Estimated Success Rate Research Articles

Bowman layer transplantation: 5-year results.

The purpose of this study was to evaluate the 5-year clinical results of isolated Bowman layer (BL) transplantation in the treatment of advanced keratoconus. In this prospective, single-center, interventional case series at a tertiary referral center, 20 eyes of 17 patients with advanced keratoconus underwent BL transplantation, i.e. an isolated Bowman layer graft was positioned into a manually dissected mid-stromal pocket. Scheimpflug-based corneal tomography measurements, best corrected spectacle and contact lens visual acuities (BSCVA and BCLVA), endothelial cell density, and complications were evaluated up to 5years after surgery. Measured simulated and maximum keratometry (Kmean and Kmax) values were stable up to 5years after surgery (P = .310 and P = .195 for 5years compared to 1month follow-up, respectively), following an initial decrease from pre- to 1month postoperatively (P < .001 each). Mean LogMAR BSCVA remained stable (P > .99), after an initial improvement from pre- to 12months postoperatively (P = .007). Mean BCLVA did not change from preoperative to 5years postoperatively (P = .219). During all postoperative follow-ups, mean densitometry values were higher than preoperatively (P < .001). A corneal hydrops occurred in one eye at 4.5years postoperatively; no other postoperative complications were observed. Kaplan-Meier analysis showed an estimated success rate of 84% at 5years postoperatively. Endothelial cell density remained stable from before to 5years after surgery (P = .319). After early postoperative corneal flattening, topographies were stable up to 5years after BL transplantation, preserving BCLVA and contact lens tolerance, potentially allowing long term postponement of penetrating or deep anterior lamellar keratoplasty.

Spatial Region Estimation for Autonomous CoT Clustering Using Hidden Markov Model

This paper proposes a hierarchical dual filtering (HDF) algorithm to estimate the spatial region between a Cloud of Things (CoT) gateway and an Internet of Things (IoT) device. The accuracy of the spatial region estimation is important for autonomous CoT clustering. We conduct spatial region estimation using a hidden Markov model (HMM) with a raw Bluetooth received signal strength indicator (RSSI). However, the accuracy of the region estimation using the validation data is only 53.8%. To increase the accuracy of the spatial region estimation, the HDF algorithm removes the high-frequency signals hierarchically, and alters the parameters according to whether the IoT device moves. The accuracy of spatial region estimation using a raw RSSI, Kalman filter, and HDF are compared to evaluate the effectiveness of the HDF algorithm. The success rate and root mean square error (RMSE) of all regions are 0.538, 0.622, and 0.75, and 0.997, 0.812, and 0.5 when raw RSSI, a Kalman filter, and HDF are used, respectively. The HDF algorithm attains the best results in terms of the success rate and RMSE of spatial region estimation using HMM.

Sulfonylurea for the treatment of neonatal diabetes owing to KATP-channel mutations: a systematic review and meta-analysis.

The effect of sulfonylurea for the treatment of neonatal diabetes (NDM) is remain uncertain. We conducted this systematic review and meta-analysis to investigate the effect of sulfonylurea for NDM and to provide the latest and most convincing evidence for developing clinical practice guidelines of NDM. A literature review was performed to identify all published studies reporting the sulfonylurea on the treatment of neonatal diabetes. The search included the following databases: PUBMED, EMBASE and the Cochrane Library. The primary outcome was the success rates of treatment, change of glycosylated hemoglobin (HbA1c) and C-peptide. Data results were pooled by using MetaAnalyst with a random-effects model. Ten studies (6 cohort studies and 4 cross-sectional studies) involving 285 participants were included in the analysis. The pooled estimated success rate by the random-effects model was 90.1%(95% CI: 85.1%–93.5%). HbA1c had a significantly lower compared with before treatment. The pooled estimate of MD was -2.289, and the 95% CI was -2.790 to -1.789 (P < 0.001). The subgroup analysis showed a similar result for cohort studies and in cross-sectional studies. The common mild side effect is gastrointestinal reaction. The present meta-analysis suggested that sulfonylurea had a positive effect for treatment NDM due to KATP channel mutations. In addition, sulfonylurea also displayed sound safety except the mild gastrointestinal reaction. However, the findings rely chiefly on data from observational studies. Further well-conducted trials are required to assess sulfonylurea for NDM.

Auto-correlated directional swimming can enhance settlement success and connectivity in fish larvae

Larvae of coastal-marine fishes have been shown repeatedly to swim directionally in the pelagic environment. Yet, biophysical models of larval dispersal typically impose a Simple Random Walk (SRW) algorithm to simulate non-directional movement in the open ocean. Here we investigate the use of a Correlated Random Walk (CRW) algorithm; imposing auto-correlated directional swimming onto simulated larvae within a high-resolution 3D biophysical model of the Gulf of Aqaba, the Red Sea. Our findings demonstrate that implementation of auto-correlated directional swimming can result in an increase of up to ×2.7 in the estimated success rate of larval-settlement, as well as an increase in the extent of connectivity. With accumulating empirical support for the capacity for directional-swimming during the pelagic phase, we propose that CRW should be applied in biophysical models of dispersal by coastal marine fish-larvae.

Abstract 21036: Differences in Arrhythmia Induction Between Isoproterenol versus Combination of Drugs and Impact on Outcomes in Patients Undergoing Catheter Ablation for Ventricular and Supraventricular Arrhythmias

Background: Catheter ablation (CA) has an estimated success rate of 50-90% after first procedure for atrial tachycardia/fibrillation (AT/AF), supraventricular tachycardia (SVT), premature ventricular complexes (PVC) and ventricular tachycardia (VT). We studied if combination of induction agents including isoproterenol (ISO), Caffeine, Calcium Chloride (CC), Atropine and Phenylephrine (PE) is better than ISO alone to uncover additional arrhythmic triggers or substrates, where supplemental CA may potentially improve long term procedural success. Methods: This is an observational study including 132 consecutive patients [AT/AF (N=27), SVT (N=25), PVC (N=42), VT (N=38)] undergoing CA for symptomatic atrial and ventricular arrhythmias. We compared combination chemical induction protocol (COMBO) which included ISO (range 5-20mcg/min) + Caffeine (50-250 mg) +CC (1gm) ± PE (range 5 -10 mcg/kg) ±intravenous atropine (0.25 mg, one time) with ISO-only (5-20 mcg/min) infusion to assess for arrhythmia re-inducibility after performing standard CA. Results: There was no significant difference in baseline or procedural characteristics between both groups. COMBO group had significantly higher induction of stable clinical arrhythmia triggers and substrates in patients undergoing CA for AT/AF (53.3% vs. 8.3%, p=0.01), SVT (33% vs 0%, p=0.04), PVC (28.5% vs 0%, p=0.02) and VT (33.3% vs. 4.3%, p=0.02) when compared with ISO group which were additionally ablated. At 1-year follow up, COMBO group had significantly higher freedom from arrhythmias in AT/AF (20% vs. 41.6%, p=0.05), SVT (0% vs. 23%, p=0.04), PVC (4.7% vs. 43%, p=0.009) and VT ablation (26% vs. 61%, p=0.05) groups. Conclusion: COMBO induction protocol during CA may uncover additional triggers and arrhythmia substrates in patients with supraventricular and ventricular arrhythmias. COMBO directed supplemental CA may improve freedom from clinical arrhythmias on long term follow up.

Determinants of the Successful Provision of Threshold Public Goods with Refund and Threshold Uncertainty

We simplify a threshold public goods game to a 2x2-game in order to generate an estimate for the probability of successful provision (success rate). This estimate relies on the calculation of belief bounds, i.e., points of indifference between two focal contribution strategies. Our analysis reveals the effect (or lack thereof) of core game elements on the success rate. The success rate increases with the step return (i.e., the benefit-cost ratio) and decreases with the number of players, but is unaffected by the players' endowment. Our model also demonstrates that the refund rate, referring to the percentage of contribution costs that is returned if the provision fails, has a positive effect on success rates. As an application, we estimate success rates for a randomly distributed threshold value. We examine uniform and logistic probability distributions and show that increasing threshold uncertainty is not necessarily detrimental to public good provision if the benefit-cost ratio is high.

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OBJECTIVES/SPECIFIC AIMS: In this pilot case-control study, the metabolome was quantified in subjects with previously measured serum and clinical biomarkers. The serum metabolome was then integrated with existing serum and clinical biomarkers of WTC-exposed firefighters to identify pathways significant to loss of lung function following acute PM-exposure. This robust subset of metabolite and serum biomarkers may be clinically relevant to predicting progression to lung disease in a larger cohort. METHODS/STUDY POPULATION: Serum drawn within 6 months of 9/11 was analyzed in this pilot. Clinical measures were obtained from electronic medical records. Never-smoking, male, WTC-exposed firefighters with normal pre-9/11 lung function were segregated based on FEV1 percent predicted (FEV1 %Pred) at symptomatic presentation. Cases of WTC-LI (FEV1 %Pred &lt;LLN, n=15) and controls (n=15) were identified from previous cohorts. Ultrahigh performance liquid chromatography tandem mass spectroscopy quantified the metabolomic fingerprints of a group with previously assessed (by multiplex panels; ELISA and Luminex) serum chemokines and cytokines. High-dimensional data analysis and dimension reduction techniques integrated metabolites, cytokines, chemokines, and clinical data to identify pathways of WTC-LI on curated data. Random Forest (RF) out-of-bag estimated success rates were used to measure classification utility of the refined biomarker profile. Principal components analysis (PCA) was used to visualize class separation produced by the refined profile. RESULTS/ANTICIPATED RESULTS: Of the 765 metabolites detected, 580 metabolites were quantified in more than 80% of subjects/group with relative standard deviation ≥15%. Relevant chemokines, cytokines, and clinical biomarkers were included based on previously established clinical importance. Initial PCA explained 34.7% of the variance in the first 3 components. RF was used to identify the top 5% of biomarkers important to class separation. RF of the refined biomarker profile correctly classified cases and controls with a 96.7% estimated success rate. A PCA of the refined metabolic profile now explained 46.2% of the variance in components 1–3, demonstrating improved class separation. Differentiators between cases of WTC-LI and controls included elevated sphingolipids in cases of WTC-LI. The metabolic-inflammatory serum biomarkers MDC, Apo AI, GM-CSF, and heart rate play an important role in class separation. Phospholipids and lysolipids also appeared to differentiate cases of WTC-LI from controls. Specifically, several glycero-phosphatidylcholines (GPC) were elevated in cases of WTC-LI. DISCUSSION/SIGNIFICANCE OF IMPACT: High-dimensional data analysis on the metabolic fingerprints, serum, and clinical biomarker data of a subset of WTC-exposed 9/11 rescue workers has identified pathways associated with the loss of lung function. Sphingolipids, known to function as inflammatory signaling mediators, are thought to play important roles in lung function under both physiological and pathological conditions. Changes in sphingolipid metabolism have been linked to several pulmonary disorders, including asthma, COPD, and acute lung injury. Interestingly, a relation between sphingolipid metabolism and the metabolic-inflammatory pathway is suggested by similarities observed in PCA. Findings of elevated GPCs are similar to COPD literature. Higher levels of GPCs could correspond to elevated levels of lysophosphatidic acid (LPA), a ligand of RAGE. RAGE is a known proinflammatory mediator; LPA species have well-described roles as lipid signaling molecules, function as synthetic intermediates in other metabolic pathways, and were found to be predictive of WTC-LI. Since metabolites are more proximal markers of disease processes, metabolites could capture the complexity of past exposures and, therefore, may better inform treatment. These pathways warrant further investigation into their mechanisms and therapeutic importance.

Intrapericardial Left Ventricular Assist Device for Advanced Heart Failure

BackgroundMechanical circulatory support with a left ventricular assist device (LVAD) is an established treatment for patients with advanced heart failure. We compared a newer LVAD design (a small intrapericardial centrifugal-flow device) against existing technology (a commercially available axial-flow device) in patients with advanced heart failure who were ineligible for heart transplantation.MethodsWe conducted a multicenter randomized trial involving 446 patients who were assigned, in a 2:1 ratio, to the study (centrifugal-flow) device or the control (axial-flow) device. Adults who met contemporary criteria for LVAD implantation for permanent use were eligible to participate in the trial. The primary end point was survival at 2 years free from disabling stroke or device removal for malfunction or failure. The trial was powered to show noninferiority with a margin of 15 percentage points.ResultsThe intention-to treat-population included 297 participants assigned to the study device and 148 participants assigned to the control device. The primary end point was achieved in 164 patients in the study group and 85 patients in the control group. The analysis of the primary end point showed noninferiority of the study device relative to the control device (estimated success rates, 55.4% and 59.1%, respectively, calculated by the Weibull model; absolute difference, 3.7 percentage points; 95% upper confidence limit, 12.56 percentage points; P=0.01 for noninferiority). More patients in the control group than in the study group had device malfunction or device failure requiring replacement (16.2% vs. 8.8%), and more patients in the study group had strokes (29.7% vs. 12.1%). Quality of life and functional capacity improved to a similar degree in the two groups.ConclusionsIn this trial involving patients with advanced heart failure who were ineligible for heart transplantation, a small, intrapericardial, centrifugal-flow LVAD was found to be noninferior to an axial-flow LVAD with respect to survival free from disabling stroke or device removal for malfunction or failure. (Funded by HeartWare; ENDURANCE ClinicalTrials.gov number, NCT01166347.)

Azimuth Tracking of Underwater Moving Sound Source Based on Time Delay Estimation Using Hydrophone Array

Hydrophones array represents underwater sensors that can be used to detect azimuth of target by obtain the time delay information. Success rate of time delay estimation is influenced by characteristics of sound propagation like reflection, scattering, and reverberation. Simulation and experiment of hydrophone array in real environment aimed to analyze performance of the cross correlation (CC) and generalized cross correlation with the phase transform (PHAT) weighting to estimate time delay between two signals. The objective of the simulation is to know the influence of time delay against various SNR by CC and PHAT algorithm. The algorithm then tested in a pond to detect stationary and moving position of sound source. Result of the simulation and experiment in real environment which is considered as scatter condition showed that PHAT performed better than CC. In moving sound experiments, tracking the azimuth of the mini vessel can be done by time delay estimation using PHAT.

Estimation of Credit Card Customers Payment Status by Using kNN and MLP

The Default of Credit Card Clients dataset in the UCI machine learning repository was used in this study. The credit card customers were classified if they would do payment or not (yes=1 no=0) for next month by using 23 information about them. Totally 30000 data in the dataset’s 66% was used for training and rest of them as 33% was used for tests. The Weka (Waikato Environment for Knowledge Analysis) software was used for estimation. In estimation Multilayer Perceptron (MLP) and k Nearest Neighbors (kNN) machine learning algorithms was used and success rates and error rates were calculated. With kNN estimation success rates for various number of neighborhood value was calculated one by one. The highest success rate was achieved as 80.6569% when the number of neighbor is 10. With MLP neural network model the estimation success rates was calculated when there are different number of neurons in the hidden layer of MLP. The best estimation success rate was achieved as 81.049% when there was only one neuron in the hidden layer. MAE and RMSE values were obtained for this estimation success rate as 0.3237 and 0.388 respectively.

Localization of underwater moving sound source based on time delay estimation using hydrophone array

Signal and noise of an underwater moving sound source is used to track the azimuth of a target. Uniform linear array with four hydrophones is used to detect azimuth of target by obtain the time delay information to get azimuth information. Success rate of time delay estimation influenced by characteristics of sound propagation like reflection, reverberation, etc. Experiment in real environment was done to analyze performance of the cross correlation (CC) and generalized cross correlation with the phase transform (PHAT) weighting to estimate time delay between two signal. The simulation done by convolute two signal that has been given time delay and impulse response of the medium test. Then the time delay of two signal estimated by CC and PHAT algorithm in Matlab in the various SNR. Then the algorithm tested in a pool to detect stationary and moving position of sound source. Result of the simulation and experiment in real environment shown that PHAT better than CC. The best azimuth tracking achieved by using PHAT algorithm with error of 0 - 9.48 degree in stationary position. In moving sound experiments, tracking the bearing and azimuth of the mini vessel (sound source) can be done by time delay estimation using PHAT.

Recombinant long-acting glycoPEGylated factor IX in hemophilia B: a multinational randomized phase 3 trial

AbstractThis multinational, randomized, single-blind trial investigated the safety and efficacy of nonacog beta pegol, a recombinant glycoPEGylated factor IX (FIX) with extended half-life, in 74 previously treated patients with hemophilia B (FIX activity ≤2 IU/dL). Patients received prophylaxis for 52 weeks, randomized to either 10 IU/kg or 40 IU/kg once weekly or to on-demand treatment of 28 weeks. No patients developed inhibitors, and no safety concerns were identified. Three hundred forty-five bleeding episodes were treated, with an estimated success rate of 92.2%. The median annualized bleeding rates (ABRs) were 1.04 in the 40 IU/kg prophylaxis group, 2.93 in the 10 IU/kg prophylaxis group, and 15.58 in the on-demand treatment group. In the 40 IU/kg group, 10 (66.7%) of 15 patients experienced no bleeding episodes into target joints compared with 1 (7.7%) of 13 patients in the 10 IU/kg group. Health-related quality of life (HR-QoL) assessed with the EuroQoL-5 Dimensions visual analog scale score improved from a median of 75 to 90 in the 40 IU/kg prophylaxis group. Nonacog beta pegol was well tolerated and efficacious for the treatment of bleeding episodes and was associated with low ABRs in patients receiving prophylaxis. Once-weekly prophylaxis with 40 IU/kg resolved target joint bleeds in 66.7% of the affected patients and improved HR-QoL. This trial was registered at www.clinicaltrials.gov as #NCT01333111.

Outcomes of robotic sacrocolpopexy: a systematic review and meta-analysis.

Robotic sacrocolpopexy has been rapidly incorporated into surgical practice without comprehensive and systematically published outcome data. The aim of this study was to systematically review the currently published peer-reviewed literature on robotic-assisted laparoscopic sacrocolpopexy with more than 6 months of anatomic outcome data. Studies were selected after applying predetermined inclusion and exclusion criteria to a MEDLINE search. Two independent reviewers blinded to each other's results abstracted demographic data, perioperative information, and postoperative outcomes. The primary outcome assessed was anatomic success rate defined as less than or equal to pelvic organ prolapse quantification system (POP-Q) stage 1. A random effects model was performed for the meta-analysis of selected outcomes. Thirteen studies were selected for the systematic review. Meta-analysis yielded a combined estimated success rate of 98.6% (95% confidence interval, 97.0%-100%). The combined estimated rate of mesh exposure/erosion was 4.1% (95% confidence interval, 1.4%-6.9%), and the rate of reoperation for mesh revision was 1.7%. The rates of reoperation for recurrent apical and nonapical prolapse were 0.8% and 2.5%, respectively. The most common surgical complication (excluding mesh erosion) was cystotomy (2.8%), followed by wound infection (2.4%). The outcomes of this analysis indicate that robotic sacrocolpopexy is an effective surgical treatment of apical prolapse with high anatomic cure rate and low rate of complications.

MUSIC 및 반향 성분 제거 기법을 이용한 음성신호의 입사각 추정

In this paper, we propose a method to improve the performance of the direction-of-arrival (DOA) estimation of a speech source using a multiple signal classification (MUSIC)-based algorithm. Basically, the proposed algorithm utilizes a complex coefficient band pass filter to generate the narrow band signals for signal analysis. Also, reverberation component reduction and quadratic function-based response approximation in MUSIC spatial spectrum are utilized to improve the accuracy of DOA estimation. Experimental results show that the proposed method outperforms the well-known generalized cross-correlation (GCC)-based DOA estimation algorithm in the aspect of the estimation error and success rate, respectively.Abstract should be placed here. These instructions give you guidelines for preparing papers for JICCE.

MTA pulpotomy as an alternative to root canal treatment in children's permanent teeth in a dental public health setting

ObjectiveThis prospective clinical study evaluated the success of vital pulpotomy treatment for permanent teeth with closed apices using mineral trioxide aggregates (MTA) in a dental public health setting. MethodsTwenty-seven mature permanent first molars and 2 premolars (in 25 patients) with carious exposure were treated using MTA pulpotomy. Age of patients ranged from 10- to 15-years (mean=13.2±1.74-years). Four trained and calibrated practitioners performed the same clinical procedure for all patients. Following isolation and caries removal, the inflamed pulp tissue was completely removed from the pulp chamber. This was followed by irrigation with 2% sodium hypochlorite. Haemostasis was achieved using a cotton pellet damped in normal saline. A white MTA paste was placed against the pulp orifices. MTA was covered with a damped cotton pellet and a base of IRM. Patients were recalled after 1 day where a glass ionomer liner and a final restoration were placed. Teeth were evaluated clinically and radiographically for up to 47 months. ResultsMean follow-up period for all teeth was 25±14 months. Twenty-six of the 29 teeth were clinically asymptomatic with no evidence of periradicular or root pathology during the follow-up period. The estimated success rate was 90%. Three teeth presented with clinical symptoms of pain and radiographic evidence of periradicular pathology that indicated root canal treatment (RCT) or extraction. ConclusionWhen managing carious pulp exposures of permanent teeth with closed root apices in children, MTA pulpotomy showed a high success rate. Clinical significanceMTA pulpotomy for permanent molars in children is a viable alternative to RCT.

The importance of local eosinophilia in the surgical outcome of chronic rhinosinusitis: a 3-year prospective observational study.

Patients with chronic rhinosinusitis with/without nasal polyps (CRSwNP/CRSsNP) benefit from endoscopic sinus surgery (ESS), with an estimated success rate of 80%. At present, the influence on clinical outcome after ESS of eosinophils, eosinophilic mucin (EM), and fungal hyphae (FH) in secretions remains unclear. By delineating CRS groups and subgroups based on the finding of eosinophils, EM, and FH, differences in recurrence after ESS were investigated. A prospective monocenter study including 221 CRS patients who were unresponsive to medical treatment and underwent ESS was performed. All tissue and sinonasal secretions were microscopically examined for the presence of eosinophils, EM, and FH. Patients were followed for 3 years after surgery. Recurrence was defined according to the European position paper on rhinosinusitis and nasal polyps. In total, 96 CRSwNP and 125 CRSsNP patients were included. Tissue eosinophils were found in 78% of CRSwNP patients compared with 42% in CRSsNP patients. EM was observed in 52% of the CRSwNP group versus 20% of the CRSsNP group. Furthermore, secretion analysis revealed FH in 7% of CRS. Recurrence in the total group was 22% over 3 years. CRSwNP patients with tissue eosinophilic involvement showed a recurrence rate of 48%, and those with additional EM showed recurrence in 56%. The presence of eosinophils in tissue or airway secretions greatly increases the risk of recurrent disease in CRSwNP patients. The finding of tissue eosinophilia and EM provides valuable information regarding the increased likelihood of CRS recurrence after ESS, whereas the finding of FH does not.

Cost-Effectiveness of Retinal Detachment Repair

To evaluate costs and treatment benefits of rhegmatogenous retinal detachment (RD) repair. A Markov model of cost-effectiveness and utility. There were no participants. Published clinical trials (index studies) of pneumatic retinopexy (PR), scleral buckling (SB), pars plana vitrectomy (PPV), and laser prophylaxis were used to quantitate surgical management and visual benefits. Markov analysis, with data from the Center of Medicare and Medicaid Services, was used to calculate the adjusted costs of primary repair by each modality in a hospital-based and ambulatory surgery center (ASC) setting. Lines of visual acuity (VA) saved, cost of therapy, adjusted cost of therapy, cost per line saved, cost per line-year saved, and cost per quality-adjusted life years (QALY) saved. In the facility, hospital surgery setting, weighted cost for PR ranged from $3726 to $5901 depending on estimated success rate of primary repair. Weighted cost was $6770 for SB, $7940 for PPV, and $1955 for laser prophylaxis. The dollars per line saved ranged from $217 to $1346 depending on the procedure. Dollars per line-year saved ranged from $11 to $67. Dollars per QALY saved ranged from $362 to $2243. In the nonfacility, ASC surgery setting, weighted cost for PR ranged from $1961 to $3565 depending on the success rate of primary repair. The weighted costs for SB, PPV, and laser prophylaxis were $4873, $5793, and $1255, respectively. Dollars per line saved ranged from $139 to $982. The dollars per line-year saved ranged from $7 to $49, and the dollars per QALY saved ranged from $232 to $1637. Treatment and prevention of RD are extremely cost-effective when compared with other treatment of other retinal diseases regardless of treatment modality. Retinal detachment treatment costs did not vary widely, suggesting that providers can tailor patient treatments solely on the basis of optimizing anticipated results because there were no overriding differences in financial impact.

Topology identification of complex networks from noisy time series using ROC curve analysis

As it is known, there is various unknown information in most real world networks, such as uncertain topological structure and node dynamics. Thus how to identify network topology from dynamical behaviors is an important inverse problem for physics, biology, engineering, and other science disciplines. Recently, with the help of noise, a method to predict network topology has been proposed from the dynamical correlation matrix, which is based on a general, one-to-one correspondence between the correlation matrix and the connection matrix. However, the success rate of this prediction method depends on the threshold, which is related to the coupling strength and noise intensity. Different coupling strength and noise intensity result in different success rate of prediction. To deal with this problem, we select a desirable threshold to improve the success rate of prediction by using Receiver Operating Characteristic (ROC) curve analysis. By the technique of ROC curve analysis, we find that the accuracy and efficiency of topology identification is mainly determined by coupling strengths. The success rate of estimation will be reduced if the coupling is too weak or too strong. The presence of noise facilitates topology identification, but the noise intensity is not always crucial to the effectiveness of topology identification.

Clinical risk factors related to failures with zirconia-based restorations: An up to 9-year retrospective study

ObjectivesThe first objective of this study was to retrospectively evaluate zirconia-based restorations (ZBR). The second was to correlate failures with clinical parameters and to identify and to analyse chipping failures using fractographic analysis. Methods147 ZBR (tooth- and implant-supported crowns and fixed partial dentures (FPDs)) were evaluated after a mean observation period of 41.5±31.8 months. Accessorily, zirconia implant abutments (n=46) were also observed. The technical (USPHS criteria) and the biological outcomes of the ZBR were evaluated. Occlusal risk factors were examined: occlusal relationships, parafunctional habits, and the presence of occlusal nightguard. SEM fractographic analysis was performed using the intra-oral replica technique. ResultsThe survival rate of crowns and FPDs was 93.2%, the success rate was 81.63% and the 9-year Kaplan–Meier estimated success rate was 52.66%. The chipping rate was 15% and the framework fracture rate was 2.7%. Most fractographic analyses revealed that veneer fractures originated from occlusal surface roughness. Several parameters were shown to significantly influence veneer fracture: the absence of occlusal nightguard (p=0.0048), the presence of a ceramic restoration as an antagonist (p=0.013), the presence of parafunctional activity (p=0.018), and the presence of implants as support (p=0.026). The implant abutments success rate was 100%. ConclusionsThe results of the present study confirm that chipping is the first cause of ZBR failure. They also underline the importance of clinical parameters in regards to the explanation of this complex problem. This issue should be considered in future prospective clinical studies. Clinical significancePractitioners can reduce chipping failures by taking into account several risk parameters, such as the presence of a ceramic restoration as an antagonist, the presence of parafunctional activity and the presence of implants as support. The use of an occlusal nightguard can also decrease failure rate.

The Learning Curve Associated with the Epidural Technique Using the Episure™ AutoDetect™ Versus Conventional Glass Syringe

The Episure™ AutoDetect™ (spring-loaded) syringe has been observed to successfully identify the epidural space in 2 pilot studies. In this study we evaluated the impact of the spring-loaded syringe on the establishment of successful epidural labor analgesia (primary outcome), elapsed time for catheter placement, and learning curve (cumulative summary analysis, i.e., Cusum) of experienced anesthesiologists. Fourteen attending and fellow anesthesiologists were randomized to perform 50 consecutive epidural technique attempts using a spring-loaded or conventional glass syringe. Ten participants completed an additional 50 attempts with the alternate syringe in a crossover design. A total of 1200 epidural placement attempts were performed. Use of the spring-loaded syringe was associated with a nonsignificant difference of estimated success rate in obtaining analgesia success (absolute difference of 1.0% 95% confidence interval, CI: -8.9% to 10.8%), shorter elapsed mean time to epidural catheter placement (ratio of 0.92 95% CI, 0.89-0.96); P = 0.003) and similar Cusum curves when compared with a conventional glass syringe. Analgesia success was more common with attending versus fellow anesthesiologists (absolute difference of 34.6% 95% CI, 14.9% to 54.3%; P < 0.001), and when the initial preferred technique was loss-of-resistance to continuous saline versus intermittent air (absolute difference of 33.8% 95% CI, 12.6% to 55.0%; P < 0.001). Shorter elapsed mean times were also observed in the group exposed to the spring-loaded syringe first (ratio of 0.65 95% CI, 0.62-0.67; P = 0.02). When used by experienced obstetric anesthesiologists, the spring-loaded syringe was associated with a similar overall rate for establishing successful epidural labor analgesia, a shorter elapsed time to epidural catheter insertion, particularly when the anesthesiologist was randomized to use the novel syringe first, and a similar Cusum curve when compared with a conventional glass syringe. Attending versus fellow anesthesiologists and an initial technique preference for loss-of-resistance to continuous saline were associated with greater analgesia success with the novel syringe.