Group IS Research Articles

Comparative Evaluation of The Microhardness of Artificial Teeth of Various Composition

Statement of the problem: To help physicians choose the right materials for treatment planning, it is necessary to investigate to the mechanical and physical characteristics of denture teeth made with new technology. Objective: This study aims to investigate the comparative microhardness of artificial teeth with different composition. Materials & Methods: A total of 96 specimens (n=32) were prepared using three different types of artificial teeth (conventional polymethylmethacrylate, , and nanohybrid composite) (Group CA - Conventional PMMA, Group IS - Isosite Group DCL - double cross-linked acrylic). Surface hardness values were determined using a microhardness tester (Shimadzu HMV Corporation, Tokyo, Japan) with a load of 500 g and a dwell time of 15 seconds. Three indentations were obtained for each sample and the Vickers Hardness Number (VHN) was calculated and averaged. One-way analysis of variance (ANOVA) and post-hoc Tukey HSD tests were used for statistical analysis. The statistical significance level of the data was taken as α=0.05. Results: The highest microhardness values were observed in Group IS (53.96 ± 8.5 VHN) and the lowest in Group CA (53.55±9.9 VHN). However, no statistically significant difference was found between the groups (P>0.05). Conclusions: For the durability and function of prosthetic rehabilitations performed by clinicians, the choice of artificial teeth should not be ignored, based on cost and accessibility criteria.

Deep learning-based automated detection of the dental crown finish line: An accuracy study

Statement of problemThe marginal fit of dental prostheses is a clinically significant issue, and dental computer-aided design software programs use automated methods to expedite the extraction of finish lines. The accuracy of these automated methods should be evaluated. PurposeThe purpose of this study was to compare the accuracy of a new hybrid method with existing software programs that extract finish lines using fully automated and semiautomated methods. Material and methodsA total of 182 jaw scans containing at least 1 natural tooth abutment were collected and divided into 2 groups depending on how the digital data were created. Group DS used desktop scanners to scan casts trimmed for improved finish line visibility, while Group IS used intraoral scans. The method from Dentbird was compared using 3 software packages from 3Shape, exocad, and MEDIT. The Hausdorff and Chamfer distances were used in this study. Three dental laboratory technicians experienced in the digital workflow evaluated clinical finish line acceptance and its Hausdorff and Chamfer distances. For statistical analysis, t tests were performed after the outliers had been removed using the Tukey interquartile range method (α=.05). ResultsOutliers identified by using the Tukey interquartile range method were more numerous in the semiautomatic methods than in the automatic methods. When considering data without outliers, the software performance was found to be similar for desktop scans of the trimmed casts. However, the method from Dentbird demonstrated statistically better results (P<.05) for the posterior tooth with finish lines in concave regions than the 3Shape, exocad, and MEDIT software programs. Furthermore, thresholds coherent with clinical acceptance were determined for the Hausdorff and Chamfer distances. The Hausdorff distance threshold was 0.366 mm for desktop scans and 0.566 mm for intraoral scans. For the Chamfer distance, the threshold was 0.026 for desktop scans and 0.100 for intraoral scans. ConclusionsThe method from Dentbird demonstrated a comparable or better performance than the other software solutions, particularly excelling in finish line extraction for intraoral scans. Using a hybrid method combining deep learning and computer-aided design approaches enables the robust and accurate extraction of finish lines.

Accuracy of implant impression techniques with a scannable healing abutment

Statement of problemScannable healing abutments are a convenient option to facilitate impression making for implant-supported restorations. However, studies evaluating the accuracy of the impression technique with scannable healing abutments are lacking. PurposeThe purpose of this in vitro study was to evaluate the accuracy of implant impression techniques with scannable healing abutments. Materials and methodsA partially edentulous mandibular dentiform model was fabricated with an epoxy resin, and implants were placed in the mandibular right second premolar and first molar areas. A maxillary dentiform model was then fabricated, and both models were mounted on an articulator. Scan data were obtained from the mounted models and set as the reference scans. The experimental models were divided into 4 groups (n=10). The conventional pick-up impression technique and definitive casts were used in group CI. The scan data from the definitive casts were obtained with a 3D model scanner. An intraoral scanner with a digital body scan was used in group DS. Group MS yielded definitive casts with dual-arch impressions with scannable healing abutments. The fabricated definitive casts were mounted and scanned with a 3D cast scanner. Intraoral scanning with scannable healing abutments was used in group IS. In all 4 groups, the interarch relationship in the maximum intercuspal position was obtained by scanning the facial aspect. The center of the implant head was set as a measurement point for linear intra-arch deviations and implant angle deviations. The mesiopalatal cusp tip of the maxillary right first molar was used to calibrate the linear interarch deviations. The data obtained from each group were compared with the data from the reference scan. As the data were not normally distributed, the Kruskal-Wallis test and Bonferroni correction were used for the analysis (α=.05). ResultsGroup MS exhibited significantly higher deviations in linear intra-arch and implant angles compared with the other groups (P<.05). No significant difference was found between the groups in linear interarch deviations (P>.05). ConclusionsThe accuracy of intraoral scanning with scannable healing abutments was comparable with that of conventional pick-up impression techniques and digital scans with scan bodies. However, model scanning with scannable healing abutments may not be clinically acceptable for implant impressions.

COMPARISON OF INTERSCALENE BRACHIAL PLEXUS BLOCK AND COMBINATION OF INTERSCALENE BRACHIAL PLEXUS BLOCK AND SUPRASCAPULAR NERVE BLOCK FOR ANAESTHESIA FOR SHOULDER SURGERIES

Objective- To compare analgesia, degree of motor block and hemodynamic effects of interscalene block with a combination of interscalene block and suprascapular nerve block employed for anaesthesia for shoulder surgeries. Methods- 46 patients of ASA grade I or II posted for shoulder surgery were divided into two groups of 23 patients each. Group IS received 15 ml local anaesthetic mixture for interscalene brachial plexus block whereas group ISSB received suprascapular nerve block with 5 ml local anaesthetic mixture in addition to interscalene brachial plexus block with 15 ml of similar mixture of local anaesthetic. Heart rate (HR), Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), degree of analgesia and degree of motor blockade were assessed intraoperatively. General anaesthesia was administered in the event of inadequate blockade. Any adverse events were documented. Results- A combination of interscalene block and suprascapular nerve block was superior to interscalene block alone in terms of degree and duration of analgesia as well as degree of motor blockade for shoulder surgeries without any signicant hemodynamic effects in either of the groups. Conclusion- Acombination of interscalene brachial plexus block and suprascapular nerve block is superior to isolated interscalene brachial plexus block for anaesthesia for shoulder surgeries

Stretching Force of Incision Affects Early Clinical Results After Primary Total Knee Arthroplasty: A Retrospective Study.

ObjectiveTo investigate the impact of different skin incisions on recovery from total knee arthroplasty (TKA).MethodsThis is a retrospective study conducted in a tertiary hospital. A total of 1210 patients accepted primary and unilateral total knee arthroplasty (TKA) at the authors' affiliated institutions between January 2015 and January 2019. Patients who accepted primary and unilateral TKA due to OA under epidural anesthesia were included. Excluded cases included patients who had no completed follow‐up; preoperative flexion contracture greater than 15° and preoperative flexion less than 90°; paresthesia in lower limb; scar within the knee area; patella alta or baja. We recorded and analyzed the following data, including each patient's characteristics, incision stretching index (IS index), perioperative information, and follow‐up assessments. Patients were grouped by trisecting the range of IS index we observed in the present study. The primary outcome measure was the visual analog scale (VAS) pain score rated on a scale of 0–10 from no pain to severe pain. Secondary outcome measures include knee girth reflecting postoperative swelling, knee range of motion (ROM), sensory testing, and the strength of quadriceps. These measures were completed 2 weeks postoperatively.ResultsA total of 1089 patients undergoing primary and unilateral TKA in our two institutions were screened for final analysis, and 121 ones were excluded. The patients were followed up for an average of 13.3 months postoperatively. The mean length of FL was 28.3 cm (range: 21.0–38.8 cm). The mean IS index was 2.7 cm (range: 0.4–5.1 cm). We found no significant difference in those data among groups (P > 0.05). VAS pain scores among group IS A, IS B, and IS C were significantly different (2.3 ± 0.6 vs 3.4 ± 1.6 vs 3.9 ± 1.5, P = 0.0001). Similar situations were seen in knee circumference, ROM, area of abnormal sensation, and quadriceps strength among groups (all P < 0.05). With the increase in the IS index, VAS pain score, knee circumference, area of abnormal sensation, and incision problems were significantly increased (P < 0.05). At the same time, ROM and the strength of quadriceps decreased (P < 0.05). With the increase in the IS index, the number of patients with incision problems was increased significantly (P < 0.05). Besides, no significant difference in PJI and DVT among groups was observed (P > 0.05).ConclusionsProper incision stretching can improve postoperative pain relief, surgical swelling, ROM, sensory disturbance of the knee, and the strength of quadriceps with reduced risk of incision complications.

How Ocado Technology Automated Covid Test Scheduling

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Effect of varying levels of expertise on the reliability and reproducibility of the digital waxing of single crowns: A preliminary in vitro study

Statement of problemThe digital waxing of single crowns can be affected by the quality of intraoral scans and use of computer-aided design (CAD) software programs. However, clinical outcomes of the resulting crowns are also affected by computer-aided manufacturing (CAM) methodologies. Studies on the effect of different levels of expertise on digital waxing are lacking. PurposeThe purpose of this in vitro study was to assess the impact of different levels of expertise on the reliability and reproducibility of margin outlining during digital waxing. Material and methodsThirty analogs of implant stock abutments (Ø4.8×4 mm) were embedded into resin blocks. To simulate different clinical situations, abutments were divided into 3 groups: 10 abutments (group GOS) received artificial gingiva and were scanned with an open system intraoral scanner, while 10 abutments with (group GIS) and 10 abutments without artificial gingiva (group IS) were scanned with an intraoral scanner within an integrated CAD-CAM system. All resulting standard tessellation language (STL) files were used by 2 different observers (an experienced CAD professional and a clinician with basic CAD knowledge) to digitally design a left mandibular central incisor in the same software program. All resulting digital crown designs were exported to STL files to assess crown margin accuracy at the coupling interface by superimposition with the control STL file of the scan body designed for the same abutment by the manufacturer. For this purpose, a CAD software program was used to automatically calculate median, minimum, and maximum deviations of margins in millimeters. Statistically significant pairwise differences among groups and between observers were assessed with the Wilcoxon signed-rank test (α=.05). ResultsFor the CAD professional, median deviations between designed crown STL files and the control STL of the scan body were 0.08 mm (range: 0.04 to 0.15) for group GOS; 0.10 mm (range: 0.06 to 0.18) for group GIS; and 0.05 mm (range: 0.03 to 0.08) for group IS. For the clinician, median deviations were 0.08 mm (range: 0.04 to 0.12) for group GOS; 0.11 mm (range: 0.07 to 0.17) for group GIS; and 0.05 mm (range: 0.04 to 0.11) for group IS. There were no significant differences between observers (P>.05). However, statistically significant differences were found between group IS and the other 2 groups (P=.001) but not between groups GOS and GIS (P>.05). ConclusionsThe present findings suggest that a digital wax pattern made with a dental CAD software program is not affected by varying levels of expertise but might be affected by subgingival margins.

Influence of intraoral scanning on the quality of preparations for all-ceramic single crowns

ObjectivesTo evaluate the influence of intraoral scanning on the quality of preparations for all-ceramic single crowns.Material and methodsA total of 690 randomly selected and anonymized in vivo single crown preparations were examined. Three hundred twenty-three preparations were directly recorded with an intraoral scanner (group IS). Data from plaster casts digitized by a laboratory scanner (group ID; N = 367) served as control. Comparisons included convergence angle, marginal design, marginal substance reduction, homogeneity of the finish line, and undercuts. Evaluation was performed using fully automated specialized software. Data were analyzed applying Kolmogorov-Smirnov, Mann-Whitney U test, and Fisher’s exact test. Level of significance was set at p < 0.05.ResultsConvergence angle was above optimum in both groups, but significantly larger for group IS (p < 0.001). Marginal design was more ideal in group IS concerning the absence of featheredge design (p < 0.001) and reverse bevel (p = 0.211). Marginal substance reduction was closer to prerequisites for all-ceramic restorations in group IS (p < 0.001). Finish lines were more homogeneous in group IS regarding the uniformity of their course (p < 0.001). Undercuts were more frequently found in group ID than in group IS (p < 0.001).ConclusionsIntraoral scanning of prepared teeth has positive impact on the quality of preparations for all-ceramic single crowns regarding marginal substance reduction, marginal design, homogeneity of the finish line, and undercuts.Clinical relevanceAccurate preparation design represents a fundamental condition for success of ceramic crowns. Since there is potential for optimization, intraoral scanning might enhance preparation quality providing instant visual feedback.

Anatomical relationship between roots of maxillary posterior teeth and maxillary sinus using cone-beam computed tomography

Aim: Maxillary sinusitis of odontogenic origin accounts for approximately 10%–12% of maxillary sinusitis cases. The primary objective of the present study was to analyze the vertical relationship between the maxillary posterior roots and the adjacent maxillary sinus floor (MSF) in the Indian population using cone-beam computed tomography. The secondary objective was to correlate the data with age and gender.Materials and Methods: The shortest distance between 452 maxillary posterior teeth and the adjacent border of MSF was measured. The data were divided into three groups. Group IS included maxillary posterior teeth roots protruding into the sinus, Group CO included root apices contacting the MSF, and Group OS included root apices not contacting the MSF. The data obtained were correlated with age and gender.Results: The vertical distance of the root apices of second premolars from the MSF was significantly lesser compared to the root apices of first premolars (P < 0.05). The difference between the vertical distance of buccal roots and palatal roots (PRs) of first molar from the MSF was significantly more (P < 0.05). Majority of the roots of posterior teeth were located below the MSF border (Type OS). Type IS was most frequently seen for PRs of maxillary first molars (29.12%). The frequency of Type IS decreased with increasing age. The distance between the posterior root apices and the adjacent border of the MSF was found to be more in males compared to females.Conclusion: The PRs of maxillary first molars were found to be closest to the MSF. Variation in the vertical relationship was found by age and gender.

Risk factors for complications and adverse outcomes in polytrauma patients with associated upper extremity injuries

BackgroundIn terms of upper extremity fractures by patients with multiple injuires, a lot of studies have assessed the functional outcome following trauma to have less favorable outcomes in regards to functional recovery. We tested the hypothesis that differences in clinical outcome occur between shaft and articular injuries of the upper extremity, when patients that sustained neurologic deficits (e.g. brachial plexus lesions) are excluded.MethodsWe involved Patients with isolated or combined upper extremity fracture, ISS > 16 in a level one trauma center. The follow up was at least 10 years after the initial injury. Both clinical examination (range of motion, instability, contractures, peripheral nerve damage) and radiographic analysis were carried out. We evaluated also the development of heterotopic ossifications. To analyse patients were subdivided into 3 different subgroups (articular [IA], shaft [IS], and combined [C]).ResultsA statistically significant difference was found when ROM was compared between Group IS and C (p = 0.012), for contractures between Groups IA and C (p = 0.009) and full muscle elbow forces between Groups IS and C (p = 0.005) and Group IA and IS (p = 0.021). There was a significantly increased incidence in heterotopic ossifications when articular involvement was present. This applied for the isolated (p < 0.02) and the combined group (Group C vs Group IS, p = 0.003).When Brooker type I/II in group IA and Brooker types III/IV were combined, there was a significant difference (p < 0.001). In group IA (n = 1) and in group C (n = 6), HO developed or worsened after revision surgery, all of which were performed for malunion or nonunion.ConclusionsIn this study, patients with isolated shaft fractures of the upper extremity tend to have a more favorable outcome in comparison with combined to isolated articular fractures in terms of range of motion, pain and the ability to use the arm for everyday activities.In the clinical practice of the treatment of polytraumatized patients with upper extremity injuries, we feel that the relevance of these injuries should not be underestimated. They are especially prone to development of heterotopic ossifications, thus requiring prophylactic measures, if necessary. As their incidence increases with the rate of reoperations, we feel that even during initial care, meticulous surgery is required to avoiding the necessity of revision surgeries. Similar to injuries below the knee, upper extremity injuries, should be treated to avoid any functional disability.

The impact of antihypertensive pharmacotherapy on interplay between protein-bound uremic toxin (indoxyl sulfate) and markers of inflammation in patients with chronic kidney disease

PurposeIndoxyl sulfate (IS) is one of the most potent uremic toxins involved in chronic kidney disease (CKD) progression, induction of inflammation, oxidative stress, and cardiovascular diseases occurrence. It is proved that hypertension is a common CVD complication and a major death risk factor as well as contributes for decline in a renal function. The aim of our study was to investigate how implementing of antihypertensive therapy impact IS concentrations and the associations between IS and markers of renal function, inflammation and oxidative stress.MethodsStudy was conducted on 50 patients diagnosed with CKD and hypertension, divided into three groups: without hypotensive therapy (CKD-NONE), hypotensive monotherapy (CKD-MONO), and hypotensive polypharmacotherapy (CKD-POLI), and 18 healthy volunteers. The markers of inflammation [interleukin-6, tumor necrosis factor-alpha (TNF-α), high-sensitive C-reactive protein (hs-CRP), neopterin, ferritin], oxidative status [superoxide dismutase (Cu/Zn-SOD), antibodies against oxidized low-density lipoprotein (oxLDL-abs)], and selectins were determinate using immunoenzymatic methods. IS levels were assayed using high-performance liquid chromatography and other parameters were analysed using routine laboratory techniques. Then cross-sectional analysis was performed.ResultsElevated levels of IS, indicators of kidney function, markers of inflammation and blood pressure values were observed in each CKD subgroups. There was no effect of antihypertensive therapy on IS levels between studied groups, as well as there was no clear relationship between IS and blood pressure values in each studied group. The positive associations between IS and Cu/Zn SOD, neopterin, hs-CRP, creatinine and neutrophils/lymphocytes ratio were observed in CKD-NONE and CKD-POLI subgroups. Additionally, in CKD-POLI group IS positively correlated with TNF-α, ferritin and neutrophils. In CKD-MONO group, IS was positively related to oxLDL-abs, neopterin, E-selectin and creatinine, whereas it was inversely associated with hs-CRP.ConclusionsOur study showed for the first time that the antihypertensive therapy has no impact on IS levels in CKD patients with hypertension. However, the introduction of the antihypertensive therapy modified the dependencies between IS and the studied markers of kidney function, inflammation, oxidative stress and hematological parameters that are crucial for mortality and morbidity amongst the CKD patients with hypertension.

Continuous Suture Technique for Aortic Valve Replacement Shortens Cross-Clamp and Bypass Times.

The interrupted noneverting mattress suture technique is typically used in conventional surgical aortic valve replacement. The continuous suture technique, although faster, has been associated with a higher incidence of paravalvular leak. Using a slightly modified technique to minimize this risk, we investigated whether continuous suturing would shorten aortic cross-clamp time in aortic valve replacement in comparison with interrupted suturing. We reviewed the cases and compared the perioperative data of 60 consecutive patients in Japan and Australia (35 men and 25 women; median age, 70 yr) who had undergone aortic valve replacement with or without septal myectomy. The continuous suture technique had been used in 41 patients (Group CS) and the standard interrupted suture technique in 19 (Group IS). The groups were similar in age, sex, pathologic valvular conditions, and operative urgency. In Group CS, aortic cross-clamp time (47 vs 63 min; P=0.0001) and cardiopulmonary bypass time (76 vs 89 min; P=0.04) were significantly shorter. Neither group had early paravalvular leak. Using our continuous suture technique safely shortened aortic cross-clamp time during surgical aortic valve replacement.

Efficacy of continuous positive airway pressure and incentive spirometry on respiratory functions during the postoperative period following supratentorial craniotomy: A prospective randomized controlled study

Study objectiveVolume controlled ventilation with low PEEP is used in neuro-anesthesia to provide constant PaCO2 levels and prevent raised intracranial pressure. Therefore, neurosurgery patients prone to atelectasis formation, however, we could not find any study that evaluates prevention of postoperative pulmonary complications in neurosurgery. DesignA prospective, randomized controlled study. SettingIntensive care unit in a university hospital in Istanbul. PatientsSeventy-nine ASAI-II patients aged between 18 and 70years scheduled for elective supratentorial craniotomy were included in the study. InterventionsPatients randomized into 3 groups after surgery. The Group IS (n=20) was treated with incentive spirometry 5 times in 1min and 5min per hour, the Group CPAP (n=20) with continuous positive airway pressure 10 cmH2O pressure and 0.4 FiO2 via an oronasal mask 5min per hour, and the Group Control (n=20) 4L·min−1O2 via mask; all during the first 6h postoperatively. Respiratory functions tests and arterial blood gases analysis were performed before the induction of anesthesia (Baseline), 30min, 6h, 24h postoperatively. Main resultsThe IS and CPAP applications have similar effects with respect to FVC values. The postoperative 30min FEV1 values were statistically significantly reduced compared to the Baseline in all groups (p<0.0001). FEV1 values were statistically significantly increased at the postoperative 24h compared to the postoperative 30min in the Groups IS and CPAP (p<0.0001). This increase, however, was not observed in the Group Control, and the postoperative 24h FEV1 values were statistically significantly lower in the Group Control compared to the Group IS (p=0.015). ConclusionAlthough this study is underpowered to detect differences in FEV1 values, the postoperative 24h FEV1 values were significantly higher in the IS group than the Control group and this difference was not observed between the CPAP and Control groups. It might be evaluate a favorable effect of IS in neurosurgery patients. But larger studies are needed to make a certain conclusion.

Internal fixation of S1-S3 iliosacral screws and pubic screw as the best configuration for unstable pelvic fracture with unilateral vertical sacral fracture (AO type C1.3).

Although internal fixation is the definitive treatment in unstable pelvic fractures with disruption of the anterior arch and a vertical fracture of the sacrum (AO type C1.3), there have been no agreement of the best technique of internal fixation yet. We aimed to derive comparable objective data on stiffness and load to failure in this type of fracture fixations. Synbone was modified into AO type C1.3 fracture model, while treatments were divided into six internal fixation treatment groups using tension band plate (TBP), symphysis pubis plate (SP) with iliosacral screw at S1 and S2 (IS S1-S2), pubic screw (PS) with iliosacral TBP, PS and IS S1-S2, SP and IS S1-S3, PS and S1-S3 and finally PS and IS S1-S3. Sensor was applied to detect the shifting and rotation of fracture fragments. Mechanical strength test conducted with the application of axial force on the sacrum vertebra (S1). The highest translational stiffness was observed in the group IS S1-S3 + PS (830.36 N/mm, p = 0.031) and there was no difference on the rigidity of the rotation between the groups posterior fixation using IS S1-S2 and IS S1-S3 ( p = 0.51). Meanwhile the highest load to failure was found in group IS S1-S3 + PS (1522.20 N). PS provided advantages compared to the use of plate. Group of PS and S1-S3 IS is the configuration of internal fixation with best translational and rotational stiffness and the largest load to failure compared to other techniques in AO type C1.3 fracture.

An Effectiveness of Oral Health Promotion Program on 12 Year old School Going Children of South Indian Children

Abstract Background and Objectives Dental care is the most common unmet health care need of children in India. The study was undertaken to test lecture method for providing oral health education to 12 year old school going children. Methods A sample size of 200 was selected randomly from 6 different schools of Davangere district. Students who were of chronological age of 12 year from the selected schools were included in the study. Before giving lecture aid, the study group IS assessed about their self-implemented oral hygiene practices through questionnaire. The study groups were assessed immediately and 6 months after given lecture aid through a questionnaire which was designed to evaluate the knowledge, attitude, and practices of 12 year old school children regarding their oral health. The data thus collected was tabulated, assessed and statistically analyzed using student paired T-test and McNemar test. Results There was statistically significant (P&lt;0.001) improvement in the knowledge and behavior regarding oral health amongst study group with the overall improvement in correct answers. There was a significant reduction (P&lt;0.001) in the memory among the study group after 6 months of oral hygiene instruction. Interpretation and Conclusion The lecture method was effective in improving oral hygiene attitudes and skills. After 6 months, there was a significant reduction in memory gained after interventional program which dictates the need for regular reinforcement of educational and motivational programs. How to cite this article Poornima P., Arora S, Neena IE, Shashibhushan KK, Nagaveni NB. An Effectiveness of Oral Health Promotion Program on 12 Year old School Going Children of South Indian Children. CODS J Dent 2015;7:55-59.

Comparison of Ultrasound-Guided Supraclavicular, Infraclavicular and Below-C6 Interscalene Brachial Plexus Block for Upper Limb Surgery: A Randomised, Observer-Blinded Study

This prospective, randomised, observer-blinded study was conducted to compare the ease of performance and surgical effectiveness of interscalene block below the C6 nerve root with supraclavicular and infraclavicular techniques of brachial plexus block for upper arm and forearm surgery. Sixty adult patients of American Society of Anesthesiologists grade 1 to 3, undergoing upper limb surgery, were randomly allocated into three groups. Group SC received supraclavicular blockade, group IC received infraclavicular blockade and Group IS received interscalene blockade. All blocks were guided by ultrasound with nerve stimulator confirmation. The anaesthetic mixture consisted of 0.5 ml/kg of equal volumes of 0.75% ropivacaine and 2% lignocaine-adrenaline. The imaging and block performance time, onset time, success rate, duration of block, and duration of postoperative analgesia were recorded by a blinded observer. The onset time was significantly longer in the interscalene group as compared with supraclavicular and infraclavicular approaches. The imaging time and block performance time were comparable between groups. No significant differences were observed between the three groups in terms of block-related pain scores, success rates, duration of block or of postoperative analgesia. Two patients in the interscalene group developed clinically detectable phrenic nerve palsy. Our findings indicate that, although interscalene block below the C6 nerve root can provide surgical anaesthesia for forearm and hand surgery, it appears to have a longer onset time than supra- and infraclavicular approaches and an unacceptable incidence of phrenic nerve palsy.

Permanent contact with females increases testosterone and improves fresh semen traits in pampas deer (Ozotoceros bezoarticus) males

Socio-sexual signals can stimulate neuroendocrinal control of reproduction. The aim of this work was to test the hypothesis that permanent and close contact with females stimulates testosterone production and enhances fresh seminal characteristics of pampas deer males. Five adult males (group CF) were established in a paddock in five breeding groups each comprising one stag and between five and ten hinds. Six adult males (group IS) were held in another paddock without any direct contact with females. Fecal testosterone concentrations were determined for each male, weekly, from October to May. Semen was collected by electro-ejaculation and evaluated before and after the addition of diluents [November: Fructose-Tris-Glycine with 20% egg yolk (FTG); April: Andromed]. Males in contact with females from mid-December to February exhibited significantly (P=0.04) greater concentrations of testosterone than those without. In November, CF males ejaculated semen of significantly (P=0.03) higher quality, with a significantly (P=0.02) greater proportion of progressive motile spermatozoa than IS males. After dilution with FTG, semen from the CF males had greater quality (P=0.04), a greater percentage of motile spermatozoa (P=0.04), spermatozoa with progressive motility (P=0.01), and spermatozoa with intact acrosomes (P=0.03). Semen from CF males also had lower fractions of spermatozoa with damaged acrosomes (P=0.04). In April, there were no significant differences in semen properties between the two groups. After the addition of extender, semen from CF males had a greater percentage of spermatozoa with damaged acrosomes (P=0.04). It is concluded that contact with females stimulates reproductive patterns of male pampas deer, resulting in better fresh semen characteristics before rutting and higher testosterone concentrations during the rut.

The Effectiveness of recombinant OL fusion protein (ovalbumin-LHRH-7) in suppressing reproductive functions when injected in single-dose vaccination protocols with different adjuvants

The objective of this study was to evaluate the effectiveness of recombinant LHRH fusion protein, Ovalbumin-LHRH-7 (OL), using a single-dose vaccination protocol in combination with different adjuvants in suppressing reproductive functions in buck kids. For this purpose, either a mixture of free OL antigen and encapsulated OL antigen, or encapsulated OL antigen was used. Thirty-nine native buck kids at 12 weeks of age were divided into control (n=7) and treatment groups (n=8 bucks/group). The four treatment groups were formed according to the different vaccine formulations: Group CpG received 0.5mg free OL protein together with 1.0mg of encapsulated protein with CpG adjuvant. Group mFCA received 0.5mg free OL protein together with 1.0mg of encapsulated protein with modified Freund's complete adjuvant. Group IS received 1.5mg encapsulated OL protein with a mix of inulin and saponin adjuvants. Group ISmFCA received 1.5mg encapsulated OL protein with a mix of inulin, saponin and modified Freund's complete adjuvants. Scrotal circumference in CpG and mFCA groups were significantly smaller than that of Control, IS and ISmFCA groups (P<0.05). Numbers and percentage of bucks having spermatozoa in their ejaculate were significantly lower in CpG and mFCA groups (P<0.05). OL immunization completely suppressed sperm production, except one buck, in CpG and mFCA groups (P<0.05). These results imply that it is possible to use OL protein in a single injection protocol for the purpose of immunocastration. Further investigation with a larger number of animals should be carried out to determine the longevity of response to a single injection.

Effect of surgical technique for unilateral orchiectomy on subsequent testicular function in Miniature Horse stallions

Management decisions on unilateral orchiectomy are often influenced by the potential for post operative return to successful breeding. The effects of 2 surgical methods (first intention [FI] vs. second intention [SI] incision healing) for unilateral orchiectomy on resulting semen quality and scrotal temperature were evaluated. To evaluate the effects of 2 surgical unilateral orchiectomy techniques on scrotal healing, size of the remaining testis and post operative sperm quality. Unilateral orchiectomy was performed on mature Miniature Horse stallions. Semen was collected prior to and up to 60 days after, unilateral orchiectomy. Semen parameters, scrotal and body temperatures, testis volume and days to incision healing were evaluated. There was no effect of treatment or time on percent total sperm motility. Total sperm numbers were higher (P < 0.05) 60 days after unilateral orchiectomy compared with 14 and 30 days. Percent viable sperm were higher (P < 0.05) 30 and 60 days compared with pre- and 14 day post unilateral orchiectomy. Scrotal temperatures were lower after unilateral orchiectomy compared with preoperative values ( < or = 0.003). Higher scrotal temperatures were recorded in Group IF, as compared with Group IS, during recoveryfrom anaesthesia and at 1 and 2 h after surgery (P = 0.02). Mean time to incision healing was less in Group II (10.0 days) than in Group II (21.5 days; P = 0.05). In this study, total sperm motility was maintained and size of the remaining testis, total sperm numbers and percent viable sperm increased after unilateral orchiectomy. Incision healing time was shorter in Group II; however, surgical technique did not have an effect on semen quality at 30 and 60 days post unilateral orchiectomy. These data suggest that surgical technique for unilateral orchiectomy may not dramatically influence function of the remaining testis.

Centrality-is proficiency alignment and workgroup performance

Virtually all of the extensive previous research investigating the effect of information systems proficiency on performance has been conducted at the individual level. Little research has investigated the relationship between IS proficiency and performance at the group level. In this paper, we argue that IS proficiency at the group level may be more than the simple sum or average of the IS proficiency of individual group members. Rather, effective group-level IS proficiency may also be a function of how a group's IS proficiency is distributed across its members. Relying on concepts associated with social network analysis (SNA), we introduce the concept of centrality--IS proficiency alignment. We argue that groups will perform better if their more proficient members are highly central in the group's communication and workflows network. Data from 468 employees in 32 workgroups show that centrality--IS proficiency alignment is significantly and positively related to performance across multiple systems examined individually and with the portfolio of systems examined as a whole. This approach effectively integrates the structural and resource perspectives of SNA, providing a roadmap so that others may follow a similar approach to address broader questions of group-level user--system interactions in the IS literature and more general questions of central resource alignment in the broader organizational literature.