Selection Protocol Research Articles

A Comparative Analysis of ANN-based Homogeneous and Heterogeneous Routing Protocols for Selection of Cluster Head in WSN

Background: WSNs are composed of various tiny low battery power Sensor Nodes (SNs). It is required to sense the dynamic network environments, which may fluctuate due to external factors or the system model itself. Furthermore, sensory data is transmitted over the communication channel to the destination. Integration of Artificial Neural Network (ANN) in WSNs provides the facility to learn SNs and networks from past experiences and make the predictions based on them. The computational ability of ANN may help to choose an efficient route for data transfer in WSNs. Also, it is able to improve the performance of the network w.r.t power consumption, latency, throughput, etc. This work explores an efficient way to manage the energy of the SNs using an ANN-based routing approach for the selection of Cluster Head (CH). Methods: In this work, an ANN-based and algorithmic approach has been applied to select the CH. Various popular routing strategies such as LEACH-C, TEEN, SEP & DEEC have been used for simulation. LEACH-C and TEEN belong to the homogeneous category, while SEP and DEEC are categorized as heterogeneous. ANN based CH selection strategy has been proposed and compared with the other routing techniques. Results: ANN based CH selection strategy has been simulated and compared. Results revealed that CH election based on ANN will enhance the network lifetime. It is clear from the simulation results that ANN-DEEC is much more stable than protocols of the same category. Conclusion: ANN-DEEC outperforms five times more than LEACH-C, 2.5 times more than TEEN and SEP, twice DEEC and 10-20% more than EDDEC and Advanced-DEEC. ANN-DEEC transmits 71021 packets to BS more than any other protocol. other: Thanks

Hybrid Time-Switching and Power-Splitting EH Relaying for RIS-NOMA Downlink

Reconfigurable intelligent surface (RIS) offers a potential performance boost for next-generation wireless networks, with significant improvements in spectral and energy efficiencies. In this paper, considering a two-user multiple-input single-output non-orthogonal multiple access (MISO-NOMA) downlink, we propose a RIS-aided cooperative transmission scheme using hybrid simultaneous wireless information and power transfer (SWIPT) and transmit antenna selection (TAS) protocols. Particularly, in the proposed scheme, the cell-center user servering as a relay helps the cell-edge user with the support of hybrid time-switching (TS), power-splitting (PS) SWIPT protocols and RIS passive beamforming. To evaluate the network performance, we first derive the best- and worst-case of closed-form expressions in terms of outage probability. For gleaning further insights, we also investigate the diversity order and the high signal-to-noise ratio (SNR) slope for the relevant outage probability. Simulation and numerical results demonstrate the achievable performance improvement for our proposed scheme with respect to schemes of orthogonal multiple access (OMA), non-cooperative NOMA and cooperative NOMA without RIS. In addition, the proposed scheme achieves a higher diversity gain with more transmit antennas and RIS elements.

Abstract TP55: Racial And Gender Disparities In Patients Undergoing Mechanical Thrombectomy At A Comprehensive Stroke Center

Introduction: Mechanical thrombectomy is the standard of care for acute ischemic stroke for select patients with large vessel occlusion (LVO). Racial and gender disparities exist in the incidence, morbidity, and mortality related to stroke. Furthermore, racial disparities in the utilization of thrombectomy have been previously identified. However, disparities in the utilization of thrombectomy in a single center with a standardized patient selection protocol have not been described. Methods: Using the American Heart Association Quality Improvement Programs Registry, we retrospectively reviewed the records of 1,143 patients with LVO between December 1, 2014, and May 31, 2021. Patient records were assessed for demographic data, stroke risk factors, process metrics, and success of thrombectomy. A Pearson’s Chi-Squared and an Independent two-sample T-test were used to determine significance. Results: Of the 1,143 LVO patients, 50.4% were female, 49.6% were male, 84.3% were white, 15.7% were nonwhite. Males were more likely to have diabetes compared to females (22.8% versus 17.9%; p=0.044). There were no significant differences based on race for stroke risk factors including diabetes and atrial fibrillation. Patient selection for thrombectomy was determined by a protocol agnostic to gender and race. Female patients were more likely to undergo thrombectomy compared to males (62.4% versus 48.9%; p<0.001). White patients were more likely to undergo thrombectomy compared to nonwhites (58.7% versus 39.7%; p<0.001). White patients were more likely to have a shorter interval between their last known well (LKW) to arrival (454 minutes versus 533 minutes; p=0.008) despite the fact our nonwhite patients were more likely to originate from our local county (58.1% versus 8.3%; p<0.001). Conclusions: In our analysis of LVO patients, female patients and white patients were more likely to undergo mechanical thrombectomy. The higher incidence of diabetes in males may have resulted in the patients presenting with a larger core infarct, making them ineligible for thrombectomy. Further investigation with data from multiple centers will be necessary to validate these findings and identify strategies for improving utilization of thrombectomy.

Improvement of life time for wireless body sensor networks using optimal clustering and routing protocol

Medical advancements are being made in order to extend the lifespan of mankind. In the medical field, the penetration of Wireless Sensor Networks (WSN) can aid doctors in diagnosing patients accurately and prescribing the medications accordingly. In recent times, several people have permanent implants such as face makers and it is threatening to life to keep altering this body enhancement as well as it is required to possess a system in place to improve the performance of the Wireless Body Sensors. Transmission loss and route loss are two important elements that will drag the battery energy and minimizes its life span. This research proposes optimal clustering and path selection protocol to enhance the lifetime of wireless body sensor networks. Initially, the data is collected from each body sensor through a clustering method called Glow-worm Swarm Optimization (GSO) and the Fruit-fly technique is applied to find the best path. Here, the cluster head is selected with the help of GSO that minimizes the energy consumption as well as enhances the lifetime of WBSN. Further, the best path is identified by the FFO using the fitness value that is measured within the nodes on the basis of the distance. Since hybrid technology is used here, the routing accomplished is shown to be better. The results reveal that the proposed model has improved the sensor life term (95 sec) while compared with other existing methods like PSO with FFO (78 sec), ACO with FFO (77 sec), GA with FFO (76 sec), and LEACH (68 sec) algorithm for 500 nodes.

Safety profile of multilevel outpatient cervical disc arthroplasty

BackgroundEfforts are underway to shift an increasing number of procedures to outpatient procedures. The literature has demonstrated high rates of safety, cost savings and patient satisfaction for various spine procedures performed in the outpatient setting. Cervical Disc Arthroplasty (CDA) has become an acceptable surgical treatment option for cervical myelopathy and or radiculopathy. While this procedure has been shown to be safe when performed in an inpatient setting, the safety of performing multilevel CDA in the outpatient setting requires careful assessment. Methods and ResultsWe searched the Pubmed database using following search keywords: “cervical disc replacement,” “cervical disc arthroplasty,” “multilevel,” “outpatient,” “ambulatory.” Four retrospective cohort studies and one meta-analysis were identified and relevant to the topic. The literature was critically evaluated. ConclusionMultilevel CDA can be safely performed in the outpatient setting, with lower complication rates, shorter operating times, and similar readmission and reoperation rates compared with inpatient CDA. When choosing to perform this procedure in the ambulatory setting each surgeon should consider their own skill set and familiarity with CDA. While no evidence-based guidelines exist regarding which patients are optimal candidates to perform this procedure on in the outpatient setting, careful patient selection is important. Further prospective randomized studies with larger sample sizes are needed to generate evidence-based protocols for patient selection in order to optimize outcomes and the safety of performing multilevel cervical disc arthroplasty in the outpatient setting. Level of EvidenceV

Secrecy analysis of cooperative NOMA-FDR systems with imperfect CSI and colluding eavesdroppers

This paper analyzes the secrecy attributes of a full-duplex relay (FDR) non-orthogonal multiple access (NOMA) system, where the best relay is chosen from a set of numerous relays by using the partial relay selection (PRS) protocol. This best relay assists the communion from source to two NOMA users under the attendance of many colluding eavesdroppers. We obtain the expressions in closed-form of the exact secure outage probability (SOP) of each user, the approximate SOP, and the exact ergodic secrecy capacity (ESC) of the proposed system, taking into consideration the impacts of outdated channel state information (CSI) at source and imperfect CSI at colluding eavesdroppers. We also give the SOP and ESC of the NOMA-FDR system with PRS protocol for comparison with other benchmark systems such as half-duplex (HD)-NOMA, FD-orthogonal multiple access (OMA) systems with PRS protocol, and NOMA-FDR system with multiple-relay (MR) protocol. The simulation results verify the accuracy of our analysis results. Numerical results demonstrate that the SOP and ESC of the NOMA-FDR system greatly vary according to the number of relays and eavesdroppers, SI cancellation capability, channel estimation error, and the correlation coefficient of outdated channels. Most importantly, the NOMA-FDR system has better secrecy performance than all benchmark relay systems.

FBCHS: Fuzzy Based Cluster Head Selection Protocol to Enhance Network Lifetime of WSN

With enormous evolution in Microelectronics, Wireless Sensor Networks (WSNs) have played a vital role in every aspect of daily life. Technological advancement has led to new ways of thinking and of developing infrastructure for sensing, monitoring, and computational tasks. The sensor network constitutes multiple sensor nodes for monitoring, tracking, and surveillance of remote objects in the network area. Battery replacement and recharging are almost impossible; therefore, the aim is to develop an efficient routing protocol for the sensor network. The Fuzzy Based Cluster Head Selection (FBCHS) protocol is proposed, which partitions the network into several regions based on node energy levels. The proposed protocol uses an artificial intelligence technique to select the Cluster Head (CH) based on maximum node Residual Energy (RE) and minimum distance. The transmission of data to the Base Station (BS) is accomplished via static clustering and the hybrid routing technique. The simulation results of the FBCHS protocol are com- pared to the SEP protocol and show improvement in the stability period and improved overall performance of the network.

Modular Access to Quaternary α-Hydroxyl Acetates by Catalytic Cross-Coupling of Alcohols

Quaternary α-hydroxyl acids and their derivatives have attracted considerable attention because of their unique and broad functionalities. Herein, we successfully established a selective and modular protocol to access quaternary α-hydroxyl acetates via dehydrogenative cross-coupling of 1,2-diols and primary alcohols by using tris-N-heterocyclic carbene iridium (tris-NHC-Ir, 0.05 mol %) complexes as catalysts and Ba(OH)2 as the base, along with the generation of byproducts water and hydrogen gas. A plausible mechanism involving dehydrogenation of alcohols, aldol-condensation, and 1,2-alkyl rearrangement reactions was proposed, in which 1,2-alkyl rearrangement was responsible for the construction of the quaternary carbon center.

Sperm cryopreservation does not affect live birth rate in normozoospermic men: analysis of 7969 oocyte donation cycles.

Does sperm cryopreservation influence the reproductive outcomes of normozoospermic patients in oocyte donation cycles? After controlling for confounders, the use of cryopreserved semen from normozoospermic patients does not affect pregnancy and live birth rates after elective ICSI. Sperm cryopreservation by slow freezing is a common practice in ART. While frozen-thawed semen typically presents reduced motility and vitality, its use for ICSI is generally considered adequate in terms of reproductive outcomes. Nevertheless, most studies comparing reproductive outcomes between fresh and cryopreserved sperm include patients with severe male factor (testicular sperm, oligo-, and/or asthenozoospermia) or women of advanced maternal age, where the altered quality of the gametes can partially mask the full effect of freezing/thawing. The study included a retrospective cohort of 7969 couples undergoing their first oocyte donation cycle between January 2013 and December 2019 in one large clinic, using normozoospermic semen from the male partner. All cycles involved elective ICSI, fresh oocytes, and a fresh embryo transfer, either at cleavage or blastocyst stage. Two study groups were established based on the sperm status: fresh (n = 2865) and cryopreserved (n = 5104). A slow freezing protocol was used for all sperm cryopreservation. Sperm washing, capacitation, and selection prior to ICSI were performed identically for fresh and frozen-thawed samples, using pellet swim-up. Fertilization rate (FR), pregnancy (biochemical and ongoing), and live birth rates were compared between study groups using univariate and multivariate regression analyses. Male and female age, sperm concentration and motility after ejaculation, and number of oocytes inseminated were similar between cycles using fresh or cryopreserved sperm. Analysis by Student's t-test did not indicate a significant difference in FR between fresh and cryopreserved sperm (P = 0.0591); however, after adjusting for confounders, this difference reached statistical significance: 74.65% FR for fresh (CI 95%: 73.92-75.38) versus 73.66% for cryopreserved sperm (CI 95%: 73.11-74.20), P = 0.0334. The adjusted regression analysis revealed higher odds of biochemical pregnancy when using fresh sperm (odds ratio (OR): 1.143, P = 0.0175), but no significant effects of sperm cryopreservation were observed for ongoing pregnancy (OR: 1.101, P = 0.0983) and live birth (OR: 1.082, P = 0.1805). Caution should be exerted when extrapolating these results to different protocols for sperm cryopreservation and selection, or to IVM, advanced maternal age and classical IVF cycles, which were excluded from analysis. Owing to the retrospective nature of the study, some uncontrolled for variables may affect the results. Sperm cryopreservation does not affect pregnancy and live birth rates in normozoospermic patients, and although it may lower FR s slightly, this would not be clinically relevant. In line with previous studies that included patients with an apparent male or female factor, sperm cryopreservation is a safe and convenient technique. The study received no external funding and all authors have no conflicts of interest to declare. N/A.

Multiple Imputation for Partial Recording Periodontal Examination Protocols.

Partial-mouth recording protocols often result in underestimation of population prevalence and extent of periodontitis. We posit that multiple imputation of measures such as clinical attachment loss for nonselected tooth sites in partial-mouth samples can reduce bias in periodontitis estimates. Multiple imputation for correlated site-level dichotomous outcomes in a generalized estimating equations framework is used to impute site-level binary indicators for clinical attachment loss exceeding a fixed threshold in partial-mouth samples. Periodontitis case definitions are applied to the imputed "complete" dentitions, enabling estimation of prevalence and other summaries of periodontitis for partial-mouth samples as if for full-mouth examinations. A multiple imputation-bootstrap procedure is described and applied for point and variance estimation of these periodontitis measures. The procedure is evaluated with pseudo-partial-mouth samples based on random site selection protocols of 28 to 84 periodontal sites repeatedly generated from full-mouth periodontal examinations of 3,621 participants in the 2013 to 2014 National Health and Nutrition Examination Survey (NHANES) survey. Multiple imputation applied to partial-mouth samples overestimated periodontitis mean extent, defined as the number of sites with clinical attachment loss 3 mm or greater, by 9.5% in random site selection protocols with 84 sites and overestimated prevalence by 5% to 10% in all the evaluated protocols. In the 2013 to 2014 NHANES data, multiple imputation of site-level periodontal indicators provides less biased estimates of periodontitis prevalence and extent than has been reported from estimates based on the direct application of full-mouth case definitions to partial-mouth samples. Multiple imputation provides a promising solution to the longstanding, vexing problem of estimation bias in partial-mouth recording, with potential application to a wide array of case definitions, periodontitis measures, and partial recording protocols. Partial-mouth sampling, while a resource-efficient strategy for obtaining oral disease estimates, often results in underestimation of periodontitis metrics. Multiple imputation for nonselected periodontal sites produces pseudo-full-mouth data sets that may be analyzed and combined to produce estimates with small bias.

An Experimentally Validated Selection Protocol for Biochar as a Sustainable Component in Green Roofs

Green roofs contribute to more sustainable cities, but current commercial substrates suffer from important limitations. If carefully selected, biochar could serve as a viable option for a more sustainable green roof substrate. We propose a protocol to select an optimal biochar for green roof substrate amendment. Coffee husks, medium-density fiberboard, palm date fronds, and a mixture of waste wood, tree bark, and olive stone kernels are selected as residues for biochar production to develop a selection protocol. The residues are pyrolyzed at 350, 450, 500, and 550 °C in a lab-scale reactor. A pyrolysis temperature of 450 °C is selected for upscaling and is based on biochar yield, pH, salinity, and elemental composition. From evaluating the biochar characteristics after upscaling, it can be concluded that the biochar’s carbonization degree is mainly controlled by pyrolysis temperature, while yield, pH, and salinity are more dependent on the biomass properties. Ultimately, our procedure evaluates the presence of important contaminants, the biochar’s water holding capacity, salinity, pH, and carbonization degree. To validate the developed protocol, plant coverage experiments on green roofs are performed, which are quantified using a novel digital image processing method, demonstrating its efficient use to facilitate future biochar selection in substrates.

Improvement of Broviac catheter-related outcomes after the implementation of a quality management system: A before-and-after prospective observational study

Background: Because of the high rates of Broviac catheter complications, we started an urgent quality process to reduce this morbidity. The aim is to assess the efficiency of the main actions we have taken in enhancing our practice and improving Broviac outcomes. Methods: We included all neonates and young infants requiring surgical central venous access using a Broviac tunneled catheter. We compared the catheters’ outcomes before and after the implementation of a quality program based on a nurse teaching program, patient selection, and catheter management multidisciplinary protocol. The significance threshold was set at p<0.05. Results: We included 94 patients: 51 in the protocol group and 43 in the control group. The complication rate was reduced from 60.3% to 25.5% with p=0.001. The lifetime of the catheter was improved from 11.3 ± 4.3 days to 19.1 ± 9 days with p=0.007. The catheter infection was reduced from 65.3% to 46.1% with p≤0.001. Conclusion: This quality improvement project shows the utility of a quality assurance program based on careful indications and patient selection, a nursing teaching program, and a multidisciplinary catheter management protocol, in reducing Broviac catheter-related morbidity.

A centre-based validator selection approach for a scalable BFT blockchain

The execution of a distributed algorithm by a fixed size subset of nodes instead of the entire network is a strategy to build a scalable distributed network. For applications like blockchain, the selection protocol of this subset need to meet decentralization criteria by promoting the diversity of nodes in order to avoid the emergence of a third-thrust party. This paper introduces metrics to measure the decentralization of this selection protocol (based on standard deviation and the Gini index). In a second step and somewhat orthogonally, selecting closed nodes could reduce the execution latency of the algorithm. Thus, this paper proposes a new selection protocol that selects in real time closed nodes in the network whose results are verifiable and ensure high decentralization although the network may vary. Such a protocol is interesting to increase the number of validators in a blockchain with a hybrid based Byzantin Fault Tolerant consensus.

Therapeutic targets in alcohol-associated liver disease: progress and challenges

Alcohol-associated liver disease (ALD) is a complex disease with rapidly increasing prevalence. Although there are promising therapeutic targets on the horizon, none of the newer targets is currently close to an Food and Drug Administration approval. Strategies are needed to overcome challenges in study designs and conducting clinical trials and provide impetus to the field of drug development in the landscape of ALD and alcoholic hepatitis. Management of ALD is complex and should include therapies to achieve and maintain alcohol abstinence, preferably delivered by a multidisciplinary team. Although associated with clear mortality benefit in select patients, the use of early liver transplantation still requires refinement to create uniformity in selection protocols across transplant centers. There is also a need for reliable noninvasive biomarkers for prognostication. Last but not the least, strategies are urgently needed to implement integrated multidisciplinary care models for treating the dual pathology of alcohol use disorder and of liver disease for improving the long-term outcomes of patients with ALD.

Transmucosal abutments in the esthetic zone: Surgical and prosthetic considerations.

This article describes an updated step-by-step protocol for transmucosal abutment selection and treatment sequencing after immediate implant placement in the esthetic zone. Current surgical and prosthetic concepts strive to preserve hard and soft-tissues to provide optimal esthetics at the implant-abutment interface. Consequently, restoring implants in the esthetic zone with transmucosal abutments presents a great challenge and must take into consideration implant depth, angulation, and bucco-lingual position as well as transmucosal height and space for an optimized emergence profile of the restoration and the dimensions of the anterior tooth to be restored. The proper selection of the type, shape, and dimensions of implant components and connections, determined by the product portfolio offered by the implant manufacturer, play a critical role in the ability to adequately address these challenges. This article provides an update on surgical and prosthetic workflows for single implant restorations in the esthetic zone. Following esthetic, mechanical, and biologic principles, the long-term success of implant-supported restorations in the esthetic zone is directly correlated to proper execution and sequencing of surgical and prosthetic treatment steps, especially after immediate implant placement. These steps must be critically assessed based on the current scientific evidence to achieve the desired clinical outcomes on a predictable and consistent basis. Selection of surgical and prosthetic treatment protocols to achieve ideal esthetic outcomes and emergence profiles in implant dentistry is often a great challenge, not only determined by technical and clinical skills of the provider but also by the type and dimensions of implant components and connections offered by the manufacturer. Following certain decision-making principles and workflows are key for clinical success with implant-supported restorations after immediate implant placement the esthetic zone.

Adaptive Threshold Residual Energy‐Based Efficient Sensor Network Protocol (ATREEN)

Wireless sensor network (WSN) hierarchical (clustering) routing involves the gathering of sensor nodes to form clusters in which sensor node communicates to cluster head (CH). The CH is responsible for data aggregation and forwarding collected data toward base station (BS). Energy expenditure in usual protocols becomes unequal because of clusters having diverse lengths. In this paper, we propose another new enhanced clustering protocol called adaptive threshold residual energy‐based efficient sensor network protocol (ATREEN) for adaptive selection of CH in WSNs. In ATREEN, CHs are chosen by comparing threshold of node value with respect to distance between cluster member and CH, residual energy of sensor nodes, and position of sensor node with respect to BS. Simulation results show that ATREEN protocol extends network lifetime and stability with decline in energy dissipation compared to clustering protocols such as low‐energy adaptive clustering hierarchy (LEACH), power‐efficient gathering in sensor information systems (PEGASIS), and distributed energy‐efficient clustering (DEEC) scheme for heterogeneous WSNs.

AHP and Machine Learning‐Based Military Strategic Site Selection: A Case Study of Adea District East Shewa Zone, Ethiopia

In dynamic situations, multicriteria decision‐making (MCDM) for classification frequently takes place. The selection of suitable land sites and clear criteria is one of the most significant challenges in strategic military site selection around the world and at the national level. The main objectives of the present study are to find out the strategic military site land suitability in Adea District by using AHP, GIS, and machine learning algorithms. To determine the subject weights of criteria, a novel approach for prioritizing the intuitionistic fuzzy judgement matrix is proposed. An optimization model is developed to determine the objective weights that maximize the distance of each alternative to the negative‐ideal solution. Machine learning methods are mainly employed for filtering, interpreting, and predicting information from satellite image data. The random forest analysis method is used for patterning the military strategic site selection in the Adea District. The results of the study were able to create models and submodels of military strategic site land suitability using the weighted linear combination (WLC) mechanism. From the entire research area woreda, 87.02 km2 (9.3%), 439.11 km2 (46.9%), 114.59 km2 (12.2%), 196.48 km2 (20.9%), and 99.19 km2 (10.6%) have not suitable, marginally suitable, moderately suitable, suitable, and highly suitable conditions, respectively, for a strategic military site. Changes in the six classes of land use/land cover were assessed with an overall accuracy of above 97% and an overall kappa statistic of 96%. Finally, the study actually suggests that ML, RS, GIS, and AHP algorithms are beneficial for decision‐makers (DMs) that will enhance the procedure for strategic military site, supported by multicriteria decision‐making and its applications for the study area’s land suitability. Furthermore, security and military authorities will be able to propose a planning protocol and suitable sites for strategic military site selection in the near future based on the study’s basic methodological application and main findings.

Fragment-based screening by protein-detected NMR spectroscopy.

Fragment-based drug discovery (FBDD) identifies low molecular weight compounds that can be developed into ligands with high affinity and selectivity for therapeutic targets. Screening fragment libraries (<10,000 molecules) with biophysical techniques against macromolecules provides information about novel chemical spacesthat bind the macromolecule and scaffolds that can be modified to increase potency. A fragment-screening pipeline requires a standardized protocol for target selection, library assembly and maintenance, library screening, and hit validation to ensure hit integrity. Herein, the fundamental aspects of a fragment screening pipeline-focusing on protein-detected NMR data collection and analysis-are discussed in detail for researchers to use as a resource in their FBDD projects. Selected screening targets must undergo rigorous stability and buffer testing by NMR spectroscopy to ensure the protein structure is stable for the entire screen. Biophysical instrumentation that rapidly measures protein thermostability is helpful in buffer screening. Molecules in fragment libraries are analyzed computationally and physically, stored at appropriate temperatures, and multiplexed in well plates for library conservation. The screening protocol is streamlined using liquid handling robotics for sample preparation and customized Python scripts for protein-detected NMR data analysis. Molecules identified from the screen are titrated to determine their binding site(s) and Kd values and confirmed with an orthogonal biophysical assay. This detailed FBDD screening pipeline developed by the Program in Chemical Biology at the Medical College of Wisconsin has successfully screened many unrelated target proteins to identified novel molecules that selectively bind to these target proteins.

Efficacy of adhesive strategies for restorative dentistry: A systematic review and network meta-analysis of double-blind randomized controlled trials over 12 months of follow-up.

The efficacy of etch-and-rinse, selective enamel-etching, and self-etching protocols for universal adhesives in follow-ups of over 12 months was compared in a network meta-analysis. Randomized controlled trials (RCTs) published from 1998 to 2022 that compared marginal staining, marginal adaptation, retention and fractures, post-operative sensitivity, or recurrence of caries that took place over 12-months post-restoration were selected. A network meta-analysis determined the performance of each adhesive protocol. After screening 981 articles, 16 RCTs were subjected to data extraction. Of which, 674 patients with 2816 restorations, were included in the network meta-analysis. The pooled risk of marginal discoloration following self-etching was significantly higher than that following etch-and-rinse at over 12, 24, and 36 months, which was time-dependent. The pooled risks of unfavorable marginal adaptation and unfavorable retention and fractures following self-etching were also significantly higher than that following etch-and-rinse, with the rates of unfavorable retention and fractures in non-carious cervical lesions increasing in a time-dependent manner. The pooled risks of marginal discoloration, unfavorable marginal adaptation, retention and fractures were similar between etch-and-rinse and selective enamel-etching protocols. Post-operative hypersensitivity and recurrence of caries were not significantly different among etch-and-rinse, selective enamel-etching, and self-etching protocols. In follow-ups over 12 months, esthetic and functional outcomes of restorations completed with an etch-and-rinse adhesive protocol were superior to the ones achieved with a self-etching strategy without selective enamel-etching. Selective enamel etching is recommended for self-etching systems. Biological responses were similar for all three adhesive strategies.

Co-infections of major tick-borne pathogens of dogs in Andhra Pradesh, South India.

Implementing hemoprotozoan control strategies in dogs has become difficult because of the co-infections. A multiplex polymerase chain reaction (PCR) was carried out for simultaneous detection of the co-infections of Babesia gibsoni, B. vogeli, Hepatozoon canis and Ehrlichia canis from dogs (N = 442) in Andhra Pradesh, South India. The co-infection combinations were classified as (i) B. gibsoni + B. vogeli + E. canis + H. canis (BEH), (ii) B. gibsoni + B. vogeli + E. canis (BE), (iii) B. gibsoni + B. vogeli + H. canis (BH) and (iv) E. canis + H. canis (EH) groups. The parasite-specific multiplex PCR amplified 18S rRNA gene of B. gibsoni, B. vogeli and H. canis and VirB9 gene of E. canis. The age, gender, breed, medium, living condition and region of dogs were studied as risk factors for co-infections using logistic regression model. Among the co-infections, the incidence was 1.81%, 9.28%, 0.69% and 0.90% for BEH, BE, BH and EH infections, respectively. Young age (< one year), females, mongrels, rural dogs, kennel dogs and presence of ticks were the identified risk factors for overall prevalence of tick-borne pathogens. The incidence of infection was less in rainy season, especially in dogs with a previous acaricidal treatment. The study concludes that the multiplex PCR assay could simultaneously detect natural co-infections in dogs, emphasizing the need for the assay in epidemiological studies to reveal the real pattern of pathogens and select pathogen-specific treatment protocols.