Pairwise Comparisons Research Articles

Color stability of precolored and extrinsically colored monolithic multilayered polychromatic zirconia: Effects of surface finishing and aging.

To explore the impact of zirconia types, coloring methods, and surface finishing on the color stability of monolithic multilayered polychromatic zirconia after artificial aging, including thermocycling and simulated toothbrushing. Eighty square-shaped zirconia samples were divided into 2 types (M3Y-TZP and M6Y-PSZ), further categorized based on coloring methods (precolored and extrinsically colored) and surface finishing techniques (mechanical polishing or glazing). The color stability was assessed using the CIEDE2000 formula. Artificial aging was simulated via thermocycling and toothbrushing. All samples were analyzed with a spectrophotometer to determine the post-aging color changes (ΔE00). The ΔE00 were interpreted and classified using the 50:50% perceptibility threshold (PT) and the 50:50% acceptability threshold (AT). Comparisons between groups for ΔE00 differences were performed using three-way ANOVA, with pairwise comparisons facilitated by Fisher's protected least significant difference test, α = 0.05. The study results indicated significant impacts of zirconia type, coloring method, and surface finishing on color stability. The M6Y groups experienced significantly greater color changes (6.61 ± 1.63) compared to the M3Y groups (3.40 ± 2.24), p < 0.0001. For both types of zirconia, extrinsically colored samples exhibited significantly higher ΔE00 when mechanically polished (p = 0.004). However, surface finishing had no significant effect on ΔE00 in precolored samples of either zirconia material (p = 1.000). The evaluation and categorization of ΔE00 variations indicated that nearly all color changes in the M6Y groups, regardless of being precolored, extrinsically colored, polished, or glazed, were deemed extremely unacceptable (Grade 1). In contrast, the M3Y groups showed more acceptable results, with the majority of color changes classified as moderately unacceptable (Grade 3). The color stability of multilayered polychromatic zirconia is influenced by the type of material, extrinsic coloring, and the chosen surface treatment post-artificial aging. The translucent 6Y-PSZ exhibited lower color stability, especially with only mechanical polishing. For the fabrication of M3Y-TZP and 6Y-PSZ monolithic multilayered polychromatic zirconia restorations, extrinsic coloring should be paired with glazing to maintain color stability. Conversely, in the absence of extrinsic coloring, both glazing and mechanical polishing are effective in preserving color stability.

The effectiveness of endoscopic diagnostics of colon tumors using artificial intelligence: prospective tandem study

AIM: to estimate the effectiveness of a medical decision support system based on artificial intelligence in the endoscopic diagnosis of benign tumors during tandem study.PATIENTS AND METHODS: from October to December 2023, a single-center comparative tandem study of medical decision support system based on artificial intelligence “ArtInCol” was done. The first stage was a traditional colonoscopy under sedation, the second one — colonoscopy using AI. A pairwise comparison of the main indicators of the effectiveness was made.RESULTS: in the primary endpoint, the polyp detection rate (PDR) in the traditional colonoscopy group was 40.6% vs 56.4% in the AI group, p = 0.0001 (RR = 1.39; 95% CI: 1.04–1.87). The mean number of lesions detected (MPP) was 1.63 (± 1.2) vs 2.47 (± 1.8) in the AI group (mean difference = 0.84; (95% CI: 1.07–0.61).CONCLUSION: the study demonstrated the effectiveness of the original medical decision support system for benign colon tumors detection in real clinical practice. The further stage, a multicenter randomized trial is needed.

Comparative Evaluation of the Sensory Qualities of Refined and Wholegrain Rice as Ingredients within Mixed Dishes.

Low wholegrain food consumption is a leading dietary risk for avoidable morbidity and mortality globally, with limited sensory acceptability suggested to be a challenge for changing behaviour. This study aimed to evaluate the sensory acceptability of both wholegrain (brown) and refined (white) rice in common preparations. Four brown- and white-rice-containing dishes (Garlic Rice, Rice and Beans, Jollof Rice, and Rice Pudding) were tested. Quantitative (five-point scales) and qualitative (open question responses) sensory information were collected for dish appearance, aroma, taste, and texture. All four characteristics were scored equally acceptable in Rice and Beans and Rice Pudding (p > 0.05) between paired comparisons for brown and white rice. Scores were significantly lower for all characteristics for Jollof Rice (p ≤ 0.002), and lower for Aroma (median (lower quartile-upper quartile)) for brown (3.5 (3-4)) vs. white rice (4 (4-5)), p = 0.006). Appearance (brown (3 (3-4)) vs. white rice (4 (3.25-5)), p = 0.012), and Texture (brown 3 (2.25-4) vs. white rice (4 (4-5)), p < 0.001) for Garlic Rice. Familiarity and appealingness were qualitative themes aligned with the higher acceptability of white-rice-containing dishes. Certain dishes appear to mask key negative sensory attributes of wholegrain foods, possibly representing a means to increase wholegrain ingredient acceptability, thereby potentially improving individual/population-level intake.

Role of CTGF and PI3K/Akt signaling pathway in paraquat-induced mesenchymal changes in alveolar epithelial cells

Objective: To investigate the role of connective tissue growth factor (CTGF) and PI3K/Akt signaling pathways in paraquat (PQ) -induced alterations in alveolar epithelial cell mesenchymalization (EMT) . Methods: In February 2023, RLE-6TN cells were divided into 2 groups, which were set as uncontaminated group and contaminated group (200 μmol/L PQ), and cellular EMT alteration, CTGF and PI3K/Akt signaling pathway related molecules expression were detected by cell scratch assay, qRT-PCR and western-blot assay. Using shRNA interference technology to specifically inhibit the expression of CTGF, RLE-6TN cells were divided into four groups: control group, PQ group (200 μmol/L PQ), interference group (transfected with a plasmid with shRNA-CTGF+200 μmol/L PQ), and null-loaded group (transfected with a plasmid with scramble- CTGF+200 μmol/L PQ), qRT-PCR and western blot were used to examine the alteration of the cellular EMT and the expression of molecules related to the activity of PI3K/Akt pathway. The PI3K/Akt signaling pathway was blocked by the PI3K inhibitor LY294002, and the expression of EMT-related molecules in cells of the control group, PQ group (200 μmol/L PQ), and inhibitor group (200 μmol/L PQ+20 μmol/L LY294002) was examined by qRT-PCR and western blot.The t-test was used to compare the differences between the two groups, while the analysis of variance (ANOVA) was applied to compare the differences among multiple groups. For further pairwise comparisons, the Bonferroni method was adopted. Results: The results of cell scratch test showed that compared with the uncontaminated group, RLE-6TN cells in the contaminated group had faster migration rate, lower mRNA and protein expression levels of E-Cadherin, and higher mRNA and protein expression levels of α-SMA, CTGF, PI3K and Akt, with statistical significance (P<0.05). After specific inhibition of CTGF expression, the mRNA and protein expression of CTGF, PI3K, Akt, and α-SMA in the cells of the interference group were significantly lower than that of the PQ group and the null-loaded group (P<0.05/6), whereas that of E-Cadherin was higher than that of the PQ group and the null-loaded group (P<0.05/6). Specifically blocking the PI3K/Akt signaling pathway, the mRNA and protein expression of PI3K, Akt and α-SMA in the cells of the inhibitor group was decreased compared with that of the PQ group (P<0.05/3), while the expression of E-Cadherin was elevated compared with that of the PQ group (P<0.05/3) . Conclusion: CTGF may promote PQ-induced alveolar epithelial cell EMT through activation of the PI3K/Akt signaling pathway. Inhibition of CTGF expression or blockade of PI3K/Akt signaling pathway activity can alleviate the extent of PQ-induced alveolar epithelial cell EMT.

Complete genome sequence and phylogenetic analysis of a newly discovered fusagra-like virus infecting Carica papaya in Ecuador.

A new fusagra-like virus infecting papaya (Carica papaya L.) was genetically characterized. The genome of the virus, provisionally named "papaya sticky fruit-associated virus" (PSFaV), is a single molecule of double-stranded RNA, 9,199 nucleotides (nt) in length, containing two discontinuous open reading frames. Pairwise sequence comparisons based on complete RNA-dependent-RNA-polymerase (RdRp) sequences revealed identity of 79.4% and 83.3% at the nt and amino acid (aa) level, respectively, to babaco meleira-like virus (BabMelV), an uncharacterized virus sequence discovered in babaco (Vasconcellea x heilbornii) in Ecuador. Additional plant-associated viruses with sequence identity in the 50% range included papaya meleira virus (PMeV) isolates from Brazil. Phylogenetic analysis based on the amino acid sequences of the capsid protein (CP), RdRp, and CP-RdRp fusion protein genes placed PSFaV in a group within a well-supported clade that shares a recent ancestor with Sclerotium rolfsii RNA virus 2 and Phlebiopsis gigantea mycovirus dsRNA 2, two fungus-associated fusagraviruses. Genomic features and phylogenetic relatedness suggest that PSFaV, along with its closest relative BabMelV, represent a species of novel plant-associated virus classified within the recently established family Fusagraviridae.

My avatar makes me feel good? The effect of avatar personalisation and virtual agent interactions on self-esteem

ABSTRACT The theory of Objective Self-Awareness (OSA) and related studies suggest that embodiment of personalised avatars may induce self-awareness and influence self-esteem. Additionally, the Computers Are Social Actors (CASA) paradigm suggests that humans may mindlessly respond to computers in ways that are similar to human interactions. Based on those assertions, it is plausible that virtual embodiment of a personalised avatar and interactions with a virtual agent can shift self-esteem. However, those effects on self-esteem have not been thoroughly examined in past studies. To address these research gaps, a 2 (avatar personalisation: personalised vs. non-personalised avatar) × 2 (virtual agent interaction valence: positive vs. negative) between-subjects experiment was conducted using a Virtual Reality (VR) simulation (N =171). Findings from the study showed that there was no effects of avatar personalisation and virtual agent interaction valence on state self-esteem change. However, the pairwise comparisons present some preliminary indications that avatar personalisation and positive interactions with a virtual agent may facilitate improvements in state self-esteem altogether. Implications of the study findings are discussed.

Identifying and Prioritizing Economic Opportunities for Medical Tourism Management: An Analytic Hierarchy process

Background: As a growing industry, medical tourism includes many economic opportunities. This industry is the largest and most diverse industry in the world, with a foreign currency income which is equal to the automotive and military weapons industries. The aim of the current research is to identify and prioritize economic opportunities related to medical tourism management, using the Analytical Hierarchy Process (AHP) as a multi-criteria decision-making tool. Methods: This was a descriptive-survey research with an applied and cross-sectional approach. A survey method was used to collect data, so this study can be classified as field research. The statistical population of the research included 25 people with experience and expertise selected through purposive sampling in the fields of management, tourism, and medicine. The method of collecting data was in the form of library and field studies. The tool for collecting data was a questionnaire of paired comparisons and a check sheet. Data analysis was done with AHP method and Expert Choice 11 software. After collecting the paired comparison questionnaire and calculating the geometric mean, the inconsistency rate of the questionnaires was less than 0.1, which showed that the data had the required validity. Results: First, using library studies, economic opportunities related to medical tourism were identified. These opportunities included cash generation, technological advancements, job creation, diversification of tourism industry, development of health care infrastructure, knowledge transfer and cooperation, services and ancillary industries, and regional development and diversification of economic activity. Opportunities were prioritized using the AHP method. Cash generation with relative importance of 0.191 was ranked first, job creation with relative importance of 0.162 was second, and technological advances was ranked third with relative importance of 0.131. Diversification to economic activities with a relative importance of 0.45 was ranked ninth which was the lowest. Conclusion: Strategic marketing, delivering quality healthcare services, competitive pricing, specialized medical care, patient-centered experience, collaboration and partnership, continuous improvement, and strengthening medical tourism infrastructure are the pillars through which medical tourism management can not only generate sustainable revenue but also provide invaluable healthcare services to patients from across the globe.

Fuzzy Interpretive Structural Modeling regarding Factors Affecting Employees’ Experience Management in Mashhad University of Medical Sciences

Background: Employees are considered internal customers of the organization, and today, employee’s experience has become a prominent topic in the field of human resources. This study aims to model the factors affecting employees’ experience management in Mashhad University of Medical Sciences using fuzzy interpretive structural modeling. Methods: This applied study was descriptive-analytical conducted in 2023. 10 faculty members, managers, and staff of Mashhad University of Medical Sciences were selected using a purposive sampling method. Interpretive Structural Modeling (ISM) questionnaire consisting of a 7x7 matrix was then given to them, and they were asked to find the contextual relationship between the variables based on the pairwise comparison scale. In the analysis section, fuzzy interpretive structural modeling and MICMAC analysis were used to structure and analyze the status of the factors. Results: 7 organized themes (organizational, physical environment, technological, job, managerial, cultural, and individual factors) were identified for employees’ experience in Mashhad University of Medical Sciences. Findings showed that cultural and managerial factors are at the lowest level of the structure and have more influence and less dependence. In other words, these are the most influential factors on employees’ experience. Job, technology, and organizational factors were placed at the second level. In contrast, individual and physical factors were at the highest level of the structure and had less influence and more dependence on other factors. Conclusion: The findings indicate that Mashhad University of Medical Sciences should focus on strengthening and improving cultural and managerial factors to improve employees’ experience. Additionally, attention to job, technology, and organizational factors, along with addressing individual employee’s needs and providing a favorable physical environment, are essential for employees’ effective experience management at the university. This study, by providing a comprehensive model of factors influencing employees’ experience, assists universities and other organizations in gaining a deeper understanding of this concept and developing effective strategies for its enhancement.

ScCross: efficient search for rare subpopulations across multiple single-cell samples.

Identifying rare cell types is an important task to capture the heterogeneity of single-cell data, such as scRNA-seq. The widespread availability of such data enables to aggregate multiple samples, corresponding for example to different donors, into the same study. Yet, such aggregated data is often subject to batch effects between samples. Clustering it therefore generally requires the use of data integration methods, which can lead to overcorrection, making the identification of rare cells difficult. We present scCross, a biclustering method identifying rare subpopulations of cells present across multiple single-cell samples. It jointly identifies a group of cells with specific marker genes by relying on a global sum criterion, computed over entire subpopulation of cells, rather than pairwise comparisons between individual cells. This proves robust with respect to the high variability of scRNA-seq data, in particular batch effects. We show through several case studies that scCross is able to identify rare subpopulations across multiple samples without performing prior data integration. Namely, it identifies a cilium subpopulation with potential new ciliary genes from lung cancer cells, which is not detected by typical alternatives. It also highlights rare subpopulations in human pancreas samples sequenced with different protocols, despite visible shifts in expression levels between batches. We further show that scCross outperforms typical alternatives at identifying a target rare cell type in a controlled experiment with artificially created batch effects. This shows the ability of scCross to efficiently identify rare cell subpopulations characterized by specific genes despite the presence of batch effects. The R and Scala implementation of scCross is freely available on GitHub, at https://github.com/agerniers/scCross/. A snapshot of the code and the data underlying this article are available on Zenodo, at https://zenodo.org/doi/10.5281/zenodo.10471063. Supplementary data are available at Bioinformatics online.

DIPG-61. ARGININE DEPRIVATION USING ADI-PEG20 IMPROVES SURVIVAL IN A SYNGENEIC DIFFUSE MIDLINE GLIOMA MOUSE MODEL

Abstract BACKGROUND Diffuse midline glioma (DMG-H3K27) presents a significant challenge in paediatric oncology, with a &amp;lt;10% two-year survival rate despite standard palliative radiotherapy. Tumour infiltration behind the blood-brain barrier hampers drug delivery, contributing to clinical trial failures. ADI-PEG20 exploits tumour metabolic vulnerabilities: lack of argininosuccinate synthetase and reliability on extracellular arginine for proliferation. This study investigates ADI-PEG20’s efficacy in a syngeneic DMG mouse model. METHODS Twenty C57BL/6J mice were intracranially injected with a DMG cell line (H1H3BK27M, DNp53, PDGFRAD642V, Acvr1G328V) and monitored via bioluminescence imaging from day 7. Weekly treatments began on day 10, comprising ADI-PEG20 (5 I.U.) alone, ADI-PEG20 with concurrent radiation (2 Gy), radiation alone, or saline (0.9%), with each group comprising n=5. Radiation was administered 24 hours post-drug treatment. Bioluminescence imaging was conducted twice weekly, with mice culled upon symptom onset. Immunohistochemistry was performed on brain tissue. RESULTS The combination and ADI-PEG20 monotherapy cohorts exhibited comparable median survival rates, both surpassing those of the radiation-only and saline groups, with the latter exhibiting the lowest median survival. A significant disparity in survival curves was observed overall (p&amp;lt;0.0001), confirmed by log-rank (Mantel-Cox) test. Pairwise comparisons revealed significant differences in survival curves between the combination and radiation-only (p=0.0066), ADI-PEG20 monotherapy and radiation-only (p=0.0018), and ADI-PEG20 monotherapy and saline (p=0.0062) groups. Minimal divergence in IVIS signal intensity was noted across groups. Histological examination via H&amp;E staining demonstrated marked tumour regression in mice treated with ADI-PEG20 ± radiation, contrasting with the persistent tumour mass evident in the radiation-only and saline cohorts, alongside discernible heterogeneity in cellular phenotypes within the ADI-PEG20 ± groups. CONCLUSIONS In conclusion, ADI-PEG20 shows promise as a therapeutic strategy for DMG, offering a significant survival advantage over radiation and saline. Ongoing efforts will elucidate its mechanistic underpinnings, explore its efficacy across diverse DMG models, and assess synergistic interactions with immune-based therapies.

Understanding maternal Ethnomedical Folklore in Central Uganda: a cross-sectional study of herbal remedies for managing Postpartum hemorrhage, inducing uterine contractions and abortion in Najjembe sub-county, Buikwe district

Pregnant women in rural Uganda largely rely on medicinal plants for inducing labor, treating postpartum hemorrhage (PPH), and inducing abortion. 90% of the women in both rural and urban Uganda use plants to manage pregnancy symptoms like constipation, heartburn, morning sickness, body aches, nausea, and vomiting. After delivery women continue using plants to manage postpartum complications and for infant care especially herbal baths. This study documented how ethnomedical folklore has been used to aid childbirth, manage postpartum hemorrhage, and induce abortion.MethodsA cross-sectional ethnobotanical survey was conducted from May – December 2023 in Najjemebe sub-county, Buikwe district. 206 respondents from 12 villages were selected using snowball sampling. Key informants included Traditional Birth Attendants (TBAs) and herbalists. Data was collected using semi-structured questionnaires and focus group discussions. Voucher specimens of the plants were identified and authenticated at Makerere University Herbarium. Data were analyzed using descriptive statistics, Informant Consensus factor (ICF), Use Reports (URs), paired comparisons, and GraphPad Prism® version 9.0.0 software.ResultsAll respondents (N = 206, 100%), used plants to induce labour, treat PPH, and induce abortion. One hundred four plant species were documented: most cited or preferred were: Hoslundia opposita (N = 109, 53%), Phytolacca dodecandra (N = 72, 35%), and Commelina erecta (N = 47, 23%). The plants belonged to 49 families, Lamiaceae (16.3%) and Fabaceae (14.3%) having the majority of the species. Herbs were 42 (40%) and trees 23 (22%). Oral administration 95(72%) was the commonest, then topical 19 (14.4%) and vaginal 14(10.6%).ConclusionHealth surveys revealed that about 27% of deliveries in Uganda take place outside a health facility. Due to the oxytocic effects of plant species reported in this study, they play a triple role of being uterotonics, abortifacients, and treating postpartum haemmorhage. The dilemma lies in the unknown dosages and toxicity levels that could endanger both the mother’s and the unborn child’s lives. Due to Uganda’s high rates of population growth, overall fertility, maternal mortality, and morbidity, policies, and programmes on gendered health provision need to be reevaluated. Integrating herbal medicine into health care systems appears to be a feasible solution.

(017) FLIBANSERIN IMPROVES LIBIDO AND SEXUAL SATISFACTION IN WOMEN WITH BREAST CANCER ON ENDOCRINE THERAPY

Abstract Introduction Decreased libido is a distressful symptom during and after cancer treatment. This is the first prospective longitudinal study that investigates the use of flibanserin to treat decreased libido in breast cancer patients on endocrine therapy. Objective This study evaluates the efficacy of flibanserin as measured by change in desire, sexual function, and distress from sexual dysfunction. These outcomes are measured using the following validated instruments: Female Sexual Function Index (FSFI) both desire and total scores, Patient-reported Outcomes Measurement Information System Sexual Function Instrument (PROMIS-SF) and patient distress via FSDS-R. Methods Forty-three women with stage 0-III ER+ breast cancer on endocrine therapy for at least 3 months who reported HSDD as defined by the DSM-IV and ISSWH consensus paper were enrolled on an IRB-approved prospective, longitudinal trial from both an academic center and an alliance community site. All patients took flibanserin 100mg nightly for 24 to 36 weeks. Patients were monitored closely for 52 weeks for adverse events, with medical exams and questionnaires at baseline, week 4, 8, 16, 24, 52 with optional week 36 appointments. Given the small sample size, descriptive, graphical, and nonparametric paired tests for pairwise comparisons of a measure were performed. Results Participants reported improved libido and sexual satisfaction as demonstrated by both the PROMIS-SF and FSFI data (see Table 1). 35/43 (83.3%) patients completed the FSFI and 25/43 (58.1%) completed the PROMIS-SF. The mean overall total FSFI score increased from 11 at baseline, to 17 at week 8 and 24 at week 36. The PROMIS data for interest in sexual activity improved from a baseline mean score of 43 to 51 at 8 weeks, to 54 at 24 weeks and 55 at 36 weeks. Similarly, the FSFI data in the domains of desire and arousal improved respectively from 1.90 and 1.56 at baseline to 3.03 and 3.05 at 8 weeks, 3.30 and 3.17 at week 16 and 3.53 and 4.01 at week 36. Satisfaction with sex life also improved from PROMIS baseline of 46 to 49 at week 8 and 55 at week 36. FSFI data for the domain of satisfaction indicate parallel trends with a baseline score of 2.36, increasing to 3.15 at week 8 and 4.45 at week 36. Furthermore, vaginal discomfort scores improved on both the PROMIS and FSFI. FSFI data on lubrication also showed improvement with a baseline mean score of 1.85 increasing to 2.84 by week 8, 3.24 at week 24 and 4.01 at week 36. However, the PROMIS suggests a decrease in lubrication from baseline to week 8. Patient distress also decreased throughout the study as measured on the FSDS-R and distress thermometer. There were no severe adverse events. The most common adverse events were nausea, somnolence and dizziness. Conclusions Flibanserin improves libido and overall sexual function as measured by the PROMIS-SF and FSFI in breast cancer patients on endocrine therapy. The exciting data from this pilot study is currently informing a larger randomized placebo-controlled study evaluating the efficacy of flibanserin in women with breast cancer. Disclosure Yes, this is sponsored by industry/sponsor: Sprout Pharmaceuticals Clarification: Industry funding only - investigator initiated and executed study Any of the authors act as a consultant, employee or shareholder of an industry for: Ms. Medicine, NanOlogy LLC, Paxman Cooling Ltd, Procter and Gamble, Rejoy, Revision Skincare, Sermonix, Shook, Hardy and Bacon, Spectrum Pharmaceuticals, Sprout Pharmaceuticals, TerSera.

A comparative evaluation of fracture resistance of three recent composite systems in Class II mesio occluso distal cavities - An in vitro study

Though composite resins have received popularity as restorative materials because of their physical properties, there was a dearth in the research about fracture resistance among recently emerged composite systems including Tokuyama Estelite Sigma Quick, Admira Fusion, and Beautifil II LS nanohybrid composite systems. To compare and evaluate the fracture resistance of maxillary premolars with class II mesio occluso distal cavities restored with Tokuyama Estelite Sigma Quick, Admira Fusion, and Beautifil II LS nanohybrid composite systems. Current invitro research was conducted on 44 intact human premolar teeth- Eleven specimens were kept completely intact for control group (Group G1). Class II MOD cavities were done with high-speed handpiece and under constant irrigation in remaining 33 teeth, Group G2, Group G3, Group G4 were restored with Tokuyama Estelite Sigma Quick (Tokuyama Dental, Tokyo, Japan.), Beautifil II LS (Shofu, Germany.), Admira Fusion (Shofu, Germany.) respectively. SPSS version 20 software to analyse the data; and ANOVA followed by Tukey’s post-hoc analysis to compare the fracture resistance were used. With a fracture resistance of 1297.27±10.27 N, Group 1 (Control) had highest fracture resistance. Group 4 has the least fracture resistance (Admira Fusion). Every pairwise comparison was significant too. Among the three materials studied, Beautifil II LS had higher fracture resistance and Admira Fusion had the least fracture resistance.

Variations in the anatomical structure of the pterion among populations from various global regions

Anatomical variations in the structure of the pterion were examined in various craniological series represent-ing modern populations from Australia, Melanesia, Southeast Asia, North Asia, America, and Europe, encom-passing 2035 adult crania. The comparison of populations based on the frequency of nonmetric traits revealed significant diversity across regions. Notably, the sphenoparietal connection is most frequent in European and South Asian populations, as well as among Native Americans, while it is least common among African groups. The frontotemporal connection predominates among Australian Aborigines and Melanesians and is also common in African populations but is almost non-existent in Europeans. The X-shaped pterion is most frequently observed in the Eskimos of Chukotka and the Chukchi, as well as among Somali and Tanzanian populations. A high fre-quency of epipteric bones is particularly characteristic of Southern Indians, Burmese, Australians, and Melane-sians. Pairwise comparisons of populations were conducted using Smith's Mean Measure of Divergence (MMD). To visualize the data from individual regions, the method of Multidimensional Scaling (MDS) was applied to the matrices of biological distances. The MDS plot for the North Asian region revealed distinct clusters of the Arctic, Baikal, Cen-tral Asian, and Ural groups, aligning with G.F. Debetz's classification based on morphological similarities among populations. In the MDS plot for the South and Southeast Asian, American, and African populations, Australians and Melanesians formed a separate cluster; Pueblo Indians were closely aligned with Peruvians, South Indians with Burmese, Malays merged with Papuans, and African populations were positioned relatively close to each other. In Europe, Caucasian groups formed a distinct cluster. On the combined graph, the populations were clearly divided by regions. The results obtained indicate that the spatial arrangement of populations on the graphs approximately mir-rors their genetic connections and shared origins. This suggests that nonmetric variations in the pterion area are more likely determined by genetic rather than ecological factors and can be considered taxonomically valuable traits at the regional level. Investigating the structure of the pterion in an evolutionary context may shed light on broader questions concerning the evolution of the skull and the mechanisms influencing its formation.

A novel endocardial activation–derived predictor for focal paraseptal atrial tachycardias: Evidence from a multicenter cohort study

BackgroundThe electrocardiogram-based algorithm for predicting paraseptal atrial tachycardia (PSAT) is limited by the significant overlaps in P-wave morphology originating from various paraseptal sites. ObjectivesThe goals of this study were to investigate the endocardial activation characteristics of PSAT and to seek an endocardial activation–derived predictor for the ablation site. MethodsForty-four patients (11 men; mean age 62.6 ± 14.7 years) with PSAT ablation in 4 tertiary medical centers were assigned to 3 groups according to the ablation site: right atrial (RA) para-Hisian region (group 1, n = 10), noncoronary cusp (NCC) (group 2, n = 13), and left atrial (LA) paraseptal area (group 3, n = 21). Multiple-chamber activation mapping was performed guided by a 3-dimensional navigation system. The discrepancies in the earliest activation time between 2 of 3 chambers (ΔRA-LA, ΔRA-NCC, and ΔLA-NCC) were calculated in each group and used for pairwise comparisons. ResultsThere was a significant difference in ΔRA-LA, ΔRA-NCC, and ΔLA-NCC among the 3 groups. ΔRA-LA was the only parameter that could consistently predict the ablation site of PSAT with good accuracy (area under the curve 1.000, sensitivity 100% and specificity 100%, and cutoff value 7 ms for predicting right para-Hisian or NCC ablation; area under the curve 0.974, sensitivity 92.3% and specificity 95.2%, and cutoff value −4 ms for predicting NCC or left paraseptal ablation). Based on 2 cutoff values, a 2-step algorithm was developed to predict the ablation site of PSAT with a positive predictive value of 95.4% and a negative predictive value of 97.0%. ConclusionΔRA-LA is a useful endocardial activation–derived parameter for predicting the successful ablation site of PSAT.

Combination of acute intermittent hypoxia and intermittent transcutaneous electrical stimulation in obstructive sleep apnea: a randomized controlled crossover trial

Intermittent hypoxia (IH) and intermittent transcutaneous electrical stimulation (ITES) might benefit patients with obstructive sleep apnea (OSA). However, the therapeutic value of combined IH and ITES in OSA is unknown. In this prospective, randomized, controlled crossover study, normoxia (air exposure for 50 min before sleep and sham stimulation for 6 h during sleep), IH (5 repeats of 5 min 10–12 % O2 alternating with 5 min air for 50 min, and sham stimulation for 6 h), ITES (air exposure for 50 min and 6 repeats of 30 min transcutaneous electrical stimulation alternating with 30 min of sham stimulation for 6 h), and IH&ITES (10–12 % O2 alternating with air for 50 min and transcutaneous electrical stimulation alternating with sham stimulation for 6 h) were administered to patients with OSA over four single-night sessions. The primary endpoint was difference in OSA severity between the interventions according to apnea-hypopnea index (AHI) and oxygen desaturation index (ODI). The efficacy was response to IH, ITES, IH&ITES defined as a ≥50 % reduction in AHI compared with normoxia. Twenty participants (17 male, 3 female) completed the trial. The median (IQR) AHI decreased from 14.5 (10.8, 17.5) events/h with normoxia to 6.9 (3.9, 14.8) events/h with IH (p=0.020), 5.7 (3.4, 9.1) events/h with ITES (p=0.001), and 3.5 (1.8, 6.4) events/h with IH&ITES (p=0.001). AHI was significantly different between IH and IH&ITES (p=0.042) but not between ITES and IH&ITES (p=0.850). For mild-moderate OSA (n=17), IH, ITES, and IH&ITES had a significant effect on AHI (p=0.013, p=0.001, p=0.001, respectively) compared with normoxia, but there were no differences in post hoc pairwise comparisons between intervention groups. No serious adverse events were observed. In conclusion, IH, ITES, and IH&ITES significantly reduced OSA severity. IH&ITES showed better efficacy in mild-moderate OSA than IH and was comparable to ITES. Our data do not support recommending IH&ITES over ITES for OSA.

Choose Wisely! – Considering the Perceived Threat in the Selection of Trauma Film Clips May Improve the Ecological Validity of the Trauma Film Paradigm

Abstract Background The trauma film paradigm (TFP) is the gold standard experimental psychopathology model of psychological trauma. However, different film clips with distinct effects on trauma-analogue symptoms are used across TFP studies, raising questions about the generalizability of study-specific results and the ecological validity of the TFP. Little is known about differences among film clips commonly used in the TFP regarding key features of psychological trauma (i.e., threat and anxiety) and their veridicality. Methods Thirty healthy participants watched eight trauma film clips in randomized order and subsequently rated each in view of perceived threat, anxiety, and realism. In addition to descriptive statistics, variance analyses and pairwise comparisons were performed to test for differences on these outcomes. Results The results indicated significant differences among the trauma film clips in terms of perceived threat and realism. However, nearly all trauma film clips evoked moderate anxiety levels. Conclusions This study stressed the importance of perceived threat as a key feature in selecting film clips for the TFP, as highly threatening film clips were also perceived as more realistic. When replicated using delayed outcomes (e.g., intrusive memories), choosing trauma film clips in view of their perceived threat might improve the ecological validity of the TFP.

Effect of Portal Vein Types on Estimated Remnant Volume in Living Donor: Preoperative CT Assessment.

The aim of this study is to examine the effect of portal vein types on the ratio of the right-left lobe liver volumes, as well as the insufficient estimated remnant liver volume (ERLV) during the preoperative assessment of donor candidates for right-lobe liver transplantation. The preoperative abdominal CT examinations of the donor candidates in a single institution between December 2018 and May 2022 were retrospectively evaluated. Portal vein types are divided into 3; classical anatomy was considered type 1, PV trifuction was considered type 2, and if the first branch arising from the main portal vein is the right posterior branch, it was accepted as type 3. Other configurations were defined as type 4. The total, right-left lobe liver volumes, the ERLV, and the portal vein variations were noted. The chi-square test was performed to assess the correlation between portal vein types, the ratio of the right-left lobe volumes, andthe ERLV ratio below 30%. Tamhane's T2 post hoc tests were performed for pairwise comparison to assess the right-left lobe volume ratio among groups. 287 donor candidates (mean age, 35years ± 8.2; 174 men) were evaluated. The volume ratio of median volume of the right and left lobe was significantly higher in candidates with type 3 portal veins compared to those with type 1 portal veins (2 (1.3-3.5) and 2.1 (1.6-3.2), respectively, p = 0.017). The ERLV ratio below 30% was significantly higher in donor candidates with type 3 portal veins (42.9%) compared to those with type 1 and 2 portal veins (24.6%, 20%)) respectively, p = 0.030). Due to its propensity to result in insufficient ERLV in the donor, the presence of a type 3 portal vein should be evaluated during the preoperative evaluation. Secondary abstract: This study suggests that donor candidates with type 3 portal vein exhibit a notable rise in the frequency of insufficient remnant liver volume during the preoperative assessment.

Virtual Reality Simulation for the Acquisition and Retention of Electrocardiogram Interpretation Skills: A Randomized Controlled Trial Among Undergraduate Medical Students.

Introduction The electrocardiogram (ECG) is one of the most important tools in diagnosing cardiac abnormalities, particularly arrhythmias and myocardial infarction. It is one of the certifiable competencies for final-year medical undergraduate students. We determined virtual reality's effectiveness in acquiring and retaining ECG interpretation skills among medical students compared to traditional teaching. Methods One hundred and forty students were randomized into two groups. Seventy-one students (immersion group) were trained using virtual reality simulation to acquire and retain interpretation skills of normal and abnormal ECG. Sixty-nine students(traditional group) were trained in the classroom using chalk and board. The primary outcome of change in acquiring knowledge of the interpretation of ECG was determined by comparing pre and post-test scores. The secondary outcome of retention of knowledge was determined by comparing pre-test and second post-test scores conducted after eight weeks of intervention. The p-value of <0.05 was considered significant. Results Out of 140 students, 50 (35.7%) were males and 90 (64.3%) were female. The mean age of the students was 22.1 (SD1.1), with 69.3% of them between the ages of 21 and 22 years.Mean pre-test scores for the interpretation of normal ECG among immersion and traditional groups were 9.8(SD8.4) and 8.3(SD7.5), respectively, and post-test scores for the acquisition of knowledge were 24.3(SD5.5) and 24.8(SD6.3), respectively. The post-test scores for retention skills were 25.3(SD5.6) and 20.7 (SD6.9) respectively (p<0.001).The mean pre-test scores for the interpretation of abnormal ECG of both groups were 7.0(SD6) and 8.3 (SD6.6), respectively. Mean post-test scores for acquiring knowledge to interpret abnormal ECG were 23.5(SD6.2) and 17.7 (SD9), respectively(p<0.001), and mean post-test scores for retention of interpretation skillsof abnormal ECG were 19.2 (SD - 6.9) and 13.3 (SD10.2) respectively (p=0.001). The pairwise comparison of the immersion group indicates that all the combinations that changed in score from the pre to post-intervention time points, from pre-to-retention time, and from the post-to-retention time were significant (p<0.001). Conclusion Virtual reality teaching had a better impact on acquiring and retaining the skill for interpreting normal and abnormal electrocardiograms.

Models and sufficiency interpretation for estimating critical soil test values for the Fertilizer Recommendation Support Tool

AbstractSoil test correlation determines whether a soil test can be used to predict the need for fertilization based on the critical soil test value (CSTV). Our objectives were to compare the CSTV estimated from five combinations of correlation models and yield sufficiency interpretations and to select one method for soil test correlation performed with the Fertilizer Recommendation Support Tool (FRST). Four models were fit to three datasets with strong (Mehlich‐1 K), moderate (Mehlich‐3 K), or weak (Olsen P) correlations between soil test P or K and crop relative yield. We tested the arcsine‐log calibration curve (ALCC), exponential (EXP), linear plateau (LP), and quadratic plateau (QP) models. The CSTV was defined as 95% of the maximum predicted yield for the ALCC and EXP methods, the join point for LP, and both the join point and 95% of the maximum for the QP providing five CSTV predictions. The five CSTVs ranged from 46 to 66 mg kg−1 for the Mehlich‐1 K dataset, 115 to 165 mg kg−1 for the Mehlich‐3 K dataset, and 7 to 16 mg kg−1 for the Olsen P dataset. Ten pairwise comparisons showed the estimated CSTV was numerically and sometimes statistically influenced by the model and sufficiency level interpretation. Despite differences among CSTVs, the frequency of significant yield responses above and below the predicted CSTV was generally comparable among the methods, with false‐negative errors occurring at 0%–18% of sites for a given dataset. The QP model with a CSTV at 95% of the predicted maximum was selected as the modeling approach for FRST.