Conventional Instruments Research Articles

Development of paper-based microfluidic analytical device (μPAD) for the determination of paracetamol in water samples: Optimization using response surface methodology (RSM)

Detecting and quantifying pharmaceutical compounds in various environmental matrices is complex and challenging. This difficulty stems from the trace levels at which these compounds are found and the lack of analytical methods that are rapid, cost-effective, and portable. To address these challenges, this study aimed to develop microfluidic paper-based analytical devices (μ-PADs) using beeswax screen printing for fabrication. Key parameters, including reaction time, concentration, reagent volume, and channel length, were optimized using response surface methodology. Under optimal conditions of 5 ppm sample concentration, 10 μL reagent volume, 10 min reaction time, and 2 cm channel length, the analytical performance of the μPAD was evaluated and compared with the standard UV–Vis spectrophotometry method. The microfluidic analytical device demonstrated detection limits at 0.03 μg/ml, compared to 0.01 μg/ml for the UV–Vis spectrophotometer. Although the sensitivity of µ-PADs in this study (0.03 μg/ml) is lower than that of UV–Vis (0.01 μg/ml), it represents an improvement over the previous µ-PAD report (1 μg/ml) on the same analytes. Both methods exhibited commendable precision, with a relative standard deviation below 2%. Additionally, recovery rates were acceptable and comparable, ranging from 86.8 to 99.6% for µ-PADs and 96.5–99% for UV–Vis. The analytical performance evaluation suggests that µPADs provide excellent sensitivity, precision, and accuracy for trace-level paracetamol analysis. A paired t-test further confirmed no statistically significant difference between the two methods, underscoring the promising potential of µ-PADs for trace-level paracetamol quantification in water samples without conventional analytical instruments.

Digital tools in primary total knee arthroplasty-Prevalence in the German-speaking region

Digital tools are being increasingly used worldwide in primary knee arthroplasty. This study aimed to analyze the utilization density of digital tools, the preferred alignment strategies, and the obstacles and benefits of implementing these technologies in German-speaking countries. An online survey with 57questions about digital tools in primary knee arthroplasty and their usage was conducted among members of the Arthroplasty Working Group (AE). The survey included questions on navigation, robotics, patient-specific instruments, individualized implants, and augmented reality. The survey revealed that 18% of hospitals use navigation and 17% use robotic systems in primary total knee arthroplasty surgery. The main reasons for not implementing supportive technologies were high acquisition and ongoing costs, as well as longer surgical duration. Patient-specific instruments and individualized implants currently play aminor role. Patient-specific alignment strategies, such as kinematic (navigation: 35%; robotics: 44%) and functional alignment (navigation: 15%; robotics: 35%), are preferred in this context. With conventional instrumentation predominantly mechanical alignment was applied (79%). The results indicate arelatively high utilization density of digital tools, which are mainly used to perform personalized alignment strategies in primary knee arthroplasty in German-speaking countries. This was particularly evident in high-volume hospitals. Economic aspects were the main reasons for not using these technologies. Future developments should aim to simplify the systems and thus achieve improved cost efficiency.

Initial experience with a 5G cellular network and robotic arm-based remote echocardiographic system in an all-comers setting

Abstract Background Echocardiography is the test-of-choice for the initial evaluation of many cardiac diseases and requires expertise that is often limited in rural area. Robotic arm-assisted remote echocardigram has been attampted for teleconsultation but was limited to heart failure patients(ref), primarily due to the network delay in telecommunication and the subsequent incoordination in robotic arm control. Purpose We aim to assess the feasibility and diagnostic accuracy of a 5G cellular network and robotic arm-based remote echocardiographic system in an all-comers setting. Methods 51 pts were enrolled from the outpatient cardiology clinic of our institute. All pts underwent standard comprehensive echocardiography on a 5G cellular network and robotic arm-based remote echocardiographic system (the robotic part was deployed at our hospital and the control part was located at another campus 20 kilometers away) (Figure 1)and a conventional echocardiographic platform (at our hospital) successively. The order in which patients were examined on the remote and conventional instruments was randomly determined. There was no interval between the two examinations, and examinations of the same patient were performed by experienced but different cardiologists, who were blinded to each other’s diagnosis. The doctor who used the remote system was also randomly allocated and had not been previously specifically trained. The exams were real-time and diagnoses were made right after the exams. Results Of the 51 pts, the image quality was sufficient for diagnosis in 50 patients (48% female, 40±18 years). 1 pt was excluded because some key views could not be obtained using the remote system (98% of exams successful). 17 pts had positive findings, including 10 with a primary diagnosis of valvulopathy (1 Barlow's syndrome, 1 bicuspid aortic valve and 8 less-than-moderate regurgitation), 2 cardiac surgery follow-ups (1 case of aortic valve replacement and septal myectomy, and 1 case of mitral valve replacement and tricuspid annuloplasty), and 2 hypertrophic cardiomyopathy (including 1 case of obstruction at papillary muscle level), 2 with abnormal left ventricular wall motion(including 1 case of apical mural thrombus) (Figure 2), and 1 with congenital heart disease (secumdum atrial septal defect). The main diagnosis was consistent in 98% of cases (papillary muscle level obstruction was missed in one case), using conventional echocardiographic findings as the standard. Time for image acquision using remote echocardiography was significantly longer than conventional one (24 minutes 36 seconds ± 4 minutes 52 seconds vs. 16 minutes 15 seconds ± 1 minute 54 seconds, p<0.0001, paired t-test). Conclusions Comprehensive echocardiographic exam with a 5G cellular network and robotic arm-based remote system is feasible with relatively good diagnostic accuracy.Figure 1Figure 2

The comparative study of temperature rise, time consuming and cut quality among piezosurgery, conventional rotary instruments and Er: YAG laser in apicectomy

ObjectivesThis study aimed to compare the temperature rise, time consuming and cut quality of apicectomy using three different methods.Materials and methodsTwenty-four single-rooted teeth were collected and divided into four groups operating apicectomy with a NINJA tip of a piezoelectric device (G1), a diamond bur with 300,000 rpm (G2), and Er: YAG laser at 200 mJ/ 30 Hz (G3) as well as 250 mJ/ 30 Hz (G4). The temperature elevation and time were recorded and the cut quality was evaluated via stereomicroscope and scanning electronic microscopy (SEM).ResultsThe temperature increases for G1 was significantly higher than for G2. However, there was no significant difference between G1 and G2 with laser groups respectively. The median time for apicectomy was: 100.14s for G1, 22.65s for G2, 33.58s for G3, and 21.80s for G4. G1 is the most time-consuming group and there was no statistically significance in the comparisons with G2, G3 and G4. Cut quality was assessed by crack occurrence, smear layer formation and dentinal tubules exposed. The percentage of cracked teeth in G1 and G2 was 33.33% and for laser groups the percentage was 16.67% each. SEM showed that no smear layer formed and almost all dentinal tubules were exposed on resected surfaces for G3&G4, surfaces from G2 were partly covered by smear layer, and surfaces from G1 were fully covered by smear layer and with no dentinal tubules exposed.ConclusionsEr: YAG laser and conventional rotary instruments were safe and efficient for apicectomy and with a better cut quality when compared with piezoelectric equipment. Er: YAG laser could be a promising technique for apicectomy and further studies are necessary, especially larger sample in vivo investigations, to verify the feasibility of Er: YAG laser in endodontic surgery.

Comparison of surgical performance using articulated (ArtiSential®) and conventional instruments for colorectal laparoscopic surgery: A single-centre, open, before-and-after, prospective study.

Rigid surgical instruments limit movement whereas articulated instruments offer better control in small spaces and allow for intuitive and ergonomic movements. However, the effectiveness of the use of articulated instruments in improving colorectal laparoscopic outcomes remains unclear. The aim of this work was to determine whether colorectal laparoscopic surgical proficiency improved when multijoint instruments were used instead of conventional ones. We enrolled 70 consecutive patients (n = 20 for conventional instruments) aged 19-80 years who underwent elective laparoscopic surgery for colorectal diseases. Unedited surgery videos were validated using the modified Global Operative Assessment of Laparoscopic Skills (mGOALS) scale. Learning curves were analysed using a cumulative sum control chart for mGOALS grades. The surgery type, length of hospital stay and 30-day postoperative complication rates were comparable between the groups, and the surgeon's mGOALS grades were similar (p = 0.190). However, in the articulated group, the scores were significantly higher for depth perception (p = 0.012) and tissue-handling domains (p = 0.046), while surgical duration was significantly shorter and intraoperative blood loss was significantly lower (p = 0.022), compared with those in the conventional (p = 0.002) group. Learning curve findings indicated that the first 10 and subsequent 40 surgeries in the articulated group were within the inexperienced and experienced phases, respectively. The mGOALS score in the experienced phase improved in the articulated group compared with that in the conventional group (p = 0.036). The use of articulated instruments in laparoscopic colorectal surgery showed potential benefits. Further studies are needed to confirm these findings.

DEVELOPMENT AND IMPLEMENTATION OF A FIVE-TIER DIAGNOSTIC TEST TO IDENTIFY STUDENT MISCONCEPTIONS ON FRACTIONS: A SIGNIFICANT STEP TOWARDS IMPROVING MATHEMATICS EDUCATION

Misconceptions in fractions, a significant challenge in mathematics education, occur when students' conceptions do not align with scientific conceptions, yet they firmly believe in the correctness of their conceptions. These deeply rooted misconceptions are difficult to eliminate and not easily identified with conventional instruments. Therefore, this study aims to develop a valid and reliable five-tier diagnostic test instrument to identify students' misconceptions about fractions effectively. The design of this development research involves qualitative and quantitative methods using the 4D model (define, design, develop, disseminate). Sixty-eight seventh-grade students were involved in quantitative instrument quality testing; data were analyzed using SPSS. The final result of the development of this instrument was 12 questions declared valid and reliable. Furthermore, the instrument was applied to 30 seventh-grade students in different schools to identify their misconceptions about fractions. Based on the analysis of the combination of students' answers, it was obtained that 36.4% of students understood the concept, 8.9% were in the false positive category, 7.2% were false negative, 9.7% lacked knowledge, and 37.8% had misconceptions. It was found that the most dominant description of misconceptions (33%), namely, students assume that the smaller the denominator of a fraction, the smaller the value of the fraction. Then, it was also found that students' thinking, in general, causes misconceptions to occur. The practical implication of the results of this study is that teachers can use the instrument and identify misconceptions to develop more effective teaching methods, thereby improving mathematics education by helping students avoid and anticipate misconceptions.

Precise Acetabular Prosthesis Positioning Using a Novel Robot-Assisted Total Hip Arthroplasty System: A Multicenter, Randomized Controlled Trial.

Total hip arthroplasty (THA) is currently one of the most effective treatment methods for end-stage hip joint disease, and its long-term effectiveness largely depends on the accurate placement of the acetabular prosthesis. In conventional surgery, the placement of the acetabular prosthesis mainly relies on the surgeon's clinical experience and surgical techniques. To further improve the accuracy of prosthesis placement, a new robotic system for THA is designed. The purpose of this study is to verify the effectiveness and safety of THA assisted by this robotic system. A multicenter, prospective, randomized controlled, superiority study design was adopted with statistical methods of t test and Chi-squared test. Participants undergoing primary THA have been enrolled in three centers of joint surgery in China since July 17, 2023. Robotic THA was operated in the experimental group, and conventional instruments were used in the control group. The primary outcome is the proportion of anteversion and inclination angles in the safe zone. The secondary outcomes include operation time, WOMAC score, Harris score, SF-36 health questionnaire, dislocation rate of hip joint, and rates of adverse events and serious adverse events. A total of 138 patients were included in this study. The proportion of both anteversion and inclination angles in the safe zone was 92.2% in the experimental group and 50.8% in the control group, with significant difference (p < 0.01). The average operation time in the experimental group and control group was 116.4 and 80.5 min respectively, with significant difference (p < 0.01). There was no significant difference in WOMAC score, Harris score, and SF-36 between the two groups (6 ± 2) weeks after operation (p > 0.05). The dislocation rate of hip joint in the experimental group and control group were 3.0% and 1.5%, respectively, without significant difference (p > 0.05). The rate of adverse events and severe adverse events in the experimental group and control group also showed no significant difference (p > 0.05). No adverse events or serious adverse events were judged to be "definitely related" to the experimental instruments. Robotic THA could prolong the operation time within an acceptable range, but more precise acetabular prosthesis positioning could be obtained when compared with conventional surgery. Besides, no significant difference was found in function scores, dislocation rate or other adverse events, which indicates that this new robot system shows both good effectiveness and safety in THA. Clinical Trials: NCT05947734.

Patient-specific instrumentation improved clinical outcome and implant survival but is not superior compared to conventional total knee arthroplasty: Ten years follow-up of a multicenter double-blind randomized controlled trial.

Patient-specific instrumentation (PSI) is a commonly used technique designed to improve mechanical alignment in total knee arthroplasty (TKA) and was therefore believed to lead to better clinical outcome and implant survival rates compared with conventional instruments (CIs). To date, long-term results comparing these two techniques are not available. This study is a 10-year follow-up of a previous double-blind multicenter randomized controlled trial where PSI was compared with CI. Patients with osteoarthritis of the knee who were candidates for TKA were included. Exclusion criteria were metal near the knee-, ankle- or hip joint, patients with contra-indications for a magnetic resonance imaging (MRI) scan and patients who had previous knee surgery (except arthroscopic meniscectomy). Clinical outcomes were assessed using patient-reported outcome measures (PROMs), and the analysis was performed with a general linear mixed model for repeated measurements. Kaplan-Meier curves were used to compare revision rates. X-rays were obtained and examined by two individual reviewers for any signs of loosening of the components. At a mean follow-up of 10.1 (SD 0.1) years, 129 patients (loss to follow-up 23%) were analysed in this trial. No statistically significant difference between the two groups were found for any of the PROMs and revision rates were comparable, six in the PSI group and three in the CI group (p = 0.29). Two X-rays in the PSI group showed a radiolucent line of the femoral component. At 10-year follow-up, PSI does not lead to better clinical outcome or survival of the prosthesis compared with CI.

The application effect of a new type of laparoscopic multi-freedom surgical instrument in the training of basic surgical skills

Objective: To evaluate the application effect of a new type of laparoscopic multi-degree-of-freedom surgical instrument in the training of basic surgical skills and analyze the learning curve. Methods: To analyze the teaching records of the trainees who received training in the training base of laparoscopic surgeons in Chinese People's Liberation Army General Hospital from January to October, 2023. The 50 trainees were randomly divided into conventional instrumentation group and new instrumentation group with 25 trainees in each group according to the random number table method before the training. According to the research design, five modules such as "accurate bean clamping, plum blossom pile bean clamping, ferrule positioning, threading with both hands, sewing and knotting" were trained. After the training, they were assessed and the completion time of each module was recorded. The comparison of the changes of the completion time of the two groups of students before and after training was statistically analyzed by differences-in-differences(DID) method, and the fitting analysis of learning curve was analyzed by cumulative summation method. Results: Before the training, there was no statistically significant difference in the time required to complete five modules between the two groups of trainees (all P>0.05). After the training, the time to complete the five modules in both groups was reduced compared to before the training (accurate bean clamping: (63.7±9.3) seconds vs. (85.4±18.2) seconds, t=2.38, P=0.035; plum blossom pile bean clamping: (45.2±6.8) seconds vs. (103.1±57.2) seconds, t=8.77, P=0.047; ring positioning: (78.5±19.1) seconds vs. (126.2±26.3) seconds, t=6.96, P=0.019; threading with both hands: (63.3±21.2) seconds vs. (105.8±27.9) seconds, t=3.43, P=0.015; sewing and knotting: (160.2±79.5) seconds vs. (228.9±96.6) seconds, t=4.58, P=0.008).The average time required to complete the five modules was shorter in the new instrument group compared to the conventional instrument group (DID for accurate bean clamping=37.66, t=2.43, P=0.007; DID for plum blossom pile bean clamping=58.42, t=3.03, P=0.013; DID for ferrule positioning=28.33, t=2.83, P=0.031; DID for threading with both hands=48.89, t=2.10, P=0.042; DID for sewing and knotting=54.78, t=3.57, P=0.012). In the learning curves for the plum blossom pile bean clamping, ferrule positioning, and sewing and knotting modules, the new instrument group required fewer class hours to reach proficiency compared to the conventional instrument group (plum blossom pile bean clamping: 3 class hours vs. 4 class hours; ferrule positioning: 4 class hours vs. 5 class hours; sewing and knotting: 3 class hours vs. 5 class hours). In the accurate bean clamping and threading with both hands modules, both the conventional and new instrument groups crossed the learning curve at the 5th class hour, but there was a statistically significant difference in the slopes of the curves between the two groups (accurate bean clamping: t=-2.85,P=0.004; threading with both hands:t=-2.66,P=0.008). Conclusion: The new type of laparoscopic multi-degree-of-freedom surgical instruments can improve the learning effect and shorten the learning curve in laparoscopic training teaching, which shows good application effect and has the potential of clinical trial.

A method for studying the effect of diegetic vs. non-diegetic rating interfaces on the assessment of virtual acoustic environments

Auditory perception experiments conducted in VR come along with a high degree of ecological validity while maintaining a controlled laboratory setting. However, since the participant's vision is occupied during simulation, conventional evaluation instruments like rating scales need to be relocated to the virtual environment to allow for immediate stimulus rating. This can be achieved either by the use of diegetic interfaces, which are implied to be a part of the simulation (e.g., a screen held by the participant's avatar) or non-diegetic interfaces, which do not claim to originate from the simulated reality (e.g., sliders and text elements laid on top of the participant's view). It is unknown whether the choice of interface does affect the participant's perception of the virtual environment - including its acoustic components. To address this shortcoming, a methodological study is presented. Participants are exposed to a virtual scenario simulating an urban green area with nearby ambience sound sources. In this setting, they are provided with diegetic and non-diegetic rating interfaces to assess the acoustic environment. Subsequently, perceived presence and involvement in the virtual environment are surveyed as well. This way, the study provides useful guidelines for future VR experiments assessing soundscape-related aspects of perception.

Comparative Evaluation of Laser System to Conventional Surgical Approaches in Periodontal Healing Using Optical Coherence Tomography

Background: Optical coherence tomography (OCT) is an emerging, radiation-free diagnostic tool in dentistry, providing high-resolution, real-time imaging of both hard and soft tissues, including periodontal areas, for more accurate postoperative evaluations. This study aims to investigate the efficacy of OCT on periodontal tissues in animals by comparing the healing effects of laser therapy with those of conventional surgical instruments. Methods: Six rabbits underwent periodontal surgery using a laser, scalpel, and punch to perform an apically positioned flap on the mandibular anterior incisors and to create a tongue ulcer on the dorsal surface of the tongue. Visual and OCT evaluations were conducted on days 1, 2, 3, 7, and 14. Results: In periodontal surgery, the laser exhibited slightly faster healing compared to other methods. In tongue ulcer formation, the scalpel and punch groups demonstrated slightly faster healing than that of the laser. However, both methods ultimately showed similar healing outcomes. Conclusions: In the dental field, OCT is emerging as a valuable tool for assessing healing, including early stages of healing, in periodontal therapy.

Feasibility and Safety of ArtiSential for Minimally Invasive Surgery in Early-stage Gynecologic Cancer: Results from the KGOG 4002/GYANT Study

Objectives: The objective is to evaluate the feasibility and safety of ArtiSential for performing minimally invasive surgeries for gynecological cancers. Materials and Methods: We conducted a prospective observational study at 10 Tertiary Institutional Hospitals in Korea between November 2021 and April 2022. Eligible patients were 18 years or older and planned to undergo minimally invasive surgery for gynecologic cancer. We collected baseline characteristics, surgical information, and postoperative outcomes. The primary endpoint was to compare the operation time required for gynecologic cancer surgery using ArtiSential with the reported operation time for surgery using conventional laparoscopic instruments or robots. The secondary endpoints were to evaluate the surgical outcomes of gynecologic cancer surgery using ArtiSential compared to conventional laparoscopic instruments or robots and collect operator feedback on equipment improvements during surgery. Results: Forty patients were enrolled in this study, including 19 with endometrial cancer, 15 with cervical cancer, and 6 with ovarian cancer. The average operation time was 187.0 ± 49.2 min, with no complications encountered during surgery. Pelvic lymph nodes were assessed in 34 patients, with the ArtiSential device utilized in 22 (64.7%) of these patients, at an average assessment time of 40.3 ± 19.4 min. Most surgeons using the ArtiSential device reported that it performed slightly better than conventional laparoscopic instruments. Conclusion: The use of the ArtiSential device in minimally invasive surgery has been demonstrated to be both feasible and safe for the treatment of early-stage gynecologic cancer.

Efficiency assessment of intelligent patient-specific instrumentation in total knee arthroplasty: a prospective randomized controlled trial

BackgroundIn total knee arthroplasty (TKA), the practical use of patient-specific instrumentation (PSI) has been reported previously with both advantage and disadvantage. The application of artificial intelligent (AI) forces overwhelmingly development of medical industries, while the impact of AI on PSI efficiency remains unknown. Thus, this study aimed to assess the efficiency of Intelligent-PSI (i-PSI) in TKA, compared with the conventional instrumentation-TKA (CI).Methods102 late-stage OA patients who met inclusive criteria were recruited in this prospective randomized controlled trial and separated into two groups (i-PSI vs. CI). In both groups, an AI preoperative planning engine was applied for surgery decision making. In CI group, conventional instrumentation was applied for bony resection, while resection of i-PSI group was completed with i-PSI. A convolutional neural network was applied to automatically process computer tomography images and thus produced i-PSI. With the help of three-dimension printing, the workflow of production was largely simplified. AI-driven preoperative planning guided resection and alignment decisions. Resection measurement, perioperative radiography and perioperative clinical outcomes were analyzed to verify efficiency of i-PSI.ResultsIn resection outcomes, smaller deviation of lateral and medial distal femoral resection were found in i-PSI group than CI group (P = 0.032 and 0.035), while no difference was found in other resection planes. In radiography outcomes, postoperative coronal alignments of i-PSI group, including postoperative Hip–knee–ankle axis (HKA) (P = 0.025), postoperative HKA outliners (P = 0.042), Femoral coronal alignment (FCA) (P = 0.019) and Joint line convergence angle (JLCA) (P = 0.043) showed closer to neutral position than CI group. Moreover, Femoral sagittal alignment (FSA) of i-PSI group showed closer to neutral position than CI group(P = 0.005). No difference was found in other alignments. In clinical outcomes, i-PSI group seemed to cost more surgical time than CI group (P = 0.027), while others showed no differences between the two groups.ConclusionIntelligent Patient-specific Instrumentation in TKA achieved simplified production flow than conventional PSI, while also showed more accurate resection, improved synthesis position and limb alignment than conventional instrumentation. Above all, this study proved that i-PSI being an applicable and promising tool in TKA.

Association of Technology Usage and Decreased Revision TKA Rates for Low-Volume Surgeons Using an Optimal Prosthesis Combination: An Analysis of 53,264 Primary TKAs.

Technology (navigation and robotics) usage during total knee arthroplasty (TKA) is often supported by literature involving high-volume surgeons and hospitals, but the value of technology for lower-volume surgeons is uncertain. This study aimed to determine if there was a relationship among surgeon volume, technology usage, and revision rate when using an optimal prosthesis combination (OPC). Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) data were obtained from January 1, 2008, to December 31, 2022, for all primary TKA procedures performed for osteoarthritis using an OPC by a known surgeon ≥5 years after their first recorded procedure. The interaction between surgeon volume and conventional-instrumentation (CV) versus technology-assisted (TA) TKA was assessed. The cumulative percent revision (CPR) was determined by Kaplan-Meier estimates. Cox proportional-hazards methods were used to compare rates of revision by surgeon volume and by the interaction of volume and technology. Subanalyses were undertaken to examine major and minor revisions separately, and to assess the influence of technology on revision rates relative to those of a surgeon undertaking 100 TKA/year. Of the 53,264 procedures that met the inclusion criteria, 31,536 were TA-TKA and 21,728 were CV-TKA. Use of technology reduced the all-cause revision rate for surgeons with a volume of <50 TKA/year and the rate of minor revisions for surgeons with a volume of <40 TKA/year. No interaction between surgeon volume and the rate of major revision surgery was found. With CV-TKA by a surgeon with a 100-TKA/year volume as the comparator, all-cause and major revision rates were significantly elevated for surgeons undertaking <50 and <100 TKA/year, respectively. In contrast, analysis of TA-TKA showed no difference in rates of all-cause or major revisions for surgeons undertaking <100 TKA/year compared with 100 TKA/year. TA-TKA was associated with a decrease in the revision rate for lower-volume surgeons but no significant alterations in revision rate for higher-volume surgeons. Preferential use of TA-TKA by lower-volume surgeons should be considered. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

PDMS/CNT electrodes with bioamplifier for practical in-the-ear and conventional biosignal recordings

Objective.Potential usage of dry electrodes in emerging applications such as wearable devices, flexible tattoo circuits, and stretchable displays requires that, to become practical solutions, issues such as easy fabrication, strong durability, and low-cost materials must be addressed. The objective of this study was to propose soft and dry electrodes developed from polydimethylsiloxane (PDMS) and carbon nanotube (CNT) composites.Approach.The electrodes were connected with both conventional and in-house NTAmp biosignal instruments for comparative studies. The performances of the proposed dry electrodes were evaluated through electromyogram, electrocardiogram, and electroencephalogram measurements.Main results.Results demonstrated that the capability of the PDMS/CNT electrodes to receive biosignals was on par with that of commercial electrodes (adhesive and gold-cup electrodes). Depending on the type of stimuli, a signal-to-noise ratio of 5-10 dB range was achieved.Significance.The results of the study show that the performance of the proposed dry electrode is comparable to that of commercial electrodes, offering possibilities for diverse applications. These applications may include the physical examination of vital medical signs, the control of intelligent devices and robots, and the transmission of signals through flexible materials.

The need for cybercrime regulation on a global scale by the international law and cyber convention

This study highlights the necessity of controlling the issue of Cybercrime with International Law Principles and treaties, the legal foundation of international cybercrime legislation. The paper pursued normative behavior relying on the legislation of the European Union and countries outside of Europe. The implications of Cybercrime in cyberattack events establish a legal foundation for preventing and punishing cyber criminals wherever they occur. The perceived threats arising from cyberattack activities are grounded in known cyberattack behaviors and literature, underscoring the imminent nature of these threats. The Convention on Cybercrime, inaugurated in Budapest, Hungary, in November 2001, is recognized as a pivotal international agreement addressing Cybercrime and electronic evidence. The negotiation process included the Council of Europe, United States, Japan, Canada, and South African participants. Significantly, nations across Africa, the Americas, and the Asia/Pacific are harnessing this agreement to implement robust strategies against cybercrime. Cybercrime is a new area of international law, namely, International Criminal Law. The international community handles it because no convention has identified Cybercrime globally. It is urgent to govern Cybercrime globally, and statistics imply that the need to regulate Cybercrime under international criminal law is critical. The paper adopts a method designed to deeply understand the global legal structures related to cybercrime. The study employs a comprehensive approach, merging normative legal research to meticulously examine and interpret key legal documents such as the Budapest Convention, with a comparative legal analysis both within the European Union and globally. This analysis scrutinizes various jurisdictions, identifying best practices and discrepancies to inform a holistic understanding of cybercrime regulation. Policy analysis is conducted to critically assess existing strategies and propose innovative solutions, while technological insights are integrated to ensure legal frameworks are attuned to the rapidly evolving landscape of cyber threats. Involving a broad spectrum of stakeholders, including legal scholars and cybersecurity experts, the research offers a diverse perspective. This multifaceted approach aims to balance thorough legal scrutiny with actionable solutions, promoting robust and flexible strategies for international cybercrime regulation. The results of this comprehensive study underscore the urgent need for a global, unified legal response to combat cybercrime effectively. It concludes that the Budapest Convention marks a significant turning point, offering a foundation for international cooperation and legal harmonization in tackling cybercrimes. However, the rapid technological advancements and the evolving sophistication of cyber threats demand that this convention and other international legal instruments adapt and expand accordingly. The study highlights the importance of harmonizing legal definitions and practices across different jurisdictions, both in common law and civil law countries, cybercrime address the borderless nature of cybercrime. The necessity for enhanced collaboration between public and private sectors in cybercrime investigations is emphasized, alongside the importance of establishing ethical data collection and sharing standards.

Guided biofilm therapy versus conventional protocol—clinical outcomes in non-surgical periodontal therapy

BackgroundThe aim of the randomized controlled clinical trial study was to evaluate the effectiveness in reducing pathologically increased pocket probing depths (PPD > 3 mm) using the Guided Biofilm Therapy (GBT) protocol (adapted to the clinical conditions in non-surgical periodontal therapy (NSPT): staining, air-polishing, ultrasonic scaler, air-polishing) compared to conventional instrumentation (staining, hand curettes/sonic scaler, polishing with rotary instruments) both by less experienced practitioners (dental students).MethodsAll patients were treated according to a split-mouth design under supervision as diseased teeth of quadrants I/III and II/IV randomly assigned to GBT or conventional treatment. In addition to the treatment time, periodontal parameters such as PPD and bleeding on probing (BOP) before NSPT (T0) and after NSPT (T1: 5 ± 2 months after T0) were documented by two calibrated and blinded examiners (Ethics vote/ Trial-register: Kiel-D509-18/ DRKS00026041).ResultsData of 60 patients were analyzed (stage III/IV: n = 36/ n = 24; grade A/ B/ C: n = 1/ n = 31/ n = 28). At T1, a PPD reduction of all diseased tooth surfaces was observed in 57.0% of the GBT group and 58.7% of the control group (p = 0.067). The target endpoint (PPD ≤ 4 mm without BOP) was achieved in 11.5% for GBT (conventional treatment: 11.2%; p = 0.714). With the exception for number of sites with BOP, which was at T1 15.9% in the GBT group and 14.3% in the control group (p < 0.05) no significant differences between the outcomes of the study were found. At 30.3(28.3) min, the treatment time was significantly shorter in GBT than in the control group at 34.6(24.5) min (p < 0.001).ConclusionsWith both protocols (GBT/ conventional instrumentation) comparably good clinical treatment results can be achieve in NSPT in stage III-IV periodontitis patients.Trial registrationThe study was registered before the start of the study and can be found under the number DRKS00026041 in the German Clinical Trials Register. The registration date was 19/08/2021.

Dynamic visualization level 3 details of latent fingerprints by fluorescence imaging and photoluminescent macromolecules functionalized with spiropyran photoswitch

Detecting latent fingerprints (LFPs) poses a considerable challenge for individual identification in the case of the criminal scene because detecting more details about three levels of identification patterns at a fast rate and by conventional instruments is very important for investigators. This research involved creating nanoparticles made of a copolymer containing tertiary amine-functionalized methacrylate through emulsion copolymerization, and then modifying them with a spiropyran derivative. The concentration of tertiary amine groups significantly influenced the optical properties, with samples containing more than 10 wt% exhibiting negative photochromism, leading to the absence of dynamic emission and reversible photochromism. The study of the kinetics of isomerization from spiropyran to merocyanine using solid-state fluorescence spectroscopy highlighted the important role of negative photochromism in the photoswitching of spiropyran. The resulting dynamic photoluminescent polymer powders were effectively utilized for LFP visualization through powder dusting, fluorescence imaging, optical security tag production, and the development of innovative OLEDs. The study confirmed the efficiency of these polymer powders in visualizing LFPs, enabling the identification of intricate details and patterns at three distinct levels. The observed LFPs emitted fluorescence in a range of colors, displaying high contrast, resolution, maximum intensity, and brightness. Three levels of identification details were detected for an unknown LFP that remained on the surface of the glass bottle as a real sample in the criminal scene. Successful identification of the unknown offender indicates the potential application of samples for time-dependent visualization of LFPs in criminal scenes.

A comparative analysis of postoperative morbidity and alveolar bone regeneration following surgical extraction of ımpacted lower third molar teeth using piezosurgery and conventional ınstruments: a split-mouth clinical ınvestigation

Background-objective(s)This randomized, split-mouth study aimed to compare postoperative complications following the surgical extraction of impacted lower third molars using piezosurgery versus conventional rotary instruments.Materials and methodsTwenty-one patients, aged 18–35 years, with bilaterally and symmetrically impacted lower third molars, were randomly assigned to undergo extraction using piezosurgery on one side and conventional rotary instruments on the other.ResultsThe piezosurgery method required a longer operation time. However, it resulted in quicker resolution of postoperative swelling by the 7th day compared to the conventional method, where swelling persisted longer. Mandibular angle-tragus measurements were significantly higher with the conventional method on the 1st, 3rd, and 7th postoperative days. Although mouth opening decreased significantly after piezosurgery, it returned to preoperative levels by the 7th day, outperforming the conventional method. Postoperative pain was notably higher with the conventional method during the first four days but showed no significant difference from the 5th day onward. Alveolar bone healing was significantly better with piezosurgery at the 3rd and 6th months. Temporary paresthesia occurred in one patient from the conventional group, resolving within four weeks. Neither method resulted in alveolar osteitis.Conclusion(s)Within the study's limitations, piezosurgery demonstrated a reduction in postoperative discomfort, suggesting its advantage in enhancing patient recovery following lower third molar extractions.Clinical significancePiezosurgery, when used appropriately, can reduce postoperative complications compared to conventional methods. Clinicians should be aware of its indications, benefits, and potential challenges.Trial registration This study was registered as a clinical trial to the ClinicalTrials.gov, and the registration ID is NCT06262841 (https://clinicaltrials.gov/study/NCT06262841).

Computational musicking: music + coding as a hybrid practice

ABSTRACT While there is a growing body of research that explores the integration of music and coding in learning environments, much of this work has either emphasised the technical aspects of computer language design or music as a motivational context within which to learn computer science concepts. In this paper, we report on a study in which five undergraduate students with experience in both music and coding completed two creative musical tasks: one using conventional instruments and tools and one using Python code in an online music + coding environment. Inspired by the work of Christopher Small (1998. Musicking: The Meanings of Performing and Listening. University Press of New England), we describe music + coding as a set of interlocking processes which we call computational musicking and explore how practices from both domains are reimagined in this new hybrid context. We introduce semiotic theories of translation and transcription to make sense of the computational musicking process and describe strategies that participants devised in their creative process.