Final Outcome Research Articles

An Evaluation of the Precision of Ocular Trauma Score and Factors for Poor Visual Outcomes in Open Globe Injury: A Retrospective Analysis of Resourcelimited Hospital Settings

Objective: To evaluate the accuracy and validity of ocular trauma scores (OTS) among patients with open globe injury (OGI) in rural hospital settings and to identify the determinants predicting poor visual outcomes. Materials and Methods: A single-center retrospective cohort study was conducted through a chart review of OGI patients between July 2018 and June 2023 at Bueng Kan Hospital. Demographic and preoperative factors affecting the final visual outcome were evaluated. OTS score for each patient was calculated and categorized. Final VA after 6 months was compared to the predicted VA from OTS study. Poor visual outcome was defined as legal blindness after 6 months of treatment. Results: Thirty-nine eyes from patients with a mean age of 44.05 years were evaluated. Most subjects were male (94.87%), and workplace injuries were the most common (78.38%). Compared to the OTS study, patients in OTS category 2 achieved a significantly higher percentage of better final VA, while categories 3 and 4 showed similar outcomes. OTS category 1 patients had a lower proportion of no light perception (NLP) outcomes, though the difference was not significant. Poor visual outcomes were predicted by initial VA (OR=4.64), wound extension ≥10 mm (OR=20.66), and lens injury (OR=7.44). Conclusion: OTS is beneficial for predicting final vision in patients with OGI, particularly with less severe trauma. Severe cases often lead to better visual outcomes, emphasizing the need for cautious management and counseling by ophthalmologists. Factors that estimate poor visual outcomes involve poor initial VA, wound extension  10 mm, and lens damage.

D-Dimer, ferritin, and lactate dehydrogenase (LDH) as predictors of mortality in hospitalized COVID-19 patients.

Several laboratory parameters may be predictors of coronavirus disease 2019 (COVID-19) mortality. This study aimed to analyze the potential of D-dimer, ferritin, and lactate dehydrogenase (LDH) to predict mortality in severe COVID-19 patients. A retrospective cohort study, including 147 patients, was examined using secondary data from medical records of hospitalized COVID-19 patients. D-dimer, ferritin, and LDH levels were obtained from the patients' blood analysis on first hospitalization. Patients were then categorized into a survival group (97 patients) and a non-survival group (50 patients) based on final outcome. Proportions and means were analyzed using Chi square and Mann-Whitney tests. Further, the correlation and accuracy were analyzed using partial correlations test and receiver operating characteristic curve analysis. The combination of multiple predictors was also analyzed. The non-survival group had significantly higher levels of D-dimer (32.11 ± 13.05 vs. 9.57 ± 16.65; p < 0.001), ferritin (1719.84 ± 539.52 vs. 808.83 ± 664.81; p < 0.001), and LDH (1782.92 ± 1537.92 vs. 622.848 ± 274.79; p < 0.001) than the survival group. These parameters also had a moderate correlation with mortality (r > 0.500) and robust sensitivity and specificity for predicting mortality, especially ferritin (AUC = 0.906; sensitivity = 92.3%; specificity = 87.5%; p < 0.001), and the combination of ferritin and LDH with or without D-dimer (AUC = 0.959; sensitivity = 100%; specificity = 87.5%; p < 0.001). The levels of these parameters are significantly higher, have robust sensitivity and specificity, and can be used as predictors of mortality.

Claiming the Reality (of Loss): Some Remarks on the Screenplay, Novel and FilmKwiecień (April, 1961) by Witold Lesiewicz and Józef Hen

The article discusses the interrelationships between Józef Hen’s novel Kwiecień (April), his two unpublishedscreenplays based on it, and Witold Lesiewicz’s fi lm Kwiecień (April, 1961), a canonicalwork of the Polish film school. The key problem concerns the question of the sense of sendingsoldiers to fight in the final days of the war, when its final outcome is already determined. Whenwriting his novel and its screenplay versions, Józef Hen referred to his own experience in April1945, when he fought in the ranks of the Second Polish Army and personally witnessed the tragedyof the soldiers dying in the final hours of the war, when personal ambitions and attitudes of commanderstook precedence over a rational assessment of the situation at the front. Hen’s noveland its screenplay and fi lm versions can therefore be seen as attempts at claiming the realityof loss. This is one of the main themes of Józef Hen’s writing. In April it is reflected in the attitudesof the main characters, as shaped by various dimensions of loss.

Serum tumor markers and outcomes in lung cancer patients with brain metastases: a retrospective longitudinal cohort study.

Serum tumor markers (STMs) are recommended for cancer diagnosis and surveillance. However, their role in lung cancer with brain metastases (BM) is not yet clear. We aim to analyze the roles of baseline levels of STMs or ongoing STM surveillance on survival. This retrospective longitudinal cohort study included 1,169 lung cancer patients with BM. The STM data during disease course were collected. Distinct trajectory groups were identified using the latent class growth mixed model (LCGMM). The roles of STMs on survival were further analyzed using Kaplan-Meier analysis and Cox proportional hazard models. Serum levels of cytokeratin-19 fragment (CYFRA21-1) (P<0.001), carcinoembryonic antigen (CEA) (P=0.005) and neuron-specific enolase (NSE) (P<0.001) at baseline exhibited significant correlation with overall survival (OS) of patients with BM, serving as independent prognostic factors. Further analysis indicated that baseline CYFRA21-1, CEA, NSE as well as status of key driver genes were independent prognostic factors in non-small cell lung cancer (NSCLC) patients with BM, while for small cell lung cancer (SCLC) patients with BM, baseline NSE and receiving chemotherapy show independent correlations with survival. Furthermore, we delineated the dynamic trajectories of STMs based on changes in disease course. More specifically, compared to those showing a baseline-high trend in CEA levels, the survival of patients with either persistently-rising or consistently normal levels seemed to be more promising. For CYFRA21-1, both early-rising and later-rising trends were observed, indicating a prognosis inferior to that of individuals with normal-level trajectory. Likewise, for NSE, patients with persistently-rising or persistently-descending trends showed no significantly survival difference. However, in comparison with the status of driver genes, receiving radiotherapy and targeted therapy, the dynamic changes in STM levels lacked independent prognostic significance. Further analysis indicated that among BM patients lacking key driver genes, NSE trajectory (P<0.05), CYFRA21-1 trajectory (P<0.05) and receiving chemotherapy (P<0.001) were independent prognostic factors. Baseline levels of serum CYFRA21-1, CEA and NSE, as well as status of key driver genes are recommended for evaluating BM patients' outcome. Dynamic changes of STMs during disease course were not significantly associated with the final outcome of BM patients.

Pengembangan Website Company Profile untuk Meningkatkan Promosi Digital PT Multi Global

In the face of digital era promotional challenges, developing a company profile website has become a crucial need for PT Multi Global. Despite operating for over two decades, the company has lacked a formal promotional platform capable of reaching a broader market. Previous promotional efforts relied solely on word-of-mouth, which is limited in expanding the company’s visibility in today’s digital landscape. Through a Community Service (PkM) initiative, this study aims to design and develop an informative and responsive company profile website using WordPress CMS and the Elementor plugin. The development process follows the System Development Life Cycle (SDLC) method with a waterfall approach, encompassing requirements analysis, design, implementation, testing, and maintenance phases. The final outcome of this project is a website that provides comprehensive information about the company, its products, and services, while also enhancing brand awareness and facilitating easier access to information for customers. This website development is expected to serve as an effective solution in supporting PT Multi Global's business growth and boosting the company’s competitiveness in an increasingly competitive market.

Buffer Screening of Protein Formulations Using a Coarse-Grained Protocol Based on Medicinal Chemistry Interactions.

In drug and vaccine development, the designed protein formulation should be highly stable against the temperature, pH, buffer, excipients, and other environmental settings. Similarly, in a sensing unit, one needs to know how strongly two biomolecules bind to guide the design of the biorecognition unit accordingly. Typically, the community performs a series of experiments to thoroughly examine the parameter space, the so-called design-of-experiment (DoE) method, to identify the optimal formulation conditions. Unfortunately, extensive physical testing entails high costs, repeatability issues, and a lack of in-depth knowledge of the underlying mechanisms that affect the final outcome. To address these challenges, we developed a physics-based simulation protocol for buffer screening of protein formulations. We are introducing a coarse-grained molecular simulation protocol that consists of six different interactions. The so-called medicinal chemistry interactions (electrostatics, hydrophobicity, hydrogen bonding propensity, disulfide bonding, and water-water) are based on the physical nature of the protein's amino acid and the partitioning/polarity of any other chemical constituent. The protocol is applied in immunoglobulin-based monoclonal antibodies. We have analyzed the protein behavior as a function of acidity (pH) to discover the isoelectric point by solving the Poisson-Boltzmann equation in a mesoscale grid. To identify the conditions under which the protein oligomerizes in a given buffer, pH, temperature, and ionic strength, we are performing dissipative particle dynamics (DPD) simulations. The protocol allows researchers to reach the high time/space scales required to study protein formulations in their full complexity. Combined with the disruptive protein folding artificial intelligence (AI) algorithms that have been recently developed, the protocol creates a powerful digital framework for cultivating advanced pharmaceutical and biological applications.

Preoperative variables affecting outcome of cochlear implant

BackgroundCochlear implants made a great impact in the management of severe-to-profound hearing loss in both children and adults. Its greatest impact is in helping children born with a profound hearing loss and implanted early to attend mainstream education and using spoken language to communicate. However, the final outcome in pediatric implantation is not predictable as there are large number of factors which will affect the outcome of cochlear implantation. Studying these determinants increases the ability of clinicians to offer educated preoperative prognosis and might potentially allow for manipulation of variables in an attempt to achieve the best possible outcome.ObjectiveThe aim of this study was to assess the preoperative factors affecting the audiological, speech, and language outcomes achieved by the recipients of cochlear implants.MethodologyA total of 39 children with severe-to-profound sensory neural hearing loss were implanted with cochlear implants. Children had received their implants before age of 5 years. Tests of receptive, expressive language quotient, aided cortical auditory-evoked potential using speech stimulus, aided free field audiometry, and aided speech reception thresholds were administered. Characteristics of the child and the family (age before implant and duration of implant use, cause of hearing loss, preimplant use of hearing aids and language therapy, and sociodemographic characteristics of their families) were the preoperative variables. These variables were considered predictors of audiological and language outcomes achieved by children and were determined using statistical analysis by univariate and multivariate analyses.ResultsAge of the studied children at time of cochlear implantation was statistically significant predictor for CI outcome as regard receptive language quotient and also for N1 latency. Hearing age of the studied children was a statistically significant predictor for CI outcome as regards P1 latency.ConclusionBased on our findings, two most important factors affecting outcome of cochlear implantation were the age at implantation and the hearing age. Other factors were important but did not affect the outcome significantly.

Prognostication in Epilepsy with Integrated Analysis of Blood Parameters and Clinical Data.

Background/Objectives: Determining the outcome of epilepsy is crucial for making proactive and timely treatment decisions and for counseling patients. Recent research efforts have focused on using various imaging techniques and EEG for prognostication; however, there is insufficient evidence regarding the role of blood parameters. Our study aimed to investigate the additional prognostic value of routine blood parameters in predicting epilepsy outcomes. Methods: We analyzed data from 1782 patients who underwent routine blood tests within 90 days of their first visit and had a minimum follow-up duration of three years. The etiological types were structural (35.1%), genetic (14.2%), immune (4.7%), infectious (2.9%), and unknown (42.6%). The outcome was defined as the presence of seizures in the last year. Results: Initially, a multivariate analysis was conducted based on clinical variables, MRI data, and EEG data. This analysis revealed that sex, age of onset, referred cases, epileptiform discharge, structural etiology, and the number of antiseizure medications were related to the outcome, with an area under the curve (AUC) of 0.705. Among the blood parameters, fibrinogen, bilirubin, uric acid, and aPTT were significant, with AUCs of 0.602, 0.597, 0.455, and 0.549, respectively. Including these blood parameters in the analysis slightly improved the AUC to 0.710. Conclusions: Some blood parameters were found to be related to the final outcome, potentially paving the way to understanding the mechanisms of epileptogenesis and drug resistance.

Evaluation of Functional Outcome of Single Dose Intralesional Autologous Blood Vs Corticosteroid Injection in Chronic Plantar Fascitis

Introduction: Plantar fascitis is one of the main underlying causes of acute and chronic heel pain. Diagnosis is mainly based on clinical symptoms and most of the time diagnostic imaging is not required routinely. Corticosteroid injection and autologous blood injection has been a possible means of treatment. Injection of autologous blood can help stimulate a healing response in chronic tendon disorders. Aims: To compare the functional outcome of single dose intra-lesional injection of autologous blood and corticosteroid in chronic plantar fascitis. Methods: This study was done in Nepalgunj medical college and teaching hospital during the period of March 2023 to August 2023 in the department of orthopedics. Sixty patients were enrolled in the study with 30 patients in each group. The patients were selected according to our inclusion and exclusion criteria and diagnosis made on clinical examination alone. The pain status was noted on the visual analog scale and the activity level noted based on the Nirschl stage. The final outcome was based on our scoring system based on the pain status and the activity level at two, four- and twelve-weeks’ duration and graded into four categories as excellent, good, and acceptable and poor. Results: We found that in chronic plantar fascitis, local intralesional steroid injection gives better pain relief and faster return to activities of daily living compared to autologous blood injections. In our study we found that 17.85% had excellent outcome, 35.72% had good outcome and 12% had acceptable outcome in steroid group, whereas in autologous blood group 7.40% had excellent, 22.22% had good and 70.37% had acceptable outcome respectively. Conclusion: Intralesional steroid injection in chronic plantar fascitis have shown to achieve better functional outcome than autologous blood injection.

Visual outcome of cataract surgery by phacoemulsification in diabetic versus non-diabetic patients: A comparative study

This study aims to evaluate and compare the results of phacoemulsification cataract surgery performed on diabetic patients with those of non-diabetic patients. The primary objective was to compare the visual outcome of phacoemulsification cataract surgery in diabetic patients and non-diabetic patients, and the secondary objective was todetermine the final visual outcome following phacoemulsification cataract surgery in diabetics and non-diabetics.A comparative study of the overall 300 eyes of the patients, in which 150 eyes were diabetic and 150 eyes were non-diabetic, underwent phacoemulsification cataract surgery with posterior chamber intra ocular lens implantation. Age, sex, follow-up, preoperative and postoperative best corrected visual acuity and post-operative complications were evaluated. Out of the 300 eyes of the patients, 150 eyes were diabetic and 150 eyes were non-diabetics. Phacoemulsification with posterior chamber intra ocular lens implantation was done in all patients. Follow up duration was 6 weeks. Postoperatively, 6 weeks after surgery, 31.7% of patients had BCVA of 6/9 or better in diabetic group while 36.3% of patients had BCVA of 6/9 or better in non-diabetic group. The difference in BCVA between two groups at postoperative 6 weeks was found to be statistically significant p value of &amp;#60;0.001. Post-operative complications included wound leak, striate keratopathy, folds in descemets membrane, corneal haze or edema, iritis, posterior capsular rent, cystoid macular edema, iridodialysis. The incidence was higher in the diabetic group as compared to non-diabetics. Overall, the final visual outcome was better in non-diabetic group as compared to diabetic group. Diabetics are more likely to develop intra operative and postoperative complications. Thus, special care should be used both throughout the surgical procedure and the post-operative period.

Long-term prognosis of penetrating keratoplasty in a patient with limited form of Scleroderma- a case report.

To explore the challenges of managing recurrent graft rejections in patients with Macular Corneal Dystrophy (MCD) undergoing Penetrating Keratoplasty (PKP) who also have an underlying diagnosis of Systemic Sclerosis, specifically the limited form known as CREST syndrome. The case of a 47-year-old female diagnosed with MCD who underwent multiple PKPs over a 13 year period was reviewed. The patients treatment included extensive surgical interventions (PKPs, amniotic membrane transplatation, tarsorrhaphy) and medical management involving systemic and topical steroids and immunosuppressive therapy (Tacrolimus ointment). Initial PKP surgeries improved the patients vision, but subsequently graft rejections,both acute and chronic, required further surgical and medical interventions. Despite aggressive management, the patient experienced multiple graft failures, with the final visual outcome being significantly compromised (vision 6/60). the presence of CREST syndrome complicated the management and prognosis of graft survival. This case illustrates the significant impact of systemic autoimmune disorders like CREST syndrome on the prognosis of PKP in patients with MCD. It highlights the necessity for diligent systemic evaluation and possibly more aggressive immunosuppresive strategies to manage graft rejections and prolong graft survival in such complex clinical scenarios.

Effects of the intraoral scanner and implant library on the trueness of digital impressions in the full-arch implant scan: A comparative in vitro study

ObjectiveTo evaluate the effect of intraoral scanners (IOSs) and implant libraries (ILs) on the trueness of digital impressions for the fabrication of implant-supported full-arch (FA) prostheses. MethodsA stone cast of an edentulous maxilla with 6 implant analogues and cylindrical scanbodies (IPD ProCam®, Matarò, Barcelona, Spain) was probed using a coordinate measuring machine to capture a reference model (RM). The cast was mounted on a mannequin and scanned with 3 different IOSs (iTERO Element 5D Plus®, Align Technologies, San José, CA, USA; IS 3800®, Dexis, Quackertown, PN, USA; and i-700®, Medit, Seoul, South Korea). Ten scans were performed by an experienced operator using each IOS, first capturing only the occlusal surfaces, then the buccal and finally the palatal surfaces (less than 45 s per scan). In each scan, the meshes of the SBs were replaced by the corresponding IL file, with and without increment, to obtain the best correction for the mesh growth. The positions of the SBs in each file were compared with those in the RM, to evaluate the linear and cross distances between them. The final outcome was the trueness of the different IOSs, evaluating the effect of using different ILs on the quality of the impressions. ResultsSignificant differences were found between the different IOS scans and the RM, and among the different IOSs, in the different segments. The correction of the mesh growth through incremental ILs did not affect the final trueness of the IOS scans. ConclusionsDifferent levels of trueness were found among the IOSs evaluated, in the different scan segments, but with the cylindrical SBs used herein, the correction of the mesh growth with incremental ILs did not affect the final quality of the digital impressions. Statement of clinical relevanceThere are still errors with IOS in the FA impressions. IOS have an effect on the quality of the digital impressions, and apparently the library has not, with purely cylindrical SBs: further studies are needed to confirm this aspect.

Making the most out of timeseries symptom data: A machine learning study on symptom predictions of internet-based CBT

ObjectivePredicting who will not benefit enough from Internet-Based Cognitive Behavioral (ICBT) Therapy early on can assist in better allocation of limited mental health care resources. Repeated measures of symptoms during treatment is the strongest predictor of outcome, and we want to investigate if methods that explicitly account for time-dependency are superior to methods that do not, with data from (a) only two pre-treatment timepoints and (b) the pre-treatment timepoints and three timepoints during initial treatment. MethodsWe use 1) commonly used time-independent methods (i.e., Linear Regression and Random Forest models) and 2) time-dependent methods (i.e., multilevel model regression, mixed-effects random forest, and a Long Short-Term Memory model) to predict symptoms during treatment, including the final outcome. This is done with symptom scores from 6436 ICBT patients from regular care, using robust multiple imputation and nested cross-validation methods. ResultsThe models had a 14 %–12 % root mean squared error (RMSE) in predicting the post-treatment outcome, corresponding to a balanced accuracy of 67–74 %. Time-dependent models did not have higher accuracies. Using data for the initial treatment period (b) instead of only from before treatment (a) increased prediction results by 1.3 % percentage points (12 % to 10.7 %) RMSE and 6 % percentage points BACC (69 % to 75 %). ConclusionTraining prediction models on only symptom scores of the first few weeks is a promising avenue for symptom predictions in treatment, regardless of which model is used. Further research is necessary to better understand the interaction between model complexity, dataset length and width, and the prediction tasks at hand.

Physicochemical Principles of AC Electrosynthesis: Reversible Reactions.

Electrolysis integrates renewable energy into chemical manufacturing and is key to sustainable chemistry. Controlling the waveform beyond direct current (DC) addresses the long-standing obstacle of chemoselectivity, yet it also expands the parameter set to optimize, creating a demand for theoretical predictions. Here, we report the first analytical theory for predicting chemoselectivity in an alternating current (AC) electrosynthesis. The mechanism is a selective reversal of the unwanted redox reaction during periods of opposite polarity, reflected in the final reaction outcome as a time-averaged effect. In the ideal scenario of all redox reactions being reversible, square AC waveform biases the outcome toward more overoxidation/over-reduction, whereas sine AC waveform exhibits the opposite effect. However, in a more realistic scenario of some redox reactions being quasi-reversible, sine AC may behave mostly like square AC. These predictions are in numerical agreement with model experiments employing acetophenone and align qualitatively with the literature precedent. Collectively, this study provides theoretical proof for a growing trend that promotes changing waveforms to overcome limitations challenging to address by varying canonical electrochemical parameters.

Machine learning reveals the rules governing the efficacy of mesenchymal stromal cells in septic preclinical models

BackgroundMesenchymal Stromal Cells (MSCs) are the preferred candidates for therapeutics as they possess multi-directional differentiation potential, exhibit potent immunomodulatory activity, are anti-inflammatory, and can function like antimicrobials. These capabilities have therefore encouraged scientists to undertake numerous preclinical as well as a few clinical trials to access the translational potential of MSCs in disease therapeutics. In spite of these efforts, the efficacy of MSCs has not been consistent—as is reflected in the large variation in the values of outcome measures like survival rates. Survival rate is a resultant of complex cascading interactions that not only depends upon upstream experimental factors like dosage, time of infusion, type of transplant, etc.; but is also dictated, post-infusion, by intrinsic host specific attributes like inflammatory microniche including proinflammatory cytokines and alarmins released by the damaged host cells. These complex interdependencies make a researcher’s task of designing MSC transfusion experiments challenging.MethodsIn order to identify the rules and associated attributes that influence the final outcome (survival rates) of MSC transfusion experiments, we decided to apply machine learning techniques on manually curated data collected from available literature. As sepsis is a multi-faceted condition that involves highly dysregulated immune response, inflammatory environment and microbial invasion, sepsis can be an efficient model to verify the therapeutic effects of MSCs. We therefore decided to implement rule-based classification models on data obtained from studies involving interventions of MSCs in sepsis preclinical models.ResultsThe rules from the generated graph models indicated that survival rates, post-MSC-infusion, are influenced by factors like source, dosage, time of infusion, pre-Interleukin-6 (IL-6)/ Tumour Necrosis Factor- alpha (TNF-α levels, etc.ConclusionThis approach provides important information for optimization of MSCs based treatment strategies that may help the researchers design their experiments.

Comparison of reactivation between ranibizumab and bevacizumab in aggressive retinopathy of prematurity: A retrospective case series.

To compare the incidence, type, interval for reactivation, and structural outcomes in infants with aggressive retinopathy of prematurity (A-ROP) treated with ranibizumab or bevacizumab. It is a single-center, retrospective, consecutive, case series. We included infants with A-ROP which were initially treated with either intravitreal ranibizumab (IVR, 0.25 mg) or intravitreal bevacizumab (IVB, 0.625 mg) between January 2017 and December 2023. The infants were followed up for reactivation. The demographic and clinical data were collected. The time, zone, type of reactivation, its treatment, type of final structural outcome, and factors associated with reactivation were analyzed. One hundred eight among the 322 infants with A-ROP were included in the study. Fifty-five received IVR, while 53 received IVB. Infants treated with IVR had higher incidence of reactivation (92.7% vs 52.8%, P < 0.001) at an earlier interval than IVB (7.7 weeks vs 12.8 weeks, P < 0.001). Infants treated with IVR had approximately 3.3 times higher possibility of reactivation than those treated with IVB. Three infants (5.9%) in the IVR group and five (9.4%) in the IVB group attained complete vascularization of the retina (P = 0.72). More infants treated with IVB had regression with a persistent avascular retina (PAR) than IVR (52.8% vs 15.7%, P < 0.001). Infants in the IVB group had 10 times higher possibility of regression with PAR. Infants of A-ROP treated with IVR have a higher incidence and earlier reactivation, while those treated with IVB have less incidence and delayed reactivation, albeit with a higher possibility of regression with a PAR.

A Prospective Randomized Control Trial of Lingual Frenuloplasty with Myofunctional Therapy in Patients with Maxillofacial Deformity in a Polish Cohort.

Introduction: There are few publications concerning ankyloglossia in mixed-aged groups utilizing myofunctional therapy and frenuloplasty in patients undergoing orthodontic treatment and maxillofacial surgery. While it is well known that ankyloglossia is mainly diagnosed in babies, research on functional and structural disorders in different age groups is less common. Thus, there is a high need for specific information about the influence and effectiveness of frenuloplasty with myofunctional therapy on the stomatognathic function and final treatment outcome for a wider variety of patients, especially those with maxillofacial deformities. Aim: This paper aims to evaluate the impact of lingual frenuloplasty as an adjunct to myofunctional therapy for the treatment of ankyloglossia in children and adults with maxillofacial deformity. Methods: Prospective randomized control trial with 155 subjects. Methods were based on visual observation and examination of the oral cavity. There were two groups: myofunctional therapy vs. myofunctional therapy and lingual frenuloplasty. Patients were randomized based on order of entry into the study. χ2 test, Kruskal-Wallis, ANOVA, Student's t-test and others were used for statistical analyses. Results: The presented protocol with myofunctional therapy and surgical procedures proved to be significantly more effective in improving tongue mobility and stomatognathic functions such as swallowing, breathing, and oral resting postures as compared to the reference group who underwent myofunctional therapy only. Conclusions: Lingual frenuloplasty with myofunctional therapy is highly effective in restoring the equilibrium of the orofacial muscles and the skeleton, which is often disturbed and may lead to unstable functional effects among patients considering orthodontic and orthognathic treatments for maxillofacial deformities.

KAJIAN ESTETIKA IMPLEMENTASI BAMBU LAMINASI PADA TRANSFORMABLE FURNITURE BRUNA CABINET

The limitation of wood as a raw material for furniture production has prompted researchers to seek non-wood alternative materials. Among these alternatives, bamboo has been utilized for furniture production. However, the bamboo used is typically in its whole form, which restricts the types and shapes of furniture that can be produced. Using the design thinking method, starting from the empathize, define, ideate, prototype, and test stages, the goal of this research was to explore the aesthetic value of a cabinet that can transform from one function to another using processed bamboo material—specifically, vertically laminated bamboo with grooves. Data collection involved initial questionnaires distributed to potential users, interviews with bamboo processing industry practitioners, and a literature review of books, journals, and internet articles. The final outcome of this study is a working drawing and a prototype cabinet made from laminated bamboo material that can transform into a writing desk. Respondent evaluations indicated that the prototype was 71.39% comfortable (Good) and had an average aesthetic rating of 84.125%. Additionally, 33% of respondents expressed interest in purchasing the prototype at the specified price.

Genetic variants regulating the immune response improve the prediction of COVID-19 severity provided by clinical variables

The characteristics of the host are crucial in the final outcome of COVID-19. Herein, the influence of genetic and clinical variants in COVID-19 severity was investigated in a total of 1350 patients. Twenty-one single nucleotide polymorphisms of genes involved in SARS-CoV-2 sensing as Toll-like-Receptor 7, antiviral immunity as the type I interferon signalling pathway (TYK2, STAT1, STAT4, OAS1, SOCS) and the vasoactive intestinal peptide and its receptors (VIP/VIPR1,2) were studied. To analyse the association between polymorphisms and severity, a model adjusted by age, sex and different comorbidities was generated by ordinal logistic regression. The genotypes rs8108236-AA (OR 0.12 [95% CI 0.02–0.53]; p = 0.007) and rs280519-AG (OR 0.74 [95% CI 0.56–0.99]; p = 0.03) in TYK2, and rs688136-CC (OR 0.7 [95% CI 0.5–0.99]; p = 0.046) in VIP, were associated with lower severity; in contrast, rs3853839-GG in TLR7 (OR 1.44 [95% CI 1.07–1.94]; p = 0.016), rs280500-AG (OR 1.33 [95% CI 0.97–1.82]; p = 0.078) in TYK2 and rs1131454-AA in OAS1 (OR 1.29 [95% CI 0.95–1.75]; p = 0.110) were associated with higher severity. Therefore, these variants could influence the risk of severe COVID-19.

ERABiLNet: enhanced residual attention with bidirectional long short-term memory

Alzheimer’s Disease (AD) causes slow death in brain cells due to shrinkage of brain cells which is more prevalent in older people. In most cases, the symptoms of AD are mistaken as age-related stresses. The most widely utilized method to detect AD is Magnetic Resonance Imaging (MRI). Along with Artificial Intelligence (AI) techniques, the efficacy of identifying diseases related to the brain has become easier. But, the identical phenotype makes it challenging to identify the disease from the neuro-images. Hence, a deep learning method to detect AD at the beginning stage is suggested in this work. The newly implemented “Enhanced Residual Attention with Bi-directional Long Short-Term Memory (Bi-LSTM) (ERABi-LNet)” is used in the detection phase to identify the AD from the MRI images. This model is used for enhancing the performance of the Alzheimer’s detection in scale of 2–5%, minimizing the error rates, increasing the balance of the model, so that the multi-class problems are supported. At first, MRI images are given to “Residual Attention Network (RAN)”, which is specially developed with three convolutional layers, namely atrous, dilated and Depth-Wise Separable (DWS), to obtain the relevant attributes. The most appropriate attributes are determined by these layers, and subjected to target-based fusion. Then the fused attributes are fed into the “Attention-based Bi-LSTM”. The final outcome is obtained from this unit. The detection efficiency based on median is 26.37% and accuracy is 97.367% obtained by tuning the parameters in the ERABi-LNet with the help of Modified Search and Rescue Operations (MCDMR-SRO). The obtained results are compared with ROA-ERABi-LNet, EOO-ERABi-LNet, GTBO-ERABi-LNet and SRO-ERABi-LNet respectively. The ERABi_LNet thus provides enhanced accuracy and other performance metrics compared to such deep learning models. The proposed method has the better sensitivity, specificity, F1-Score and False Positive Rate compared with all the above mentioned competing models with values such as 97.49%.97.84%,97.74% and 2.616 respective;y. This ensures that the model has better learning capabilities and provides lesser false positives with balanced prediction.