Comparison Of Variables Research Articles

Self-Etching Ceramic Primer Affects Surface Topography and Roughness of Two Zirconia-Reinforced Lithium Silicate Ceramics.

This article evaluates the etching efficacy of a self-etching ceramic primer (SECP) on zirconia-reinforced lithium silicate (ZLS) ceramics. Celtra Duo (DeguDent GmbH, Hanau-Wolfgang, Germany) and Vita Suprinity (Vita Zahnfabrik, Bad Säckingen, Germany) were used in this study. A total of 36 ceramic slices were prepared from each ceramic material and randomly distributed into three groups according to the surface treatment applied (n = 12 per group). Group 1 (polished) was polished with silicon carbide paper discs and did not undergo any surface treatment; group 2 (SECP) was surface treated with SECP (Monobond Etch and Prime, Ivoclar Vivadent, Schaan, Liechtenstein); group 3 (hydrofluoric acid [HF]) was surface treated with 4.7% HF etching. Half of the specimens (n = 6) from each group were gold-sputtered, and the surface topographic alterations were evaluated by scanning electron microscopy at magnifications of 5,000× and 10,000 × . The surface roughness of the other half (n = 6) from each group was tested using a three-dimensional optical profiler. Data were statistically analyzed using two-way analysis of variance and Tukey's multiple comparisons test. Both SECP and HF etching surface treatments resulted in a statistically significant increase (p < 0.05) in the surface roughness of both ceramic materials, compared to that of their respective control group specimens (polished). HF etching resulted in a significant dissolution of the glassy phase of each ceramic. SECP can effectively etch ZLS ceramics. The etching patterns created after the application of SECP were mild compared to those produced by HF etching. The topographic surface features of ceramics are affected by both, surface treatment and material composition.

Ultrasound normalized local variance to assess metabolic dysfunction-associated steatotic liver disease

PurposeIncreased prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) highlights a desire for screening with liver ultrasound normalized local variance (NLV). We aimed to assess variations in NLV values measured at different sampling depths and discuss common technical considerations in measuring liver NLV. MethodsWe retrospectively measured liver NLVs at variable depths on ultrasound images pre-recorded in 116 participants who underwent liver magnetic resonance imaging-proton density fat fraction (MRI-PDFF) and ultrasound to screen for MASLD. Liver NLVs were measured and differences at variable depths were tested using one-way analysis of variance (ANOVA) and multiple paired comparisons using post hoc Tukey honestly significant difference (HSD), Scheffé, Bonferroni, and Holm multiple comparisons. Diagnostic performance of NLV values were analyzed by area under the receiver operating characteristics (AUROC) curve. ResultsThe NLV measured at a depth of 10 cm significantly differed from those measured near the liver capsule and at depths of 6 cm and 8 cm (p < 0.001) from the skin. There was no significant difference in NLV value in other paired groups (p > 0.05). The difference in the area under AUROCs for NLVs measured at variable depths was not significant (p > 0.05). ConclusionsThe best diagnostic performance of liver NLV was measured at depth of 8 cm from the skin, although NLV measured at variable depth showed similar diagnostic performance for assessing ≥ mild hepatic steatosis. The study results provide a reference that can be used in the development of standardized scanning protocols and technical considerations in measuring liver NLV.

Overproduction of gamma-aminobutyric acid and increased antioxidant capacity by Lactiplantibacillus pentosus TEJ4 through optimization by response surface methodology

Lactic Acid bacteria (LAB) are the main producers of bioactive compounds (peptides, exopolysaccharides, antioxidant compounds, gamma-aminobutyric acid-GABA, etc.). Different strains produce at least one metabolite in high quantities as part of their metabolism, however, there are few reports of LAB with the capacity to produce two or more metabolites simultaneously. Due, the ability of 35 LAB strains previously isolated from dairy products, fermented beverages, and honey to produce gamma-aminobutyric acid (GABA) and the antioxidant capacity was determined. Based on analysis of variance and subsequent comparison of means, the Lactiplantibacillus pentosus strain was selected, and subsequently, using a Draper-Lin small composite design, the conditions of the culture medium (MRS broth) were optimized to achieve the highest production of GABA and increase the antioxidant capacity evaluated by the DPPH assay. The optimal conditions for obtaining 7.99 mg/mL of GABA were 100 mM glutamic acid, a pH of 6, a temperature of 40 °C, and 72 h of fermentation. To obtain the highest antioxidant capacity (6.87 µmol TE/mL), 200 mM glutamic acid and a pH of 4.0 were used. We reported an isolated strain of nondairy product (L. pentosus TEJ4) with the capacity to produce both bioactive, GABA, and antioxidants in a single fermentation process in a non-dairy defined medium, which is a feasible alternative to the normal process of producing bioactive compounds.

Comparison of 3D UTE free-breathing lung MRI with hyperpolarized 129Xe MRI in pediatric cystic fibrosis.

To compare phase-resolved functional lung (PREFUL) regional ventilation derived from a free breathing 3D UTE radial MRI acquisition to hyperpolarized 129Xe-MRI (Xe-MRI), conventional 2D multi-slice PREFUL MRI, and pulmonary function tests in pediatric cystic fibrosis (CF) lung disease. Free-breathing 3D UTE and 2D multi-slice 1H MRI as well as Xe-MRI were acquired in 12 stable pediatric CF patients. Using PREFUL, regional ventilation (RVent) maps were calculated from the free-breathing data. Ventilation defect percentage (VDP) was determined from 3D and 2D RVent maps (2D VDPRVent and 3D VDPRVent, respectively) and Xe-MRI ventilation (VDPXe). VDP was calculated for the whole lung and for eight regions based on left/right, anterior/posterior, and superior/inferior divisions of the lung. Global and regional VDP was compared between the three methods using Bland-Altman analysis, linear mixed model-based correlation, and one-way analysis of variance and multiple comparisons tests. Global 3D VDPRVent, VDPXe, and 2D VDPRVent were all strongly correlated (all R2 > 0.62, p < 0.0001) and showed minimal, non-significant bias (all <2%, p > 0.05). Three dimensional and 2D VDPRVent significantly correlated to VDPXe in most of the separate lung regions (R2 = 0.18-0.74, p < 0.04), but showed lower inter-agreement. The superior/anterior lung regions showed the least agreement between all three methods (all p > 0.12). Absolute VDP assessed by 3D UTE PREFUL MRI showed good global agreement with Xe-MRI and 2D multi-slice PREFUL MRI in pediatric CF lung disease. Therefore, 3D UTE PREFUL MRI offers a sensitive and potentially more accessible alternative to Xe-MRI for regional volumetric evaluation of ventilation.

Efficient semiparametric estimation in two‐sample comparison via semisupervised learning

AbstractWe develop a general semisupervised framework for statistical inference in the two‐sample comparison setting. Although the supervised Mann–Whitney statistic outperforms many estimators in the two‐sample problem for nonnormally distributed responses, it is excessively inefficient because it ignores large amounts of unlabelled information. To borrow strength from unlabelled data, we propose a class of efficient and adaptive estimators that use two‐step semiparametric imputation. The probabilistic index model is adopted primarily to achieve dimension reduction for multivariate covariates, and a follow‐up reweighting step balances the contributions of labelled and unlabelled data. The asymptotic properties of our estimator are derived with variance comparison through a phase diagram. Efficiency theory shows our estimators achieve the semiparametric variance lower bound if the probabilistic index model is correctly specified, and are more efficient than their supervised counterpart when the model is not degenerate. The asymptotic variance is estimated through a two‐step perturbation resampling procedure. To gauge the finite sample performance, we conducted extensive simulation studies which verify the adaptive nature of our methods with respect to model misspecification. To illustrate the merits of our proposed method, we analyze a dataset concerning homelessness in Los Angeles.

Surgical control time estimation variability: Implications for medical systems and the future integration of AI and ML models

BackgroundAccurate estimation of surgical procedure times, crucial for optimizing healthcare access, patient outcomes, and cost-effectiveness, is essential for operating room efficiency. Surgical control time (SCT) is a preoperative estimate by surgeons representing their predicted time to complete the surgery, spanning from completion of anesthesia induction to surgical site closure. MethodsIn this within-subjects, longitudinal study, we examined the differences between predicted surgical control times versus actual SCTs and determined variability by surgical specialty. We included cases regardless of classification (i.e., outpatient or inpatient), type of surgery (i.e., elective, urgent, or emergent), or level of complexity (i.e., major or minor). We ran Shapiro–Wilk tests to assess the normality of the difference in actual versus predicted surgical control times (dSCT) by surgical specialty. We used a generalized linear model (GLM) with robust clustered variance and pairwise comparisons of surgical specialties (with Bonferroni adjustment for family-wise error rate) to assess differences in the prediction accuracy of SCTs by specialty. ResultsWe analyzed 14,438 surgical cases performed by 168 surgeons across 13 specialties from January 2019 to January 2023. 11 of 13 specialties had higher actual than predicted times, suggesting an overall pattern of underestimating SCTs. On average, surgeries took 12.3 % longer than predicted, with surgeons underestimating SCTs by an average of 10.4 min. SCTs comprised 78 % of the total operative time. The four specialties with the largest underestimations of SCTs were neurosurgery (27.04 min), orthopedics (22.75 min), urology (19.4 min, and plastic surgery (18.67 min), while two specialties exhibited overestimations, namely ear nose and throat (11.14 min) and pediatrics (–3.21 min). GLM results and pairwise comparisons showed that surgeons significantly differed in their SCT prediction by surgical specialty. ConclusionsOur findings showed significant differences across surgical specialties in the accuracy of predicting surgical control times. These results have implications for integrating evolving technologies such as artificial intelligence and machine learning models to assist surgical administrators in accurately predicting surgical case durations and optimizing resource allocation.

Nontechnical Skills Assessment in Acute Care Trauma Simulations: A Mixed Methods Approach Using Eye Tracking and Behavioral Marker Systems.

The condition of trauma patients and the urgent need for timely resuscitation present unique challenges to trauma teams. These difficulties are exacerbated for military trauma teams in combat environments. Consequently, there is a need for continued improvement of nontechnical skills (NTS) training for trauma teams. However, current approaches to NTS assessment rely on subjective ratings, which can introduce bias. Accordingly, objective methods of NTS evaluation are needed. Eye-tracking (ET) methods have been applied to studying communication, situation awareness, and leadership in many health care settings, and could be applied to studying physicians' NTS during trauma situations. In this study, we aimed to assess the relationship between trauma team leaders' objective gaze patterns and subjective expert NTS ratings during patient care simulations. After Institutional Review Board approval, 9 trauma teams from first-year post-graduate general surgery and emergency medicine residents were recruited to participate in 1 of 2 trauma simulations (a difficult airway case and a multi-patient trauma). Each scenario lasted approximately 15 minutes. All team leaders wore a mobile ET system to evaluate gaze metrics-time to first fixation (TTFF), average fixation duration (AFD), and total percentage of the scenario (TPS) focused on Areas of Interest (AOI), which included patient, care team, diagnostic equipment, and patient care equipment. Trained faculty raters completed the Non-Technical Skills for Surgeons (NOTSS) assessment tool and the Trauma Non-Technical Skills (T-NOTECHS) scale. One-way analysis of variance, Kruskal-Wallis, and appropriate post-hoc pairwise comparison tests were run to assess differences between ET metrics across AOI groups. Spearman's Rho tests were used to assess correlations between ET and subjective NTS ratings. Compared to other NTS domains, trauma teams scored relatively poorly on communication across both T-NOTECHS (3.29$ \pm $0.61, maximum = 5) and NOTSS (2.87$ \pm $0.66, maximum = 4). We found significant differences in trauma team leaders' TTFF between teammates and the patient (Team: 1.56 vs Patient: 29.82 seconds, P < .001). TTFF on the diagnostic equipment was negatively correlated (P < .05) to multiple measures of subjective NTS assessments. There were no significant differences in AFD between AOIs, and AFD on teammates was positively correlated (P < .05) to communication and teamwork. There were significant differences in TPS across most AOI pairs (P < .05), and the average TPS fixated was highest on the patient (32%). Finally, there were several significant correlations between additional ET and NTS metrics. This study utilized a mixed methods approach to assess trauma team leaders' NTS in simulated acute care trauma simulations. Our results provide several objective insights into trauma team leaders' NTS behaviors during patient care simulations. Such objective insights provide a more comprehensive understanding of NTS behaviors and can be leveraged to guide NTS training of trauma physicians in the future. More studies are needed to apply these methods to capture NTS from a larger sample of teams in both simulated and real trauma environments.

Evaluation of the accuracy and efficiency of the modified maximum variance method for multiaxial fatigue analysis under constant amplitude loading

An optimized version of the Maximum Variance Method (MVM) is employed to determine maximum shear stress amplitudes in high-cycle multiaxial fatigue analysis using the critical plane approach, increasing accuracy and reducing computational burden. This refined approach posits that the MVM assumes that the critical plane is the one subjected to the maximum variance of the shear stress history. Comprehensive statistical analyses, including Analysis of Variance (ANOVA) and multiple comparison techniques such as Tukey’s HSD and Bonferroni correction, were conducted to systematically investigate the impact of critical factors on fatigue resistance, such as mean stress, phase, synchrony, failure criteria, and the strategy for calculating maximum shear stress amplitude. These analyses highlighted significant effects of mean stress and phase on the accuracy of fatigue strength predictions, underscoring the effectiveness of the enhanced MVM in managing complex loading scenarios. The results demonstrate that the proposed methodology performs equal to or better than conventional methods, with significantly lower computational costs.

Effects of conservation agriculture technologies on soil macrofauna community attributes in rainfed agriculture system

AbstractInappropriate rainfed crop management, especially wrong tillage and crop residue management, led to reduce the diversity of soil biological quality, especially soil macrofauna community, in semiarid region. This study was conducted to investigate the effect of 5 year conservation agriculture operation techniques on the quality and the diversity indices of soil macrofauna community in the rainfed lands in the west of Iran. This experiment was carried out in the statistical format of split‐split plots based on a randomized completely block design with three replications. The main treatments include control or conventional tillage, compound tillage, chisel tillage, and direct cultivation (no tillage) with three sub‐treatments of plant residues (no residues, one‐third, and two‐thirds of plant residues) in rainfed wheat (Triticum aestivum) rotation with rainfed chickpea (Cicer arietinum). Changes in soil biological quality indicators, such as soil microbial respiration were measured. Also, the indicators related to the population of soil macrofauna, including biodiversity index, uniformity index, and species richness, were measured and the effect of treatments on the measured indicators were compared with the classical statistical method of analysis of variance and Duncan's mean comparison test. The results showed that conservation agricultural treatments, including no‐tillage treatment, have led to significant increase of 19% and 15% of macrofauna biodiversity index in wheat and chickpea, respectively. Also, keeping one‐third of the wheat residues has led to an 18% increase in the biodiversity index of the soil macrofauna during the evaluation period. Biodiversity index and taxonomic richness of soil macrofauna were generally higher in the years of wheat than chickpea, and on the contrary, the species uniformity index of soil macrofauna biological community was higher in chickpea than wheat.

Evaluation of Some Sweetpotato (Ipomoea batatas [L.] Lam) Varieties in Mozambique

In Mozambique, sweetpotato plays a significant role in rural areas, where the farmers use it to feed their families and as an income. In this study, we aimed to investigate the performance of different sweetpotato varieties in Niassa, Mozambique. The trial was set up in Malulu, Sanga district, located 60 km away from Lichinga, capital of Niassa, Mozambique. In Sanga, the rainy and hot season occurs from December to March, and the dry and cold season is from May to October. In this trial, the treatments correspond to sweetpotato varieties. We used the randomized block design with 12 sweetpotato varieties and 3 replications. The evaluated traits were as follows: weevil damage, roots commercial yield, roots non-commercial yield, total yield, and vine yield. Regarding statistical analysis, the results per trait were submitted to the Bartlett test of homogeneity of variances and Shapiro-Wilk normality test, and then the analysis of variance and means comparison using the Scott-Knott test when necessary was performed. All the statistical analysis was conducted at 5% on the R programming language. For commercial and total yield, the varieties Local, Sumaia, Olga, and Alisha presented the best results. Esther and Irene were the varieties most attacked by weevils.

Trueness of the apical and middle root portion segments of 3D-printed removable die and alveolar cast designs manufactured using stereolithographic 3D printing.

The present study evaluated the effects of the root portion design, segment (middle vs. apical), and part (die vs. cast) on the trueness of three-dimensional (3D)-printed removable die-cast complex. The trueness of apical and middle segments of the root portion of 45 3D-printed removable dies and casts with three different root portion designs (n = 15) was assessed using a metrology-grade computer program. The three removable dies and cast designs (root form [RF], conical [CON], and cylindric [CYL]) were created using professional computer-aided manufacturing computer programs (DentalCAD 3.1 Rijeka, and InLab CAD 22.0), and manufactured using stereolithographic 3D printer (Form3; FormLabs, Somerville, MA). Subsequently, the 3D-printed removable dies and casts were scanned by a single operator with an intraoral scanner (PrimeScan; Dentsply Sirona, Charlotte, NC), and their respective standard tessellation language files were aligned and compared to master reference files in a metrology-grade computer program (Geomagic Control X; 3D systems, Rock Hill, NC). The root mean square (RMS) values of the middle and apical segments for each removable die and cast were calculated and analyzed using a mixed model including a repeated measure 3-way analysis of variance (ANOVA) and post-hoc stepdown Bonferroni-corrected pairwise comparisons (α = 0.05). A statistically significant 3-way interaction between factors was detected, suggesting that the part (removable die or alveolar cast) and their design affected the RMS values of their apical and middle root portion segment. (p = 0.045). The post-hoc analysis identified significant differences between RMS values of the apical segments of the CON and CYL removable dies (p = 0.005). Significant differences were observed between the middle and apical segments of the CON (p < 0.001) and RF removable die designs (p = 0.004). No statistically significant differences were noticed between the RMS of the different alveolar cast designs (p > 0.05). Significant differences were detected between the apical and middle segments of the same alveolar cast design (p < 0.05). For the manufacturing trinomial and 3D printing strategy used in the present study, the interaction of the part, design, and segment affected the trueness of removable dies and alveolar casts. The trueness was higher on the middle segment on removable dies and alveolar casts in all designs used, except for CYL removable dies, where the trueness difference between segments was small. Higher trueness values may be achieved with designs with simple apical segment geometries.

The Effect of Different Marinades on Some Quality and Sensory Properties of Chicken Breast Meat

In this study, it was aimed to determine the effects of different marination liquids on some quality and sensory properties of chicken breast meat. Three different marination formulations (containing olive oil, red wine and yogurt) were used in the study. After cooking, cooking loss, marinade absorption, pH, color, texture analysis results and sensory test results are discussed. As a result, it was observed that the differences between cooking loss, marinade absorption and pH values of the cooked samples were statistically significant (p&lt;0.05) as a result of analysis of variance and multiple comparison test (Tukey). When the color analysis results were examined, it was determined that different marinades could be effective on the brightness (L*), redness (a*) and yellowness (b*) values of the cooked chicken meat samples and the results obtained were statistically significant (p&lt;0.05). Since the textural values did not show a normal distribution, the Wilcoxon test was applied and no significant difference was detected between the marinades (p&gt;0.05). A panelist test was conducted on 25 people by examining the smell, texture, flavor and color of the samples sensory-wise and a general appreciation scale was created. As a result of the Tukey multiple comparison test applied to sensory analysis data, it was determined that the marination solution containing olive oil had the highest approval score by consumers.

Temporal Convolutional Neural Network-Based Prediction of Vascular Health in Elderly Women Using Photoplethysmography-Derived Pulse Wave during Exercise.

(1) Background: The objective of this study was to predict the vascular health status of elderly women during exercise using pulse wave data and Temporal Convolutional Neural Networks (TCN); (2) Methods: A total of 492 healthy elderly women aged 60-75 years were recruited for the study. The study utilized a cross-sectional design. Vascular endothelial function was assessed non-invasively using Flow-Mediated Dilation (FMD). Pulse wave characteristics were quantified using photoplethysmography (PPG) sensors, and motion-induced noise in the PPG signals was mitigated through the application of a recursive least squares (RLS) adaptive filtering algorithm. A fixed-load cycling exercise protocol was employed. A TCN was constructed to classify flow-mediated dilation (FMD) into "optimal", "impaired", and "at risk" levels; (3) Results: TCN achieved an average accuracy of 79.3%, 84.8%, and 83.2% in predicting FMD at the "optimal", "impaired", and "at risk" levels, respectively. The results of the analysis of variance (ANOVA) comparison demonstrated that the accuracy of the TCN in predicting FMD at the impaired and at-risk levels was significantly higher than that of Long Short-Term Memory (LSTM) networks and Random Forest algorithms; (4) Conclusions: The use of pulse wave data during exercise combined with the TCN for predicting the vascular health status of elderly women demonstrated high accuracy, particularly in predicting impaired and at-risk FMD levels. This indicates that the integration of exercise pulse wave data with TCN can serve as an effective tool for the assessment and monitoring of the vascular health of elderly women.

Generalized Confidence Intervals for Ratios of Standard Deviations Based on Log-Normal Distribution when Times Follow Weibull Distributions.

Modern anesthetic drugs ensure the efficacy of general anesthesia. Goals include reducing variability in surgical, tracheal extubation, post-anesthesia care unit, or intraoperative response recovery times. Generalized confidence intervals based on the log-normal distribution compare variability between groups, specifically ratios of standard deviations. The alternative statistical approaches, performing robust variance comparison tests, give P-values, not point estimates nor confidence intervals for the ratios of the standard deviations. We performed Monte-Carlo simulations to learn what happens to confidence intervals for ratios of standard deviations of anesthesia-associated times when analyses are based on the log-normal, but the true distributions are Weibull. We used simulation conditions comparable to meta-analyses of most randomized trials in anesthesia, and coefficients ofvariation . The estimates of the ratios of standard deviations were positively biased, but slightly, the ratios being 0.11% to0.33% greater than nominal. In contrast, the 95% confidence intervals were very wide (i.e., > 95% of P ≥ 0.05). Although substantive inferentially, the differences inthe confidence limits were small from a clinical or managerial perspective, with amaximum absolute difference inratios of 0.016. Thus, P < 0.05 isreliable, but investigators should plan for TypeII errors atgreater than nominal rates.

Denture Adhesives Associated with Silver Vanadate: Antimicrobial Approach Against Multi- Species Biofilms on Acrylic Resin Surfaces.

Alternatives have been sought to add an antimicrobial property to denture adhesives. This study evaluated the antimicrobial potential of adhesives associated with nanostructured silver vanadate decorated with silver nanoparticles (β-AgVO3). Specimens in acrylic resin were treated with the adhesives associated with β-AgVO3 (1%, 2.5%, 5% and 10%). As control, specimens treated only with Ultra Corega Cream (UCC) or Ultra Corega Powder (UCP) adhesive were used. Multispecies biofilm of Candida albicans, Candida glabrata, Streptococcus mutans and Staphylococcus aureus was evaluated by counting colony forming units per milliliter (CFU/mL), colorimetric assay and fluorescence microscopy. The data were analyzed using the two-way analysis of variance (ANOVA) and Bonferroni multiple comparisons test (α=0.05). For both adhesives, a small amount of β-AgVO3 (1%) completely inhibited S. mutans (P⟨0.05). For the other microorganisms, there was a reduction in metabolic activity and complete inhibition in the groups with intermediate or greater amounts of nanomaterial (P⟨0.05), except for C. albicans, which was reduced (P⟨0.05) but not completely inhibited in UCP. Microscopy that showed less biofilm in the groups with β-AgVO3 and in the UCC than UCP. Denture adhesives in powder and cream form with β-AgVO3 showed potential antimicrobial activity against multispecies biofilm. Powder adhesive showed higher biofilm formation.

Decreased Hepatic and Serum Levels of IL-10 Concur with Increased Lobular Inflammation in Morbidly Obese Patients.

Background and Objectives: Non-alcoholic fatty liver disease (NAFLD) is associated with obesity and ranges from simple steatosis to non-alcoholic steatohepatitis (NASH), fibrosis, cirrhosis, and hepatocellular carcinoma. Accumulating evidence in animal models suggests that loss of interleukin-10 (IL-10) anti-inflammatory actions might contribute to lobular inflammation, considered one of the first steps toward NASH development. However, the role of IL-10 in lobular inflammation remains poorly explored in humans. We examined mRNA and protein levels of IL-10 in liver biopsies and serum samples from morbidly obese patients, investigating the relationship between IL-10 and lobular inflammation degree. Materials and Methods: We prospectively enrolled morbidly obese patients of both sexes, assessing the lobular inflammation grade by the Brunt scoring system to categorize participants into mild (n = 7), moderate (n = 19), or severe (n = 13) lobular inflammation groups. We quantified the hepatic mRNA expression of IL-10 by quantitative polymerase chain reaction and protein IL-10 levels in liver and serum samples by Luminex Assay. We estimated statistical differences by one-way analysis of variance (ANOVA) and Tukey's multiple comparison test. Results: The hepatic expression of IL-10 significantly diminished in patients with severe lobular inflammation compared with the moderate lobular inflammation group (p = 0.01). The hepatic IL-10 protein levels decreased in patients with moderate or severe lobular inflammation compared with the mild lobular inflammation group (p = 0.008 and p = 0.0008, respectively). In circulation, IL-10 also significantly decreased in subjects with moderate or severe lobular inflammation compared with the mild lobular inflammation group (p = 0.005 and p < 0.0001, respectively). Conclusions: In liver biopsies and serum samples of morbidly obese patients, the protein levels of IL-10 progressively decrease as lobular inflammation increases, supporting the hypothesis that lobular inflammation develops because of the loss of the IL-10-mediated anti-inflammatory counterbalance.

Comparative evaluation of the efficacy of Triphala mouthwash and Curcumin mouthwash in the treatment of gingivitis – A randomized controlled study

BackgroundNumerous studies on Triphala and Curcumin mouthwashes were analyzed individually and no study has compared the efficacy of Triphala mouthwash to Curcumin mouthwash in the management of gingivitis. Although various mouthwashes have shown reduction of plaque and gingivitis the search is still on for an ideal mouthwash with minimum side effects and better patient acceptance. ObjectivesTo access the efficacy of all the mouthwashes in the management of gingivitis. MethodsBy purposive sampling, 81 patients of both sexes with gingivitis were randomized by lottery method into 3 groups - A, B and C. Group A received scaling and Triphala mouthwash, Group B received scaling and Curcumin mouthwash and Group C underwent scaling and received Chlorhexidine mouthwash. Oral hygiene was assessed using Plaque, Gingival and Bleeding indices at baseline,7th day and 14th day. The inter-group comparisons were analysed using One-way analysis of variance (ANOVA) and multiple comparisons using Tukey's Honest significant difference test (α = 0.05) and the intra-group comparisons for the indices across various time periods within each group were analysed using Repeated-measures ANOVA and Bonferroni-adjusted pairwise comparisons post hoc test (α = 0.05). The statistical significance was set at p ≤ 0.05. ResultsThe study has shown that herbal mouthwashes are as effective as chlorhexidine in treating gingivitis although curcumin mouthwash showed a greater potential in reducing gingival inflammation. ConclusionBoth Triphala and Curcumin mouthwashes were proven to be equally effective in reducing plaque, gingival and bleeding scores, although curcumin was better in reducing gingival inflammation. Hence herbal mouthwashes such as Triphala and Curcumin with no side effects can be considered as an alternative mouthwash to chlorhexidine.

Flexural Strength of Different Monolithic Computer-Assisted Design and Computer-Assisted Manufacturing Ceramic Materials Upon Accelerated Aging.

The durability of ceramic is crucial, which is probably influenced by aging. This study evaluated the effect of aging on flexural strength of different ceramics. One-hundred twenty ceramic discs (Ø 12 mm, 1.5 mm thickness) were prepared from zirconia-reinforced lithium silicate (ZLS, C), lithium disilicate (LS2, E), precolored yttria-stabilized tetragonal zirconia polycrystalline (Y-TZP, Ip), and customized color Y-TZP (Ic). Samples were randomly divided into two groups for accelerated aging (A) between 5 and 55°C water baths, 30-second immersing time each, for 10,000 cycles, and nonaged group (N), serving as control. Biaxial flexural strength (σ) was evaluated utilizing the piston-on-three-balls at 0.5 mm/min speed. Analysis of variance and Tukey comparisons were determined for significant differences (α = 0.05). Weibull analysis was applied for survival probability, Weibull modulus (m), and characteristic strength (σo). Microstructures were evaluated with scanning electron microscopy and X-ray diffraction (XRD). The highest σ and σo were seen for IcN, followed by IcA, IpN, IpA, EN, CA, CN, and EA, respectively. CN showed the highest m, while EA showed the lowest m. Significant differences of σ for each ceramic were indicated (p < 0.05). Aging caused a significant difference in σ (p < 0.05). XRD showed t→m phase transformation of Ip and Ic after aging. Aging affected strength of ceramics. Comparable strength between LS2 and ZLS was evidenced, but both were less strength than Y-TZP either aging or non-aging. Comparable strength between precolored Y-TZP and customized color Y-TZP was indicated. Better resisting aging deterioration of Y-TZP than LS2 and ZLS is suggested for fabrication restorative reconstruction.

Finite Element Analysis of Anterior Implant-Supported Restorations with Different CAD-CAM Restorative Materials.

Due to the lack of literature concerning the selection of crown materials for the restoration of anterior teeth, this study aimed to investigate the effects of six distinct computer-aided design and computer-aided manufacturing (CAD-CAM) crown materials on stress and strain distribution within implant-supported maxillary central incisor restorations, employing finite element analysis (FEA). Furthermore, a comparative analysis was conducted between models that incorporated adjacent natural teeth and those that did not, intending to guide the selection of the most suitable modeling approach. Crown materials, including Lava Ultimate, Enamic, Emax CAD, Suprinity, Celtra Duo, and Cercon xt ML, were the subjects of the investigation. FEA models incorporating Coulomb friction were developed. These models were subjected to an oblique load, simulating the average maximum bite force experienced by anterior teeth. The potential for failure in titanium implant components and the prosthesis crown was evaluated through von Mises and principal stress, respectively. Furthermore, the failure of crestal bone was assessed through principal strain values. Stress values for each implant component and strain values of the bone were extracted from the models. To assess the impact of the six groups of crown materials, Kruskal-Wallis analysis of variance and post-hoc comparisons were conducted. Additionally, a statistical comparison between the two groups with Lava Ultimate and Cercon xt ML was performed using the Mann-Whitney U test to determine the difference in the two modeling approaches. Higher crown material stiffness led to decreased stress in the abutment, fixture, and retaining screw, along with reduced strain in the surrounding bone. However, the decrease in stress and strain values became less significant with increasing crown stiffness. Additionally, the model with adjacent teeth showed significantly lower stress and strain concentrations compared to the model without adjacent teeth. Crowns with a high elastic modulus were the optimal choice for anterior teeth restoration. Constructing FEA models with adjacent teeth was highly recommended to gain a deeper understanding of the mechanical behavior of dental implant restorations.

Sports-Related Concussion in Collegiate Athletes: The Potential Benefits of Using Graded Neuropsychological Tests With High Ceilings

Objective: Sports-related concussion management in collegiate athletes has been focused on return-to-play. However, resuming schoolwork without a gradual stepwise reintroduction contributes to symptom exacerbation, delayed recovery, and adverse academic performance. Return-to-learn guidelines are limited by a lack of sensitivity in methods monitoring cognitive function. This study evaluated 2 neuropsychological tests, the Sternberg test and the Paced Auditory Serial Addition Test (PASAT), with high ceilings for sensitivity to deficits in speed of information processing, cognitive efficiency, and complex attention. Setting: Academic center research laboratory. Participants: We recruited 56 male and female collegiate contact and noncontact sports athletes. They were categorized into as follows: (1) nonconcussed (n = 23; 7F, 16M); (2) chronic (n = 21; 4F, 17M), at least 1 year from their last concussion; and (3) acute (n = 12; 1F, 11M), within 2 weeks from concussion. Design: Observational cohort study. Main Measures: The PASAT assesses complex attention. The Sternberg test examines processing speed and cognitive efficiency. Cognitive difficulty increases with progression through the tasks for both the PASAT and the Sternberg test. The mean outcome differences of the 3 groups (nonconcussed, acute, and chronic) across the 3 or 4 conditions (difficulty level) were measured with repeated-measures analysis of variance and subsequent pairwise comparison. Results: For processing speed (Sternberg reaction time), the acute group responded slower than the chronic group on the medium (P = .021, Bonferroni corrected) and hard difficulty tasks (P = .030, Bonferroni corrected). For cognitive efficiency (Sternberg reaction time variability), the acute group had increased reaction time variability compared with the chronic group on the medium difficulty task (P = .04, Bonferroni corrected). For complex attention (PASAT omissions), there was a difference between the acute and nonconcussed groups on the moderate-hard difficulty trial (P = .023, least significant difference [LSD] corrected) and between the acute and chronic groups for hard difficulty trial (P = .020, LSD corrected). The acute group performed worse, with progressively shorter interstimulus intervals. Conclusion: Neuropsychological testing without ceiling effects can capture higher-level cognitive dysfunction and use of such tests can contribute to the understanding of how collegiate athletes are affected by SRC. Future studies can investigate optimal testing batteries that include neuropsychological testing with high ceilings and whether the pattern of performance has implications for the return-to-learn process after SRC in the college setting.