Post System Research Articles

Abstract 18762: Pacemaker Pocket Erosion - An Undesired Complication of Leuprolide Therapy

Introduction: Pacemaker pocket erosion is an uncommon delayed complication of the cardiac implantable electronic device (CIED) implantation that most frequently occurs in frail and elderly patients. We present a case of such a patient who developed pacemaker pocket erosion after being initiated on hormonal therapy for advanced prostate cancer. Case presentation: The patient is a ninety-three-year-old male with a history of persistent atrial fibrillation and dual chamber pacemaker in situ with last generator change two years prior presented with a two-week history of pacemaker wound dehiscence and exposed pacemaker. Six months earlier, the patient was diagnosed with advanced prostate cancer, was initiated on gonadotropin-releasing hormone agonist, leuprolide, and subsequently developed unintentional weight loss of 30 pounds. For two months prior to the current presentation, the patient noticed subjective discomfort at the site of the pacemaker pocket which he did not report to his cardiologist and eventually developed an erosive wound overlying the pacemaker pocket exposing the device (Image 1). He was admitted to the hospital and found to be hemodynamically stable, without leukocytosis and, negative blood cultures. Transthoracic and transesophageal echocardiograms showed no evidence of vegetation. He was empirically treated with daptomycin and was referred for pacing system extraction. He underwent pacing system replacement with leads and device extraction followed by leadless Micra VR (Medtronic, Minneapolis, MN) pacemaker implantation. Following a 4-week antibiotic course post pacemaker system extraction, the pacemaker pocket wound was fully healed. Conclusions: Aging and weight loss are known major risk factors for device-pocket erosion and externalization of the CIED. It highlights the importance of improving awareness of this entity and that initiation of hormonal therapy can be a contributing factor to such complications.

Transverse magnetic mode waveguide switches employing metal and negative index metamaterial loads

Abstract A compact optical switch concept based on moving a negative-index media (NIM) load is extended here to include waveguides carrying transverse magnetic (TM) modes. Many current metamaterial NIM implementations work with TM waves. Simulations show that with a current metamaterial NIM implementation switching is possible for TM modes. The simulated switch structure is based on an optical waveguide coupler made by a commercial foundry process. The NIM load is realized above the waveguides in a post foundry micro-electro mechanical systems (MEMS) layer. Metal loads are also shown to be suitable for switching TM modes. However, only NIM loads can in theory permit simultaneous switching of both transverse electric and TM modes.

CAD/CAM Customized Metal Post and Core with Digital Intraoral Impression: A Case Report

Background: Following endodontic treatment, it is crucial to utilize a suitable restorative technique to secure the coronal seal as well as shield remaining dental structure. When two or more walls of a tooth are lost, it becomes necessary to restore it with posts in order to enhance retention and stability of the final restoration. These posts can be categorized as either prefabricated or customized, and can be produced via the CAD-CAM. Purpose: The development of digital dentistry has been aimed at augmenting the accuracy of workflow and expediting the production process. The focus of this case report is the restoration of undamaged teeth that have undergone endodontic treatment. This was done with the assistance of a CAD-CAM post and core system that was milled through digital impression. Patients and Methods: For this particular case, the method employed involved utilizing an intraoral scan for the fabrication of a post and core restoration for inferior premolars that had undergone endodontic treatment. This approach was derived from in vitro experiments which validated the intraoral scanner's capacity to accurately discern post-space up to a depth of 12 mm with the assistance of the scan post. Results: The digital technique allows us to convert the concave surface of the root canal into the convex surface of the post, and realize an anatomical post and core that improves the biomechanics of the endodontically treated tooth reducing the possibility of root fractures. Conclusion: The use of an intraoral digital scanner represents an opportunity for the clinician as it speeds up the production of an anatomical post and core restorations.

The effect of different post systems having various sizes on the fracture resistance of endodontically treated teeth. An in vitro study

The effect of different post systems having various sizes on the fracture resistance of endodontically treated teeth. An in vitro study

Floor impact sound reduction and impact absorption performance of floor mat

In Korea, the post evaluation system of floor impact sound performance was implemented in August 2022. Therefore, it is necessary to check the floor impact sound performance after the completion of the apartment. If a floor impact sound performance does not meet the regulation limit, compensationm and follow-up renovations are required. In this study, in order to develop a floor mat that can reduce heavy weight floor impact sound, the floor impact sound reduction performance and impact absorption performance of each condition of the sample were confirmed. Floor impact sound reduction performance was measured using the test methods of KS F 2865 and ISO 10140-3, and impact absorption performance was measured according to the test method of JIS A 6519. As a result of the measurement, the performance of reducing floor impact sound showed a clear difference in performance according to thickness rather than material type. Impact absorption performance was found to be affected by surface hardness and material thickness. In conclusion, it is considered that the selection, thickness, and surface hardness of materials are important design factors when developing floor mats.

Evaluation of Retention and Fracture Strength of All Ceramic Crowns with Three Different Esthetic Cast Post-Core Systems.

This study investigates the fracture and retention strength of all-ceramic crowns with modified composite resin and ceramic cores compared to conventional casted post and core systems. A prepared human central tooth was initially scanned to design and 3D print the post and core. Subsequently, 40 bovine teeth were adjusted to accommodate the fabricated post and cores. They were then divided into four groups of 10 each: group 1 comprised cast cores without cover (control group), group 2 involved cast cores reduced and replaced with IPS Empress material (IPS group), group 3 consisted of cast cores covered with opaque composite (composite group), and group 4 included cast cores covered with opaque ceramic (ceramic group). Zirconia crowns were cemented onto all samples. After an aging process, pull-off and fracture strength tests were conducted. Fracture strength was determined by applying a compressive force at an angle of 135° to the tooth's longitudinal axis until the fracture occurred. For retention strength assessment, a universal testing machine with a 10 mm/min crosshead speed was employed. The resulting data underwent statistical analysis utilizing two-way analysis of variance (ANOVA) and Mann-Whitney U tests. The analysis revealed no significant difference in fracture strength among the groups (P-value = 0.997). However, the retention strength of the control and IPS groups was significantly higher than that of the other groups. There were no discernible distinctions among the three study methods regarding fracture strength. Nonetheless, the retention strength of the IPS group resembled that of the control group, surpassing that of the composite and ceramic groups.

Post-Endodontic Restorations Using Direct Fiber-Reinforced Composite Resins: A Case Report

Endodontically treated teeth always poses a challenge for dentists while reconstruction using the post and core system. This paper describes the clinical steps involved in reconstruction of maxillary anterior teeth. Endodontic treatment was performed first, followed by the placement of a fiber-reinforced resin post. The crown was then reconstructed with a composite restoration. Fiber posts have excellent properties, including elasticity, translucency, adaptability, tenacity, and resistance to traction and impact. They are also easy to apply, making them a viable alternative to traditional materials. The objectives of this article are to describe the various properties of fiber-reinforced composite resins with an exploration of their failure causes.

Development, optimization and in vitro-in vivo evaluation of solid lipid microparticles for improved pharmacokinetic profile of bisoprolol

The current research aimed at designing and optimizing controlled release solid lipid microparticles (SLMs) of Bisoprolol (BPL) from biocompatible waxes by using Box-Bhenken design (BBD) for improving the drug pharmacokinetics, enhancing compliance in hypertensive patients as well as eliminating inefficiencies of traditional methods of drug delivery. Seventeen formulations (F1 to F17) of controlled release BPL loaded SLMs were made by melt emulsification technique where Carnauba wax (CW) and Ceresin wax (CSW) were used as carriers and Tween 80 was used as stabilizer. The SLMs were characterized using fourier transforms infrared spectroscopy (FTIR), differential scanning calorimetry (DSC), and scanning electron microscopy (SEM). Results revealed that micromeritics properties of all SLMs were satisfactory and showed good percentage yield (PY) and entrapment efficiency (EE). The minimum EE was observed by formulation-1 (F1) as 21.66% whereas F3 has showed maximum EE as 88%. Results of in vitro release study revealed that all formulations showed a well-controlled release in simulated intestinal medium at pH 7.4. The formulation F3 with high wax concentration revealed best extended release characteristics (29%) in 12 h. The pharmacokinetics studies of SLMs demonstrated an expressively lower Cmax (maximum plasma concentration) of BPL (53.61 ± 2:52) with a satisfactorily higher time to achieve maximum plasma concentration (Tmax) of 10.24 h as compared to Cmax (79.63 ± 5.75) and Tmax (2.45 ± 3.83) of BPL released from commercial brands. Moreover the attainment of greater bioavailability of BPL was most probably due to the increase in half-life (20.44 ± 2.82), mean residence time (24.81 ± 4.22) and area under the plasma concentration level curve (AUC0–24) of 9688.6 ± 4.18 for BPL released from SLMs. Convincingly, the inventive technique could not only sustain the drug release in the in vitro and in vivo environment but also maintain the plasma drug concentration level constant for a longer time without elevating Cmax.

Mind the Gap: Gender Disparity in Online Learning Platform Interactions

Problem definition: Education technology innovations, such as massive open online course (MOOC) platforms, could potentially enable a more inclusive learning environment by delivering education to traditionally disadvantaged learners, like women. However, inclusivity does not necessarily translate into equal treatment on the platform. We investigate whether female and male learners benefit equally from forum discussions—typically the only form of interaction available—in online learning platforms. Methodology/results: Utilizing a large-scale, interaction-level data set on 174 courses on Coursera, we uncover an economically sizable and statistically significant disparity between male and female learners in receiving responses to their posts in MOOC discussion forums. On average, female learners’ questions are 3.11 percentage points less likely to receive responses from teaching staff than male learners’ questions, which equals 15.2% of the female group average. We also find significant gender disparity in staff response quality and sentiments. We investigate possible mechanisms behind the gender disparity using new techniques, including textual analysis tools. We show that the disparity is not because of content differences in male and female learners’ posts, nor is it attributable to their linguistic styles or the reputation of the posters. Instead, our results are most consistent with a male-driven gender homophily mechanism; although female staff members are gender neutral in their interactions with learners, male staff members systemically prefer responding to posts from male learners. We additionally show that receiving staff response leads to significant improvement in course passing rates, particularly for female learners. Therefore, the unequal access to information through course forums unfavorably hinders female learners’ performance. Managerial implications: Our results provide operational and organizational suggestions to platforms and content providers, including degendering user identifiers, implementing a content-focused post recommendation system, incorporating a gender-neutral user reputation system, promoting the recruiting of female teaching staff, and providing staff training that highlights the importance of gender-neutral interactions. Supplemental Material: The online appendix is available at https://doi.org/10.1287/msom.2022.0426 .

Fracture resistance and failure mode of endodontically treated premolars reconstructed by different preparation approaches: Cervical margin relocation and crown lengthening with complete and partial ferrule with three different post and core systems.

To assess the fracture resistance and failure mode of endodontically treated premolars reconstructed by different preparation approaches: cervical margin relocation (CMR) and crown lengthening (CL) with complete ferrule (CLF) and partial ferrule (CLPF) with three different post and core systems. In this in vitro study, 100 maxillary premolars were assigned to the following 10 groups according to their preparation approach and type of post and core system (n = 10): (I) control (intact teeth), (II) prefabricated fiber post (PFP) and composite core with CMR (PFP-CMR), (III) polyethylene fiber-reinforced composite (PEFRC) with CMR (PEFRC-CMR), (IV) casting post (CP) and core with CMR (CP-CMR), (V) PFP-CLPF, (VI) PEFRC-CLPF, (VII) CP-CLPF, (VIII) PFP-CLF, (IX) PEFRC-CLF, and (X) CP-CLF. After thermomechanical loading, the fracture resistance and failure mode were assessed. Data were analyzed statistically (α = 0.05). In all post and core systems, the CLPF approach had lower fracture resistance than CMR (p<0.05); CLF showed higher fracture resistance than CLPF only in the PFP system (p = 0.038). In PEFRC and CP systems, the difference between CLF and CLPF was not significant (p > 0.05). No significant difference was found in fracture resistance of different post and core systems with the same preparation approach (p > 0.05). CLPF showed the highest frequency of favorable, and CLF showed the highest frequency of unfavorable fractures. CLPF yielded lower fracture resistance than CMR. The difference in fracture resistance was not significant between CLF and CMR but the frequency of unfavorable fractures was higher in CLF than in other groups.

Evaluation of mechanical properties of different polyetheretherketone endodontic post systems: an in vitro study

BackgroundSurvival of endodontically treated teeth depends on an efficient restoration of the missing tooth structure.ObjectivesThis study aimed to investigate the mechanical properties of different endodontic post systems.Materials and methodsHuman permanent maxillary central incisors (no.=58) were decoronated and root-filled. The specimens with prepared root canals were randomly divided into Group P: Polyether Ether Ketone (PEEK) post and composite core and Group C: custom-made post-core of PEEK. The cementation of the posts was carried out using self-adhesive resin cement. Nano-hybrid composite resin was used for core fabrication. After cementation, the specimens from each group were randomly divided into two subgroups according to the types of tests utilized: 14 from each group were for the fracture strength test, which was restored with IPS e-max CAD crown, and 15 from each group for the pullout resistance test. A universal testing machine was used for the test performance.ResultsThe fracture resistance test showed that the values significantly differed among tested posts (P = 0.013). Group P showed the highest fracture resistance. Group C exhibited higher mean pullout resistance values than the other group (P) (P = 0.059). In the two-piece PEEK post and composite core, the predominant type of failure was a core fracture, while in the one-piece PEEK post-core, most types of failures were either in the crown or in the post.ConclusionsThe prefabricated posts are more resistant to fracture than the custom-made posts, with fracture and displacement mainly of the core. In contrast, both showed similar pullout resistance.

Extraction and determination of free glutathione and its disulfide in various flour samples using liquid chromatography and on-line post column derivatization

In the present report we propose an HPLC method coupled to on-line post column derivatization for the simultaneous determination of glutathione and its disulfide in flour samples. The extraction of the analytes from the sample matrix was investigated in terms of efficiency, stability and compatibility with the analytical method. The selection of o-phthalaldehyde at high alkaline medium as post column reaction system enabled the determination of both analytes in a single run at reasonable separation times (<10 min). Fluorimetric detection allowed determination at the low nmol g−1 (5–75 nmol g−1) levels in the absence of matrix interferences from endogenous compounds. The LOD values were 1.2–1.3 nmol g−1 and the precision better than 7.2% in all cases. Various commercially available flour samples (wheat, corn, rice) were analyzed and were found to contain glutathione and its disulfide in the ranges of 29–243 and 8–84 nmol g−1 respectively. Only in one rice flour sample the levels of GSH were < LOQ of the method.

Evaluation of the push-out bond strength of an adjustable fiberglass post system to an endodontically treated oval root canal.

To evaluate the push-out bond strength of the adjustable fiberglass post system to dentin. Twenty maxillary canine roots were endodontically treated and divided into two groups (n=10): conventional fiberglass posts (CFPs) and with single adjustable post (SAP) system. Two slices of each third were subjected to the push-out and failure pattern test and the most apical slice was subjected to analysis of the adhesive interface by scanning electron microscopy (SEM). Data were analyzed by the three-way analysis of variance, Tukey, and Friedman tests, and linear regression (α=0.05). The results showed higher push-out bond strength in the initial time interval for SAP (10.3±5.3, p<0.01). After 6 months, there was reduction in push-out bond strength for both (p<0.001). A higher percentage of adhesive and cohesive failures to dentin. After 6 months areas of maladaptation were noted (p=0.000). The SAP is completed to the promissory root canal in relation to alternative CFP.

Effect of degree of conversion on the surface properties of polymerized resin cements used for luting glass fiber posts

Statement of problemLack of conversion of resin cements for luting glass fiber posts in deeper levels of the root canal may compromise clinical performance. PurposeThe purpose of this in vitro study was to evaluate the effect of the degree of conversion on the surface properties of dual-polymerized resin cements used for cemented glass fiber posts according to the root level. Material and methodsFifty maxillary central incisor teeth were endodontically treated, and glass fiber posts were cemented using the following systems: self-adhesive dual-polymerized resin luting cement (RelyX U200) and dual-polymerizing flowable core and a post luting system (Rebilda DC) with a self-etching adhesive (Futurabond DC). The degree of conversion was determined via attenuated total reflectance and Fourier transform infrared spectroscopy, and surface microhardness and cement film thickness were measured. The intraradicular fit was evaluated with microscopy. All tests were performed in the coronal, middle, and apical third of the root canal. Statistical analysis was done with ANOVA and the multiple comparison Tukey test (α=.05). ResultsThe degree of conversion was higher in the coronal third using Rebilda DC (65.3 ±4.8%) than RelyX U200 (38.7 ±5.3%) (P<.05); on both resin cements, these values decreased from the coronal to the apical third (30.9 ±3.7%, 61.9 ±8.7%, respectively). The cement film thickness was higher for RelyX U200 in the 3 thirds than for Rebilda DC; significant differences (P<.05) were recorded in both cementing systems in the coronal and apical thirds. In the middle third, no significant differences were observed (P>.05). The mean surface microhardness values increased in the coronal thirds and decreased with increasing root canal depth. The marginal seal in the coronal thirds and the intraradicular fit in the middle thirds showed closer adaptation; however, some tags were observed in the interface resin cement and radicular dentin. Gap and tag formations were observed in the apical third. ConclusionsDepending on the root canal third, the surface properties of dual-polymerized resin cements are influenced by the degree of conversion.

FORMULATION A NATURAL COSMETIC SCRUB OF DURIAN HUSK (DURIO ZIBETHINUS MURR.) AND THE CHARACTERISTIC TESTS)

The high production of durian fruit gives an environmental problem if it is not used properly. Durian fruit skin contains flavonoids, phenolic compounds, saponins, and tannins which have antioxidant activity. Its antioxidant activity makes durian husk a candidate as a basic ingredient for natural cosmetics. Producing a formulation of scrub preparations as natural cosmetics based on the results of the characteristic test was the purpose in this research. Experimental research with a post-test design technique was carried out by making the changes of the concentration of durian husk as an active ingredient in the scrub preparations used in this study. The form of an oil-in-water cream scrub was used as the formulation in a change of concentration range of 1% (F1), 1.5% (F2), and 3% (F3) for each formula. Furthermore, the characteristic test was carried out which included organoleptic test, homogeneity test. pH test, viscosity test, spreadability test, and adhesion test. In this research also used statistica tests. The results showed that the best formulation is obtained from formulation 3 (F3) with a concentration of 3% durian rind. The characteristic test results include: stable organoleptic test for storage in terms of shape, color and odor; homogeneity test formed granules and there was no separation between the oil and water phases; Stable pH test according to skin pH at 5.05; spreadability test 7.3 cm; viscosity test 64 dPa.s; and 2.41 minutes of adhesion test. It pointed that all formulations fulfilled the requirements for topical scrubs in each characteristic test.

The effect of different ferrule heights and crown-to-root ratios on fracture resistance of endodontically-treated mandibular premolars restored with fiber post or cast metal post system: an in vitro study

BackgroundThis study aimed to investigate the effects of different ferrule heights and crown-to-root ratios on the fracture resistance of endodontically-treated premolars restored with fiber post or cast metal post system.MethodsEighty extracted human mandibular first premolars with single root canal were treated endodontically and cut from 2.0 mm above the buccal cemento-enamel junction, to create horizontal residual roots. The roots were randomly divided into two groups. The roots in group FP were restored with a fiber post-and-core system, while the roots in group MP were restored with a cast metal post-and-core system. Each group was divided into five subgroups with different ferrule heights (0: no ferrule; 1: 1.0 mm ferrule; 2: 2.0 mm ferrule; 3: 3.0 mm ferrule; 4: 4.0 mm ferrule). All specimens were subsequently restored with metal crowns and embedded in acrylic resin blocks. The crown-to-root ratios of the specimens were controlled at approximately 0.6, 0.8, 0.9, 1.1, and 1.3 of the five subgroups, respectively. Fracture strengths and fracture patterns of the specimens were tested and recorded by a universal mechanical machine.ResultsMean fracture strengths (mean ± standard deviation (kN)) of FP/0 to FP/4 and MP/0 to MP/4 were: 0.54 ± 0.09, 1.03 ± 0.11, 1.06 ± 0.17, 0.85 ± 0.11; 0.57 ± 0.10, 0.55 ± 0.09, 0.88 ± 0.13, 1.08 ± 0.17, 1.05 ± 0.18 and 0.49 ± 0.09, respectively. Two-way ANOVA revealed significant effects of different ferrule heights and crown-to-root ratios on the fracture resistance (P < 0.001), but no difference in fracture resistance between two post-and-core systems (P = 0.973). The highest fracture strengths of the specimen were found with the ferrule length of 1.92 mm in group FP and 2.07 mm in group MP, the crown-to-root ratio of which in 0.90 and 0.92 respectively., there is a significant difference in fracture patterns among the groups(P < 0.05).ConclusionsWhen a certain height of ferrule is prepared and a cast metal or fiber post-and-core system is restored for the residual root, the clinical crown-to-root ratio of the tooth after restoration should be kept within 0.90 to 0.92, so as to improve the fracture resistance of endodontically-treated mandibular first premolars.

Phase 1 trial evaluating TTI-101, a first-in-class, orally bioavailable, small molecule, inhibitor of STAT3, in patients with advanced solid tumors.

3018 Background: Signal transducer and activator of transcription 3 (STAT3) is a transcription factor at the critical intersection of signaling pathways controlling gene networks integral to the survival and immune sequestration of cancer cells. Given the integral role of STAT3 in tumorigenesis and immune suppression, STAT3 signaling inhibition may have dual antitumor activity. TTI-101 is a first-in-class, orally bioavailable, selective small molecule that binds to STAT3 and prevents STAT3-mediated transcriptional activation. A first-in-human, Phase 1, dose escalation and expansion study of TTI-101 monotherapy was conducted in patients with advanced/refractory solid tumors (NCT03195699). Methods: Patients with advanced metastatic cancer who had failed standard therapy were treated with TTI-101 twice daily in 28-day cycles at dose levels (DL) 1-4: 3.2 (DL1), 6.4 (DL2), 12.8 (DL3), and 25.6 (DL4) mg/kg/d (“3+3” design). Three different formulations of TTI-101 were used stepwise, beginning with formulation 1 (F1). A second-generation formulation (F2) was introduced at DL3 during dose escalation and patients were stratified into two cohorts: hepatocellular carcinoma (HCC) and other solid tumors. A third-generation formulation (F3) was evaluated once the recommended phase 2 dose (RP2D) was determined. Treatment continued until disease progression, unacceptable toxicity, or study withdrawal. Results: Key patient characteristics included a median age of 63 years (range, 33-78), 52% male, and a median number of 3 (range, 1-9) prior systemic therapies. No dose limiting toxicities (DLTs), or fatal treatment-related adverse events (TRAEs) were observed. Diarrhea was the only TRAE observed in ≥30% of the safety population (n=64) with events being mostly Grade 1/2. F3 was better tolerated than F1 and F2 with no events ≥Grade 3. One patient experienced transient Grade 4 hyperglycemia which resolved with insulin and metformin. Five patients had serious TRAEs (all Grade 3), which resolved. TTI-101 showed linear pharmacokinetics from DL1-3 plateauing at DL3. The RP2D was determined to be 12.8mg/kg/d (DL3) for both the HCC and other solid tumor cohorts. Of the 39 patients evaluable for response, 5 (13%) patients had confirmed partial responses (cPR) and 16 (41%) stable disease (SD). Of the 15 patients with HCC, 3 (20%) had a cPR with a median duration of 10.5 months. The other two cPRs were in ovarian cancer (n=1) and gastric cancer (n=1). Conclusions: TTI-101 was well-tolerated and no DLTs were noted. cPRs were observed across tumor types. The antitumor activity of TTI-101 monotherapy in the relapsed/refractory setting is promising, particularly in HCC. Two Phase 2 oncology studies of TTI-101 in STAT3-driven cancers (HCC and metastatic breast cancer) are underway. Clinical trial information: NCT03195699 .

Current status and future perspectives on the methods of prognosis evaluation for intrahepatic cholangiocarcinoma

Intrahepatic cholangiocarcinoma (ICC) is the second most common primary malignant tumor in the liver after hepatocellular carcinoma. Its incidence and mortality rates have increased worldwide in recent years. Surgical resection is the best treatment modality for ICC;however,the overall prognosis remains poor. Accurate evaluation of post operative prognosis allows personalized treatment and improved long-term outcomes of ICC. The American Joint Commission on Cancer TNM staging manual is the basis for the standardized diagnosis and treatment of ICC;however,the contents of stage T and stage N need to be improved. The nomogram model or scoring system established in the analysis of commonly used clinicopathological parameters can provide individualized prognostic evaluation and improve prediction accuracy;however,more studies are needed to validate the results before clinical use. Meanwhile,imaging features exhibit great potential to establish the post operative prognosis evaluation system for ICC. Molecular-based classification provides an accurate guarantee for prognostic assessment as well as selection of populations that are sensitive to targeted therapy or immunotherapy. Therefore,the establishment of a prognosis evaluation system,based on clinical and pathological characteristics and centered on the combination of multidisciplinary and multi-omics,will be conducive to improving the long-term outcomes of ICC after surgical resection in the context of big medical data.

The Influence of Finger Grip Relaxation on The Intensity of Perineal Wound Pain During Wound Treatment in Post Partum Mothers at Sundari Hospital

The delivery process often causes injuries and trauma to the uterine and vaginal areas. Especially those who do vaginal delivery. This wound can cause uncomfortable feelings and also quite severe pain when giving birth to pregnant women. And in order to reduce or overcome this pain, of course there are several ways that can be done to help pregnant women who are in labor so that pain can be overcome during labor. The purpose of this study was to find out and also obtain information and data on how the effect of holding finger relaxation can overcome and become the management of perineal wound pain in postpartum mothers for respondents or informants who control and deliver the process at the Sundari General Hospital. This study used pre and post test systems based on control of groups of respondents or informants in Sundari Public Hospital. In this study, there were 50 postpartum mothers who experienced perineal injuries. From this population the experimental group consisted of 25 people, while the control group also consisted of 25 respondents. For sampling using a purposive sampling technique where the research instrument will use an observation sheet with the NRS pain scale or Numerical Ra Scale as the data to be collected. The data collection will be analyzed using the Mann-Whitney system. And the effect of finger grip relaxation on perineal wound pain in postpartum mothers carried out at Sundari General Hospital can be an application process for mothers who are about to give birth to reduce pain.

Dental Fiber-Post Systems: An In-Depth Review of Their Evolution, Current Practice and Future Directions.

The field of dental medicine is constantly evolving and advancing toward minimally invasive techniques. Several studies have demonstrated that bonding to the tooth structure, particularly enamel, yields the most predictable results. In some instances, however, significant tooth loss, pulpal necrosis, or irreversible pulpitis may limit the options available to the restorative dentist. In these cases, placement of a post and core followed by a crown is the preferred treatment option, provided all requirements are met. This literature review provides an overview of the historical development of dental FRC post systems as well as a comprehensive examination of the currently available posts and their bonding requirements. In addition, it offers valuable insights for dental professionals seeking to understand the current state of the field and the prospects of dental FRC post systems.