High Success Research Articles

Adverse events in endoscopic ultrasound-guided choledochoduodenostomy with lumen-apposing metal stents: A systematic review and meta-analysis.

Several meta-analyses have analyzed the technical and clinical success of endoscopic ultrasound-guided choledochoduodenostomy (EUS-CDS) by using lumen-apposing metal stents (LAMS) in malignant biliary obstruction, but those concerning adverse events (AEs) are scarce. The current systematic review and meta-analysis was conducted to evaluate the AEs after EUS-CDS with LAMS. A comprehensive literature search of PubMed, Embase, Scopus, Web of Science, and the Cochrane Library was conducted for studies reporting the outcomes of EUS-CDS with LAMS. The main endpoints were the incidence of overall and specific AEs. Moreover, the stent dysfunction, and reintervention rates were evaluated independently. A total of 21 studies (n=1438) were included in the final meta-analysis. The pooled rate of technical and clinical success was 93.5% (95% confidence interval [CI]: 91.3-95.1) and 88.0% (95% CI: 83.9-91.1), respectively. After EUS-CDS with LAMS, the pooled incidence of overall AEs was 20.1% (95% CI: 16.0-24.9). The estimated rate of early AEs was 10.6% (95% CI: 7.9-14.2), and late AEs was 11.2% (95% CI: 8.2-15.2). Infection/cholangitis was the commonest AE, with a pooled incidence of 6.1% (95% CI: 3.7-10.1). The estimated incidence of stent dysfunction and reintervention was 10.5% (95% CI: 7.5-14.4), and 12.1% (95% CI: 9.3-15.7), respectively. Despite with a high technical and clinical success rate, EUS-CDS with LAMS may be associated with overall AEs and stent dysfunction in one-fifth and one-tenth of cases, respectively. Further efforts are required to optimize its safety and long-term stent patency.

[Clinical study on the efficacy and safety of glaucoma drainage implants in the treatment of different types of glaucoma].

Objective: To evaluate the efficacy and safety of glaucoma drainage implants(XEN-45 Gel Stent) for glaucoma treatment. Methods: A prospective study was conducted to continuously collect the clinical data of patients who were diagnosed with glaucoma and underwent XEN-45 Gel Stent implantation in the Ophthalmology Department of Peking University People's Hospital from January 2022 to August 2023. The visual acuity, intraocular pressure, number of glaucoma medications, and success rate of the patients were analyzed before and after surgery at 1 day, 1 week, 1 month, 3 months, 6 months, 12 months, and 18 months. The differences in intraocular pressure and number of glaucoma medications among primary open-angle glaucoma, primary angle closure glaucoma, secondary glaucoma, and different implantation methods of XEN-45 Gel Stent among patients with primary open-angle glaucoma were compared. The intraoperative and postoperative complications were observed, and the risk factors for needling and surgical complete success were analyzed. Results: A total of 48 eyes from 48 patients were included in this study, comprising 27 males and 21 females, with a mean age of (54.4±18.0) years and the disease duration was 36.0(7.3, 81.0) months.There were 28 cases of primary open-angle glaucoma, 4 cases of primary angle closure glaucoma, and 16 cases of secondary glaucoma.The follow-up period was 8.0 (3.0, 12.0) months. At 12 months after surgery, the intraocular pressure decreased from 20.5 (17.0, 26.0) mmHg to (13.5±3.3) mmHg (P<0.05), and the number of glaucoma medications decreased from 3.0 (3.0, 4.0) to 0.0 (0.0, 0.0) (P<0.05). The complete success rate and qualified success rate were 73.9% (17/23) and 91.3% (21/23), respectively. The most common postoperative complications were shallow anterior chamber in 6 cases (12.5%), hypotony in 3 cases (6.3%), and blocked stent in 3 cases (6.3%). The most common postoperative treatment was needling in 27 cases (56.3%). There was no significant difference in intraocular pressure among different types of glaucoma. In the comparison of postoperative effects of different surgical implantation methods for primary open-angle glaucoma, there were no statistically significant differences in intraocular pressure and the number of glaucoma medications at other follow-up time points except 1 month after surgery (P<0.05). Univariate logistic regression analysis did not find any risk factors associated with needling and surgical complete success. Conclusions: XEN-45 Gel Stent implantation is an effective and safe surgical option for different types of glaucoma patients in China, which can significantly reduce intraocular pressure and the use of glaucoma medications and has a high success rate. However, some patients may need needling or other treatments after surgery.

One and five-year efficacy of tension-free vaginal tape (TVT) abbrevo and TVT-obturator in the treatment of stress urinary incontinence: a retrospective study

BackgroundSurgical interventions are more effective than nonsurgical approaches in providing a cure for stress urinary incontinence (SUI). In this study, we aimed to assess the benefits of tension-free vaginal tape (TVT) abbrevo by comparing its efficacy and complications to those of TVT obturator.Methods and results49 and 47 patients at The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University between January 2013 and December 2016 were included in the TVT-O and TVT-A groups, respectively. We evaluate the success rate and perioperative complications associated with TVT-O and TVT-A. A questionnaire that utilized the Patient Global Impression of Improvement (PGI-I) Scale was employed to assess the impact of surgery. Patients were followed up at 1 year, and 5 years after surgery. There were no statistically significant differences found in the efficacy of the TVT-A group and TVT-O group during both the one-year (p = 0.4) and five-year (p = 0.32) follow-up periods. In the period of one-year follow-up, 95.9% (n = 47) of patients in the TVT-O group and 95.8% (n = 45) of patients in the TVT-A group demonstrated improvement. During the period of five-year follow-up, 87.8% (n = 43) of patients in the TVT-O group and 93.6% (n = 44) of patients in the TVT-A group demonstrated improvement.ConclusionsBased on our findings, TVT-A and TVT-O procedures exhibited similarly high success rates and low frequencies of complications.

Sustainable Sheep and Goat Farming in Arid Regions of Jordan

This study examines the sustainability of livestock farming in Jordan’s arid regions, focusing on smallholder Awassi sheep and Baladi goat farming. It assesses breeders, economic factors, herd productivity, and sustainability, evaluating the vitality of these breeds by examining reproductive success through birth and survival rates. In 2021–2022, a total of 53 traditional Awassi sheep and Baladi goat farms in Northern Jordan’s Mafraq Governorate were surveyed using a comprehensive questionnaire to gather data on breeders’ information, farm economics, and herd indicators. Dry seasons in arid lands are tough on sheep and goats, with limited fodder and water availability harming their health and reproductive capacity. While wet seasons bring relief, they can also introduce diseases. Special care for these animals throughout the year is crucial to maintain healthy herds in arid regions. Linear models were employed to analyze sample data, with variance and correlation tests used to explore relationships among variables. Additionally, chi-squared analysis was utilized to assess the impact of male replacement plans on these herds. The main outcomes of this study reveal that breeder indicators pose challenges to the sustainability and growth of Awassi sheep and Baladi goat farming. Conversely, economic indicators suggest a blend of financial stability alongside obstacles related to profitability and resource ownership. Breeder age emerges as a significant factor in livestock herd management, influenced by elements such as experience, resource availability, and adherence to traditional practices. Experience notably influences breeders’ decisions regarding male insemination replacements, likely due to acquired skills. Crop cultivation is shown to reduce fodder costs, thereby enhancing profitability for each young animal sold and consequently increasing the breeders’ returns. Winter conditions elevate animal mortality rates due to cold stress, while other animals within herds contribute to increased kid mortality by facilitating disease transmission. Breeder experience significantly impacts lamb survival, underscoring its importance in ensuring proper care. Increasing ewe proportions within herds enhances lamb production and lowers lamb mortality rates. Effective ram management and yearling lamb sales further contribute to herd health and productivity. A higher proportion of goats within a herd positively correlates with the number of young yearlings sold but inversely affects breeding males and overall kid numbers, indicating a delicate balance that influences herd productivity and mortality rates. Sheep (92.5%) and goat herds (90.6%) demonstrate reproductive success, indicative of superior long-term vitality. While sheep excel in birth rates, survival, and sales, they exhibit lower ewe and lambing percentages. Goat farming demonstrates high birth rates, sales, and overall success but requires particular attention to ensuring kid survival, especially during the winter months. Improving the characteristics of the Awassi sheep and Baladi goat flocks is crucial for ensuring sustainability, achievable through proper care practices in dry lands. In conclusion, despite the challenges, there are promising opportunities to enhance sheep and goat farming in Jordan. Effective management, informed by the breeders’ experience and economics, is crucial. Empowering small-scale herders and implementing targeted interventions, like winter mortality solutions and selective breeding, is vital for sustainable growth.

Urgent TAVI not associated with higher rates of conversion to urgent cardiac surgery: a systematic review and meta-analysis

Abstract Funding Acknowledgements None. Introduction Transcatheter Aortic Valve Implantation (TAVI) has been established as a therapeutic option in patients with severe Aortic valve Stenosis (AoS). Although TAVI has been associated with high procedural success, it is rarely required conversion to cardiac surgery, for the management of complications. It remains unknown whether the rate of conversion to urgent cardiac surgery is higher in patients undergoing urgent TAVI compared to elective TAVI. Purpose The aim of our systematic review and meta-analysis is to investigate whether patients treated with urgent TAVI are under higher risk for urgent conversion to cardiac surgery. Methods We systematically conducted a thorough search of three major databases (Medline, Cochrane Central Register of Controlled Trials, and Scopus) to identify studies comparing urgent and elective TAVI. Our primary endpoint in this systematic review and meta-analysis was the incidence of unanticipated, emergent conversions to open cardiac surgery during the TAVI procedure. Only studies that provided data on this endpoint were considered for inclusion in our analysis. Secondary endpoints included vascular complications, the presence of post-procedural moderate or severe aortic regurgitation, in-hospital mortality, and the device success. These secondary endpoints were evaluated during the inpatient stay of the patients. For the statistical analysis, we computed risk ratios (RR) with corresponding 95% confidence intervals (CIs). We employed a random-effects model (Mantel-Haenszel), to estimate the pooled RR. Results A total of six studies, encompassing 70,296 patients, were included in our analysis. Among them, 5,021 patients underwent an urgent TAVI procedure, while the remaining 65,275 underwent elective TAVI. During TAVI, conversion to urgent cardiac surgery did not vary significantly between the two groups (RR: 0.90, 95% CI:0.66-1.24]. Moreover, no significant differences were observed in vascular complications (RR:1.55, 95% CI: 0.92-2.61), post-procedural moderate or severe aortic regurgitation (RR:1.20, 95% CI: 0.85-1.69) and device success (RR:0.99, 95% CI: 0.98-1.00). Notably, in-hospital mortality was higher in urgent TAVR group (RR: 2.08, 95% CI: 1.69-2.56). Conclusion Our systematic review and meta-analysis have demonstrated that patients undergoing urgent TAVI are not at a higher risk for urgent cardiac surgery, device failure, vascular complications, or post-procedural moderate or severe aortic regurgitation. Notably, despite these findings, the higher in-hospital mortality observed in patients undergoing urgent TAVI suggests the presence of other factors that should be explored to account for this increased mortality.Urgent conversion to surgery

INFLUENCE OF HUMAN RESOURCE MANAGMENENT STRATEGIES IN CONSTRUCTION PROJECTS

In the dynamic landscape of project management understanding the significant relationship between human resource management functions and project health has become an essential aspect. This research has invested in a primary quantitative investigation focused on the INDIAN construction sector through which the relationship between human resource management functions and project health would be analysed and their contribution to enhancing project success rate would also be evaluated. With the growing emphasis on efficient resource utilisation and project Optimisation, the study would help into the impact of HRM practices on project teams. Scrutinisation of HRM Strategies and their Correlation with Project Success, this research has aimed at offering significant insights that can revolutionise HRM approaches within the construction sector that can ultimately enhance project health and ensure high success rates in INDIAN construction projects.

Integration of LST and NDVI for adjusted night light index (ILNANLI): a novel index to reduce the effect of saturation and blooming of DMSP-OLS data

ABSTRACT DMSP-OLS night-light images have provided an effective way to monitor cities on a global scale. These images can separate urban areas and other human activities from the background without light with correct spatial measurement. However, due to saturation and blooming problems, the ability of these images to describe urban features is limited, especially in urban cores. Therefore, in this research, a new index, ILNANLI, has been developed and presented by integrating LST and NDVI for the adjusted night-light index. This index has two general goals: reducing the effects of saturation in the city centres, increasing the variety of brightness pixel values of night-light images, and reducing the blooming in the surrounding areas. The ILNANLI has been developed in such a way that it has put the indicators and relationships together, taking into account the characteristics of different regions of the city (such as buildings, vegetation, and soil) in such a way that in every urban environment (temperate and dry and semi-desert) to be successful. Another feature is its easy implementation and high success. In fact, the prominent feature of this index, which distinguishes it from the rest of the indices, is that it has been able to work successfully in arid and semi-desert areas in addition to temperate regions. The evaluation results showed that the average overall accuracy of ILNANLI in mapping and extracting built-up areas with automatic thresholds in cities with different climates has effectively increased by 8% compared to other indexes. Also, the examination of transects shows that the proposed index is more effective than the other four indexes in increasing the diversity of values and reducing blooming. Therefore, as a favourable option with easy implementation, the proposed index can be used to reduce the effect of saturation and blooming and study the urban structure at local scales.

Enhancing Cryptographic Primitives through Dynamic Cost Function Optimization in Heuristic Search

The efficiency of heuristic search algorithms is a critical factor in the realm of cryptographic primitive construction, particularly in the generation of highly nonlinear bijective permutations, known as substitution boxes (S-boxes). The vast search space of 256! (256 factorial) permutations for 8-bit sequences poses a significant challenge in isolating S-boxes with optimal nonlinearity, a crucial property for enhancing the resilience of symmetric ciphers against cryptanalytic attacks. Existing approaches to this problem suffer from high computational costs and limited success rates, necessitating the development of more efficient and effective methods. This study introduces a novel approach that addresses these limitations by dynamically adjusting the cost function parameters within the hill-climbing heuristic search algorithm. By incorporating principles from dynamic programming, our methodology leverages feedback from previous iterations to adaptively refine the search trajectory, leading to a significant reduction in the number of iterations required to converge on optimal solutions. Through extensive comparative analyses with state-of-the-art techniques, we demonstrate that our approach achieves a remarkable 100% success rate in locating 8-bit bijective S-boxes with maximal nonlinearity, while requiring only 50,000 iterations on average—a substantial improvement over existing methods. The proposed dynamic parameter adaptation mechanism not only enhances the computational efficiency of the search process, but also showcases the potential for interdisciplinary collaboration between the fields of heuristic optimization and cryptography. The practical implications of our findings are significant, as the ability to efficiently generate highly nonlinear S-boxes directly contributes to the development of more secure and robust symmetric encryption systems. Furthermore, the dynamic parameter adaptation concept introduced in this study opens up new avenues for future research in the broader context of heuristic optimization and its applications across various domains.

Influence of E-Scaffolding in Problem-Based Learning on Students’ HOTS in Standing Wave

In the 21st century, students’ higher-order thinking skills (HOTS) are crucial, as they focus on students’ capacity to identify problems and think analytically to solve them. Therefore, students were required to have higher-order thinking skills. The purpose of this research was to assess the impact of e-scaffolding in problem-based learning (PBL) on students’ HOTS in the context of standing waves. This study utilized a quasi-experimental approach employing a non-equivalent control group design. The experimental group, which was taught with e-scaffolding in PBL, consisted of 31 students, while the control group, taught only with the PBL model, had 29 students. A total of eight multiple-choice questions that had been proven valid with a reliability of 0.752 were used to assess students’ HOTS. The data were then analyzed using ANCOVA, with pretest scores as covariates. The results showed statistically significant differences among students with increased higher-order thinking skills in favor of using e-scaffolding in PBL: 0.000 (α &lt; 0.005). The eta squared statistic (0.785) indicates a large effect size. By employing PBL with electronic scaffolding, students actively participate in collaborative activities focused on successful problem-solving, resulting in a high success rate. Consequently, it is recommended to consider e-scaffolding as a primary method for developing higher-order thinking skills.

Unlocking the secrets of success in probing for congenital nasolacrimal duct obstruction: investigating the factors that matter.

The objective of this study was to analyze the impact of different factors on the success rate of probing for congenital nasolacrimal duct obstruction (CNLDO). A retrospective analysis was conducted on 239 eyes of 202 patients who underwent probing for CNLDO between 2014 and 2019. Patients were divided into three age groups (12-24months, 25-36months, and over 36months) and two groups based on the type of membranous obstruction (MO) and incomplete complex obstruction (ICO), with complete complex obstruction (CCO) cases being excluded. The study involved administering general anesthesia (GA) to all participants during the probing procedure. The patients were then monitored at scheduled intervals for up to 6 months after the surgery. Success was defined as an improvement in symptoms and signs, and logistic regression and Fisher's exact test were used for statistical analysis. The mean age of the patients was 25.48 ± 13.38months, and the total success rate was 86.61%. The success rate for MO was 92.8%, 95.87%, and 97% in age groups 1, 2, and 3, respectively. The success rate for ICO was 91.17%, 80%, and 23.52% in age groups 1, 2, and 3, respectively. The success rate for MO was significantly higher than ICO in all age groups. The success rate for ICO was significantly lower in age group 3 (p = 0.009). The study found that probing performed within the first 36months had high success rates regardless of age and type of obstruction. However, the success rate significantly decreased in patients undergoing probing for ICO at 36months or later.

Combined low dose dobutamine and exercise stress echocardiography: a new hybrid protocol to detect inducible ischaemia

Abstract Aims Myocardial response to stress echocardiography may be elicited physiologically, through exercise, or pharmacologically, often with dobutamine. Both have advantages but also limitations due to reduced exercise capacity or side-effects to stressor agent/lack of closeness to true pathophysiology of ischaemic cascade. We have combined low-dose dobutamine and exercise, creating a “hybrid” protocol to utilise the advantages of both techniques and limit the drawbacks. The aim of the study was to evaluate its safety and feasibility. Methods In the hybrid protocol low dose dobutamine infusion (up to 10 mcg/kg/min) is enhanced by supine bicycle exercise at 3 min increments of workload of 25W to achieve target heart rate. We analysed safety and outcome data for all patients who underwent this protocol from 2017-2022. Results 727/835 (87.1%) patients referred for evaluation of ischaemia underwent the hybrid protocol. The median age was 61 years old and 61% (442/727) were men. The median exercise time was 11 (9-13.5) minutes with a median maximum workload of 100W (75-125). 670/727 (92.2%) achieved target heart rate. Atropine was not used. 192/727 (26.4%) of studies were positive for ischaemia. 102/122 (83.6%) with positive stress who underwent invasive angiography had significant coronary disease. The incidence of complications was low: 1/727 - severe arrhythmia, 5/727 (0.7%) developed a vasovagal episode and 14/727 (1.9%) had a hypertensive response to exercise. Conclusion Our findings suggest that this protocol is safe, feasible and has a high success rate in achieving target heart rate.

Aukštų pareigūnų skyrimas pusiau prezidentiniame modelyje: Lietuvos atvejis*

Both academics who study presidential powers and political practitioners acknowledge that Lithuanian president enjoys the power to appoint high-ranking officials. This article investigates the determinants of success (or failure) of presidential decrees by which nominations of high-ranking public officials are submitted to Seimas. Presented theory and results are also discussed in a wider context of literature on semi-presidentialism: what does this power say about the role of presidents and the functioning of such regimes? Analysis employs an original data set, which consists of 337 decrees by presidents of Lithuania from 1993 to 2023 that were submitted to Seimas for consent regarding the appointment of respective public officials. The statistical analysis is complemented by information from semi-structured interviews with several high-ranking politicians. The study reveals several key points. First, high success rate of decrees (about 92.7 percent) is explained by the incentives of the constitutional algorithm and the informal practice of coordinating nominations between the president and the ruling majority before submitting them to Seimas. Second, quantitative analysis and qualitative interviews reveal that the success of decrees increases with the judicial appointments that are advised by a body of experts (Council of Judges) and decreases with appointments to heads of institutions. Third, some cases can also be explained by personal characteristics of nominees: age (result of quantitative analysis) or their self-presentation to Seimas (semi-structured interviews). Fourth, cohabitation – when the president and the parliamentary majority are of different political camps – only partially explains the success of decrees. Some unsuccessful decrees occur because of a short-term drop in the “temperature” of intra-executive relationship. However, this drop usually bounces back to cooperation phase – thus, the power to appoint high-ranking officials contradicts popular paradigm of literature on semi-presidentialism, namely that sees the relationship between president and government as competitive. The president himself together with the system of checks and balances around this power almost ideally embody the moderating power: important condition is that the moderator himself is also constitutionally “moderated”.

Unintended Exchange of Target Vessels for Celiac Trunk and Superior Mesenteric Artery Branches in Complex Endovascular Aortic Repair.

The treatment of thoracoabdominal aortic aneurysms (TAAAs) using branched endovascular aortic repair (BEVAR) is safe and effective. During deployment, the superior mesenteric artery (SMA) branch can unintentionally open into the celiac trunk (CT) ostium and switched catheterization of the SMA from the CT branch and the CT from the SMA branch can be used as an alternative technique in these cases. This study aimed to investigate the outcome of exchanging the intended target vessels (TVs) for the CT and SMA branches during BEVAR. A single-center retrospective analysis of patients with TAAAs who underwent BEVAR, using off-the-shelf or custom-made devices (CMDs), with an unintended exchange of TVs for the CT and SMA branches was performed. Between 2014 and 2023, 397 patients were treated with BEVAR for TAAA. Eighteen (4.5%) of those patients were treated with an exchange of TVs for the CT and SMA branches. T-branch was used in 9 cases (50%) and the remaining patients were treated with CMDs. Twelve patients were treated electively, 3 were symptomatic and 3 presented with rupture. Of 36 mesenteric TVs in those 18 patients, 34 (94%) were catheterized successfully, including all 18 SMAs and 16 of the 18 CTs. No branch stenosis or occlusion of the switched mesenteric TVs was detected during follow-up. During 30-day follow-up, 3 patients died and during a median follow-up of 3 (interquartile range [IQR]: 1-15) months 3 more patients died. None of the deaths or the 2 unintended reinterventions was induced by the mesenteric TV exchange. The median hospital stay was 14 (IQR: 9-22) days with a median of 4 (IQR: 2-11) days at the intensive care unit. The exchange of the mesenteric TVs for the CT and SMA branches during BEVAR with off-the-shelf and CMD endografts is feasible with good TV patency and freedom from TV-related reinterventions. This alternative technique should be considered in selected cases when direct catheterization via the intended branch is deemed more time-consuming or not feasible. This is the first description of using an exchange of target vessels for the celiac trunk and the superior mesenteric artery branches in patients with thoracoabdominal aortic aneurysms undergoing BEVAR, using off-the-shelf or custom-made devices. The high success rate as well as the good clinical results without any branch stenosis or occlusion during follow-up highlight the feasibility of this alternative technique. It could help in challenging cases when catheterization of the intended target vessels is not possible or too time consuming, resulting in higher success rates of BEVAR and better clinical results.

Assessing the Relationship between Physical Health, Mental Health and Students’ Success among Universities in Lebanon: A Cross-Sectional Study

Background: Achieving high academic success is known to be influenced by many factors including, but not limiting to, physical and mental health. The present study aimed to assess the relationship between physical health, mental health, and university students’ success, and to explore the associations between these factors and their academic achievement. Methods: A cross-sectional, self-administered online survey was used to collect data from college students in three different universities in Lebanon during the Fall 2023 semester. Mental health was evaluated using validated screening tools for depression, anxiety, and stress, specifically the Patient Health Questionnaire (PHQ-9), the General Anxiety Disorder (GAD-7), and Cohen’s Perceived Stress Scale (PSS), respectively. Additionally, general questions regarding physical health and lifestyle factors were incorporated into the questionnaire. Academic achievement was measured using students’ grade point average (GPA). Results: A total of 261 students completed the self-administered online survey. The results revealed that approximately 42% and 36% of students were experiencing moderate to severe symptoms of depression and anxiety, respectively, and 75.1% of students exhibited symptoms of moderate stress. The majority of participants (99.2%) did not report any physical disability. Chi-square analysis revealed a significant association between mental health status (depression, anxiety, and stress) and GPA level (p = 0.03, p = 0.044, p = 0.015, respectively). Multiple logistic regression models identified eight correlates of GPA and highlighted the relationship between physical health and student success. For instance, students who considered themselves moderately active had lower odds of achieving a higher GPA than those who considered themselves active (OR = 0.41, p = 0.045). Conclusions: This is the first investigation into Lebanese university students’ academic success in relation to lifestyle and mental health profiles. The findings indicate that implementing public health programs and interventions targeting mental health and lifestyle behaviors is essential for enhancing student success.

Robotic Technology in Prosthetic Dentistry: A Review

Objective The purpose of the article is to present a narrative review of the literature related to application of robotic technology in prosthodontics. Dentistry has made a significant technical transition from manual techniques to digital technology. Applications of robotics have become more and more popular in many medical fields, including dentistry, as a means of streamlining manual procedures and enhancing accuracy. The main applications of robotic interventions in prosthodontics are in the design and manufacture of complete or partial dentures, as well as in assisting with dental implantology surgical procedures. In both situations, significant advancements have been made, enabling treatments with high success rates to be carried out with a better degree of accuracy with significantly reduced amount of time required for completion of procedure.  Materials And Methods A literature search was performed in the online databases – PubMed, Science Direct, Medline and Google Scholar with the following:  Conclusion Robotic assistance in prosthodontics has led to tremendous progress specially in laboratory work and placement of implants. However, using these intricately built robots for various prosthodontic procedures needs close supervision from a trained dentist. Clinical judgment and specialist competence of dentist are indispensable.

Treatment outcomes of tuberculosis cases by HIV status in Haramaya General Hospital, Ethiopia: A retrospective cross-sectional study.

Tuberculosis (TB) and human immunodeficiency virus (HIV) coinfection pose significant challenges to global health, particularly in achieving the target of ending TB. However, the impact of HIV status on TB treatment outcomes remains unclear, especially in eastern Ethiopia. This study aimed to assess the treatment outcomes of TB cases by HIV status and associated factors in Haramaya General Hospital from November 15 to December 30, 2022. A retrospective cross-sectional study was conducted, reviewing the TB registry and treatment cards of patients who received anti-TB treatment between September 2017 and August 2022. Of the 420 samples addressed, 91.0% (95% CI: 88.3%-96.7%) of all TB patients had successful treatment outcomes. The treatment success rates of HIV-positive and HIV-negative TB patients were 80.0% and 91.9%, respectively. Being HIV-negative (AOR: 2.561, 95% CI: 1.002-6.542), being in the age group of 20 to 35 years (AOR: 2.950, 95% CI: 1.171-7.431), and urban residence (AOR: 2.961, 95% CI: 1.466-5.981) were associated with the TB treatment success rate. There was a high treatment success rate among all patients with TB. HIV status was associated with TB treatment outcomes. Strengthening TB-HIV collaborative activities, providing patient-centered care and support, and frequent monitoring and evaluation are recommended to improve the TB success rate.

Mining Real-World Big Data to Characterize Adverse Drug Reaction Quantitatively: Mixed Methods Study.

Adverse drug reactions (ADRs), which are the phenotypic manifestations of clinical drug toxicity in humans, are a major concern in precision clinical medicine. A comprehensive evaluation of ADRs is helpful for unbiased supervision of marketed drugs and for discovering new drugs with high success rates. In current practice, drug safety evaluation is often oversimplified to the occurrence or nonoccurrence of ADRs. Given the limitations of current qualitative methods, there is an urgent need for a quantitative evaluation model to improve pharmacovigilance and the accurate assessment of drug safety. In this study, we developed a mathematical model, namely the Adverse Drug Reaction Classification System (ADReCS) severity-grading model, for the quantitative characterization of ADR severity, a crucial feature for evaluating the impact of ADRs on human health. The model was constructed by mining millions of real-world historical adverse drug event reports. A new parameter called Severity_score was introduced to measure the severity of ADRs, and upper and lower score boundaries were determined for 5 severity grades. The ADReCS severity-grading model exhibited excellent consistency (99.22%) with the expert-grading system, the Common Terminology Criteria for Adverse Events. Hence, we graded the severity of 6277 standard ADRs for 129,407 drug-ADR pairs. Moreover, we calculated the occurrence rates of 6272 distinct ADRs for 127,763 drug-ADR pairs in large patient populations by mining real-world medication prescriptions. With the quantitative features, we demonstrated example applications in systematically elucidating ADR mechanisms and thereby discovered a list of drugs with improper dosages. In summary, this study represents the first comprehensive determination of both ADR severity grades and ADR frequencies. This endeavor establishes a strong foundation for future artificial intelligence applications in discovering new drugs with high efficacy and low toxicity. It also heralds a paradigm shift in clinical toxicity research, moving from qualitative description to quantitative evaluation.

Bent ab interno needle goniotomy versus gonioscopy-assisted transluminal trabeculotomy in primary open-angle glaucoma: study protocol of a randomized clinical trial

BackgroundMinimally invasive glaucoma surgery (MIGS) is a new class of surgeries, which combines moderate to high success rates and a high safety profile. Bent Ab interno Needle Goniotomy (BANG) and Gonioscopy-Assisted Transluminal Trabeculotomy (GATT) are two low-cost MIGS procedures that communicate the anterior chamber to Schlemm’s canal. Most of the available publications on MIGS are either case series or retrospective studies, with different study protocols. The aim of this manuscript is to describe a randomized clinical trial (RCT) protocol to compare the long-term intraocular pressure (IOP) control and the safety of both procedures in eyes with primary open-angle glaucoma.MethodsThis is a parallel, double-arm, single-masked RCT that includes pseudophakic primary open-angle glaucoma (POAG) eyes. After inclusion criteria, medications will be washed out to verify baseline IOP before surgery. Patients will be randomized to BANG or GATT using a sealed envelope. Follow-up visits will be 1, 7, 15, 30, 60, 90, 180, 330 and 360 days after surgery. On PO330, a new medication washout will be done. The main outcome is the IOP reduction following the procedures. Complimentary evaluation of functional and structural parameters, safety, and quality of life will be done after 30, 90, 180, and 360 days.DiscussionOur study was designed to compare the long-term efficacy and safety of two low-cost MIGS. Most of the published studies on this subject are case series or retrospective cohorts, with different study protocols, which included different types and severities of glaucomas, combined with cataract extraction. Our study only included mild to moderate POAG eyes, with previous successful cataract extraction. Moreover, it provides a standardized protocol that could be replicated in future studies investigating various types of MIGS. This would allow comparison between different techniques in terms of efficacy, safety, and patients’ quality of life.Trial registrationRetrospectively registered at the Registro Brasileiro de Ensaios Clínicos (ReBEC) platform RBR-268ms5y. Registered on July 29, 2023.The study was approved by the Ethics Committee of the University of Campinas, Brazil.

A New Concept Proposal in History Education: History Capital

History capital is a new interdisciplinary concept proposal in the field of history education, including the fields of history and sociology. In this study, a discussion was conducted on the conceptualization of science capital as a sub-heading of the concept of science capital, which was developed by the French sociologist Pierre Bourdieu's sociology and the British academician Louise Archer's joint work based on Bourdieu's sociology. It is seen that students achieve more success in the field they study, engage in research and reading activities, spend more time on educational activities in this field outside of school, and benefit from more resources. The fact that the student's interest in the course is a determining factor reveals the need to investigate the factors affecting his interest. Bourdieu explained accumulation with the concept of capital and divided it into economic, cultural, social and symbolic capital. He proposed the concept of "habitus" as a concept expressing interest, tendency and predisposition. The concept of field refers to certain locations with their own rules and accumulation criteria. If his capital and habitus are compatible, the person can achieve high success in that field. However, in order to measure a person's interest, tendency and predisposition in a field, his capital and habitus must first be measurable in accordance with the field. It is clear that in order for this problem to be understandable and measurable, it must first be conceptualized. For this reason, we first propose the concept of "history capital" to the literature. The aim of this study is to explain and define the concept of history capital in accordance with the field of history education, determine its scope and discuss the content of this concept. It is thought that this discussion and evaluation process will contribute to the literature by expressing students' tendencies, interests and predispositions with a concept in line with their knowledge. At the end of the study, by using Bourdieu's concepts of capital, habitus and field with the concept of science capital, the following definition in the field of history education was reached with the dialectical method in which deduction and induction are used together: “The accumulation (capital) acquired from (social and cultural) sources that affect and form a person's interest, tendency and predisposition (habitus) in history (field) is called history capital.”In addition, eight dimensions used in science capital were taken into account for the dimensions affecting the level of history capital.

Electrocatalytic Formal C(sp2)–H Alkylations via Nickel‐Catalyzed Cross‐Electrophile Coupling with Versatile Arylsulfonium Salts

Producing sp3‐hybridized carbon‐enriched molecules is of particular interest due to their high success rate in clinical trials. The installation of aliphatic chains onto aromatic scaffolds was accomplished by nickel‐catalyzed C(sp2)–C(sp3) cross‐electrophile coupling with arylsulfonium salts. Thus, simple non‐prefunctionalized arenes could be alkylated through the formation of aryldibenzothiophenium salts. The reaction employs an electrochemical approach to avoid potentially hazardous chemical redox agents, and importantly, the one‐pot alkylation proved also viable, highlighting the robustness of our approach.