Pairwise Tests Research Articles

Effect of crystallization temperature on the flexural strength of lithium disilicate glass ceramics.

This pilot study aimed to compare the flexural strength of Amber Mill CAD to IPS e.max CAD and to determine the impact of different crystallization protocols on the flexural strength of Amber Mill CAD ceramics. Amber Mill CAD ceramic blocks of a known Vita Classic shade were selected for testing against control IPS e.max CAD blocks of the same shade. Four different translucencies were selected for Amber Mill CAD blocks: high translucency (HT), medium translucency (MT), low translucency (LT), and medium opacity (MO). Two different translucencies were selected for IPS e.max CAD blocks: HT and LT. The partially crystallized blocks were sectioned and placed into six groups for each temperature protocol for a total of 36 samples for Amber Mill CAD and 18 samples for IPS e.max CAD. The samples were sectioned at a thickness of 1.5mm to simulate the material thickness recommended by the manufacturer for posterior lithium disilicate (LD) crowns. Four crystallization protocols, as recommended by the manufacturer, were used with Amber Mill CAD blocks, and one crystallization protocol was used with IPS e.max CAD blocks. The samples from each group were subjected to 3-point bending test. A two-way analysis of variance (ANOVA) and Tukey pairwise comparison tests were used for statistical analysis and interpretation of collected data. The mean averages of maximum flexural strength for Amber Mill CAD samples were 269.54MPa, 280.10MPa, 277.55MPa, and 254.16MPa for HT, MT, LT, and MO, respectively. The mean averages of maximum flexural strength for the IPS e.max CAD samples were 302.99MPa and 283.49MPa for HT and LT, respectively. No significant differences in the mean average flexural strength were found between the Amber Mill CAD and IPS e.max CAD blocks (p>0.05). Further, there were no statistical differences in flexural strength between the four crystallization protocols of Amber Mill CAD (p>0.05). Amber Mill CAD shows similar flexural strength to IPS e.max CAD. Further, altering crystallization protocols of the same shade to obtain different translucencies did not affect the flexural strength of Amber Mill CAD.

DIGITAL THERAPEUTIC COMBINING HYPNOSIS AND DIAPHRAGMATIC BREATHING INTERVENTION FOR FUNCTIONAL ABDOMINAL BLOATING (FAB): A FEASIBILITY STUDY.

Abdominal bloating is a difficult symptom to treat. Hypnotherapy and diaphragmatic intervention have separately shown benefit on bloating in prior work but have not been united into a single intervention. We aimed to obtain data on the potential therapeutic impact of a novel audio-recorded bloating treatment for bloating integrating hypnosis and diaphragmatic breathing, with proposed synergistic effect. Patients with non-organic bowel disorders with predominant bloating symptoms completed a digitally delivered seven-session audio-recorded hypnotherapy program without clinician involvement. The intervention combined bloating-targeted hypnotic suggestions and guided diaphragmatic breathing delivered under hypnosis, supplemented with interval self-guided breathing exercises. Participants completed online REDCap assessments at baseline, mid-treatment, at end-of-treatment and at 3-month follow-up, evaluating symptom severity, GI symptom specific anxiety, overall anxiety/depression, and quality of life. Outcomes were assessed in an intention-to-treat manner with repeated measures ANOVAs with Bonferroni-adjusted pairwise post-hoc tests. Of 23 patients who started treatment, 22 (95.6%) completed follow-up. Bloating severity on IBS-SSS and PAGI-SYM showed reduction in bloating with large effect sizes (Cohen's d of ∼0.8) at the end of treatment, as did VSI bloating-related anxiety. At end of treatment, 16 patients (69.6 %) were IBS-SSS treatment responders (>30% symptom reduction) on bloating, and 17 (73.9%) on overall bowel symptom severity. Anxiety, depression, and quality of life scores were unchanged. Outcome measures were fully maintained at 3-month follow-up. Results suggest the therapeutic utility of a new cost-effective self-administered bloating intervention. A randomized controlled trial is planned to confirm these therapeutic effects.

Accuracy of Established Prognostic Staging Systems for Cardiac Transthyretin Amyloidosis in the Tafamidis Era.

Biomarker-based prognostic staging systems, including the National Amyloidosis Centre (NAC) and the Mayo staging systems, are widely-used but have only been validated for treatment-naive patients with cardiac transthyretin amyloidosis (ATTR-CA). The purpose of this study was to assess the accuracy of the NAC and Mayo staging systems in patients with ATTR-CA treated with tafamidis. A retrospective observational study following patients with ATTR-CA from initiation of tafamidis (baseline) to time of all-cause death was conducted. Patients were stratified according to the NAC and an adapted Mayo staging system incorporating high-sensitivity cardiac troponin T. Agreement was assessed using weighted Cohen's kappa. The staging systems' ability to identify subgroups with distinct overall survival was assessed using Kaplan-Meier analyses and pairwise log-rank tests. A total of 251 patients with wild-type ATTR-CA treated with tafamidis were followed for a median of 521 (IQR: 262-842) days. There was substantial agreement (weighted kappa=0.661; P<0.001) between the NAC and the adapted Mayo staging system. Significant differences in estimated overall survival were observed across all disease stages of the adapted Mayo staging system (I vs II: P=0.032; I vs III: P<0.001; II vs III: P=0.036). Accordingly, estimated overall survival was significantly lower in NAC III compared to NAC I (P<0.001) and NAC II (P=0.015). However, there was no significant difference between NAC I and NAC II (P=0.340). Both staging systems identified a distinct group of patients with ATTR-CA at the highest risk of death but only the adapted Mayo staging system could accurately distinguish between low- and intermediate-risk patients in the setting of disease-modifying treatment with tafamidis.

Morphological and phylogenetic analyses reveal two new species of the Fusariumfujikuroi (Hypocreales, Nectriaceae) species complex in China.

The Fusariumfujikuroi species complex (FFSC) encompasses a diverse array of more than 80 phylogenetic species with both phytopathological and clinical importance. A stable taxonomy is crucial for species in the FFSC due to their economical relevance. Fungal strains used in this study were obtained from Castaneamollissima and Rubuslambertianus, collected from Beijing and Shaanxi Province. We employ morphological and phylogenetic analyses based on partial gene fragments of the translation elongation factor 1-alpha (tef1), beta-tubulin (tub2), calmodulin (CaM), RNA polymerase largest subunit (rpb1), and RNA polymerase II second largest subunit (rpb2), as well as the pairwise homoplasy index tests. Studies have shown that these phylospecies are clustered in the Asian clade of the FFSC. The present study delineates two novel Fusarium species within the FFSC, named F.castaneophilum and F.rubicola, complemented by illustrations and descriptions.

Evaluating the impact of severe hypoglycaemia definition wording on severe hypoglycaemia history assessment.

Several wordings of the definition of severe hypoglycaemia (SH) exist. This study aims to evaluate how different SH definition wordings affect SH history assessment. In this cross-sectional study, surveys were emailed to registrants of the T1D Exchange, a U.S. national type 1 diabetes patient registry. Participants' demographic information was collected. Six-month SH history was evaluated with questionnaires including SH definition wordings from either (1) professional societies, (2) a diabetes community website, or (3) a hypoglycaemia research questionnaire. Analyses included the McNemar test, pairwise Wilcoxon signed-rank test, logistic regression analysis, Kappa statistics, and Spearman correlation. A total of 1580 valid responses were obtained from participants (52% female; mean ± SD age: 46 ± 15 years; 95% White; mean ± SD diabetes duration: 25 ± 16 years). Questionnaires with four different SH definition wordings yielded significant variations in the prevalence of SH (i.e., having developed at least one episode of SH) and the number of SH episodes: the ADA/ENDO 2013 definition wording yielded the highest results on both metrics, whereas HypoA-Q and ADA 2023 yielded the lowest. Among participants reporting at least one SH episode, the number of episodes identified with the different SH definition wordings was poorly correlated (Rs: 0.09-0.37; p < 0.001). Race, education level, and household income were associated with higher odds of discrepancies in SH history (p < 0.05). This U.S. national survey with individuals living with type 1 diabetes demonstrated significant discrepancies in SH history when assessed with different SH definition wordings. Race and socioeconomic status were associated with these discrepancies.

Comparing analog and 3D measurements of vertical dimension in edentulous subjects.

This study aimed to explore the feasibility and reliability of measuring the vertical dimension of occlusion/rest (OVD/RVD) on 3D facial scans of edentulous patients. Nineteen edentulous participants rehabilitated with complete removable dental prostheses (CDs) participated in this study. Analog measurements (control) were obtained directly on the face for each participant with the jaws positioned at the rest position (without CDs, RVD) and at central occlusion (OVD), between the facial landmarks: Glabella (G) and Soft Pogonion (SP), Pronasale (PN) and SP, and Subnasale (SN) and SP. Participants' faces were scanned twice, using a face-scanner (Class 1 LASER, Obiscanner). Scans were imported into a mesh-processing software, and the OVD/RVD were measured digitally. Two investigators performed all the measurements and were blinded. Data analysis included intra-class correlation coefficient (ICC) and pairwise comparison tests (p<0.05). Digital measurements were higher than analog measurements, and the mean paired difference ranged from -4.86±3.2 to 0.42±2.7 mm. All the differences were statistically significant, expect for SN-SP (p=0.110). Magnitude of the differences for the RVD were large for G-SP and SN-SP (ES>0.80) and moderate for PN-SP (ES>0.50). There was a large effect for G-SP when measuring OVD (ES>0.50), and small effect for PN-SP and SN-SP (ES≤0.20). Considering the limitations associated with the specific type of facial scanner used in this study, it can be concluded that registering the resting vertical dimension in edentulous patients through digital methods may not be recommended. This is due to the potential errors that may arise during the data acquisition process, which could compromise the accuracy and reliability of the measurements. Digital methods for registering the vertical dimension of rest (RVD) in edentulous patients can introduce errors, resulting in occlusal errors and discomfort. Clinicians must, for the moment, still use conventional analog methods to ensure accurate RVD measurement for a successful denture therapy.

Influence of edentulous areas on the accuracy of the maximum intercuspal position recorded by using different intraoral scanners or an artificial intelligence-based program.

Intraoral scans can be articulated in maximum intercuspal position (MIP) by using an artificial intelligence (AI) based program; however, the impact of edentulous areas on the accuracy of the MIP located using this AI-based program is unknown. The purpose of this in vitro study was to assess the impact of edentulous areas (0, 1, 2, 3, and 4 posterior mandibular teeth) on the accuracy of the MIP located using 3 intraoral scanners (IOSs) and an AI-based program. Stone casts articulated in MIP in an articulator were digitized (T710). Five groups were created: no edentulous area (Group 0) or edentulous area of 1 (Group 1), 2 (Group 2), 3 (Group 3), or 4 (Group 4) posterior mandibular teeth. A maxillary and mandibular scan were obtained from the reference casts with 3 IOSs: Primescan, Aoralscan3, and i700. The nonarticulated scans were duplicated 20 times. Six subgroups were created based on the program used to locate the MIP: 3 IOS subgroups: PrimeScan, AoralScan3, and i700 and 3 subgroups for the AI-based program (Bitefinder) (Primescan-AI-articulated, Aoralscan3-AI articulated, and i700-AI articulated) (n=10). In the Group 0-Primescan subgroup, the 10 duplicated corresponding scans were articulated by recording a bilateral occlusal record. In the Group 0-Primescan-AI articulated subgroup, the 10 duplicated corresponding scans were automatically articulated in MIP by the AI-based program. In the Group 0-Aoralscan3 and Group 0-i700 subgroups, the same procedures were completed as in the Group 0-Primescan. In the Group 0-Aoralscan3-AI articulated and Group 0-i700-AI articulated subgroups, the same procedures were accomplished as in the Group 0- Primescan-AI articulated. For the data acquisition of Groups 1, 2, 3, and 4, the right mandibular posterior teeth were removed sequentially. The same procedures were completed as in Group 0. A program (Geomagic Wrap) was selected to compute interlandmark measurements on the digitized articulated casts (control) and each articulated specimen. Two-way ANOVA and pairwise multiple comparison Tukey tests were used to analyze trueness (α=.05). The Levene and pairwise multiple comparison Wilcoxon rank tests were used to analyze precision (α=.05). Trueness and precision discrepancies were found between the groups (P<.001) and subgroups (P<.001), with a significant interaction group×subgroup (P<.001). Groups 0, 1, and 2 obtained the best trueness and precision, while Group 4 demonstrated the worst trueness and precision. Primescan and Aoralscan3 obtained better trueness than the i700. The AI-based program obtained lower MIP trueness and precision when compared with the IOSs tested. The AI-based program revealed the best MIP accuracy when articulating scans recorded by using the i700 and the worst with the Aoralscan3. Edentulous areas impacted the trueness and precision of the MIP recorded by using the IOSs or AI-based program tested. Edentulous spaces involving 1 or 2 posterior teeth did not impact the MIP accuracy. An edentulous space of 4 teeth revealed the worst accuracy values captured by using the IOSs assessed or AI-based program. The performance of the AI-based program was influenced by the IOS system used to record the nonarticulated digital scans.

Socioeconomic Disparities in Exposures to PFAS and Other Unregulated Industrial Drinking Water Contaminants in US Public Water Systems.

Unregulated contaminants in drinking water, such as per- and polyfluoroalkyl substances (PFAS), can contribute to cumulative health risks, particularly in overburdened and less-advantaged communities. To our knowledge, there has been no nationwide assessment of socioeconomic disparities in exposures to unregulated contaminants in drinking water. The goals of this study were to identify determinants of unregulated contaminant detection among US public water systems (PWSs) and evaluate disparities related to race, ethnicity, and socioeconomic status. We gathered data from the US Environmental Protection Agency's (US EPA's) Third Unregulated Contaminant Monitoring Rule (2013-2015), PWS characteristics, sociodemographic data, and suspected pollution sources from regulatory databases. We included four target contaminants (or classes) with industrial sources: PFAS, 1,4-dioxane, 1,1-dichloroethane, and chlorodifluoromethane (HCFC-22). Associations were evaluated with pairwise comparison tests and generalized logistic mixed-effects regression models for six dichotomous outcomes: detection of each of four target contaminants, detection of target contaminant, and PWS exceedance of US EPA health reference level that was in effect in 2017. More than 97 million US residents were served by a PWS with detectable levels of 1,4-dioxane (22% of PWSs), HCFC-22 (5.8%), 1,1-dichloroethane (4.7%), and/or PFAS (4.0%). Unregulated contaminant detection was more frequent among large systems, urban systems, and systems using groundwater or a combination of groundwater and surface water. In comparison with PWSs with no detectable levels of these unregulated contaminants, PWSs with detectable levels served counties with higher proportions of Hispanic residents (17% vs. 13%), as did PWSs that exceeded EPA health reference levels in comparison with PWSs with no exceedances (18% vs. 14%). There were persistent positive associations between proportions of Hispanic residents and detections of target contaminants, even after accounting for pollution sources. Previously, inequities in exposures to drinking water contaminants were underestimated because prior studies have focused on regulated contaminants. PWSs serving counties with more Hispanic residents, non-Hispanic Black residents, and urban households may benefit from additional resources to proactively mitigate unregulated chemical contamination. Future studies should evaluate factors underlying these disparities to promote actions that protect water quality for all residents. https://doi.org/10.1289/EHP14721.

An interprofessional model to improve LGBTQ+ specific cultural competence in dental and pharmacy students.

Disproportionate access to healthcare services among the Lesbian, Gay, Bisexual, Transgender, Queer or Questioning and others (LGBTQ+) population can be partially attributed to the lack of cultural competence among healthcare providers. The aim of this study was to evaluate the impact of an interprofessional model in improving cultural competence and clinical preparedness among dental and pharmacy students for providing LGBTQ+ specific care. This study is a retrospective observational study which used a novel interprofessional model of three different LGBTQ+ focused educational interventions within a group of dental and pharmacy students. The study used pre- and post-surveys, Assessment of Interprofessional Team Collaboration Scale (AITCS-II) and the Team Observed Structured Clinical Encounter (TOSCE) evaluations to assess the effectiveness of the interventions. Descriptive statistics, Fisher's exact test, Wilcoxon signed-rank test, Welch test, Kruskal-Wallis Test, and pairwise Wilcox Test were employed to analyze quantitative data while qualitative insights were gathered from evaluator comments and student feedback. The study evaluated cultural competence among 154 dental and pharmacy students revealing improved cultural humility post-intervention, particularly for dental students although not statistically significant (p>0.05). Students participating in multiple interventions had higher mean scores, but the differences were not significant (p>0.05). Significant differences were found among interprofessional teams of students in the domains of roles and responsibilities (p = 0.039) and patient centered approach (p = 0.039). No significant differences were found in individual scores participation in the teams (p = 0.018). Students also provided positive feedback on the program's impact on their understanding of LGBTQ+ health issues and inclusive care. This program was a novel intervention aimed at improving cultural competence for health professional students in an interprofessional environment Further research in the direction can be useful in creating replicable programs.

The financial crisis, economic development and business management in Pakistan: An Evidence through time-series data analysis in Pakistan

The aim of this research work is to analyze the causal linkage among Pakistan's economic development and the three main financial crisis indicators—interest rates, inflation, and the amount of foreign debt. Additionally, this analysis emphasizes how consistently financial crisis indicators and economic growth. The analysis makes use of sample size covering data from 2000 to 2024. The convergence of equilibrium for series utilized in the work is examined using Johansen's co-integration test. The findings show that the three elements of Pakistan's financial crisis and economic growth have overall causal relationship. The business, economic and each financial crisis indicator taken into consideration in this study have a bidirectional causal relationship, according to estimations based on the pair-wise Granger Causality test. Whereas, the management of economy is determined on the economic and business parameters as analyzed on data which provides a sometimes unidirectional or bidirectional indication for solution of economic crisis and way for economic development

Evaluation and Comparison of the Comprehensiveness of Canadian and American Ophthalmology Residency Program Websites

ABSTRACT Purpose We descriptively and comparatively evaluated the comprehensiveness of Canadian and US-accredited ophthalmology residency program websites as of August 28, 2024. Methods Using Canadian Resident Matching Service (n = 15) and US Fellowship and Residency Electronic Interactive Database (n = 125), we assessed website content across seven criteria: recruitment, faculty, residents, education/research, teaching, benefits, and community. Two independent reviewers used a 40-point system, with Kruskal-Wallis and post-hoc pairwise tests for analysis by country and funding model. Results US programs more frequently had highly comprehensive websites than Canadian programs (US: 74.4%, Canada: 40%). Canadian programs mostly achieved moderate comprehensiveness (Canada: 60%, US: 22.4%). Larger program size and US origin were significantly linked to higher comprehensiveness scores (p < .01). Conclusion Our findings suggest that US-based, larger programs offer more extensive online resources. We recommend standardized guidelines to improve residency program website transparency and accessibility for medical learners.

Life expectancy and health care spending in South Asia: An econometric analysis

Affordable health care is often a result of increased government spending on the health sector. Out-of-pocket expenses remain the primary health care funding source in many South Asian nations. Lack of adequate public funding for health services, difficulty in obtaining health insurance, and high out-of-pocket costs can result in indebtedness, reductions in actual consumption, and decreased access to health care services. The study examines life expectancy and health care spending in South Asian countries. The life expectancy of South Asian countries is studied as a health outcome in relation to health care spending, gross national income per capita, and expected years of schooling. This study is based on secondary data from World Bank statistics that covers eight South Asian countries from 2000 to 2021, for a total of 176 pooled time series and cross-sectional observations. The data were analysed using econometric models, including the cross sectional dependency test, panel unit root test, panel co-integration test, vector error correction model, pair-wise Granger causality test, and Wald test statistics. The vector error correction model results indicate that health care spending, anticipated years of schooling, and gross national income per capita have a long-run association with health outcomes. Health care spending, per capita gross national income, and expected years of education have all greatly enhanced life expectancy in South Asian countries. An effective health strategy is necessary to increase people’s healthy life expectancy and well-being. To accomplish this, government may need to promote school enrolment to help people become more health literate and aware of their health outcomes. As a result, persons with more years of schooling have better health, higher levels of well-being, healthier habits, and ultimately, a longer life expectancy. This study will provide an important insight to policymakers in improving health outcomes through targeted and sustained health care spending in South Asia.

The Comparison of Accuracy of Post Space Digital Impressions Made by Three Different Intraoral Scanners: An In Vitro Study.

The present study aims to assess and compare the accuracy of post-space impressions captured by three different intraoral scanners (IOS) using various canal diameters. Three extracted natural maxillary central incisors were selected and prepared for a 1 mm wide margin and a 3 mm ferrule. All steps required for the endodontic procedure were performed, and the post space was prepared using post drills. The post length was kept constant at 12 mm, whereas the width was varied (Group 1: 1.4 mm, Group 2: 1.6 mm, and Group 3: 1.8 mm). Three IOSs (Trios3, iTero2, and Medit i700) were used to acquire a digital impression of the prepared post space. Each tooth was scanned 10 times by each scanner. So, in the end, 90 digital images were recorded, and the STL files were stored. GC Pattern resin was used to fabricate resin post and core patterns, which were scanned using an extraoral scanner (EOS). The STL file obtained was used as the reference file. To evaluate the trueness of the tested IOSs, each three-dimensional scan from an IOS was superimposed on the reference scan with the help of the Medit Design software 2.1.4. The software generates color plots and gives numerical values as deviations in the Root mean square (RMS) for the variance between the two superimposed scans. The data collected was tabulated for statistical analysis. One Way ANOVA was used to test the significance difference between three different IOSs, followed by Bonferroni Post-hoc test pairwise test to identify the differences between every two different IOS. Statistical significance was set at p < 0.05. The mean deviation for trueness in post space impression values recorded by the Medit i700 was highest among groups 1, 2, and 3 [0.825 (±0.071), 0.673 (±0.042) and 0.516 (±0.039), respectively], followed by iTero2 [0.738 (±0.081), 0.569 (±0.043) and 0.470 (±0.037), respectively] and Trios3 [0.714 (±0.062), 0.530 (±0.040) and 0.418 (±0.024), respectively]. Significant differences were found between the groups for all three IOSs (Trios3: p-value < 0.0001; iTero2: p-value < 0.0001; Medit i700: p-value < 0.0001). Within the limitations of this study, it can be concluded that Trios3 IOS has higher accuracy (as it exhibited minimal deviation for trueness) in recording post space, followed by iTero2 and Mediti700 IOS. As the diameter of the post space is increased, the accuracy of recording by IOS increases. For all the tested IOSs (except for Trios3 and iTero2, when used to record post space with 1.8 mm canal diameter), the deviations in trueness were higher than the clinically acceptable limits. Thus, IOSs should be used cautiously when recording impressions of post spaces.

Asymmetric effect of Oil Prices on Inflation in South Africa: An Econometric Approach

The surge in oil price levels remains a world-wide concern, more specifically to oil-importing countries such as South Africa. The dependence on crude oil from these net exporters makes the country vulnerable to external shocks, such as geopolitics. These effects have a pass-through effect to domestic headline inflation, induced by imported inflation. The general objective of the study is to investigate the asymmetric effect that the price of oil has on inflation in South Africa. To achieve these objectives, the study applied the Nonlinear Autoregressive Distributed Lags (NARDL), Error Correction Model (ECM), Pairwise Granger Causality, Impulse Response Function and Variance Decomposition. The bounds test of cointegration revealed that cointegration exists between the observed variables of the study. After estimating the error correction model, the study found that in the short-run, the relationship between a positive change in oil price and inflation is negative and significant. However, the relationship between a negative change in oil price and inflation in the short-run is now positive and significant. Therefore, the correction of disequilibrium will take place in the long run by means of short-run adjustments, with the speed of 1.71%. Pairwise Granger Causality test revealed that a unidirectional relationship occurs from oil prices to inflation. The Variance Decomposition results show that a shock to oil price accounts for a greater percentage of fluctuation in inflation. The Impulse Response Function reveals that within a 10-year period there is a positive response of inflation to oil prices, specifically from year three to year five. The study recommends the South African oil import diversification policy to source oil from multiple exporting countries to ensure steady supply and reduce dependence on any single source. This strategy improves security and reduces vulnerability to oil price shocks and supply disruptions caused by various factors.

Wear resistance of 3D printed, milled, and prefabricated methacrylate-based resin materials: An in vitro study.

Three-dimensional (3D) printing and milling technologies have been increasingly used in prosthodontic practice for fabricating digital prostheses. Nevertheless, evidence relating to the wear resistance of denture teeth fabricated using these methods is lacking. The purpose of this in vitro study was to compare the wear resistance exhibited by denture teeth fabricated using 3D printing and milling technologies with prefabricated denture teeth. Fifty specimens of resin denture teeth from 3 types of manufacturing processes were prepared and divided into 5 groups: 1 group of 3D printed denture teeth (NextDent C&B MFH), 2 groups of milled denture teeth (Ivotion Dent and VIPI Block), and 2 groups of prefabricated denture teeth (Major Dent and Cosmo HXL). Each group of specimens was occluded with a zirconia antagonist under a 49-N load with thermocycling conditions for 120 000 cycles. The antagonist was horizontally displaced back and forth at a 2-mm distance and a frequency of 1.6Hz. The quantification of the volume loss and the maximal wear depth of the worn specimens were recorded, while the wear characteristics were assessed with a scanning electron microscope (SEM). Data were analyzed using the Kruskal-Wallis test followed by pairwise comparison tests (α=.05). Significantly different wear depths and volume losses were found among groups (P<.05). The highest wear depth and volume loss were observed in the VIPI Block (0.513 ±0.147 mm and 3.094 ±0.790 mm³), followed by Cosmo HXL group (0.312 ±0.020 mm and 1.446 ±0.134 mm³), Major Dent (0.261 ±0.034 mm and 1.219 ±0.196 mm³), Ivotion Dent (0.253 ±0.021 mm and 1.082 ±0.089 mm³), and NextDent C&B MFH (0.208 ±0.059 mm and 0.843 ±0.372 mm³). Based on the analysis of the SEM images, distinct groups of specimens exhibited varying degrees of crack formation. Furthermore, their worn surfaces showed diverse characteristics in terms of wear patterns and roughness attributes. The manufacturing methods for fabricating 3D printed, milled, and prefabricated denture teeth exhibit comparable wear resistance, with 3D printed denture teeth demonstrating the highest level of wear resistance.

Psoriasis severity assessment: Optimizing diagnostic models with deep learning.

Psoriasis is a chronic skin condition with challenges in the accurate assessment of its severity due to subtle differences between severity levels. The aim of this study was to evaluate deep learning models for automated classification of psoriasis severity. A dataset containing 1,546 clinical images was subjected to pre-processing techniques, including cropping and applying noise reduction through median filtering. The dataset was categorized into four severity classes: none, mild, moderate, and severe, based on the Psoriasis Area and Severity Index (PASI). It was split into 1,082 images for training (70%) and 463 images for validation and testing (30%). Five modified deep convolutional neural networks (DCNN) were evaluated, including ResNet50, VGGNet19, MobileNetV3, MnasNet, and EfficientNetB0. The data were validated based on accuracy, precision, sensitivity, specificity, and F1-score, which were weighted to reflect class representation; Pairwise McNemar's test, Cochran's Q test, Cohen's Kappa, and Post-hoc test were performed on the model performance, where overall accuracy and balanced accuracy were determined. Findings revealed that among the five deep learning models, ResNet50 emerged as the optimum model with an accuracy of 92.50% (95%CI: 91.2-93.8%). The precision, sensitivity, specificity, and F1-score of this model were found to be 93.10%, 92.50%, 97.37%, and 92.68%, respectively. In conclusion, ResNet50 has the potential to provide consistent and objective assessments of psoriasis severity, which could aid dermatologists in timely diagnoses and treatment planning. Further clinical validation and model refinement remain required.

Preliminary study: Evaluating the reliability of cone-beam computed tomography images for upper airway volume in orthodontics

Objectives: The primary aim of this study was to evaluate the reliability of cone-beam computed tomography (CBCT) in measuring upper airway volume in orthodontics. The secondary aim was to compare the upper airway volumes between laypeople and military personnel (physically fit individuals). Material and Methods: This study included 36 male participants aged 21–29 years who had no upper airway pathology or history of upper airway surgery. CBCT scans had been previously obtained as part of routine dental checkups using a standardized protocol by the same operator. The digital imaging and communications in the medicine files of the subjects were imported into the 3D analysis software SimPlant® 17 Pro (Materialize Dental, Leuven, Belgium) to facilitate the measurement of upper airway volume. The upper airway volume was divided into three sections and measured on days 0 and 14 by the same operator. The intrarater intra-class correlation coefficient (ICC) and Bland-Altman plot were used to assess reliability. The upper airway volumes of the laypeople and military personnel were compared using Tukey’s pairwise test. Results: The variables demonstrated excellent reliability across all sections of the upper airway; the Superior part of the upper airway has an ICC of 0.993, the middle part of the upper airway has an ICC of 0.995, and the inferior part of the upper airway has an ICC of 0.989. The ICC for the entire upper airway was 0.987. The intrarater plot for superior airway measurement showed that 8 out of 8 measurements (100%) fell within the limits of agreement. Similarly, the intrarater plot for the middle airway measurements indicated that 8 out of 8 measurements (100%) fell within the limits of agreement. For inferior airway measurement, the intrarater plot revealed that 7 out of 8 measurements (87.5%) fell within the limits of agreement. No significant differences were found between the upper airway volumes of the laypeople and military personnel. Conclusion: Preliminary evidence suggests that CBCT using a standardized protocol is reliable for measuring upper airway volume. Separating the upper airway into three different parts also demonstrated high reliability and reproducibility among the raters. The ability to accurately measure the upper airway enhances the evaluation of the effects of orthodontic treatment by comparing the pre-and post-upper airway volume.

Pilot Study on the Relationship Between Different Lower Limb Raising Velocities and Trunk Muscle Contraction in Active Straight Leg Raise.

The active straight leg raise requires intricate coordination between the hip, knee, pelvis, and spine. Despite its complexity, limited research has explored the relationship between lower limb raising velocity and trunk muscle motor control during an active straight leg raise in healthy individuals. This study aimed to explore the potential effects of increased lower limb raising velocity on core muscle contractions during active straight leg raises. Six healthy adult men (mean age: 24.5 ± 2.5 years) participated in this study. Electromyography signals were recorded using surface electrodes placed on the rectus abdominis, external oblique, and internal oblique/transverse abdominis muscles. The participants performed active straight leg raises at three different velocities: 3 s, 2 s, and as fast as possible (max). The electromyography data were analyzed from 250 ms before to 1000 ms after movement initiation, with muscle activity expressed as a percentage of the maximal voluntary isometric contraction. Statistical analyses were conducted using non-parametric tests, including the Friedman test for overall differences, followed by pairwise Wilcoxon signed-rank tests with Bonferroni correction for multiple comparisons (p < 0.05). During the 250 ms before movement initiation, the internal oblique/transverse abdominis, external oblique, and rectus abdominis muscles showed greater activity in the max condition compared to the 3 s and 2 s conditions (Friedman test, p < 0.05), but no significant differences were found in pairwise comparisons (Wilcoxon test, p > 0.05). Similarly, during the 500 ms after movement initiation, internal oblique/transverse abdominis activity was higher in the max condition, with no significant pairwise differences observed. Faster lower limb raising velocities during active straight leg raise may enhance core stability by activating anticipatory and sustained internal oblique/transverse abdominis, external oblique, and rectus abdominis activity on the raised limb side. Training to promote this activation could improve dynamic stability in rapid or asymmetric movements.

An Assessment of Statistical Power for Analysis of Variance with Missing Data using Multiple Imputation

This study proposes a framework for statistical power assessment in the analysis of variance (ANOVA) models with missing data handled through multiple imputation. While existing literature has examined the power for t-tests with missing data, extending these techniques to ANOVA designs with multiple group means remains an open challenge. The methodology involves incorporating the variance component into an existing power model derived for a pairwise test, enabling explicit power estimation for two-factor, three-factor, and split-plot ANOVA designs with incomplete data. Empirical evaluations across varying effect sizes, missing data rates (8%, 16%, 40%), and numbers of imputations (20, 30, 40, 100) were conducted for both monotone and arbitrary patterns of missing data. The findings reveal that while power remains high at low missing data rates, it declines substantially with increasing missingness, particularly for higher proportions of missing data. Furthermore, arbitrary patterns of missing data exhibit slightly lower power compared to monotone patterns. The number of required imputations to achieve desired power levels depends on the missing data rate, with more imputations needed for higher proportions of missing data. This study provides a framework for power analysis in ANOVA models with missing data, addressing the critical need for reliable guidance in designing studies with incomplete data

Postmortem interval determination in excised porcine skin using a novel ultrasound-based elasticity measurement device.

Postmortem interval (PMI) estimation, a parameter critical for solving criminal cases, remains a challenge. It has been suggested that elasticity of decomposing tissue may show a relationship to PMI. We measured elasticity of excised porcine skin at regular intervals for 17 days using a novel ultrasound device. Kruskal-Wallis test followed by Dunn's pair-wise comparison test was performed on the elastic modulus values from each time-point. We found statistically significant differences (p < 0.0001) between the elastic modulus values. Pair-wise comparison showed that tissue measured with a PMI of 1-4, 6-9, 10-14, and 16-17 days can be distinguished from each other based on elastic modulus values. An overall trend of increasing elastic modulus values with time was also observed. Histology and H&E staining of skin samples at PMI of 1, 5, 8, and 12 days showed increasingly prominent fibre bundles which may explain the observed trend. The results of our study suggest that estimation of PMI using an ultrasound device is promising and should be explored further.