Post Treatment Research Articles

498. LATROGENIC ESOPHAGEAL DISEASE POST OBESITY TREATMENT: SEVERE ESOPHAGEAL DILATATION RELATED TO ADJUSTABLE GASTRIC BANDING (AGB)

Abstract Iatrogenic Esophageal Disease post obesity treatment: severe esophageal dilatation related to adjustable gastric banding (AGB) Introduction Obesity is considered one of the biggest epidemics of the 21st century, which pushes us as health professionals to seek for solutions to this pathology. Within the medical-surgical approach, the most used techniques are gastric bypass, vertical gastrectomy and adjustable gastric banding (AGB). Even though they are frequently used, they are not free of complications. In this communication based on a case we would like to comment on the main complications of the use of the gastric band. These side effects has being between 0.5-5% to 20%: stoma stenosis, band slippage, intraluminal erosion, gastric volvulus and perforation. Clinical Case 54-year-old woman underwent surgery 20 years ago for obesity using a restrictive technique with adjustable gastric banding. The patient began 18 years later with retrosternal pain, epigastric pain, vomiting and dysphagia. Endoscopic tests revealed esophageal dilation with retention of food remains, tortuous and macerated mucosa; said achalasia was caused by a gastroesophageal stenosis. Among the diagnostic tests, an esophageal-gastric-duodenal barium transit was performed, showing a decrease in peristalsis with diffuse esophageal dilation of up to 7cm in diameter. Stenosis was observed in the lower esophageal third at the level of the esophagogastric junction of approximately 16 x 11 mm in longitudinal and transverse diameters. Evolution Surgical removal of the device is decided by a multidisciplinary team. Laparoscopic release of the gastric band was performed with electrocautery following adhesions around the device. Complete withdrawal upon release. Intraoperative endoscopy was performed, showing significant esophageal dilation with retained fermented food remains, mucous membrane affected by esophageal candidiasis. After the esophagogastric junction, a gastric fibrous ring was evidenced at the place of location of the gastric band, with good passage without evidence of gastric or esophageal lesions. Favorable postoperative evolution, being discharged 24 hours after surgery. After the case we observed the failure of the safety mechanism of the gastric band that regulates the internal diameter of the device due to the formation of a fibrotic constriction ring. Removal of the device improves the symptoms without requiring, in this case, section of the constriction ring. Currently, the patient shows improvement in her symptoms 6 months after the bariatric revision surgery.

363. REFLUX MICRO-ASPIRATION: WHAT HAVE WE LEARNED

Abstract Background The accurate diagnosis of gastro-oesophageal reflux pulmonary microaspiration has only become possible recently with the introduction of a novel technique of reflux micro-aspiration scintigraphy study combined with single photon emission computed tomography (SPECT) combined with x-ray tomography (CT) in a hybrid instrument. This has allowed the accurate diagnosis of pulmonary and airway contamination with refluxate. Previously only patients with large volume symptomatic reflux aspiration were diagnosed clinically (Mendelson syndrome) or by 2-dimentional barium meal or an older plantar (2 dimensional) technique of scintigraphic aspiration studies. The concept of reflux micro-aspiration has been implicated in multiple pulmonary diseases but without absolute proof from an adequate diagnostic test. Little was known about the natural history, physiology, and response to treatment amongst patients with silent reflux micro-aspiration. The aim of this presentation is to summarise a series of research projects studying the natural history of the disease, common presenting symptoms, pathophysiology and response to treatment. Methods A prospectively populated database of patients referred to a tertiary specialist reflux diagnostic service with atypical and/or treatment resistant reflux was evaluated. The database contained records of consecutive patients including demographic information, presenting symptoms, investigations including imaging, upper gastro-intestinal physiology studies and novel reflux micro-aspiration scintigraphy studies. Treatment details including medical and surgical treatment and post treatment clinical information and investigations. Multiple studies were conducted using the information from the database and findings are summarised in this presentation. Results The novel reflux micro-aspiration scintigraphy with SPECT/CT was compared with other studies (multichannel intraluminal impedance and 24-hour pH monitoring) and was found to be sensitive to reflux occurring outside the oesophagus. Patients with reflux micro-aspiration can present a wide variety of symptoms, commonly a combination of typical symptoms of gastro-oesophageal reflux disease (heartburn and regurgitation) and respiratory symptoms. Reflux micro-aspiration was associated with reduced lower oesophageal sphincter pressure, severe ineffective oesophageal motility (IOM), and pharyngeal contamination with refluxate on reflux scintigraphy. Delayed liquid gastric emptying was not associated with reflux micro-aspiration, however gastroparesis with solids is associated with micro-aspiration. Micro-aspiration was common in patients with giant hiatus hernias and mostly resolved with surgery. Anti-reflux surgery resulted in resolution of aspiration in the majority of patients, however severe IOM was associated with lesser rates of microaspiration resolution. Conclusion Reflux micro-aspiration appears to be a more common manifestation of GORD than previously thought. The work summarised in this presentation discusses the presentation, physiological associations, and treatment of patients with reflux micro-aspiration.

Efficacy Comparison of Low Level Laser Treatment with Muscle Energy Procedure Among Diabetic Patients Suffering from Frozen Shoulder

Frozen shoulder incidence in diabetic patient is twice as high as normal controls. There are various conventional as well as electrotherapies for its treatment within which low-level laser therapy versus muscle energy technique are well debated for efficacy in diabetic patients frozen shoulder. Objective: Comparative analysis of effectiveness of low-level laser therapy and muscle energy technique among diabetic patients with frozen shoulder. The study design was comparative study. The Place and Duration of Study was Department of Orthopaedic, Indus Medical College, Tando Muhammad Khan from 1st January 2023 to 30th June 2023. Methods: One hundred and twenty patients who were having diabetes mellitus (type 1 and type 2) and suffering from frozen shoulders were enrolled. The conventional therapeutic exercise included exercises like pendulum, arm overhead, finger wall ladder, twisting arm outwards, overhead pulley, cross-body reach exercises, hand behind-back exercise and outward rotation exercise. Muscle energy technique was administered in cases where restriction in shoulder flexion, as well as abduction, external rotation was observed. Results: There were 59% females and 41% males with majority being within the age group of 45-65 years. It was observed that there was a significant variance between pain scores at pretreatment and post treatment stages with highest value decrease observed in muscle energy technique group II. The ROM was least improved in control group only treated through conventional protocol. Conclusions: The Muscle energy technique is slightly more effective than low-level laser therapy technique in terms of pain, inflammation reduction and angular movements.

Global assessment of swallow function (GASF) following VMAT radiotherapy for head and neck squamous cell carcinoma

AimThis study aimed to conduct a global assessment of swallow function (GASF) using a range of swallow outcome tools, in a cohort of patients pre- and post-treatment with image-guided volumetric modulated arc therapy (VMAT) radiotherapy. Materials and methodsAll patients receiving radical (chemo)radiation for SCC of the larynx, oro-, hypo- or nasopharynx between October 2016 – 2021 were eligible for inclusion.Patients were treated with VMAT radiotherapy according to institutional and national protocols.Patients underwent GASF pre- and 6 months post-treatment. Data were collated from the MD Anderson Dysphagia Inventory (MDADI), the Functional Oral Intake Scale (FOIS), the Performance Status Scale-Head and Neck: Normalcy of Diet scale (PSS-NoD), the 100 ml water swallow test (WST) for capacity and maximal interincisal opening (MIO). ResultsOne hundred and seventy-five patients were included. 55.2 % of patients experienced a fall in MDADI-Composite score greater than the published meaningful clinical important difference (MCID).A trend for a decrease in FOIS score reflects a decrease in range of diet textures and increase in reliance on enteral feeding at 6 months post-treatment.Mean PSS-NoD score decreased reflecting increased restriction in diet textures.20 patients’ WST capacity improved by the minimal clinically important difference of > 4mls whilst 37 % of patients experienced a decrease in WST capacity of 4mls or more. 12.6 % of patients developed trismus following radiotherapy. ConclusionsThis paper adds new detail to the understanding of the decline in measured eating, drinking and swallowing function that patients treated with VMAT radiotherapyexperience at 6 months post treatment. However, gaps are highlighted in the evidence base in terms of interpretation of swallow outcomes tool scores; future research in HNC should include ongoing discussion and development around robust outcomes tools and data collection.

Hypoglycemic effects of organic extracts from Ganoderma sp. and Kombucha in streptozotocin-induced diabetic Wistar rats

Evaluate the hypoglycemic effects of Kombucha and Ganoderma aqueous extractsin a model of diabetes with streptozotocin. Eight-week-ol male wistar ratsweighimg approximately 180 g were randomized into four groups (12 rats eachgroup). Control group (C), streptozotocin (E) without treatment, Kombucha (K)was given Kombucha extract 324 mg/kg orally, and Ganoderma group (G) wasgiven 250 mg/kg orally both for 45 days. Four animals per group were sacrificedat 2-, 15- and 45-days post treatment. Consumption of water and food wereregistered. Blood glucose and insulin levels were measured by spectrophotometryand the islets of Langerhans in the pancreas were quantified by ELISA assay. Datawere analyzed with an ANOVA two-ways and Tukey’s test as post hoc, Sigmastat3.1 Software was used and 0.05% significance was considered. Among the mainresults found, both extracts presented hypoglycemic effects after 15 days oftreatment. An interaction between the number of islets, insulin synthesis, water,and food consumption were also found with the streptozotocin group thatpresented the lowest average number of islets compared to other groups. Bothextracts showed a hypoglycemic, protective and regenerative effect on thepancreas, with differences observed in the physical condition of the animalstreated with Ganoderma, which showed signs of cachexia.

The Effects of Different Treatment Methods on Blood Hematological Parameters İn COVID 19: A Retrospective Look at Patients in Pandemic İntensive Care Unit During The First Wave of the Pandemic

Introduction: In this study, we compared the pre- and post-treatment values of basic hematological parameters in severe COVID 19 patients, whose were received favipiravir, tocilizumab, methylprednisolone and convalescent plasma therapy. Methods: Hematological parameters such as eosinophyl, neutrophil, lymphocyte, platelet count and, neutrophil / lymphocyte, platelet/ lymphocyte ratio were investigated pre and post treatment of favipiravir, tocilizumab convalescent plasma and methylprednisolone in severe COVID 19 patients in ICU. Results: Lymphocyt values were increased after convelescent plasma theraphy and i.v. methyl prednisolon group. Eosinophil count improvement was only in the favipiravir group . We found that favipiravir, convalescent plasma andmethyl prednisolon treatment, were statistically significant increased both NLR and PLR. Conclusion : Hematologic parameters and their contribution of the respond of the treatment and clinical improvement should be taken into account.

Impact of occlusal stabilization splints on global body posture: a prospective clinical trial

ObjectivesBody posture of patients with temporomandibular disorders (TMD) has been investigated using different methods, whereas outcome and conclusions were controversial. The present clinical trial aimed to investigate the effects of splint therapy on global body posture.Materials and methods24 subjects (20 females, 4 males; age 24.2 ± 4.0 years) with TMD symptoms were examined clinically (RDC/TMD) and subsequently, splint fabrication was initiated. Along with routine therapy, all subjects underwent three-dimensional pre- and post-treatment full body scans in standing and upright sitting posture using a Vitus Smart XXL 3D scanner. Each scan was acquired in triplicate and evaluated in duplicate, measuring twelve standing and nine sitting postural parameters. Influencing factors were analyzed using analysis of variance (ANOVA), and additional Bland-Altman analyses verified the significance of the ANOVA results.ResultsThe increase of Forward Head angles and the decrease of Round Shoulders angles were consistent for both positions and sides. Forward Head angles were significantly influenced by limited mandibular mobility and myofascial pain. Round Shoulders angles showed a significant correlation with myofascial pain, joint noises and the absence of limited mandibular mobility.ConclusionThe influence of occlusal splints on global posture is limited and only small effects on cervicocranial parameters were found. In the present study, the average head position of post treatment measurements was more centered on the body’s core, whereas the shoulders were tilted more anteriorly.Clinical relevanceUnderstanding the limited influence of occlusal splints on cervicocranial parameters underscores the need for multimodal treatment strategies for TMD patients.

Family therapy and cognitive behavior therapy for eating disorders in children and adolescents in routine clinical care: a systematic review and meta-analysis.

Family therapy for eating disorders (ED) is well-established and represents the treatment choice for ED in children and adolescents according to guidelines, with cognitive behavior therapy (CBT) as a second line treatment. There is limited knowledge about how these treatments work in routine clinical care. The goal of the present meta-analysis is to investigate the effectiveness of family therapy and CBT for various EDs in children and adolescents when carried out in routine clinical care. Ovid MEDLINE, Embase OVID, and PsycINFO were searched for articles published until December 2023. The outcome of family therapy and CBT, methodological quality, risk of bias, and moderators of treatment outcome were examined and benchmarked by meta-analytically comparing with ED efficacy studies. Forty-four effectiveness studies comprising 3251 family therapy or CBT patients were included. Large to very large within-group effect sizes (ES) were found for ED-psychopathology (0.80) and weight measures for AN (1.64) at post treatment. The attrition rate was 15%. Risk of bias was considerable. Moderate to large ES were found for family therapy and CBT, respectively. The benchmarking analysis showed that effectiveness studies had comparable ESs to efficacy studies (0.80 and 0.84 for the ED-psychopathology at post treatment). The findings support family therapy and CBT for ED in children and adolescents as effective treatments when delivered in routine clinical care, with effects comparable with those found in efficacy studies. The evidence needs to be interpreted with caution because of the risk of bias in a high proportion of studies.PROSPERO [CRD42023441794].

Evaluation of sodium hyaluronate-based composite hydrogels for prevention of nasal adhesions.

During the healing process after intra-nasal surgery, the growth and repair of damaged tissues can result in the development of postoperative adhesions. Various techniques have been devised to minimize the occurrence of postoperative adhesions which include insertion of stents in the middle meatus, application of removable nasal packing, and utilizing biodegradable materials with antiadhesive properties. This study assesses the efficacy of two sodium hyaluronate (SH)-based freeze-dried hydrogel composites in preventing postoperative nasal adhesions, comparing them with commonly used biodegradable materials in nasal surgery. The freeze-dried hydrogels, sodium hyaluronate and collagen 1(SH-COL1) and sodium hyaluronate, carboxymethyl cellulose, and collagen 1 (SH-CMC-COL1), were evaluated for their ability to reduce bleeding time, promote wound healing, and minimize fibrous tissue formation. Results showed that SH-CMC-COL1 significantly reduced bleeding time compared to both biodegradable polyurethane foam and SH-COL1. Both SH-COL1 and SH-CMC-COL1 exhibited enhanced wound healing effects, as indicated by significantly greater wound size reduction after two weeks compared to the control. Histological analyses revealed significant differences in re-epithelialization and blood vessel count among all tested materials, suggesting variable initial wound tissue response. Although all treatment groups had more epithelial growth, with X-SCC having higher blood vessel count at 7 d post treatment, all treatment groups did not differ in all histomorphometric parameters by day 14. However, the long-term application of SH-COL1 demonstrated a notable advantage in reducing nasal adhesion formation compared to all other tested materials. This indicates the potential of SH-based hydrogels, particularly SH-COL1, in mitigating postoperative complications associated with nasal surgery. These findings underscore the versatility and efficacy of SH-based freeze-dried hydrogel composites for the management of short-term and long-term nasal bleeding with an anti-adhesion effect. Further research is warranted to optimize their clinical use, particularly in understanding the inflammatory factors influencing tissue adhesions and assessing material performance under conditions mimicking clinical settings. Such insights will be crucial for refining therapeutic approaches and optimizing biomaterial design, ultimately improving patient outcomes in nasal surgery.

Effect of exogenous melatonin on growth and antioxidant system of pumpkin seedlings under waterlogging stress.

Melatonin regulates defense responses in plants under environmental stress. This study aimed to explore the impact of exogenous melatonin on the phenotype and physiology of 'BM1' pumpkin seedlings subjected to waterlogging stress. Waterlogging stress was induced following foliar spraying of melatonin at various concentrations (CK, 0, 10, 100, 200, and 300 μmol·L-1). The growth parameters, malondialdehyde (MDA) content, antioxidant enzyme activity, osmoregulatory substance levels, and other physiological indicators were assessed to elucidate the physiological mechanisms underlying the role of exogenous melatonin in mitigating waterlogging stress in pumpkin seedlings. The results indicate that pumpkin seedlings exhibit waterlogging symptoms, such as leaf wilting, water loss, edge chlorosis, and fading, under waterlogging stress conditions. Various growth indicators of the seedlings, including plant height, stem diameter, root length, fresh and dry weight, and leaf chlorophyll content, were significantly reduced. Moreover, the MDA content in leaves and roots increased significantly, along with elevated activities of superoxide dismutase, catalase, peroxidase, and soluble protein contents. When different concentrations of melatonin were sprayed on the leaves post waterlogging stress treatment, pumpkin seedlings showed varying degrees of recovery, with the 100 μmol·L-1 treatment displaying the best growth status and plant morphological phenotypes. There were no significant differences compared to the control group. Seedling growth indicators, chlorophyll content, root activity, antioxidant enzyme activities, soluble protein content, and osmotic adjustment substance content all increased to varying degrees with increasing melatonin concentration, peaking at 100 μmol·L-1. Melatonin also reduced membrane damage caused by oxidative stress and alleviated osmotic imbalance. Exogenous melatonin enhanced the activities of antioxidant enzymes and systems involved in scavenging reactive oxygen species, with 100 μmol·L-1 as the optimal concentration. These findings underscore the crucial role of exogenous melatonin in alleviating waterlogging stress in pumpkins. The findings of this study offer a theoretical framework and technical assistance for cultivating waterlogging-resistant pumpkins in practical settings. Additionally, it establishes a theoretical groundwork for the molecular breeding of pumpkins with increased tolerance to waterlogging.

Comprehensive Review on Effectiveness of Single and Multiple Visit Regenerative Endodontics and Comparative Evaluation of Patient Reported Outcomes in Single Visit and Multiple Visit Regenerative Endodontics in Permanent Teeth: A Systematic Review and Meta-Analysis

This systematic review aimed to investigate the efficacy of single visit and multiple visit regenerative endodontics and compare the patient based clinical outcome of permanent teeth treated with single visit & multiple visit regenerative endodontic therapy. The protocol was registered with Prospero registration code CRD42024505225. A comprehensive search strategy was performed in different databases—PubMed, CENTRAL, ScienceDirect, CINAHL, ERIC and PsycINFO using searching keywords and was limited to studies published till January 2024 in English. The Inclusion criteria for the study were randomized clinical trial, prospective clinical studies, case Reports and case Series. The search found 20 eligible articles, which were included in the study. Risk of bias of clinical studies was conducted using ROBINS-I tool and JBL tool was used for quality assessment of case reports and case series included. The conclusions of our study concluded that in terms of clinical outcome both the approaches presented success of treatment with odds were greater with multiple visits as compared to single visit REP but statistically there was no difference between both the group. Radiographically outcome - In terms of root width diameter post treatment, single visit REPs were more successful as compared to multiple visits but statistical difference was not present. However, further research and emphasis should be given on undertaking more clinical trials regeneration in endodontics to provide proper results.

Anomalous temperature-dependent strength of copper alloy manufactured by laser-beam powder bed fusion

This study reports an anomalous temperature-dependent tensile behavior of laser-beam powder bed fusion (PBF-LB) processed Cu–Cr–Zr alloy. The yield strength of the alloy initially decreases as the temperature increases to 200±5 MPa and then increases to 350±11 MPa at 500°C before reducing to 234±6 MPa at 600°C. The microstructure consists of elongated Cu grains with a high concentration of Cr solute (∼1 mass%), resulting from rapid solidification during the PBF-LB process. Transmission electron microscopy for the specimens deformed at 500°C revealed the presence of numerous nanoscale Cr-rich particles embedded inside the supersaturated solid solution of the Cu matrix. Nanoscale particles can act as barriers to dislocation motion, leading to an increase in internal stress during plastic deformation at elevated temperatures. This work provides the high potential of post heat treatments for achieving superior mechanical performance using high solute supersaturation formed by the PBF-LB process.

Preparation of 2D AlxGa1-xN film via printing liquid metals

AlGaN film is a promising barrier layer widely used in high electron mobility transistor. Facile preparation of 2D AlGaN with high quality is still a challenge for traditional process. In this work, high quality 2D AlxGa1-xN (mixture of AlN and GaN) is synthesized by using liquid alloy printing technique and post nitriding treatment. The prepared 2D AlxGa1-xN shows good crystallinity and ultra-wide bandgap of 5.55 eV. Besides, the 2D AlxGa1-xN is a n-type semiconductor and can act as channel layer in field effect transistor. This novel process provides a facile way to obtain 2D AlxGa1-xN film, which will have a potential application in AlGaN/GaN heterostructure field effect transistors.

Gene and Protein Expression of MAGE and Associated Immune Landscape Elements in Non-Small-Cell Lung Carcinoma and Urothelial Carcinomas.

Melanoma-associated antigen-A (MAGE-A) is expressed in multiple cancers with restricted expression in normal tissue. We sought to assess the MAGE-A3/A6 expression profile as well as immune landscape in urothelial (UC) and non-small cell lung carcinoma (NSCLC). We also assessed co-expression of immune-associated markers, including programmed cell death ligand 1 (PD-L1) in tumor and/or immune cells, and assessed the effect of checkpoint inhibitor treatment on these markers in the context of urothelial carcinoma. We used formalin-fixed paraffin-embedded (FFPE) tissue sections from a variety of tumor types were screened by IHC for MAGE-A and PD-L1 expression. Gene expression analyses by RNA sequencing were performed on RNA extracted from serial tissue sections. UC tumor samples from patients treated with checkpoint inhibitors were assessed by IHC and NanoString gene expression analysis for MAGE-A and immune marker expression before and after treatment. Overall, 84 samples (57%) had any detectable MAGE-A expression. Detectable MAGE-A expression was present at similar frequencies in both tumor tissue types, with 41 (50%) NSCLC and 43 (64%) UC. MAGE-A expression was not significantly changed before and after checkpoint inhibitor therapy by both IHC and NanoString mRNA sequencing. Other immune markers were similarly unchanged post immune checkpoint inhibitor therapy. Stable expression of MAGE-A3/A6 pre and post checkpoint inhibitor treatment indicates that archival specimens harvested after checkpoint therapy are applicable to screening potential candidates for MAGE therapies.

WITHDRAWN: Study on relationships between α morphology and properties of TC11 alloy laser melting deposition parts after post heat treatment

WITHDRAWN: Study on relationships between α morphology and properties of TC11 alloy laser melting deposition parts after post heat treatment

Unlocking fast Li-ion transport in micrometer-sized Mn-based cation-disordered rocksalt cathodes

The development of cation-disordered rocksalt (DRX) cathodes has garnered worldwide attention due to their high capacity, broad chemical space and excellent structural flexibility. However, their low intrinsic Li-ion conductivity necessitates extensive particle pulverization, typically achieved through ball-milling process, which impedes large-scale production. In this work, we present a proton-exchange assisted strategy to activate the Li-ion transport in Mn-based DRX cathodes. Short-range spinel-like ordering is observed to form within the DRX matrix after the post treatment, which significantly enhances the intrinsic Li ion mobility. Notably, more than 280 mAh g−1 discharge capacity can be delivered at a slow rate from micrometer-sized particles with an overall disordered cation arrangement, which retains more than 150 mAh g−1 when cycled at a very high rate of 2000 mA g−1. Furthermore, we also demonstrate that the electrochemical performance of the post-treated cathodes can be further optimized by fine-tuning the reaction parameters.

Relationship between Texture, Hydrogen Content, Residual Stress and Corrosion Resistance of Electrodeposited Chromium Coating: Influence of Heat Treatment.

Electrodeposited chromium plating continues to be widely used in a number of specialized areas, such as weapons, transport, aerospace, etc. However, the formation of texture, hydrogen content and residual stress can degrade the serviceability and lead to material failure. The effect of post heat treatment processes on the relationship of texture, hydrogen content, residual stress and corrosion resistance of hexavalent [Cr(VI)] chromium coatings deposited on Cr-Ni-Mo-V steel substrates was investigated. Macrotexture was measured by XRD. Microtexture, dislocation density and grain size were studied by EBSD. With the increase of the heat treatment temperature, it was found that the fiber texture strength of the (222) plane tended to increase and subsequently decrease. Below 600 °C, the increase in the (222) plane texture carried a decrease in the hydrogen content, residual stress, microhardness and an increase in the corrosion resistance. In addition, crack density and texture strength were less affected by the heat treatment time. Notably, relatively fewer crack densities of 219/cm2, a lower corrosion current density of 1.798 × 10-6 A/dm2 and a higher microhardness of 865 HV were found under the preferred heat treatment temperature and time of 380 °C and 4 h, respectively. The hydrogen content and residual stress were 7.63 ppm and 61 MPa, with 86% and 75% reduction rates compared to the as-plated state, respectively. In conclusion, in our future judgement of the influence of heat treatment on coating properties, we can screen or determine to a certain extent whether the heat treatment process is reasonable or not by measuring only the macrotexture.

Clinical audit of an artificial intelligence (AI) empowered smile simulation system: a prospective clinical trial

Smile aesthetics is an important factor to consider during orthodontic treatment planning. The aim of the present study is to assess the predictability of Invisalign SmileView for digital AI smile simulation in comparison to actual smile treatment outcomes, using various smile assessment parameters. A total of 24 adult subjects (12 females and 12 males; mean age 22 ± 5.2 years) who chose to be treated using Invisalign were prospectively recruited to have their pretreatment smiles captured using the Invisalign SmileView to simulate their new smiles before treatment was started. Patients were then treated using upper and lower Invisalign aligners with average treatment time of 18 ± 6 months. Full post-treatment records were obtained and full smile frame images of simulated smile and actual final smile of each subject were evaluated by an independent examiner using an objective assessment sheet. Ten smile variants were used to assess the characteristics of the full smile images. Significance level was set at P < 0.05. The ICC for the quantitative parameters showed that there was an overall excellent & good internal consistency (alpha value > 0.7 & > 0.9). The Independent t test was performed amongst the quantitative variables. The P value was not significant for all except maxillary inter canine width (P = 0.05), stating that for the five variables namely; philtrum height, commissure height, smile width, buccal corridor and smile index, actual mean values were similar to the simulation mean values. For the qualitative variables, the Kappa value ranged between 0.66 and − 0.75 which showed a substantial level of agreement between the examiners. Additionally, the Chi square test for the qualitative variables, revealed that the P value was found to be significant in all except lip line. This implies that only the lip line values are comparable. More optimal lip lines, straighter smile arcs and more ideal tooth display were achieved in actual post treatment results in comparison to the initially predicted smiles. Five quantitative smile assessment parameters i.e., philtrum height, commissure height, smile width, buccal corridor, and smile index, could be used as reliable predictors of smile simulation. Maxillary inter canine width cannot be considered to be a reliable parameter for smile simulation prediction. A single qualitative parameter, namely the lip line, can be used as a reliable predictor for smile simulation. Three qualitative parameters i.e., most posterior tooth display, smile arc, and amount of lower incisor exposure cannot be considered as reliable parameters for smile prediction.Trial Registration number and date: NCT06123585, (09/11/2023)

Impact of NPSR1 gene variation on the neural correlates of phasic and sustained fear in spider phobia-an imaging genetics and independent replication approach.

The functional neuropeptide S receptor 1 (NPSR1) gene A/T variant (rs324981) is associated with fear processing. We investigated the impact of NPSR1 genotype on fear processing and on symptom reduction following treatment in individuals with spider phobia. A replication approach was applied [discovery sample: Münster (MS) nMS = 104; replication sample Würzburg (WZ) nWZ = 81]. Participants were genotyped for NPSR1 rs324981 [T-allele carriers (risk) versus AA homozygotes (no-risk)]. A sustained and phasic fear paradigm was applied during functional magnetic resonance imaging. A one-session virtual reality exposure treatment was conducted. Change of symptom severity from pre to post treatment and within session fear reduction were assessed. T-allele carriers in the discovery sample displayed lower anterior cingulate cortex (ACC) activation compared to AA homozygotes independent of condition. For sustained fear, this effect was replicated within a small cluster and medium effect size. No association with symptom reduction was found. Within-session fear reduction was negatively associated with ACC activation in T-allele carriers in the discovery sample. NPSR1 rs324981 genotype might be associated with fear processing in the ACC in spider phobia. Interpretation as potential risk-increasing function of the NPSR1 rs324981 T-allele via impaired top-down control of limbic structures remains speculative. Potential association with symptom reduction warrants further research.

Exposure effects of benzalkonium chloride (BAC) on gonadal physiology and fertility suppression in medaka (Oryzias latipes)

Benzalkonium chloride (BAC), a commonly used quaternary ammonium compound in various products like antiseptics, cosmetics, and disinfectants, has raised concerns due to its potential to contaminate aquatic environments and subsequently affect the reproductive performance of the organisms within those ecosystems. The article underscores a critical concern regarding the impact of BAC on aquatic ecosystems, particularly its effect on fish reproductive quality, using medaka (Oryzias latipes) as a model organism. Firstly, while measuring lethal dose of BAC in adult medaka, we observed a dose dependent mortality in BAC treated fish (100 and 200 ppm: 100%; 60 ppm: 51.7%; 30 ppm or less: no mortality at 24 h post treatment (hpt)) and calculated the LD50 at 96 hpt as 39.291 ppm (95% confidence interval: 28.817–53.570 ppm). Further, we assessed the molecular, cellular and histological changes through long-term exposure. Enlarged sperm pockets and reduced spermatocyte were seen in BAC exposed testis while no significant structural changes were observed in the ovaries. Following BAC exposure, drastic alterations in the gene expression and cellular localization related to sex, estrogen signaling, and autophagy were also noted from gonads and liver. Subsequently, using a short-term exposure analysis, we confirmed the sex and time responsive transcriptional kinetics and found that BAC sequentially affected the gonadal somatic cells followed by germ cell differentiation. Finally, using reproductively competent male and female medaka, we conducted progeny production and performance analysis and depicted a drastic reduction in fecundity, and fertilization and hatching rate, indicating adverse effects of BAC on reproductive success. Cumulatively, these findings emphasize the consequences of widespread use of BAC on reproductive security of aquatic animals and highlights the need for further research to comprehend the potential harm posed by such compounds to aquatic animal health and ecosystem integrity.