Contemporary Techniques Research Articles

A Review of Contemporary Image Guidance Techniques in Head and Neck Cancer.

Traditional head and neck cancer treatment involves open surgery, cytotoxic chemotherapy, and conventional radiotherapy planning. Emerging techniques aim to improve precision and reduce associated toxicity and functional impairment in current practice. This review article describes four such adaptations in image guidance, tailored to next generation therapies. This is a review of current literature, including feasibility studies from our cancer center, relating to: saline-aided intra-oral ultrasound-guided retropharyngeal biopsy; intra-oral ultrasound guided trans-oral robotic surgery (TORS); ultrasound-guided injection of "directly injectedtherapies"; and magnetic resonance imaging-guided radiotherapy. Presented within the context of the wider literature, initial local experience and data indicate good technical outcomes and patient tolerance, and low technical complications in all four image guidance techniques. Initial findings suggest a potentially important future role for these four image guidance techniques, on which next generation therapies are reliant. The broader implications on cross-disciplinary collaboration are also explored herein.

Multi-objective design of fractional frequency-load control for hydro-thermal system considering nonlinear models and uncertainty

One of the crucial quantities in the power system problem is frequency, which should never exceed its nominal value. In normal conditions of load changes, the frequency is adjusted by automatic generation control. Still, in the face of special conditions, such as logging of the downstream network from the main network or a significant amount of generated power leaving the circuit, the power imbalance between generation and consumption causes a rapid frequency drop. In this case, the automatic generation control cannot stop the frequency drop, so the frequency tends toward instability. In this paper, to automatically produce a water-thermal system in two zones of discrete and continuous modes, the design of a fractional controller is discussed and investigated in different functional conditions and uncertainties. The proposed NSGA-II multi-objective method is used in this article to optimize each area’s load frequency control parameters for various goals. The ideal response for the entire network will be obtained by modifying these responses using a multi-factor method. This paper defines a multi-zone frequency load control based on time objective functions and eigenvalues. Based on the speed changes for the proposed algorithm and the novel approachfunction method employed in the control design. The simulation performed and analyzed in different working conditions with different comparative criteria has been discussed and investigated. Compared to more contemporary techniques, the simulation results show that the system’s performance is guaranteed. The main successes of the suggested method in comparison to earlier methods have been the reduction of overshoot, undershoot, and settling time.

Radiology during a war - experience in Ukraine.

Military radiology, an integral part of military medicine, plays a pivotal role in medical triage, diagnosis, and treatment. Its significance lies in providing timely and accurate assessments in challenging situations.The utilization of contemporary sonographic techniques enables rapid identification of life-threatening conditions, ensuring prompt medical aid and facilitating regional anesthesia. Computed tomography emerges as a critical tool for assessing injury extent, planning surgeries, monitoring postoperative phases, and conducting retrospective evaluations, especially when anatomical dissection is complex.Battlefield radiology not only enhances the understanding of injury mechanisms and battlefield traumas but also contributes significantly to the overall improvement of diagnostic and treatment approaches. Ukrainian doctors actively engaged in diverse stages of patient care accumulate a wealth of knowledge, substantially elevating the survival rates of wounded individuals. This experience serves as the foundation for ongoing enhancements and the advancement of military radiology, even during periods of peace. · Military radiology is essential in medical triage, diagnosis, and treatment within military contexts.. · Modern sonographic methods enable swift identification of life-threatening conditions.. · Computed tomography is indispensable for assessing injuries, planning surgeries, and conducting retrospective evaluations.. · Ukrainian doctors actively contribute to the knowledge base, improving diagnostic and treatment practices.. · The acquired experience serves as a foundation for ongoing advancements in military radiology, extending its impact beyond wartime scenarios.. · Nehria N, Nehria Y, Bukharin T. Radiology during a war - experience in Ukraine. Fortschr Röntgenstr 2024; DOI 10.1055/a-2326-7724.

Multicenter comparison of non-operative techniques of intussusception reduction: saline versus air versus barium

Purpose: Intussusception is a common pediatric surgical emergency and non-operative reduction is its first line of management. We aimed to compare 3 contemporary techniques of intussusception reduction.Methods: A retrospective study was performed in 3 tertiary care centers in India from January 2017 through December 2019. In the 3 centers, the primary reduction techniques were ultrasound-guided saline reduction (USR), fluoroscopy-guided pneumatic reduction (FPR), and fluoroscopy-guided barium reduction (FBR), respectively. As per these techniques used, we compared clinical characteristics, such as the successful reduction.Results: A total of 255 patients underwent one of the 3 reduction techniques in the study period. Reduction was successful in 90.3%, 85.1%, and 87.7% in the USR, FPR, and FBR groups, respectively (P = 0.961). Mean time to reduction was shorter in the FPR group (30.8 ± 8.9 seconds), compared with the USR (575.0 ± 242.3 seconds) and FBR groups (495.0 ± 118.4 seconds; P < 0.001). Recurrence rates were 11.8%, 20.3%, and 15.8% in the USR, FPR, and FBR groups, respectively (P = 0.522). No association was found between the patients’ age or symptom duration and the successful reduction. One patient in the USR group, 3 in the FPR group, and 4 in the FBR group reported second recurrences. Perforation occurred in 1 patient in the FPR group while no complications occurred in the other groups. There was no in-hospital mortality.Conclusion: All 3 techniques are equally effective, with FPR requiring a shorter time than the other 2 techniques. The reduction technique should be chosen based on the strengths and weaknesses of each technique, as well as local availability.

A Foresight Framework for the Labor Market with Special Reference to Managerial Roles—Toward Diversified Skill Portfolios

This study introduces a methodology for labor market foresight through alternative futures. It discusses three alternative scenarios for managerial roles, each exploring varying levels of technological advancement and economic growth, to provide insights into the evolving demands for managerial roles. By drafting a diversified skill portfolio, it is argued that employability skills for managers concern providing education in a combination of areas, such as new technologies, trend analysis, and strategic foresight based on the sector in which the firm operates, negotiation skills and human resources management, contemporary sales techniques, entrepreneurship, and personal growth, including time management, creativity, public speaking skills, and foresight skills. Utilizing responses obtained through an online survey administered in Greece during 2024 to managers and employing principal component analysis (PCA), we establish correlations between skill portfolio composition preferences, foresight analysis, and design of diversified skill portfolios. Diversified skill portfolios are a holistic approach to training, reskilling, and upskilling, including an optimum combination of foundational, complex, digital, green, and always case-fit per occupation or sector of economic activity. Consequently, the insights derived from this study offer a microeconomic perspective regarding the optimal combination of skills for managerial occupations and a macroeconomic perspective concerning the formulation of future training policies for human capital development.

Experimentally Verified Retrofit Combining Hybrid Solutions for Enhancing the Seismic Response of Multistory RC Structures

ABSTRACTThis experimental and numerical study proposes hybrid retrofit alternatives involving multiple contemporary techniques to upgrade the fundamental seismic response characteristics of multistory reinforced concrete frame (MSRCF) structures. The impact of thin high‐performance reinforced concrete (HPRC) jackets on the concrete framing system's seismic response is first investigated through shake table testing (STT). The performance of the HPRC‐retrofitted frame is then compared with another STT campaign conducted for fabric‐reinforced cementitious matrix (FRCM)–retrofitted frame. The STT results indicated that at the same input ground motion intensity that caused failure for the FRCM‐retrofitted frame, the curvature ductility and interstory drift ratio of the HPRC‐retrofitted specimen were reduced by 79% and 87%, respectively. Upon verifying the fiber‐based modeling technique of HPRC and FRCM alternatives through STT, the study probabilistically assesses the seismic performance of a benchmark MSRCF building considering different hybrid retrofit alternatives by combining each technique with a self‐centering energy dissipation (SCED) bracing system. Following a systematic seismic assessment framework, it is concluded that the performance‐cost index of the less disruptive HPRC‐SCED option exceeded that of the FRCM‐SCED by 36%, confirming its preference among the considered alternatives for upgrading the seismic response of MSRCF deficient in stiffness, strength, and ductility.

Clinical validation of the 2021 European Society of Cardiology guidelines on pre-existing right bundle branch block patients undergoing transcatheter aortic valve replacement

Abstract Introduction The management of patients with right bundle branch block (RBBB) undergoing transcatheter aortic valve replacement (TAVR) remains challenging. In these patients, the 2021 ESC guidelines recommend early pacemaker (PM) implantation in case of PR prolongation, QRS axis change or transient high-degree atrioventricular block (HAVB). However, evidence for the proposed criteria is scarce. Purpose Our aim was to evaluate the ESC recommendation for risk stratification of RBBB patients undergoing TAVR. Methods We retrospectively analyzed patients with pre-existing RBBB undergoing TAVR at our institution between 2011-2023. A surface 12-lead electrocardiogram (ECG) was available before and after procedure in all patients. The following, proposed ESC criteria were validated: ΔPR interval ≥ 20ms, QRS axis change or transient HAVB < 24 hours after TAVR. Results Of a total 1412 patients undergoing TAVR, 109 had pre-existing RBBB and were eligible for final analysis (mean age 83±5 years, 39% female). Of 109 RBBB patients, 36 (33%) developed persistent HAVB and received a permanent PM. Among the other 73 patients (67%), 17 patients (23%) suffered delayed HAVB during 30-days FU. When applying the ESC Guidelines, PM placement would have been indicated in 52% (38/73) of patients with RBBB after TAVR: due to transient HAVB in 17 (23%), due to PR prolongation ≥ 20ms in 19 (26%) and due to QRS axis change in 20 patients (27%). The proposed ESC criteria identified 82% of patients (14/17) with delayed HAVB during 30-day FU, while missing 3 patients (18%, 2.8% of overall cohort, Figure). This resulted in a sensitivity of 82% and a negative predictive value of 91%. Among the 17 patients with delayed HAVB, 12 patients (71%) displayed transient atrioventricular (AV) block within 24 hours after TAVR. Conclusion In this large cohort of RBBB patients undergoing TAVR with contemporary valves and techniques, the proposed ESC criteria of PR prolongation, QRS axis change or transient HAVB correctly identified 4/5 patients developing HAVB during 30-day FU. Prospective studies are warranted to confirm these findings.

Invited Commentary on "Maxillomandibular Fixation: Risks and Benefits of Contemporary Techniques" by Johnson, et al.

Invited Commentary on "Maxillomandibular Fixation: Risks and Benefits of Contemporary Techniques" by Johnson, et al.

Maxillomandibular Fixation: Understanding the Risks and Benefits of Contemporary Techniques in Adults.

Numerous techniques achieve maxillomandibular fixation (MMF), each with benefits and risks. While using Erich arch bars to achieve MMF has remained the gold standard through the last century, the technique has multiple limitations, which have spurred innovative approaches, such as intermaxillary fixation (IMF) screws, hybrid arch bars, embrasure wires, and dental occlusion ties. The surge in new MMF technologies over the past decade prompted this analysis to compare these techniques. A PubMed search was conducted to identify all current FDA-approved modern MMF technologies from 2005 through 2023, evaluating their advantages and limitations. Studies with controlled scientific comparisons of techniques were limited, precluding a systematic review. Analysis showed no definitive data exist to endorse one technique as a universal option. As multiple MMF options offer appropriate stability, a surgeon may choose an approach based upon numerous factors: comminution/instability; need for physiotherapy, including guiding elastics; safety; time of application/removal; and patient comfort. This article guides the selection between techniques based on these factors and presents a decision algorithm to assist surgeons in selecting the ideal MMF technique for each patient.

Fluctuations in Prejudice Do Not Track Fluctuations in Ordinary Contact in Three 5-Wave “Shortitudinal” Studies Examining Daily, Weekly, or Monthly Intervals

Intergroup contact is regarded as one of the most effective ways to reduce prejudice. However, recent longitudinal studies using contemporary statistical techniques (e.g., random intercept cross-lagged panel models [RI-CLPMs]) have failed to find evidence of within-person changes in prejudice following contact fluctuations. We propose that past time-lags may have been too long to capture change and conducted three studies with shorter time-lags of single days, weeks, or months. We also considered effects of positive versus negative contact frequency. We consistently found that people who are less prejudiced have more contact (i.e., between-person effects); however, fluctuations in naturally occurring contact were not followed by corresponding within-person changes in prejudice, suggesting shorter-term contact fluctuations are detached from prejudice. With abundant support for contact in the field, we argue that prejudice may be impacted by major contact events, or through gradually acquired cumulative experiences, but effects are not apparent when examining “thin-slices” of time.

The Impact of COVID-19 Vaccination on Oxidative Stress and Cardiac Fibrosis Biomarkers in Patients with Acute Myocardial Infarction (STEMI), a Single-Center Experience Analysis

The relationship between the classical cardiac biomarker and acute myocardial infarction (STEMI) in patients with COVID-19 is far from being elucidated. Furthermore, superoxide dismutase (SOD), a marker for oxidative stress, was associated with cardiac ischemia. Also, Galectin-3 is significant for defining the relationship between cardiac fibrosis and COVID-19. There are no studies on the effect of SARS-CoV-2 virus infection and vaccination on patients with STEMI and biomarkers above-mentioned. Aim: our single-center prospective study assesses the relationship between COVID-19 infection with/without vaccination and the value of SOD and Galectin-3 in STEMI patients. Material and methods: In total, 93 patients with STEMI and SARS-CoV-2 virus infection were included in the analysis, patients were divided in two groups based on COVID-19 vaccination status. Echocardiographic and laboratory investigations for cardiac ischemia, oxidative stress, and cardiac fibrosis biomarkers were investigated. Results: In total, 93 patients were included, the majority of which were male (72.0%), 45.2% (n = 42) were vaccinated against SARS-CoV-2; the mean age of vaccinated patients is 62 years, and 57% (n = 53) are smokers; blood pressure is found with a higher frequency in unvaccinated people (62.7%) compared to 28.6% in vaccinated people (p = 0.015), and 90.5% of the vaccinated people presented STEMI, compared with 96.1% of the unvaccinated ones. Revascularization with one stent was achieved in 47.6% of the vaccinated people and 72.5% for the unvaccinated people (p = 0.015). Galectin-3 was slightly more reduced in the vaccinated patients compared to the unvaccinated patients (0.73 vs. 0.99; p = 0.202), and the average level of Cu/ZnSOD was slightly more reduced in vaccinated patients compared to the unvaccinated patients (0.84 vs. 0.91; p = 0.740). Conclusions: Regarding patient’s SARS-CoV-2 infection functional status, the results from our single-center analysis did not find a statistically significant decrease in oxidative stress and cardiac fibrosis biomarkers along with cardiovascular complication following STEMI treated with percutaneous coronary angioplasty (PCI) in the case of patients with COVID-19 vaccination compared with patients who did not receive COVID-19 vaccine. Anyway, our data suggest that contemporary PCI techniques may offer an alternative revascularization strategy that enables complex CAD COVID-19 patients to be safely discharged from hospital.

Hyperspectral Image Classification Algorithm for Forest Analysis Based on a Group-Sensitive Selective Perceptual Transformer

Substantial advancements have been achieved in hyperspectral image (HSI) classification through contemporary deep learning techniques. Nevertheless, the incorporation of an excessive number of irrelevant tokens in large-scale remote sensing data results in inefficient long-range modeling. To overcome this hurdle, this study introduces the Group-Sensitive Selective Perception Transformer (GSAT) framework, which builds upon the Vision Transformer (ViT) to enhance HSI classification outcomes. The innovation of the GSAT architecture is primarily evident in several key aspects. Firstly, the GSAT incorporates a Group-Sensitive Pixel Group Mapping (PGM) module, which organizes pixels into distinct groups. This allows the global self-attention mechanism to function within these groupings, effectively capturing local interdependencies within spectral channels. This grouping tactic not only boosts the model’s spatial awareness but also lessens computational complexity, enhancing overall efficiency. Secondly, the GSAT addresses the detrimental effects of superfluous tokens on model efficacy by introducing the Sensitivity Selection Framework (SSF) module. This module selectively identifies the most pertinent tokens for classification purposes, thereby minimizing distractions from extraneous information and bolstering the model’s representational strength. Furthermore, the SSF refines local representation through multi-scale feature selection, enabling the model to more effectively encapsulate feature data across various scales. Additionally, the GSAT architecture adeptly represents both global and local features of HSI data by merging global self-attention with local feature extraction. This integration strategy not only elevates classification precision but also enhances the model’s versatility in navigating complex scenes, particularly in urban mapping scenarios where it significantly outclasses previous deep learning methods. The advent of the GSAT architecture not only rectifies the inefficiencies of traditional deep learning approaches in processing extensive remote sensing imagery but also markededly enhances the performance of HSI classification tasks through the deployment of group-sensitive and selective perception mechanisms. It presents a novel viewpoint within the domain of hyperspectral image classification and is poised to propel further advancements in the field. Empirical testing on six standard HSI datasets confirms the superior performance of the proposed GSAT method in HSI classification, especially within urban mapping contexts, where it exceeds the capabilities of prior deep learning techniques. In essence, the GSAT architecture markedly refines HSI classification by pioneering group-sensitive pixel group mapping and selective perception mechanisms, heralding a significant breakthrough in hyperspectral image processing.

The Curve Fitting Problem, Data Validation, and Inductive Generalization in Machine Learning

AbstractAris Spanos and Deborah Mayo’s error-statistical approach to statistical modeling and inference adopts the reliability of inductive inference as a primary criterion for statistical model and estimator selection (e.g., curve fitting). In this paper, we expand the error-statistical approach’s adoption of reliable inductive inference by scrutinizing the epistemic legitimacy of contemporary techniques leveraged in data science. We argue that data validation and testing potentially provides a direct, measurable method of evaluating evidence for reliable inductive inferences in cases where the error-statistical approach is not easily applied, and conclude with an exploration of core methodological foils to the reliability of inductive inference revealed by this argument.

Nurturing the Faculty: Training for Excellence and Growth

"The impact of teacher education and wellbeing on higher education: a critical analysis" is one of the primary topics of the research. The well-being and ongoing education of faculty and staff are crucial for the advancement of higher education and significantly contribute to the achievements of both faculty and students. In this paper, we have explored the significance of providing training opportunities and prioritizing the wellbeing of faculty members.The significance of teacher training in higher education is paramount as it guarantees that educators are well-informed about contemporary teaching techniques, technological advancements, and the latest research findings. In a constantly evolving educational landscape, ongoing professional development is crucial to guarantee that teachers can offer the highest quality education to their students. Exciting challenges among educators in higher education frequently encounter stress and pressure as a result of demanding workloads, intense research, various responsibilities, and job searches. Failing to prioritize health can result in reduced job satisfaction, psychological issues, and the loss of teaching and research opportunities.It is crucial to find a balance between faculty and health in order to ensure the success of higher education institutions. It's not sufficient to solely concentrate on one aspect. Failing to prioritize education can result in a chaotic teaching environment, while neglecting health can lead to teacher exhaustion. Training and wellbeing are closely linked, as training equips educators with the necessary knowledge and skills to effectively teach and conduct research, while wellbeing ensures they can maintain their efforts in the long run. "Faculty training and wellbeing in higher education: a crucial balancing act" is a subject that requires the attention of higher education institutions, policy-makers, and educators themselves. Striking the right balance between training and wellbeing can result in a more productive, innovative, and compassionate higher education system that benefits both faculty members and students. It's a challenge worth tackling for the improvement of academia.

Environmental Design Teaching with the Integration of Traditional and Modern Techniques

Background: Environmental management considers the architecture in design, planning, programming, or manufacturing. It intends to create places that recover the cultural, social, ecological, and physical architecture of certain locations. However, traditional teaching methods are indeed employed. Modern technologies serve as supplemental tools. The current method of instruction is a step toward contemporary technology.Objective: Examining environmental design training using conventional and contemporary techniques was the aim of the study. Method:We collected survey data for this investigation. 400 students completed and submitted the questionnaire. Statistical Package for Social Sciences (SPSS) software was used to present the data. The research examines well-known visualization tools and traditional contemporary presentation techniques.Result: According to the study, architecture students rated modern technologies more satisfactory than traditional methods, indicating higher quality facilities and services. Modern technology in Environmental Design Teaching enhances learning experiences by reducing time consumption (65%), increasing efficiency (85%), offering flexibility (65%) and improved visualization (90%), and facilitating better documentation (80%), leading to higher student satisfaction (87%).Conclusion: Integrating traditional and modern architectural design techniques enhances learning experiences and efficiency, resulting in more effective and innovative design solutions through advanced tools and methods.

Revisiting the earliest hyperscanning study: power and functional connectivity in the alpha band may link brains far apart.

This brief report revisits the earliest known hyperscanning study published in 1965, which examined simultaneous EEG recordings of identical twins separated by six meters. The original study's findings suggested that eye closure in one twin elicited alpha activity in the other, despite physical separation. Leveraging contemporary signal processing techniques, we reanalyzed the digitized data to validate their findings. Spectral analysis confirmed alpha activity in the twins' EEG signals, aligning with the original observations. Multitapering along with background noise subtraction also revealed the alpha activity in the unrelated subject, which could not be observed by visual inspection alone. Coherence analysis revealed significant alpha band synchrony between a twin and an unrelated subject, differing from the initial study's conclusions. Our findings indicate that even historical data can yield new insights when revisited with contemporary data analysis tools and highlight the potential for future large-scale studies using advanced techniques to explore nonlocal brain interactions.

Resistance Pattern of Acinetobacter baumannii in Hospitalized Patients

Background: One of the most prevalent bacteria in nosocomial infections is Acinetobacter baumannii. Misuse of antibiotics has resulted in an increase in A. baumannii multidrug-resistant (MDR) strain resistance. To assess the resistant gene pattern of MDR A. baumannii, empirical antibiotic therapy is required. In order to do this, the current study used a genotypic diagnostic technique to assess the resistance gene pattern of MDR A. baumannii that was collected from hospitalized patients. A. baumannii has resistance mechanisms against broad-spectrum antibiotics, including β-lactamases, efflux pumps, and aminoglycosides, altering targets, permeability shifts, and enzyme modifications. Efforts have been made to target plant-derived compounds and a combination of antibiotics and phytocompounds to circumvent resistance mechanisms. Many studies have been conducted on plant extract-synthesised nanoparticles. Additionally, we projected contemporary techniques to investigate insights into the mechanisms of action of antibiotics, such as multi-omics analysis. The data implied that A. baumannii putative antibiotic pathways would result in a different approach to treating A. baumannii infections. One of these resilient pathogens is A. baumannii, which is becoming more common in hospitals, resistant to treatment, and linked to higher death rates. Notwithstanding its clinical importance, little is known about this pathogen's behavior outside of hospitals. Additionally, unknown are its virulence factors. Consequently, our goal in this review is to provide light on the most recent findings about the ecological niches, microbiological characteristics, and antibiotic resistance profiles of A. baumannii. According to recent research, this bacterium is found in an increasing number of environmental niches, such as soils, treatment plants, and rivers.

Getting in the zone: Metabolite transport across liver zones.

The liver has many functions including the regulation of nutrient and metabolite levels in the systemic circulation through efficient transport into and out of hepatocytes. To sustain these functions, hepatocytes display large functional heterogeneity. This heterogeneity is reflected by zonation of metabolic processes that take place in different zones of the liver lobule, where nutrient-rich blood enters the liver in the periportal zone and flows through the mid-zone prior to drainage by a central vein in the pericentral zone. Metabolite transport plays a pivotal role in the division of labor across liver zones, being either transport into the hepatocyte or transport between hepatocytes through the blood. Signaling pathways that regulate zonation, such as Wnt/β-catenin, have been shown to play a causal role in the development of metabolic dysfunction-associated steatohepatitis (MASH) progression, but the (patho)physiological regulation of metabolite transport remains enigmatic. Despite the practical challenges to separately study individual liver zones, technological advancements in the recent years have greatly improved insight in spatially divided metabolite transport. This review summarizes the theories behind the regulation of zonation, diurnal rhythms and their effect on metabolic zonation, contemporary techniques used to study zonation and current technological challenges, and discusses the current view on spatial and temporal metabolite transport.

Experimental and Chitosan-Infused Adhesive with Dentin Pretreated with Femtosecond Laser, Methylene Blue-Activated Low-Level Laser, and Phosphoric Acid.

Aim: To prepare experimental adhesive (EA) with 1% and without chitosan nanoparticles on dentin conditioned with a conventional technique phosphoric acid (PA) compared with two different contemporary techniques: photodynamic therapy (PDT) and femtosecond laser (FSL). Method: The methodology consisted of synthesis of EA and 1% chitosan-modified adhesive (CMA). Scanning electron microscopy, dentin adhesive interface assessment, energy-dispersive spectroscopy, shear bond strength (SBS), degree of conversion (DC), and bond failure were assessed. Teeth were selected, disinfected, and mounted in acrylic up to the cementoenamel junction. Occlusal enamel was removed and teeth were randomly allocated into groups and conditioned. These included Group 1: samples treated with PA; Group 2: specimens conditioned with methylene blue photosensitizer (MBP) activated by PDT; and Group 3: samples conditioned with FSL. Following different conditioning regimes, specimens were bonded using 1% CMA and EA. The composite buildup was followed by SBS testing and a bond failure assessment. DC was assessed for both EA and CMA. Analysis of variance and Tukey's post hoc test were used to compare the mean and standard deviation of SBS and DC in different experimental groups, with a significance level of p < 0.05. Results: Dentin pretreated with etch and rinse demonstrated the highest bond strength with 1% CMA. Dentin conditioned with MBP activated by PDT and bonded to EA showed the lowest bond scores. Overall SBS values of 1% CMA were better than EA irrespective of the conditioning regime of dentin. The DC was higher in EA adhesive. This was followed by DC in 1% CMA. DC in EA was found to be comparable with 1% CMA. Conclusions: PA remains the gold standard for dentin conditioning. The incorporation of 1% chitosan in adhesive improves SBS and results in no change in DC. The use of FSL in dentin conditioning can be used as an alternative approach as it results in SBS within acceptable limits. The study was approved by the ethical board of King Saud University.

Total Ankle Arthroplasty Incision Management: What Matters? A Systematic Review

Modern advancements in total ankle arthroplasty techniques and implants have increased the popularity of this treatment for ankle osteoarthritis. The preeminent approach for ankle replacement involves an anterior incision, however, wound complications with this approach provide a persistent challenge to surgeons. The present study was conducted to synthesize current data on ankle replacement wound complications via an anterior approach. A systematic review was completed including studies published from 1993 to present that employed an anterior approach and had precise criteria for wound healing and revisions. Twenty-nine studies, with level 3 to 4 evidence and moderate to serious bias, were included for a total of 6,986 ankle arthroplasties. The rate of wound healing without any complication was 90.38%. Minor dehiscence occurred in 6.00% of cases, while major wounds or infections occurred in 3.62%. Across 2,966 implants, the rate of major wounds or infections decreased from 7.03% before 2013 to 4.75% after 2013 (p = 0.034). Limited comparisons involving simple suture closure to various adjunct wound management techniques including negative pressure wound therapy, 2-octyl cyanoacrylate, platelet-rich plasma, dehydrated human amniotic membrane allograft, non-invasive skin expansion strips, compression wound dressings, tranexamic acid, surgical helmets, tourniquets, ankle arthrodesis, and lateral approach ankle arthroplasty, yielded non-significant differences (p > 0.18). Therefore, contemporary techniques, patient selection, and current implants may be leading to better soft tissue healing. As ankle replacement continues to surge in popularity, further research is needed to evaluate causative factors in successful anterior incision healing. Level of Clinical Evidence3