Ease Of Placement Research Articles

Comparative analysis of different filling materials in deciduous teeth

Dental caries in pediatric patients presents a significant challenge in maintaining oral health, making the choice of filling materials for deciduous teeth crucial for long-term success. Various restorative materials, including composite resins, glass ionomer cements (GICs), and resin-modified glass ionomers (RMGICs), have been used, each with distinct properties regarding durability, biocompatibility, and aesthetic outcomes. Composite resins are well-regarded for their ability to closely match the natural color of teeth, making them ideal for anterior restorations. However, they are technique-sensitive and may not provide sufficient durability in posterior regions subjected to high stress. Glass ionomer cements, known for their ease of placement and fluoride release, offer functional benefits in high-caries-risk patients, despite their lower aesthetic quality and susceptibility to wear over time. Resin-modified glass ionomers attempt to combine the strengths of both composites and GICs by improving durability and aesthetics while maintaining the fluoride-releasing property. The safety and biocompatibility of these materials also play a pivotal role in pediatric dentistry. While composite resins may release small amounts of bisphenol A (BPA), which has raised concerns about its potential health risks, GICs and RMGICs are generally considered safer due to their simpler chemical composition and fluoride release. In terms of functional longevity, composite resins offer better wear resistance compared to GICs, though resin-modified glass ionomers provide a compromise with improved strength and ease of use. Ultimately, the choice of restorative material should consider the specific clinical circumstances, including the child’s caries risk, tooth location, and the balance between aesthetic and functional needs. No single material is universally ideal for all cases, and a tailored approach is necessary to optimize outcomes in pediatric dental restorations.

#2431 Vascular access outcomes among patients on maintenance hemodialysis in Perpetual Succour Hospital: a 3-year cross-sectional analysis

Abstract Background and Aims Hemodialysis (HD) is the most widely used treatment modality worldwide in the care of patients with end stage renal disease (ESRD). The success of the therapy depends largely on the quality of the VA and its proper functioning, which has a bearing on the patient's quality of life. Vascular access dysfunction remains one of the leading causes of excessive morbidity, mortality, and healthcare costs in this group. A functional vascular access is mandatory to achieve good levels of dialytic efficiency, and it is considered the lifeline of patients on maintenance HD. The ideal vascular access should have specific characteristics among which the most important are the following: ease of placement; delivery of adequate blood flow for effective dialysis; good primary patency rates; low rates of complications and side effects; long-lasting life; and low economic costs. There are 3 types of vascular accesses (VAs): the internal arteriovenous fistula (IAVF); the central venous catheter, which can be tunneled (CVC-T) or not (CVC-nT); and the synthetic vascular graft. Internal arteriovenous fistula is considered the best option because it is safer, more durable, and less expensive. The catheter is essential for emergency onset in HD but is associated with a higher number of infections, higher mortality, and greater costs. Arteriovenous fistulae (AVF) have advantages over arteriovenous grafts (AVG) and central venous catheters (CVC), but whether AVF are associated independently with better survival is unclear. The aim of this study is to determine the vascular access outcomes of ESRD patients on maintenance hemodialysis. Specifically, this study (1) described the clinicodemographic profile of the patients in terms of age, sex, primary etiology of ESRD, employment status, comorbidities, hepatitis status and family history of the disease; (2) determined the vascular access used on the HD patients (AVF/AVG, CVC or IJ; (3) identified interventions performed to maintain vascular access for hemodialysis; (4) determined the categories of the vascular access site; (5) assessed the vascular access outcome; (6) determined the reason and number for vascular access change and the (7) clinical outcome of the HD patients. Method This is a single center, cross-sectional study of ESRD patients on maintenance hemodialysis enrolled in Perpetual Succour Hospital Hemodialysis Unit from April 1, 2021, to November 30, 2023. Results There were 260 hemodialysis patients included, with successful vascular access outcome (73.13%) and were younger (57.2 ± 14.1). Those who had failed vascular access were females (54.2%), unemployed (61.4%) and had diabetes mellitus (50.6%) as the primary etiology of their ESRD. Those with failed vascular access were hypertensive (86.7%), with history of CAD and MI (57.8%) and were having diabetes mellitus (56.6%). Proportion of those with failed and successful vascular access significantly differ among hypertensives $(p = .012)$, diabetics $(p = .039)$, with chronic glomerulonephritis $(p = .011)$, and among those with malignancy $(p = .003)$. Most of those who were alive had successful vascular access (76.8%), however, among those who had failed vascular access died (57.6%). And the association of clinical outcomes (death or not) and failure or success of vascular access is statistically significant, $(p = .001)$. Conclusion Our study showed that failed vascular access were more associated with female gender, diabetes mellitus as the primary etiology of ESRD and with other co-morbid conditions such as hypertension and CAD or MI. Successful vascular outcome were among those of younger age group compared to those whose vascular access failed, probably due to better vascular condition and fewer co-morbidities. As shown in Table 2, type of access, interventions performed, and vascular access site significantly differ among HD patients with failed vascular access outcome and with those who were successful $(p = .001)$Those with failure on the vascular access were changed to CVC (44.6%) while others had changed to IJ (22.9%). Eighty of those with failed vascular (96.4%) access has changed site due to no bruit (65.0%) and thrombosis (33.8%).

Tolerance to preoperative placement of electrodes for neuromuscular monitoring using the Tetragraph™.

Quantitative train-of-four (TOF) monitoring has recently been shown to be feasible in infants and children using a novel electromyography (EMG)-based monitor with a pediatric-sized self-adhesive sensor. However, placement of the sensor and initiation of TOF monitoring may require additional time in the operating room (OR), delaying workflow and the time to induction of anesthesia. The current study evaluates the feasibility of placing the self-adhesive sensor in the preoperative holding area in pediatric patients before arrival to the OR. Consented pediatric patients undergoing inpatient surgery requiring the administration of NMBAs were enrolled. The EMG electrode was placed along the ulnar nerve on the volar aspect of the distal forearm to provide neurostimulation. After the induction of anesthesia, monitoring was initiated and TOF recording started before the administration of the NMBA. A Likert score (0-10) was used to assess ease of placement, tolerability of the monitor during the preoperative period, and its ability to generate a recorded response in the OR. The final study cohort included 40 patients with a median age of 3.7 years. Fourteen patients (35%) pulled off the sensor before arrival to the OR and 26 patients (65%) arrived at the OR with the sensor intact and functioning. Older children were more likely to maintain the sensor until arrival to the OR compared to younger patients (median age of 5.24 versus 1 year, P = 0.0521). A median age of 3.7 years correlated with an 80% chance of arriving in the OR with the sensor intact. Application ease and tolerance of the sensor were higher in the group that maintained the sensor until OR arrival. In patients more than 4 years of age, placement of the self-adhesive sensor for EMG-based TOF monitoring may be feasible. However, in younger patients, additional interventions may be required to achieve a similar success rate.

HAYMAN COMPRESSION SUTURES : AN UNDERUTILIZED TOOL FOR MANAGEMENT OF UTERINE ATONY AND POSTPARTUM HAEMORRHAGE.

Background: Postpartum hemorrhage (PPH) is the leading cause of maternal mortality in low- andmiddle-income countries. Uterine atony accounts for 70–80% of PPH cases. Management of PPH isusually based on a cascade beginning with the use of uterotonics and eventually hysterectomy in casesof refractory PPH. Different compression suture techniques have been described and used for themanagement of uterine atony where medical management is insufficient and preservation of fertility isdesired.Case presentation: This is a series of four patients who presented to our facility and consequentlydeveloped uterine atony that was unresponsive to medical management during cesarean delivery despitethe use of multiple uterotonics. All four patients had established risk factors for uterine atony, includinginduction of labor, augmentation of labor, chorioamnionitis, or fetal macrosomia. Hayman compressionsutures were performed in all four patients with success. Estimated blood loss in the series ranged from400 to 1200 mls. All patients recovered well with no complications reported during the postpartum period.Conclusion: Hayman compression sutures offer an alternative to the more ubiquitous B-Lynch suturewith several advantages, including ease of placement and no need for a hysterotomy in PPH post vaginalbirth or placement post repair of hysterotomy in cesarean cases. Thus, the may be easier to perform forjunior health care professionals as well as in stressful situations.

How Does Customized Cutting Guide Design Affect Accuracy and Ergonomics in Pelvic Tumor Resection? A Study in Cadavers.

Customized cutting guides are technical aids that make primary pelvic bone tumor resection safer and more reliable. Although the effectiveness of such devices appears to be widely accepted, their conception and design remain varied. Two main designs have been reported: the heavier block-type customized cutting guides and the lighter patch-type customized cutting guides. As recent tools, there must be more evidence regarding the impact of design on their accuracy and ergonomics. Thus, an evaluation of their respective performances appears warranted. In a cadaver model, we assessed whether (1) a thinner, patch-type customized cutting guide design results in resections that are closer to the planned resections than the heavier block-type customized cutting guides, and (2) the patch-type customized cutting guide design is more ergonomic than the block-type customized cutting guide with improved usability in surgery (in terms of bulkiness, ease of placement, primary and secondary stability, and stability during cutting). We conducted an experimental study involving five fresh whole-body anatomic specimens (three women and two men with a median age of 79 years and median weight of 66 kg) by simulating six virtual tumors in three areas according to the Enneking classification (Zones I: iliac wing, II: periacetabular area, and I and IV: sacroiliac joint area). We compared the impact of the customized cutting guide's design on performance in terms of the resection margin accuracy using CT scan analysis (deviation from the planned margin at the closest point and the maximum deviation from the planned margin) and the intraoperative ergonomic score under conditions simulating those of an oncologic resection of a bone tumor (with a range of 0 to 100, with 100 being best). The patch customized cutting guides performed slightly better than the block customized cutting guides regarding deviation from the planned margin at the closest point, with median values of 1 mm versus 2 mm (difference of medians 1 mm; p = 0.02) and maximum deviation from the planned margin of 3 versus 4 mm (difference of medians 1 mm; p = 0.002). In addition, the patch design was perceived to be slightly more ergonomic than the block design, with a 92% median score versus 84% for the block design (difference of medians 8%; p = 0.03). We observed an equivalence in performance regarding accuracy and ergonomics, with slight advantages for patch customized cutting guides, especially in complex zones (Zone I and IV). Owing to a small cohort in a cadaver study, these results need independent replication. The patch-type customized cutting guide with thinner contact spots to the bone in specific areas and less soft tissue dissection might offer an advantage over a larger block design for achieving negative oncologic bony margins, but it does not address issues of soft tissue margins.

Exploring Intraoral Photography: A Cross-sectional Analysis of Commercially Available versus Newly Designed and Patented Contraster using Self-designed Criteria

Introduction: Intraoral photography is crucial in dentistry for documentation, communication and education. Contrasters play a pivotal role, influencing patient experience and image quality. Traditional metal contrasters have limitations regarding patient friendliness and procedural compatibility. Aim: To assess ease and comfort among patients and operators and to compare the contrasting ability of commercially available contrasters with newly designed contrasters in intraoral photography. Materials and Methods: A single-blinded, cross-sectional analytical study was conducted in the Department of Conservative and Endodontics and the Department of Orthodontics, KM Shah Dental College and Hospital, Vadodara, Gujarat, India, from January 2024 to February 2024. After obtaining ethical approval, 50 patients with no pain, swelling, or discomfort in the maxillary anterior region, as well as, only those operators trained in intraoral Digital Single-lens Reflex (DSLR) photography, were enrolled. Following randomisation and standard camera settings, intraoral images were captured by 50 operators using both conventional metal and newly designed 3D-printed contrasters. Patients and operators evaluated ease, comfort, contrasting ability, and the presence of a palatal gap using self-designed criteria. The data were subjected to statistical analysis using International Business Machines (IBM) Statistical package for the Social Sciences (SPSS) software version 21.0. The Chi-square test of proportion was applied to evaluate differences in proportion, while the Mann-Whitney U test was used to compare the two contrasters. A confidence interval of 95% and p-value<0.05 were considered statistically significant. Results: The results revealed a statistically significant difference in discomfort and pain experienced by patients during the placement and removal of the contrasters between the conventional and newly designed groups (p-value<0.05). Similarly, operators reported significantly lower ease of placement and removal in the conventional group compared to the newly designed group (p-value<0.05). However, no statistically significant difference in contrasting ability was observed between the two groups (p-value>0.05). Conclusion: The newly designed contrasters demonstrated superior patient comfort and reduced pain compared to commercially available contrasters. Operators experienced easier placement with similar contrasting abilities.

Two Postpartum Blood Collection Devices: The Brass-V Drape and MaternaWell Tray-As Experienced by Birth Attendants and Birthing Women-A Questionnaire-Based Randomised Study.

Postpartum haemorrhage is the leading cause of preventable maternal mortality worldwide. Early identification and prompt management of postpartum haemorrhage improve outcomes. Objective assessment of postpartum blood loss is an important step in identifying postpartum haemorrhage. The Brass-V drape and MaternaWell tray have been designed for routine measurement of postpartum blood loss. The perceived utility and acceptability of these devices to the parturients and birth attendants still begged exploring. To assess the perceived usefulness and ease of use of a Brass-V drape versus a MaternaWell tray for the collection of postpartum blood loss. We conducted a prospective parallel randomised trial, employing a questionnaire to assess the experiences of birth attendants and birthing women who used these devices. The study was conducted at site B midwife obstetric unit in Khayelitsha Cape Town. Pregnant women presenting in early labour were approached for voluntary participation. After informed consent was obtained, participants were randomly assigned to the Brass-V drape or the MaternaWell tray, which the birth attendant placed after the birth of the baby. There were 63 participants, of which 33 were assigned to the MaternaWell tray and 30 to the Brass-V drape. Birth attendants indicated a desire to use the MaternaWell tray (30 (90%)) or Brass-V drape (26 (87%)) in future deliveries. The parturients were also in favour of the future use of MaternaWell tray (33 (100%)) and Brass-V drape (28 (93%)). Ease of measurement favoured the Brass V-drape, and ease of placement favoured the MaternaWell tray. Five (8%) participants experienced postpartum haemorrhage, two with the MaternaWell tray and three with the Brass-V drape. One parturient required hospital transfer. The responses of the birth attendants and parturients were positive. The MaternaWell tray has the benefit of reuse and lower cost and is an acceptable alternative to the Brass-V drape. Both devices aid in the early recognition of postpartum haemorrhage.

Z-shaped Miniplates vs Conventional Miniplates for Fixation of Mandibular Parasymphyseal Fractures.

The aim of this study was to evaluate a clinically and radiographically Z-shaped miniplate for the fixation of the parasymphyseal fractures. Twenty patients (10 patients in each group) who had parasymphseal mandibular fractures were randomly selected for this study. In this study, open reduction and internal fixation were performed for mandibular parasymphyseal region fractures using two miniplates as group I, and open reduction and internal fixation were performed for mandibular parasymphyseal region fractures using a newly designed Z-shaped miniplate as group II. Clinical and radiographic evaluations were made. Each patient was evaluated: (1) clinically evaluated preoperatively and postoperatively for operating time, ease of placement of the miniplate, and occlusion and (2) radiological: postoperative reduction of fracture was evaluated radiologically at 5-day, 1-month, 2-month, and 3-month intervals with orthopantomogram, and lingual splaying was evaluated by cone-beam computed tomography (CBCT) immediately postoperatively and at an interval of 3 months. The collected data were subjected to statistical analysis. Data analysis was performed by SPSS software, version 25 (SPSS Inc., PASW statistics for Windows version 25). Chicago: SPSS Inc. There was a statistically significant difference (p < 0.001) between the mean intraoperative time. This indicates that group I had a longer time for fracture fixation than group II. Group I had a longer time elapsed for plate adaptation and definitive fixation than group II. Occlusion and reduction stability in both groups were similar. There was a statistically significant difference in postoperative lingual display control after 5 days and 3 months between the studied groups. This indicates that lingual display control in group II is better than in group I. The Z-shaped miniplate is effective and provides three-dimensional stability for the fixation of parasymphyseal fractures, ease of use, easily adapted in cases of fractures near the mental nerve reduced operative time, and better control of lingual splaying than conventional miniplates. The newly designed Z-shaped miniplate is a valuable option for fixation parasymphysis fractures that need open reduction and internal fixation instead of using conventional miniplates, which are less successful in controlling lingual splaying.

Simplified Septal Stabilization in Closed-Approach Low-Septal-Resection Dorsal Preservation Rhinoplasty

Background Septal fixation is a basic step in low-septal-resection dorsal preservation rhinoplasty. Inadequate septal stabilization can lead to supratip depression or more severe saddle nose deformity. This paper presents a simple surgical maneuver to stabilize quadrangular septal cartilage instead of suture fixation to the anterior nasal spine. Methods Thirty patients who underwent closed-approach low-septal-resection dorsal preservation rhinoplasty between July and December 2021 were included in this retrospective study. Depending on the surgical maneuver performed to stabilize quadrangular septal cartilage, the patients were divided into 2 groups as follows: (1) a group in which the septum was stabilized with transfixion sutures (the transfixion suture group) and (2) a group in which the septum was fixed to the anterior nasal spine with suture (the anterior nasal spine suture fixation group). Standardized postoperative 12-month lateral-view photographs were scanned for the presence of supratip depression or saddle nose deformity that may indicate insufficient septum stabilization. Results Supratip depression was observed in 1 patient in the transfixion suture group (n = 16) and in 1 patient in the anterior nasal spine suture fixation group (n = 14; P &gt; 0.05). No saddle nose deformity was observed in either group. Conclusions Transfixion sutures seem effective in providing septal stabilization to prevent supratip depression or saddle nose deformity in closed-approach low-septal-resection dorsal preservation rhinoplasty. Transfixion sutures can be used for septal stabilization in closed-approach rhinoplasty, allowing the surgeon to take advantage of the ease of placement.

Comparison of the LMA BlockBuster and intubating LMA as a conduit to blind tracheal intubation.

Primary aim of the study was to evaluate the performance of Intubating LMA (ILMA) and blockbuster LMA in terms of first pass success rate, ease and duration taken for blind tracheal intubation. The present prospective randomised study was conducted on 70 patients of either sex aged 18-60 years belonging to ASA physical status I or II. Patients were randomly allocated to either, group I and group B of n = 35 each. In group I and B patients were intubated using ILMA and LMA BlockBuster respectively. Insertion time and ease of placement of supraglottic device, total time taken for successful intubation, number of attempts for endotracheal tube (ETT) placement, and ease of placement of ETT, were recorded. In both groups, the supraglottic device was placed on the first attempt in 88.6% patients. The first-attempt success rate for ETT placement was 71.4% in group I versus 94.3% in group B, (P = 0.01) with an overall success rate of 88.5% in group I and 100% in group. More failure rate was observed in group I (11.4%) compared to group B (0%). The total time taken for successful intubation in group I was 11.53 ± 6.410 sec and 9.17 ± 2.749 sec in group B (P = 0.04). We conclude that the modifications in the design of LMA Blockbuster (>95° angle, availability of the parker flex tube 27-30°angle of the emergence of airway tube) make it a more convenient, effective, simpler, and faster intubating device than ILMA.

Comparison of I-Gel and Auragain in Airway Management

Objective: We aimed to compare the superiority of I-Gel and Auragain, the second-generation supraglottic airway devices (SGAD) with different cuff structures, in terms of speed and ease of placement, oropharyngeal leak pressure (OLP), resistance of gastric contents, and post-operative oropharyngeal pain. Materials and Methods: A total of 70 patients aged 18-65 years, with ASA scores I-II, who used I-Gel or Auragain to provide airways under general anesthesia were included in the study. Patients were divided into two groups as I-Gel and Auragain according to the type of SGAD used. Results: OLP, placement duration and Visual Analogue Score (VAS) were found to be statistically significantly higher in the Auragain group (p

Amplatzer Occluders for Effective Nonsurgical Management of Bronchopleural Fistulae

BackgroundTo assess the safety and efficacy of bronchopleural fistulae closure with Amplatzer occluder devices (AGA Medical, Golden Valley, MN) through our experience of over 14 years. MethodsRetrospective data review of patients from Rabin Medical Center who underwent Amplatzer occluder device placement between March 2007 and September 2021 for bronchopleural fistulae closure. ResultsIn total, 72 patients had 83 Amplatzer occluder devices implanted for bronchopleural fistulae closure. The median age was 65.5 (interquartile range 56.0-72.3) years. The primary diseases were lung malignancy (48 [66.7%]) and thoracic infection (9 [12.5%]). Bronchopleural fistulae developed mainly following pneumonectomy (40.3%) and lobectomy (33.3%), with a median time from surgery to Amplatzer placement of 3.9 (interquartile range 1.4–16.4) months. We encountered no procedural or immediate postprocedural complications or deaths. Six months after Amplatzer insertion, there were 7 (8.4%) Amplatzer removals and 11 (15.3%) fistula-related deaths. ConclusionsAmplatzer occluders are a safe modality for nonsurgical bronchopleural fistulae management with ease of placement under moderate sedation and flexible bronchoscopy with good short- and long-term effectivity.

Self-designed three-dimensional printed skeletal anchorage titanium device for orthopaedic traction in a growing Class III patient

Maxillary retrusion in a growing skeletal class III patient can be treated with growth modification by facemask therapy with skeletal anchorage. A 12-year-old boy presented with Skeletal Class III relationship, retrognathic maxilla and paranasal deficiency. Cone beam computer tomography (CBCT) was taken for the design of the customized skeletal anchorage device with a 3D planning computer software. Two pairs of skeletal anchorage surgical guides and plates were designed with the correct vector and location, and to avoid tooth roots in the fixation. The plates were printed with titanium and fixed onto the patient for the facemask therapy. CAD-CAM technology allows customization and precise execution of the skeletal anchorage for the facemask therapy. Self-designed 3D printed skeletal anchorage device, with the advantages of increased rigidity, ease of placement and accuracy of force application, can be a valid alternative to stock titanium plates.

Rectus sheath catheters reduce opiate use in pancreaticoduodenectomy: a pre- and postintervention cohort study.

Pancreaticoduodenectomy is the only curative option for patients with pancreatic cancer; however, pain remains a considerable problem postoperatively. With many centres moving away from using epidural analgesia, there is the need to evaluate alternative opiate sparing techniques for postoperative analgesia. We sought to determine if rectus sheath catheters (RSCs) had an opiate sparing and analgesic effect compared with standard care alone (opiate analgesia). We conducted a retrospective pre- and postintervention cohort study of patients undergoing pancreaticoduodenectomy at a single tertiary academic hospital in Toronto, Canada, between April 2018 and December 2019. All patients undergoing a pancreaticoduodenectomy were eligible for inclusion. Among the 101 patients identified, 84 (61 control, 23 RSCs) were analyzed after exclusion criteria were applied (epidural analgesia, admission to intensive care intubated or reintubated within the first 96 hours). The pre-intervention group received a semi-standardized course of analgesics, including intravenous hydromorphone, acetaminophen, ketamine, with or without nonsteroidal anti-inflammatory, and with or without intravenous lidocaine; the latter 2 drugs were at the individual anesthesiologist and surgeon's preference. For the postintervention group, the same course of analgesics were used, with the addition of RSCs. These were inserted at the end of the operation, with a loading dose of ropivacaine administered and followed by a programmed intermittent bolus regime for 72-96 hours. The primary outcome measure was total postoperative opiate consumption (oral morphine equivalents). Secondary outcomes included pain scores (numeric rating scale) and treatment-related adverse effects. Opiate consumption (oral morphine equivalents) at 96 hours was significantly lower (median 188 mg, interquartile range [IQR] 112-228 v. 242.4 mg, IQR 166.8-352) with and without RSC, respectively (p = 0.01). The RSC group used significantly less opiates at each time point from 24 hours postoperatively, with no significant difference in pain scores between the groups and no significant catheter-related complications. The use of RSCs was associated with significant reductions in postoperative opiate consumption. Given the ease of placement and management, with minimal complications, RSCs should be incorporated into a course of postoperative multimodal analgesia. A large scale randomized controlled trial should be conducted to further investigate these findings.

Hydraulic Response and Overtopping Performance of Single-Layer Double Cube Unit Armored Mound Breakwater

A newly developed friction-interlocking armor unit called the ‘Double cube’ (DC) was designed to improve the performance of a concrete armor unit used in river/marine structures against currents/waves actions. The DC unit is an octagonal-shaped block made up of two parts: an upper cube set on a lower base that is either square or octagonal in shape. The innovative design aims to provide good performance in terms of stability, to allow for high tolerance placement with various contact points, and to allow for ease of placement. The DC’s shape and placement enhance the unit’s stability by bringing the center of gravity closer to the underlayer and by providing a large contact surface with the surrounding blocks that reduces the chance of extraction and limits movements (rocking, lifting) via the “keystone” effect. The characteristics of this new unit provide a relatively high hydraulic stability number for the armor layer (NS = 2.9), a favorable hydraulic performance due to energy dissipation from turbulence and aeration, as well as a high roughness coefficient (γf ≈ 0.46), helping to reduce overtopping.

Transiting Milestones in Conventional Composites: A Headway for Flowables

Flowable composite materials still need to be explored. Most literature generally addresses conventional composites, with little emphasis on flowables. This review article provides a concise overview of many essential characteristics of this helpful material. Newer generations of flowable composites incorporating improved mechanical properties such as higher compressive strength due to increased filler loading have come into practice in restorative dentistry recently. These provide benefits of improved handling properties and ease of placement into prepared cavities. This makes them unique and a novel material of choice in replacing traditional composite resins as a restorative material in endodontics.

Method for Classifying Schizophrenia Patients Based on Machine Learning.

Schizophrenia is a chronic and severe mental disorder that affects individuals in various ways, particularly in their ability to perceive, process, and respond to stimuli. This condition has a significant impact on a considerable number of individuals. Consequently, the study, analysis, and characterization of this pathology are of paramount importance. Electroencephalography (EEG) is frequently utilized in the diagnostic assessment of various brain disorders due to its non-intrusiveness, excellent resolution and ease of placement. However, the manual analysis of electroencephalogram (EEG) recordings can be a complex and time-consuming task for healthcare professionals. Therefore, the automated analysis of EEG recordings can help alleviate the burden on doctors and provide valuable insights to support clinical diagnosis. Many studies are working along these lines. In this research paper, the authors propose a machine learning (ML) method based on the eXtreme Gradient Boosting (XGB) algorithm for analyzing EEG signals. The study compares the performance of the proposed XGB-based approach with four other supervised ML systems. According to the results, the proposed XGB-based method demonstrates superior performance, with an AUC value of 0.94 and an accuracy value of 0.94, surpassing the other compared methods. The implemented system exhibits high accuracy and robustness in accurately classifying schizophrenia patients based on EEG recordings. This method holds the potential to be implemented as a valuable complementary tool for clinical use in hospitals, supporting clinicians in their clinical diagnosis of schizophrenia.

(471) The Transfacial Fixation of an Ectopic Low Submuscular Reservoir: A Novel Approach to Inflatable Penile Prosthesis Reservoir Placement

Abstract Introduction Ectopic reservoir placement has become a more routine practice among high-volume penile prosthesis implanters. In particular, the low submuscular approach has gained considerable popularity given its safe location away from structures of concern such as the iliac vein or bowel, which can frequently be in the proximity of reservoirs placed in the traditional Space of Retzius position in patients with prior pelvic procedures such as a radical prostatectomy. However, the low submuscular approach is not without its own risks, most notably, herniation of the reservoir to an unintended location. In order to maximize the benefits of submuscular reservoir placement and minimize risk for herniation, we describe a novel approach to low submuscular reservoir placement. Objective The objective of this study is to present outcomes data on inflatable penile prosthesis patients who underwent low submuscular (LSM) reservoir placement with transfascial fixation (TFF). Methods A retrospective review was conducted on patients who underwent an IPP placement using the LSM with TFF technique between June 2019 and March 2022 by a single, high-volume surgeon at a tertiary medical center. Preoperative patient characteristics were collected, and patients then conducted a telephone interview with a modified questionnaire to assess satisfaction with the IPP and reservoir concealment. Results A total of 34 patients underwent IPP surgery with low submuscular reservoir placement with TFF of which 29 completed the questionnaire (85.2%). The average age of patients was 68.3 years, and 61.5% of patients had undergone a radical prostatectomy. Overall satisfaction with the penile implant was 4.1 (out of 5). Eight patients (26%) were able to palpate the reservoir, and four patients (15.4%) were able to visualize the reservoir impression below the abdominal skin. However, overall satisfaction with reservoir concealment was 4.6 (out of 5) (Table 1). No surgical revisions were required and there were no surgical complications such as bowel obstruction, herniations, bladder erosion, or vascular injuries. Conclusions Low submuscular IPP reservoir placement with TFF is an alternative approach for reservoir placement with a high degree of patient satisfaction, decreased risk for reservoir herniation, and significant ease of placement compared to alternative methods in the literature. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Boston Scientific

Various materials used for the repair of bone defects: A review

Now a days most commonly used material to treat the defects in the bone after trauma or after any pathology are bone grafts. Bone grafting is a procedure which is performed surgically to join any defect which is surrounding the bone or for the union of the bone. It was found that the graft material which are allogenic in nature as well as other bioactive synthetic substitutes of the bone graft material shows good integration with the remaining bone. To increase the chances of acceptance of these allogenic bone graft materials and others synthetic bioactive graft materials addition of different growth factors for e.g. such as bone morphogenic proteins, platelet rich plasma, platelet rich fibrin have been considered very well. Bone is found to be the second commonly transplanted tissue after the blood. There are various methods present in the treatment of the bone defects such as guided regeneration of bone, use of stem cells and bone grafts, but bone graft shows promising results in the terms of maintaining the normal outline structure of the bone, bone grafts helps in maintaining the aesthetic restoration, helps in eliminating the space or defect which is surrounding the bone due to trauma or due to any pathological condition, helps in providing the width or height for the ease of placement of implant in the oral cavity.

In-Service Performance Evaluation of Flexible Pavement with Lightweight Cellular Concrete Subbase

The objective of engineers to improve the long-term performance of road infrastructure in changing global climate has led to the development of alternate materials for pavement construction. Lightweight cellular concrete (LCC) is a viable option for colder climates where pavements undergo several freeze-thaw cycles each year, resulting in faster deterioration of pavements. This is due to LCCs’ excellent freeze-thaw resistance, ease of placement, and potential sustainability benefits such as reduced use of virgin material and industrial by-products. However, there is a need to quantify these benefits and develop unified specifications for using LCC in the pavement structure. Therefore, this study examined the performance of flexible pavement sections that included a subbase layer, unbound granular materials for the control section, and three LCC densities (400, 475, and 600 kg/m3) for the LCC sections. Post-construction evaluation of pavement stiffness and roughness were evaluated using a Lightweight deflectometer and SurPro equipment. The results showed that LCC subbase thickness ≥ 250 mm produced over 22% smoother riding surfaces than unbound granular pavements while increasing pavement stiffness by up to 21%. Finally, this study recommends that LCC subbase thickness should not be thinner than 250 mm when using densities below 475 kg/m3 over weak subgrades.