model (sensitivity, 78.3%; specificity, 84.6%; accuracy, 82.3%; AUC, 0.818). The AUCs were statistically different (p value = 0.038). In the test group, the AUCs, sensitivity, specificity, and accuracy were 0.840, 73.3%, 90.1%, and 80.8% when the non-texture model was used and 0.896, 75.0%, 94.0%, and 88.5% when the combined model was used. CONCLUSION MRI-based texture features combined with clinical and conventional MRI features may assist in differentitating between BEOT and FIGO stage I/II MEOT patients.

Aim: The present study aimed to investigate the effectiveness of PRF in the treatment of infrabony defects in patients with chronic periodontitis by evaluating the clinical outcome through periodontal depth, clinical attachment level at the baseline, 6 and 9 months post operatively. Material and Methods: Sixty infrabony defects with probing depth ≥ 5 mm were treated. The inclusion criterion was the necessity for surgical bilateral maxillary treatment. By using split-mouth study design, each patient had one side treated with conventional flap surgery and the other side with conventional flap surgery and PRF. Clinical parameters, such as probing depth (PD) and clinical attachment lost (CAL), were recorded in both groups at baseline, 6 and 9 months post operatively. Results: Positive effects for all clinical and radiographic parameters were evident in the group with PRF. Mean PD reduction demonstrated statistically significant greater results in the test group (4.00±1.07 mm) compared to the control one (4.83±0.99 mm), p = 0.003 after 9 months postoperatively. After 9 months, there were better results in the test group compared to the control group for CAL (5.60±1.61 mm, 6.20±1.58 mm), but statistically not significant. Conclusion: Additional use of PRF in the conventional surgical treatment of infrabony defects demonstrated better parameters than the open flap debridement alone.

Objectives The objective of the present study was to examine the influence of a combination material of a collagen cone and a collagen membrane on the healing process of extraction sockets with regard to histological, histochemical, and immunohistochemical parameters. Materials and methods In a prospective randomized clinical study, 10 patients (test group) received a collagen combination material after tooth removal. The extraction sockets of 10 other patients (control group) were left to heal without further intervention. Eleven ±1 weeks after tooth extraction, histological biopsies were performed in both groups at the time of implant placement. Subsequently, the biopsies were evaluated semiquantitatively in terms of histological, histochemical, and immunohistochemical parameters for the identification of factors of bone metabolism and vascularization. Results No significant difference between test and control group were found for any parameter. According to the descriptive data, the use of a collagen combination material seems to result in slightly higher values of the osteogenic Runt‐related transcription factor 2 (Runx2) and vascularization. Conclusion The histological, histochemical, and immunohistochemical analysis of ARP with a collagen cone combined with a collagen membrane showed no significant differences in terms of bone metabolism and vascularization.

Purpose The purpose of this investigation was to compare quality of chewing in children with CP to the healthy controls, and determine whether the functional capacity of chewing units and overall dental health affect the quality of chewing. Methods A total of 86 were included in the investigation: 43 children with CP and 43 controls (13 girls aged 7–16 years and 30 boys aged 9–16 years) residents of the institutions for the children with special needs. Control group included the same number of children matched by age and gender for every child from the test group according to the pairing principle. The number of functional masticatory units was expressed through the number of healthy teeth and teeth with cavities which the patients could use for chewing. Masticatory efficiency assessment was determined by the method of chewed almond transparency after ten chewing cycles. The particles were passed through 12 sieves with diameter range from 0.6 to 7.2 mm. The masticatory efficiency was expressed with the number of sieves needed to pass 50% of the total almond mass. Results Healthy children had significantly more teeth in occlusal contact, while the DMF index did not differ significantly. Both groups had the same number of functional masticatory units. Children with CP had significantly poorer quality of chewing. Conclusion Children with CP had significantly poorer quality of chewing which is not affected by tooth functionality, but rather the primary condition.

Each year in the US more than 300,000 older adults suffer from hip fractures. While protective measures exist, identification of those at greatest risk by DXA scanning has proved inadequate. This study proposed a new technique to enhance hip fracture risk prediction by accounting for many contributing factors to the strength of the proximal femur. Twenty-two isolated cadaveric femurs were DXA scanned, 16 of which had been mechanically tested to failure. A function consisting of the calculated modes from the statistical shape and appearance modeling (to consider the shape and BMD distribution), homogeneity index (representing trabecular quality), BMD, age and sex of the donor was created in a training set and used to predict the fracture load in a test group. To classify patients as "high risk" or "low risk", fracture load thresholds were investigated. Hip fracture load estimation was significantly enhanced using the new technique in comparison to using t-score or BMD alone (average R² of 0.68, 0.32, and 0.50, respectively) (P 0.05). Using a fracture cut-off of 3400 N correctly predicted risk in 94% of specimens, a substantial improvement over t-score classification (38%). Ultimately, by identifying patients at high risk more accurately, devastating hip fractures can be prevented through applying protective measures.

The Palatal Rugae are considered a useful human identification marker for both orthodontists and forensic personnel. The principal aim of the present study was to evaluate the stability of palatal rugae with a 3D-3D superimposition procedure following Slow Maxillary Expansion (SME), in order to assess whether they kept their uniqueness and validity for human identification, even after a specific dental treatment. For this purpose, a sample of 27 digital dental models - belonging to growing patients (13 males and 14 females), aged between 8.5 and 15 years, who underwent SME therapy - was retrospectively studied and compared with a control group of 27 untreated subjects - (13 males and 14 females). Digital dental models were obtained pre-treatment and at device removal; both were processed by means of an intraoral scanner. A superimposition procedure was thus performed to reach the minimum point-to-point distance between two models of palatal rugae. Intra- and inter-observer differences were statistically analyzed by paired Wilcoxon test and Intra-class Correlation coefficient (ICC), showing values larger than 0.93. There was no difference in Root-Mean-Square (RMS) values between untreated control subjects and subjects treated with Leaf Expander (p = 0.062). A RMS value of 0.43 was the threshold to distinguish the pooled group (“Untreated” and “Leaf”) from any mismatch. According to the obtained results, this study failed to reject the null hypothesis and presented no differences between the RMS values of the Test group and the RMS values of the untreated control group. This work highlighted the usefulness of 3D superimposition procedure for purposes of human identification, in subjects undergoing dental treatment. However, keeping in sight the forensic use of this technique as a helpful probation element in court, further studies should be performed to confirm these findings.

Background Immediate implants have shown risks of esthetic complications. The hypothesis was that a customized healing abutment could improve the peri-implant tissue healing. Purpose To evaluate and compare the soft and hard tissue healing around immediate implants that received bone grafting and a customized vs a standard healing abutment. Materials and methods Patients, who required tooth extraction and who received an immediate implant (with an alloplastic graft material) were randomly assigned to a customized or a standard healing abutment group. Clinical and radiographic examinations were taken at baseline, at 4 and 12 months. Results Twenty-five patients out of 61 were excluded from the study because unsuitable for immediate implantation. In total, 36 patients were randomized in the two groups. There were 17 females and 19 males (age range 23-77). No prosthetic or implant failure was registered during the study period. The Papilla Index was significantly higher in the customized than in the standard group at 4 and 12 months (P = .0002). The bone loss at mesial sites was significantly higher in the control than in the test group (P = .0014). Conclusion The customized healing abutment group showed the most favorable outcomes (in terms of PI and MBL) in case of immediate implant that received a peri-implant bone grafting procedure.

This study was conducted to evaluate the effect of maternal exposure to TiO2 nanoparticles on the pain response in offspring mice. 30 female mice with a mean ± SD weight of 30 ± 5 g were randomly divided into three groups: the control group (group 1) received only the basal diet; the sham group (group 2) received saline plus as a carrier (100 μL/mice) subcutaneously on days 3, 7, 10, and 14 post-mating; and the test group (group 3) received 100 μL/mice TNPs subcutaneously on days 3, 7, 10, and 14 post-mating. Offspring were divided into 6 groups 21 days after birth and underwent formalin test. Blood samples were taken to evaluate possible oxidative changes in total antioxidant capacity (TAC) and malondialdehyde (MDA). Exposure to TNPs significantly ( p < 0.05) decreased pain perception. Except for a significant difference between the sham group and the control group, MDA and TAC were not significantly different among the studied groups. Injection of TNPs to pregnant mice would affect the pain perception in their offspring. This may be attributable to the ability of these particles to pass through the placenta to produce free radicals.

Objective. To explore the image enhancement model based on deep learning on the effect of ureteroscopy with double J tube placement and drainage on ureteral stones during pregnancy. We compare the clinical effect of ureteroscopy with double J tube placement on pregnancy complicated with ureteral stones and use medical imaging to diagnose the patient’s condition and design a treatment plan. Methods. The image enhancement model is constructed using deep learning and implemented for quality improvement in terms of image clarity. In the way, the relationship of the media transmittance and the image with blurring artifacts was established, and the model can estimate the ureteral stone predicted map of each region. Firstly, we proposed the evolution-based detail enhancement method. Then, the feature extraction network is used to capture blurring artifact-related features. Finally, the regression subnetwork is used to predict the media transmittance in the local area. Eighty pregnant patients with ureteral calculi treated in our hospital were selected as the research object and were divided into a test group and a control group according to the random number table method, 40 cases in each group. The test group underwent ureteroscopy double J tube placement, and the control group underwent ureteroscopy lithotripsy. Combined with the ultrasound scan results of the patients before and after the operation, the operation time, time to get out of bed, and hospitalization time of the two groups of patients were compared. The operation success rate and the incidence of complications within 1 month after surgery were counted in the two groups of patients. Results. We are able to improve the quality of the images prior to medical diagnosis. The total effective rate of the observation group was 100.0%, which is higher than that of the control group (90.0%). The difference between the two groups was statistically significant ( P < 0.05 ). The adverse reaction rate in the observation group was 5.0%, which was lower than 17.5% in the control group. The difference between the two groups was statistically significant ( P < 0.05 ). The comparison results are then prepared. Conclusions. The image enhancement model based on deep learning is able to improve medical diagnosis which can assist radiologists to better locate the ureteral stones. Based on our method, double J tube placement under ureteroscopy has a significant effect on the treatment of ureteral stones during pregnancy, and it has good safety and is worthy of widespread application.

The δ13C value of blood is a novel proposed biomarker of added sugars (AS) intake. AS prediction equations using either a single- (δ13C) or dual-isotope model (δ13C and δ15N) were previously developed in an adult population with high AS intake living in southwest Virginia (reference group). The purpose of this investigation was to test the δ13C single- and δ13C and δ15N dual-isotope prediction equations for AS intake in adults with a lower mean AS intake and different demographic characteristics (test group). The blood samples for the reference (n = 257 for single-isotope, n = 115 for dual-isotope) and test groups (n = 56) were analyzed for δ13C and δ15N values using natural abundance stable isotope mass spectrometry and were compared to reported dietary AS intake. When the δ13C single-isotope equation was applied to the test group, predicted AS intake was not significantly different from reported AS intake (mean difference ± standard error = −3.6 ± 5.5 g, Z = −0.55, p = 0.51). When testing the dual-isotope equation, predicted AS was different from reported AS intake (mean difference ± SEM = 13.0 ± 5.4 g, Z = −2.95, p = 0.003). δ13C value was able to predict AS intake using a blood sample within this population subset. The single-isotope prediction equation may be an alternative method to assess AS intake and is more objective, cost-feasible, and efficient than traditional dietary assessment methods. However, more research is needed to assess this biomarker with rigorous study designs such as controlled feeding.

Background and Purpose. This study established a suitable animal model of ovariohysterectomy; characterized the course and pattern of vaginal healing after ovariohysterectomy; and compared healing obtained after closure of the vaginal cuff with a novel cuff-closure device (Zip-stitch® clips) and VICRYL® sutures. Research Design and Study Sample. This prospective, randomized, controlled, blinded animal study was conducted in 27 mongrel hounds according to an IACUC-approved protocol. Each animal underwent ovariohysterectomy followed by vaginal cuff closure with Zip-stitch or VICRYL. At two or six weeks, animals were sacrificed for gross and histological analysis. Data Collection. The primary endpoint was the difference in the fraction of vaginal cuff healed six weeks after application of the closure device. Secondary endpoints included histopathologic cellular and tissue responses, including inflammation, necrosis, infection, and vascular and muscle changes. Results. In the test group, there were two distinct locations where fibrotic or granular tissue fusion between the anterior and posterior vaginal walls was observed: in tissue “captured” by a clip or in tissue around the clip. The fraction of the vaginal cuff healed was similar in animals treated with Zip-stitch clips and those treated with sutures at six weeks (68±10% vs 67±18%; P=.148, test for non-inferiority) after surgery. The test article performed similarly or better than the control article in terms of the intensity or extent of the secondary endpoints. Conclusions. Subject to further confirmation, this study supports Zip-stitch clips as a method to maintain immediate post-operative approximation of the vaginal cuff leading to healing but did not achieve statistical significance in its primary endpoint.

Background The main cause of cancer death is lung cancer (LC) which usually presents at an advanced stage, but its early detection would increase the benefits of treatment. Blood is particularly favored in clinical research given the possibility of using it for relatively noninvasive analyses. Copy number variation (CNV) is a common genetic change in tumor genomes, and many studies have indicated that CNV-derived cell-free DNA (cfDNA) from plasma could be feasible as a biomarker for cancer diagnosis. Methods In this study, we determined the possibility of using chromosomal arm-level CNV from cfDNA as a biomarker for lung cancer diagnosis in a small cohort of 40 patients and 41 healthy controls. Arm-level CNV distributions were analyzed based on z score, and the machine-learning algorithm Extreme Gradient Boosting (XGBoost) was applied for cancer prediction. Results The results showed that amplifications tended to emerge on chromosomes 3q, 8q, 12p, and 7q. Deletions were frequently detected on chromosomes 22q, 3p, 5q, 16q, 10q, and 15q. Upon applying a trained XGBoost classifier, specificity and sensitivity of 100% were finally achieved in the test group (12 patients and 13 healthy controls). In addition, five-fold cross-validation proved the stability of the model. Finally, our results suggested that the integration of four arm-level CNVs and the concentration of cfDNA into the trained XGBoost classifier provides a potential method for detecting lung cancer. Conclusion Our results suggested that the integration of four arm-level CNVs and the concentration from of cfDNA integrated withinto the trained XGBoost classifier could become provides a potentially method for detecting lung cancer detection. Key points Significant findings of the study: Healthy individuals have different arm-level CNV profiles from cancer patients. Amplifications tend to emerge on chromosome 3q, 8q, 12p, 7q and deletions tend to emerge on chromosome 22q, 3p, 5q, 16q, 10q, 15q. What this study adds CfDNA concentration, arm 10q, 3q, 8q, 3p, and 22q are key features for prediction. Trained XGBoost classifier is a potential method for lung cancer detection.

In this study, a prototype artificial neural network model (ANN) was used to estimate the stone passage rate and to determine the effectivity of predictive factors on this rate in patients with ureteral stones. The retrospective study included a total of 192 patients with ureteral stones, comprising 128 (66.7%) men and 64 (33.3%) women. Patients were divided into two groups. Group 1 (n: 125) consisted of people who spontaneously passed their stones, Group 2 (n: 67) consisted of people who could not pass stones spontaneously. The groups were compared with regard to the relationship between input data and stone passage rate by using both ANN and standard statistical tests. To implement the ANN, the patients were randomly divided into three groups: (a) training group (n = 132), (b) validation group (n = 30), and (c) test group (n = 30). The accuracy rate of ANN in the estimation of the stone passage ratio was 99.1% in the group a, 89.9% in the group b, and 87.3% in the group c. It was revealed that certain criteria (stone size, body weight, pain score, ESR, and CRP) were relatively more significant for saving treatment cost and time and for avoiding unnecessary treatment. ANN can be highly useful for the avoidance of unnecessary interventions in patients with ureteral stones as it showed remarkably high performance in the estimation of stone passage rate (99.16%).

Objective: Evaluation of the potential of combined multivariate chemometric methods for seeking markers of lung cancer. Methods: Statistical methods such as Mann-Whitney U test, discriminant function analysis (DFA), factor analysis (FA) and artificial neural network (ANN) were applied to evaluate the obtained data from GC/MS analysis of exhaled breath. Results: The total number of compounds identified by GC/MS in human breath was equal to 88. The statistical analysis indicates seven analytes which have the highest discriminatory power. Cross validation of the obtained model shows that the sensitivity was 80% and the specificity was 91.23%, while for the test group the sensitivity and specificity were both 86.36%. Conclusion: The application of combined statistical methods allowed to reduce the number of compounds to significant ones and indicates them as markers of lung cancer.

Dual localization of SLN in breast cancer patients using isotope & dye is the best-approved modality with limitations such as high cost of radioactive materials, complex logistic preparations & scheduling issues, especially in developing countries. We investigated the feasibility & accuracy of a novel technique for SLN localization using silver wire insertion or liquid charcoal injection guided by CT lymphography. 120 patients with clinically node-negative breast cancer were enrolled. In the test group, SLN was localized using preoperative CTLG guided injection of liquid charcoal or by placing a 3 cm silver wire. In addition, intraoperative SLN mapping was performed using methylene blue dye followed by searching for the SLN localized by both methods. In the control group, SLN was localized by the blue dye only. Feasibility, accuracy, detection rates, and number of SLNs retrieved were reported as well as matching between the LN detected with the CTLG and that detected with the dye technique. SLN could be detected in 59 out of 60 patients (98.3%) in the test group and in 54 out of 60 patients (90%) in the control group (P = .057). In self-controlled analysis of the test group comparing CTLG only to dye only was significant (P = .050). Comparing charcoal to silver wire in detection was statistically insignificant (P = .5). This novel method can offer advantages which are as follows: being more accurate than the dye alone, saving operative time, abandoning complex logistic preparations for the radioisotope, and solving the problem of timing.

Estradiol production varies cyclically, changes in levels are hypothesized to affect the voice. The main objective of this study was to investigate vocal acoustic and auditory-perceptual characteristics during fluctuations in the levels of the hormone estradiol during the menstrual cycle. A total of 44 volunteers aged between 18 and 45 were selected. Of these, 27 women with regular menstrual cycles comprised the test group (TG) and 17 combined oral contraceptive users comprised the control group (CG). The study was performed in two phases. In phase 1, anamnesis was performed. Subsequently, the TG underwent blood sample collection for measurement of estradiol levels and voice recording for later acoustic and auditory-perceptual analysis. The CG underwent only voice recording. Phase 2 involved the same measurements as phase 1 for each group. Variables were evaluated using descriptive and inferential analysis to compare groups and phases and to determine relationships between variables. Voice changes were found during the menstrual cycle, and such changes were determined to be related to variations in estradiol levels. Impaired voice quality was observed to be associated with decreased levels of estradiol. The CG did not demonstrate significant vocal changes during phases 1 and 2. The TG showed significant increases in vocal parameters of roughness, tension, and instability during phase 2 (the period of low estradiol levels) when compared with the CG. Low estradiol levels were also found to be negatively correlated with the parameters of tension, instability, and jitter and positively correlated with fundamental voice frequency.

OBJECTIVES: We aimed to test the validity and test-retest reliability of the Dutch translation of the Chronic Otitis Media Benefit Inventory (COMBI) questionnaire. MATERIALS AND METHODS: In total, 30 chronic otitis media (COM) patients with a previous ear surgery completed the questionnaire; 30 patients with a negative medical history of COM complaints and with previous non-otologic surgery as the control group completed the questionnaire. For estimating the test–retest reliability, patients of the COM group completed the questionnaire twice; the scores were compared to those of the control group to test the validity. RESULTS: The overall COMBI score ranged as 32–60 in the patient test group, 32–60 in the patient retest group, and 35–40 in the control group. A mean (standard deviation) score of 43.87 (6.81) in the patient test group, 44.4 (6.83) in the patient retest group, and 36.7 (1.29) in the control group was noted. Post-intervention, the COM patients had a significantly higher absolute COMBI score compared to the control group. The diagnostic accuracy was investigated, and a cut-off score of 38.5 was found to have a high sensitivity and specificity in distinguishing a significant positive change from an insignificant change after the intervention. The average-measures intra-class correlation coefficient for absolute agreement (ICCAA) was 0.985 (95% confidence interval: 0.969–0.993), indicating an excellent test–retest reliability in the control group. CONCLUSION: The Dutch version of the COMBI questionnaire has a good validity, diagnostic accuracy, and test-retest reliability.

To evaluate the effectiveness of collagen matrix (CM) grafts as an alternative to free gingival grafts (FGGs) in increasing the zone of keratinized tissue (KT) around dental implants.Thirty subjects with 2 contralateral implants were recruited. The test group (n = 30) received CM grafts. The control group (n = 30) received FGGs. Clinical variables were plaque index, gingival index, probing depths, bleeding on probing (BOP), and mucosal recession (MR). Subjects were followed at 1 and 2 weeks and 1, 3, and 6 months.FGGs resulted in mean gains (3.73 ± 1.93 mm) in KT for 28 of 30 implants (93% success rate). CM grafts resulted in mean gains (3.23 ± 1.52 mm) in KT for 29 of the 30 implants (97% success rate). Mean change in pocket depth around implants grafted with FGG was -0.24 ± 1.02 mm and with CM was -0.25 ± 0.80 mm. Mean change in BOP around implants grafted with FGG was 0.03 ± 0.49 and with CM was 0.13 ± 0.57.CM grafts achieved results comparable to those of FGGs in augmented tissue. They do not negatively affect probing depths, MR, or bleeding on probing.

Objectives: To examine the relationship between the medium term use (>1 year) of a toothpaste containing natural enzymes and proteins (Zendium™) upon gingival index, plaque index and bleeding index compared to medium term use of toothpastes without antimicrobial/antiinflammatory ingredients. Methods: A total of 305 participants eligible for inclusion were grouped according to their toothpaste use and matched with regard to gender and age (18–30, 31–55 and 56+ years of age). A total of 161 persons were using a toothpaste which contained enzymes and proteins (Zendium™ test group), and 144 persons were using a toothpaste without these ingredients (control group). The amount of dental plaque and the gingival condition were assessed at six sites of each tooth using the modified gingival index (MGI), plaque index (Modified Quigley and Hein plaque index, PI), and bleeding index (BI). Mean values of MGI, PI and BI were compared using analysis of covariance. Results: The test group had significantly less gingival inflammation than the control group (adjusted mean scores (SD); 1.80 (0.65) vs. 2.27 (0.63),p < 0.0001), as well as lower levels of plaque (2.03 (0.33) vs. 2.12 (0.33), p = 0.0168) and gingival bleeding (0.74 (0.45) vs. 1.08 (0.45), p < 0.0001). Females had significantly less gingival inflammation (p < 0.0001), plaque (p = 0.0005) and bleeding (p = 0.0118) than males. Participants aged 18–30 years had significantly higher levels of inflammation and bleeding than the older age groups (p < 0.001), and also higher plaque levels compared to participants aged 31–55 years (p = 0.0069). Potential confounding factors including oral hygiene practices and consistency of dental visits did not differ between groups. Conclusions: Our findings indicate that medium term use of fluoride toothpaste containing enzymes and proteins (Zendium™) is associated with a better gingival health than the use of other types of fluoride toothpastes without antimicrobial active ingredients. Clinical significance: Medium term (> 1 year) use of toothpaste containing naturally occurring enzymes and proteins (Zendium™) in an unsupervised home setting is associated with better gingival health compared to the unsupervised use of other commercially available toothpastes without antimicrobial/antiinflammatory active ingredients.

Background This study aimed to verify the efficacy of two elastodontic devices in overjet (OJ) and overbite (OB) reduction during treatment with the Equilibrator Series II (Eptamed) and Occlus-o-Guide (Sweden & Martina) devices. Method Sixty patients aged 7–15 years were enrolled in the study, and were divided into test and control groups. The test group included 30 patients (14 males, 16 females; mean age, 10.66 ± 2.12 years) treated with the EQ (Equilibrator) Series II. The control group included 30 patients (15 males, 15 females; mean age, 10.76 ± 2.52 years) treated with the Occlus-o-Guide. The two groups exhibited the same orthodontic features. The orthodontic criteria were: skeletal and dental class II malocclusion (divisions 1 and 2); and the presence of OJ and OB. Evaluation of OJ and OB was performed at two timepoints: T0 (before starting therapy) and T1 (after 1 year). Results At T0, OJ and OB were similar for the two groups; however, at T1, both OJ and OB were significantly lower with the Eptamed device compared to the Occlus-o-Guide device (p = 0.0019). Conclusions Elastodontic devices improve orthodontic outcomes by aiding orthodontic patient management, diagnosis, and treatment planning, reducing the risk relapse acting on the whole organism and the rehabilitation of the tongue.

A pleasant touch reduces psychoemotional stress via the oxytocin mechanism due to its anti-inflammatory and antioxidant effects. Our research is aimed to reveal the correlations between the subjectively perceived pleasantness of touch, the antioxidant potential of saliva, and salivary oxytocin. A total of 56 healthy volunteers aged 18-38 years participated in the study. The control group consisted of 24 volunteers. The participants were subjected to tactile stimulation using a specially designed protocol. They ranked the touch pleasantness on a scale from 1 to 10. Heart rate variability and low-frequency/high-frequency ratios from the power spectral density of ECG were determined to assess psychoemotional relaxation. Salivary oxytocin and antioxidant capacity were quantified before and after the touch test. We found a significant increase in salivary antioxidant potential and oxytocin after pleasant tactile stimulation for the participants compared to the control group. The difference in antioxidant capacity values before and after the test positively correlated with mean pleasantness in the touch test (r = 0.57) and the difference in heart rate variability (r = 0.67); it negatively correlated with the difference in low-frequency/high-frequency ECG band ratio (r = -0.59). Oxytocin ratio positively correlated with the difference in antioxidant capacity values (r = 0.47). As a result of tactile stimulation, a significant increase in the antioxidant capacity of saliva and salivary oxytocin was found in the test group compared to the control group. These findings support further studies of the effects of pleasant touch on hormonal and oxidative metabolism.

Purpose: To develop an artificial intelligence (AI)-based method for the detection of focal skeleton/bone marrow uptake (BMU) in patients with Hodgkin´s lymphoma (HL) undergoing staging with FDG-PET/CT. The results of the AI in a separate test group were compared to the interpretations of independent physicians. Methods: The skeleton and bone marrow were segmented using a convolutional neural network. The training of AI was based on 153 un-treated patients. Bone uptake significantly higher than the mean BMU was marked as abnormal, and an index, based on the total squared abnormal uptake, was computed to identify the focal uptake. Patients with an index above a predefined threshold were interpreted as having focal uptake. As the test group, 48 un-treated patients who had undergone a staging FDG-PET/CT between 2017-2018 with biopsy-proven HL were retrospectively included. Ten physicians classified the 48 cases regarding focal skeleton/BMU. Results: The majority of the physicians agreed with the AI in 39/48 cases (81%) regarding focal skeleton/bone marrow involvement. Inter-observer agreement between the physicians was moderate, Kappa 0.51 (range 0.25-0.80). Conclusion: An AI-based method can be developed to highlight suspicious focal skeleton/BMU in HL patients staged with FDG-PET/CT. Inter-observer agreement regarding focal BMU is moderate among nuclear medicine physicians.

Background: Insulin is an essential therapy for treating diabetes, but many patients lack standard insulin injection skills. Purpose: We developed a standard training procedure based on a new simulation tool. Then we conducted a study to investigate the effect of this standard training on the ability of diabetic patients to inject themselves with insulin. Methods: After follow-up, a total of 120 patients with diabetes mellitus were included. These patients needed insulin therapy depending on their condition and had not previously learned insulin injection. We randomly divided them into the intervention group (60 cases) and the control group (60 cases). The control group was trained on insulin injection before being discharged according to the traditional method, and the intervention group was trained based on an improved simulation tool. All participants were trained as individuals or groups. Finally, we evaluated the learning effects of both groups. Results: The time spent at the training stage in the intervention group was shorter than the control group. We found that after applying simulation devices to mimic operations, the learning time for patients was reduced. The first subcutaneous injection success rate was 73.33% in the intervention group, which was significantly higher than that in the control group by 46.67%. The score of the first subcutaneous injection and pre-discharge score in the test group was significantly higher than that of the control group. One month later, the score for injection skills in the 2 groups was higher than that before discharge, and the score in the trial group was still higher than that in the control group. The incidence of subcutaneous fat hyperplasia in the trial group was lower than that in the control group (3.3% vs 15%, P

OBJECTIVE Studies conducted in developed countries have shown that attentional impairment is commonly seen in patients with major depressive disorders (MDD). There is a lack of studies using culture-free neuropsychological instruments. Additionally, attention consists of different subdomains. Deficits in subdomains have not been investigated in MDD. Studies on subdomains using systematic frameworks are needed. We aimed to verify the percentage of Brazilian MDD patients with attention deficits, using a culture-free instrument; compare different attention subdomains in MDD patients with paired controls; find the subdomain that best discriminated controls from MDD patients. METHOD Forty-five unmedicated patients currently with MDD and 45 age- and sex-matched controls participated in the study. Attention performance was measured by a Go/No-go task which detected omission errors, commission errors, reaction time (RT), and variability of reaction time (VRT). These variables assess four specific subdomains: focused attention (omission errors), response inhibition (commission errors), alertness (RT), and sustained attention (VRT). MANCOVAs were used to test group differences and logistic regressions to find the strongest predictor of MDD. RESULTS Compared with normative data, 73.3% of the patients and 17.7% of the controls exhibited attention deficits, defined as a z-score < 2.0 on two or more subdomains. Depressed patients showed poorer performance in all attention subdomains. The VRT variable was the strongest predictor of MDD. Lapses in attention as the test progresses affected the stability of RTs and increased VRT in MDD patients. CONCLUSIONS A significant proportion of the depressive patients shows attention deficits, as described in developed countries; all attention subdomains are affected in MDD patients; sustained attention is the most affected subdomain. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Objectives. To predict the regenerative rate of liver in patients with HCCs after right hepatectomy using texture analysis on preoperative CT combined with clinical features. Materials and Methods. 88 patients with 90 HCCs who underwent right hepatectomy were retrospectively included. The future remnant liver was semiautomatically segmented, and the volume of future remnant liver on preoperative CT (LVpre) and the volume of remnant liver on following-up CT (LVfu) were measured. We calculated the regeneration index (RI) by the following equation: (LVfu – LVpre)/LVpre) × 100 (%). The support vector machine recursive method was used for the feature selection. The Naive Bayes classifier was used to predict liver RI, and 5-fold cross-validation was performed to adjust the parameters. Sensitivity, specificity, and accuracy were calculated to evaluate the diagnostic efficiency of the model. Results. The mean RI was 142.99 ± 92.17%. Of all clinical parameters and texture features, the AST, ALB, PT-INR, Perc.10%, and S(5, −5)Correlat were found to be statistically significant with RI. The diagnostic sensitivity, specificity, and accuracy of the model in the training group were 0.902, 0.634, and 0.768, and the AUC value of the obtained model was 0.841. In the test group, the sensitivity, specificity, and accuracy of the model were 1.0, 0.429, and 0.778, respectively, and the AUC value was 0.844. Conclusion. The use of texture analysis on preoperative CT combined with clinical features can be helpful in predicting the liver regeneration rate in patients with HCCs after right hepatectomy.

To explore the predictive performance of machine learning on the recurrence of patients with gastric cancer after the operation. The available data is divided into two parts. In particular, the first part is used as a training set (such as 80% of the original data), and the second part is used as a test set (the remaining 20% of the data). And we use fivefold cross-validation. The weight of recurrence factors shows the top four factors are BMI, Operation time, WGT and age in order. In training group:among the 5 machine learning models, the accuracy of gbm was 0.891, followed by gbm algorithm was 0.876; The AUC values of the five machine learning algorithms are from high to low as forest (0.962), gbm (0.922), GradientBoosting (0.898), DecisionTree (0.790) and Logistic (0.748). And the precision of the forest is the highest 0.957, followed by the GradientBoosting algorithm (0.878). At the same time, in the test group is as follows: the highest accuracy of Logistic was 0.801, followed by forest algorithm and gbm; the AUC values of the five algorithms are forest (0.795), GradientBoosting (0.774), DecisionTree (0.773), Logistic (0.771) and gbm (0.771), from high to low. Among the five machine learning algorithms, the highest precision rate of Logistic is 1.000, followed by the gbm (0.487). Machine learning can predict the recurrence of gastric cancer patients after an operation. Besides, the first four factors affecting postoperative recurrence of gastric cancer were BMI, Operation time, WGT and age.

One of the goals of functional-appliance devices is to modify the vertical growth pattern, solving several kinds of malocclusion. This study aimed to evaluate Class II malocclusion treatment’s stability with Austro Repositioner, followed by fixed appliances, and assess its capacity to modify vertical dimensions in brachyfacial patients. A test group of 30 patients (16 boys and 14 girls, mean 11.9 years old) with Class II malocclusion due to mandibular retrognathism and brachyfacial pattern treated with Austro Repositioner and fixed appliance were compared to a matched untreated Class II control group of 30 patients (17 boys and 13 girls, mean age 11.7 years old). Lateral cephalograms were taken at T1 (initial records), T2 (end of treatment), and T3 (one year after treatment). Statistical comparisons were performed with a paired-sample t-test and two-sample t-tests. Significant improvements in the skeletal Class II relationship were observed in the treated group. The ANB angle decreased (4.75°), the SNB angle increased (3.92°), and the total mandibular length (Co-Pg) increased (8.18 mm) (p &lt, 0.001). Vertical dimensions were also significantly modified, the FMA angle increased (3.94°), LAFH-distance increased (3.15 mm), and overbite decreased (3.35 mm). These changes remained stable one year after treatment. The Austro Repositioner was adequate for treating the skeletal Class II malocclusion resulting from the mandible retrusion in brachyfacial patients.

The aim of the study was to investigate the intelligent recognition of radiomics based on the convolutional neural network (CNN) in predicting endometrial cancer (EC). In this study, 158 patients with EC in hospital were selected as the research objects and divided into a training group and a test group. All the patients underwent magnetic resonance imaging (MRI) before surgery. Based on the CNN, the imaging model of EC prediction was constructed according to the characteristics. Besides, the comprehensive prediction model was established through the clinical information and imaging parameters. The results showed that the area under the working characteristic curve (AUC) of the radiomics model and comprehensive prediction model was 0.897 and 0.913 in the training group, respectively. In addition, the AUC of the radiomics model was 0.889 in the test group and that of the comprehensive prediction model was 0.897. The comprehensive prediction model was established through specific imaging parameters and clinical pathological information, and its prediction performance was good, indicating that radiomics parameters could be applied as noninvasive markers to predict EC.

The diagnosis of thoracic endometriosis (TE) is challenging, hence resulting in under-diagnosis as well as long delays before arriving at a correct definitive diagnosis. Our aim is to review the histopathological findings in TE, summarise the diagnostic features, identify any major histo-morphological indicator(s) hitherto unrecognised as such, suggest diagnostic criteria; all with the aim of improving the diagnostic capacity and reducing observer error even where the clinical suspicion is low. A case-control study in which a search in the pathology archives of a referral hospital over a 10-year period was conducted. Twenty-six cases of TE were identified, reviewed, and compared with a control population of 48 cases taken from common benign thoracic diseases. Nine notable histological features were identified in varying permutations in the test group, namely: endometrioid glands, lymphoid clusters, ceroid macrophages, siderophages, cholesterol crystals, capillary congestion, multinucleated giant cells, smooth muscle bundles and fibrosis. The first 6 features were frequent; each being present in over 13 (13/26; 50%) test cases. The first 8 features showed significant association with TE by the Chi-squared test (P

BackgroundMembranous nephropathy (MN) and minimal change disease (MCD) are two common causes leading to nephrotic syndrome (NS). They have similar clinical feature but different treatment strategy and prognosis. M-type phospholipase A2 receptor (PLA2R) is considered as a specific marker of membranous nephropathy. However, its sensitivity is only about 70%. Therefore, there is a lack of effective and noninvasive tools to distinguish PLA2R-negative MN and MCD patients without renal biopsy. We aim to develop a discrimination model using noninvasive parameters for distinguishing the two diseases and support immediate treatment before result of renal biopsy.MethodsA total 949 patients who were pathologically diagnosed as idiopathic MN or primary MCD in the First Affiliated Hospital of Zhengzhou University from January 2017 to August 2019 were enrolled in this study, including 805 idiopathic MN (605 PLAR2-positive MN and 200 PLA2R-negative MN) and 144 primary MCD. Based on the basic information and laboratory examination of 200 PLA2R-negative MN and 144 MCD, we used univariate and multivariate logistic regression analysis to select the relevant variables and develop the discrimination model. ROC curves and calibration curves were used to evaluate the diagnostic ability and calibration ability of the model. The decision curve was used to show the net benefit. We also tested the effectiveness of our model in all 949 patients.ResultsA novel model that included age, albumin, urea, high density lipoprotein, urea and red blood cell count was established for PLA2R-negative MN and MCD. The discrimination model has good differential capability (an AUC of 0.889 in training group and an AUC of 0.920 in test group) and calibration capability. When testing in all 949 patients, our model also showed good discrimination ability for all idiopathic MN and MCD.Conclusion We constructed a discrimination model with high diagnostic effectiveness for PLA2R-negative MN and MCD. The model could also be used for all idiopathic MN and MCD patients.

To investigate of effects of using phase-contrast video technique on education in oral hygiene training. This one blind, parallel randomized controlled trial was conducted in a tertiary clinic. Fifty-three patients who presented to the orthodontics department aged 12-20 years were divided into two groups randomly by computer-generated assigned codes to receive oral hygiene education. The participants were blinded to type of education method. Before orthodontic therapy, the control group was trained only by the conventional method, while the test group was trained by phase-contrast video microscopy method in addition to conventional method. Some images and videos of moving microorganisms in dental plaque were shown to the patients in test group on a computer monitor.The bacterial count, plaque index, and gingival index scores were compared. Measurements were obtained in baseline and follow-ups which were repeated with 1-month intervals after the training.The plaque index scores (1.05 ± 0.1 vs. 1.43 ± 0.2; P0.001) and gingival index scores (0.90 ± 0.1 vs. 1.14 ± 0.2; P0.001) in test group was statistically lower than those in control group at the end of the study. The gingival index scores reduced by 39% in test group vs. 14% in control group. The number of bacteria significantly decreased in the group trained with phase-contrast video microscope technique (8,059,133 ± 3016 vs. 10,830,600 ± 4919; 0.018).The training with phase-contrast microscopy has a more positive effect than the traditional method in oral hygiene education.

PURPOSE This investigation aimed to evaluate clinical, prosthetic, and patient-based outcomes of a milled bar with polyether ether ketone (PEEK) and metal housings for inclined implants supporting mandibular overdentures. MATERIALS AND METHODS Eighteen edentulous participants received four implants in the interforaminal area of the mandible (two vertically and two distally inclined), and implants were connected with milled bars. Overdentures were attached to the bars with PEEK female housing (test group). The control group consisted of participants who received milled bar overdentures with conventional metal housings but were case matched to the test group and served as a historical cohort. Clinical parameters (Plaque Index, Gingival Index, pocket depth, and bone loss) were measured at baseline, 6 months, and 12 months. Patient satisfaction (using visual analog scale) and prosthetic complications were recorded after 12 months. RESULTS The control group showed a significantly higher plaque score and marginal bone resorption compared with the test group. The test group showed higher satisfaction with retention, stability, speech, and esthetics compared with the control group (P < .048). The test group showed a significantly lower incidence of female housing wear (P = .017), plastic clip wear (P < .001), and plastic clip fracture/renewal (P = .049) than the control group. No difference between groups was noted for other clinical, prosthetic, and patient-based outcomes. CONCLUSION PEEK housing of a milled bar may be a successful alternative to conventional metal housing for inclined implants supporting mandibular overdentures, as it is associated with favorable clinical, prosthetic, and patient-based outcomes after 1 year.

The aim of this trial was to determine whether a toothpaste with microcrystalline hydroxyapatite is not inferior to a fluoride toothpaste in prevention of caries in children. This double-blinded randomized control trial compared two toothpastes regarding the occurrence of caries lesions using International Caries Detection and Assessment System (ICDAS) ≥ code 1 on the primary dentition within 336 days. The test group used a fluoride-free hydroxyapatite toothpaste three times daily while control group used a toothpaste with fluoride. 207 children were included in the intention-to-treat analysis; 177 of them finished the study per protocol. An increase in caries ICDAS ≥ code 1 per tooth was observed in 72.7% of the hydroxyapatite-group (n = 88), compared with 74.2% of the fluoride-group (n = 89). The exact one-sided upper 95% confidence limit for the difference in proportion of participants with ICDAS increase ≥ 1 (-1.4%) was 9.8%, which is below the non-inferiority margin of 20% demonstrating non-inferiority of hydroxyapatite compared to the fluoride control toothpaste. This RCT showed for the first time, that in children, the impact of the daily use of a toothpaste with microcrystalline hydroxyapatite on enamel caries progression in the primary dentition is not inferior to a fluoride control toothpaste (Clinical Trials NCT03553966).

We used five machine-learning algorithms to predict cancer-specific mortality after surgical resection of primary non-metastatic invasive breast cancer. This study was a secondary analysis of data for 1661 women with primary non-metastatic invasive breast cancer. The overall patient population was divided into a training group and a test group at a ratio of 8:2 and python was used for machine learning to establish the prognosis model. The machine-learning Gbdt algorithm for cancer-specific death caused by various factors showed the five most important factors, ranked from high to low as follows: the number of regional lymph node metastases, LDH, triglyceride, plasma fibrinogen, and cholesterol. Among the five algorithm models in the test group, the highest accuracy rate was by DecisionTree (0.841), followed by the gbm algorithm (0.838). Among the five algorithms, the AUC values from high to low were GradientBoosting (0.755), gbm (0.755), Logistic (0.733), Forest (0.715), and DecisionTree (0.677). Machine learning can predict cancer-specific mortality after surgery for patients with primary non-metastatic invasive breast.

Objectives This study aims to explore the clinical effect of Arbidol (ARB) combined with adjuvant therapy on patients with coronavirus disease 2019 (COVID‐19). Methods The study included 62 patients with COVID‐19 admitted to the First Hospital of Jiaxing from January to March, 2020, and all patients were divided into the test group and the control group according to whether they received ARB during hospitalization. Various indexes in the two groups before and after treatment were observed and recorded, including fever, cough, hypodynamia, nasal obstruction, nasal discharge, diarrhea, C‐reactive protein (CRP), procalcitonin (PCT), blood routine indexes, blood biochemical indexes, time to achieve negative virus nucleic acid and so on. Results The fever and cough in the test group were relieved markedly faster than those in the control group (p0.05); the time for two consecutive negative nucleic acid tests in the test group were shorter than that in the control group; the hospitalization period of the patients in the test group and control group were (16.5 ± 7.14) d and (18.55 ± 7.52) d, respectively. Conclusion ARB combined with adjuvant therapy might be able to relieve the fever of COVID‐19 sufferers faster and accelerate the cure time to some degree, hence it's recommended for further research clinically. This article is protected by copyright. All rights reserved.

Threatened preterm labor (TPL) is the most common cause of hospitalization in the second half of pregnancy and entails high costs for health systems. Currently, no reliable labor proximity prediction techniques are available for clinical use. Regular checks by uterine electrohysterogram (EHG) for predicting preterm labor have been widely studied. The aim of the present study was to assess the feasibility of predicting labor with a 7- and 14-day time horizon in TPL women, who may be under tocolytic treatment, using EHG and/or obstetric data. Based on 140 EHG recordings, artificial neural networks were used to develop prediction models. Non-linear EHG parameters were found to be more reliable than linear for differentiating labor in under and over 7/14 days. Using EHG and obstetric data, the &lt, 7- and &lt, 14-day labor prediction models achieved an AUC in the test group of 87.1 &plusmn, 4.3% and 76.2 &plusmn, 5.8%, respectively. These results suggest that EHG can be reliable for predicting imminent labor in TPL women, regardless of the tocolytic therapy stage. This paves the way for the development of diagnostic tools to help obstetricians make better decisions on treatments, hospital stays and admitting TPL women, and can therefore reduce costs and improve maternal and fetal wellbeing.

Recent studies showed an evident correlation between the stomatognathic system and the visual system. These results suggest that subjects who are affected by both temporomandibular (TMD) disorders and refractive disorders present with altered control of pericranial musculature tone and higher open-eye electromyographic (EMG) values. The objective of this work was to evaluate the effects of standard vision correction on EMG in subjects suffering from TMD compared with application of the same vision treatments to non-TMD subjects. 40 subjects were enrolled in this study. The test group included 20 myopic subjects and also included patients with TMD. The control group included 20 healthy myopic subjects. All of the participants underwent a complete ocular examination and a sEMG analysis. The results showed that TMD subjects with vision disorders that are corrected with standard glasses present EMG values that are significantly higher than those presented by non-TMD subjects with vision disorders and standard glasses. Infact, in TMD subjects, eye correction did not have a positive effect on the stomatognathic or pericranial musculature.

One of teachers’ concerns, with students in general and medical students in particular, is to ensure as much as possible that information goes from students’ short-term memories to their long-term memories. The present study focuses on knowledge retention in Medical Microbiology and assesses the effectiveness of some strategies implemented for short- and long-term retention. A pre- and post-test was used to assess student’s learning. This study involved students of Porto University (test group). Test group participants were all attending the third year of the Medicine Degree Program. The results of post-test 1 were considered very positive and support the importance of these applied active activities and/or methodologies in Medical Microbiology for short-term retention. However, the results obtained in post-test 2 showed that knowledge retention after 9 months, despite substantial, decreases. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s42770-018-0031-4) contains supplementary material, which is available to authorized users.

Importance Myopia is a major public health concern worldwide, while outdoor time is indicated to be protective against the onset of myopia. Background To describe the methodology and baseline data of the Shanghai Time Outside to Reduce Myopia (STORM) trial. Design A 2-year, school-based, prospective, cluster randomized trial. Participants Children from grade I and II classes of 24 schools from eight districts in Shanghai, China, were randomized to either a control group, a test group I (40-min outdoor time/day) or test group II (80-min outdoor time/day). Methods At baseline and annual intervals, cycloplegic autorefraction and axial length measurement will be performed. Time outdoors and light exposure will be monitored via parent/carer questionnaires and a wearable device. Main outcome measures Spherical equivalent, prevalence of myopia and time outdoors in each group. Results A total of 6295 eligible children (age 7.2 ± 0.7 y [6-9 y]) were randomized to control (n = 2037), test group I (n = 2329) and test group II (n = 1929). At baseline, spherical equivalent was +0.98 ± 1.02D, +1.02 ± 1.02D and +1.00 ± 0.99D (P = 0.708), myopia prevalence was 8.9, 7.7 and 7.8% (P = 0.270) and time outdoors was 58.5 ± 35.8, 59.8 ± 34.7 and 58.5 ± 35.3 min/d (P = 0.886) for control, test groups I and II, respectively. Conclusions and relevance Myopia prevalence was high at nearly 8 to 9% in school children aged 7 years in Shanghai, China. The current trial will help evaluate if increased time outdoors has a role to play in reducing the incidence of myopia and/or slow the progression of myopia.

OBJECTIVEDecompressive craniectomy (DC) is a widely used procedure in neurosurgery; however, few studies focus on the best surgical technique for the procedure. The authors’ objective was to conduct a prospective randomized controlled trial comparing 2 techniques for performing DC: with watertight duraplasty and without watertight duraplasty (rapid-closure DC).METHODSThe study population comprised patients ranging in age from 18 to 60 years who were admitted to the Neurotrauma Service of the Hospital da Restauração with a clinical indication for unilateral decompressive craniectomy. Patients were randomized by numbered envelopes into 2 groups: with watertight duraplasty (control group) and without watertight duraplasty (test group). After unilateral DC was completed, watertight duraplasty was performed in the control group, while in the test group, no watertight duraplasty was performed and the exposed parenchyma was covered with Surgicel and the remaining dura mater. Patients were then monitored daily from the date of surgery until hospital discharge or death. The primary end point was the incidence of surgical complications (CSF leak, wound infection, brain abscess, or subgaleal fluid collections). The following were analyzed as secondary end points: clinical outcome (analyzed using the Glasgow Outcome Scale [GOS]), surgical time, and hospital costs.RESULTSFifty-eight patients were enrolled, 29 in each group. Three patients were excluded, leaving 27 in the test group and 28 in the control group. There were no significant differences between groups regarding age, Glasgow Coma Scale score at the time of surgery, GOS score, and number of postoperative follow-up days. There were 9 surgical complications (5 in the control group and 4 in the test group), with no significant differences between the groups. The mean surgical time in the control group was 132 minutes, while in the test group the average surgical time was 101 minutes, a difference of 31 minutes (p = 0.001). The mean reduction in total cost was $420.00 USD (a 23.4% reduction) per procedure in the test group.CONCLUSIONSRapid-closure DC without watertight duraplasty is a safe procedure. It is not associated with a higher incidence of surgical complications (CSF leak, wound infection, brain abscess, or subgaleal fluid collections), and it decreased surgical time by 31 minutes on average. There was also a hospital cost reduction of $420.00 USD (23.4% reduction) per procedure.Clinical trial registration no.: NCT02594137 (clinicaltrials.gov)

Stable pronator quadratus repair following volar plate fixation of distal radius fractures with complete plate coverage is difficult. This study compares a modified pronator quadratus repair technique involving the brachioradialis muscle insertion (test group) with a conventional radial incision through the muscle without pronator quadratus repair (standard group). This prospective randomised study included 16 patients in the test group and 12 in the standard group; all were available for clinical, radiographic and ultrasound examination at a mean follow-up of 15 months. Pronator quadratus repair was feasible in all test group patients, and complete coverage of the distal plate was achieved in 11. No differences in functional outcome were observed between the groups. Pronator quadratus repair with a part of the brachioradialis muscle insertion is a reliable technique for coverage of a volar plate by slight distal transposition. In the repair of distal radius fractures, this may better protect the finger flexor tendons against irritation and/or rupture. That likelihood should now be studied.

Aim. To compare the outcome of digital versus analog procedures for the restoration of single implants. Methods. Over a two-year period (2014-2016), all patients who had been treated in a dental center with a single implant were randomly assigned to receive either a monolithic zirconia crown, fabricated with digital workflow (test group), or a metal-ceramic crown, fabricated with analog workflow (control group). All patients were followed for 1 year after the delivery of the final crown. The outcomes were success, complications, peri-implant marginal bone loss (PIMBL), patient satisfaction, and time and cost of the treatment. Results. 50 patients (22 males, 28 females; mean age 52.6±13.4 years) were randomly assigned to one of the groups (25 per group). Both workflows showed high success (92%) and low complication rate (8%). No significant differences were found in the mean PIMBL between test (0.39±0.29mm) and control (0.54±0.32mm) groups. Patients preferred digital impressions. Taking the impression took half the time in the test group (20±5min) than in the control (50±7min) group. When calculating active working time, workflow in the test group was more time-efficient than in the control group, for provisional (70±15min versus 340±37min) and final crowns (29±9min versus 260±26min). The digital procedure presented lower costs than the analog (€277.3 versus €392.2). Conclusions. No significant clinical or radiographic differences were found between digital and analog procedures; however, the digital workflow was preferred by patients; it reduced active treatment time and costs. The present study is registered in the ISRCTN (http://www.isrctn.com/ISRCTN36259164) with number 36259164.

Background A training program consisting of only one-repetition maximum (1RM) training results in similar strength adaptations as traditional resistance exercise. However, little is known regarding the affective or behavioral responses to this type of training. Aim To examine the affective and behavioral response to either a traditional resistance exercise program or a biweekly 1RM-training program. Methods Participants were trained for 8 weeks (2× per week). The HYPER group completed four sets of 8–12 repetitions; the 1RM group (TEST) worked up to a single maximal repetition. Results The TEST group felt more revitalized and had an increase in positive engagement during their first visit, whereas the HYPER group showed an increase in feelings of physical exhaustion during their first and last visits. There were no pre to post differences for the change in behavior or self-efficacy between groups. Conclusion 1RM training appears to elicit a more favorable affective response, compared with HYPER training, which may ultimately improve adherence to resistance-type exercise.

Since early childhood caries (ECC) is a major disease in the public health sector, an interdisciplinary prevention concept to avert this disease was developed, launched in a project region, and evaluated. It was examined whether the emergence of ECC could be prevented or curbed with the newly developed program. The program encompasses seven pulses of information from an interdisciplinary team (gynecologists, midwives, pediatricians, dentists, municipal social services, and the public health office). The primary dependent variables were caries experience and prevalence among the 3- to 4-year-olds who took part in the ECC prevention program, compared to children of the same age without such measures. The effect of the prevention program was assessed by means of a “historical” comparison. The dental diagnoses were performed by two calibrated dentists based on the “ICDAS collapsed.” Data on diet and preventive behavior were gathered using a standardized parental questionnaire. The significance was tested using the nonparametric Mann-Whitney U test. There were 661 3- to 4-year-olds in the control group and 706 in the test group. The mean d3−6mf-t for the control group (0.92) was significantly higher than that for the test group (0.46). While 78.8% of the children examined in the control group exhibited predominantly sound primary dentition, this was the case for 86.3% of the test group. The proportion of children with S-ECC was 7.9% in the test group and 14.5% in the control group. The test group differed significantly from the control group both in terms of reported diet and dental hygiene habits. The interdisciplinary prevention program presented here is an effective concept for preventing ECC and considerably helps reduce problems in the treatment of small children.

Objective To examine if (i) characteristics of the fresh extraction socket site influenced subsequent dimensional alterations and (ii) placement of deproteinized bovine mineral in the socket affected volumetric change during healing. Materials and methods Twenty seven subjects and 28 extraction sites were included. Immediately after the removal of the tooth and after 6 months of healing, stone and virtual models of the jaw were produced. A cone beam computerized tomography scan was obtained immediately after extraction and the thickness of the buccal bone wall at the extraction site was measured. Extraction sites were randomly assigned to test or control group. In the test group, extraction sockets were filled with deproteinized bone mineral and covered with a collagen membrane. In the control group, only a collagen membrane was placed. Results The thickness of the buccal bone wall at the extraction site influenced the amount of volume reduction that occurred. Socket grafting influenced the degree of ridge diminution only at sites where the buccal bone wall was thin (≤ 1 mm). Conclusion A graft comprised of collagen-enriched deproteinized bovine bone mineral, placed to fill extraction sockets failed to influence the overall diminution of the ridge that occurred during healing. The thickness of the buccal bone wall apparently had a significant influence on volumetric alterations of the edentulous ridge following tooth extraction.